Occipitocervical fusion (OCF) is used to treat the instability of the cranio-cervical junction due to various reasons (such as trauma, rheumatoid arthritis, infection, tumor, congenital malformations and degeneration). A satisfactory fusion rate can be obtained and the stability of the occipital neck can be reconstructed by OCF. Dysphagia is one of the most common complications after OCF, which seriously affects the quality of life of patients after surgery. This article mainly focuses on the evaluation and prediction methods of dysphagia after OCF, and summarizes related research in the past 16 years, and provides guidance and direction for how to predict the occurrence of dysphagia during OCF and the evaluation of postoperative dysphagia. The evaluation of dysphagia is mainly conducted using the Bazaz dysphagia score, swallowing quality of life scale (SWAL-QOL) and eating assessment tool-10 (EAT-10) score. However, the clinical prediction of dysphagia is mainly based on the changes of cervical curvature parameters (O-C 2 angle, O-EA angle, Oc-Ax angle, PI angle). At present, there are many methods for clinical evaluation and prediction of dysphagia, but the best evaluation method is still uncertain. We reviews the evaluation and prediction methods of postoperative dysphagia of OCF, showing that the Bazaz dysphagia score, SWAL-QOL score and EAT-10 score scale are suitable for evaluating postoperative dysphagia of OCF. During OCF operation, adjustment of O-C 2 Angle >-5°, O-EA Angle >100°, Oc-Ax Angle >65°, and increase of postoperative PI Angle from preoperative PI Angle (that is, dPI Angle) ≥0° can reduce the probability of dysphagia to a certain extent.

Background and aims:Liver cirrhosis is a complex disease that may result in increased morbidity and mortality following bariatric surgery(BS).This study aimed to explore the outcome of BS in patients with unexpected cirrhosis,focusing on postoperative complications and the progression of liver disease. Methods:A retrospective study of bariatric patients with cirrhosis from four centers in China between 2016 and 2023 was conducted,with follow-up for one year after BS.The primary outcome was the safety of BS in patients with unexpected cirrhosis,while the secondary outcome was the metabolic efficacy of BS in this group postoperatively. Results:A total of 47 patients met the study criteria,including 46 cases of Child-Pugh class A cirrhosis and 1 case of Child-Pugh B.Pathological examination confirmed nodular cirrhosis in 21 patients(44.68％),pseudolobule formation in 1 patient(2.13％),lipedema degeneration with inflammatory cell infiltration in 3 patients(6.38％),and chronic hepatitis in 1 patient(2.13％).The average percentage of total weight loss was 29.73±6.53％at one year postoperatively.During the 30-day postoperative period,the complication rate was 6.38％,which included portal vein thrombosis,gastrointestinal bleeding,and intra-abdominal infection.Moreover,no cases of liver decompensation or mortality were reported during the follow-up period.The remission rates of comorbidities among 41 patients one year after surgery were as fol-lows:dyslipidemia 100％,type 2 diabetes 82.61％,hypertension 84.62％,and obstructive sleep apnea syndrome 85.71％. Conclusions:BS can be safely performed in patients with unexpected cirrhosis in the compensated stage of liver disease,with low postoperative morbidity and no mortality observed during one-year follow-up.

Objective: To investigate the neural connections between Shenmen (HT7)-heart and the brain by observing the tracing viruses co-labeled brain nuclear groups after injection of the pseudorabies viruses (PRV), the reverse transsynaptic virus tracer carrying different fluorescent protein genes, into the myocardium and Shenmen (HT7) point, respectively.Methods: Pseudorabies virus 531 (PRV531) carrying the green fluorescent protein gene and pseudorabies virus 724 (PRV724) carrying the red fluorescent protein gene were injected into the left ventricular wall and Shenmen (HT7) point area of the left forelimb of six C57BL/6 mice, respectively. After 120 h, whole brain tissue was extracted under 4％ paraformaldehyde perfusion to prepare brain sections. Neuronal co-labeling with the tracing viruses was observed under fluorescence microscopy. Results: Co-labeled signals from the mouse ventricular wall and Shenmen (HT7) point region were found at all levels of the mouse central nervous areas, such as the cerebral cortex, hypothalamus, midbrain, pons, and medulla oblongata. The number of co-labeled neurons was higher in the primary motor area, the hypothalamic paraventricular nucleus, the subceruleus nucleus, and the paramedian reticular nucleus. Conclusion: There is a neural connection between Shenmen (HT7), the heart, and the brain, which may be most closely related to the autonomic nervous system.

Objective:To explore the correlation between hepatitis B virus (HBV) infection and deep infection after spinal internal fixation surgery and analysis of pathogenic bacteria.Methods:One hundred and eighty-four patients who underwent spinal internal fixation with HBV infection in Xiaogan First People′s Hospital of Hubei Province from January 2013 to January 2019 were selected as the HBV infection group, and 184 patients who underwent spinal internal fixation with non-HBV infection were selected as the non-HBV infection group. The incidence of deep infection and the distribution of pathogenic bacteria were compared between 2 groups. The influencing factors of postoperative deep infection and HBV reactivation in patients with HBV infection were analyzed by single factor analysis and multi-factor Logistics regression analysis.Results:The incidence of deep infection after spinal internal fixation surgery in HBV infection group was significantly higher than that in non-HBV infection group: 19.57% (36/184) vs. 9.24% (17/184), and there was statistical difference ( P<0.01). The pathogenic bacteria of deep infection in both groups were mainly acinetobacter bausinensis, klebsiella pneumoniae, staphylococcus aureus, staphylococcus epidermidis. There was no statistically significant difference in the distribution of pathogenic bacteria between 2 groups ( P>0.05). The deep infection incidences in age ≥ 65 years, operation time ≥ 3 h, intraoperative blood loss ≥ 1000 ml, CD 4+/CD 8+<1.4, total lymphocyte count<0.7 × 10 9/L, liver function abnormalities (AST>40 U/L or ALT>50 U/L), HBV-DNA (+) patients with HBV infection were significantly higher: 27.16%(22/81) vs. 13.59%(14/103), 28.77%(21/73) vs. 13.51%(15/111), 31.15%(19/61) vs. 13.82%(17/123), 29.69%(19/64) vs. 14.17%(17/120), 27.78% (20/72) vs. 14.29%(16/112), 7/18 vs. 17.47%(29/166), 30.43%(21/69) vs. 13.04%(15/115), and there were statistical differences ( P<0.05 or <0.01). Multivariate Logistic regression analysis showed that intraoperative blood loss (≥ 1 000 ml), CD 4+/CD 8+(<1.4), total lymphocyte count (<0.7 × 10 9/L), and HBV-DNA (+) were independent risk factors for deep infection after spinal internal fixation in patients with HBV infection ( P<0.01 or <0.05). The HBV reactivation incidence in age ≥ 65 years, operation time ≥ 3 h, intraoperative blood loss ≥ 1 000 ml, liver function abnormalities, HBV-DNA (+), postoperative deep infection patients with HBV infection were significantly increased: 33.33% (27/81) vs. 18.45% (19/103), 34.25% (25/73) vs. 18.92% (21/111), 34.43% (21/61) vs. 20.33% (25/123), 8/18 vs. 22.89% (38/166), 34.78% (24/69) vs. 19.13% (22/115), 41.67% (15/36) vs. 20.95% (31/148), and there were statistical differences ( P<0.05). Multivariate Logistic regression analysis showed that intraoperative blood loss (≥ 1 000 ml), HBV-DNA (+) and postoperative deep infection were independent risk factors for HBV reactivation after spinal internal fixation in patients with HBV infection ( P<0.05 or <0.01). Conclusions:HBV infection significantly increases the incidence of deep infection after spinal internal fixation surgery, and the independent risk factors are intraoperative blood loss (≥1 000 ml), CD 4+/CD 8+ (<1.4), total lymphocyte count (<0.7 × 10 9/L), and HBV-DNA (+). Spinal internal fixation surgery can cause HBV reactivation, and its independent risk factors are intraoperative blood loss (≥ 1 000 ml), HBV-DNA (+) and postoperative deep infection.

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.
Anilides/pharmacology* ; Cerebral Hemorrhage/drug therapy* ; Hematoma/drug therapy* ; Humans ; Macrophages ; Microglia ; Neuroprotection ; PPAR gamma ; Retinoid X Receptor alpha

Endogenously eliminating the hematoma is a favorable strategy in addressing intracerebral hemorrhage (ICH). This study sought to determine the role of retinoid X receptor-α (RXR-α) in the context of hematoma absorption after ICH. Our results showed that pharmacologically activating RXR-α with bexarotene significantly accelerated hematoma clearance and alleviated neurological dysfunction after ICH. RXR-α was expressed in microglia/macrophages, neurons, and astrocytes. Mechanistically, bexarotene promoted the nuclear translocation of RXR-α and PPAR-γ, as well as reducing neuroinflammation by modulating microglia/macrophage reprograming from the M1 into the M2 phenotype. Furthermore, all the beneficial effects of RXR-α in ICH were reversed by the PPAR-γ inhibitor GW9662. In conclusion, the pharmacological activation of RXR-α confers robust neuroprotection against ICH by accelerating hematoma clearance and repolarizing microglia/macrophages towards the M2 phenotype through PPAR-γ-related mechanisms. Our data support the notion that RXR-α might be a promising therapeutic target for ICH.

Tripartite motif (TRIM) family proteins are important effectors of innate immunity against viral infections. Here we identified TRIM35 as a regulator of TRAF3 activation. Deficiency in or inhibition of TRIM35 suppressed the production of type I interferon (IFN) in response to viral infection. Trim35-deficient mice were more susceptible to influenza A virus (IAV) infection than were wild-type mice. TRIM35 promoted the RIG-I-mediated signaling by catalyzing Lys63-linked polyubiquitination of TRAF3 and the subsequent formation of a signaling complex with VISA and TBK1. IAV PB2 polymerase countered the innate antiviral immune response by impeding the Lys63-linked polyubiquitination and activation of TRAF3. TRIM35 mediated Lys48-linked polyubiquitination and proteasomal degradation of IAV PB2, thereby antagonizing its suppression of TRAF3 activation. Our in vitro and in vivo findings thus reveal novel roles of TRIM35, through catalyzing Lys63- or Lys48-linked polyubiquitination, in RIG-I antiviral immunity and mechanism of defense against IAV infection.
A549 Cells ; Animals ; Apoptosis Regulatory Proteins/immunology* ; DEAD Box Protein 58/immunology* ; Dogs ; HEK293 Cells ; Humans ; Influenza A Virus, H1N1 Subtype/immunology* ; Madin Darby Canine Kidney Cells ; Mice ; Mice, Knockout ; Orthomyxoviridae Infections/pathology* ; Proteolysis ; RAW 264.7 Cells ; Signal Transduction/immunology* ; THP-1 Cells ; TNF Receptor-Associated Factor 3/immunology* ; Ubiquitination/immunology* ; Viral Proteins/immunology*

BACKGROUND:There is a lack of the research concerning the biocompatibility of nano-hydroxyapatite/polyphenylene sulfide (nHA/PPS) composites.OBJECTIVE:To evaluate the in vivo biocompatibility of nHA/PPS composites based on the completed research in vitro.METHODS:Systemic toxicity test:Sprague-Dawley rats were given the intraperitoneal injection of nHA/PPS extract or normal saline.The general situation,body mass and the histological changes of the liver and kidney were observed at 72 hours after injection.Delayed type hypersensitivity test:nHA/PPS extract or normal saline was injected subcutaneously into the back of the rats.Afterwards,skin irritation symptoms were observed at 72 hours.Local reaction experiment:nHA/PPS composites and polyethylene were respectively implanted into the back of the rats.The pathological changes of the implanted materials and their surrounding tissues were observed at 15 and 30 days after implantation.RESULTS AND CONCLUSION:(1) The rats were in good situation after nHA/PPS injection;the body mass increased steadily,which showed no significant difference from the control group (P ＜ 0.05);the morphology and color of the liver and kidney were normal,and the systemic toxicity of the composite materials was normal according to the degree of toxicity classification.(2) There were no obvious skin irritation symptoms after the subcutaneous injection of nHA/PPS composites,and the primary irritation index was less than 0.4,suggesting a low hypersensitivity.After implantation of nHA/PPS composites,there was no obvious degradation,absorption and rejection,and both the degree of inflammatory reaction (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) and the thickness of fibrous capsule (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) revealed the good biocompatibility of the composites.These results suggest that the nHA/PPS composites hold an excellent biocompatibility in vivo.

AIM:To investigate the serum miRNA-101 expression level in patients with newly diagnosed type 2 diabetes mellitus (T2DM),and to evaluate the clinical implications of miRNA-101 expression level variation.METHODS:qRT-PCR was used to determine the serum miRNA-101 expression level.Pearson correlation analysis was performed to observe the relationship between two variables.Multiple stepwise linear regression analysis was used to assess the association of serum miRNA-101 level and other parameters.RESULTS:Serum miRNA-101 level in patients with newly diagnosed T2DM was significantly higher than that in control subjects (P ＜ 0.05).The serum level of miRNA-101 was positively correlated with the glycosylated hemoglobin A1c (HbA1c,P ＜0.05).Multiple linear regression analysis revealed that the circulating miRNA-101 was in significant positive correlation with HbA1c (P ＜ 0.05) after adjustment for age,sex and body weight.CONCLUSION:Enhanced circulating miRNA-101 level in newly diagnosed T2DM patients may be associated with elevation of HbA1 c.

Objective The electrophysiological parameters of atrioventricular conduction function in patients with atrioventricular nodal reentry tachycardia (AVNRT)were analyzed,and to explore the effect of different ablation endpoints on atrioventricular conduction function in patients with AVNRT.Methods 96 cases with AVNRT under-went radiofrequency catheter ablation (RFCA)of slow conduction pathway.According to whether the slow pathway eliminated,the patients were divided into the slow pathway disappeared group and slow tracks remaining group.Preop-erative and postoperative intracavitary electrophysiological examination and atrioventricular function data were recor-ded,including before and after radiofrequency ablation of bundle of HIS,PA,AH,HV interval,atrioventricular prequel venturi point(AVN -WKB),ventriculoatrial retrograde venturi point(VAN -WKB),atrioventricular node prequel effective refractory period(AVB -WKB).Patients were followed up by telephone for a year.Then,a comparative anal-ysis of preoperative and postoperative was done.Results RFCA of AVNRT patients with atrioventricular node pre-quel time effect:RFCA and preoperative ratio,after his bundle electrogram PA,ah,HV interval had no significant changes(P >0.05).Effect of RFCA surgery on patients with AVNRT refractory atrioventricular node prequel:com-pared with RFCA before surgery,postoperative slow pathway disappear fast pathway shortening of effective refractory period[preoperative(287.5 ±46.2)ms,postoperative(260.2 ±55.6)ms,t =2.901,P =0.005],slow pathway effec-tive refractory period[disappear preoperative(243.3 ±43.2),postoperative(0.0 ±0.0)ms,t =43.290,P =0.000], AV node Wenckebach point in advance before operation[(261.3 ±44.3)ms,postoperative(293.2 ±46.2)ms,t =3.828,P =0.000];group after slow pathway to improve fast pathway effective refractory period without obvious change (P >0.05 ),the slow pathway effective refractory period in high concentration [preoperative (242.2 ± 42.8)ms,postoperative(281.2 ±41.3 )ms,t =3.879,P =0.000〗,atrioventricular node Wenckebach point in advance before operation[(261.5 ±43.5)ms,postoperative(291.3 ±46.5)ms,t =2.769,P =0.007〗.Comparison between groups,after slow pathway disappeared group fast pathway effective refractory period was significantly shorter in the slow diameter improvement group,but between the two groups in the atrioventricular node Wenckebach point differences was not statistically significant(P >0.05).There was no recurrence in the follow -up after a year of slow path loss and slow pathway.Conclusion RFCA caused by slow pathway to disappear or modified two slow pathway ablation right AVNRT patients atrioventricular time had no effect,but all the atrioventricular junction the prequel's point advance.The atrioventricular node slow pathway disappear fast and effective pathway refractory period short-ened,slow pathway improved the slow pathway effective refractory period.RFCA surgery done by the slow pathway dis-appeared or slow pathway ablation is effective in patients with AVNRT,and there was no significant recurrence rate in both groups within 1 year.