BACKGROUND:With the rapid development of minimally invasive spinal surgery and enhanced recovery after surgery,endoscopic intervertebral fusion techniques have gradually emerged and been widely used in clinical practice in recent years. OBJECTIVE:To analyze the early clinical efficacy of uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases. METHODS:135 patients with lumbar degenerative diseases treated by uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the Suining Central Hospital from October 2020 to December 2021 were enrolled in this study.There were 59 males and 76 females,aged 47-79 years.The lower limb and lumbar pain was evaluated by visual analog scale and lumbar function was assessed by Oswestry disability index before the operation,1 week,1,and 6 months after the operation,and at the end of follow-up.The overall pain recovery of patients was evaluated by the scoring criteria for low back pain surgery of Spine Group of Chinese Orthopedic Association and the lumbar physiological curvature and intervertebral fusion were evaluated on lumbar lateral X-ray preoperatively and at the end of follow-up. RESULTS AND CONCLUSION:(1)The 135 patients were followed up for(17.8±3.0)months after surgery.There was 1 case of endplate injury,1 case of cerebrospinal fluid leakage,1 case of nerve root injury,1 case of intervertebral cage subsidence and displacement,1 case of chronic infection,and 1 case of pedicle screw rupture.The complication rate was 5.2%.(2)The lumbar visual analog scale score and Oswestry disability index significantly decreased in the waist and lower limbs at various time points postoperatively compared with those preoperatively in 135 patients(P<0.05).The scoring criteria for low back pain surgery of the Spine Group of the Chinese Orthopedic Association were significantly better at the last follow-up than that preoperatively in 135 patients(P<0.05).(3)At the last follow-up,there was no significant difference in physiological curvature of lumbar vertebra as compared with that preoperatively in 135 patients(P>0.05),with a fusion rate of 95.8%.(4)It is concluded that uniaxial spinal endoscopic intervertebral fusion combined with posterior percutaneous pedicle screw fixation in the treatment of lumbar degenerative diseases has shown satisfactory early clinical results and is a highly safe minimally invasive spinal surgery mode.

Objective:To investigate the hemodynamic characteristics of the lenticulostriate artery (LSA) in cerebral small vessel disease (CSVD) patients with recent small subcortical infarcts (RSSI) using 7.0 T two-dimensional phase-contrast MRI (2D PC-MRI).Methods:A total of 16 CSVD patients with deep RSSI and 18 age-and sex-matched healthy controls (HC group) meeting the inclusion criteria were prospectively recruited from July 2021 to June 2022 at Beijing Tiantan Hospital, Capital Medical University. All participants underwent 7.0 T 2D PC-MRI with imaging plane localized at the level of the basal ganglia. A self-developed software (Flow analyze V1.0) was used to analyze the hemodynamic status of bilateral LSAs. The hemodynamic parameters including the maximum velocity (V max), average velocity (V avg), pulsatility index (PI), and resistance index (RI) of LSAs were calculated and recorded. As for the CSVD cases, the symptomatic side was defined as the ipsilateral side to the RSSI (CSVD symptomatic-side group), and the contralateral side was defined as the asymptomatic side (CSVD asymptomatic-side group). ANOVA or Mann-Whitney U test was used to compare hemodynamic parameters among the three groups. Results:Significant differences in V max, V avg and PI were observed among the CSVD symptomatic-side group, CSVD asymptomatic-side group, and HC group ( F=5.22, P=0.006; F=3.47, P=0.033; F=4.37, P=0.014). Specifically, CSVD symptomatic-side group showed significantly reduced V max ( P=0.004) and V avg ( P=0.017), and increased PI ( P=0.007) compared to the HC group. The CSVD asymptomatic-side group showed decreased V max ( P=0.026) and increased PI ( P=0.039) compared to the HC group. Conclusions:Hemodynamic assessment based on 7.0 T 2D PC-MRI reveal that CSVD patients with RSSI decrease blood flow velocity and increase arterial PI of LSAs. These findings suggest potential corresponding hemodynamic mechanisms associated with CSVD with RSSI lesions.

Objective:To investigate the impact of excessive fluoride exposure on the expression profile of microRNA (miRNA) in mouse testes, and elucidate the reproductive toxicity mechanism of fluoride.Methods:A total of 24 8-week-old C57BL/6J male mice weighing (23 ± 1) g were randomly divided into a control group [0 mg/L sodium fluoride (NaF)] and a fluoride exposure group (50 mg/L NaF) using a random number table method, with 12 mice in each group. After 90 days of treatment, the mice were anesthetized and euthanized. Sperm samples were collected to assess their quantity, viability, and deformity rate. Additionally, testicular tissue was stained with hematoxylin-eosin (HE). RNA was extracted from testicular tissue, and high-throughput sequencing technology was employed to analyze the effect of fluoride on the expression profile of mouse testicular miRNA. Deferentially expressed miRNA was screened and its target genes were predicted, and functional annotation and pathway enrichment analysis were performed. Real-time fluorescence quantitative PCR (qRT-PCR) was used to verify the expression level of deferentially expressed miRNA.Results:Compared with the control group [number of sperm: (11.30 ± 2.52) × 10 6/ml; viability rate: (90.07 ± 4.34)%; deformity rate: (15.49 ± 3.25)%], the number of sperm of mice exposed to fluoride [(9.01 ± 2.25) × 10 6/ml] and the viability rate [(84.34 ± 4.21)%] decreased ( P = 0.041, 0.003), while deformity rate [(22.36 ± 6.51)%] increased ( P = 0.003). Furthermore, in the fluoride exposure group, the interstitial distance of testis increased, the number of sperm in the spermatogenic tubule decreased, and the cell arrangement was disordered. Through sequencing, 34 deferentially expressed miRNAs were identified in the testes of mice exposed to fluoride. According to qRT-PCR verification, compared with the control group, the expression levels of mmu-miR-29b-1-5p ( P < 0.001), mmu-miR-196a-5p ( P = 0.002), and mmu-miR-196b-5p ( P = 0.031) in the testes of mice exposed to fluoride were significantly increased, and the expression levels of mmu-let-7a-2-3p ( P < 0.001) and mmu-miR-466n-3p ( P = 0.018) were significantly decreased, consistent with the sequencing results. By KEGG enrichment of deferentially expressed miRNA target genes, it was found that fluoride exposure could change the axon guidance signal pathway, olfactory transduction pathway, neuroactive ligand-receptor interaction pathway, and lysosome signal pathway, etc., in mouse testes. Conclusions:Fluoride exposure may induce testicular injury by altering the expression profile of miRNA in the testes and by mediating the post-transcriptional regulatory signal pathway. Testicular miRNA may be a potential biomarker of fluoride reproductive toxicity, which may provide a new idea and perspective for exploring the mechanism of fluoride poisoning.

Objective:To investigate the risk factors of cardiovascular and cerebrovascular diseases in young patients with hyperhomocysteinemia.Methods:A total of 260 patients younger than 45 years old who received treatment at the Department of Emergency, Seventh Medical Center, Chinese PLA General Hospital from January 2018 to January 2019 were included in this study. Among these patients, 126 patients with serum homocysteine levels ≥ 15.0 μmol/L were included in the hyperhomocysteinemia group, and 134 patients with serum homocysteine levels < 15.0 μmol/L were included in the control group. Height, body weight, body mass index, blood pressure, homocysteine, fasting blood glucose, blood uric acid, total cholesterol, triacylglycerol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and N-terminal B-type natriuretic peptide were determined in each group. Changes in risk factors of cardiovascular and cerebrovascular diseases were compared between the hyperhomocysteinemia and control groups.Results:There were significant differences in body mass index [(26.42 ± 3.54) kg/m 2vs. (22.14 ± 3.22) kg/m 2, t = 10.21, P = 0.016], blood uric acid [(308.71 ± 78.44) μmol/L vs. (285.05 ± 92.09) μmol/L, t = 2.22, P = 0.027], the incidence of coronary heart disease (73/126 vs. 61/134, χ2 = 4.00, P = 0.045) and the incidence of stroke (19/126 vs. 6/134, χ2 = 8.39, P = 0.004) between the hyperhomocysteinemia and control groups. There were no significant differences in fasting blood glucose, blood lipid level, N-terminal B-type natriuretic peptide, and the incidences of diabetes mellitus and hypertension between the two groups (all P > 0.05). Conclusion:The related risk factors of cardiovascular and cerebrovascular diseases increase in young patients with hyperhomocysteinemia. The incidences of coronary heart disease and stroke are very high, and therefore timely intervention should be carried out.

ObjectiveTo summarize the current situation, hot spots and frontiers of the application of functional near-infrared spectroscopy (fNIRS) in rehabilitation in recent ten years. MethodsLiterature related to the application of fNIRS in rehabilitation was retrieved from the core collection of Web of Science from January, 2003 to December, 2022, and the visualized analysis was performed by CiteSpace 6.1.R6 software. ResultsA total of 828 literatures were included. The annual publication volume was on the rise. The most prolific author was LI Zengyong. The most published country was the United States. And the most published institution was Karolinska Institute. Hot keywords included children, stroke, activation, quality of life, cerebral palsy, etc. The hot keywords of bursting intensity included early intervention, speech perception, cerebral palsy, plasticity, spinal cord injury, physical therapy, visual feedback, Parkinson's disease, etc. Cluster analysis suggested that in the past decade, the application of fNIRS in rehabilitation involved physical therapy, speech therapy, occupational therapy, pre-rehabilitation and early rehabilitation of surgery, mainly focusing on six themes: the rehabilitation of motor dysfunction after stroke, cognitive impairment, hearing and speech dysfunction, children with cerebral palsy, cardiopulmonary function monitoring in severe diseases and long-term nursing of chronic diseases. Among them, the application of fNIRS in neurological rehabilitation of stroke patients occupied a large proportion, which might be the current research hot spot and trend. ConclusionThe application of fNIRS in rehabilitation is on the rise. In the future, more attention should be paid to the application of fNIRS in the study of the injury and recovery mechanism of neurological disorders, especially the effects of various rehabilitation interventions on cortical plasticity and the etiology of neurological disorders.

Objective:To explore the association between dietary patterns and the incidence of type 2 diabetes mellitus(T2DM), so as to provide insights for the prevention and management of T2DM.Methods:Participants were recruited from the " The Tianjin Chronic Inflammation and Health Cohort Study(TCLSIH)" cohort study from 2013 to 2018, who had completed the modified semiquantitative food frequency questionnaire(FFQ) and blood glucose testing( n=26 425), free of cardiovascular disease, cancer, or diabetes at baseline. The relevant information collected includes food frequency, blood glucose concentration, and other confounding factors. In this study, the correlation between dietary patterns and T2DM was tested using Cox proportional risk regression model, and the gender stratification analysis and body mass index stratification analysis of different gender groups were carried out. All statistical analysis was performed using SAS 9.3 software. Results:The age of all participants was (41.0±11.5)years, and the cumulative incidence was 3.84% for T2DM. The cumulative incidence of T2DM in male population was 5.29%, while that in female population was 2.16%. There were significant differences in the incidence of T2DM among different genders( P <0.001). The multivariable-adjusted hazard ratios( HR) and corresponding 95% CI of T2DM across the plant-based dietary pattern score were 1.09(95% CI 0.91-1.31), 0.80(95% CI 0.66-0.97), and 0.76(95% CI 0.62-0.94; Ptrend =0.010). Moreover, no statistically significant differences were observed between animal and traditional northern Chinese diets with the incidence of T2DM. Conclusions:The plant-based dietary patterns were associated with substantially lower risk of developing T2DM, and there were no significant association between animal and traditional northern Chinese dietary patterns with T2DM. Plant-based dietary patterns characterized by a variety of fruit, leeks, onions, seaweed may be beneficial to the prevention and control of T2DM.

Cardiac disease is the general term of diseases, caused by damage to the structure or abnormal function of the heart. Its morbidity and mortality have remained high, seriously threatening the lives and health of people. The tyrosine kinase receptor ErbB2 (also known as EGFR2 or HER2) was originally discovered for its oncogenic activity, however, recent studies have found that ErbB2 have protective effects in various heart diseases. Therefore, this article reviews the role and underlying mechanism of ErbB2 in myocardial infarction, myocardial ischemia/reperfusion injury, cardiac hypertrophy, heart failure, doxorubicin-induced cardiotoxic injury and diabetic cardiomyopathy. Furthermore, this article also preliminarily discusses the application prospects, limitations and development directions of ErbB2 as a clinical diagnostic marker and therapeutic target for heart disease.

Pulmonary hypertension is a progressive disease characterized by pulmonary vascular remodeling and eventually develops into right heart failure, which seriously affects the quality of life and safety of patients. Traditional drug therapy can alleviate disease progression, but the prognosis is poor.Mesenchymal stem cells have been shown to be effective in experimental pulmonary hypertension and right heart failure, which is an important research direction in the future.In this paper, the research progress of mesenchymal stem cells in pulmonary hypertension and right heart failure is reviewed.

Objective:To summarize the strategies and effects of portal vein reconstruction after liver transplantation in recipients with diffuse portal vein thrombosis(PVT).Methods:Clinical data were retrospectively reviewed for 10 PVT patients undergoing liver transplantation(LT)from January 2014 to June 2019. There were 8 males and 2 females with a age of (50.7±10.1)years. The follow-up period was (66.3±25.8)months. Diameter of portal vein anastomosis, diameter and flow velocity of portal vein and presence of ascites were evaluated by color Doppler ultrasound. And computed tomography(CT)was employed for assessing the presence of esophagogastric varices. And patency of portal vein blood flow, therapeutic outcomes of portal hypertension and survival status of recipients were evaluated.Results:Among 7 patients with diffuse PVT without enlarged collaterals, cavoportal hemitransposition( n=6) and renoportal anastomosis( n=1) were performed.Ascites subsided gradually and minimal ascites( n=4) perdisted.Variceal bleeding did not recur within 6 months.As of December 2021, portal vein blood flow remained unobstructed in 4 recipients and 3 patients died.One case of inferior vena cava thrombosis and renal injury at 3 months post operation died of multiple organ failuer at 8 months post-operation.Another patient died of recurrent hepatocarcinoma at 11 months post-operation.Another case died of stroke at 44 months post-operation.Among 3 patients with diffuse PVT complicated with enlarged collaterals, there were right gastric vein to portal vein anastomosis( n=1), gastric coronary vein to portal vein anastomosis( n=1) and pericholedochalvarix to portal anastomosis( n=1). Ascites gradually subsided within 2 months post-operation.Portal vein anastomosis thrombosis was formed 1 month after operation and racanalizated after anticogulation and thrombosis therapies in patient with gastric coronary vein to portal vein anastomosis.Upper gastroinstestinal hemorrhage occurred 36 months after operation and was relieved by endoscopic ligation and sclerotherapy.Blood flow of portal vein was unobstructed in patients with right gastric vein and pericholedochalvarix to portal vein anastomosis.During the last follow-up, velocity of portal vein surpassed 20 cm/s and liver function remained normal in 7 survivors. Conclusions:For patients with complex PVT, portal vein reconstruction may ensure sufficient portal vein blood flow of graft. After operation, portal hypertension disappears and liver function normalizes.

Objective:To investigate the expression levels of interferon-α receptor (IFNAR), interferon-stimulated gene factor 3(ISGF3), double-stranded RNA-activated protein kinase(PKR) and ribonuclease L (RNase L) in patients with chronic hepatitis B (CHB) treated with interferon.Methods:From July 2014 to June 2017, 41 treatment naive CHB patients were enrolled in the Department of Infectious Diseases, First Affiliated Hospital of Nanchang University. Eighteen patients were treated with polyethylene glycol interferon α-2b, and 23 patients were treated with conventional interferon. The mRNA and protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in peripheral blood mononuclear cells (PBMC) were detected by reverse transcription polymerase chain reaction and Western blot, respectively. The differences of these molecular expression levels in PBMC between the effective and ineffective groups were compared. The data were analyzed by t test. Results:After 24 weeks of treatment, 25 cases were effective, while 16 cases were ineffective. At four weeks of treatment, the mRNA expression levels of IFNAR1, IFNAR2 and PKR in PBMC of the effective group were 0.748±0.129, 1.169±0.125 and 1.047±0.091, respectively, which were all higher than those in the ineffective group (0.591±0.021, 0.689±0.059 and 0.791±0.033, respectively). The differences were statistically significant ( t=-4.304, 16.482 and -5.346, respectively, all P<0.01). The mRNA expressions of ISGF3 and RNase L in PBMC of the effective group were 0.739±0.159 and 0.780±0.140, respectively, while those in the ineffective group were 0.690±0.035 and 0.733±0.122, respectively, which were not significantly different ( t=-0.160 and -1.443, respectively, both P>0.05). The mRNA expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L at baseline, week eight, 12 and 24 of treatment in the effective group were all higher than those in the ineffective group (all P<0.01). The protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in the effective group were all higher than those in the ineffective group (all P<0.01). Conclusion:After interferon treatment, the mRNA and protein expression levels of IFNAR1, IFNAR2, ISGF3, PKR and RNase L in PBMC of CHB patients are all increased, especially IFNAR2 and PKR levels increase in the early stage of treatment (four weeks).