Reinforced radiculoplasty for the treatment of symptomatic sacral Tarlov cysts: A clinical analysis of 71 cases / 北京大学学报(医学版)

OBJECTIVE@#To investigate the safety and efficacy of reinforced radiculoplasty in the treatment of symptomatic sacral Tarlov cysts (TCs).@*METHODS@#A retrospective analysis was performed on the clinical data and follow-up data of 71 patients with symptomatic sacral TCs who underwent reinforced radiculoplasty in the Neurosurgery Department of Peking University Third Hospital from June 2018 to March 2021. All the operations were performed under neuroelectrophysiological monitoring. Intraoperative cyst exploration, partial resection of the cyst wall, narrowing of the leak, nerve root sleeve radiculoplasty and artificial dural reinforcement were performed. The incidence of postoperative complications and new neurological dysfunction was analyzed. Visual analogue scale (VAS) was used to assess the changes of pain before and after surgery. The Japanese Orthopedics Association (JOA) low back pain score was used to evaluate the changes in nerve function before and after surgery.@*RESULTS@#In the study, 71 patients had 101 TCs, 19 (18.8%) TCs originated from the left S1 nerve, 26 (25.7%) originated from the left S2 nerve, 3 (3.0%) originated from the left S3 nerve, 14 (13.9%) originated from the right S1 nerve, 33 (32.7%) originated from the right S2 nerve, 6 (5.9%) originated from the right S3 nerve, all the TCs underwent reinforced radiculoplasty. Deep infection (1 case), subcutaneous effusion (1 case), fat li-quefaction (1 case) and urinary tract infection (4 cases) were recorded postoperatively. The patients were followed up for 12-43 months (median, 26 months). Two cases had new urinary retention after operation, and the catheter was removed at the end of the first and second months respectively. One case had new fecal weakness, which improved after 3 months. Compared with preoperation, VAS decreased significantly at the last follow-up [median, 6 (4-9) vs. 1 (0-5), Z=-7.272, P < 0.001], JOA score increased significantly [median, 20 (16-25) vs. 27 (18-29), Z=-7.265, P < 0.001]. There were 18 cured cases (25.4%), 41 excellent cases (57.7%), 8 effective cases (11.3%), and 4 invalid cases (5.6%). The total efficiency was 94.4% (67/71). Two (1.98%) cysts recurred.@*CONCLUSION@#For patients with symptomatic sacral TCs, reinforced radiculoplasty can significantly improve the pain and nerve function, which is safe and reliable.

Relationship between adolescent parent attachment and attempted suicide among middle school students / 中国学校卫生

Objective@#To understand the current situation of suicide attempts in middle school students and to explore its relation with adolescent parent attachment, to provide a basis for the prevention and control of middle school students suicidal behavior.@*Methods@#A total of 4 419 students from grades 7 to 12 in Ezhou City and Xiaogan City, Hubei Province were selected by stratified cluster random sampling. The Inventory of Parent and Peer Attachment, Rosenberg Self Esteem Scale, Kessler Psychological Distress Scale were used to conduct a questionnaire Survey, and evaluated the suicide attempts of middle school students.@*Results@#The detection rate of attempted suicide among middle school students was 6.8%. The detection rate of attempted suicide varies among different grades, family types, parental relation, parenting style, family income, self esteem level, and psychological distress( χ 2/ t =3.88, 10.12, 18.00, 52.54, 13.90 , 2.37, 8.99, P <0.05). The scores of paternal attachment and maternal attachment ( 14.64 ±13.45, 14.77±12.26) in the group with attempted suicide were lower than those without attempted suicide(22.05±16.08, 23.79±14.93)( t =-9.07, -12.11, P <0.05). Logistic regression analysis showed that both paternal attachment and maternal attachment were associated with lower rate of suicide attempts among middle school students(paternal attachment, OR=0.99, 95%CI = 0.98 -0.99; maternal attachment OR=0.97, 95%CI =0.96-0.98), with paternal attachment for girls only( OR=0.98, 95%CI= 0.97 -0.99)(P <0.05).@*Conclusion@#Adolescent parent attachment may be a protective factor for middle school students suicide attempts. Sex specific effects are observed in adolescent father attachment in girls. Parents should pay attention to cultivating a good attachment relationship with their children and promote the healthy growth of middle school students.

Association between sexual orientation and high risk sexual behaviors among college students in Hubei Province / 中国学校卫生

Objective@#To examine the association between sexual orientation and high risk sexual behaviors and its sex differences among college students, so as to provide a theoretical basis for intervention and controlling of high risk sexual behaviors of the college students.@*Methods@#From November 2020 to May 2021, 1 920 college students among four universities in Hubei Province were recruited by multi stage stratified random cluster sampling, and their sexual orientation and the frequency of high risk sexual behaviors were investigated by a self designed questionnaire. And then analyzed the association between sexual orientation and high risk sexual behaviors and its sex differences by using Chi square test and Logistic regression analysis method.@*Results@#The prevalence of sexual behaviors was 18.2%, the prevalence of high risk sexual behaviors was 7.2%, and the prevalence of high risk sexual behaviors was higher among non heterosexuals(13.5%) than among heterosexuals (6.7%),the prevalence of high risk sexual behaviors was higher among males (9.2%) than among females(5.3%)，and the differences were statistically significant( χ 2=9.40, 10.77, P <0.01). Logistic regression analysis showed that the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=1.52, 95%CI=0.83-2.80, P >0.05). However, stratified analysis by sex revealed that among male students, the risk of high risk sexual behaviors was 3.57 times higher among non heterosexuals than among heterosexuals( OR= 3.57 , 95%CI=1.52-8.41, P <0.01), while among female students, the association between sexual orientation and high risk sexual behaviors was not statistically significant( OR=0.48, 95%CI=0.15-1.57, P >0.05).@*Conclusion@#There are sex differences in the relationship between sexual orientation and high risk sexual behaviors among college students. Male non-heterosexuals are at higher risk for high risk sexual behaviors than male heterosexuals. Therefore, prevention and interventions for high risk sexual behaviors among college students should focus on gay and bisexual men so as to reduce the occurance rate of their high risk sexual behaviors.

MicroRNA-22-3p Regulates the Expression of Kruppel-like Factor 6 to Affect the Cardiomyocyte-like Differentiation of Bone Marrow Mesenchymal Stem Cell / 中国医学科学院学报

Objective To explore the effect of microRNA-22-3p (miR-22-3p) regulating the expression of Kruppel-like factor 6 (KLF6) on the cardiomyocyte-like differentiation of bone marrow mesenchymal stem cell (BMSC). Methods Rat BMSC was isolated and cultured,and the third-generation BMSC was divided into a control group,a 5-azacytidine(5-AZA)group,a mimics-NC group,a miR-22-3p mimics group,a miR-22-3p mimics+pcDNA group,and a miR-22-3p mimics+pcDNA-KLF6 group.Real-time fluorescent quantitative PCR (qRT-PCR) was carried out to determine the expression of miR-22-3p and KLF6 in cells.Immunofluorescence staining was employed to detect the expression of Desmin,cardiac troponin T (cTnT),and connexin 43 (Cx43).Western blotting was employed to determine the protein levels of cTnT,Cx43,Desmin,and KLF6,and flow cytometry to detect the apoptosis of BMSC.The targeting relationship between miR-22-3p and KLF6 was analyzed by dual luciferase reporter gene assay. Results Compared with the control group,5-AZA up-regulated the expression of miR-22-3p (q=7.971,P<0.001),Desmin (q=7.876,P<0.001),cTnT (q=10.272,P<0.001),and Cx43 (q=6.256,P<0.001),increased the apoptosis rate of BMSC (q=12.708,P<0.001),and down-regulated the mRNA (q=20.850,P<0.001) and protein (q=11.080,P<0.001) levels of KLF6.Compared with the 5-AZA group and the mimics-NC group,miR-22-3p mimics up-regulated the expression of miR-22-3p (q=3.591,P<0.001;q=11.650,P<0.001),Desmin (q=5.975,P<0.001;q=13.579,P<0.001),cTnT (q=7.133,P<0.001;q=17.548,P<0.001),and Cx43 (q=4.571,P=0.037;q=11.068,P<0.001),and down-regulated the mRNA (q=7.384,P<0.001;q=28.234,P<0.001) and protein (q=4.594,P=0.036;q=15.945,P<0.001) levels of KLF6.The apoptosis rate of miR-22-3p mimics group was lower than that of 5-AZA group (q=8.216,P<0.001).Compared with the miR-22-3p mimics+pcDNA group,miR-22-3p mimics+pcDNA-KLF6 up-regulated the mRNA(q=23.891,P<0.001) and protein(q=13.378,P<0.001)levels of KLF6,down-regulated the expression of Desmin (q=9.505,P<0.001),cTnT (q=10.985,P<0.001),and Cx43 (q=8.301,P<0.001),and increased the apoptosis rate (q=4.713,P=0.029).The dual luciferase reporter gene experiment demonstrated that KLF6 was a potential target gene of miR-22-3p. Conclusion MiR-22-3p promotes cardiomyocyte-like differentiation of BMSC by inhibiting the expression of KLF6.

Effect of rTMS combined with CBT on alcohol craving and cognitive function in patients with alcohol dependence / 中华行为医学与脑科学杂志

Objective:To explore the effect of repetitive transcranial magnetic stimulation (rTMS) combined with cognitive behavioral therapies (CBT) on the cognitive function and alcohol craving in patients with alcohol dependence.Methods:From March 2019 to September 2021, a total of 150 patients with alcohol dependence were enrolled and randomly divided into rTMS treatment group (rTMS+ sham CBT, n=41), CBT treatment group (CBT+ sham rTMS, n=34), rTMS+ CBT treatment group( n=36) and control group (sham rTMS+ sham CBT, n=39). At baseline (before treatment), 2nd week, 8th week, 12th week and 24th week, alcohol dependence scale (ADS) was used to evaluate the degree of alcohol dependence, the obsessive compulsive drinking scale (OCDS) was used to assess patients' drinking craving, and Montreal cognitive assessment scale (MoCA) was used to assess the overall cognitive level of patients.SPSS 23.0 statistical software was used to compare the differences of ADS, OCDS and MoCA scale scores of the four groups by repeated measure ANOVA and simple effect analysis. Results:(1)The patients in the four groups were evaluated with ADS scale at baseline, 12th week and 24th week respectively.The interaction of group×time( F=1.279, P=0.279) and the main effect of group were not significant ( F=0.882, P=0.454), and the main effect of time was significant ( F=12.925, P<0.001) .Further simple effect analysis showed that the ADS score of rTMS+ CBT group was lower than that of baseline(14.48±5.70, 10.00±6.51) ( P=0.01) at 24th week.(2)Patients in the four groups were assessed with OCDs scale at baseline, 2nd week, 8th week, 12th week and 24th week, and the interaction of group×time was significant ( F=2.015, P=0.042). Further simple effect analysis showed that the OCDs scores of rTMS group and rTMS+ CBT group at each follow-up time node were lower than those at baseline period (all P<0.05). (3)Patients in the four groups were assessed with MoCA scale at baseline, 8th week, 12th week and 24th week, and the interaction of group×time was not significant ( F=1.660, P=0.106), and the main effect of group and the main effect of time were significant ( F=2.964, P=0.038; F=14.239, P<0.001). Further simple effect analysis showed that the score of MoCA scale in CBT group at the 24th week was higher than that at baseline (21.73±5.81, 24.60±3.98)( P=0.029), the score of MoCA scale in rTMS+ CBT group at the 24th week was higher than that at the 8th week (23.50±6.01, 25.95±2.87) ( P=0.006), and the score of MoCA scale in rTMS group at the 12th week was higher than that in control group (22.08±6.64, 26.64±2.46)( P=0.009). Conclusion:rTMS combined with CBT can be effective in improving alcohol craving and cognitive function in patients with alcohol dependence, and has a good long-term effect.

Microscopic resection of lumbar intraspinal tumor through keyhole approach: A clinical study of 54 cases / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility and key technology of microscopic resection of lumbar intraspinal tumor through microchannel keyhole approach.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 54 cases of lumbar intraspinal tumor which were microscopically operated by microchannel from February 2017 to September 2019 were reviewed and analyzed. There were 8 cases of extradural tumor, 3 cases of extra-and intradural tumor and 43 cases of subdural extramedullary tumor (including 3 cases of ventral spinal tumor). The tumors were 0.5-3.0 cm in diameter. The clinical symptoms included 49 cases of pain in the corresponding innervation area, 5 cases of sensory disturbance (numbness) at or below the tumor segment, 7 cases of limb weakness and 2 cases of urination and defecation dysfunction.@*RESULTS@#In the study, 37 tumors were resected through hemilaminectomy, 14 tumors were resected through interlaminar fenestration, 3 tumors were resected through hemilaminectomy or interlaminar fenestration combined with facetectomy of medial 1/4 facet. All of the 54 tumors were totally resected. The operation time was 75-135 min, with an average of 93.3 min. The postoperative hospital stay was 4-7 days, with an average of 5.7 days. Postoperative pathology included 34 cases of schwannoma, 4 cases of meningioma, 9 cases of ependymoma, 1 case of enterogenous cyst, 5 cases of teratoma/epidermoid/dermoid cyst, and 1 case of paraganglioma. No infection or cerebrospinal fluid leakage was found after operation. No neurological dysfunction occurred except 1 case of urination dysfunction and 4 cases of limb numbness. The follow-up period ranged from 3 to 33 months with an average of 14.4 months. Five patients with new onset symptoms returned to normal. The pain symptoms of 49 patients were completely relieved; 4 of 5 patients with hypoesthesia recovered completely, the other 1 patient had residual mild hypoesthesia; 7 patients with limb weakness, and 2 patients with urination and defecation dysfunction recovered to normal. No spinal instability or deformity was found, and no recurrence or residual tumors were found. According to McCormick classification, they were of all grade Ⅰ.@*CONCLUSION@#The lumbar intraspinal extramedullary tumors within two segments (including the ventral spinal tumors) can be totally resected at stage Ⅰ through microchannel keyhole approach with appropriate selection of the cases. Microchannel technique is beneficial to preserve the normal structure and muscle attachment of lumbar spine, and to maintain the integrity and stability of lumbar spine.

Gender measurement invariance of the Perceived Social Support Scale in people aged 50 years and older / 中华老年医学杂志

Objective:To investigate gender measurement invariance of the Perceived Social Support Scale(PSSS)in people aged 50 years and older.Methods:A total of 1013 adults(50-96 years old)in Beijing, Hunan and Shandong were tested by using PSSS.The measurement invariance of PSSS between middle-aged and elderly males and females was analyzed.Differences in PSSS total scores and subscale scores between males and females were examined.Results:The equivalence test results of each item in the questionnaire met the requirements of the metrology(△CFI≥0.010, △TLI≥0.010, △RSMEA≤0.015), indicating that the hypotheses of morphological equivalence, weak equivalence, strong equivalence and strict equivalence of PSSS were all valid in the middle-aged and elderly population regardless of gender.In addition, middle-aged and elderly females had higher scores in family support, support from friends, support from other people and perceived social support than their male counterparts( P<0.05). Conclusions:PSSS has cross-gender equivalence in middle-aged and elderly people.Thus, differences in PSSS can reflect the perceived social support level in middle-aged and elderly people of different genders.

Effect of total saponins from Panax japonicus on non-alcoholic steatohepatitis by regulating autophagy / 中国中药杂志

Non-alcoholic steatohepatitis(NASH) was induced by high-sugar and high-fat diet in mice to investigate the intervention effect of total saponins from Panax japonicus(TSPJ) and explore its possible mechanism. Mice were fed with high-sugar and high-fat diet to establish NASH model, and intervened with different doses of TSPJ(15, 45 mg·kg~(-1)). The animals were fed for 26 weeks. The histomorphology and pathological changes of liver tissues were observed by HE staining. The transcriptional expression levels of miR-199 a-5 p, autophagy related gene 5(ATG5) and inflammatory cytokines interleukin-6(IL-6), interleukin-1β(IL-1β) and tumor necrosis factor α(TNF-α) in mouse liver were measured by quantitative Real-time polymerase chain reaction(qRT-PCR). Western blot was used to detect the expression of autophagy-related proteins ATG5, P62/SQSTM1(P62), and microtubule-associated protein light chain 3(LC3)-I/Ⅱ proteins in mouse liver. The expression of P62 protein was detected by immunofluorescence staining. In order to verify the targeting regulation relationship between miR-199 a-5 p and ATG5, miR mimic/inhibitor NC and miR-199 a-5 p mimic/inhibitor were transfected into Hepa 1-6 cells, and the expression of ATG5 mRNA and protein was detected. pMIR-reportor ATG5-3'UTR luciferase reporter gene plasmid was constructed and co-transfected with miR mimic/inhibitor NC and miR-199 a-5 p mimic/inhibitor into Hepa 1-6 cells to detect luciferase activity. In vivo, HE staining in the model group showed typical fatty degeneration and inflammatory infiltration, with increased expression of miR-199 a-5 p and decreased expression of ATG5 mRNA and protein. The expression of autophagy-associated protein P62 increased significantly, the ratio of LC3Ⅱ/Ⅰ decreased, and the transcriptional expression of inflammatory factors increased significantly. After the intervention by TSPJ, the pathological performance of liver tissue was significantly improved, the expression of miR-199 a-5 p decreased and the expression of ATG5 mRNA and protein increased, the expression of autophagy-associated protein P62 decreased significantly, the ratio of LC3Ⅱ/Ⅰ increased, and the transcriptional expression of inflammatory cytokines IL-6, IL-1β and TNF-α decreased significantly. In vitro, it was found that the expression of ATG5 mRNA and protein and luciferase activity decreased significantly in miR-199 a-5 p overexpression cells, while after inhibition of miR-199 a-5 p expression, the expression level of ATG5 mRNA and protein and luciferase activity increased. The results showed that TSPJ can improve NASH in mice fed with high-sugar and high-fat diet, and its mechanism may be related to the regulation of miR-199 a-5 p/ATG5 signal pathway, the regulation of autophagy activity and the improvement of inflammatory response of NASH.

Individual mortality risk predictive system of patients with acute-on-chronic liver failure based on a random survival forest model / 中华医学杂志(英文版)

BACKGROUND@#The basis of individualized treatment should be individualized mortality risk predictive information. The present study aimed to develop an online individual mortality risk predictive tool for acute-on-chronic liver failure (ACLF) patients based on a random survival forest (RSF) algorithm.@*METHODS@#The current study retrospectively enrolled ACLF patients from the Department of Infectious Diseases of The First People's Hospital of Foshan, Shunde Hospital of Southern Medical University, and Jiangmen Central Hospital. Two hundred seventy-six consecutive ACLF patients were included in the present study as a model cohort (n = 276). Then the current study constructed a validation cohort by drawing patients from the model dataset based on the resampling method (n = 276). The RSF algorithm was used to develop an individual prognostic model for ACLF patients. The Brier score was used to evaluate the diagnostic accuracy of prognostic models. The weighted mean rank estimation method was used to compare the differences between the areas under the time-dependent ROC curves (AUROCs) of prognostic models.@*RESULTS@#Multivariate Cox regression identified hepatic encephalopathy (HE), age, serum sodium level, acute kidney injury (AKI), red cell distribution width (RDW), and international normalization index (INR) as independent risk factors for ACLF patients. A simplified RSF model was developed based on these previous risk factors. The AUROCs for predicting 3-, 6-, and 12-month mortality were 0.916, 0.916, and 0.905 for the RSF model and 0.872, 0.866, and 0.848 for the Cox model in the model cohort, respectively. The Brier scores were 0.119, 0.119, and 0.128 for the RSF model and 0.138, 0.146, and 0.156 for the Cox model, respectively. The nonparametric comparison suggested that the RSF model was superior to the Cox model for predicting the prognosis of ACLF patients.@*CONCLUSIONS@#The current study developed a novel online individual mortality risk predictive tool that could predict individual mortality risk predictive curves for individual patients. Additionally, the current online individual mortality risk predictive tool could further provide predicted mortality percentages and 95% confidence intervals at user-defined time points.

Effect of oxytocin on empathy in male adolescents with conduct disorder / 中华行为医学与脑科学杂志

Objective:To investigate the effect of intranasal oxytocin administration on empathy in male adolescents with conduct disorder.Methods:The male adolescents with conduct disorder in the Psychological Counseling Clinic of the Second Xiangya Hospital of Central South University from September 2015 to August 2016 were selected.And they were randomly assigned to oxytocin group ( n=46) and placebo group ( n=51) by random number table. Subjects in oxytocin group were given nasal spray of 24 IU oxytocin twice per day for two weeks, while those in placebo group were given nasal spray of 0.9% sodium chloride solution for two weeks. The empathy of patients was assessed with a pain-related empathy task and interpersonal reactivity index (IRI) before and after two weeks′ administration. SPSS 20.0 software was used for statistical analysis, and repeated measurement analysis of variance was used to compare the empathy ability of the two groups before and after intervention. Results:Repeated measurement analysis of variance showed that there were significant time×group interaction effects in the scores of painful expressions during the pain-related empathy task ( F=13.86, P<0.001), IRI ( F=5.59, P=0.020) and empathic concern subscale ( F=4.99, P=0.028). There was significant between-group effect in the score of perspective-taking subscale of IRI( F=4.22, P=0.043). Simple effect analysis revealed that after two weeks of intervention, the score of needle-pain expression in oxytocin group was significantly higher than that at baseline ( t=-2.08, P=0.040). And the score of needle-pain expression in oxytocin group was significantly higher than that in placebo group ( t=2.33, P=0.022). After two weeks of intervention, the total IRI score ( t=-2.58, P=0.011) and empathy factor score ( t=-3.15, P=0.002) of oxytocin group were both higher than those at baseline. After intervention, the total IRI score ( t=2.30, P=0.024) and perspective-taking factor score ( t=2.57, P=0.012) in oxytocin group were higher than those in placebo group, and the differences were statistically significant. Conclusions:Oxytocin may improve the cognitive and emotional empathy in male adolescents with conduct disorder.

Visual and Haptic Feedback Fusion Based on Force Tracking in Upper-limb Rehabilitation Robot System / 中国康复理论与实践

Objective:To solve the issue regarding a low correlation between visual and haptic feedback provided by the current upper-limb rehabilitation training system, this study was implemented based on the end-effector based upper-limb rehabilitation robot developed in the lab. A novel visual and haptic feedback fusion technology based on force tracking was investigated and its effect on upper-limb training was also studied. Methods:Based on the force model constructed in a virtual environment, two types of haptic feedbacks correlated to the visual feedback were designed, including the repulsive force when two objects getting close and the friction force when the object moving above medium surfaces. The haptic feedback constructed in the virtual environment was delivered to the trainees by using force tracking based on robot controlling algorithm. Eight health subjects were recruited and trained with and without feedback fusion. In the training process, the actual and expected haptic feedbacks as well as the surface electromyography (EMG) signals from anterior deltoid, posterior deltoid, biceps, and triceps were collected. The root means square error (RMSE) between the actual and expected haptic feedback was calculated under the feedback fusion training mode to characterize the force tracking-based multi-sensory feedback fusion technology. The integrated EMG values (iEMG) and EMG amplitudes per unit time (EMG/T) under two training modes were measured to explore the effect of feedback fusion technology on the upper-limb motor training. Results:Under feedback fusion training mode, the RMSE between actual and expected haptic feedback was (0.757±0.171) N. The values of iEMG from four muscles were significantly higher (|t| > 7.965, P < 0.001), and the values of EMG/T from the biceps, triceps and anterior deltoid were significantly larger under feedback fusion training mode than under the training mode without feedback fusion. Conclusion:The proposed upper-limb rehabilitation robot training system could accurately transmit the haptic feedback constructed under the virtual environment to the trainees. This system could increase the stimulation to trainees' peripheral nervous function through visual and haptic feedback fusion as well as increase the trainees' training effort. The advantages of force tracking-based visual and haptic feedback fusion technology are to freely construct the force model under the virtual environment and the haptic feedback mode is not constrained by the spatial position. Moreover, two or more types of force models can be superimposed in the same spatial position by using this technology that could improve the matching effect between haptic feedback and visual feedback under a virtual environment. The trainees' motor rehabilitation interest could be stimulated and the experience feeling of human-robot interaction could also be enhanced.

Minimally invasive treatment of cervical1-2 epidural neurilemmoma / 北京大学学报(医学版)

OBJECTIVE@#To explore the minimally invasive surgical method for cervical1-2 epidural neurilemmoma.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 63 cases of cervical1-2 epidural neurilemmoma from July 2010 to December 2018 were reviewed and analyzed. Pain and numbness in occipitocervical region were the common clinical symptoms. There were 58 cases with pain, 30 cases with numbness, 3 cases with limb weakness and 2 cases with asymptomatic mass. Magnetic resonance imaging (MRI) showed that the tumors located in the cervical1-2 epidural space with diameter of 1-3 cm. The equal or slightly lower T1 and equal or slightly higher T2 signals were found on MRI. The tumors had obvious enhancement. Individualized laminotomy was performed according to the location and size of the tumors, and axis spinous processes were preserved as far as possible. Resection of tumor was performed strictly within the capsule.@*RESULTS@#Total and subtotal resection of tumor were achieved in 60 and 3 cases respectively, and no vertebral artery injury was found. The operation time ranged from 60 to 180 minutes, with an average of 92.83 minutes. The hospitalization time ranged from 3 to 9 days, with an average of 5.97 days. All tumors were confirmed as neurilemmoma by pathology. There was no postoperative infection or cerebrospinal fluid leakage. There was no new-onset dysfunction except 9 cases of numbness in the nerve innervation area. The period of follow-up ranged from 6 months to 8 years (median: 3 years). All the new-onset dysfunction recovered completely. Pain disappeared in all of the 58 patients with pain. Numbness recovered completely in 27 patients while slight numbness remained in another 3 patients. Three patients with muscle weakness recovered completely. The spinal function of all the patients restored to McCormick grade Ⅰ. No recurrence was found on MRI. No cervical spine instability or deformity was found on X-rays.@*CONCLUSION@#It is feasible to resect cervical1-2 epidural neurilemmoma by full use of the anatomical space between atlas and axis and individual laminotomy. It is helpful to prevent cervical instability or deformity by minimizing the destruction of cervical2 bone and preserving normal muscle attachment to cervical2 spinous process. Strict intracapsular resection can effectively prevent vertebral artery injury.

Molecular characteristics of the hemagglutinin 1 and neuraminidase genes of influenza B viruses isolated in Yancheng city from 2015 to 2017 / 中华疾病控制杂志

Objective To analyze the genetic characteristics of the hemagglutinin （HA) and neuraminidase （NA) genes of influenza B viruses isolated in Yancheng City from 2015 to 2017. Methods The throat swab specimens of influenza-like illness( ILI) from sentinel surveillance hospital and outbreak sites were collected and sent to Yancheng CDC for virus nucleic acids and virus isolation testing. After validation with serological tests, eighteen strains of influenza B virus isolates were selected to amplify their HA1 and NA genes through RT-PCR assay. Their molecular characteristics of the obtained viral HA1 and NA gene sequences were analyzed using bioinformation software from three aspects, including nucleic acid level, amino acid level and molecular evolution level. Results Basically, the clustering relationships and the branche patterns between HA1 and NA genes from the 18 Yancheng influenza B virus strains were similar. The Yamagata lineage strains in 2015 were distributed in the Yamagata Clade 3 branch, belonging to Phuket/3073 strains. The Victoria lineage strains in 2016-2017 were distributed in the Victoria Clade 1A branch, belonging to Brisbane/60 strains. D196N substitution was detected on HA1 protein in all of Yamagata lineage strains at 190-helix epitope; Amino acid substitutions of victoria lineage strains involved two antigenic epitopes, 117 and 129 sites of 120-loop epitope and 197 and 199 sites of 190-helix epitope. No Intra-lineage or inter-lineage rearrangements occurred in Yancheng strains. Eighteen influenza B strains had no mutations in catalytic residues and drug resistant sites of NA genes. Conclusion The Yamagata strains well matched with vaccine strain B/Phuket/3073/2013. The HA1 and NA genes of victoria lineage strains circulated in Yancheng City during 2016 to 2017 are changing gradually. The accumulation of these mutations will result in antigenic drift of victoria lineage strains and increase the mismatch of the IFV field stains with the available vaccine strains, which may reduce the protective effect of flu vaccine.

Clinical study of 21 cases of sacral cysts containing fila terminale / 北京大学学报(医学版)

OBJECTIVE@#To summarize the characteristics of sacral cysts containing fila terminale and to explore the surgical treatment methods.@*METHODS@#The clinical features, imaging characteristics and surgical methods of 21 cases of sacral cysts containing fila terminale from July 2010 to March 2017 were reviewed and analyzed. Lumbosacral and perineal pain, weakness of the lower limbs and bladder and bowel dysfunction were the common clinical symptoms. MRI showed that the cysts located in the sacral canal. The lower T1 and higher T2 signals were found on MRI. There were fila terminale within the cysts which tethered the spinal cord. No enhancement was visible within the lesion. The key steps of operation included the resection of the cyst wall, the cutting off of the fila terminale, the release of the tethered cord and the reconstruction of the cisterna terminalis.@*RESULTS@#The total and subtotal resections of cyst walls were achieved in 14 and 7 cases, respectively. The fila terminales were separated and cut off in all the cases, and the tethered cords were released completely. The reconstructions of the cisterna terminalis were accomplished in all the cases. There was no new-onset dysfunction except for 7 cases of mild numbness around anus postoperatively. Pathological examinations confirmed that the cyst wall was fibrous connective tissue, and hyperplasia of fibrous tissue and/or adipose tissue was found within the thickened fila terminale. The lumbosacral and perineal pain disappeared. The weakness of the lower extremities and the bladder and bowel dysfunction gradually improved. The period of follow-up ranged from 3 months to 7 years (average: 2.25 years). The spinal function of all the patients restored to McCormick grade Ⅰ. Only 1 case encountered recurrence of cyst.@*CONCLUSION@#The sacral cysts containing fila terminale are rare. The common symptoms include lumbosacral and perineal pain and symptoms of tethered cord. MRI is helpful to the diagnosis, which shows the signal of cerebrospinal fluid and the fila terminale in the cyst as well as tlow-placed conus medullaris. Microsurgery should remove the cyst wall, cut off the fila terminale, release the tethered cord and reconstruct the cisterna terminalis.

Diagnosis and treatment of primary intraspinal abscess / 北京大学学报(医学版)

OBJECTIVE@#To summarize the feature and treatment of the primary intraspinal abscess in order to improve the prognosis.@*METHODS@#In the study, 13 cases of primary intraspinal abscess of the recent 20 years were retrospectively analyzed. The history, etiology, pathogen, surgical methods and prognosis were summarized.@*RESULTS@#The course of the illness ranged from 7 days to 6 months. All the cases began with pain. Of the 13 patients, 10 had limb weakness. Five had a fever and 8 had increased white blood cells. As for distribution, 1 was in cervical vertebra, 1 in cervicothoracic junction, 1 in thoracic vertebra, 4 in thoracolumbar junction, and 6 in lumbosacral segment. The results of bacterial culture were positive in 4 cases, 3 cases were diagnosed as tuberculosis by pathological examination, and 1 case was recognized as infection of Brucella melitensis bacteria because of prior brucellosis. The pathogen of the remaining cases were unclear. All the cases received surgical treatment and pathology examination. The surgical aim was mainly removal of the lesion, decompression and drainage. Postoperatively anti-infection and glucocorticoid therapy were performed according to the pathogeny results and clinical experience. Incision abscesses were seen in 2 cases and reoperations including debridement and repair with transferred muscle flap were performed. Postoperative follow-up ranged from 6 months to 3 years (mean 1.8 years). One case suffered postoperative recurrence and the abscess spread along the vertebral canal. Reoperation was performed. Infections of all the cases were recovered completely and the nervous system signs were all improved in different degrees.@*CONCLUSION@#The onset of primary intraspinal abscess is relatively urgent, mainly with pain. The lumbar and sacral vertebra is the predilection site. The bacterial culture is mostly negative. Early operation and use of sufficient amount of broad-spectrum antibiotic are recommended. If the incision abscess forms after the operation, it is advisable to transfer the muscle flap to repair the coloboma on the basis of debridement. In order to relieve edema of spinal cord and nerve root, the glucocorticoid can be used in the escort of antibiotics.

Effect of Real-time Visual Trajectory Feedback on Upper Limb Movement Learning / 中国康复理论与实践

Objective:To explore the effect of real-time visual trajectory feedback on the motor learning ability of healthy volunteers during upper limb circle-drawing movements by using rehabilitation robots. Methods:From July to September, 2018, 24 right-handed healthy volunteers were divided into two groups according to the baseline level of motor ability, one group received three kinds of feedbacks including visual, result and real-time trajectory feedbacks (V+KP+KR group), and the other group only received two kinds of feedbacks including visual and performance (V+KR group). Both groups were trained in clockwise circle drawing task under different conditions for five sessions, 20 times per session, and then underwent one session of maintenance test after three days. The motor learning processes of two groups were evaluated and analyzed by two parameters including roundness score and completion time. Results:By using two-factor repeated measures variance analysis, it was found that there were intergroup and intragroup interactions (F = 6.029, P < 0.001). The intergroup individual effects showed that except for the fifth training section (F = 8.775, P = 0.658), the values of roundness score in other sessions were higher in V+KP+KR group than in V+KR group (F > 13.126, P < 0.001). The intragroup individual effects showed that there were significant differences among sessions in both groups (F > 12.465, P < 0.001). For completion time, there was no intergroup and intragroup interactions (F = 1.606, P = 0.228), the intergroup main effect was not significant (F = 0.55, P = 0.477), and the intragroup main effect was significant (F = 3.95, P = 0.031). Conclusion:Real-time trajectory feedback can help volunteers quickly understand the essentials of motor tasks at the early stage of motor learning, thus helping them to improve the fast learning ability of new tasks, but the improvement effect on motor learning during middle and late stages is not obvious. The dependence of volunteers on real-time trajectory feedback gradually decreases in the middle and later stages of motor learning, and they might rely on proprioception to complete tasks.

Effect of Wuzi Yanzong Fang in Promoting Spermatogonial Stem Cells Proliferation in Aging Rats by Regulating miR-let-7-Imp Axis / 中国实验方剂学杂志

Objective: To explore the effect and mechanism of Wuzi Yanzong Fang (WZ) on proliferation of spermatogonial stem cells in aging rats by regulating miR-let-7-Imp axis.Method: A total of 40 18-month-old male SD rats were randomly divided into aging model group, and low, middle and high-dose WZ groups, with 10 rats in each group. Ten 2-month old rats were used as young control group. Low, middle and high-dose WZ groups were given by gastric WZ 0.4, 0.8, 1.6 g·kg-1 respectively. Young control group and aging model group were given normal saline for 4 months, which was suspended for 2 days every week. Rats were put to death after the final treatment with WZ, and then the testes were quickly removed from rats. The relative mRNA expression levels of miR-let-7 and Imp were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). The expressions and localization of p-JAK2/JAK2, phosphate(p)-signal transduction and transcriptional activators3 (STAT3)/STAT3 signaling pathway proteins were detected by Western blot and immunofluorescence. The numbers of spermatogonial stem cells and the expression levels of proliferating cell nuclear antigen (PCNA) were detected by immunofluorescence. The testicular tissue morphology was observed using htoxylin eosin (HE) staining.Result: Compared with young control group, the expression levels of miR-let-7 mRNA were significantly increased, while the expression levels of Imp mRNA were decreased in the aging model group(PPPPPPPConclusion: WZ effectively promote the proliferation of spermatogonial stem cells by regulating miR-let-7-imp axis in testis.

Improved effects of saponins from Panax japonicus on decline of cognitive function in natural aging rats via NLRP3 inflammasome pathway / 中国中药杂志

The aim of this paper was to investigate the effect of total saponins from Panax japonicus( SPJ) on cognitive decline of natural aging rats and its mechanism. Thirty male SD rats of eighteen month old were randomly divided into three groups: aged group,10 mg·kg~(-1) SPJ-treated group and 30 mg·kg~(-1) SPJ-treated group. The SPJ-treated groups were given SPJ at the dosages of 10 mg·kg~(-1) and 30 mg·kg~(-1),respectively,from the age of 18 to 24 months. Aged group were lavaged the same amount of saline,10 six-month-old rats were used as control group,with 10 rats in each group. The open field test,novel object recognition and Morris water maze were performed to detect the changes of cognitive function in each group. The changes of synaptic transmission of long-term potentiation( LTP) in hippocampal CA1 region were detected by field potential recording. Western blot was used to detect the protein levels of NLRP3,ASC,caspase-1 and the changes of Glu A1,Glu A2,CAMKⅡ,CREB and phosphorylation of CAMKⅡ,CREB in each group.The results showed that SPJ could improve the decline of cognitive function in aging rats,reduce the damage of LTP in the hippocampal CA1 region of aged rats,and decrease the expression of NLRP3,ASC,caspase-1 in aging rats. At the same time,SPJ could enhance the membrane expression of AMPA receptor( Glu A1 and Glu A2),and increase the expression of p-CAMKⅡand p-CREB in aging rats.SPJ could improve cognitive decline of natural aging rats,and its mechanism may be related to regulating NLRP3 inflammasome,thus regulating the membrane expression of AMPA receptor,and enhancing the expression phosphorylation of CAMKⅡ and CREB.

Composition and source apportionment differences of daytime and nighttime samples of PM2.5 in the community of suburb in Tianjin during different heating periods / 中华疾病控制杂志

Objective To study the pollution and source apportionment differences of different periods PM2.5 in the residential community of suburb in Tianjin City during heating and non-heating periods. Methods From 2015 to 2016, daytime and nighttime PM2.5 samples were collected at a community in the suburb of Tianjin. The mass concentration of PM2.5 samples and major chemical components in PM2.5, including metal elements, polycyclic aromatic hydrocarbons (PAHs) and inorganic water-soluble ions were monitored. Positive matrix factorization (PMF) model was used to apportion potential sources of metal elements, PAHs and inorganic water-soluble ions in daytime and nighttime PM2.5. Results In the heating period, the concentrations of some metal elements of suburban residential community were higher in the daytime than in the nighttime. In the non-heating period, the concentrations of some PAHs and inorganic water-soluble ions of suburban residential community were higher in the nighttime than in the daytime. Meanwhile, the concentrations of some metal elements were greater in the daytime than in the nighttime. When in heating period, the main source of PM2.5 in the suburban residential community was coal combustion during daytime and its source contribution rate was 50.1% while secondary aerosol and fuel combustion emissions of gasoline and diesel vehicles were main sources during nighttime and their source contribution rates were 41.0% and 35.9%. The principal source of daytime PM2.5 in the suburban residential community was indoor activity emissions during non-heating period, and secondary aerosol was main source during nighttime and their source contribution rates were 29.8% and 31.1%. Conclusions The pollution status of PM2.5 in residential communities of suburban is serious, and the source apportionment of day and night PM2.5 samples has different in different heating periods.

Triterpene saponins in Panax japonicus and their ~(13)C-NMR spectroscopic characteristics / 中国中药杂志

Panax japonicus( PJ) is a valuable medicinal plant belonging to the genus Panax of Araliaceae,the recumbent rhizome of which is widely used in clinic therapy,healthcare products and as cosmetic additives with functions of dissipating stasis,reducing swelling,stanching bleeding,and reinforcing deficiency,etc. PJ contains abundant levels of oleanane-and dammarane-type triterpene saponins,which are considered as the material basis for exerting pharmacodynamic action. Based on the previous researches,more than110 triterpene saponins have been reported from PJ. These triterpene saponins were summarized in this review,and could be classified into dammarenediol Ⅱ,protopanaxadiol,protopanaxatiol,ocotillol,oleanolic acid,ursolic acid and miscellaneous subtypes,according to their molecular skeletons in biosynthesis processes. Further more,the structural features of these triterpene saponins in the seven different subtypes,together with their~(13)C-NMR spectroscopic characteristics were described,hoping to provide available information for chemical diversity research of PJ.