OBJECTIVE:Anterior cervical decompression and fusion is a classic surgical method for the treatment of degenerative cervical spondylosis.The use of nail plates increases the fusion rate and stability and indirectly leads to adjacent vertebral degeneration and postoperative dysphagia.In this paper,the clinical results and complications of ROI-CTM self-locking system and traditional cage combined with screw-plate internal fixation in the treatment of degenerative cervical spondylosis were compared by meta-analysis to provide evidence-based support for the selection of internal fixation methods in anterior cervical decompression and fusion. METHODS:CNKI,WanFang,VIP,PubMed,Cochrane Library,Web of Science,and Embase databases were searched for Chinese and English literature on the application of ROI-CTM self-locking system and fusion cage combined with screw plate internal fixation in the treatment of degenerative cervical spondylosis.The retrieval time range was from inception to July 2023.Two researchers selected the literature strictly according to the inclusion and exclusion criteria.The Cochrane bias risk tool was used to evaluate the quality of randomized controlled trials.Newcastle-Ottawa Scale was used to assess the quality of cohort studies.Meta-analysis was performed using RevMan 5.4 software.Outcome indicators included operation time,intraoperative blood loss,Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,incidence of adjacent vertebral degeneration,cage subsidence rate,and incidence of dysphagia. RESULTS:Thirteen articles were included,including eleven retrospective cohort studies and two randomized controlled trials,with 1 136 patients,569 in the ROI-C group,and 567 in the cage combined with the nail plate group.Meta-analysis results showed that the operation time(MD=-15.52,95%CI:-18.62 to-12.42,P<0.000 01)and intraoperative blood loss(MD=-24.53,95%CI:-32.46 to-16.61,P<0.000 01)in the ROI-C group and the fusion device combined with nail plate group.Postoperative adjacent segment degeneration rate(RR=0.40,95%CI:0.27-0.60,P<0.000 01)and postoperative total dysphagia rate(RR=0.18,95%CI:0.13-0.26),P<0.000 01)were statistically different.The two groups had no significant difference in Japanese Orthopaedic Association score,Neck Disability Index,C2-C7 Cobb angle,fusion rate,or cage subsidence rate(P≥0.05). CONCLUSION:Applying an ROI-CTM self-locking system and traditional cage combined with plate internal fixation in anterior cervical decompression and fusion can achieve satisfactory clinical results in treating degenerative cervical spondylosis.The operation of the ROI-CTM self-locking system is more straightforward.Compared with a cage combined with plate internal fixation,the ROI-CTM self-locking system can significantly reduce the operation time and intraoperative blood loss and has obvious advantages in reducing the incidence of postoperative dysphagia and adjacent segment degeneration.The ROI-CTM self-locking system is recommended for patients with skip cervical spondylosis and adjacent vertebral disease.However,given its possible high settlement rate,using a fusion cage combined with screw-plate internal fixation is still recommended for patients with degenerative cervical spondylosis with multiple segments and high-risk factors of fusion cage settlement,such as osteoporosis and vertebral endplate damage.

OBJECTIVE To explore the mechanism of improvement effect of Chanbao zhichuang suppository （CBZCS） on hemorrhoids in rats through network pharmacology and metabolomics. METHODS A hemorrhoid model was established by subcutaneous injection of rhododendron oil to induce anal swelling. SD rats were divided into blank group （NC group， 0.32 g/kg vaseline）， model group （Model group， 0.32 g/kg vaseline）， CBZCS low-， medium-， and high-dose groups （CBZCS-L， CBZCS- M， CBZCS-H groups， with dosages of 0.16， 0.32， and 0.64 g/kg respectively）， and Mayinglong musk hemorrhoids suppository group （Positive group， 0.32 g/kg）， with 9 rats in each group. Anal administration was performed at 6， 12， 24， 48， and 72 hours after modeling. After the last administration， the pathological changes of the anal tissues in rats were observed， and the serum levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in rats were detected. Differential metabolite analysis and enrichment analysis were conducted by metabolomics methods， and the target proteins of CBZCS in treating hemorrhoids were obtained by network pharmacology. The core metabolic pathways were screened by interaction and enrichment analysis of differential metabolites and proteins， and the core proteins were experimentally verified. RESULTS Compared with the NC group， the anal tissues of the Model group showed obvious lesions， and the levels of IL-6 and TNF- α in the serum were significantly increased （P＜0.05）； compared with the Model group， the pathological damage of the anal tissues in the treatment groups was alleviated to varying degrees， and serum levels of IL-6 in CBZCS-H group， CBZCS-M group， and Positive group as well as serum levels of TNF-α in CBZCS-H group were significantly reduced （P＜0.05）. The metabolomics results showed that 34 differential metabolites were screened from the anal tissues of rats， and 22 of them showed a return after CBZCS administration. The differential metabolites mainly enriched in arachidonic acid metabolism， histidine metabolism， and glycerophospholipid metabolism. Through the network pharmacology， 138 intersection genes of CBZCS against hemorrhoids were determined. The analysis results showed that differential metabolites and target proteins were mainly enriched in the arachidonic acid metabolism pathway， and the regulation of this pathway might be related to cyclooxygenase-2 （COX-2）， Myc proto-oncogene protein （c-MYC）， cytochrome P450 1B1 （CYP1B1）， interleukin-1β （IL-1β）， and IL-6 protein expression. The experimental verification results showed that the expression levels of key proteins （COX-2， c-MYC， CYP1B1， IL-6， IL-1β） in the anal tissues of the Model group were significantly higher than those in the NC group （P＜0.05）， and the levels of the above proteins in the anal tissues of CBZCS-H group and Positive group were significantly lower than those in the Model group （P＜0.05）. CONCLUSIONS The mechanism of CBZCS in treating hemorrhoids may be to inhibit the expression of COX-2， c-MYC and CYP1B1 proteins， thereby inhibiting arachidonic acid metabolism and reducing the release of inflammatory factors IL-6 and IL-1β.

Objective:To investigate the effects of stem cells combined with dual drug nanoassemblies on ventricular remodeling and cardiac function after acute myocardial infarction in rats.Methods:A dual drug nano assembly of angiotensin 1-7 (SAAl-7) peptide and temisal was constructed. Male SD-rats (100 cases) were randomly divided into the sham group, model group, nano group, stem cell group, and combination group. And each group had 20 cases. Acute myocardial infarction rat models were established with anterior descending artery ligation in the model group, nano group, stem cell group, and combination group. The rats in the sham group took the same surgical steps but did not ligate the ligation line. In addition, rats in the stem cell group and combination group were injected with 20 μl of stem cells at the edge of the infarct area after ligation during the surgery. Rats in the other groups were injected with equal doses of phosphate buffered solution (PBS) by the same method. Starting from the day of surgical modeling, rats in nano group and combined group were injected with 0.5 ml of two-drug nano assemblies in the tail vein, while rats in the sham group, model group, stem cell group received a tail vein injection of an equal volume of 0.9% sodium chloride solution. After surgery, rats in all groups were continuously observed for 14 days. The cardiac function indicators, ventricular remodeling indicators, serum indicators, the myocardial infarction area, and the myocardial cell apoptosis rate of rats in all groups were detected and compared. The cardiac function indicators include left ventricular ejection fraction (LVEF), fraction shorting (FS), left ventricular end diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD). The ventricular remodeling indicators include left ventricle weight (LVW), left ventricular mass index (LVWI), and transdiameter of cardiomyocytes (TDM). The serum indicators include interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), superoxide dismutase (SOD), glutathione, malondialdehyde, creatinine, and alanine aminotransferase (ALT).Results:Compared with the sham group, LVEF, FS, body mass, SOD, and glutathione levels in the model group were decreased (all P < 0.05), while LVEDD, LVESD, LVW, LVWI, TDM, IL-6, TNF-α, malondialdehyde, creatinine, ALT, myocardial infarction area, and myocardial cell apoptosis rate were increased (all P < 0.05). Compared with the model group, LVEF, FS, body mass, SOD, and glutathione levels in the nano group, stem cell group, and combination group were increased (all P < 0.05), while LVEDD, LVESD, LVW, LVWI, TDM, IL-6, TNF-α, malondialdehyde, creatinine, ALT, myocardial infarction area, and myocardial cell apoptosis rate were decreased (all P < 0.05). Compared with the nano group and stem cell group, LVEF, FS, body mass, SOD, and glutathione levels in the combination group were increased (all P < 0.05), while LVEDD, LVESD, LVW, LVWI, TDM, IL-6, TNF-α, malondialdehyde, creatinine, ALT, myocardial infarction area, and myocardial cell apoptosis rate were decreased (all P < 0.05). Conclusions:The combination of stem cells and dual drug nano assemblies can effectively treat acute myocardial infarction rats, improve their cardiac function, and reduce ventricular remodeling, which may be related to the reducing inflammatory response and oxidative stress inhibiting myocardial cell apoptosis and narrowing the area of myocardial infarction.

Objective:To systematically quantify the access to screening and surveillance service of liver cancer in populations in China, especially a series of sub-indicators of the availability.Methods:Following the specific indicators applied by the International Agency for Research on Cancer in the session of availability and use of screening practices in several cancer screening handbooks, information about the access/availability of liver cancer screening and surveillance in population in China were collected; the indicators included local policies and guidelines, procedures most commonly used or recommended, population coverage and participation rate, compliance and related factors, treatment rate, acceptability, equity and others. Systematic review approach was used, combined with searching core literatures/monograph, websites of governments and available program reports, for a systematic analysis on the access to liver cancer screening and surveillance in populations in China.Results:A total of 34 journal articles were included from the systematic review and most of which were about the participation of secondary liver screening or surveillance compliance; additional information were mainly obtained from the other sources. Overall, there were clearly recommended screening and surveillance procedures for liver cancer in the three major cancer screening programs funded by the central government of China. It was estimated that 0.09% of the population aged 35-74 years were covered by liver cancer screening in 2019 in China. The overall participation rates of secondary screening ranged from 37.5% to 62.3% in three major programs, the median compliance rate of surveillance was reported as 26.9% ( Q1, Q3: 23.5%, 41.0%) in the 6 included studies. Two studies reported the factors affecting the participation and compliance. A large-scale multicenter analysis showed that the subject acceptability to alpha fetoprotein test combined with ultrasound screening was as high as 99.3% in high-risk population in urban area. The treatment rate of liver cancer founded by screening, surveillance or follow-up was estimated to be >90% in rural population. No studies of equity were obtained via the systematic review. Conclusions:The public health service programs in China all recommend specific procedures for liver cancer screening in general population and surveillance for high-risk individuals. However, the overall availability needs to be improved, particularly in the indicator of population coverage. Participation rates of screening and compliance rates of surveillance varied among the included programs and the studies, suggesting that the influencing factors need to be further identified. The relatively high subject acceptability suggests the potential demands for screening service. More efforts are needed to address the access to screening and surveillance of liver cancer in populations in China.

Objective:This paper makes a comprehensive evaluation on the columns of Chinese Pediatric Emergency Medicine from communication effect and citation effect, and analyzes the advantages and disadvantages of each column setting, so as to provide evidence-based basis for journal soliciting contributions, and guide column selection planning.Methods:The communication index (website browsing frequency, website download frequency, Wanfang download frequency) and citation index (citation frequency, zero citation rate, high citation rate, high citation rate ratio) of columns in Chinese Pediatric Emergency Medicine from 2016 to 2018 were counted, and whether there were statistical differences among the evaluation indexes of columns was analyzed.Results:In terms of communication index: among the top 20 column communication indicators, comments and guidance columns account for a very high proportion; The communication index of comment column and guidance column was significantly higher than that of other columns, and the differences were statistically significant; There was no significant difference between Article column and Clinical application research column.In terms of citation index: the citation frequency and high citation rate of the Article column are the highest, while the zero citation rate is the lowest, and there was no significant difference among the four columns of Expert forum, Clinical application research, Review and Guideline·consensus·interpretation; The high citation rate ratio of the Guideline·consensus·interpretation column is the highest, followed by the Article column, and the two columns are significantly higher than the Expert forum column; Among the top 20 papers with the highest citation frequency, the column of treatise accounts for 65%.Conclusion:Expert forum column and Guidelin·consensus·interpretation column are the key to influence the communication effect of journals.Article column and Guidelin·consensus·interpretation column are the key to influence the citation effect of journals.The absolute value of evaluation index can not scientifically evaluate the academic quality of journals.

Objective To observe the digestive system related symptoms in patients with early-middle stage Parkinson's disease (PD) and healthy subjects,and investigate the incidence of the symptoms and the influencing factors.Methods One hundred and eight PD patients with early and middle stage (Hoehn-Yahr staging 1-3) were admitted to Xuzhou Central Hospital and followed up for a long time.A questionnaire,including seven items of digestive system related symptoms selected from the PD Non-Motor Symptom Scale and the Scale for Outcomes in PD for Autonomic Symptoms (taste abnormalities,swallowing disorders,salivation,easy or early satiety,constipation,loose stools,fecal incontinence),and additional five items of digestive system related symptoms (loss of appetite,dry mouth,oral pain,nausea,vomiting),totally 12 items,was used in a survey on PD patients.Seventy-six healthy subjects in the physical examination center of the hospital served as control group,and conducted the same questionnaire survey.Results There was no statistically significant difference in age,gender,height,weight,body mass index (BMI) between the PD and control groups.In 108 PD patients,dry mouth accounted for 64 cases (59.26％),constipation 53 cases (49.07％) and taste abnormalities 40 cases (37.04％),followed by loss of appetite 35 cases (32.41％) and early satiety 26 cases (24.07％),swallowing disorders 20 cases (18.52％),nausea 11 cases (10.19％),salivation 10 cases (9.26％),oral pain seven cases (6.48％),vomiting four cases (3.70％),loose stools one case (0.87％).In 76 controls,taste abnormalities accounted for 13 cases (17.11％),early satiety six cases (7.89％),loss of appetite six cases (7.89％),nausea five cases (6.58％),salivation three cases (3.95％),oral pain one case (1.32％),and the rest zero.The incidence of constipation (x2=52.390,P＜0.01),dry mouth (x2=69.050,P＜0.01),early satiety (x2=8.128,P=0.004),loss of appetite (x2=16.010,P＜0.01),taste abnormalities (x2=8.642,P=0.003) and swallowing disorders (x2=15.790,P＜0.01) showed statistically significant difference between the two groups.Analysis of the influencing factors showed that male had an effect on constipation (95％CI 1.371-7.495,OR=3.205),early satiety (95％CI 4.227-282.913,OR=34.582),taste abnormalities (95％CI 6.620-88.942,OR=24.260) and swallowing disorders (95％CI 2.784-88.475,OR=22.906),while other factors such as age,body mass index,disease duration and motor symptom types had no effect on the occurrence of digestive system related symptoms.Conclusions Digestive system related symptoms in patients with PD include dry mouth,constipation,taste abnormalities,loss of appetite,early satiety,and swallowing disorders,which may be their unique symptoms.Male is a risk factor for taste abnormalities,swallowing disorders,early satiety and constipation.

1,3-1,4-β-glucanase (E.C.3.2.1.73) is an important industrial enzyme which cleave β-glucans into oligosaccharides through strictly cutting the β-1,4 glycosidic bonds in 3-O-substituted glucopyranose units. Microbial 1,3-1,4-β-glucanase belongs to retaining glycosyl hydrolases of family 16 with a jellyroll β-sandwich fold structure. The present paper reviews the industrial application and protein engineering of microbial β-glucanases in the last decades and forecasts the research prospects of microbial β-glucanases.
Amino Acid Sequence ; Glycoside Hydrolases ; Models, Molecular ; Protein Engineering ; Substrate Specificity

Objective To observe the nutritional status of patients with Parkinson's disease (PD) and investigate the influences of some non-motor symptoms in nutritional status. Methods One hundred and nineteen PD patients, admitted to our hospital from May 2016 to May 2017, and followed up for a long time, were chosen in our study. General clinical data, as age, gender, disease history, and Hoehn-Yahr (H-Y) grading, were collected, and the nutritional status of the patients was evaluated by subject global assessment (SGA) and patient generated subject global assessment (PG-SGA). According to the PG-SGA results, groups of grading A (well-nourished status), grading B (moderately malnourished status), and grading C (severely malnourished status) were divided. The proportion of each type of symptoms appeared in each group was compared and the risk factors of malnutrition in PD patients were determined by Logistics regression analysis. Results Among the 119 PD patients, 86 (72.26％) were classified as grading A, 33 (27.73％) as grading B, and none as grading C. There were statistically significant differences in body mass, body mass index, PG-SGA total scores and H-Y grading between patients from grading A and grading B groups (P<0.05). Among the 82 grading A patients, the common symptoms were dry mouth (n=49, 56.98％), constipation (n=43, 50.00％) and abnormal taste (n=25, 29.07％); among the 33 grading B patients, the common symptoms were dry mouth (n=23, 69.70％), constipation (n=21, 63.64％) and abnormal taste (n=18, 52.90％); there were statistically significant differences in the frequencies of anorexia, abnormal taste or no taste, bad smell, early satiety, pain and dietary intake between patients from the two groups (P<0.05). Anorexia (OR=10.76, 95％CI:2.00-57.894, P=0.006), early satiety (OR=4.539, 95％CI: 1.633-11.491, P=0.003), and pain (OR=4.608, 95％CI: 1.038-20.452, P=0.045) were independent risk factors for malnutrition in PD patients. Conclusion PD patients are prone to malnutrition; when patients have anorexia, early satiety and pain symptoms, timely intervention should be given or nutritional support should be further strengthened.

Objective To find out the cerebral blood flow velocity and its relationship with attention and execu?tion function in patients with major depressive episode. Methods A total of 70 patients with major depressive episode and 65 healthy controls were included. The 24 items Hamilton depression scale (HAMD-24) was adopted for patients' depressive symptoms assessment. The Cancellation Test (CT) and Wisconsin Card Sorting Test (WCST) were adopted for cognitive function assessment. And the blood flow velocity of cerebral arteries were detected by transcranial Doppler ul?trasonography (TCD). Results Compared with the controls, the patients showed significantly slower average blood flow ve?locity in basilar artery, left middle cerebral artery, right middle cerebral artery, left anterior cerebral artery and right ante?rior cerebral artery (P<0.05). Compared with those in the controls, the net score of each stage and the total net score of CT were significantly lower in the patients, while the total number of responses, response errors, perseverative errors and the necessary response number to complete the first category of WCST were significantly higher (P<0.01). The blood flow velocity in the cerebral basilar artery (r=0.25), left middle cerebral artery (r=0.46), right middle cerebral artery (r=0.25) and right posterior cerebral artery (r=0.26) showed positive correlations with total net score of CT (P<0.05), and the cere?bral artery average blood flow velocity showed negative correlations with the total number of responses, response errors and perseverative errors of WCST in the patients (P<0.05). Conclusions Compared with healthy controls, patients with major depressive episode suffer from lower average cerebral artery blood flow velocity, bad attention and executive func?tion. The change of average cerebral artery blood flow velocity may be responsible for impaired cognitive function in epi?sode major depression patients.

Objective To study the effectiveness of comprehensive rehabilitative therapy with paraplegic spinal cord injury (SCI) patients. Methods Forty patients with SCI-caused paraplegia were divided randomly into a rehabilitation group and a control group. The routine treatment was administered to both groups, and comprehensive rehabilitative therapy was also administered to patients in the rehabilitation group as an addition. Functional assessments and somatosensory evoked potential (SEP) tests were performed with the two groups pre-treatment and 30 days post-treatment. Results The rehabilitation group achieved, on average, greater improvement in their physical functions , as demonstrated by their much higher scores in terms of the Barthel index than those of the control group ( P