1.Effect of "Fahan" on Metabolites of Blumea balsamifera Analyzed by Non-targeted Metabolomics
Jiayuan CAO ; Xin XU ; Xiangsheng ZHANG ; Bingnan LIU ; Yongyao WEI ; Ke ZHONG ; Yuxin PANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):200-207
ObjectiveTo characterize the changes of metabolites of Blumea balsamifera in the process of sweating by non-targeted metabolomics, and to investigate the influence of sweating processing on the constituents of B. balsamifera. MethodsUltra performance liquid chromatography-quadrupole/electrostatic field orbitrap high resolution mass spectrometry(UPLC-Q-Exactive Orbitrap-MS) metabolomics was used to identify the metabolites in no sweating group(F1), sweating 2 d group(F2) and sweating 4 d group(F3), the differences of metabolites between the groups were compared by principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA), and differential metabolites were screened according to the variable importance in the projection(VIP) value>1 and P<0.05, and the pathway enrichment of the differential metabolites was analyzed by Kyoto Encyclopedia of Genes and Genomes(KEGG). ResultsThe results of PCA and OPLS-DA showed a clear distinction between the three groups of samples, indicating significant differences in the compositions of the three groups of samples. A total of 433 differential metabolites were screened between the F1 and F2, with 154 up-regulated and 279 down-regulated, the significant up-regulated metabolites were tangeritin, 5-O-demethylnobiletin and so on, while the metabolites with significant down-regulation included alternariol, fortunellin, etc. A total of 379 differential metabolites were screened between the F2 and F3, with 150 up-regulated and 229 down-regulated, the significant up-regulated metabolites were isoimperatorin, helianyl octanoate and so on, and the significant down-regulated metabolites were hovenoside I, goyasaponin Ⅲ, etc. KEGG pathway enrichment analysis showed that tyrosine metabolism, isoquinoline alkaloid biosynthesis, phenylalanine, tyrosine and tryptophan biosynthesis, tryptophan metabolism, valine, leucine and isoleucine biosynthesis, pantothenate and coenzyme A biosynthesis may be the key pathways affecting metabolite differences of B. balsamifera after sweating treatment. ConclusionSweating can reduce the content of endophytic mycotoxins in B. balsamifera and has a great impact on the synthesis and metabolic pathways of total flavonoids and auxin. This study can provide a reference for the process research on the sweating conditions of B. balsamifera.
2.Key Information and Modern Clinical Application of Classic Formula Xiaoji Yinzi
Baolin WANG ; Lyuyuan LIANG ; Jialei CAO ; Chen CHEN ; Jinyu CHEN ; Chengxin LUO ; Bingqi WEI ; Kaili CHEN ; Peicong XU ; Wei DENG ; Bingxiang MA
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(6):189-198
Xiaoji Yinzi is one of the classic prescriptions for treating urinary diseases, originated from the Yan's Prescriptions to Aid the Living (Yan Shi Ji Sheng Fang) written by YAN Yonghe in the Song dynasty. Xiaoji Yinzi is composed of Rehmanniae Radix, Cirsii Herba, Talcum, Akebiae Caulis, Typhae Pollen, Nelumbinis Rhizomatis Nodus, Lophatheri Herba, Angelicae Sinensis Radix, Gardeniae Fructus, and Glycyrrhizae Radix et Rhizoma and has the effects of cooling blood and stopping bleeding, draining water and relieving stranguria. The medical experts of later generations have inherited the original prescription recorded in the Yan's Prescriptions to Aid the Living, while dispute has emerged during the inheritance of this prescription. In this study, the method of bibliometrics was employed to review and analyze the ancient documents and modern clinical studies involving Xiaoji Yinzi. The results showed that Xiaoji Yinzi has two dosage forms: powder and decoction. According to the measurement system in the Song Dynasty, the modern doses of hers in Xiaoji Yinzi were transformed. In the prepration of Xiaoji Yinzi powder, 149.2 g of Rehmanniae Radix and 20.65 g each of Cirsii Herba, Talcum, Akebiae Caulis, stir-fried Typhae Pollen, Nelumbinis Rhizomatis Nodus, Lophatheri Herba, wine-processed Angelicae Sinensis Radix, stir-fried Gardeniae Fructus, and stir-fried Glycyrrhizae Radix et Rhizoma are grounded into fine powder with the particle size of 4-10 meshes and a decocted with 450 mL water to reach a volume of 240 mL. After removal of the residue, the decoction was taken warm before meals, 3 times a day (i.e., 7.77 g Rehmanniae Radix and 0.97 g each of the other herbs each time). In the preparation of Xiaoji Yinzi decoction, 20.65 g each of the above 10 herbs are used, with stir-fried Typhae Pollen, wine-processed Angelica Sinensis Radix, stir-fired Gardeniae Fructus, stir-fired Glycyrrhizae Radix et Rhizoma, and raw materials of other herbs. Xiaoji Yinzi is specialized in treating hematuresis and blood stranguria due to heat accumulation in lower energizer, which causes injury of the blood collaterals of gallbladder and dysfunction of Qi transformation. In modern clinical practice, Xiaoji Yinzi is specifically used for treating urinary diseases and can be expanded to treat diseases of the cardiovascular system and other systems according to pathogenesis. The comprehensive research on the key information could provide a scientific reference for the future development of Xiaoji Yinzi.
3.Analysis of Differential Compounds of Poria cocos Medicinal Materials by Integrated Qualitative Strategy Based on UPLC-Q-Orbitrap-MS
Jiayuan WANG ; Xiaohan FAN ; Xiaoxiao WEI ; Rong CAO ; Jin WANG ; Lei WANG ; Fengqing XU ; Shunwang HUANG ; Deling WU ; Hongsu ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):148-156
ObjectiveTo establish a rapid analytical method for identifying the differential components in Poria cocos medicinal materials based on ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry(UPLC-Q-Orbitrap-MS), combined with mass defect filtering(MDF) and molecular network integration techniques. MethodsUPLC-Q-Orbitrap-MS was used for MS data acquisition and identification of P. cocos medicinal materials, with the help of MDF for the study of cleavage behavior and structural identification of triterpenoids. According to the similarity of MS/MS fragmentation patterns of each component, global natural product social molecular network(GNPS) was established, and Cytoscape 3.6.1 was used to screen molecular clusters with similar structures and the the structure of main compound classes were identified and confirmed. Multivariate statistical analyses such as principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to screen the differential components of the five P. cocos medicinal materials with the variable importance in the projection(VIP) value>1 and P<0.05 as the criteria. ResultsA total of 66 compounds were identified by database comparison, 8 compounds were newly identified by MDF, 28 compounds were newly identified by GNPS, and a total of 102 chemical compounds were identified, including 43 triterpenoids, 16 saccharides, 26 amino acids and peptides, 3 nucleosides, and 14 other compounds. Triterpenoids were predominant in Poriae Cutis and wild Fushen, amino acids and peptides were the most abundant in Poria and cultivated Fushen, carbohydrates were the most abundant in Poriae Cutis. Type Ⅰ and Ⅱ triterpenoids had higher amounts in Poria and cultivated Fushen, type Ⅲ triterpenoids were more abundant in Poriae Cutis, all four types of triterpenoids were higher in Fushenmu, and type Ⅰ, Ⅱ, and Ⅳ triterpenoids were higher in wild Fushen. A total of 12 common differential chemical constituents were screened, including serine, guanosine, gallic acid, 2-octenal, maltotriose, trametenolic acid, dehydroeburicoic acid, dehydrotrametenolic acid, poricoic acid A, poricoic acid B, poricoic acid E and G, but the relative contents of them varied significantly among different medicinal materials. ConclusionAmong the five P. cocos medicinal materials, the types of constituents are generally similar, but their relative contents differed significantly among these medicinal materials, especially in the distribution of triterpenoids. The integration of UPLC-Q-Orbitrap-MS, MDF and GNPS can provide a reference for the rapid qualitative analysis of other Chinese medicines.
4.Analysis of Differential Compounds of Poria cocos Medicinal Materials by Integrated Qualitative Strategy Based on UPLC-Q-Orbitrap-MS
Jiayuan WANG ; Xiaohan FAN ; Xiaoxiao WEI ; Rong CAO ; Jin WANG ; Lei WANG ; Fengqing XU ; Shunwang HUANG ; Deling WU ; Hongsu ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):148-156
ObjectiveTo establish a rapid analytical method for identifying the differential components in Poria cocos medicinal materials based on ultra performance liquid chromatography-quadrupole-electrostatic field orbital trap high-resolution mass spectrometry(UPLC-Q-Orbitrap-MS), combined with mass defect filtering(MDF) and molecular network integration techniques. MethodsUPLC-Q-Orbitrap-MS was used for MS data acquisition and identification of P. cocos medicinal materials, with the help of MDF for the study of cleavage behavior and structural identification of triterpenoids. According to the similarity of MS/MS fragmentation patterns of each component, global natural product social molecular network(GNPS) was established, and Cytoscape 3.6.1 was used to screen molecular clusters with similar structures and the the structure of main compound classes were identified and confirmed. Multivariate statistical analyses such as principal component analysis(PCA) and orthogonal partial least squares-discriminant analysis(OPLS-DA) were used to screen the differential components of the five P. cocos medicinal materials with the variable importance in the projection(VIP) value>1 and P<0.05 as the criteria. ResultsA total of 66 compounds were identified by database comparison, 8 compounds were newly identified by MDF, 28 compounds were newly identified by GNPS, and a total of 102 chemical compounds were identified, including 43 triterpenoids, 16 saccharides, 26 amino acids and peptides, 3 nucleosides, and 14 other compounds. Triterpenoids were predominant in Poriae Cutis and wild Fushen, amino acids and peptides were the most abundant in Poria and cultivated Fushen, carbohydrates were the most abundant in Poriae Cutis. Type Ⅰ and Ⅱ triterpenoids had higher amounts in Poria and cultivated Fushen, type Ⅲ triterpenoids were more abundant in Poriae Cutis, all four types of triterpenoids were higher in Fushenmu, and type Ⅰ, Ⅱ, and Ⅳ triterpenoids were higher in wild Fushen. A total of 12 common differential chemical constituents were screened, including serine, guanosine, gallic acid, 2-octenal, maltotriose, trametenolic acid, dehydroeburicoic acid, dehydrotrametenolic acid, poricoic acid A, poricoic acid B, poricoic acid E and G, but the relative contents of them varied significantly among different medicinal materials. ConclusionAmong the five P. cocos medicinal materials, the types of constituents are generally similar, but their relative contents differed significantly among these medicinal materials, especially in the distribution of triterpenoids. The integration of UPLC-Q-Orbitrap-MS, MDF and GNPS can provide a reference for the rapid qualitative analysis of other Chinese medicines.
5.Influence of parental smoking and household secondhand smoke exposure on adolescents smoking initiation
SU Qi, XU Luting, SHI Jianhui, ZENG Xinying, LIU Ying, QI Mingxin, CAO Yuan, LIU Shiwei
Chinese Journal of School Health 2025;46(3):339-342
Objective:
To explore the impact of household tobacco smoke exposure on adolescents attempted smoking behavior, so as to provide a reference for tobacco control policy formulation and evaluation.
Methods:
From September to November 2023, a stratified cluster random sampling method was employed to select 7 841 middle and high school students from 10 monitoring sites (districts/counties) in Beijing for a questionnaire survey. Rao-Scott Chi square test was used to assess differences in proportions across subgroups, and complex sampling design based multivariate Logistic regression analysis was conducted to explore the influence of parental smoking and secondhand smoke (SHS) exposure at home on adolescents attempted smoking behavior.
Results:
About 47.17% of adolescents reported to have at least one parent smoked, with 42.36% reported of having only the father smoked, 0.73% reported of having only the mother smoked, and 4.08% reported of having both parents smoked. About 34.66% of middle and high school students were reported SHS exposure at home in the past 7 days, with 10.98%, 4.79% and 18.89% reported SHS exposure for 1-2, 3-4 and 5-7 days. Compared to adolescents with non smoking parents, those with a smoking father or both smoking parents had higher rates of attempted smoking [ OR (95% CI )=1.45(1.06-1.98), 3.73(2.18-6.37), P < 0.05 ]. Compared to adolescents without SHS exposure at home in the past 7 days, those exposed for 3-4 or 5- 7 days had higher rates of attempted smoking [ OR (95% CI )=2.21(1.27- 3.84 ), 2.46(1.58-3.83), P <0.01].
Conclusions
Household tobacco smoke exposure is associated with adolescent attempted smoking behavior. Parents should quit smoking and prohibit smoking at home to create a smoke free environment for adolescents.
6.Propensity score matching analysis of the impact of left behind experience on the mental health of secondary vocational school students
ZHOU Quanxiang, SHE Fuqiang, WAN Yan, HE Xuehua, YANG Jingyuan, CAO Xianming, XU Xiangyang
Chinese Journal of School Health 2025;46(3):353-357
Objective:
To understand the impact of left behind experience on the mental health of secondary vocational school students, so as to provide theoretical basis for the psychological health education of secondary vocational school students.
Methods:
From September to December in 2019, a total of 3 401 students from Duyun, Guiding and Pingtang County were selected by multi stage cluster random sampling method. Self designed questionnaire and Symptom Check List-90(SCL-90) were used to investigate mental health status. A total of 1 415 left behind students and 1 415 non left behind students were matched by using propensity score matching (PSM). Wilcoxon test and Logistic regression analysis were conducted.
Results:
Before the matching of propensity score, there were statistically significant differences in the distribution of family structure, mother s educational level, family residence,family harmony and children s past health among the students with or without left behind experience ( χ 2=28.17, 52.40, 96.31, 29.75 , 19.10, P <0.05). After the matching, there were no statistically significant differences in the distribution of the above variables among the students with or without left behind experience ( χ 2=0.02-4.32, P >0.05). Before the matching of propensity scores, there were significant differences in the scores of 10 dimensions of SCL-90, including somatization (1.67,1.58), interpersonal sensitivity (2.00,1.89), anxiety (1.90,1.70), obsessive compulsive symptoms (2.20, 2.10), depression (2.00, 1.85), hostility (1.83, 1.67), terror (1.85, 1.71), paranoia (1.83, 1.67), psychotic (1.70, 1.60) and other (1.85, 1.71) dimensions among secondary vocational school students with or without left behind experience ( Z=-5.15 to -2.84, P <0.05). After propensity score matching, there were significant differences in scores remained only in three factors for interpersonal sensitivity [(2.00(1.56,2.67),2.00(1.44,2.56)], paranoia [1.83(1.33,2.50),1.83(1.33,2.33)] and psychoticism [1.70(1.30,2.30),1.70(1.20,2.20)] in SCL- 90 among secondary vocational students with or without left behind experience ( Z=-2.45, -2.12, -2.23, P <0.05).
Conclusion
The impact of left behind experience on the mental health of vocational school students is mainly reflected in interpersonal sensitivity, paranoia, and psychoticism, which should be identified as key areas of psychological education for secondary vocational school students.
7.Effects and mechanism of total alkaloids of Corydalis Rhizoma on the regulation of cuproptosis in rats with diabetic cardiomyopathy
Jun LI ; Yazhi QI ; Ya TANG ; Rui CAO ; Qiang XU ; Yusheng HAN
China Pharmacy 2025;36(7):801-806
OBJECTIVE To investigate the effects and mechanism of total alkaloids of Corydalis Rhizoma (TAC) on the regulation of cuproptosis in rats with diabetic cardiomyopathy (DCM) based on silence information regulator 1(Sirt1)/tumor protein 53(P53)signaling pathway. METHODS DCM rat model was induced by high-fat and high-sugar diet and intraperitoneal injection of streptozotocin. Thirty-two model rats were randomly divided into model group, TAC low-dose, medium-dose and high-dose groups (7, 10.5, 14 mg/kg), with 8 rats in each group. An additional 8 rats were assigned to normal control group. Related drugs or normal saline were administered intragastrically in each group, once a day, for 4 weeks. After the last medication, the fasting blood glucose (FBG) levels of the rats were measured. The levels of myocardial creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and lactate dehydrogenase (LDH) in serum and myocardial tissue of rats were all detected. The pathological morphology, fibrosis degree, and Cu2+ deposition of myocardial tissue in rats were observed. The levels of Cu2+ and glutathione (GSH) in myocardial tissue, the expressions of Sirt1/P53 signaling pathway-related proteins [Sirt1, P53, solute carrier family 7 membrane 11 (SLC7A11)], and iron-sulfur cluster-related proteins [ferredoxin 1 (FDX1), lipoic acid synthetase (LIAS), aconitase 2 (ACO2), NADH-ubiquinone oxidoreductase core subunit S8 (NDUFS8), dihydrolipoamide acetyltransferase (DLAT), dihydrolipoamide succinyltransferase (DLST)], and heat shock protein 70 (HSP70) were all determined. RESULTS Compared with normal control group, the model group exhibited significantly elevated levels of FBG, CK, CK-MB and LDH in both serum and myocardial tissue, as well as increased 2+ levels of Cu in myocardial tissue and the expression of P53 and HSP70 proteins (P<0.05); the level of GSH and the expression levels of Sirt1, SLC7A11, FDX1, LIAS, ACO2, NDUFS8, DLAT, and DLST proteins in myocardial tissue were all significantly decreased (P<0.05); the myocardial tissue exhibited severe pathological damage, with numerous inflammatory cell infiltrations and significant fibrosis, as well as increased deposition of Cu2+. Compared with model group, most of the above quantitative indicators in rats were significantly reversed in TAC groups (P<0.05); the pathological damage to the myocardial tissue was alleviated, with reduced fibrosis and Cu2+ deposition. CONCLUSIONS TAC can ameliorate DCM in rats, and its mechanism of action may be related to activating the activity of the Sirt1/P53 signaling pathway, promoting the chelation of GSH with Cu2+, and inhibiting cuproptosis of cardiomyocyte.
8.Biocompatibility of poly(vinylidene fluoride)piezoelectric bionic periosteum prepared by electrospinning
Shuai ZHAO ; Dongyao LI ; Suiyan WEI ; Yijing CAO ; Yan XU ; Guoqiang XU
Chinese Journal of Tissue Engineering Research 2025;29(4):730-737
BACKGROUND:Our previous studies have found that poly(vinylidene fluoride)bionic periosteum prepared by electrospinning has good cytocompatibility,but its biocompatibility is unknown. OBJECTIVE:To evaluate the biocompatibility of poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+. METHODS:Poly(vinylidene fluoride),poly(vinylidene fluoride)bionic periosteum doped with 1%Zn2+,doped with 1%Mg2+,and doped with 1%(Zn2++Mg2+)were prepared by electrospinning to make bionic periosteum extract.SD rats were selected as the experimental subjects for hemolysis test,short-term systemic toxicity test,and heat source test.Guinea pigs were selected as the experimental subjects for skin sensitization test.The biocompatibility of bionic periosteum of four groups was tested. RESULTS AND CONCLUSION:(1)The hemolysis test results showed that the hemolysis rates of 1%Zn2+poly(vinylidene fluoride),1%Mg2+poly(vinylidene fluoride),1%Zn2++1%Mg2+poly(vinylidene fluoride)bionic periosteum and poly(vinylidene fluoride)extract were(0.130±0.013)%,(0.149±0.020)%,(0.466±0.018)%,and(0.037±0.018)%,respectively,which met the hemocompatibility standard of biomaterials.(2)The results of short-term systemic toxicity test showed that the four groups of bionic periosteal extract had no toxic signs such as body mass reduction,food intake changes,and dyspnea in SD rats,and had no toxic effects on major organs of rats.(3)Heat source test results showed that after intervention with poly(vinylidene fluoride)bionic periosteum doped with 1%Zn2+,doped with 1%Mg2+,and doped with 1%(Zn2++Mg2+),and poly(vinylidene fluoride)bionic periosteum extract,the elevated body temperature values of SD rats were(0.133±0.058),(0.100±0.010),(0.300±0.010),and(0.300±0.017)℃respectively.All were less than 0.6 ℃and the total temperature increase was less than 1.4 ℃.(4)The results of skin sensitization test showed that no erythema or edema was observed under the skin of guinea pigs after the intervention of bionic periosteum extract of four groups.(5)The results showed that poly(vinylidene fluoride)and poly(vinylidene fluoride)bionic periosteum doped with Zn2+and Mg2+had good biocompatibility.
9.SR9009 combined with indolepropionic acid alleviates inflammation in C2C12 myoblasts through the nuclear factor-kappa B signaling pathway
Huihui JI ; Xu JIANG ; Zhimin ZHANG ; Yunhong XING ; Liangliang WANG ; Na LI ; Yuting SONG ; Xuguang LUO ; Huilin CUI ; Ximei CAO
Chinese Journal of Tissue Engineering Research 2025;29(6):1220-1229
BACKGROUND:Rev-erbα is involved in the regulation of inflammation,but pharmacological activation of Rev-erbα increases the risk for cardiovascular diseases.To reduce the relevant risk,an exploration on SR9009,a Rev-erbα agonist,combined with other drugs to relieve inflammation in skeletal myoblasts was conducted,laying the theoretical foundation for the treatment of inflammation-associated skeletal muscle atrophy. OBJECTIVE:To investigate the relationship of SR9009,indolepropionic acid and nuclear factor-κB signaling pathways in lipopolysaccharide-induced C2C12 myoblasts. METHODS:(1)C2C12 myoblasts were induced to differentiate in the presence of lipopolysaccharide(1 μg/mL).RNA-seq and KEGG pathway analysis were used to study signaling pathways.(2)C2C12 myoblast viability was assessed using the cell counting kit-8 assay to determine optimal concentrations of indolepropionic acid.Subsequently,cells were categorized into control group,lipopolysaccharide(1 μg/mL)group,SR9009(10 μmol/L)+lipopolysaccharide group,indolepropionic acid(80μmol/L)+lipopolysaccharide group,and SR9009+indolepropionic acid+lipopolysaccharide group.ELISA was employed to measure protein expression levels of interleukin-6 in the cultured supernatant.Real-time quantitative PCR were employed to measure mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Western blot assay were employed to measure protein expression levels of NF-κB p65 and p-NF-κB p65.(3)After Rev-erbα was knocked down by siRNA,knockdown efficiency was assessed by RT-qPCR.And mRNA levels of interleukin-6 and tumor necrosis factor α were also measured. RESULTS AND CONCLUSION:Compared with the blank control group,lipopolysaccharide time-dependently inhibited myofibroblast fusion to form myotubes,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were elevated,and the level of interleukin-6 in the cell supernatant was significantly increased.The results of KEGG pathway showed that the nuclear factor-κB signaling pathway was activated by lipopolysaccharide.Indolepropionic acid exhibited significant suppression of C2C12 myoblasts viability when its concentration exceeded 80 μmol/L.Indolepropionic acid and SR9009 inhibited the activation of NF-κB signaling pathway,thereby played an anti-inflammatory role,and suppressed the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.Compared with the lipopolysaccharide group,the ratio of p-NF-κB p65/NF-κB p65 protein expression were downregulated.SR9009 combined with indolepropionic acid notably reduced lipopolysaccharide-induced inflammation,further downregulated the mRNA expression levels of interleukin-6,tumor necrosis factor α,TLR4 and CD14.The ratio of p-NF-κB p65/NF-κB p65 protein expression was significantly lower than that in the SR9009+lipopolysaccharide group or indolepropionic acid+lipopolysaccharide group.Rev-erbα increases time-dependently with lipopolysaccharide induction.The knockdown efficiency of Rev-erbα by siRNA reached over 58%,and lipopolysaccharide was added after Rev-erbα was successfully knocked down.Compared with the lipopolysaccharide group,the mRNA expression levels of interleukin-6 and tumor necrosis factor α were significantly up-regulated.These results conclude that Rev-erbα may act as a promising pharmacological target to reduce inflammation.SR9009 targeted activation of Rev-erbα combined with indolepropionic acid significantly inhibits the nuclear factor-κB signaling pathway and attenuates the inflammatory response of C2C12 myofibroblasts.Moreover,the combined anti-inflammatory effect is superior to that of the intervention alone.
10.Decompression mechanism of symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous
Chunlin ZHANG ; Zhaohua HOU ; Xu YAN ; Yan JIANG ; Su FU ; Yongming NING ; Dongzhe LI ; Chao DONG ; Xiaokang LIU ; Yongkui WANG ; Zhengming CAO ; Tengyue YANG
Chinese Journal of Tissue Engineering Research 2025;29(9):1810-1819
BACKGROUND:Traditional surgery for lumbar disc herniation involves extensive excision of tissue surrounding the nerve for decompression and removal of protruding lumbar intervertebral discs,which poses various risks and complications such as nerve damage causing paralysis,lumbar instability,herniation recurrence,intervertebral space infection,and adjacent vertebral diseases. OBJECTIVE:To propose the symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous technique for lumbar spine symmetrically decompression,showing the induced resorption of herniated nucleus pulpous phenomenon and early clinical efficacy,and then analyze its decompression mechanism. METHODS:214 patients with lumbar disc herniation at Department of Orthopedics,First Affiliated Hospital of Zhengzhou University from March 2021 to May 2023 were enrolled in this study.Among them,81 patients received conservative treatment as the control group,and 133 patients received symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous treatment as the trial group.Before surgery,immediately after surgery(7-14 days),and early after surgery(over 1 year),MRI images were used to measure the volume changes of lumbar disc herniation.CT images were used to measure the posterior displacement distance of the lumbar spinous process ligament complex,as well as the width and height of the lateral recess.Japanese Orthopaedic Association scores were used to evaluate the patient's neurological function recovery. RESULTS AND CONCLUSION:(1)Control group:81 patients with lumbar disc herniation were treated conservatively,with a total of 171 herniated lumbar discs.The average follow-up time was(22.7±23.1)months.The first and second MRI measurements of 171 herniated lumbar discs showed herniated lumbar disc volumes of(551.6±257.9)mm3 and(792.2±330.4)mm3,respectively,with an average volume increase rate of(53.2±44.4)%,showing statistically significant differences(P<0.001).Out of 171 herniated lumbar discs,4 experienced natural shrinkage,with an absorption ratio of 2.3%(4/171)and an absorption rate of(24.5±9.9)%.(2)Trial group:133 patients with lumbar disc herniation had a total of 285 herniated lumbar discs.(1)Immediately after surgery:All patients were followed up immediately after surgery.229 out of 285 herniated lumbar discs experienced retraction,with an absorption ratio of 80.3%(229/285)and an average absorption rate of(21.5±20.9)%,with significant and complete absorption accounting for 6.5%.There were a total of 70 herniated lumbar discs in the upper lumbar spine,with an absorption ratio of 85.7%(60/70),an average absorption rate of(23.1±19.5)%,and a maximum absorption rate of 86.6%.There were 215 herniated lumbar discs in the lower lumbar spine,with an absorption ratio of 78.6%(169/215),an average absorption rate of(21.0±21.3)%,and a maximum absorption rate of 83.2%.Significant and complete absorption of the upper and lower lumbar vertebrae accounted for 5.7%and 6.5%,respectively,with no statistically significant difference(P>0.05).The average distance of posterior displacement of the spinous process ligament complex immediately after surgery was(5.2±2.8)mm.There were no significant differences in the width and height of the left and right lateral recess before and immediately after surgery(P>0.05).The Japanese Orthopaedic Association score immediately after surgery increased from(10.1±3.4)before surgery to(17.0±4.8),and the immediate effective rate after surgery reached 95.6%.(2)Early postoperative period:Among them,46 patients completed the early postoperative follow-up.There were 101 herniated lumbar discs,with an absorption ratio of 94%(95/101)and an average absorption rate of(36.9±23.7)%.Significant and complete absorption accounted for 30.6%,with a maximum absorption rate of 100%.Out of 101 herniated lumbar discs,3 remained unchanged in volume,with a volume invariance rate of 2.97%(3/101).Out of 101 herniated lumbar discs,3 had an increased volume of herniated lumbar discs,with an increase ratio of 2.97%(3/101)and an increase rate of(18.5±18.4)%.The Japanese Orthopaedic Association score increased from preoperative(9.3±5.1)to(23.5±4.0),with an excellent and good rate of 93.4%.(3)The early postoperative lumbar disc herniation absorption ratios of the control group and trial group were 2.3%and 85.9%,respectively,with statistically significant differences(P<0.001).(4)Complications:There were two cases of incision exudation and delayed healing in the trial group.After conservative treatment such as dressing change,no nerve injury or death occurred in the incision healing,and no cases underwent a second surgery.(5)It is concluded that symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous is a new method for treating lumbar disc herniation that can avoid extensive excision of the"ring"nerve and achieve satisfactory early clinical efficacy.It does not damage the lumbar facet joints or alter the basic anatomical structure of the lateral recess,fully preserves the herniated lumbar discs,and can induce significant or even complete induced resorption of herniated nucleus pulpous.Symmetrically adduction of lumbar decompression induced resorption of herniated nucleus pulpous provides a new basis and method for the clinical treatment of lumbar disc herniation.


Result Analysis
Print
Save
E-mail