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.

Objective To explore the mechanism of microRNA(miRNA)-365a-3p affecting the function of vascular endothelial cells involved in the pathogenesis of preeclampsia(PE).Methods Primary human umbilical vein endothelial cells(HUVECs)were set as a NC group(transfected miR-365a-3p NC),a mimics group(trans-fected miR-365a-3p mimics)and a inhibitor group(transfected miR-365a-3p inhibitor).Logarithmic HUVECs cells were set as the blank group.The cell proliferation,migration and angiogenesis in each group were detected.Dual luciferin assay verified the targeting relationship between miR-365a-3p and downstream gene.The protein expressions of TGF-β1,Smad4 and Smad7 in each group were detected.Results Compared with the blank group and the NC group,the absorbance value and mobility of 24,48 and 72 h were decreased(P＜0.05),the number of tubular structures per field were decreased in the mimics group(P＜0.05),the absorbance value and mobility of 24,48 and 72 h were increased(P＜0.05),and the number of tubular structures per field were increased in the inhibitor group(P＜0.05).Dual luciferin assay showed that Smad7 was a target gene of miR-365a-3p.Compared with the blank group and the NC group,the protein expressions of TGF-β1 and Smad4 in the mimics group were increased(P＜0.05),while the protein expression of Smad7 was decreased(P＜0.05).The protein expression levels of TGF-β1 and Smad4 in the inhibitor group were decreased(P＜0.05),while the protein expression levels of Smad7 were increased(P＜0.05).Conclusion miR-365a-3p may affect the function of vascular endothelial cells by regulating the downstream TGF-β signaling pathway,and thus participate in the pathogenesis of PE.

Objective:To investigate the influence of different characteristics of implant-supported fixed dental prostheses on the incidence of peri-implant disease.Methods:Prospective cohort was established for patients who received implant-supported fixed dental prostheses at the Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University between June 2014 and September 2015. Several patient-related factors, implant prostheses factors, and oral hygiene maintenance factors were collected. The Log-rank test was used to compare the peri-implant disease rates of various factors, and the Cox proportional hazards model was used to conduct multivariate study on single factor significant factors to analyze the impact on the incidence of peri-implant disease.Results:A total of 214 subjects and 351 implants were included in the cohort, the follow-up period was (11.0±3.5) months. Finally, 43.0% (92/214) of patients and 37.3% (131/351) of implants developed peri-implant diseases. The incidence of peri-implant mucositis and peri-implantitis was 41.1% (88/214) and 4.2% (9/214) at the subject level,and 34.2% (120/351) and 3.1% (11/351) at the implant level. Among the factors associated with the implant prosthesis, single factor Log-rank analysis showed that prostheses retention methods, proximal contact of the prostheses, occlusion situation were statistical significance ( P<0.05). Multivariate analysis using Cox proportional hazards model showed that screw retention (hazard ratio=2.38, 95% CI: 1.42-3.99), proximal contact loss of the prostheses (hazard ratio=2.36, 95% CI: 1.31-4.27) were independent risk factors for peri-implant disease ( P<0.05). Conclusions:Factors such as prostheses retention mode and proximal contact characteristics have important influence on the health status of the implant.

Objective: To investigate the diagnostic value of multimodal magnetic resonance imaging (MRI) in primary central nervous system lymphoma (PCNSL). Methods: The multimodal MRI findings of 16 patients with PCNSL confirmed by histopathology from January 2016 to December 2018 in Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. Routine MRI plain scan, enhancement, diffusion weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) examination were performed in all cases. Results: All 16 patients were diagnosed with diffuse large B cell non-Hodgkin lymphoma. There were 7 cases with solitary lesions and 9 cases with multiple lesions. A total of 36 lesions were detected, with 30 above and 6 below the curtain. Sixteen lesions were located in the deep white matter near the ventricle (among which 2 lesions involved the corpus callosum), 5 lesions in the superficial cerebral hemisphere, 7 lesions in basal ganglia, 2 lesions in thalamus, 3 lesions in cerebellum, and 3 lesions were in brainstem. T₁WI showed equal or slightly low signal, and T₂WI showed equal or slightly high signal. There was different degree of edema around the lesions. 32 lesions were mild to moderate, and 4 lesions were severe. On enhancement scanning, 31 lesions showed patchy, nodular or lumpy uniform enhancement; 5 lesions showed irregular annular enhancement. "Incision" was found in 12 lesions, and "angular" was found in 7 lesions. Obvious enhancement of adjacent meninges or ependymal membranes occurred in 1 case each. DWI showed 29 high signals in the focal areas and 7 equal or slightly high signals, and all apparent dispersion coefficient (ADC) values were reduced. MRS showed that choline peak increased, and N-acetyl aspartate (NAA) peak and creatine peak decreased in all cases. highly elevated lipid peak was observed in 8 cases, inverted lactic acid peak in 3 cases, and both lipid peak and lactic acid peak were observed in 2 cases. Conclusions Multimodal MRI can reflect the characteristics of PCNSL from different aspects, which is of great value in improving the diagnostic accuracy of PCNSL.

Objective To grope for an ideal immune strategy in grown-ups via comparison of immunological effects under 4 different vaccination schemes.Methods Study population was selected by stratified random cluster sampling.A total of 4 different vaccination proposals,including Strategy A (3 doses,10 μg,administrated repeatedly into the unilateral deltoid muscle at 0-1-6 months),Strategy B (2 doses,20 μg,administrated into the bilateral deltoid muscles simultaneously),Strategy C (3 doses,10 μ g,administrated repeatedly into the unilateral deltoid muscle at 0-1-2 months) and Strategy D (2 doses,10 μg,administrated to the bilateral deltoid muscles at the same time),were conducted in Liangzhou,Minqin Gulang,and the Tianzhu Tibetan Autonomic county respectively,in Wuwei city,Gansu province.Under 4 different strategies,post-vaccination immunological effectiveness was evaluated when blood samples of participants collected in the eighth months,post-first injection and in the third year,and tested by enzyme-linked immunoassays and electro-chemiluminescence immunoassay.Chi-squared test and Fisher exact test were used to evaluate the immumological differences between the 4 strategies.Wilcoxon's signed rank test and Kruskal-Waillis H test were conducted to compare the differences of the geometric mean titers (GMTs) of antibody against HBV surface antigen (anti-HBs) titers.Results A total of 1 621 eligible participants aged 16 to 60 years old,were recruited for the study.Numbers of administration and gender were testified as the presuming factors for influencing immune effectiveness.The vaccination completion rates were 53.97％ and 79.82％ in Strategy A and C,respectively,and the difference statistically significant (P＜0.05).In the first year,the protective antibody sero-conversion rates (standardization rate) were 89.21％,54.88％,92.11％,and 41.63％,in Strategy A,B,C and D,respectively,and the significant statistically differences emerged (P＜0.05) if Strategy B,C and D were compared with Strategy A (as the gold standard).Over a 3-year follow-up period,the levels of GMTs on protective antibody declined from 179.2 IU/L,51.6 IU/L,277.1 IU/L and 10.1 IU/L to 61.3 IU/L,21.2 IU/L,31.8 IU/L and 6.0 IU/L in Strategy A,B,C and D,respectively,and the differences of declination on GMTs showed statistically significant differences (P＜0.05) when compared within or between the 4 strategies.Conclusion The 0-1-2 months' prophylactic schedules (Strategy C) seemed superior to the others,in terms of effectively inducing the protective antibody,with shorter duration of vaccination,persisting longer immunity and having higher rate of completive vaccination,so is worth to be recommended as a feasible immune programme for adults,especially for migrants from the rural regions.

Objective To perform a Meta-analysis on hepatitis B surface antigen (HBsAg)-positive rates among general Chinese population aged 1-59 years.Methods We systemically reviewed the related data (January 2007 to August 2016) published from Chinese National Knowledge Infrastructure (CNKI),VIP,and PubMed.We also assessed the HBsAg-positive rates among general Chinese populations aged 1-59 years,using a random effects regression model with the comprehensive Meta-analysis software 2.2.Results A total of 46 papers were finally included,with a total sample size of 625 053 individuals.Results from the Meta-analysis showed that the overall combined HBsAg-positive rate was 5.7％ (95％CI:4.8％-6.6％) among general Chinese populations aged 1-59 years.When comparing the HBsAg-positive rates in different regions,data showed that the HBsAg-positive rate of was higher in the mid-western areas (6.3％,95％CI:4.9％-8.0％)than in the eastern areas (5.5％,95％CI:4.4％-6.8％).Results showed that HBsAg-positive rates was higher in males (6.1％,95％CI:5.3％-7.0％) than in females (4.8％,95％CI:4.2％-5.5％).As for the HBsAg-positive rates in different time periods,data showed positive rate of 6.3％ (95％CI:5.5％-7.2％)in 2007-2009,5.9％ (95％CI:4.4％-8.0％) in 2010-2012 and 3.5％ (95％CI:2.0％-6.1％) in 2013-2016,respectively.Conclusion The prevalence of hepatitis B virus infection was decreasing between 2007 and 2016 in China,making the country an intermediate endemic area on HBV.

Human enterovirus 71 (EV71) is the main causative pathogen of hand, foot, and mouth disease (HFMD) in children. The epidemic of HFMD has been a public health problem in Asia-Pacific region for decades, and no vaccine and effective antiviral medicine are available. Curcumin has been used as a traditional medicine for centuries to treat a diversity of disorders including viral infections. In this study, we demonstrated that curcumin showed potent antiviral effect again EV71. In Vero cells infected with EV71, the addition of curcumin significantly suppressed the synthesis of viral RNA, the expression of viral protein, and the overall production of viral progeny. Similar with the previous reports, curcumin reduced the production of ROS induced by viral infection. However, the antioxidant property of curcumin did not contribute to its antiviral activity, since N-acetyl-l-cysteine, the potent antioxidant failed to suppress viral replication. This study also showed that extracellular signal-regulated kinase (ERK) was activated by either viral infection or curcumin treatment, but the activated ERK did not interfere with the antiviral effect of curcumin, indicating ERK is not involved in the antiviral mechanism of curcumin. Unlike the previous reports that curcumin inhibited protein degradation through ubiquitin-proteasome system (UPS), we found that curcumin had no impact on UPS in control cells. However, curcumin did reduce the activity of proteasomes which was increased by viral infection. In addition, the accumulation of the short-lived proteins, p53 and p21, was increased by the treatment of curcumin in EV71-infected cells. We further probed the antiviral mechanism of curcumin by examining the expression of GBF1 and PI4KB, both of which are required for the formation of viral replication complex. We found that curcumin significantly reduced the level of both proteins. Moreover, the decreased expression of either GBF1 or PI4KB by the application of siRNAs was sufficient to suppress viral replication. We also demonstrated that curcumin showed anti-apoptotic activity at the early stage of viral infection. The results of this study provide solid evidence that curcumin has potent anti-EV71 activity. Whether or not the down-regulated GBF1 and PI4KB by curcumin contribute to its antiviral effect needs further studies.

In the present study, we carried out intratracheal administration of bone marrow-derived mononuclear cells (BM-MNCs) to dehydromonocrotaline (DMCT)-induced canine pulmonary artery hypertension (PH) of rat model to examine the security and feasibility, and the aim was to discuss the mechanism. All animals (n=30) were randomly divided into 3 groups (n=10 in each group), i. e. control group, PH group and BM-MNCs group. Six weeks after the transplantation, the hemodynamic data and right ventricle weight ratio were significantly improved for those in BM-MNCs group compared with those in PH group. The lung mRNA levels of vascular endothelial growth factor (VEGF) were higher, while preproendothelin-1 (ppET-1), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were lower compared with those in the PH group (P<0. 05). Immunofluorescence and histochemical results confirmed that 6 weeks after the administration, transplanted BM-MNCs were still alive and could differentiate into pulmonary vascular endothelial cells. These results showed that intratracheal administration of BM-MNCs could obviously reduce or even reverse the DMCT induction of PAH process. The mechanism could be explained as that the function was mainly through the paracrine effect to promote renewable and reduce inflammation.
Animals ; Bone Marrow Cells ; cytology ; Cell Transplantation ; methods ; Dogs ; Familial Primary Pulmonary Hypertension ; Female ; Hypertension, Pulmonary ; chemically induced ; therapy ; Leukocytes, Mononuclear ; transplantation ; Male ; Monocrotaline ; analogs & derivatives ; Rats

BACKGROUND:Stem cel transplantation has a certain effect in the treatment pulmonary arterial hypertension.
OBJECTIVE:To investigate the effect of bone marrow mesenchymal stem cel s transplantation on the treatment of pulmonary arterial hypertension and to discuss the mechanism.
METHODS:Bone marrow mesenchymal stem cel s were in vitro cultured, purified and amplified by density gradient centrifugation method, and labeled with the fluorescent dye for preparation. Pulmonary arterial hypertension model was established by subcutaneous injection of monocrotaline. One week after modeling, the rats were randomly divided into three groups. Rats in the stem cel transplantation group and pulmonary arterial hypertension group received subcutaneous injection of monocrotaline to establish the pulmonary arterial hypertension model. One week later, the rats in the stem cel transplantation group received sublingual vein injection of bone marrow mesenchymal stem cel solution, the rats in the pulmonary arterial hypertension group were injected with the culture medium without stem cel s, and the rats in the control group were injected with the normal saline in the same dose.
RESULTS AND CONCLUSION:At 2 weeks after transplantation, compared with the mesenchymal-induced pulmonary arterial hypertension rats, the hemodynamic parameters and the ratio of right ventricular/body weight of the rats in the stem cel transplantation group were significantly improved (P<0.05);the degree of pulmonary vascular remodeling was significantly reduced (P<0.05). Fluorescence microscope observation showed that the transplanted bone marrow mesenchymal stem cel s could alive at least 2 weeks in the stem cel transplantation group, and part of the stem cel s could differentiate into pulmonary vascular endothelial cel s. The results show that bone marrow mesenchymal stem cel transplantation can significantly improve the pulmonary vascular and right ventricular structural impairments in the rats with mesenchymal-induced pulmonary arterial hypertension.

OBJECTIVETo explore the role of p38 signal pathway in regulating matrix metalloproteinase-9 (MMP-9) expression and brain edema formation in a rat model of traumatic brain injury (TBI).

METHODSA total of 130 adult male Sprague Dawley rats were randomly divided into 4 groups, namely the normal group (n=10), sham-operated group (n=40), TBI (induced by Feeney free falling methods) group (n=40), and SB group with intraperitoneal SB203580 treatment (10 µmol/L) 15 min before TBI (n=40). The rats were sacrificed 2 h and 2 days after TBI. The expressions of p38, p-p38, and MMP-9 mRNA and protein were detected by RT-PCR and Western blotting. The blood brain barrier permeability was detected by Evans Blue (EB) test, and the brain water content (BWC) was determined using a gravimetric technique.

RESULTSThe expression of p-p38 protein increased markedly 2 h after TBI (P<0.05), and was suppressed by SB203580 treatment (P<0.05). MMP-9 mRNA and protein showed no obvious increase at 2 h after TBI, but significantly increased at 2 days as compared with those in the sham-operated group (P<0.05). MMP-9 mRNA and protein were much lower in SB group than in TBI group 2 days after TBI (P<0.05). The blood brain barrier permeability significantly increased 2 h after TBI (P<0.05) and kept increasing until 2 days (P<0.05), but was reduced significantly by SB203580 (P<0.05). BWC increased obviously 2 days after TBI (P<0.05) and was lessened by SB203580 (P<0.05).

CONCLUSIONBlocking p38 signal pathway can attenuate MMP-9 upregulation and brain edema after TBI, suggesting the important role of p38 in regulating MMP-9 expression to affect traumatic brain edema.

Animals ; Brain Edema ; pathology ; Brain Injuries ; metabolism ; Enzyme Inhibitors ; pharmacology ; Imidazoles ; pharmacology ; MAP Kinase Signaling System ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Pyridines ; pharmacology ; Rats ; Rats, Sprague-Dawley