The traditional theory of "the spleen governs the dispersion of essence" refers to the spleen's pivotal role in distributing refined nutrients throughout the body. In traditional Chinese medicine （TCM）， lipids are categorized under "gaozhi （膏脂）"， and their transportation and metabolism via apolipoproteins are believed to be closely related to the spleen's dispersing function. The liver， which synthesizes apolipoproteins， is functionally linked to the spleen system in TCM. Impaired dispersion of essence by the spleen and disrupted transportation of gaozhi constitute the pathological mechanism of dyslipidemia due to spleen deficiency. Strengthening the spleen and resolving dampness is the core therapeutic principle. From the perspective of modern medicine， this may involve promoting hepatic functional recovery related to lipid metabolism， thereby enhancing lipid processing and reducing the levels of abnormally accumulated lipids in the bloodstream.

Post-stroke urinary incontinence (PSUI) is a common complication in patients with stroke, affecting at least one-third of patients with stroke and seriously affecting their quality of life and rehabilitation process. This article reviews the pathogenesis, risk factors, and treatment of PSUI.

Homeostasis ; Lysosomes/metabolism* ; Lipid Metabolism ; Glycosphingolipids/metabolism*

The unilateral biportal endoscopic technique is defined as posterior unilateral of two small incision with established percutaneous observation channel and endoscopic observation channel in monitoring field. The operation tools were placed within the channel for each operation inside and outside vertebral canal. The characteristics of dual channel intervention make this technology different from coaxial endoscopic technology. This technique has a clear vision for flexible and convenient operation with the advantages of relatively simple surgical instrument requirements. In recent years, the use of unilateral dual channel endoscopic surgery in treating spinal diseases was gradually increasing, especially in the removal of nucleus including lumbar intervertebral disc protrusion and lumbar spinal stenosis disease decompression, and in endoscopic space-occupying lesions such as vertebral fusion and spinal canal between inside and outside. It was also applied in cervical and thoracic diseases with good clinical effects. Its advantages include less surgical trauma and faster recovery process. In addition, it has a large surgical field of vision under the microscope for easy identification of structures and surgery and with relatively gentle learning curve. Thus, it is conducive to beginners' mastery. However, complications such as nerve injury and postoperative lower limb numbness are still frequently reported. Some factors have to be considered, including insufficient understanding of the new technology, the local anatomy of the dual-channel endoscope, the operation of the spinal canal under the microscope. The successful application of the technique in treating various lumbar diseases needs understanding the operation process of the technique and local anatomy under the microscope.

Objective:To develop a unilateral biportal endoscopic technique and investigate the clinical efficacy of unilateral biportal endoscopic technique in the treatment of lumbar disc herniation and lumbar spinal stenosis.Methods:Between July 2018 and June 2019, 60 patients with lumbar disc herniation or spinal stenosis were treated by unilateral biportal endoscopic technique. According to the inclusion and exclusion criteria, 51 patients were included in the study. There were 25 cases of prolapsed lumbar disc herniation, 26 cases of degenerative lumbar spinal stenosis, all of which were treated with posterior lumbar decompression by unilateral biportal endoscopic laminectomy, and contralateral stealth decompression by unilateral approach was performed on the patients with bilateral stenosis. Endoscopic interbody fusion and percutaneous pedicle screw fixation were performed in 5 patients with instability. Operation time, length of incision, hospital stay and complications were recorded. Visual analogue scale (VAS) for low back pain and leg pain, Oswestry dysfunction index (ODI) and the modified Macnab scale were used to evaluate the clinical efficacy.Results:All operations were completed successfully, and no cases were transferred to open surgery. The operative time was 70.29±19.55 min (44-151 min), while the length of incision was 1.79±0.34 cm (1.4-3.0 cm). Postoperative CT suggested complete decompression with intact contralateral structure. All patients got out of bed 1-3 d after surgery, and the postoperative hospital stay was 3.49±2.76 d (1-14 d). The postoperative follow-up time was 13.59±2.80 months (10-21 months). Forty-six patients returned to work or normal activities within 3 weeks and 5 patients with interbody fusion returned to normal activities within 4 weeks. According to the modified Macnab criteria, the final outcome was excellent in 43 cases, good in 6 cases, and fair in 2 cases. There were 3 cases of dural sac tear during operation and 2 cases of transient numbness of lower limbs after surgery and they all recovered after conservative treatment. The VAS score of low back pain of 26 patients with lumbar spinal stenosis was reduced from 6.69±1.44 before surgery to 3.27±1.43 at postoperative 1 month, 2.69±1.57 at postoperative 3 months, 2.31±1.16 at postoperative 6 months and 2.23±1.28 at the last follow-up, respectively, and the difference was statistically significant ( F=128.534, P<0.005). The VAS scoreof leg pain was reduced from 6.77±1.34 before surgery to 3.27±1.37 at postoperative 1 month, 2.88±1.48 at postoperative 3 months, 2.85±1.52 at postoperative 6 months and 2.54±1.53 at the last follow-up, and the difference was statistically significant ( F=146.951, P<0.005). The ODI score was reduced from 64.18%±8.23% before surgery to 37.53%±4.45% at postoperative 1 month, 27.51%±3.83% at postoperative 3 months, 19.91%±5.27% at postoperative 6 months and 6.84%±2.74% at the last follow-up, and the difference was statistically significant ( F=783.966, P<0.005). The VAS score of low back pain of 25 patients with lumbar disc herniation was reduced from 5.60±1.38 before surgery to 3.04±1.54 at postoperative 1 month, 2.84±1.75 at postoperative 3 months, 3.12±1.86 at postoperative 6 months and 3.44±1.69 at the last follow-up, respectively, and the difference was statistically significant ( F=22.357, P<0.005). The VAS scoreof leg pain was reduced from 5.48±1.45 before surgery to 2.88±1.64 at postoperative 1 month, 2.52±1.83 at postoperative 3 months, 2.76±1.83 at postoperative 6 months and 3.00±1.92 at the last follow-up, and the difference was statistically significant ( F=29.445, P<0.005). The ODI score was reduced from 53.59%±6.87% before surgery to 32.46%±3.78% at postoperative 1 month, 23.39%±2.78% at postoperative 3 months, 16.49%±3.49% at postoperative 6 months and 7.23%±3.15% at the last follow-up, and the difference was statistically significant ( F=790.985, P<0.005). Conclusion:Unilateral biportal endoscopic technique has the advantages of clear and wide field of vision, large operating space, relatively simple surgical instrument need and convenient and flexible operation procedure. It has excellent clinical effects in the treatment of lumbar disc herniation and lumbar spinal stenosis.

Objective:To explore the expression levels of aldehyde dehydrogenase 1 (ALDH1) and ATP-binding cassette superfamily G member 2 (ABCG2) in non-small cell lung cancer (NSCLC) tissues, and to observe the correlations of their expressions with clinicopathological features and prognosis of patients.Methods:The tissue samples from 82 patients with NSCLC who underwent surgical treatment from January 2016 to November 2018 in Taishan Hospital of Shandong Province were selected. The expressions of ALDH1 and ABCG2 in fresh cancer tissues and adjacent tissues were detected by immunohistochemistry. χ 2 test was used to analyze the correlations of ALDH1 and ABCG2 expressions with clinicopathological features of patients; Pearson method was used to analyze the correlation between ALDH1 and ABCG2; Kaplan-Meier method and log-rank test was used to analyze the correlations of ALDH1 and ABCG2 expressions with the overall survival (OS) of patients; Cox proportional hazards model was used to analyze the influencing factors of OS. Results:The positive expression rates of ALDH1 and ABCG2 in NSCLC tissues were higher than those in adjacent tissues, and the differences were statistically significant [60.98% (50/82) vs. 12.19% (10/82), 51.22% (42/82) vs. 3.66% (3/82), χ 2 values were 42.051 and 46.582, both P < 0.01]. ALDH1 expression was positively correlated with ABCG2 expression in NSCLC tissues (P < 0.05). The positive expression rates of ALDH1 and ABCG2 in patients with TNM stage Ⅱ-Ⅲ were higher than those in patients with stage Ⅰ [70.00% (35/50) vs. 46.88% (15/32), 60.00% (30/50) vs. 37.50% (12/32), both P < 0.05], and the positive expression rates of ALDH1 and ABCG2 in patients with lymph node metastasis were higher than those in patients without metastasis [75.00% (27/36) vs. 50.00% (23/46), 66.67% (24/36) vs. 39.13% (18/46), both P < 0.05]. The median follow-up time was 22.5 months, a total of 2 patients were lost to follow-up, and the median OS time was 25.4 months. The OS rate of ALDH1-positive patients was lower than that of ALDH1-negative patients (χ 2 = 5.124, P = 0.031), and the OS rate of ABCG2-positive patients was lower than that of ABCG2-negative patients (χ 2 = 6.969, P = 0.008). Multivariate Cox analysis showed that age (OR = 1.241, 95% CI 1.021-2.535, P = 0.045), lymph node metastasis (OR = 1.521, 95% CI 1.102-4.281, P = 0.012), TNM stage (OR = 2.104, 95% CI 1.289-6.150, P = 0.018), ALDH1 (OR = 2.435, 95% CI 1.214-8.654, P = 0.001), and ABCG2 (OR = 1.503, 95% CI 1.148-5.696, P = 0.021) were independent influencing factors of OS for patients with NSCLC. Conclusions:The expressions of ALDH1 and ABCG2 in NSCLC tissues are increased, and they are associated with lymph node metastasis and TNM staging. The OS rate in ALDH1-positive and ABCG2-positive patients is low. ALDH1 and ABCG2 may be prognostic markers for NSCLC.

Objective To construct a new biomechanical testing system of in vitro spine based on LabVIEW and six-axis robot arm and conduct preliminary reliability studies, so as to make preparation for further studies on coupled motion testing. Methods By programming on LabVIEW platform, using Ethernet and Profibus to communicate the data of the robot arm with PC in real time, the displacement control and load control were realized, and the end position and rotation angle of the robot arm were read in real time. Through the force/torque sensor and data acquisition (DAQ), board DAQ, processing, storage and other functions were acquired. Using the digital micrometer and special stationary fixture, the 6-direction translation accuracy test was completed, and the data were analyzed. The flexion, extension, lateral flexion and rotation were applied on sheep spine specimen to draw the load-displacement curve, analyze and compare the experimental result, and verify the effectiveness of the biomechanical platform. Results A biomechanical test system with high precision for spine in vitro based on LabVIEW and 6-axis robot arm was developed and established, of which the average translational precision was 8.1 μm and the average translational accuracy was 56.7 μm. The program of control, data acquisition, data processing and storage were written, and the biomechanical test of the sheep spine was completed effectively. Conclusions This biomechanical test system based on Labview and 6-axis robot arm could complete the conventional three-dimensional spinal motion test with high precision and be used to conduct coupled motion test research in the next step.

A change in the metabolic flux of glucose from mitochondrial oxidative phosphorylation (OXPHOS) to aerobic glycolysis is regarded as one hallmark of cancer. However, the mechanisms underlying the metabolic switch between aerobic glycolysis and OXPHOS are unclear. Here we show that the M2 isoform of pyruvate kinase (PKM2), one of the rate-limiting enzymes in glycolysis, interacts with mitofusin 2 (MFN2), a key regulator of mitochondrial fusion, to promote mitochondrial fusion and OXPHOS, and attenuate glycolysis. mTOR increases the PKM2:MFN2 interaction by phosphorylating MFN2 and thereby modulates the effect of PKM2:MFN2 on glycolysis, mitochondrial fusion and OXPHOS. Thus, an mTOR-MFN2-PKM2 signaling axis couples glycolysis and OXPHOS to modulate cancer cell growth.

Objective To evaluate the efficacy of the sleeve type guide growth rod sliding automatically with the growth of piglet spine.Methods Fourteen 4-month-old piglets were randomly divided into growth rod group (n=8) and control group (n=6).Animals in growth rod group were implanted with the sleeve type guide growth rod system through the small incision of the tho racodorsal.Whereas ones in control group were just expose the bilateral lamina.On the day of surgery,6 and 12 weeks of postoperation,all piglets accepted the spinal X-ray examination.Measured the mean height of T8,T9 vertebral bodies,the average height of T7-8,T8-9,Tg-10 discs and the mean length of the rods through X-ray film.Spinal MRI was measured 3 months after the operation.The morphological changes of the plate were observed after HE staining.The morphological changes of the nucleus pulposus cells were observed and the thickness of the growth plate and the length of the growth bar were measured.Results Two piglets of growth rod group did not complete the experiment,1 piglet died of aspiration due to anesthesia resuscitation,and 1 piglet had infection after operation.The average height of T8,T9 vertebral bodies of the piglets in the growth rod group on the day after surgery and 3 months after operation was 18.26±3.26 mm and 27.15±4.18 mm,respectively,and the difference was statistically significant (F=16.868,P=0.002).Similarly,the mean height of T7-8,T8-9,Tg-10 discs of the piglets in growth rod group on the day after surgery and 3 months of postoperation was 1.79±0.24 mm and 2.14±0.23 mm,respectively,and the difference was statistically significant (F=6.455,P=0.029).The average height of T8,T9 vertebral bodies in the control group on the day after surgery and 3 months after operation was 17.86±3.50 mm and 28.63±4.45 mm,respectively,and the difference was statistically significant (F=21.654,P=0.001).Similarly,the mean height of T7-8,Ts-9,Tg-10 discs in control group at the day after surgery and 3 months of postoperation was 1.78±0.27 mm and 2.17±0.30 mm,respectively,the difference was statistically significant (F=5.928,P=0.035).There was no statistically significant difference in average height between T8 and T9 vertebral bodies in growth rod group and the control group at 3 months after operation (F=0.352,P=0.566).Similarly,There was no statistically significant difference in average height of T7-8、Ts-9、Tg-10 discs in growth rod group and the control group at 3 months after operation (F=0.053,P=0.823).The average sliding length of the growth rod in growth rod was 65.74 mm.Furthermore,growth plate chondrocytes and nucleus pulposus cells in EG and SG,all showed that the cells were arranged in order,the cell volume was large,the shape was round and the cytoplasm was rich.Simultaneously,there was no significant difference between the two groups in growth plate chondrocytes (P ＞ 0.05).Conclusion The sleeve type guiding growing rod can automatically slip to extend due to the driving force of young pig's spine growth,without obvious effects on the normal growth of piglet's spine.

The mechanistic target of rapamycin (mTOR) signaling pathway regulates many metabolic and physiological processes in different organs or tissues. Dysregulation of mTOR signaling has been implicated in many human diseases including obesity, diabetes, cancer, fatty liver diseases, and neuronal disorders. Here we review recent progress in understanding how mTORC1 (mTOR complex 1) signaling regulates lipid metabolism in the liver.
Animals ; Humans ; Lipid Metabolism ; Lipogenesis ; Liver ; cytology ; metabolism ; pathology ; Mechanistic Target of Rapamycin Complex 1 ; metabolism ; Signal Transduction