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Objective:To screen plasma exosomal protein molecular markers in patients with spinal cord injury (SCI) by applying Label-Free quantification and bioinformatics analysis.Methods:Fifty plasma specimens from the First Affiliated Hospital of Nanjing Medical University (from January 2021 to June 2022) were collected from SCI patients and healthy people, respectively. Plasma exosomes were isolated using ultracentrifugation and identified by transmission electron microscopy, nanoparticle tracking analysis and western blot. Plasma exosomal differentially expressed proteins (DEPs) were analyzed using Label-Free quantitative proteomics, and DEPs were characterized, annotated, and enriched based on Gene Ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) databases. The screened DEPs were validated by western blot and enzyme linked immunosorbent assay (ELISA) using plasma exosomal specimens.Results:According to the spinal cord injury classification of the American Spinal Injury Association, 14 cases were grade A, 19 cases were grade B, 12 cases were grade C, and 5 cases were grade D. Plasma exosomes of SCI patients and control groups showed typical cup-like morphology, with diameters mainly ranging from 30-200 nm. A total of 493 exosomal proteins were identified by Label-Free quantification, and 126 proteins were screened for differential expression, of which 38 were up-regulated and 88 were down-regulated. GO annotation revealed that DEPs were mainly involved in functions such as protein activation cascade, complement activation and immune response. KEGG pathway analysis revealed that DEPs were involved in biological pathways such as complement and coagulation cascade reactions, proteasome and neurodegenerative disease pathways. Two candidate proteins, APOB and S100A9, were initially screened based on quantitative results from proteomics and bioinformatics analyses. Western blot results showed that the relative expression of S100A9 protein in plasma exosomes of 30 SCI patients (1.62±0.19) was elevated compared with that of 30 control groups (0.86±0.24), and the difference was statistically significant ( t=8.55, P<0.001), while the relative expression of APOB protein (1.06±0.13 and 1.02±0.23) were not statistically significant ( t=0.46, P=0.653). The results of ELISA analysis showed that the expression of S100A9 in plasma exosomes of patients with different degrees of SCI (grade A 197.7±11.7 pg/ml, grade B 151.7±15.2 pg/ml, grade C 136.3±14.7 pg/ml) had statistical significance ( F=69.94, P<0.001), the higher the severity of SCI, the higher the expression of S100A9 in plasma exosomes (A vs. B, q=13.11, P<0.001; A vs. C, q=15.66, P<0.001; B vs. C, q=4.19, P=0.005). Conclusion:S100A9 is a potentially valid plasma exosomal molecular marker for assessing the severity of SCI.
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ObjectiveTo investigate the epidemiological characteristics of respiratory disease mortality in Baoshan residents during the period of 2009‒2020. MethodsRespiratory disease deaths of Baoshan residents from 2009‒2020 were collected. ICD-10 codes were used to classify the causes of death， and R-4.2.1 was applied for statistical analysis. The average annual percent change （AAPC） of standardized mortality rates of different respiratory diseases were analyzed by using Joinpoint 4.9.0.0. ResultsThe average annual mortality rate of respiratory diseases in Baoshan from 2009 to 2020 was 58.86/105， and the standardized mortality rate was 35.62/105， which was the 3rd leading cause of mortality. The mortality rate of respiratory diseases was higher in men than in women （χ2=46.70， P<0.001）. COPD ranked first among respiratory diseases in Baoshan from 2009 to 2020， followed by pneumonia， asthma and pneumoconiosis in that order. The standardized mortality rate for COPD decreased from 38.66/105 in 2009 to 19.88/105 in 2020 （AAPC=-6.6%， 95%CI： -8.2% to -4.9%， P<0.001）. The standardized mortality rate of asthma decreased from 2.86/105 in 2009 to 1.43/105 in 2020 （AAPC=-5.8%， 95%CI： -8.8% to -2.8%， P<0.01）. The standardized mortality rate of pneumoconiosis decreased from 0.64/105 in 2009 to 0.12/105 in 2020 （AAPC=-7.4%， 95%CI： -13.0% to -1.5%， P<0.05）. The standardized mortality rate for pneumonia decreased from 2.63/105 in 2009 to 0.70/105 in 2020 （AAPC=-6.2%， 95%CI： -12.2% to 0.2%， P=0.056）， but not statistically significant. The annual average mortality rates of COPD， pneumonia and asthma were all highest in January. Crude mortality rates for COPD （χ2=2 669.01， P<0.001）， pneumonia （χ2=217.82， P<0.001）， asthma （χ2=100.09， P<0.001）， pneumoconiosis （χ2=26.46， P<0.001） and all categories of respiratory diseases （χ2=2 995.84， P<0.001） increased with age showed an increasing trend. The crude mortality rates for COPD （χ2=101.69， P<0.001）， pneumonia （χ2=7.39， P<0.01） and asthma （χ2=7.41， P<0.01） were higher in the central than in the northern part of Baoshan District， while the crude mortality rate for COPD （χ2=19.97， P<0.001） was higher in the central than in the southern part. ConclusionThe attention should be focused on COPD； increased detection in males and the elderly， especially in winter and spring； and a good balance between environmental and economic when planning the regional development.
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Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.
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Objective:To evaluate the accuracy and safety of cervical pedicle screw (CPS) placement under orthopaedic robot navigation system guidance.Methods:From March 2019 to February 2021, the data of 33 patients (19 males and 14 females, aged from 26 to 75 years, with an average age of 50.5 years) treated with pedicle screw fixation with the assistance of orthopaedic surgery robot through the posterior cervical spine were retrospectively analyzed. In clinical diagnosis, there was upper cervical fracture with instability in 14 patients (fracture nonunion in 2 patients), upper & subaxial cervical fracture in 1 patient, cervical spinal cord injury with spinal stenosis in 2 patients, cervical spinal stenosis in 9 patients, occipitocervical deformity in 2 patients, post-operative revision of cervical spondylosis in 2 patients, cervical intraspinal tumor in 3 patients. A total of 151 CPSs were inserted in C 1-C 7 using robot navigation system based on intraoperative three-dimensional C-arm fluoroscopy to assist in screw placement in posterior cervical surgery. Among them, 74 screws were implanted into upper cervical spine; 77 screws were implanted in the lower cervical spine. CT was used to obtain image data within 7 days after operation, and Neo classification was used to evaluate the accuracy of cervical pedicle screw placement. The patients were followed up for 2 weeks to observe the clinical symptoms and signs, and to determine whether there were surgical complications such as nerve and blood vessel injury and incision infection. Results:According to Neo classification, 91.4% (138/151) screws were completely contained in the pedicle without breaking through the pedicle cortex (grade 0). Among them, the accuracy of C 1 screws was 97.1% (34/35), C 2 screws was 92.3% (36/39), C 3 screws was 88.2% (15/17), C 4 screws was 71.4% (10/14), C 5 screws was 85.7% (12/14), C 6 screws was 93.3% (14/15), C 7 screws was 100.0% (17/17). The screw accuracy was highest in C 7, the lowest in C 4. The Kruskal-Wallis H test was performed on the accuracy of screw placement in different cervical level, and the results showed that there was no statistical difference (χ 2=1.31, P=0.971). However, a total of 13 screws were found to perforate the cortex of pedicle, although any neural or vascular complications associated with CPS placement were not encountered. Among them, 9 screws were found to perforate laterally, and 4 screws were found to perforate medially. No postoperative incision infection occurred in all cases. Conclusion:The safety of CPS placement can be effectively guaranteed with the assistance of the orthopaedic robot system.
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Objective To analyze the changes of mortality and potential years of life lost （PYLL） due to chronic obstructive pulmonary disease （COPD） among residents in Baoshan District， Shanghai from 2010 to 2019 and provide strategies and basis for COPD prevention and treatment in the future. Methods Based on the cause-of-death surveillance system in Baoshan District of Shanghai from 2010 to 2019， Microsoft Excel 2010， SPSS 22.0 and Joinpoint Trend Analysis Software were used to sort out and analyze the data over the years and calculate the crude mortality， standardized mortality， age-specific mortality， PYLL， annual percent change （APC）， etc. Results From 2010 to 2019， the average annual mortality of COPD was 48.08/100 000， and the standardized mortality rate was 39.95/100 000， accounting for 5.82% of the total deaths in the same period， and COPD ranked as the third leading cause of death in Baoshan District. During the 10 years， the crude and standardized mortality of male COPD patients were generally higher than those of female patients （ P <0.01）. However， the crude mortality and standardized mortality of COPD showed a decreasing trend with the increase of years （ P <0.001）， and an increasing trend with the increase of age， of which the proportion of patients aged 75 and above was the highest， accounting for 85.71% of all age groups. The PYLL caused by COPD deaths was 2 352.5 years， including 1 977.5 years for men and 375.0 years for women. The number of years of life lost per 10 000 people due to COPD in males （4.18 years） was much longer than that in females （0.82 years）. Conclusion From 2010 to 2019， the standardized mortality of chronic obstructive pulmonary disease among residents in Baoshan District， Shanghai has shown a significant decline. However， due to the heavy burden brought by COPD， which has an especially profound impact on the health of elderly and male residents， COPD should be regarded as one of the key diseases in the prevention and control of chronic diseases in public health services， and effective preventive measures should be taken.
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Objective To analyze the changes of mortality and potential years of life lost （PYLL） due to chronic obstructive pulmonary disease （COPD） among residents in Baoshan District， Shanghai from 2010 to 2019 and provide strategies and basis for COPD prevention and treatment in the future. Methods Based on the cause-of-death surveillance system in Baoshan District of Shanghai from 2010 to 2019， Microsoft Excel 2010， SPSS 22.0 and Joinpoint Trend Analysis Software were used to sort out and analyze the data over the years and calculate the crude mortality， standardized mortality， age-specific mortality， PYLL， annual percent change （APC）， etc. Results From 2010 to 2019， the average annual mortality of COPD was 48.08/100 000， and the standardized mortality rate was 39.95/100 000， accounting for 5.82% of the total deaths in the same period， and COPD ranked as the third leading cause of death in Baoshan District. During the 10 years， the crude and standardized mortality of male COPD patients were generally higher than those of female patients （ P <0.01）. However， the crude mortality and standardized mortality of COPD showed a decreasing trend with the increase of years （ P <0.001）， and an increasing trend with the increase of age， of which the proportion of patients aged 75 and above was the highest， accounting for 85.71% of all age groups. The PYLL caused by COPD deaths was 2 352.5 years， including 1 977.5 years for men and 375.0 years for women. The number of years of life lost per 10 000 people due to COPD in males （4.18 years） was much longer than that in females （0.82 years）. Conclusion From 2010 to 2019， the standardized mortality of chronic obstructive pulmonary disease among residents in Baoshan District， Shanghai has shown a significant decline. However， due to the heavy burden brought by COPD， which has an especially profound impact on the health of elderly and male residents， COPD should be regarded as one of the key diseases in the prevention and control of chronic diseases in public health services， and effective preventive measures should be taken.
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Objective@#To investigate the expression of circular RNA hsa_circ_0128298 in hepatocellular harcinoma (HCC) and evaluate its function in the growth process of HCC. @*Methods@#qPCR was used to detect the expressions of hsa_circ_0128298 in 50 HCC tissues, corresponding paracancerous tissues and HCC cells. The effects of hsa_circ_0128298 on HCC growth was analyzed by CCK-8 kit, flow cytometry and western blot assays. The values of hsa_circ_0128298 for the diagnosis and prognosis of HCC were assessed by ROC curve and survival curve analyses. @*Results@#Compared with the paracancerous tissues, the expression of hsa_circ_0128298 was significantly increased in HCC tissues ( U =846.0， P =0.005). The area under ROC curve (AUCROC) was 0.661, 95% confidence interval ( CI ) was 0.560 to 0.753, sensitivity was 80.0% and specificity was 50.0%. HCC patients with high expression of hsa_circ_0128298 displayed less overall survival time than those with low expression of hsa_circ_0128298 ( χ 2=6.294, P =0.012). RNA interference of hsa_circ_0128298 (si-hsa_circ_0128298) significantly inhibited HCC cell proliferation and induced cell cycle arrest at G0/G1, and also induced mRNA upregulation and protein expression of cyclin p21. Meanwhile，si-p21 partially reversed the proliferation inhibition and cell cycle arrest of HCC cells induced by si-hsa_circ_0128298, and restore its growth and proliferation potential. @*Conclusion@#The highly expressed hsa_circ_0128298 in HCC could promote the growth of HCC by regulating the expression of p21 and promise to be a new target for diagnosis and treatment of HCC.
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To explore the clinical significance of the altered expression of polycomb group (PcG)-associated protein RYBP in hepatocellular carcinoma (HCC) specimens. Methods: The expression levels of RYBP in tumor tissues and adjacent normal tissues in 77 HCC cases were detected by immunohistochemistry (IHC), and the relationships between RYBP expression levels and HCC clinicopathological characteristics, five-year survival rates or prognosis of HCC patients were analyzed. Results: RYBP expression level was significantly decreased in HCC tumor tissues than that in the adjacent normal tissues (P<0.05). The expression levels of RYBP in HCC specimens were highly correlated with HBsAg, ALT, GGT, Type III procollagen, tumor size, distant metastasis, and tumor differentiation (P<0.05). The RFS and OS for patients with RYBP-low expression were markedly lower than those with RYPB-high expression (P<0.05). Both age and RYBP expression level were protective factors for RFS, while GGT, lymph node metastasis, TNM stage, tumor differentiation and tumor size were risk factors for RFS (P<0.05). As to OS, RYBP expression level was a protective factor, while tumor number, ALT, GGT, AFP, pCEA, lymph node metastasis, TNM stage, tumor differentiation and tumor size were risk factors (P<0.05). The age, GGT, lymph node metastasis and TNM stage were independent prognostic factors for RFS (P<0.05), and both lymph node metastasis and TNM stage were independent risk factors for OS (P<0.05). Comparing to serum alpha fetoprotein (AFP) level, RYBP expression level in tumor tissues was applied to predict the prognosis of HCC patients more accurately. Conclusion: PcG associated protein RYBP displays a reduced expression in HCC tissues, which is related to poor prognosis of HCC patients. It might be a promising therapeutic target for HCC treatment.
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Humans , Biomarkers, Tumor , Carcinoma, Hepatocellular , Immunohistochemistry , Intracellular Signaling Peptides and Proteins , Metabolism , Liver Neoplasms , Lymphatic Metastasis , PrognosisABSTRACT
OBJECTIVE:To establish a method for content determination of schizantherin E,gomisin J,angeloylgomisin H,schisantherin A,schisantherin B,schisanhenol,anwuligan,schizandrin A,schizandrin B and schizandrin C in Wuzhi tablets.METHODS:RP-HPLC method was adopted.The determination was performed on Symmetry C18 column with acetonitrile-0.1％ phosphoric acid solution (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelength was set 225 rm,and the column temperature was 30 ℃.The sample size was 10 μL.RESULTS:The linear ranges of schizantherin E,gomisin J,angeloylgomisin H,schisantherin A,schisantherin B,schisanhenol,anwuligan,schizandrin A,schizandrin B and schizandrin C were 2.25-67.5ng(r=0.999 6),2.1-63 ng(r=0.999 8),28-840 ng(r=0.999 9),124.6-3 738 ng(r=0.999 9),22.7-681 ng(r=0.999 9),32.7-981 ng(r=0.999 9),47-1 410 ng(r=0.999 9),208-6 240 ng(r=0.999 9),5.36-160.8 rig(r=0.999 9),4.48-134.4 ng(r=0.999 8).The limits of quantitation were 14.17,13.32,9.33,11.37,14.62,19.88,14.66,12.50,16.40,13.55 rg.The limits of detection were 4.62,4.60,3.08,3.76,4.81,6.74,4.93,4.16,5.86,5.03 ng.RSDs of precision,stability and reproducibility tests were less than 3.0％;the recoveries were 96.36％-100.00％(RSD=1.83％,n=6),95.00％-100.00％(RSD=2.07％,n=6),95.00％-98.00％(RSD=1.22％,n=6),95.37％-98.91％ (RSD=1.29％,n=6),95.62 ％-103.71％ (RSD=2.85％,n=6),97.33％-102.67％ (RSD=2.00％,n=6),95.00％-99.33％ (RSD=1.75％,n=6),97.24％-104.93％ (RSD=2.63％,n=6),95.00％-97.50％ (RSD=1.42％,n=6),96.00％-102.00％ (RSD=2.45％,n=6),respectively.CONCLUSIONS:The developed method is accurate,sensitive and reproducible,and it can be used for content determination of 10 lignanoids in Wuzhi tablets.
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[Objective]To study changes of ultrastructures and respiratory function of the spinal cord mitochondrial in experimental spinal cord injury.[Method]Forty-eight SCI models in adult SD rats were built based on modified Allen's method.Mitochondria was extracted from injuried spinal cord tissue by using modified Estabrook's method at 6h,12h and 24h after SCI.Then ultrastructural changes and respiratory function,including R3,R4,RCR,P/O were observed.[Result]Ultrastructure of mitochondria was damaged greatly.The results revealed that R3、RCR and P/O of injuried spinal cord mitochondria decreased significantly after injury compared to the normal control group(P
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[Objective]To evaluate the incidence of postoperative residual numbness and the factors that influenced numbness in lumbar canal stenosis(LCS).[Method]Eighty patients with LCS including 24 males and 32 females,who were 27～78 years of age with an average age of 61.3,were operated by posterior decompression,and followed 10 days,1 month,3 months,1 year and 2 years after operation.All patients were examined by neurological findings and residual symptoms.[Result]In LCS,there were 82.1% of patients who complained numbness preoperativety.The incidence of residual numbness was 43.6%,39.1%,36.6%,35.3% and 35.7% after 10 days,1 month,3 months,12 months and 24 months,respectively.The factors that influenced residual numbness were related to stenosis types;JOA score before operation and the type of spinal canal stenosis were independent of age and nerve root diameter.[Conclusion]The lower limbs numbness recovered within 1 month postoperatlvely.The incidence of postoperative residual numbness was 35.3% and 35.7% in LCS after 1 year and 2 years.It is speculated that the potential of recovery of neural tissue is important for lower limbs residual numbness.
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BACKGROUND: Pathogenesis and pathophysiological changes of chronic compressive cervical myelopathy havenotbeen completely clarified.OBJECTIVE: To establish an animal model of experimental chronic compressive cervical myelopathy for the exploration of the pathological and electrophysiological changes after chronic spinal compression.DESIGN: A randomized and controlled observatory study using experimental animals as subjects.SETTING: An Animal Experimental Center of a University and an Orthopaedic Laboratory of Affiliated Hospital of a Military Medical University MATERIALS: The study was conducted in the Animal Experimental Center of Nantong Medical University and the Orthopaedic Laboratory of Shanghai Changzheng Hospital from June 2002 to April 2003. Sixty 12-week healthy Chinese rabbits of either gender with a bodymass between 2.5 kg and 3.0 kg were randomly divided into control group( n = 6) and study group( n = 54).METHODS: Titanic metal screw was put into C5 vertebra through cervical anterior approach for progressive compression to establish chronic cervical myelopathy model.MAIN OUTCOME MEASURES:Principal consequences: ①histological examination ;②electrophysiological examination. Secondary consequence:neural function evaluation.RESULTS: Totally 48 rabbits entered into result analysis, in which 6 rabbits from control group and 42 rabbits from study group. Modified Tarlov's motor function evaluation was 3 in 31 rabbits with compression signs, and 4 in 11rabbits without compression signs. The latency of N1 wave in cortical somatosensory evoked potentials (CSEP) was (9.11 ± 1.61 ), ( 11.36 ± 2.17)and (17.55 ± 3.73) ms respectively in animals of control group, animals of study group without compression signs and animals of study group with compression signs. The lantency of CSEP N1 wave was significantly longer in animals of study group with compression signs than that of the animals in the control group and study group without compression signs (P＜0.05).CONCLUSION: This animal model can simulate clinical invasion process of chronic compressive cervical myelopathy. The severer the spinal compression is, the more often the compression signs appear, the longer the lantency of CSEP N1 wave is, and the more serious the spinal pathological damages are.
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Objective To observe the effect of intravenous anesthesia (IVA) with propofol (P),ketamine (K) and fentanyl (F) in different ways in children. Methods 90 pediatric patients were divided into three groups ( n =30) randomly according to the drug used for IVA. Ⅰgroup used compounds of P, F and K; Ⅱgroup used compounds of P and F; Ⅲ group used compounds of P and K. All the drugs were injected intravenously with micro-pump. Total dosage of anaesthetics, awaken time after operation and variation of circulation and breath were observed and sedative and analgesic effect during operation were evaluated. Results Compared with Ⅱ or Ⅲ group, Ⅰgroup showed less dosage, shorter awaken time and smaller degree of change in circulation and breath with complete sedation and analgesia ( P