OBJECTIVE: To evaluate the impact of preoperative cervical sagittal parameters on the loss of cervical lordosis (LCL) after expansive open-door laminoplasty (EOLP) and explore the optimal predictors. METHODS: A retrospective analysis was performed on the clinical data of 94 patients with cervical spondylotic myelopathy who underwent EOLP from January 2019 to January 2021, including 61 males and 33 females, aged 34 to 75 years old with an average age of(53.1±9.7) years old. Preoperative routine anteroposterior, lateral, and dynamic X-ray films of the cervical and thoracic spine were taken to comprehensively assess various cervical sagittal parameters: T₁ slope (T₁S), C₂-C₇ sagittal vertical axis (C₂-C₇ SVA), C₂-C₇ cervical lordosis (CL), T1 slope-cervical lordosis (T₁S-CL), cervical lordosis/T₁ slope (CL/T₁S), C₂-C₇ cervical range of motion (ROM), thoracic kyphosis (TK), cephalad vertebral level undergoing laminoplasty (CVLL), and C_2,3 disc angle. Statistical analysis was conducted to identify the independent risk factors of preoperative sagittal parameters for postoperative LCL. RESULTS: A total of 94 patients meeting the inclusion and exclusion criteria were enrolled, with a postoperative follow-up period of 12 to 24 months. Pearson correlation analysis showed that T₁S, T₁S-CL, CVLL, and C_2,3 disc angle were significantly correlated with postoperative LCL, while C₂-C₇ SVA, CL, CL/T₁S, C₂-C₇ ROM, and TK had no significant correlation with postoperative LCL. Regression analysis further indicated that T₁S (β=0.426, P<0.001), T₁S-CL (β=0.716, P<0.001), C_2,3 disc angle (β=0.351, P<0.001), and CVLL (β=-3.348, P<0.001) were significantly correlated with postoperative LCL. CONCLUSION For patients with cervical spondylotic myelopathy treated with EOLP, T₁S, T₁S-CL, CVLL, and C_2,3 disc angle are important factors for predicting cervical lordosis loss, among which CVLL may be the most critical predictive indicator.
Humans ; Male ; Female ; Middle Aged ; Laminoplasty/methods* ; Aged ; Cervical Vertebrae/physiopathology* ; Retrospective Studies ; Adult ; Lordosis/surgery* ; Spondylosis/surgery*

Objective:To explore the role of using methacholine challenge test（MCT）to detect airway responsiveness in standardized drug treatment management of asthma in children and adolescents.Methods:A total of 64 children diagnosed with moderate to severe persistent asthma from August 2010 to May 2021 at the Pediatric Asthma Clinic of the Second Hospital of Tianjin Medical University，who received standardized pharmacotherapy for 2 years，were selected and divided into a discontinued group（31 cases）and a continued group（33 cases）.The clinical value of lung function indicators，fractional exhaled nitric oxide（FeNO）values，and MCT results for evaluating and predicting the treatment effect of asthma in children and adolescents before and after treatment were analyzed.Results:The percentage of the expected value of forced expiratory volume in one second（FEV 1）before treatment discontinued group was higher than that in the continued group，and the difference was statistically significant（ F=7.283， P=0.009）.After standardized treatment for 6 months，1 year，and 2 years，the percentage of the expected value of FEV 1 in the discontinued group（ F=3.045， P=0.036）and continued group（ F=17.485， P<0.001）was significantly higher than that before treatment.There was no statistically significant difference in FeNO between the two groups before treatment（ F=0.298， P=0.587）.By treated for 6 months（ F=6.568， P=0.013），1 year（ F=4.317， P=0.042），and 2 years（ F=8.737， P=0.004），the FeNO levels of continued group were significantly higher than those of the discontinued group，with statistical significance.After treatment for 2 years，the PD 20 of the discontinued group was（1.702 ± 0.906）mg，while the PD 20 of the continued group was（1.184 ± 0.924）mg.The result was a significant difference between the two groups（ t=2.263， P=0.027）. Conclusion:Airway hyperresponsiveness of asthma patients persists，and the time for asthma to achieve clinical symptom control and inflammation improvement is earlier than that when airway responsiveness reaches the ideal level.In the long-term treatment and management of asthma，the clinical value of airway responsiveness assessment is relatively important.

Objective:To obsere the clinical efficacy of Hall technology in the treatment of primary molar caries in children with au-tism.Methods:80 children aged 4-8 years with primary molar caries,40 normal children and 40 children with autism,with a total of 153 primary molars.The normal and the autism children were respectively divided into 2 groups(n=20)randomly.The normal children were grouped into resin filling(CR)of 38 teeth and Hall technology group(CH)of 39 teeth,the autistic children were grouped into resin filling(AR)of 37 teeth and Hall technology group(AH)of 38 teeth.Corresponding treatment was given to the pa-tients in the groups.The duration of oral treatment time,Frankl scores,Houpt scores and parental satisfaction scoves were compaired among groups.The patients were followed up for 6,12,18 and 24 months and the treatment outcomes were compared among groups.Results:There was no statistically difference between CH group and AH group in terms of operating time,compliance,Houpt score and follow-up effects(P＞0.05).The satisfaction of parents in the AR group was the lowest(P＜0.05).Hall technology treatment re-mained effective rate was higher than resin filling at the 24 month follow-up(P＜0.05).Conclusion:Hall technology is more effective than traditional resin filling in the treatment of primary molars caries in children with autism.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The comparison between traditional Chinese medicine Jinzhen oral liquid (JZOL) and Western medicine in treating children with acute bronchitis (AB) showed encouraging outcomes. This trial evaluated the efficacy and safety of the JZOL for improving cough and expectoration in children with AB. 480 children were randomly assigned to take JZOL or ambroxol hydrochloride and clenbuterol hydrochloride oral solution for 7 days. The primary outcome was time-to-cough resolution. The median time-to-cough resolution in both groups was 5.0 days and the antitussive onset median time was only 1 day. This randomized controlled trial showed that JZOL was not inferior to cough suppressant and phlegm resolving western medicine in treating cough and sputum and could comprehensively treat respiratory and systemic discomfort symptoms. Combined with clinical trials, the mechanism of JZOL against AB was uncovered by network target analysis, it was found that the pathways in TRP channels like IL-1β/IL1R/TRPV1/TRPA1, NGF/TrkA/TRPV1/TRPA1, and PGE2/EP/PKA/TRPV1/TRPA1 might play important roles. Animal experiments further confirmed that inflammation and the immune regulatory effect of JZOL in the treatment of AB were of vital importance and TRP channels were the key mechanism of action.

Pain is often debilitating, and current treatments are neither universally efficacious nor without risks. Transient receptor potential (TRP) ion channels offer alternative targets for pain relief, but little is known about the regulation or identities of endogenous TRP ligands that affect inflammation and pain. Here, transcriptomic and targeted lipidomic analysis of damaged tissue from the mouse spinal nerve ligation (SNL)-induced chronic pain model revealed a time-dependent increase in Cyp1b1 mRNA and a concurrent accumulation of 8,9-epoxyeicosatrienoic acid (EET) and 19,20-EpDPA post injury. Production of 8,9-EET and 19,20-EpDPA by human/mouse CYP1B1 was confirmed in vitro, and 8,9-EET and 19,20-EpDPA selectively and dose-dependently sensitized and activated TRPA1 in overexpressing HEK-293 cells and Trpa1-expressing/AITC-responsive cultured mouse peptidergic dorsal root ganglia (DRG) neurons. TRPA1 activation by 8,9-EET and 19,20-EpDPA was attenuated by the antagonist A967079, and mouse TRPA1 was more responsive to 8,9-EET and 19,20-EpDPA than human TRPA1. This latter effect mapped to residues Y933, G939, and S921 of TRPA1. Intra-plantar injection of 19,20-EpDPA induced acute mechanical, but not thermal hypersensitivity in mice, which was also blocked by A967079. Similarly, Cyp1b1-knockout mice displayed a reduced chronic pain phenotype following SNL injury. These data suggest that manipulation of the CYP1B1-oxylipin-TRPA1 axis might have therapeutic benefit.

ObjectiveTo confirm the clinical efficacy and safety of Yishen Yangxin Anshen tablets in the treatment of insomnia （heart-blood deficiency and kidney-essence insufficiency syndrome）. MethodA randomized block， double-blind， placebo-controlled， multi-center clinical trial design method was adopted， and a total of 480 patients with insomnia due to deficiency of heart blood and insufficiency of kidney essence （treatment group-control group 3∶1） from seven hospitals （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， The First Clinical Hospital， Jilin Province Academy of Traditional Chinese Medicine（TCM）， The Second Affiliated Hospital of Liaoning University of TCM， The First Affiliated Hospital of Henan University of Chinese Medicine， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine） were enrolled. The treatment group was given Yishen Yangxin Anshen tablets and the control group received placebo tablets （4 tablets/time， 3 times/day， 4 weeks of administration， 4 weeks of follow-up after drug withdrawal）. The sleep dysfunction rating scale （SDRS） score， pittsburgh sleep quality index （PSQI） score， TCM， polysomnography （PSG） indicators from four hospital （Guang'anmen Hospital， China Academy of Chinese Medical Sciences， Henan Province Hospital of TCM， Hebei General Hospital， The First Hospital of Hunan University of Chinese Medicine）， and other efficacy indicators were compared between the two groups before and after treatment. Through general physical examination， laboratory examination， and observation of adverse events， the safety of the drugs was evaluated. ResultThe baseline indexes of the two groups showed no significant difference and thus the two groups were comparable. After treatment， the total score of SDRS in the treatment group was lower than that in the control group （P<0.01）. After drug withdrawal for 4 weeks， the total score of SDRS demonstrated no significant change in the treatment group as compared with that at the end of treatment， indicating that the rebound change of curative effect was not obvious. After treatment， the total score of PSQI in the treatment group decreased as compared with that in the control group （P<0.01）， and the change of total score of PSQI in the treatment group was statistically significant （P<0.05） after drug withdrawal for 4 weeks but small， indicating that the rebound change of curative effect was not obvious. After treatment， the total effective rate about the TCM symptoms in the treatment group was higher than that in the control group （χ²=137.521，P<0.01）. After treatment， the disappearance rates of single indexes in the treatment group， such as difficulty in falling asleep， easily waking up after sleeping， early awakening， short sleep time， dreamfulness， palpitation， forgetfulness， dizziness， mental fatigue， and weakness of waist and knee， increased compared with those in the control group （P<0.01）. After treatment， the treatment group demonstrated fewer awaking times （AT）， longer total sleep time （TST）， lower ATA/TST ratio， and higher sleep efficiency （%） than the control group （P<0.05）. No abnormal value or aggravation related to drugs was observed in either group. The incidence of adverse events in the treatment group and the control group was 5.57% and 8.40% respectively. No serious adverse events or adverse events leading to withdrawal happened in either group. ConclusionYishen Yangxin Anshen tablets is effective and safe for patients with insomnia of deficiency of heart-blood and insufficiency of kidney-essence.

Objective:To analyze the efficacy and safety of Omalizumab (OMA) combined with allergen immunotherapy (AIT) on children with allergic asthma.Methods:Clinical data of 43 children with allergic asthma from the Second Hospital of Tianjin Medical University between August 2018 and October 2022, who were managed by OMA combined with double mite subcutaneous immunotherapy (SCIT) were retrospectively analyzed, including 30 males and 13 females with the age of 5-15 years.Twenty children with allergic asthma who were managed by the monotherapy for SCIT during the same period, including 16 males and 4 females with the age of 4-13 years were included in the control group(group1: conventional immunotherapy; group2: cluster immunotherapy). Among the 43 cases managed by OMA combined with SCIT, 20 were treated with OMA, followed by AIT (OMA-AIT group), and 23 were treated with AIT, followed by OMA (AIT-OMA group). Notably, 6 cases in AIT-OMA group who were additionally given OMA due to the difficulty in increasing doses were subgrouped in AO1 group, and 17 who were additionally given OMA due to poor control of asthma or comorbidities during the course of AIT and frequent adverse events were subgrouped in AO2 group.The number of asthma exacerbations within 1 year and during the combination therapy, the Childhood Asthma Control Test/Asthma Control Test (C-ACT/ACT) findings, the Visual Analogue Scale (VAS) for grading rhinitis, inhaled corticosteroid (ICS) dosage converted to budesonide equivalent, the Total Medication Score (TMS), comorbidities, lung function [percent-predicted forced expiratory volume in 1 second(FEV 1% pred), percent-predicted peak expiratory flow(PEF%pred), percent-predicted maximal mild-expiratory flow(MMEF%pred)], exhaled nitric oxide (FeNO), completion of the initial SCIT and adverse effects [local adverse reactions (LRs) and systemic adverse reactions (SRs)] were analyzed for assessing the efficacy and safety of OMA combined with AIT on children with allergic asthma.The t-test of two independent samples was used for comparison of measurement data that followed normal distribution.Wilcoxon′s test was used for non-normally distributed between-group comparisons.The χ2 test was used for the between-group comparison of counting data. Results:(1)Baseline comparison showed that the male ratio (17/20 cases vs.13/23 cases) and the proportion of moderate-to-severe persistent asthma (18/20 cases vs.18/23 cases) in the OMA-AIT group were significantly higher than those of the AIT-OMA group (all P<0.05). (2)Efficacy: ①In OMA-AIT group, all children reached the AIT maintenance treatment stage successfully after combination therapy.At the maintenance treatment stage, the C-ACT/ACT, VAS and TMS scores(26.0±1.25 vs.24.55±2.28, 1.50±1.24 vs.2.55±1.70, 3.60±1.47 vs.5.45±1.19)were significantly improved from baseline(all P<0.05). There were no significant differences in lung function indexes FEV 1%pred, PEF%pred, and MMEF%pred ( P>0.05), and FeNO level did not change significantly than baseline.After the combination treatment, ICS dosage significantly decreased from 240.00 (160.00, 380.00) μg/d at baseline to 140.00 (80.00, 300.00) μg/d ( P<0.05). Comorbidities, including allergic rhinitis, food allergy, atopic dermatitis and angioedema were improved.Five cases (25.00%) had once asthma exacerbation during the treatment.The duration of maintenance dose of conventional (22.70±7.10 vs.15.20±1.32) and cluster immunotherapy (13.00±4.97 vs.7.30±1.06) were longer than those of the corresponding control group(all P<0.05). ②AIT-OMA group: In AO1 group, the C-ACT/ACT score were improved from baseline( P<0.05), and VAS score, TMS score decreased from 3.00(1.75, 3.00), (4.67±1.97) points at baseline to 1.00(0, 1.00), (2.83±1.60) points by the maintenance dose in AO1 group (all P<0.05). There were no significant differences in the FEV 1%pred, PEF%pred, MMEF%pred and FeNO compared with baseline in AO1 group.ICS dosage in AO1 group significantly decreased from (180.00±78.99) μg/d at baseline to (88.88±26.23) μg/d ( P<0.05). In AO2 group, the C-ACT/ACT, VAS and TMS scores at the completion of OMA treatment[26.53±0.94 vs.25.06±2.05, 1.00 (0, 2.00) vs.2.00(2.00, 3.50), 3.41±0.94 vs.5.53±1.23]were significantly improved from baseline (all P<0.05). PEF%pred[(106.47±22.37)% vs.(94.47±26.39)%] significantly increased than baseline ( P<0.05), and the remaining lung function indexes and FeNO were not significantly improved.ICS dosage significantly decreased from 240.00(160.00, 400.00) μg/d at baseline to 80.00 (20.00, 160.00) μg/d ( P<0.05). During the combination treatment, 1 case (5.88%) had once asthma exacerbation, and all 8 cases with food allergy or atopic dermatitis or conjunctivitis had improved comorbidities.(3)Safety: adverse events during OMA injection were not reported.①In OMA-AIT group, a total of 165 OMA injections were performed in the initial treatment stage of the conventional immunotherapy group, with 13 (7.88%) reported LRs and 2 (1.21%) grade-1 SRs.A total of 143 OMA injections were performed in the initial treatment stage of the cluster immunotherapy group, with 19(13.29%) reported LRs and none of SRs.②In AIT-OMA group, there were 6 cases of adverse events in the initial treatment stage of AIT who were successfully reached the maintenance treatment stage after the addition of OMA in AO1 group.In AO2 group, children who were additionally given OMA due to adverse events in the maintenance treatment phase did not report adverse events during the combination therapy. Conclusions:OMA combined with AIT not only expands the scope of AIT, improves allergic and asthma symptoms in children, reduces the use of drugs, but also enhance the safety of AIT and compliance, reduces adverse events during AIT treatment, and even shortens the time of initial treatment.

OBJECTIVE To study the secondary metabolites of the endophytic fungus Fusarium sp. HSL-3 isolated from Hainan Mangrove and screen their anti-inflammatory and anti-tumor activities. METHODS This fungus was fermented statically by using rice medium, and the secondary metabolites of the fungus were isolated and purified by column chromatography and HPLC. Structures indentification of the ortained compounds was carried out through MS and NMR. RESULTS Eight compounds were respectively isolated and identified as follows:lateritin(1), 4-carbomethoxy-6-hydroxy- 2-quinolone(2), 3,5-dimethoxydihydro-fusarubin D(3), anhydrofusarbin(4), 3,3'-methylene-bis(4-hydroxybenzaldehyde)(5), crypticin B(6), vanillyl alcohol(7) and 3,4-dihydroxyphenylaceticacid(8), among which, compounds 2 and 5 were isolated from the genus Fusarium for the first time. Compounds 3 and 5 showed good anti-inflammatory activity on RAW264.7 cells with the inhibition rate of NO at 50 µmol·L-1 were 87% for compound 3 and 71% for compound 5, while compound 1 showed significant cytotoxic activity against human non-small cell lung cancer cell line A549, among which the IC50 value was (7.92±0.27) µmol·L-1. CONCLUSION Compounds 3 and 5 isolated from endophytic fungus Fusarium sp. HSL-3 isolated from Hainan Mangrove show strong anti-inflammatory activity, while compound 1 shows significant anti-tumor activity.

Bronchial asthma(asthma)is a common chronic airway inflammatory disease in children, most of which are allergic asthma.Allergen immunotherapy can change the natural course of asthma, and has certain efficacy in controlling asthma symptoms, reducing airway hyperresponsiveness and reducing the use of control drugs.It is the treatment for the cause.The most common allergen immunotherapy treatments are subcutaneous immunotherapy and sublingual immunotherapy.This article reviews the effectiveness of subcutaneous immunotherapy in the treatment of children with asthma, and focuses on the effective evaluation indicators and potential biomarkers that can be used as reference in clinical practice.