An MRI study of lateral vascular safety zones in oblique lumbar interbody fusion surgery / 中国修复重建外科杂志

OBJECTIVE@#To study the anatomical characteristics of blood vessels in the lateral segment of the vertebral body through the surgical approach of oblique lumbar interbody fusion (OLIF) using MRI imaging, and evaluate its potential vascular safety zone.@*METHODS@#The lumbar MRI data of 107 patients with low back and leg pain who met the selection criteria between October 2019 and November 2022 were retrospectively analyzed. The vascular emanation angles, vascular travel angles, and the length of vessels in the lateral segments of the left vertebral body of L 1-L 5, as well as the distance between the segmental vessels in different Moro junctions of the vertebral body and their distances from the edges of the vertebrae in the same sequence (bottom marked as I, top as S) were measured. The gap between the large abdominal vessels and the lateral vessels of the vertebral body was set as the lateral vascular safe zones of the lumbar spine, and the extent of the safe zones (namely the area between the vessels) was measured. The anterior 1/3 of the lumbar intervertebral disc was taken as the simulated puncture center, and the area with a diameter of 22 mm around it as the simulated channel area. The proportion of vessels in the channel was further counted. In addition, the proportions of segmental vessels at L 5 without a clear travel and with an emanation angel less than 90° were calculated.@*RESULTS@#Except for the differences in the vascular emanation angles between L 4 and L 5, the vascular travel angles between L 1, L 2 and L 4, L 5, and the length of vessels in the lateral segments of the vertebral body among L 1-L 4 were not significant ( P>0.05), the differences in the vascular emanation angles, vascular travel angles, and the length of vessels between the rest segments were all significant ( P<0.05). There was no significant difference in the distance between vessels of L 1, L 2 and L 2, L 3 at Moro Ⅰ-Ⅳ junctions ( P>0.05), in L 3, L 4 and L 4, L 5 at Ⅱ and Ⅲ junction ( P>0.05). There was no significant difference in the vascular distance of L 2, L 3 between Ⅱ, Ⅲ junction and Ⅲ, Ⅳ junction, and the vascular distance of L 3, L 4 between Ⅰ, Ⅱ junction and Ⅲ, Ⅳ junction ( P>0.05). The vascular distance of the other adjacent vertebral bodies was significant different between different Moro junctions ( P<0.05). Except that there was no significant difference in the distance between L 2I and L 3S at Ⅰ, Ⅱ junction, L 3I and L 4S at Ⅱ, Ⅲ junction, and L 2I and L 3S at Ⅲ, Ⅳ junction ( P>0.05), there was significant difference of the vascular distance between the bottom of one segment and the top of the next in the other segments ( P<0.05). Comparison between junctions: Except for the L 3S between Ⅰ, Ⅱ junction and Ⅱ, Ⅲ junction, and L 5S between Ⅰ, Ⅱ junction and Ⅱ, Ⅲ and Ⅲ, Ⅳ junctions had no significant difference ( P>0.05), there were significant differences in the distance between the other segmental vessels and the vertebral edge of the same sequence in different Moro junctions ( P<0.05). The overall proportion of vessels in the simulated channels was 40.19% (43/107), and the proportion of vessels in L 1 (41.12%, 44/107) and L 5 (18.69%, 20/107) was higher than that in the other segments. The proportion of vessels in the channel of Moro zone Ⅰ (46.73%, 50/107) and zone Ⅱ (32.71%, 35/107) was higher than that in the zone Ⅲ, while no segmental vessels in L 1 and L 2 were found in the channel of zone Ⅲ ( χ 2=74.950, P<0.001). Moreover, 26.17% (28/107) of the segmental vessels of lateral L 5 showed no movement, and 27.10% (29/107) vascular emanation angles of lateral L 5 were less than 90°.@*CONCLUSION@#L 1 and L 5 segmental vessels are most likely to be injured in Moro zones Ⅰ and Ⅱ, and the placement of OLIF channels in L 4, 5 at Ⅲ, Ⅳ junction should be avoided. It is usually safe to place fixation pins at the vertebral body edge on the cephalic side of the intervertebral space, but it is safer to place them on the caudal side in L 1, 2 (Ⅰ, Ⅱ junction), L 3, 4 (Ⅲ, Ⅳ junction), and L 4, 5 (Ⅱ, Ⅲ, Ⅳ junctions).

This paper analyzes the factors that are not qualified for the routine test of urine and feces, and discusses the corresponding countermeasures / 中国生化药物杂志

Objective To analyze the factors related to the disqualification of urine routine and stool routine, and to formulate corresponding solutions. Methods In April 2014 to April 2017 our collected 600 cases of hospitalized patients, urine and stool samples for routine detection, made clear that cause unqualified samples related factors, and develop effective solution strategy. Results 600 cases in the selected routine urine, excrement and urine routine test specimens, the unqualified samples of total 110 cases, fraction defective is 18.33%, 490 qualified samples, percent of pass is 81.67%, the difference was statistically significant (P<0.05).There are a number of factors that cause the sample to fail, such as the contamination of the sample, the length of storage, the operation and the preparation. Conclusion In the process of actual diagnosis of disease, clinical result in urine, feces routine test specimen unqualified often appear, the reason is to a great extent, and the related nursing staff in urine and stool samples of patients before the lack of relevant guidance and so on, and nursing staff after the complete collection of specimens does not usually in accordance with the relevant standard of serious check, to avoid the sample inspection is unqualified, hospitals need to develop scientific inspection process, nurses in practice need to strict adherence to the process, and through intensive training, promote nursing staff awareness test, can to improve the qualification rate of sample test provide strong guarantee.

Clinical effect of TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention treatment for Cockett syndrome complicated with deep venous thrombosis of lower limbs / 中国医师进修杂志

Objective To evaluate the clinical effect of TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention treatment for Cockett syndrome complicated with deep venous thrombous of lower limbs. Methods The clinical data of 31 patients of Cockett syndrome complicated with deep venous thrombosis of lower limbs were retrospectively analyzed, and the patients were treated with TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention.Results Thirty patients were placed self-expandable stent,and 1 patient was treated by balloon dilation.The pain disappeared and the swelling decreased postoperatively.Twenty-two cases was cured (70.97%, 22/31), 7 cases showed excellence (22.58%, 7/31), and 2 cases showed effective (6.45%, 2/31), and there were no invalid patients. There was no pulmonary embolism and bleeding event during treatment. Conclusions The TAPAS intravascular closed catheter-directed thrombolysis combined with endovascular intervention treatment for Cockett syndrome complicated with deep venous thrombous of lower limbs is an effective and safe technique with satisfactory short term result.However,the long term clinical effect need to be further researched.

The changes of microRNA in nasal mucosa after the specific immunotherapy for allergic rhinitis in mice / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the changes of microRNAs in nasal mucosa after the specific immunotherapy (SIT) for allergic rhinitis (AR) in mice.@*METHOD@#Female BALB/c mice, 6-8 weeks of age, were randomly divided into control group, model group and treatment group. AR model were established by intraperitoneal injection and intranasal challenge of ovalbumin and SIT was performed by inguinal subcutaneous injections. AR symptom scores were documented. The eosinophils (EOS) in the nasal mucosa were measured. Ovalbumin-specific IgE (OVA-sIgE) in the serum and expression of interferon-γ and interleukin-4 in the nasal lavage were measured by enzyme-linked immunosorbent assay meanwhile the ratio of interferon-γ and interleukin-4 was calculated. The microRNAs in the nasal mucosa were preliminary screened by microRNA gene microarray. Comparing with model group, the Fold changes of microRNA of the treatment group were ≥ 2.0 and the P < 0.05. MicroRNA target genes were predicted with GeneSpring 12.5 software. We took the intersection between genes in the signal pathway which associated with immune response,inflammation and target genes. The MEV-4-6-0 and Cytoscape_v2. 8. 2. software was applied to perform the cluster analysis and target gene regulatory networks maps.@*RESULT@#The model of AR in mice and its SIT were successful. Comparing with the model group, the Fold changes of 15 microRNAs, of which 9 microRNAs were up-regulated and 6 microRNAs were down-regulated, were ≥ 2.0 in treatment group (P < 0.05). Cluste analysis showed clearly that microRNAs in the treatment group and model group respectively aggregated in two branches. The 15 microRNAs had 5302 target genes, of which, 451 genes were related more with SIT by the intersection. One microRNA can regulate many target genes, and one gene can also be affected by many microRNAs. Their synergistic effects may be involved in the mechanism of SIT.@*CONCLUSION@#The expressions of microRNAs are changed in nasal mucosa after SIT for AR in mice and we can speculate that microRNAs are involved in the process of SIT for AR. Bioinformatics methods can diminish the scope of target genes of microRNAs, which will help us studying the effect of changed microRNA on its relative target genes after SIT, and make us better understanding the mechanism of the disease and its SIT.

Effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with Moderate-severe obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To explore the effects of simultaneous multi-level surgery intervention on the changes of the oxidative stress and the cognitive function in young and middle-aged patients with moderate-severe OSAHS.@*METHOD@#One hundred and sixteen young and middle-aged patients with moderate-severe OSAHS received simultaneous multi-level surgery. PSG,malondialdehyde (MDA), advanced oxidation protein products (AOPP) and 8-isoprostaneF2α (8-iso-PGF2α) were tested, together with the evaluation of the questionnaires of Montreal cognitive assessment (MoCA), mini-mental state examination (MMSE) and Epworth sleepiness scale (ESS) before and 6 months after surgery.@*RESULT@#(1) The AHI, TS90% and LSaO₂ were all improved significantly 6 months after operation. No severe complications were observed in any patient. (2) The preoperative MoCA and MMSE scores were (23.52 ± 2.64) and (26.54 ± 1.07) respectively. The cognitive impairment were detected in OSAHS patients. MoCA was negatively correlated with AHI, TS90%, MDA, AOPP and 8-iso-PGF2a, while positively correlated with LSaO₂ (P < 0.05, r = -0.233, -0.190, -0.256, -0.247, -0.221 and 0.215, respectively). Cognitive impairment was mainly manifested as disorder in the visual space and execu- tive function, memory and delayed recall (mainly short-term memory). (3) MoCA and MMSE scores were both increased (P < 0.05) after the operation. MoCA showed negative correlations with MDA, AOPP, 8-iso-PGF2α, AHI and TS90%, and positive correlation with LSaO₂ (P < 0.05, r = -0.495, -0.463, -0.397, -0.332, -0.292 and 0.336, respectively).@*CONCLUSION@#Oxidative stress and cognitive dysfunction are closely related in young and middle-aged patients with Moderate-severe OSAHS. Oxidative stress may play an important role in cognitive function of young and middle-aged patients with Moderate-severe OSAHS. Multi-level surgery can improve oxidative stress so that to improve cognitive impairment.

Experimental study on inguinal subcutaneous immunotherapy for allergic rhinitis in mice / 中国免疫学杂志

Objective:To explore the feasibility of inguinal subcutaneous immunotherapy for allergic rhinitis ( AR ) in mice. Methods:36 female BALB/c mice were divided randomly into six groups( n=6 per group) including the control A,the model A, the treatment A groups,and the control B,the model B,the treatment B groups(inguinal subcutaneous immunotherapy for group A, cervical back subcutaneous immunotherapy for for group B). AR model was established with ovalbumin. At 25 to 55 days,ovalbumin im-munotherapy were performed in treatment groups,once two days,15 times totally. After intranasal rechallenge was performed at 56 to 62 days the AR symptom scores were documented. The eosinophils(EOS)in the nasal mucosa were measured by chromotropic acid 2R staining. Ovalbumin-specific IgE( OVA-sIgE) in the serum and expression of interferon-γ and interleukin-4 in the nasal lavage were measured by enzyme-linked immunosorbent assay meanwhile the ratio of interferon-γ and interleukin-4 was calc μlated. SPSS17. 0 software was used to analyze the data. Results:Before treatment ,the AR symptom scores of the model and treatment groups were more than 5. After treatment,the treatment A group were less than 5. The EOS count of the control A,model A,treatment A groups and the control B,model B, treatment B groups was 0. 78 ± 0. 31, 21. 60 ± 2. 90, 10. 43 ± 2. 56, 0. 83 ± 0. 46, 22. 44 ± 3. 39, 23. 40 ± 4. 24, respectively. The EOS count of the treatment A group was significantly lower than those in model A group ( P0. 05 ) . OVA-sIgE expressed was negative in control groups and positive in other groups. The ratio of interferon-γ and interleukin-4 was 10. 75 ± 3. 38,10. 38 ± 3. 08,3. 02 ± 0. 69,2. 71 ± 0. 89,2. 52 ± 0. 30,5. 45±1. 41,respectively. The ratio in treatment A group was significantly higher than those in model A group(P0. 05 ) . Conclusion: Inguinal subcutaneous immunotherapy has a good effect on this disease. It spends short time ,has simple operation and good feasibility,which is a novel treatment method for AR in mice.

Progress in Gene Logic Networks / 生物化学与生物物理进展

As tremendous genomic data avalanches, exploring biological mechanism by data analysis and theory methods has become important for theoretical biology research. This method is significant for the study of complex gene functions and gene networks. Bowers used higher order logic relationships to decipher protein network organization, which is a systemic method called logic analysis of phylogenetic profiles (LAPP). LAPP is a data modeling and different from traditional computational methods. This computational approach identifies logic relationships of the elements (or components) in complex networks through the logic analysis of their expression data. The method can be used to infer functional relationships of two associated proteins to one another. It is important for discovering the new function mechanism of the protein. The clusters of orthologous groups (COGs) involved in a gene network usually are large groups and therefore LAPP is also an approach for complex gene logic networks. After the establishment of the gene logic network, it is convenient for the regulation of gene through the network. The method can used in many fields, such as species evolution, oncologic diagnosis and so on. LAPP was systematically described and analyzed and recent developments in methodologies and applications were highlighted. Some opinions of them were also given.