ObjectiveTo investigate the effects of maltol aluminum exposure on miR-193a-3p, demethylase AlkB homolog 5 (ALKBH5), phosphatase and tensin homolog deleted on chromosome ten (PTEN) and protein kinase B (AKT), and whether miR-193a-3p is involved in aluminum-induced cognitive impairment by regulating ALKBH5/PTEN/AKT signaling pathway. Methods Specific pathogen-free male SD rats were randomly divided into control group and low-, medium- and high- dose groups according to their body weight, with eight rats in each group. Rats in the low-, medium-, and high- dose groups were intraperitoneally injected with maltol aluminum solution at concentrations of 10.00, 20.00, and 40.00 μmol/kg body weight, respectively, while the rats in control group were given an equal volume of 0.9% sodium chloride solution. Rats were injected for five days every week for three months. After injection, the novel object recognized test was used to assess the learning and memory ability of the rats. The relative expression of miR-193a-3p and B-cell lymphocytoma-2 (Bcl-2), Bcl-2 associated X protein (Bax) and cysteine aspartate protease-3 (Caspase-3) mRNA in rat hippocampus was detected using the real-time quantitative polymerase chain reaction. The relative protein expression of ALKBH5, PTEN, and AKT2 in the rat hippocampus was detected using Western blot. Results The discrimination index and the preference index of the new object recognition test of the rats in high-dose group were lower than those in control group and low-dose group (all P<0.05). The relative expression of miR-193a-3p and Bcl-2 mRNA in the hippocampus of the rats in high-dose group was lower than those in control group and low-dose group (all P<0.05). The relative mRNA expression of Bax in the high-dose group was higher than those in the control group and low-dose group (both P<0.05). The relative mRNA expression of Caspase-3 of the rats in the high-dose group was higher than that in the other three groups (both P<0.05). The relative protein expression of ALKBH5 in the hippocampus of the rats in the high-dose group was lower than that in the control group (P<0.05). The relative expression of PTEN protein was higher than those in the control group and low-dose group (both P<0.05). The relative protein expression of AKT2 was lower than those in the control group and low-dose group (both P<0.05). Conclusion Sub-chronic aluminum exposure can inhibit the expression of miR-193a-3p in the hippocampus of rats, which may disrupt the ALKBH5/PTEN/AKT pathway and affect normal neuronal homeostasis and cellular function. This pathway may play an important role in aluminum-induced cognitive impairment.

Objective The literature on perioperative management of patients with spinal tuberculosis(STB)in China was analyzed.To provide ideas and directions for the perioperative management of patients with spinal tuberculosis.Methods The journal literature on"spinal tuberculosis"and"perioperative period"were retrieved from Chinese National Knowledge Infrastructure,VIP Chinese Journal Service Platform,China Biology Medicine Disc and Wanfang Data during the period from January 1,1990 to May 31,2023.The VOSviewer software was used to visually analyze the retrieved literature data.The analysis includes publication year,publication region,journal distribution,keywords and so on.Results A total of 1306 papers were included.The overall number of published papers showed a trend of first increasing and then decreasing.The journal with the largest number of publications was Chinese Journal of Tuberculosis,with 53 publications(4.06％).75 keywords with frequency≥8 times were analyzed to form a cluster graph,and a total of 6 clusters were found.The themes of clustering were operation mode and timing,elderly patients and children,perioperative nursing,recurrence risk factors,postoperative complications,rehabilitation and functional exercise.Conclusion Research on perioperative management of patients with STB in China showed an initial rise and then a slow decline.Future studies need to focus more on vulnerable populations.Combined with the concept of rapid rehabilitation,we can explore the effective management mode of patients with STB in perioperative period.Accelerate the postoperative rehabilitation of patients with STB.

Carotid artery stenosis is one of the primary causes of ischemic stroke.At present,the main surgical treatments for carotid artery stenosis include carotid endarterectomy(CEA)and carotid artery stenting(CAS).In-stent restenosis(ISR)is a long-term complication after CAS,which significantly affects the long-term outcomes of the surgery and the prognosis of patients,with a relatively high incidence in clinical practice.Based on a review of domestic and international studies,the authors provided a comprehensive overview of ISR,covering its pathogenesis,risk factors,treatment options,and the latest research developments,in order to provide clinicians with guidance for the diagnosis and treatment of ISR.

Objective To investigate the application value of neutrophil count(N),neutrophil percentage(N％),neutrophil to lymphocyte ratio(NLR)and neutrophil to albumin ratio(NAR)in the evaluation of ul-cerative colitis(UC)patients.Methods A total of 87 UC patients admitted to the hospital from May 2022 to July 2023 were collected as the UC group,and 42 healthy people in the same hospital during the same period were selected as the control group.Blood routine and biochemical routine related inflammatory indicators in-cluding lymphocyte count(L),N,lymphocyte percentage(L％),N％,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),albumin(ALB)were collected,NLR and NAR were calculated.The clinical data of UC patients were collected.According to medical history,modified Mayo scoring system and Montreal classifi-cation criteria,UC patients were divided into clinical types,disease activity and lesion extent.The levels of N,N％,NLR and NAR in the control group and UC group and different subgroups of UC were evaluated.Spearman correlation analysis was used to analyze the correlation between the four indexes and ESR and CRP.The receiver operating characteristic curve was drawn to test the diagnostic efficacy of the four indicators a-lone and in combination in the detection of UC patients,and the best cut-off value,sensitivity and specificity were calculated.Results The levels of N,N％,NLR and NAR in UC group were higher than those in control group,and the differences were statistically significant(P＜0.05).There were significant differences in N,N％,NLR and NAR levels between UC patients with different activity and lesion range(P＜0.05).Spearman correlation analysis showed that CRP level was positively correlated with N,N％,NLR and NAR in UC pa-tients(r=0.392,0.343,0.354,0.503,P＜0.001).ESR level was positively correlated with N,NLR and NAR(r=0.383,0.233,0.475,P＜0.05).The area under the curve of N,N％,NLR and NAR alone and in combi-nation were 0.668,0.702,0.723,0.741 and 0.882,respectively.The sensitivity and specificity of the combina-tion of the four were higher(80.5％and 88.1％,respectively).Conclusion N,N％,NLR and NAR have cer-tain clinical value in the diagnosis,disease activity and lesion extent prediction of UC patients.

The kidney is the body's most important organ and the protein components in urine could be detected for diagnosing certain diseases. The amount of IgG protein in urine could be used to determine the degree of kidney function damage. IgG protein in human urine was detected by vertical flow paper-based microfluidic chip, double-antibody sandwich immunoreaction, and cell phone image processing. The results showed that using an IgG antibody concentration of 500 μg/mL and a gold standard antibody concentration of 100 μg/mL, the image signal showed a good linear relationship in the range of IgG concentration of 0.2-3.2 μg/mL, with R²=0.973 3 achieved. A complete set of detection devices were designed and the detection method showed good non-specificity.
Humans ; Microfluidics ; Immunoglobulin G ; Kidney ; Microfluidic Analytical Techniques

Objective To develop an intelligent management system of documents and records that meets the requirements of ISO 15189 quality management system applied to regional medical laboratory center.Methods Based on the relevant terms of ISO 15189 document and record,an intelligent management system for laboratory documents and records with B/S architecture was established by the help of computer technology.Results The document and record management system stored the quality system documents required for ISO 15189 review as well as the external documents,such as laboratory-related laws and regulations,standard guidelines and expert consensus,which can be accessed by users through a computer or mobile phone.The multi-process control mode was adopted to author-ize the special personnel to complete the compiling,review,approval and,release of the files according to the type and attribute of the documents.The management system of records established 9 special records,319 form records and 20 process records to support the ef-fective operation of the quality system.Conclusion The established intelligent management system for documents and records has fully met the requirements of ISO 15189 on documents and records management,realized the sharing and interconnection of the documents in the given region.It is convenient for the employees to consult the documents and fill in the records in a timely and efficient manner.

Hepatolithiasis is a common biliary tract disease in China and other Asian countries.It has insidious onset,recurrent disease,and may lead to biliary cirrhosis or even cancer in the late stage without inter-vention.At present,surgery is considered to be the best choice for treatment.In the 21st century of minimally inva-sive surgery,traditional procedures such as partial hepatectomy,choledochotomy,cholangioenterostomy and liver transplantation can be performed with the assistance of laparoscopy and da Vinci robots,and emerging endoscopic techniques such as endoscopic retrograde cholangiopancreatography(ERCP)and percutaneous transhepatic cho-ledochoscopic lithotripsy(PTCSL)have also been developed,bringing better treatment for patients with hepatoli-thiasis.As treatment options are becoming more varied,there are also some clinical problems that need to be addressed.In this article,we would like to briefly review the current surgical treatment modalities in order to provide a theoretical basis for optimizing the treatment modalities.

AIM:To investigate the effects of subchronic aluminum exposure on the expression of silent infor-mation regulator(Sirt1),Kelch-like ECH-associated protein 1(Keap1),nuclear factor E2-related factor 2(Nrf2),and microRNA-128-3p(miR-128-3p)in the hippocampus of rats.Additionally,we aimed to explore the mechanism of miR-128-3p and the Sirt1-Keap1/Nrf2 signaling pathways in aluminum-induced cognitive impairment in rats.METHODS:Thirty-two healthy 6-week-old SPF male SD rats,weighing(190±20)g,were randomly divided into four groups based on body weight:control group,low-dose(10 μmol/kg)group,medium-dose(20 μmol/kg)group,and high-dose(40 μmol/kg)group,with 8 rats in each group.The rat exposure model was established by intraperitoneal injection of maltol alumi-num.The Morris water maze test was used to assess the learning and memory ability of the rats.Western blot analysis was performed to measure the protein expression of Sirt1,Keap1 and Nrf2 in the hippocampus,while RT-qPCR was used to measure the expression of miR-128-3p in the hippocampus.The level of reactive oxygen species(ROS)in the cerebral cor-tex was detected using fluorescence staining in frozen sections.RESULTS:(1)In the positioning cruise experiment,the escape latency of the aluminum exposure group was significantly higher than that of the control group on the 3rd,4th,and 5th days(P＜0.05).On day 6,the number of times the rats crossed the platform and the platform quadrant in the high-dose group was reduced compared to the control and low-dose groups(P＜0.01).(2)The expression levels of Sirt1 and Nrf2 in the hippocampal tissues of all groups decreased gradually with increasing maltol aluminum exposure dose.The ex-pression level of Keap1 increased gradually with increasing maltol aluminum exposure dose.The expression level of miR-128-3p in the high-dose group was significantly higher than that in the control group(P＜0.05).(3)The content of gluta-thione peroxidase in the hippocampus of rats decreased with increasing exposure dose,while ROS levels gradually in-creased.CONCLUSION:Subchronic aluminum exposure can increase the expression of miR-128-3p in the rat hippo-campus and suppress the Sirt1-Keap1/Nrf2 signaling pathway.This inhibition prevents the activation of the Sirt1-Keap1/Nrf2 signaling pathway,leading to a reduced antioxidant capacity.The imbalance in the antioxidant system in rats results in oxidative damage to nerve cells and a subsequent decline in cognitive function.

Objective: : To retrospectively analyze the clinical characteristics and surgical experience of 10 adults with spinal extradural meningeal cysts (SEMCs) in the thoracolumbar spine which may further provide evidence for surgical decision-making. Methods: : Ten adults with SEMCs in the thoracolumbar spine were surgically treated and enrolled in this study. Clinical manifestations, imaging data, intraoperative findings and postoperative outcome were recorded. Results: : Clinical manifestations of SEMCs included motor and sensory dysfunction of the lower limbs and urination and defecation disturbance. The cysts presented as intraspinal occupying lesions dorsal to the spine, ranging from the T8 to L3 level. Defects of eight cases were found on preoperative magnetic resonance imaging (MRI). Selective hemilaminectomy or laminectomy were used to reveal the defect within the cyst, which was further sutured with microscopic technique. The final outcome was excellent or good in seven cases and fair in three cases. No recurrence was observed during follow-up. Conclusion : SEMCs are rare intraspinal cystic lesions. Radiography and MRI are clinically practical methods to assess defects within SEMCs. Selective hemilaminectomy or laminectomy may reduce surgical trauma. Detection and microscopic suturing of the defects are the key steps to adequately decompress the nervous tissue and prevent postoperative recurrence.

Objective To study the efficacy and safety of four surgical techniques of tuberculosis of lumbosacral junction retrospectively. Methods Between Jul 2001 and Jan 2013, 79 patients with lumbosacral spinal tuberculosis underwent surgery. Antituberculous chemotherapy and nutrition support prior to surgery were used for at least two weeks. 45 patients underwent single stage radical debridement, fusion and anterior instrumentation (A group). 18 patients underwent combined anterior and posterior spinal surgery (AP group), 10 patients underwent transpedicular drainage, posterior instrumentation, and fusion (P group), and 6 patients underwent anterior radical debridement (D group). All the patients were treated by antituberculous chemotherapy for 18 months and followed regularly. The operation duration, blood loss, clinical status, ESR, VAS, ODI, roentgenogram and 3D?CT were concerned to estimate the progress of tuberculosis. Radiographs were analyzed before surgery, immediately after surgery, and at the final follow?up examination to assess the result of anterior fusion and maintenance of correction. Results There was no inju?ry of blood vessel, ureter or cauda equina during surgery. The mean follow?up period was 23 months (range 18-42 months). No obvious loss of deformity correction was observed. There was no recurrence, no tuberculous peritonitis, and no incidence of im?potence or retrograde ejaculation in any of these patients. The average operating duration(min) were 144.31 ± 23.18, 444.72 ± 141.63, 351.50 ± 85.25, 90.00 ± 29.66, respectively; The average blood loss(ml)were 266.67 ± 104.45, 988.99 ± 488.26, 890.00 ± 306.23, 200.00±104.88, respectively; The average Pre?op VAS were 4.71±1.79, 5.22±1.48, 3.30±1.64, 2.50±1.52, respectively;The average last follow?up VAS were 0.89±0.68, 0.90±0.74, 1.00±0.63, respectively; The average Pre?op ODI(%)were 29.64± 7.85, 32.17±7.59, 28.20±4.26, 20.67±4.63, respectively; The average last follow?up ODI(%)were 5.09±3.59, 4.78±3.78, 4.80± 3.39, 4.00 ± 1.18, respectively; The average Pre?op lumbosacral angle(°)were 20.61 ± 4.92, 23.78 ± 5.84, 25.10 ± 4.28, 21.67 ± 4.27, respectively; The average Post?op lumbosacral angle were 27.17±3.66, 30.56±5.31, 32.10±4.01, 24.83±2.32, respectively;The average last follow?up lumbosacral angle were 23.89 ± 3.12, 27.00 ± 5.46, 29.00 ± 4.85, 23.33 ± 2.50, respectively. Conclu?sion Single stage anterior interbody fusion with anterior instrumentation worked effectively to stabilize lumbosacral junction (less invasive, short surgical duration, no injury of posterior column). Anterior interbody fusion combined with posterior instrumentation was recommended for patients with extensive bone defect and low iliocava junction.