Genome-wide identification and drought stress-induced expression analysis of the NHX gene family in potato.

NHX proteins are transmembrane antiporters belonging to the cation/proton antiporter gene family, with a conserved Na+ (K+)/H+ exchange (PF00999) protein domain. NHXs play a prominent role in plant growth, development, and defense. However, the role of NHX gene family in potato (Solanum tuberosum L.) is yet to be known. In this study, we conducted a genome-wide analysis of the potato NHX gene family. A total of 25 StNHX family members were identified to be unevenly distributed on 10 chromosomes. The proteins ranged in length from 252 to 1,153 amino acids, with molecular masses ranging from 27516.32 to 127860.87 kD, and isoelectric points (pI) ranging from 4.96 to 9.3. Analyses of gene structures and conserved motifs indicated that StNHX genes in the same phylogenetic cluster are conserved. Phylogenetic analysis divided the StNHX genes into three subfamilies (Classes I, II, and III). Synteny analysis indicated that StNHX gene family Class III of NHX and all Arabidopsis thaliana NHXs shared a close evolutionary relationship. Analysis of cis-acting elements in the upstream 1,500 bp promoter region of potato NHX genes showed that these genes could be regulated by light, stress, and hormones such as abscisic acid and gibberellic acid. Protein-protein interaction network analysis indicated that StNHX proteins may participate in the regulation of potato growth and stress response. Besides, To determine a potential role of these genes in tissue development and drought response, we analyzed the RNA-seq data of different DM potato tissues. The results showed that NHX genes exhibited distinct tissue-specific expression patterns. We further examined the expression patterns of StNHX in different tissues (leaves, roots, shoots, tubers, stolons, and flowers) during the flowering stage in 'Jizhangshu NO.8.' potato. The qRT-PCR results further confirmed the importance of StNHX genes in potato plant growth and development. We further analyzed the RNA-seq data (DM potato) under different abiotic stresses (salt, drought, and heat), and found that the expression of StNHX genes was induced under abiotic stress. qRT-PCR analysis of shoots and roots of 'Jizhangshu NO.8.' potato treated for 0, 6, 12, and 24 h with 15% PEG6000 confirmed that the 25 StNHX genes are involved in the response to drought stress in potato. The results of this study may be useful for selecting appropriate candidate genes for the breeding of new drought-tolerant potato varieties. Furthermore, this study lays a foundation for prospective analysis of StNHX gene functions.

Application of modified no-touch technique in rabbit arteriovenous fistula model and its effect on venous neointimal hyperplasia.

BACKGROUND: To investigate the technical advantages of a modified no-touch technique (MNTT) in constructing arteriovenous fistulas (AVF) compared to the conventional technique (CT) and assess its potential to reduce neointimal hyperplasia in the outflow vein. METHODS: Forty-seven New Zealand rabbits were randomly divided into three groups: control, CT, and MNTT. Rabbits in control group were observed using ultrasound and then euthanized to obtain external jugular vein (EJV) for Hematoxylin-eosin (H-E). We established common carotid artery (CCA)-EJV AVF using MNTT in the MNTT group and the CT in the CT group. AVF patency and complications were compared between the CT and MNTT groups. Rabbits with patent AVF in both groups were observed using ultrasound 2 weeks after surgery to evaluate changes in the vessel diameter and blood flow spectrum of the AVFs. H-E staining measured the intima thickness of EJV adjacent to the anastomosis and histologic characteristics of the AVF at 2 and 4 weeks after surgery. RESULTS: Five rabbits died after surgery with common symptoms of sneezing, coughing, runny nose, anorexia, and diarrhea; two in the MNTT group and three in the CT group. There were significant differences in the diameter (p = 0.010) and peak systolic velocities (PSV) (p = 0.001) of EJV between the CT and MNTT groups 2 weeks after surgery. Spiral laminar flow (SLF) was observed in CCA and EJV adjacent to anastomosis in the MNTT group. Additionally, histological observations showed less venous neointimal hyperplasia in the MNTT group than in the CT group 4 weeks after surgery. CONCLUSION: The rabbit model of CCA-EJV AVF established using MNTT demonstrated fewer complications, larger vein diameters, and reduced venous neointimal hyperplasia, indicating that this maybe an ideal animal model to further investigate the application of MNTT in AVF surgery.

A modified technique for arteriovenous fistula anastomosis: Preserving the surrounding tissue of the vein without the use of vascular clamps.

BACKGROUND: This pilot study describes a new technique for creating an arteriovenous fistula (AVF) and presents the preliminary outcomes after 1 year of follow-up. METHODS: The study included 19 patients (10 males, 9 females) with a mean age of 62 years (range 26-88 years). All patients received an AVF using a modified technique in which the surrounding tissues were not removed from the veins and no elastic loops or vascular clamps were used. RESULTS: Immediate patency was obtained for all patients. The proportion of patients experiencing primary patency at 30 days and 6 months was 89.5% and 83.1%, respectively, and cumulative patency at 30 days and 6 months was 100%. At 1 year of follow-up, primary patency was 83.1% and cumulative patency was 100%. CONCLUSIONS: Complete preservation of the surrounding venous tissue in the absence of vascular clamps successfully established AVF, with a high surgical success rate.

Characterization of group Ⅰ metabotropic glutamate receptors in rat superior cervical ganglion and their changes following chronic intermittent hypoxia / 解剖学报

Objective To observe the expression and localization of group Ⅰ metabotropic glutamate receptors (mGluR1/ 5) in rat superior cervical ganglion (SCG) and the effect of chronic intermittent hypoxia (CIH) on mGluR1/ 5 protein level. Methods Twelve male SD rats were randomly divided into control group(Ctrl)and CIH group(CIH), 6 rats in each group. After 6 weeks of modeling, the effect of CIH on mGluR1/ 5 protein level was detected by Western blotting, the expression and distribution of mGluR1/ 5 in SCG were detected by immunohistochemistry and double-immunofluorescent staining. Results mGluR1/ 5 was expressed in rat SCG. mGluR1 was distributed in neurons and small intensely fluorescent (SIF) cells, but not in satellite glial cells (SGCs), nerve fibers and blood vessels, whereas mGluR5 was mainly distributed in nerve fibers and a little in neurons, but not in SGCs, SIF cells and blood vessels. CIH increased the protein levels of mGluR1/ 5 (P<0. 01) in rat SCG. Conclusion Both mGluR1 and mGluR5 are expressed in the rat SCG, but their distribution are different, and the increased protein levels of both may be involved in CIH-induced hypertension.

Clinicopathological features of intravascular large B-cell lymphoma and collision tumors of five cases / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics, diagnosis and differential diagnosis of intravascular large B-cell lymphoma (IVLBCL) and its collision tumors. Methods: Five cases of IVLBCL were collected, including 2 cases of collision tumors, and 1 case complicated with liver cirrhosis. The morphology and immunophenotype were analyzed. The related literature was reviewed. Results: There were 2 females and 3 males, aged from 53 to 73 years, with a median age of 65 years. The tumors were located in the lower extremities, right cerebellar hemisphere, left kidney, bilateral nasal cavity, and liver, respectively. Cases 2 and 3 were incidentally found in meningioma and renal cell carcinoma tissues, respectively. Case 5 had a background of liver cirrhosis. Morphologically, atypical large lymphoid cells were located in small blood vessels and capillary lumen, with little cytoplasm, hyperchromasia, prominent nucleoli, and obvious mitotic figures. Immunohistochemically, the IVLBCL tumor cells expressed CD20 and PAX5; 2 cases were CD5 positive. One of the 5 cases was GCB phenotype, and 4 cases were non-GCB phenotype. All cases expressed C-MYC (positive rate was 10%-40%). PD-L1 was positive in 4 cases (positive rate was 60%-90%). Ki-67 proliferation index was 70%-90%. CKpan, CD3, TDT, and CD34 were negative. In case 2, meningioma cells were positive for PR, EMA, and vimentin, but negative for CKpan and PD-L1. In case 3, renal carcinoma cells were positive for CKpan, PAX8, EMA, vimentin, CAⅨ and CD10, while PD-L1 was negative. No EBER expression (by in situ hybridization) or C-MYC gene translocation (FISH, break-apart probe) was detected in any of the 5 cases. Three patients were followed up, and all died within 1-13 months. Conclusions: IVLBCL is a highly aggressive lymphoma, with occult clinical manifestations and poor prognosis. Collision tumors of IVLBCL are extremely rare. A better understanding of IVLBCL would help pathologists avoid misdiagnoses.

Cascading effects of seed-stem-individual spatial patterns along a grazing gradient.

Studying the seed trait-stem trait-individual spatial pattern system is helpful for understanding the developmental direction of plant dynamics and populations under grazing disturbance as well as the antagonistic relationship between animals and plants, but few systematic analyses of this spatial pattern system have been carried out. Kobresia humilis is the dominant species in alpine grasslands. We studied K. humilis seed traits and their relationship with K. humilis reproductive individuals, the relationship between reproductive and vegetative stems, and the weights and spatial patterns of reproductive and nonreproductive individuals under four grazing treatments: no grazing (control), light grazing, moderate grazing and heavy grazing. We explored the relationship among seed size and seed number with reproductive stems and vegetative stems along the grazing gradient and assessed the spatial pattern changes between reproductive and nonreproductive individuals. The results showed the following: (1) Seed size increased with increasing grazing intensity, and the coefficient of variation for seed size and seed number in the heavy grazing treatment was greater than 0.6. (2) The structural equation model showed that grazing treatment had a positive effect on seed number, seed size and reproductive stem number and a negative effect on reproductive stem weight. (3) Grazing treatment did not affect the resource allocation to reproductive stems and vegetative stems per unit length of reproductive K. humilis individuals. (4) Compared with the number of reproductive individuals in the no grazing treatment, the number in the heavy grazing treatment decreased significantly, and the negative correlation between reproductive individuals and nonreproductive individuals changed from a full-scale negative correlation to a small-scale negative correlation and a large-scale positive correlation. Our study showed that grazing could activate and change the resource allocation pattern of dominant species in a grassland and have significant positive effects on reproductive stem number, reproductive stem weight, seed number and seed size. Along a grazing intensity gradient, with the increase in distance between reproductive and nonreproductive individuals, the transformation of intraspecific relationships from a negative correlation to a positive correlation is an ecological strategy conducive to population survival.

A Modified Technique for Arteriovenous Fistula Construction in Rabbits.

Juxta-anastomotic stenosis is a challenging problem that often causes non-maturation and decreases the patency of an arteriovenous fistula (AVF). Injury to the veins and arteries during the operation and hemodynamic changes can lead to intimal hyperplasia, leading to juxta-anastomotic stenosis. To reduce injury to the veins and arteries during the operation, this study proposes a new modified no-touch technique (MNTT) for AVF construction that can decrease the rate of juxta-anastomotic stenosis and improve the AVF patency. To unravel the hemodynamic changes and mechanisms of the MNTT, this study presented an AVF procedure using this technique. Although this procedure is technically challenging, 94.4% procedural success was achieved after adequate training. Ultimately, 13 out of 34 rabbits had a functional AVF 4 weeks after the surgery, leading to a 38.2% AVF patency rate. However, at 4 weeks, the survival rate was 86.1%. Ultrasonography showed active blood flow through AVF anastomosis. Furthermore, the spiral laminar flow was observed in the vein and artery near the anastomosis, suggesting that this technique may improve the hemodynamics of the AVF. On histological observation, significant venous intimal hyperplasia was observed at the AVF anastomosis, whereas no significant intimal hyperplasia was observed at the proximal external jugular vein (EJV) of the anastomosis. This technique will improve the understanding of the mechanisms underlying the use of MNTT for AVF construction and provide technical support for the further optimization of the surgical approach in AVF construction.

Clinical and genetic analysis of essential hypertension with CYB gene m.15024G>A mutation / 浙江大学学报·医学版

OBJECTIVES@#To explore the role of mitochondrial CYB 15024G>A mutation in the development of essential hypertension.@*METHODS@#Mitochondrial genome sequences of hypertensive patients were obtained from previous studies. Clinical and genetic data of a hypertensive patient with mitochondrial CYB 15024G>A mutation and its pedigree were analyzed. Lymphocytes derived from patient and family members were transformed into immortalized lymphoblastoid cell lines, and the levels of adenosine triphosphate (ATP), mitochondrial membrane potential and intracellular reactive oxygen species (ROS) were detected.@*RESULTS@#The penetrance of this essential hypertension family was 42.9%, and the age of onset was 46-68 years old. Mitochondrial genome sequencing results showed that all maternal members carried a highly conserved mitochondrial CYB 15024G>A mutation. This mutation could affect the free energy of mitochondrial CYB for secondary and tertiary structure and protein folding, thereby changing its structural stability and the structure of the electron transfer function area around the mutation site. Compared with the control, the cell line carrying the mitochondrial CYB 15024G>A mutation showed significantly decreased levels of mitochondrial CYB, ATP and mitochondrial membrane potential, and increased levels of ROS (P<0.01).@*CONCLUSIONS@#Mitochondrial CYB 15024G>A mutation may affect the structure of respiratory chain subunits and mitochondrial function, leading to cell dysfunction, which suggests that the mutation may play a synergistic role in essential hypertension.

Characterization and phylogenetic analysis of complete chloroplast genome of cultivated Qinan agarwood / 中国中药杂志

"Tangjie" leaves of cultivated Qinan agarwood were used to obtain the complete chloroplast genome using high-throughput sequencing technology. Combined with 12 chloroplast genomes of Aquilaria species downloaded from NCBI, bioinformatics method was employed to determine the chloroplast genome characteristics and phylogenetic relationships. The results showed that the chloroplast genome sequence length of cultivated Qinan agarwood "Tangjie" leaves was 174 909 bp with a GC content of 36.7%. A total of 136 genes were annotated, including 90 protein-coding genes, 38 tRNA genes, and 8 rRNA genes. Sequence repeat analysis detected 80 simple sequence repeats(SSRs) and 124 long sequence repeats, with most SSRs composed of A and T bases. Codon preference analysis revealed that AUU was the most frequently used codon, and codons with A and U endings were preferred. Comparative analysis of Aquilaria chloroplast genomes showed relative conservation of the IR region boundaries and identified five highly variable regions: trnD-trnY, trnT-trnL, trnF-ndhJ, petA-cemA, and rpl32, which could serve as potential DNA barcodes specific to the Aquilaria genus. Selection pressure analysis indicated positive selection in the rbcL, rps11, and rpl32 genes. Phylogenetic analysis revealed that cultivated Qinan agarwood "Tangjie" and Aquilaria agallocha clustered together(100% support), supporting the Chinese origin of Qinan agarwood from Aquilaria agallocha. The chloroplast genome data obtained in this study provide a foundation for studying the genetic diversity of cultivated Qinan agarwood and molecular identification of the Aquilaria genus.

Effect of intermittent theta burst transcranial magnetic stimulation on non-fluent aphasia after stroke / 中国康复理论与实践

ObjectiveTo explore the therapeutic effect and mechanism of intermittent theta burst transcranial magnetic stimulation (iTBS) on non-fluent aphasia after stroke. MethodsFrom August, 2021 to August, 2022, 50 patients with non-fluent aphasia after stroke in the First People's Hospital of Lianyungang were randomly divided into sham stimulation group (n = 25) and iTBS group (n = 25). Both groups accepted speach training. iTBS group accepted iTBS, and the sham stimulation group received sham iTBS, for four weeks. The serum brain-derived neurotrophic factor (BDNF) was measured, and they were assessed by China Rehabilitation Research Center Standard Aphasia Examination (CRRCAE) and Boston Diagnostic Aphasia Examination before and after treatment. ResultsTwo cases in the sham stimulation group and three cases in iTBS group dropped down. The BDNF level, and listen and understand, repeat, name, read aloud, and total score of CRRCAE improved in two groups after treatment (|t| > 5.012, P < 0.001); and they were better in iTBS group than in the sham stimulation group (|t| > 3.968, P < 0.001). The total effective rate was more in iTBS group than in the sham stimulation group (χ2 = 8.835, P < 0.05). ConclusioniTBS can improve speech function in patients with non-fluent aphasia after stroke, which may associate with the promotion of BDNF.

Clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection / 中华消化内镜杂志

To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.

Clinical outcomes of selecting the vertebra above sagittal stable vertebra as distal fusion level for Scheuermann's thoracic kyphosis / 中华骨科杂志

Objective:To investigate the clinical outcome and complications associated with utilizing sagittal plane stable vertebra-1 (SSV-1) as the distal instrumented vertebra (LIV) in posterior fusion of thoracic kyphosis with Scheuermann's Disease kyphosis (STK).Methods:A longitudinal study on patients with STK who underwent posterior correction and fusion surgery from January 2018 to June 2021 were conducted. All participants had a follow-up duration over two years. Patients were divided into two groups according to the segment of LIV: the SSV group, where LIV was located in SSV; and the SSV-1 group, where LIV was located in the vertebral body above SSV. The radiographic parameters, including global kyphosis (GK), lumbar lordosis (LL), and sagittal plane (SVA), LIV offset distance (LIV translation), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS), were compared between the two groups. The SRS-22 scale was used to evaluate health-related quality of life at pre-operation and last follow-up, and the incidence of postoperative distal junctional kyphosis (DJK) was also recorded. Analytical techniques, such as Analysis of Variance and Mann-Whitney tests, were employed to compare inter-group differences.Results:A total of 57 patients were included in the study, 36 in the SSV group and 21 in the SSV-1 group. The average age for patients were 16.1±2.3 years (range 13-20 years), and the average follow-up time was 32.8±6.8 months (range 24-53 months). There were no statistically significant differences between the two groups in terms of gender, age, follow-up time, surgical time, intraoperative bleeding volume, and fusion level. Before surgery, the LIV deviation distance in the SSV group was significantly lower than that in the SSV-1 group (-7.9±11.0 mm vs. 31.5±11.5 mm, t=7.64, P<0.001). In the SSV group, the preoperative GK was 79.3°±10.5°, and the last follow-up GK was 44.4°±8.5°, which was significantly improved compared to preoperative value ( t=28.28, P<0.001); in the SSV-1 group, the preoperative GK was 81.1°±10.6°, and the value at 1-week post-operative was 44.9°±7.8°, which was significantly improved compared to pre-operative value ( t=22.23, P<0.001). At the last follow-up, it was 45.1°±8.7°, with a correction rate of 44.3%±8.5%. No significant difference was observed between the two groups in terms of GK, LL, SVA, PI, PT and SS at pre-operative, 1-week post-operative and last follow-up ( P>0.05). All patients had no intraoperative complications of nerve injury. During the follow-up period, one patient (1/21, 4.8%) developed DJK without complications such as proximal kyphosis, pseudarthrosis, or failed internal fixation. At the last follow-up, the functional score of SRS-22 in SSV-1 group improved from preoperative (3.5±0.54) to postoperative (4.1±0.62), with an average improvement rate of 19.2%±3.2%, and the difference was statistically significant ( t=3.74, P=0.001). These results indicating that the surgical treatment was effective in relieving the symptoms of the patients. Conclusion:Selecting SSV-1 as LIV in corrective surgeries for STK appears to produce commendable clinical results with minimal implant-associated complications over a two-year observation period.

The utilization of second sacral alar-iliac screw fixation technique in the treatment of adult spinal deformity: analysis of risk factors for postoperative sagittal imbalance / 中华骨科杂志

Objective:To evaluate the clinical outcomes and complications of second sacral alar-iliac (S 2AI) technique utilized in degenerative spinal deformity patients, and to analyze the potential risk factors for postoperative sagittal imbalance. Methods:From January 2014 to October 2020, a consecutive cohort of 39 degenerative spinal deformity patients who were treated with S 2AI were retrospectively reviewed, including 4 males and 35 females, aged 63.1±6.7 years (range, 43-73 years). All of the patients had a minimum of 2-year follow-up. According to the sagittal vertical axis (SVA) at the final follow-up, patients were divided into 2 groups. Sagittal balance group (SVA≤50 mm) and sagittal imbalance group (SVA>50 mm). Radiographic parameters including the Cobb's angle, coronal balance distance (CBD), thoracic kyphosis (TK), lumbar lordosis (LL), SVA, pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) were measured in the standing radiographs before and after operation and at the latest follow up. Comparison was made between the two groups and the differences with statistical significance were analyzed with binary logistic regression analysis. Intraoperative and postoperative complications were recorded. The Scoliosis Research Society-22 (SRS-22) score were employed to evaluate the quality of life. Results:The average follow-up period was 30.3±9.1 months (range, 43-73 months). Eighteen patients (46%) were identified with sagittal imbalance at the last follow-up. Compared with the patients in the sagittal balance group, the preoperative SVA was significantly larger (83.1±56.2 mm vs. 48.1±51.1 mm, t=2.04, P=0.049) and the postoperative TK was significantly greater (27.8°±9.6° vs. 18.9°±13.4°, t=2.36, P=0.024) for patients in the sagittal imbalance group. Scores of pain domain (3.2±0.5 vs. 3.7±0.6) and self-image domain (3.4±0.8 vs. 3.8±0.6) in sagittal imbalance group were significantly lower than those of sagittal balance group ( P<0.05). Logistic regression analysis showed that larger preoperative SVA ( OR=1.02, P=0.028) and greater postoperative TK ( OR=1.09, P=0.022) were independent risk factors for the occurrence of sagittal imbalance during the follow-up periods. Conclusion:S 2AI screw fixation can achieve satisfying coronal deformity correction and great sagittal reconstruction after surgery in patients with degenerative spinal deformity. However, sagittal imbalance may still occur during the follow-up periods. Larger preoperative SVA and greater postoperative TK are independent risk factors for the occurrence of sagittal imbalance.

Prevalence and distribution of ossification of ligamentum flavum at the adjacent segment of the apex in patients with degenerative kyphosis / 中华骨科杂志

Objective:To evaluate the prevalence and distribution of ossification of ligamentum flavum (OLF) at the segments adjacent to the apex in patients with degenerative kyphosis.Methods:All of 74 patients with degenerative kyphosis from January 2018 to December 2021 were retrospective reviewed. All patients were taken anteroposterior and lateral radiographs, CT scan and magnetic resonance imaging (MRI) of the entire spine. Global kyphosis, the morphology of kyphosis and the occurrence of OLF at three segments adjacent to the kyphosis apex were recorded.Results:Of the 74 patients, 54 patients (73%) developed OLF in three segments adjacent to the kyphotic apex. The mean age of the 54 patients was 61.4±6.8 years, and the mean global kyphosis was 49.5°±21.2°. Among other 20 patients without OLF, the mean age was 56.1±7.5 years, and the mean kyphosis angle was 52.1°±19.1°. There was a statistically significant difference in ages ( t=2.92, P=0.005), but no statistically significant difference was observed regarding global kyphosis ( t=0.48, P=0.634). In these 74 patients, 9 patients had angular kyphosis, of which 8 (89%) developed OLF; of the 65 patients without angular kyphosis, 46 patients (71%) developed OLF. There was no significant difference between them (χ 2=1.32, P=0.251). Among the 54 patients diagnosed with OLF, 5 patients (9%) suffered ossification of the posterior longitudinal ligament (OPLL) and 20 patients (37%) suffered dural ossification; 43 patients (80%) developed OLF at proximal segments of apex, 6 patient (11%) developed OLF at distal segments of apex, and 5 patients (9%) developed OLF both at proximal and distal segments of apex. Thirty-two patients (59%) developed OLF at the first segment adjacent to the kyphotic apex, 27 patients (50%) developed OLF at the second segment, and 15 patients (28%) developed OLF at the third segment. Conclusion:Among patients with degenerative kyphosis, about 73% may development OLF within three segments adjacent to the kyphotic apex, and it mostly occurred within two segments adjacent to the apex proximally.

The late-onset spine deformity in patients underwent myelomeningocele repair: radiologic characteristic and surgical strategy / 中华骨科杂志

Objective:To investigate the imaging features and surgical strategies of late-onset spinal deformity after myelomeningocele (MMC) repair.Methods:A total of 23 patients with late-onset spinal deformity after MMC repair from January 2006 to December 2019 were retrospectively analyzed, including 16 males and 7 females, aged 15.4±5.9 years (range, 6-28 years). All patients underwent MMC resection and repair in infancy (0-4 years). The complications of MMC, imaging characteristics of spinal deformity (Cobb angle of scoliosis, coronal balance, regional kyphosis), surgical methods, clinical outcomes and incidence of complications were analyzed. The Scoliosis Research Society-22 (SRS-22) score and Oswestry disability index (ODI) were used to evaluate the quality of life.Results:All patients were followed up for 2.4±0.8 years (range, 1-4 years). Among 23 patients, MMC occurred in the upper thoracic segment in 3 cases, thoracic segment in 1 case, thoracolumbar segment in 13 cases, and lumbosacral segment in 6 cases. 16 patients had scoliosis or kyphosis with the apex of the spine in the same segment as the MMC lesion. Among 13 patients with MMC located in thoracolumbar segment, 12 patients had scoliosis and 9 patients had kyphosis. Among 6 patients with MMC located in lumbosacral segment, 3 patients had pelvic tilt. Vertebral deformities included widening of pedicle space in 21 cases, enlargement of spinal canal in 19 cases, absence of spinous process in 17 cases, malsegmentation in 17 cases, and hemivertebra deformity in 9 cases. Intramedullary lesions included split cord in 6 cases and tethered cord in 9 cases. The overall implant density was 57.2%±17% (range, 16.6%-100%). At the last follow-up, the Cobb angle of scoliosis was 40.9°±19.1°, which was significantly smaller than 71.5°±28.2° before operation ( P<0.001). The local kyphosis angle was 26.7°±12.9°, which was significantly lower than that before operation (40.4°±21.5°), the difference was statistically significant ( P<0.001).The coronal balance was 16.1±13.6 mm, which was smaller than that before operation 28.5± 23.7 mm, the difference was statistically significant ( P<0.001). The total score of SRS-22 was 18.7±0.7, which was higher than that before operation 17.7±0.9, and the difference was statistically significant ( t=-9.74, P<0.001); ODI was 25.5%±6.2% after operation, which was significantly lower than that before operation (44.8%±10.1%), the difference was statistically significant ( t=13.66, P<0.001). Dural rupture occurred in 4 patients, including postoperative cerebrospinal fluid leakage in 2 cases; postoperative pleural effusion in 1 patient; and screw malposition in 2 patients. Three patients had broken rods and one had deep infection at final follow-up. Conclusion:About 70% of MMC patients who underwent resection and repair in early childhood developed late-onset spinal deformity in adulthood with the lesion at the parietal vertebrae. Posterior correction can obtain satisfactory clinical results. If the posterior element of the apical vertebral body is hypoplastic, the implant density can be increased by anterior vertebral screw, lamina hook fixation, and S 2 sacroiliac screw.

Severe kyphoscoliosis patients with type III spinal cord on preoperative apex MRI: preoperative traction does improve the safety of correction surgery / 中华骨科杂志

Objective:To analyze the radiographic improvements after Halo-gravity traction in severe kyphoscoliosis patientswith type III spinal cord on preoperative apex MRI, and to assess the clinical outcomes and surgical safety of Halo-gravity traction in this cohort.Methods:A total of 47 severe thoracic kyphoscoliosis patients with type III spinal cord on preoperative apex MRI who underwent preoperative Halo-gravity traction followed by one-stage posterior spinal fusion from February 2019 to June 2021 in the Nanjing Drum Tower Hospital were retrospectively analyzed. There were 18 males and 29 females with an average age of 22.5±12.8 years (range, 9-60 years). The average duration of traction was 7.4±3.9 weeks (range, 4-16 weeks). Radiographic parameters were measured including the coronal Cobb angle, distance between C 7 plumb line and center sacral vertical line (C 7PL-CSVL), sagittalglobal kyphosis (GK) and sagittal vertical axis (SVA) atpre-traction, post-traction and post-operation, respectively. The traction correction rate was measured as "traction degree before traction-traction degree after traction)/traction degree before traction" and the surgical correction rate was represented as "traction degree before traction-postoperative degree)/ traction degree before traction". The Frankel scoring system was used for the evaluation of neurological status at pre-traction, post-traction and post-operation. Results:All of 47 patients underwent the Halo-gravity traction and posterior spinal correction surgery. The C 7PL-CSVL was 35.7±16.9 mm at initial visit. At post-operation, C 7PL-CSVL was improved to 22.0±13.7 mm ( t=13.75, P<0.001), and the improvement rate was 39.9%±15.5%. The GK was 110.9°±22.1° at initial visit, which was improved to 84.1°±19.9° ( t=8.84, P<0.001) after Halo-gravity traction with an average correction of 23.7%±8.9%. At post-operation, GK was improved to 65.3°±19.3° ( t=10.63, P<0.001), and the improvement rate were 40.1%±20.7%. The SVA was 43.8±19.5 mm at initial visit. At post-operation, SVA was improved to 21.1±14.9 mm ( t=10.32, P<0.001), and the improvement rate were 53.1%±27.0%. A total of 14 patients showed neurological deficits of lower limbs at pre-traction, of which 8 patients had significant neurological improvement after Halo gravity traction; 3 patients had significant neurological improvement after surgery, and the remaining 3 patients had no significant neurological improvement during treatment. No new neurological deficits were observed after Halo-gravity traction or surgery. Conclusion:For severe kyphoscoliosis patients with type III spinal cord on preoperative apex MRI, the Halo-gravity traction could effectively correct the deformity, improve neurological function, enhance the tolerance of spinal cord to surgery and reduce the risk of intraoperative iatrogenic neurological deficit.

Research progress of soluble growth stimulating gene 2 protein in cardiovascular disease / 中国基层医药

Growth stimulating gene 2 (ST2) protein is a member of the interleukin-1 receptor family. It is mainly divided into a soluble secreted form sST2 and a transmembrane form ST2L. sST2 is a decoy receptor that competitively binds to interleukin-33 to block the interleukin-33/ST2L signaling pathway, worsening myocardial hypertrophy, fibrosis, and ventricular dysfunction. Measuring sST2 is of important value for diagnosis and/or prognosis evaluation of cardiovascular diseases. This paper mainly reviews the research progress in the relationship between cardiovascular diseases such as heart failure, coronary heart disease, hypertension, atrial fibrillation, myocarditis, cardiomyopathy, acute aortic dissection, and pulmonary hypertension, and sST2.

Application of self-developed rapid tracheotomy apparatus for acute tracheotomy / 中国基层医药

Objective:To investigate the application effects of self-developed rapid tracheotomy apparatus for acute tracheotomy.Methods:A total of 120 patients who underwent an acute tracheotomy in the Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force from January 2019 to December 2020 were included in this study. These patients were randomly divided into a rapid group and a conventional group, with 60 patients in each group. Patients in the rapid group underwent tracheotomy with a self-developed rapid tracheotomy apparatus. Patients in the conventional group underwent the standard steps of traditional tracheostomy. The operation time, incision length, amount of bleeding, and incidence of postoperative complications were compared between the two groups.Results:The operation time in the rapid group was significantly shorter than that in the conventional group [(4.5 ± 0.9) minutes vs. (19.3 ± 4.7) minutes, t = 23.86, P < 0.001]. The length of incision in the rapid group was significantly shorter than that in the conventional group [(2.8 ± 0.3) cm vs. (4.2 ± 1.3) cm, t = 8.68, P < 0.001]. The amount of bleeding during the surgery in the rapid group was significantly less than that in the conventional group [(4.4 ± 1.6) mL vs. (11.8 ± 4.1) mL, t = 12.99, P < 0.001]. The incidence of postoperative complications in the rapid group was significantly lower than that in the conventional group ( χ2 = 4.66, P = 0.031). Conclusion:The self-developed rapid tracheotomy apparatus for acute tracheotomy can be used to establish an artificial airway quickly and minimally invasively by simplifying the operational steps. It is remarkably innovative to increase safety with open-view operations and decrease the incidence of complications. It can be repeatedly sterilized and reused, which is worthy of clinical application and popularization.

Relationship between interleukin-1β and silicosis development / 中国基层医药

Silicosis is a diffuse pulmonary fibrosis disease caused by occupational exposure to silica, which is one of the occupational diseases with high incidence in developing countries. Up to now, there is no definite drug to relieve or reverse the lung injury caused by silicosis, so it is very important to prevent, diagnose and treat pulmonary fibrosis as soon as possible. Studies have shown that a chronic inflammatory environment contributes to pulmonary fibrosis to a certain extent. Interleukin-1β is a cytokine that increases the number of inflammatory factors in the microenvironment in the immune response and plays a key role in inflammatory reaction. Therefore, the release of interleukin-1β is of great significance in the pathogenesis of silicosis. This paper aims to systematically expound the development course of silicosis, the signal pathway of interleukin-1β production, and the relationship between them.