Objective To explore the feasibility and short-term clinical efficacy of single segment thora-columbar tuberculosis treated with one-stage posterior approach lamina-sparing decompression.Methods A total of 11 patients with single segment thoracolumbar tuberculosis who underwent one-stage posterior ap-proach preservation of vertebral plate lesion removal,bone graft fusion,and internal fixation treatment in this hospital from September 2021 to June 2022 were selected.C-reactive protein(CRP)and erythrocyte sedimen-tation rate(ESR)were monitored to evaluate tuberculosis bacteremia and activity control,visual analogue scale(VAS)score and Oswestry disability index(ODI)were followed up to evaluate the improvement of clin-ical function,and the American Spinal Injury Association(ASIA)injury scale was used to evaluate neurologi-cal function,and the correction of kyphosis was followed up.Results All 11 patients were fully followed up.The average surgical duration is(270.91±45.98)minutes,and the average surgical bleeding is(522.72± 194.11)mL.During the follow-up period,none of the 11 patients experienced tuberculosis recurrence,and all 11 patients achieved bone graft fusion.The fusion time was 6-9 months after surgery with an average of(7.36±1.12)months.Two patients with preoperative nerve damage recovered after surgery.During the fol-low-up period,11 patients did not experience any complications related to surgery.The average CRP,ESR,ODI score,and VAS score of postoperative patients decreased compared to preoperative levels,and further de-creased at 12 months after surgery;The patient's kyphosis caused by thoracolumbar tuberculosis was correc-ted,and no obvious angle loss was found at the last follow-up(P＞0.05).Conclusion One-stage posterior ap-proach lamina-sparing decompression is a safe and effective method for treating single segment thoracolumbar tuberculosis.

BackgroundCognitive impairment， a core clinical feature of schizophrenia， is considered to be associated with the aberrant functional connectivity in patients with schizophrenia， whereas previous studies on the characteristics of cognitive impairment in patients with chronic schizophrenia and its correlation with interhemispheric voxel-mirrored homotopic connectivity （VMHC） are somewhat inadequate. ObjectiveTo investigate the characteristics of cognitive impairment in patients with chronic schizophrenia who are clinically stable on their antipsychotic medication， and to explore its correlation with resting-state interhemispheric VMHC， so as to provide theoretical basis for the identification of neurobiological mechanism possibly responsible for cognitive impairment in chronic schizophrenia. MethodsA total of 15 patients with chronic schizophrenia who met the criteria of the International Classification of Diseases， tenth edition （ICD-10） and hospitalized in Suzhou Guangji Hospital from January 2021 to December 2022 were included. Another 15 healthy community-dwelling individuals were concurrently recruited. All participants were requested to complete the Positive and Negative Symptom Scale （PANSS）， Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） and resting-state functional Magnetic Resonance Imaging （rs-fMRI） scanning to evaluate their mental symptoms， cognitive function and interhemispheric functional connectivity. The rs-fMRI data were analyzed with VMHC method. Then Pearson correlation analysis was performed to examine the correlation between VMHC values of regions of interest and scores of RBANS and PANSS within patient group. ResultsPatient group obtained lower scores than control group based on RBANS immediate memory， visuospatial/constructional， language， attention and total score， with statistically significant differences （t=-2.853， -2.107， -5.576， -7.108， -5.354， P<0.05 or 0.01）. The VMHC values of left superior occipital gyrus （t=-5.188， P<0.05） and right cuneus （t=-5.188， P<0.05） in patient group were lower than those in control group， with statistical difference. Correlation analysis denoted that the VMHC values of left superior occipital gyrus （r=0.612， P=0.015） and right cuneus （r=0.612， P=0.015） were positively correlated with visuospatial/constructional index score in RBANS. ConclusionThe resting-state VMHC is abnormal in left superior occipital gyrus and right cuneus of patients with chronic schizophrenia， and yields a correlation with the visuospatial/constructional performance of patients. ［Funded by Suzhou Science and Technology Development Plan Project （number， SKJYD2021131； SKJY2021143）］

Objective:To investigate the level of serum vascular endothelial growth factor (VEGF) and its correlation with clinical symptoms in patients with first-episode drug-naive schizophrenia patients of different genders.Methods:From January 2016 to October 2019, a total of 81 first-episode drug-naive schizophrenia patients(patient group, 41 male, 40 female) and 64 healthy controls (control group, 40 male, 24 female) were included in this study.The serum level of VEGF was detected with flow cytometric bear array (CBA). Positive and negative symptom scale (PANSS) was used to evaluate the relevant clinical symptoms of patients.SPSS 22.0 software was used for statistical analysis.Independent sample t-test and nonparametric test were used for comparison between groups.The relationship between VEGF and clinical variables was analyzed by Pearson correlation analysis and Spearman correlation analysis. Results:The level of serum VEGF in the patient group was significantly lower than that in the control group(148.08(75.89, 208.61)pg/mL, 179.94(99.14, 318.41)pg/mL, Z=-2.20, P=0.028). The total PANSS score((82.71±17.30), (73.45±16.36), t=2.473, P=0.016)and cognitive score((7.88±3.36), (6.23±2.81), t=2.402, P=0.019) in male patients were higher than those in female patients.There was a negative correlation between VEGF level and PANSS negative symptom score in the patient group( r=-0.228, P=0.041), as well as significant negtive correlation between VEGF level and cognitive score in male patients( r=-0.425, P=0.007). Conclusion:The level of serum VEGF is reduced in first-episode patients with schizophrenia, which influences their negative symptom. Moreover, the decline in serum VEGF level is implicated in cognitive impairments in male patients with first-episode schizophrenia.

Objective: To study the rapid antidepressant effects of cannabioiol(CBD) on depression-like mice and its possible mechanism. Methods: Chronic restraint was used to establish a mouse depression model. The test mice were divided into 5 groups: normal control group, model group, positive control group, CBD low-dose group (25 mg/kg) and CBD high-dose group(50 mg/kg). The mice in each group were given intragastric administration one hour before the behavioral experiment. After the behavioral experiment, the hippocampus and prefrontal cortex specimens were collected, and brain-derived neurotrophic factor(BDNF), postsynaptic density protein 95(PSD-95), synaptophysin(SYP) and target of rapamycin(mTOR) were tested by ELISA. Results: Compared with the model group, the central area activity distance percentage, the central area activity time percentage and total distance increased in the open field experiment in the CBD low-dose group. Compared with the model group, the percentage of immobility in the forced swimming experiment in the low-dose CBD group decreased. The ELISA test results showed that CBD could rapidly increase the concentration of BDNF and PSD-95 in the prefrontal cortex, as well as the concentration of SYP and mTOR in the hippocampus and prefrontal cortex. Conclusion CBD can rapidly improve the behavioral performance of depression-like mice, and rapidly up-regulate the level of BDNF and synaptic protein in the hippocampus or prefrontal cortex.

BACKGROUND: Lung cancer incidence in Macao increases gradually, smoking is one of the important high risk factors. The purpose of this study is to observe the detection rate of lung cancer and nodules in long-term smoking Macao individuals. METHODS: We recruited eligible Macao residents by publicity, all subjects were arranged to receive low-dose computed tomography screening. Image features of lung nodules were analyzed by radiologist. For suspicious lung cancer, multiple disciplinary team (MDT) was arranged. RESULTS: A total of 291 were adopted, 10 lung cancers were detected, the detection rate of lung cancer was 3.44% (95%CI: 2.78%-4.01%), all were males. There were 5 adenocarcinoma patients, each 2 squamous-cell carcinoma and small cell lung carcinoma patients; 1 adenosquamous cancer patient. Among 10 lung cancers, 40% had stage 1 disease. The detection rate of lung nodules was 72.9% (95%CI: 67.8%-78.0%); The number of suspicious lung nodules were 44, and the detection rate was 15.1% (95%CI: 11.0%-19.2%). There was no significant differences in the lung cancer detection rate between the single and multiple lung nodule groups (P>0.05). There were 168 subjects in the <6 mm solid lung nodule (SN) and <5 mm no-solid lung nodule (NSN) group and no lung cancer was found, 44 subjects in the ≥6 mm SN and ≥5 mm NSN group. All 9 lung cancer patients were detected in this group. The detection rate of lung cancer was higher than that of the <6 mm SN and <5 mm NSN group (P<0.05). CONCLUSIONS There are high detection rate of lung cancer and lung nodule in the long-term smoking individuals. The lung cancer rate increases when the lung nodule size is larger than 6 mm in SN and 5 mm in NSN. Adenocarcinoma is the major type in the smokers' lung cancers. We suggest long-term smokers should join in the future lung cancer screening trial in Macao. Female lung cancer screening should be established different standard.

BACKGROUND:There are many positive effects by activation of peroxisome proliferator activated receptor-gamma (PPARγ) signal pathway in cardiovascular system. Angiotensin II is closely related with myocardial fibrosis, however, there are few articles demonstrating that the activation of PPARγsignal pathway can weaken the expression of angiotensin II to improve the radiation-induced heart injury. OBJECTIVE:To evaluate the effect of angiotensin II type 1 receptor in the rat model of radiation-induced heart injury after PPARγsignal pathway is activated. METHODS:Sixty rats were randomly and equal y divided into five groups:control, pioglitazone, model, radiation+low-dose pioglitazone, radiation+high-dose pioglitazone. In the model, radiation+low-dose pioglitazone, radiation+high-dose pioglitazone groups, rats received 6 MV high energy X-ray irradiation at the range of 1.5 cm × 1.5 cm and the irradiation dose of 300 cGy/min, for 6 hours. Furthermore, rats in the radiation+low-dose pioglitazone and radiation+high-dose pioglitazone groups were given 10 and 20 mg/kg pioglitazone by lavage, for 30 days;rats in the model group were given 2 mL distil ed water. In the pioglitazone group, rats were treated with 10 mg/kg pioglitazone by lavage. RESULTS AND CONCLUSION:After rats were treated with pioglitazone, the heart injury and the heart fibrosis in the irradiated rats were decreased. The expressions of angiotensin II type 1 receptor mRNA and protein in the heart tissue were down-regulated. Experimental findings indicate that, pioglitazone intervention downregulates the expression of angiotensin II type 1 receptor in the rat models of radiation-induced heart injury and activation of PPARγsignal pathway al eviates the radiation-induced heart injury.

ObjectiveTo investigate the effects of splenectomy on the intestine mucosa barrier in rats with obstructive jaundice. Methods50 Wistar rats were divided randomly into the obstructive jaundice group (OJ), in which the animals underwent operation to ligate common bile duct, and the obstructive jaundice + splenectomy group (OJ+ S). Seven days post-operation, plasma endotoxin levels were detected. Intestinal mucosa permeability was measured by the ratios of lactulose and mannitol (L/M). Immunohistochemistry and Western blot were used to examine the expression of tight junction proteins (ZO-1 and occludin) in the distal ileum mucosa. Western blots images were analyzed quantitatively. ResultsAverage ratios of L/M and plasma endotoxin were decreased obviously in the OJ+S group compared to those in the OJ group (all P=0. 001). Compared with the OJ group, the average intestinal villus height and mucosa thickness were upgraded somewhat in the OJ + S group (P = 0.019, 0. 001 ). By immunohistochemistry staining seven days post-operation, same comment as above the amounts of strong positive expression of ZO-1 were significantly decreased in the OJ group (6/18, P-0. 021). There wewas no difference between the OJ+S group(8/17) and the OJ group.The amount of strong positive expression of occludin was higher in the OJ + S group than that of the OJ group(10/17 vs 4/18, P= 0. 026). The same outcomes were obtained by quantitative Western blot images. Conclusion The intestinal epithelial permeability was increased in rats with obstructive jaundice,and intestinal barrier was damaged. After excising spleen, the amount and distribution of tight junction proteins were changed and the impairment of intestinal barrier was abated.

Objective To investigate the correlation of insulin resistance (IR) and benign prostate hyperplasia (BPH). Methods The 200 health examination men were divided into three groups according to the prostate volume (PV). There were 100 healthy subjects as control group (PV≤20 ml), 50 cases in BPH1 group (20 ml＜PV＜50 ml) and 50 cases in BPH2 group (PV≥50 ml).The fasting blood glucose (FBG) and fasting serum insulin (FSI) were determined using hexokinase method and radioimmunoassy, respectively. The IR index (IRI) and body mass index (BMI) were calculated according to the formula in HOMA model. Results There were no statistical differences between BPHl group and healthy control group in IRI (1.10±0. 18 vs. 1.18±0.21) and BMI (22. 0±3.0vs. 21.8±2.7) (t=0.74, 0.18, both P＞0. 05), but the IRI (1.31±0.19) and BMI (24. 8±3.29) increased in BPH2 group (P=0. 01, 0.03). The percentage of hyperglycosemia was higher in BPH patients than in normal controls (25% vs. 5%, P = 0. 00). Of them, the percentage of hyperglycosemia was the highest in BPH2 group (36%, P = 0. 01 ), their IRI ( 1.47 ± 0.21 ) was higher than in euglycemia patients (t=3.92, P=0.00), but the BM1 was unchanged compared with the control group ( 25.8 ± 4.3 vs. 24.3 ± 2.71, P = 0. 95 ). Conclusions There is a positive correlation of IR and hyperglycosemia with severe BPH, and the IR in severe BPH is independent of BMI.

Objective To investigate the effects and mechanisms of bile on small intestine mucosal barrier.Methods Fifty Wistar rats were assinged into 3 groups randomly: obstructive jaundice(OJ) group(n=20),biliary external drainage group(n=20) and control group(n=10).Ten days after operation,the plasma endotoxin level was determinated,the terminal ileum mucosas was obtained to be morphologically measured by light microscope,and immunohistochemistry and Western blot were uesd to examine the expressions of tight junction proteins zona occludens-1(ZO-1) and occludin in the mucosas.Results Atrophy significantly appeared in the distal ileum mucosas in OJ group.Compared with control group,the intestinal villus height,mucosa thickness and crypt depth in OJ group were obviously decreased 27.8%,21.7%,and 25.4%(P=0.001,0.001,0.040).There were no differences between external drainage group and control group(P=0.050,0.070,0.080);While the values of external drainage group were significantly higher than those in OJ group(all P=0.001).The level of plasma endotoxin was up to(1.49?0.27) EU/ml in OJ group compared with control group((0.27?0.09) EU/ml),P=0.001.In external drainage group,the value was(0.91?0.25) EU/ml,which was obviously higher than that in control group and lower than that in OJ group(all P=0.001).Immunohistochemical study showed strong positive expression of ZO-1 dropped from 7/10 in the control group to 6/20 in OJ group(P=0.040),occludin expression was 8/10 in control group and 7/20 in OJ Group(P=0.020);expressions of them in external drainage group(8/20(P=0.100,0.210) and 9/20(P=0.060,0.200)) displayed no significant differences compared with the other twogroups.Quantitative testing of Western blot showed the expressions of ZO-1 and occludin in OJ group were significantly lower than those in control group(P=0.001,0.010),the values in external drainage group were higher than those in OJ group(P=0.005,0.014).The expression of ZO-1 was lower in external drainage group than that in control group(P=0.001),and there was no significant difference of occludin between the two groups(P=0.062).Conclusion Lack of intestinal bile will undermine the intestinal tight junction protein composition,and make intestinal mucosal barrier impaired.The intestinal barrier more severely injured when biliary tract obstructs because of multiple factors.Bile plays an important role in the maintenance of intestinal mucosal barrier.

Objective To explore the effects of glucagon-like peptide-2(GLP-2) on intestinal mucosa epithelium myosin light chain kinase(MLCK)of the rat with obstructive jaundice.Methods The obstructive jaundice models of rats were set up.At postoperative 10 d,the control group rats were subcutaneously injected with 0.5 mL PBS;experiment group A with 250g/(kg?d) GLP-2 (0.5 mL),and experiment group B with 125 g/(kg?d) GLP-2 (0.5 mL),b.i.d?7 d,then all the rats were killed The villus height,mucosa thickness and crypt depth of the terminal ileum mucosa were detected.Immunohistochemistry and Western-blot were used to examine the distribution and expression of MLCK.Image analytical system and statistics software were used to analyze the results quantitately.Results The intestinal villi of the distal ileum mucosa were short and sparse in control group.Compared with control group,the average intestinal villus height,mucosa thickness and crypt depth were increased 27.8%,21.7% and 25.4%(all P0.05).The same outcomes were obtained by quantitative analysing Western blot images.The degression of intestinal villus height and absorbance of MLCK images presented direct correlation.Conclusions The intestinal mucous membrane shows obvious atrophy in obstructive jaundice.Exogenous supplemented GLP-2 can enhance the quantity and distribution of MLCK in intestinal mucosa in obstructive jaurdice,and can restore the morphology of intestinal mucosa epithelium.