Objective To explore the clinical value of neurography and nerve root sealing in treatment of multilevel lumbar spinal stenosis with lumbar instability using Endo-P/TLIF.Methods A total of 60 patients with multi-segment lumbar spinal stenosis and lumbar instability hospitalized in our hospital were included in this study From January 1,2022 to June 21,2022.All patients underwent nerve root closure angiography before surgery to confirm the responsible segments,and then the responsible segments were treated with Endo-P/TLIF.The patients were followed up for 6 months.The basic information on the age,gender,course of disease,surgical time,intraop-erative bleeding,hospitalization time,and off-bed ambulation time was collected.Then the data on VAS score,ODI score,JOA score,lumbar lordosis angle,intervertebral height,dural cross-sectional area,sacral inclination angle,pelvic projection angle,and pelvic inclination angle before,right after,3 months and 6 months after the operation were calculated.The number of responsible segments indicated by MRI and confirmed by nerve root closure angiography and the number of the single segment,double segments,3 segments,and above finally decompressed were statisti-cally analyzed.Results All patients went through the surgery safely.During the 6-month follow-up,one patient did not return to the hospital for consultation on time,and one patient was out of contact.Finally,the follow-up data of 58 patients were completely collected for statistical analysis.Fifty-five cases were remarkably improved,2 better,and 1 moderately,6 months after the operation,with a total effectiveness rate of 100%.The number of unilateral and bilateral single responsible segments confirmed by nerve root angiography and sealing was significantly larger than by MRI(P<0.05),but the number of unilateral and unilateral double,or multiple responsible segments was signifi-cantly smaller(P<0.05).There were statistically significant differences in terms of postoperative VAS score,ODI score,JOA score,VAS score,ODI score,JOA score,lumbar lordosis angle,intervertebral height,dural cross-sectional area,sacral inclination angle,pelvic inclination angle as compared to the preoperative data(P＜0.05).The pelvic projection angle was insignificantly improved as compared to the preoperative condition(P ? 0.05).Conclusion The accurate diagnosis with selective neurography and nerve root sealing improves the confirmation of responsible nerve segments before operation.Base on the accurate diagnosis,multi-segment lumbar spinal canal stenosis with lumbar instability can be effectively treated with Endo-P/TLIF,the responsible segment decompressed,trauma and bleeding reduced,hospital stay shortened,spinal physiological curvature well recovered,and clinical efficacy improved.Therefore,the method is worthy of extensive application in clinical practice.

【Objective】 To investigate the distribution characteristics of Rh blood group antigen phenotypes, haplotypes and irregular antibodies between patients in our hospital and local blood donors, so as to ensure safe and effective blood transfusion and improve the rationality and scientificity of clinical blood transfusion. 【Methods】 A total of 113 326 blood samples, from hospitalized patients in our hospital and local blood donors from October 2015 to March 2020, were subjected to Rh antigen typing and irregular antibody detection. The frequency of Rh phenotypes, haplotypes, and irregular antibodies were retrospectively analyzed and calculated. Chi square test was used to compare the data among different population groups. Rh antigen typing and irregular antibody detection were completed using the automatic blood group analyzer. 【Results】 The prevalence of negative RhD was 0.36% (408/113 326). The most prevalent Rh phenotype was DCCee [40.69%(46 112/ 113 326)] followed by DCcEe [36.82%(41 727/ 113 326)]. Anti-E was the most common irregular antibody, accounting for [0.26%(295/ 113 326)], and DCe [62.51%(70 840/ 113 326)] was the most common haplotype. The most common Rh phenotypes and haplotypes in Caucasians in Germany, North Indian and North African were DCcee, DCCee and Dccee, while DCe, DCe and Dce, respectively. 【Conclusion】 The distribution characteristics of Rh phenotypes, haplotypes and irregular antibodies of patients in our hospital and local blood donors were in line with the distribution characteristics of the population in northern China. Corresponding plans concerning blood storage and collection, as well as the establishment of Rh blood type registry should be carried to effectively ensure the safety, rationality and accuracy of clinical blood transfusion.

Tryptophan 2,3-dioxygnease 2 (TDO2) is specific for metabolizing tryptophan to kynurenine (KYN), which plays a critical role in mediating immune escape of cancer. Although accumulating evidence demonstrates that TDO2 overexpression is implicated in the development and progression of multiple cancers, its tumor-promoting role in esophageal squamous cell carcinoma (ESCC) remains unclear. Here, we observed that TDO2 was overexpressed in ESCC tissues and correlated significantly with lymph node metastasis, advanced clinical stage, and unfavorable prognosis. Functional experiments showed that TDO2 promoted tumor cell proliferation, migration, and colony formation, which could be prevented by inhibition of TDO2 and aryl hydrocarbon receptor (AHR). Further experimentation demonstrated that TDO2 could promote the tumor growth of KYSE150 tumor-bearing model, tumor burden of C57BL/6 mice with ESCC induced by 4-NQO, enhance the expression of phosphorylated AKT, with subsequent phosphorylation of GSK3

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Background: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. Methods: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. Results: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. Conclusion The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE ) questionnaires were used to evaluate the satisfaction of all patients preoperative and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included, 97 cases were given questionnaires, and 60 cases were effectively recovered, 30 cases in each group.There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0. 05). The mean improvement in the experimental group was (4. 10±0. 88) points, while the mean improvement in the control group was (2. 53±0. 73) points. There was statistical significance in the improvement of the postoperativeROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29. 5±9. 7) points, which increased to (77. 3±13. 7) points after surgery. In the control group, the average satisfaction score was (30. 4±11. 3) points before surgery and increased to (62. 7±23. 4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients.VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) questionnaires were used to evaluate the satisfaction of all patients preoperatively and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included. 97 cases were given questionnaires, and 60 cases were effectively recovered.There were 30 cases in each group. There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0.05). The mean improvement in the experimental group was (4.10±0.88) points, while the mean improvement in the control group was (2.53±0.73) points. There was statistical significance in the improvement of the postoperative ROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29.5±9.7) points, which increased to (77.3±13.7) points after surgery.In the control group, the average satisfaction score was (30.4±11.3) points before surgery and increased to (62.7±23.4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients. VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE ) questionnaires were used to evaluate the satisfaction of all patients preoperative and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included, 97 cases were given questionnaires, and 60 cases were effectively recovered, 30 cases in each group.There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0. 05). The mean improvement in the experimental group was (4. 10±0. 88) points, while the mean improvement in the control group was (2. 53±0. 73) points. There was statistical significance in the improvement of the postoperativeROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29. 5±9. 7) points, which increased to (77. 3±13. 7) points after surgery. In the control group, the average satisfaction score was (30. 4±11. 3) points before surgery and increased to (62. 7±23. 4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients.VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

Objective:To evaluate the effect of preoperative 3D simulation on the evaluation of rhinoplasty.Methods:From December 2017 to March 2019, patients in the Department of Burn and Plastic Surgery of the Second Xiangya Hospital of Central South University were randomly selected as the research subjects. According to whether they had received 3D simulation before surgery, they were divided into the experimental group (after 3D simulation before comprehensive surgery) and the control group (without 3D simulation before comprehensive surgery). Visual analogue scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) questionnaires were used to evaluate the satisfaction of all patients preoperatively and one month after surgery.Results:At the beginning of this study, a total of 97 cases were included. 97 cases were given questionnaires, and 60 cases were effectively recovered.There were 30 cases in each group. There was statistical significance in the improvement of the postoperative VAS scores between the experimental group and the control group ( P<0.05). The mean improvement in the experimental group was (4.10±0.88) points, while the mean improvement in the control group was (2.53±0.73) points. There was statistical significance in the improvement of the postoperative ROE satisfaction scores between the two groups. The average preoperative satisfaction score of the experimental group was (29.5±9.7) points, which increased to (77.3±13.7) points after surgery.In the control group, the average satisfaction score was (30.4±11.3) points before surgery and increased to (62.7±23.4) points after surgery. Conclusions:3D simulation before nasal synthesis can improve the postoperative satisfaction of patients. VAS and ROE questionnaires are good tools for evaluating the effect of comprehensive rhinoplastic surgery.

PD-1 and CTLA-4 antibodies offer great hope for cancer immunotherapy. However, many patients are incapable of responding to PD-1 and CTLA-4 blockade and show low response rates due to insufficient immune activation. The combination of checkpoint blockers has been proposed to increase the response rates. Besides, antibody drugs have disadvantages such as inclined to cause immune-related adverse events and infiltration problems. In this study, we developed a cyclic peptide C25 by using Ph.D.-C7C phage display technology targeting LAG-3. As a result, C25 showed a relative high affinity with human LAG-3 protein and could effectively interfere the binding between LAG-3 and HLA-DR (MHC-II). Additionally, C25 could significantly stimulate CD8 T cell activation in human PBMCs. The results also demonstrated that C25 could inhibit tumor growth of CT26, B16 and B16-OVA bearing mice, and the infiltration of CD8 T cells was significantly increased while FOXP3 Tregs significantly decreased in the tumor site. Furthermore, the secretion of IFN- by CD8 T cells in spleen, draining lymph nodes and especially in the tumors was promoted. Simultaneously, we exploited T cells depletion models to study the anti-tumor mechanisms for C25 peptide, and the results combined with MTT assay confirmed that C25 exerted anti-tumor effects CD8 T cells but not direct killing. In conclusion, cyclic peptide C25 provides a rationale for targeting the immune checkpoint, by blockade of LAG-3/HLA-DR interaction in order to enhance anti-tumor immunity, and C25 may provide an alternative for cancer immunotherapy besides antibody drugs.