OBJECTIVE To comprehensively evaluate the quality of Sanzi powder from different batches based on 12 components quantitative analysis combined with chemical pattern recognition and entropy weight-TOPSIS method. METHODS The contents of 12 components in 15 batches of Sanzi powder （No. S1-S15） were determined by HPLC-MS/MS， such as ethyl gallate， gallic acid， ferulic acid， corilagin， genipin-1-O-β-D-gentiobioside， toosendanin， geniposide， caffeic acid， methyl deacetylated coumarinate， tannic acid， rutin， quercetin. Cluster analysis （CA）， principal component analysis （PCA）， and orthogonal partial least squares-discriminant analysis （OPLS-DA） were conducted on the assay results. Using variable importance projection （VIP） value＞1 and P＜0.05 as the evaluation criteria， the quality differential markers in Sanzi powder were screened. The entropy weight method was used to calculate the weight value， and TOPSIS method was used to rank the quality of 15 batches of Sanzi powder from superior to inferior. RESULTS The contents of the 12 components were 13.494-24.292， 2 069.608-3 188.100， 1.410-3.616， 1 065.030-2 630.584， 1 404.704-1 838.078， 101.640-354.268， 9 193.720-14 777.854， 1.240-5.060， 148.028-5 541.990， 4 261.422-5 607.438， 107.560- 195.512， 2.226-4.192 μg/g， respectively. The results of CA， PCA and OPLS-DA indicated that 15 batches of Sanzi powder could be clustered into two groups. Specifically， batches S3， S7， S10 and S15 were grouped into one category， and remaining batches were grouped into one category. VIP values of geniposide， quercetin， caffeic acid， and methyl deacetylated coumarinate were all greater than 1， with corresponding P-values less than 0.05. The results of the entropy weight-TOPSIS analysis revealed that methyl deacetylate exhibited the smallest information entropy and the highest weight. The relative closeness degrees of samples S3， S7， S10 and S15 ranged from 0.789 to 0.973， while the remaining samples ranged from 0.054 to 0.172. CONCLUSIONS The contents of 12 components in Sanzi powder could be determined accurately by using HPLC-MS/MS technology. Methyl deacetylated coumarinate， geniposide， quercetin and caffeic acid were identified as the quality differential markers. It was found that the overall quality of samples S3， S7， S10 and S15 were superior to that of other batches. Notably， the quality of Gardeniae Fructus decoction pieces emerges as a critical factor in ensuring the consistency of the preparation’s quality.

COVID-19 is caused by coronavirus SARS-CoV-2. Current systemic vaccines generally provide limited protection against viral replication and shedding within the airway. Recombinant VSV (rVSV) is an effective vector which inducing potent and comprehensive immunities. Currently, there are two clinical trials investigating COVID-19 vaccines based on VSV vectors. These vaccines were developed with spike protein of WA1 which administrated intramuscularly. Although intranasal route is ideal for activating mucosal immunity with VSV vector, safety is of concern. Thus, a highly attenuated rVSV with three amino acids mutations in matrix protein (VSV_MT) was developed to construct safe mucosal vaccines against multiple SARS-CoV-2 variants of concern. It demonstrated that spike protein mutant lacking 21 amino acids in its cytoplasmic domain could rescue rVSV efficiently. VSV_MT indicated improved safeness compared with wild-type VSV as the vector encoding SARS-CoV-2 spike protein. With a single-dosed intranasal inoculation of rVSV_ΔGMT-S_Δ21, potent SARS-CoV-2 specific neutralization antibodies could be stimulated in animals, particularly in term of mucosal and cellular immunity. Strikingly, the chimeric VSV encoding S_Δ21 of Delta-variant can induce more potent immune responses compared with those encoding S_Δ21 of Omicron- or WA1-strain. VSV_MT is a promising platform to develop a mucosal vaccine for countering COVID-19.

Objective:To investigate the clinical effect of minimally invasive treatment of supracondylar fracture of humerus with nerve injury and the need for surgical exploration of nerve.Methods:From August 2017 to September 2020, 34 cases of children with supracondylar fracture of humerus with nerve injury in the Department of orthopedics of Shanxi Children′s Hospital were selected for retrospective analysis.Closed reduction, Kirschner wire fixation and small incision surgery were used to explore the injured nerve.The follow-up period ranged from 6 months to 3 years, with a follow-up time of (2.15±0.49) years.The elbow function, radial nerve, median nerve and ulnar nerve function were evaluated according to the trial standard of upper limb peripheral nerve function evaluation of Hand Surgery Society of Chinese Medical Association.Results:The elbow function of children in this group: excellent 31 cases, good 2 cases, fair 1 cases, poor 0 cases, excellent 33 cases.Three patients failed to take early functional rehabilitation exercise.Two patients recovered after 2.5 months of treatment by professional orthopedic rehabilitation therapists and physical therapy.One of them did not cooperate with functional rehabilitation training.After 3.5 months of treatment by orthopedic rehabilitation therapists, elbow and finger functions were not affected.Two weeks after nerve injury: radial nerve function evaluation: excellent in 15 cases, good in 3 cases, fair in 4 cases, poor in 0 cases, excellent in 18 cases.Median nerve function evaluation: excellent in 5 cases, good in 2 cases, fair in 6 cases, poor in 0 cases, excellent in 7 cases.Ulnar nerve function evaluation: excellent 5 cases, good 0 cases, fair 1 cases, poor 0 cases, excellent 5 cases.At 3 months after injury, the excellent and good rate of radial nerve, median nerve and ulnar nerve was 100%.Conclusion:The supracondylar fracture of humerus with nerve injury is treated by minimally invasive surgery, and the nerve exploration is still a few.The recovery of nerve injury after surgery is smooth, and the clinical effect is good.

Objective To investigate the influence of sodium fluoride(NaF)on alkaline phosphatase (ALP)activity and bone gla protein(BGP)synthesis in yellow ligament cells from different surgical simples in vitro.Methods The human ligament cells were divided into three groups according to its sources,including normal yellow ligament cells(NLF)group(from acute traumatic thoracolumbar fractures with paraplegia in 7 patients),degenerative yellow ligament cells(DLF)group(from degenerative lumbar stenosis in 9 cases)and ossified ligament cells(OLF)group(thoracic yellow ligament from 8 patients).Twenty-four groups of cells were obtained under vitro cell culture by the method of tissue adherence.Different concentrations of NaF were added into the medium when the cells spread to the fifth generation.Then,the morphological changes were observed and ALP activity and BGP synthesis were tested.Results Human yellow ligament cells from different samples can proliferate and be passaged in vitro.The cell in ossific groups and degenerative groups were pleomorphic and could form calcium nodules.High concentration of NaF(1.0 mmol/L)can lead to cytotoxic reaction in all 24 groups.Low concentrations of(0.01-0.125 mmol/L)NaF can enhance the ALP activity and BGP synthesis in DLF groups while no effect was found in OLF and NLF groups cells under the same concentration of NaF.Conclusion The fact that fluoride can promote ALP activity and BGP synthesis in degenerative yellow ligament cells in vitro indicates fluoride may play an important role in inducing further ossification of human ligament cells.

Objective To study the diagnosis and treatment of lower thoracic ossification of ligamentum flavum(OLF)combined with lumbar spinal stenosis.Methods Retrospective analysis was carried out on 11 cases of lower thoracic OLF combined with lumbar spinal stenosis.There were 4 males and 7 females,with an average age of 56 years,and the average course of disease was 42 months.From March 2007 to March 2009,all patients undergone thoracic and lumbar laminectomy and posterior-lateral fusion in one stage.Oswestry disability index(ODI)was used to assess the neurological functional status,visual analogue score(VAS)was recorded to assess low back pain,and Cobb's angle was used to evaluate the change of thoracolumbar kyphosis.Results Operation time was 200 to 450 min,with an average of 273 min;blood loss was 600 to 1800 ml,averaged 954 ml.There were two cases of cerebrospinal fluid leakage.Eleven cases were followed up for 13 to 36 months,with an average of 23.7 months,Preoperative VAS,Oswestry score and Cobb's angle was 7.91±0.83,66.36%±10.91%,5.91°±0.83° respectively.Postoperative VAS,ODI and Cobb's angle at the final follow-up was 2.18±1.90,25.45%±12.19% and 12.18°±3.06° respectively.VAS and ODI were significantly decreased after operation.The Cobb's angle was significant increased after operation,resulting in pathologic thoracolumbar kyphosis.Conclusion The clinical features of lower thoracic OLF are complicated,which may result in misdiagnosis if the thoracic OLF is accompanied with lumbar spinal stenosis.It is an optimal selection for lower thoracic OLF combined with lumbar spinal stenosis to resect lower thoracic and lumbar lamina in one stage.For females with osteoporosis,additional internal fixation in lower thoracic spine is necessary.

[Objective]To evaluate the posterior approach treatment of old traumatic lumbar spinal stenosis,lumbar kyphosis,intervertebral space stenosis using vertebral plate decompression,nucleus pulposus removal,intervertebral fusion and CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.[Method]Twenty patients with low lumbar spinal canal and intervertebral space stenosis,lumbar kyphosis caused by trauma were enrolled in this study.There were 13 males and 7 females,with an average age of 31.4 years (range 22-49).Four had lesions of L3、4,10 of L4、5 and 6 of L5S1.One patient was treated at 4 years after injury,3 within 9-15 months,6 within 3-6 months and 10 within 1-3 months after injury.All patients were treated with vertebral plate decompression,some serious patients underwent laminectomy decompression,nucleus pulposus removal,intervertebral fusion,CAPSTONE cage insertion and internal fixation with pedicle screw and rod,TLIF.One week after surgery,patients could wear thoracic waist-iliac orthosis and take out-of-bed activity.[Result]All the patients lumbodynia,lower limb pain,muscle strength and hypoesthesia improved within one week after operation.X-rays showed that both the intervertebral space and the physiological curvature improved to some degrees.Twenty patients were followed up(ranged,1 to 3 years)and the clinical outcomes were good.The average Franke1 grade was 1.4.Re-X-rays showed that interbody fusion was achieved in all 20 patients.No loss was found about the altitude of the intervertebral space and the physiological curvature.[Conclusion]For patients with old traumatic lumbar spinal stenosis,the recovery of body altitude is almost impossible.This method is simple and has less complications.It can be widely used in the clinical practice.

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways: 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.