BACKGROUND:Stand-alone oblique lateral interbody fusion has a high rate of complications of fusion segment sink.Oblique lateral interbody fusion with posterior fixation can provide stable support,but intraoperative position changes and double incisions weaken the advantages of this technique.Oblique lateral interbody fusion combined with lateral plate fixation can achieve one-stage decompression in the same incision,while the lateral internal fixation provides stable support. OBJECTIVE:To analyze the short-term efficacy of oblique lateral interbody fusion combined with lateral plate fixation in the treatment of single-level lumbar degenerative disease. METHODS:The clinical data of 34 patients with single-level lumbar degenerative disease treated with oblique lateral interbody fusion combined with lateral plate fixation were collected from May 2020 to October 2022.Among them,14 were males and 20 were females aged from 41 to 72 years at the mean age of(58.6±9.9)years.There were 11 cases of lumbar spondylolisthesis(Ⅰ°),7 cases of lumbar disc herniation with segmental instability,and 16 cases of lumbar spinal stenosis.Operation time,blood loss,and complications were recorded.Visual analog scale scores of lumbago,radiative pain of both lower limbs,and Oswestry disability index scores were evaluated before surgery,3 months after surgery,and the last follow-up.Dural sac cross-sectional area,intervertebral height,and intervertebral fusion were measured and observed. RESULTS AND CONCLUSION:(1)The 34 patients were followed up for 14-36 months,with an average of(21.3±5.2)months.(2)The operation time ranged from 50 to 92 minutes,with an average of(68.5±11.1)minutes.Intraoperative blood loss was 50-170 mL,with an average of(71.6±25.3)mL.(3)Compared with the preoperative results,the visual analog scale scores and Oswestry disability index scores were significantly decreased at 3 months after surgery and at the last follow-up(P<0.001),and the maximum Oswestry disability index scores were improved by nearly 50％.(4)Bone fusion was achieved in all patients during half-year follow-up.The overall complication rate was 21％(7/34),including 1 case of plate displacement,3 cases of cage subsidence,1 case of psoas weakness,and 2 cases of anterior thigh pain.(5)It is concluded that oblique lateral interbody fusion combined with lateral plate fixation for the treatment of lumbar degenerative diseases has the characteristics of less blood loss,short operation time,rapid postoperative recovery,and significant short-term clinical efficacy with the stable support to a certain extent.The long-term curative effect needs further follow-up observation.

Objective : To investigate the role and related molecular mechanisms of vitamin D3 ( VitD3 ) in airway inflammation and oxidative stress response in bronchial asthma mice． Methods : Twenty-eight female C57BL/6 mice were randomly divided into a control group ( Ctrl) and a model group．The model group mice were sensitized using ovalbumin ( OVA) to establish an asthma model，and were further divided into an asthma (Asthma) group， VitD3 treatment (Asthma + VitD3 ) group，and Forkhead Box O1 (FOXO1) inhibitor AS1842856 treatment (Asth- ma + AS) group．Lung resistance (LR) changes were measured in each group of mice．Enzyme-linked immunosor- bent assay (ELISA) was used to detect the levels of tumor necrosis factor-alpha (TNF-α) ，interleukin ( IL) -1 β , and IL-18 in bronchoalveolar lavage fluid ( BALF) ．Western blot was used to determine the expression levels of FOXO1，NOD-like receptor pyrin domain containing 3 (NLRP3) ，Caspase-1，and apoptosis-associated speck-like protein (ASC) in lung tissue. Results : ompared to the Ctrl group mice，LR increased in the Asthma group mice (P＜0. 01) ．Compared to the Asthma group，LR decreased in the Asthma + VitD3 and Asthma + AS group mice (P＜0. 05) ，with no significant difference in LR change between Asthma + VitD3 and Asthma + AS group mice. Compared to the Ctrl group，TNF-α , IL-1 β , and IL-18 levels in BALF，as well as NLRP3，Caspase-1，and ASC protein expression levels in lung tissue，increased in the Asthma，Asthma + VitD3 ，and Asthma + AS group mice (P＜0. 05) ．Compared to the Asthma group，the Asthma + VitD3 and Asthma + AS group mice showed decreased levels of the mentioned inflammatory factors in BALF and reduced protein expression of NLRP3，FOXO1，Caspase- 1，and ASC in lung tissue (P＜0. 05) ．Compared to the Asthma + VitD3 group，the Asthma + AS group showed in- creased FOXO1 protein expression (P ＜0. 05) ，with no statistically significant differences in the other measured indicators． Conclusion VitD3 can alleviate asthma symptoms induced by OVA in mice，improve the degree of air- way inflammation，and reduce oxidative stress levels．The mechanism may be related to the downregulation of the FOXO1/ NLRP3 axis.

Objective:To observe the effect of metformin on intestinal metabolites and its protective effect on lung injury in an elderly sepsis rat.Methods:SD rats were fed at the Animal Laboratory Center of Zhengzhou University, fourteen elderly SD rats were randomly divided into three groups: sham surgery (age-Sham, AgS group, n=4), cecal ligation and perforation induced sepsis (age-Cecal ligation and puncture, AgCLP group, n=5), and oral administration of metformin (100 mg/kg) after 1 h of CLP treatment (age-Metformin, AgMET group, n=5). Collected rat feces 24 h after modeling, and analyzed the composition and inter group differences of metabolites in the feces using liquid chromatography tandem mass spectrometry non targeted metabolomics. Collected rat lung tissues and detected the expression levels of inflammation related genes and pathological changes in the tissue. The visualization of metabolic changes between groups were presented using orthogonal partial least squares discriminant analysis, heatmaps, and unsupervised principal component analysis, respectively. MetaboAnalyst 3.0 was used to evaluate the Pathway analysis of metabolites, and this software was based on the KEGG database and the human metabolome database. Results:The expressions of CCL4 ( F=203.00, P<0.001), CXCL1( F=65.69, P<0.001), IL-6 ( F=38.94, P<0.002), TNF-α ( F=14.85, P=0.005) between two groups of rats were significantly different (all P<0.05). However, there was no significant difference in CCL2 expression between AgCLP group and AgMET group. Furthermore, compared with the AgS group, the relative intensities of 17 metabolites such as 7-methylxanthine, N-Arachidonylglycine and Manolide in AgCLP group were significantly increased, whereas the 9 metabolites such as Phenazone, Gly-Phe and Valyproline were significantly decreased, and metformin treatment could reverse these changes of the above metabolites. Correlation analysis showed that the IL-6 and TNF-α levels were positively correlated with the relative strength of 7-Methylxanthine, N-Arachidonylglycine and other metabolites, but negatively correlated with the Phenazone and Gly-Phe. CCL4 and CXCL1 were positively correlated with Manolide, but negatively correlated with Valyproline. Conclusion:The results of this study showed that metformin improved sepsis induced acute lung injury and regulates the host intestinal metabolites, which might provide a potential and effective treatment for elderly sepsis induced acute lung injury.

Inhibiting the death receptor 3(DR3)signaling pathway in group 3 innate lymphoid cells(ILC3s)pre-sents a promising approach for promoting mucosal repair in individuals with ulcerative colitis(UC).Paeoniflorin,a prominent component of Paeonia lactiflora Pall.,has demonstrated the ability to restore barrier function in UC mice,but the precise mechanism remains unclear.In this study,we aimed to delve into whether paeoniflorin may promote intestinal mucosal repair in chronic colitis by inhibiting DR3 signaling in ILC3s.C57BL/6 mice were subjected to random allocation into 7 distinct groups,namely the control group,the 2％dextran sodium sulfate(DSS)group,the paeoniflorin groups(25,50,and 100 mg/kg),the anti-tumor necrosis factor-like ligand 1A(anti-TL1A)antibody group,and the IgG group.We detected the expression of DR3 signaling pathway proteins and the proportion of ILC3s in the mouse colon using Western blot and flow cytometry,respectively.Meanwhile,DR3-overexpressing MNK-3 cells and 2％ DSS-induced Rag1-/-mice were used for verification.The results showed that paeoniflorin alleviated DSS-induced chronic colitis and repaired the intestinal mucosal barrier.Simultaneously,paeoniflorin inhibited the DR3 signaling pathway in ILC3s and regulated the content of cytokines(interleukin-17A,granulocyte-macrophage colony stimulating factor,and interleukin-22).Alternatively,paeoniflorin directly inhibited the DR3 signaling pathway in ILC3s to repair mucosal damage indepen-dently of the adaptive immune system.We additionally confirmed that paeoniflorin-conditioned me-dium(CM)restored the expression of tight junctions in Caco-2 cells via coculture.In conclusion,paeoniflorin ameliorates chronic colitis by enhancing the intestinal barrier in an ILC3-dependent manner,and its mechanism is associated with the inhibition of the DR3 signaling pathway.

Objective To report and analyze the clinical characteristics of kidney transplant recipients(KTRs)combined with novel coronavirus Omicron variant strain infection of novel coronavirus(SARS-CoV-2),and to investigate the possible factors affecting the serum creatinine change.Methods The patients under-going allogeneic kidney transplantation and complicating Omicron variant strain infection in this hospital from October 2022 to December 2023 were retrospectively observed.Their clinical data,basic complications and prognosis,etc.were collected and analyzed.The possible factors affecting the serum creatinine change were an-alyzed.Results Among the 114 cases of KTRs combined with Omicron variant strain infection included in this study,there were 90 cases(78.9％)in the home management group(group A),18 cases(15.8％)in the non-intensive isolation ward group(group B)and 6 cases(5.3％)in the ICU group(group C).The most common symptoms were in turn fever(90.4％),fatigue(65.8％)and cough(61.4％),the clinical manifesta-tions were mainly upper respiratory tract infection symptoms.The overall mortality rate was 2.6％(3/114),moreover the dead patients all were in the group C.The number of basic comorbidities in the group C was higher than that in the group B and group A(P＜0.05).The patients were re-divided into 33 cases(28.9％)in the creatinine increase group(group D),71 cases(62.3％)in the creatinine unchange group(group E)and 10 cases(8.8％)in the creatinine decrease group(group F).The patients in the F group were the patients with mild and moderate Omicron variant strain infection in the group A,and a larger proportions of the pa-tients in the group D and group F discontinued or reduced the calcineurin inhibitor(CNI)type drugs than in the group E.Conclusion The hazard of Omicron variant strains to KTRs has been greatly reduced compared with previous other variant strains.Realizing the immune balance between anti-infection and anti-rejection is the effective measure for preventing renal function damage in KTRs.

Objective To verify the biomechanical stability of oblique lateral interbody fusion ( OLIF) combinedwith different fixation methods for treating degenerative lumbar scoliosis (DLS) by three-dimensional (3D) finite element analysis. Methods The L1-S1 3D finite element DLS model ( Model 1) was established, and then the OLIF (L2-5) at 3 contiguous levels of fusion and its combination with different internal fixation methods were simulated, namely, stand-alone OLIF model ( Model 2), vertebral screw fixation model ( Model 3), unilateral pedicle screw fixation model (Model 4) and bilateral pedicle screw fixation model (Model 5) were established,respectively. Under upright, flexion, extension, lateral bending and axial rotation states, range of motion (ROM) of fusion segments, as well as cage stress, internal fixation stress, and stress distribution were recorded and analyzed. Results Under six motion states, the overall ROM of fusion segments in Models 2-5 was smaller than that of Model 1. Compared with Model 1, the overall ROM reduction of Model 3 and Model 4 was larger than that of Model 2 and smaller than that of Model 5. Under flexion and extension, the overall ROM reduction of Model 4 and Model 5 was basically equal. Under left and right lateral bending, the overall ROM reduction of Model 3 and Model 5 was basically equal. Under all motion states, the peak stress of Model 3 and Model 4 fusion cage was larger than that of Model 5 and smaller than that of Model 2. The peak stresses of L2-3, L3-4 and L4-5 fusion cages in Model 3 increased by 5. 52% , 10. 96% and 7. 99% respectively compared with Model 5 under left lateral bending, and the peak stresses of L2-3, L3-4 and L4-5 fusion cages in Model 4 increased by 8. 70% , 7. 00% and 6. 99% respectively under flexion. Under all motion states, the peak stress of screw rod in Model 5 was smaller than that of Model 3 and Model 4, and the peak stresses of screw rod in Models 3-5 were the smallest in upright state. Conclusions The OLIF with unilateral pedicle screw fixation or vertebral screw fixation can provide favorable biomechanical stability of the fusion segment. The results provide some references for clinical application of OLIF technology in the treatment of DLS.

Objective:To investigate the efficacy of the novel bone cement bridging screw system combined with percutaneous vertebroplasty (PVP) in the treatment of symptomatic chronic osteoporotic vertebral fractures (SCOVF) with intravertebral vacuum cleft (IVC).Methods:A retrospective case series study was used to analyze the clinical data of 27 patients with SCOVF admitted to Honghui Hospital affiliated to Xi′an Jiaotong University from August 2016 to August 2018, including 6 males and 21 females; age 69-88 years [(75.2±4.9)years]. All patients were treated by the novel bone cement bridging screw combined with PVP. The operation time, amount of bone cement injected and occurrence of bone cement leakage or displacement were recorded. The vertebral body index (VBI), vertebral body angle (VBA), two-segment Cobb angle (BCA), visual analogue score (VAS) and Oswestry disability index (ODI) were compared preoperatively, at day 1 after operation and at the last follow-up. The results of the MOS 36-item short form health survey (SF-36) and Odom′s criteria were compared preoperatively and at the last follow-up to evaluate pain relief and neurological recovery.Results:All patients were followed up for 36-48 months [(40.2±3.7)months]. The operation time was 37-70 minutes [(49.6±10.8)minutes], with the amount of bone cement injected for 3-6 ml [(34.7±0.9)ml]. Intraoperative bone cement leakage occurred in 4 patients (15%), among which 3 had lateral vertebral leakage and 1 superior intervertebral disc leakage. There was no bone cement displacement during the postoperative period to the last follow-up. The VBI, VBA, BCA, VAS and ODI were (43.1±5.9)%, (21.0±2.6)°, (45.0±6.3)°, 7.6 (7.0, 8.0)points, (79.9±7.6)% preoperatively, were (78.7±2.6)%, (12.7±2.1)°, (26.1±4.7)°, 3.2 (3.0, 4.0)points, (50.0±9.3)% at day 1 after operation, and were (78.0±2.3)%, (13.2±2.4)°, (27.1±4.9)°, 2.0 (2.0, 2.0)points, (22.9±5.1)% at the last follow-up. There were significant differences in above five measures at day 1 after operation and at the final follow-up in comparison with the preoperative values (all P<0.05), and their values measured at day 1 after operation and at the final follow-up were also significantly different (all P<0.05). The SF-36 score in physical function, role physical, body pain, vitality and social function was 45.2 (40.0, 50.0)points, 28.7 (25.0, 50.0)points, 15.9 (10.0, 22.0)points, 48.3 (40.0, 60.0)points, 29.2 (25.0, 37.5)points preoperatively, significantly different from 78.0 (75.0, 85.0)points, 75.0 (75.0, 75.0)points, 68.1 (64.0, 74.0)points, 62.0 (55.0, 70.0)points, 34.7 (25.0, 37.5)points at the last follow-up (all P<0.05). However, there were no significant differences in SF-36 before operation and at the last follow-up in dimensions of general health, emotional function and mental health (all P>0.05). According to Odom′s criteria, 19 patients were graded as excellent, 7 good, 1 fair and 0 poor, with an excellent and good rate of 96%. Conclusion:For SCOVF patients with IVC, the novel bone cement bridging screw system combined with PVP has advantages of no displacement of bone cement, satisfactory fixation, significant pain relief and satisfactory functional recovery.

Gesture imitation is a common rehabilitation strategy in limb rehabilitation training. In traditional rehabilitation training, patients need to complete training actions under the guidance of rehabilitation physicians. However, due to the limited resources of the hospital, it cannot meet the training and guidance needs of all patients. In this paper, we proposed a following control method based on Kinect and NAO robot for the gesture imitation task in rehabilitation training. The method realized the joint angles mapping from Kinect coordination to NAO robot coordination through inverse kinematics algorithm. Aiming at the deflection angle estimation problem of the elbow joint, a virtual space plane was constructed and realized the accurate estimation of deflection angle. Finally, a comparative experiment for deflection angle of the elbow joint angle was conducted. The experimental results showed that the root mean square error of the angle estimation value of this method in right elbow transverse deflection and vertical deflection directions was 2.734° and 2.159°, respectively. It demonstrates that the method can follow the human movement in real time and stably using the NAO robot to show the rehabilitation training program for patients.
Humans ; Upper Extremity ; Robotics/methods* ; Stroke Rehabilitation/methods* ; Elbow Joint ; Physical Therapy Modalities ; Biomechanical Phenomena

Objective:To explore the application value of scenario simulation teaching combined with two-way evaluation in standardized training of pediatric nursing.Methods:A total of 34 trainees who received standardized training of pediatric nursing in The First Affiliated Hospital of Air Force Medical University from March 2018 to March 2019 were selected as the control group, and another 42 trainees from April 2019 to July 2020 were selected as the study group. The control group used traditional teaching, and the study group used scenario simulation teaching combined with two-way evaluation. Theoretical examination and scenario simulation exercise examination were used to assess the theoretical knowledge and clinical practice ability of the trainees, and questionnaire survey was used to evaluate the satisfaction of the trainees with the teaching effect. SPSS 22.0 was used for t-test. Results:The scores of theoretical examination[(95.12±6.24) vs. (91.05±5.12)] and scenario simulation exercise examination (nursing practice skill operation ability, ability to combine theory and practice, clinical thinking and judgment ability, emergency handling ability, communication ability, humanistic care and professional learning ability, and work attitude) of the trainees in the study group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The satisfaction evaluation of the trainees in the study group with the teaching effect was higher than that in the control group, and the difference was statistically significant ( P<0.001). Conclusion:Scenario simulation teaching combined with two-way evaluation can improve the theoretical knowledge, clinical practice ability, and teaching satisfaction of pediatric nursing trainees.

The conventional analytical methods cannot effectively adjust for time-varying confounding that occur in a longitudinal study and thus cannot correctly estimate the causal effects. This study explains the necessity of precisely controlling time-varying confounding and outlines G methods, including parametric g-formula, inverse probability of weighting, and G-estimation. We also compare the methods above to provide a reference for correctly estimating causal effects in the longitudinal study.