Early result of percutaneous full-endoscopic transforaminal lumbar interbody fusion in the treatment of single-level lumbar degenerative diseases: a retrospective study.

OBJECTIVE: The study aimed to evaluate the short-term clinical efficacy of percutaneous full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for lumbar degenerative diseases (LDD). METHODS: From July 2020 to July 2021, 93 patients who underwent single-level lumbar fusion procedure were retrospective analysis. The patients were divided into Endo-TLIF group and transforaminal lumbar interbody fusion (TLIF) group. General demographic and perioperative data were recorded, the clinical outcomes were evaluated using visual analogue scale (VAS) and oswestry disability index (ODI). The disk height (DH) was compared between the two groups. RESULTS: All of the surgical procedures were successfully completed, and the patients were followed for a minimum of 2 years. Intraoperative blood loss, drainage volume, time to independent ambulation and hospital length of stay in the Endo-TLIF group were significantly decreased in comparison with the open TLIF group (p < 0.05). The VAS for back pain on postoperative 7 day and ODI on postoperative 1 month were lower in the Endo-TLIF group than in the open TLIF group (P < 0.05), but no significant difference at 1 year and 2 years postoperatively (P > 0.05). The VAS score of leg pain had no demographic statistically significant differences between the groups (P > 0.05). The DH were significantly heightened after surgery compared to the preoperative height (p < 0.05). CONCLUSION: Endo-TLIF is a minimally invasive, safety surgery which can achieve comparable short-term effects as open TLIF. It may be a promising option for the treatment of LDD.

Apelin-13 alleviates osteoclast formation and osteolysis through Nrf2-pyroptosis pathway.

Wear particle-induced periprosthetic osteolysis is the key to aseptic loosening after artificial joint replacement. Osteoclastogenesis plays a central role in this process. Apelin-13 is a member of the adipokine family with anti-inflammatory effects. Here, we report that apelin-13 alleviates RANKL-mediated osteoclast differentiation and titanium particle-induced osteolysis in mouse calvaria. Mechanistically, apelin-13 inhibits NLRP3 inflammasome-mediated pyroptosis by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. In summary, apelin-13 is expected to be a potential drug for relieving aseptic osteolysis. RESEARCH HIGHLIGHTS: This study reveals the molecular mechanism by which apelin-13 inhibits NLRP3 inflammasome activation and pyroptosis by promoting Nrf2. This study confirms that apelin-13 alleviates osteoclast activation by inhibiting pyroptosis. In vivo studies further confirmed that apelin-13 alleviated mouse skull osteolysis by inhibiting the activation of NLRP3 inflammasome.

Influence of sarcopenia on surgical efficacy and mortality of percutaneous kyphoplasty in the treatment of older adults with osteoporotic thoracolumbar fracture.

BACKGROUND: Sarcopenia is an age-related condition that causes loss of skeletal muscle mass and disability. Sarcopenia is closely related to the prognosis of patients suffering osteoporotic thoraco-lumbar compression fractures (OTLCF). The purpose of this study was to investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty (PKP) in the treatment of older adults with OTLCF surgery and postoperative mortality. METHODS: From February 2016 to June 2019, 101 patients who met the inclusion and exclusion criteria were included in this study. The grip strength of the dominant hand was measured using an electronic grip tester. The diagnostic cutoff value of grip strength for sarcopenia was <27 kg for males and <16 kg for females. The cross-sectional area (cm2) of the musculature at the level of the pedicle of the thoracic 12th vertebra (T12) was measured by chest CT. The skeletal muscle index (SMI) was calculated by dividing the muscle cross-sectional area at the T12 pedicle level by the square of the height. The diagnostic cut-off value of SMI at T12 level is 42.6 cm2/m2 for males and 30.6 cm2/m2 for females. Sarcopenia was diagnosed when the grip strength and SMI values were both lower than the diagnostic cut-off value. All included patients received PKP treatment for OTLCF. The age, gender, operation time, bleeding volume, time to ground, length of hospital stay, visual analog scale (VAS) score before operation and one month after operation, Oswestry Disability Index (ODI) one month after operation and the incidence of refracture within 36 months after operation were compared between the two groups. The survival curves of the two groups were analyzed by Kaplan Meier. Chi-square test was used to compare the differences in survival rates between the two groups at 12, 24, and 36 months after operation. Univariate and multivariate Cox regression analysis compared multivariate factors on OTLCF postoperative mortality. RESULTS: There was no significant difference in gender, operation time, blood loss and preoperative VAS score between the two groups (χ2 = 1.750, p = 0.186; t = 1.195, p = 0.235; t = -0.582, p = 0.562; t = -1.513, p = 0.133), respectively. The patients in the sarcopenia group were older (t = 3.708, p = 0.000), and had longer postoperative grounding time and hospitalization time (t = 4.360, p = 0.000; t = 6.458, p = 0.000). The VAS scores and ODI scores one month postoperatively were also higher in sarcopenia group (t = 5.900, p = 0.000; t = 7.294, p = 0.000), and there was a statistical difference between the two groups. Interestingly, there was no significant difference in the incidence of spinal refracture within 36 months between the two groups (χ2 = 1.510, p = 0.219). The sarcopenia group had a higher mortality rate at 36 months after operation, and the difference was statistically significant (p = 0.002). Sarcopenia is an independent risk factor for long-term mortality in OTLCF patients received PKP surgery. CONCLUSIONS: Patients with sarcopenia combined with OTLCF have poor postoperative recovery of limb function and a high risk of death in the long-term (36 months) after surgery. Active and effective intervention for sarcopenia is required during treatment.

Clinical Study of Percutaneous Endoscopic Large-channel Fusion and Transforaminal Lumbar Interbody Fusion in the Treatment of Degenerative Lumbar Spinal Stenosis.

Context: Degenerative changes in the lumbar spine more commonly cause spinal stenosis and with the aging of society, its incidence is on the rise. Endoscopic spinal surgery is a minimally invasive technique for decompression. The efficacy of percutaneous, endoscopic, large-channel fusion and transforaminal lumbar interbody fusion (TLIF) need confirmation by more studies. Objective: The study intended to investigate the clinical efficacy of percutaneous endoscopic large-channel fusion and TLIF in the treatment of degenerative lumbar spinal stenosis, to find the best treatment plan. Design: The research team performed a retrospective study. Setting: The study took place at Nanjing Lishui People's Hospital in Nanjing, Jiangsu Province, PR China. Participants: Participants were 100 patients with degenerative, lumbar, spinal stenosis who had been admitted to the hospital between October 2018 and October 2022. Intervention: The research team randomly divided participants into an intervention group and a control group, with 50 participants in each group. The intervention group received percutaneous, endoscopic, large-channel fusion and internal fixation, and the control group received foraminal, lumbar, interbody fusion. Outcome Measures: The research team measured: (1) perioperative indexes, (2) clinical efficacy at a postoperative follow-up at 6 months postintervention, (3) indexes for inflammatory responses at baseline and postintervention, (4) postoperative pain at baseline and at months 3 and 6 postintervention using a visual analog scale (VAS), (6) lumbar function at baseline and months 3 and 6 postintervention using the Oswestry Disability Index (ODI) and the Japanese Orthopedic Association (JOA) scale, and (7) complications. Results: Compared with the control group, the intervention group's perioperatively related and inflammatory-response indexes were significantly better: (1) amount of bleeding- 112.67 ± 17.38 for the control group and 78.62 ± 10.52 for the intervention group (P = .002); (2) volume of drainage-79.63 ± 14.21 for the control group and 52.18 ± 8.21 for the intervention group (P = .001); (3) ESR at baseline and postintervention-22.41 ± 5.62 and 15.18 ± 5.26, respectively, for the control group and 22.58 ± 5.82 and 10.54 ± 3.18, respectively, for the intervention group, with P = .013 postintervention; and (4) CRP at baseline and postintervention-17.42 ± 3.52 and 13.98 ± 3.65 for the control group, respectively, and 18.65 ± 3.78 and 10.14 ± 2.78 for the intervention group, with P = .008 postintervention; Also, compared to the control group, the intervention group's: (1) total effective rate was significantly higher (P = .018); (2) incidence of postoperative complications was significantly lower (P = .006); (3) VAS pain score was significantly lower at months 3 and 6, with P = .028 and P = .021, respectively; (4) Oswestry Disability Index (ODI) function score was significantly lower at months 3 and 6, with P = .016 and P = .014, respectively; and (5) postoperative JOA function score was significantly higher at months 3 and 6, with P = .011 and P = .007, respectively. Conclusions: Both percutaneous, endoscopic, large-channel fusion and TLIF had good therapeutic effects in the treatment of degenerative lumbar spinal stenosis. However, compared with the latter, the former was more effective, with better comprehensive efficacy and more obvious benefits for patients, so it's worthy of clinical promotion and use.

Resistance monitoring and mechanism in the fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae) for chlorantraniliprole from Sichuan Province, China.

The fall armyworm, Spodoptera frugiperda (Noctuidae: Lepidoptera), is a wide-reaching notorious insect pest of important cereal crops, which has developed resistance to multiple classes of insecticides. It invaded the Sichuan Province of China in 2019. In this study, we performed resistance monitoring of insecticides for 11 field-collected populations from Sichuan, and all the populations were susceptible to emamectin benzoate and chlorpyrifos. The variations in resistance level to indoxacarb (resistance ratio (RR), 9.23-45.53-fold), spinetoram (RR, 4.32-18.05-fold), and chlorantraniliprole (RR, 2.02-10.39-fold) were observed among these populations. To investigate the resistance mechanism of chlorantraniliprole, synergism tests were performed and showed that piperonyl butoxide had a slight synergistic effect on chlorantraniliprole for the QJ-20 population (1.43-fold) in moderate resistance (RR, 10.39-fold) compared with the treatment group without synergist. Furthermore, the expression scanning for resistance-related genes showed that five P450 genes (CYP6AE43, CYP321A8, CYP305A1, CYP49A1, and CYP306A1) and the ryanodine receptor gene (Ryr, chlorantraniliprole target) were overexpressed in the QJ-20 population. These results indicated that the fall armyworm in Sichuan has exhibited diverse susceptibilities to several classes of insecticides, and the overexpression of Ryr and several P450 genes may contribute to the development of resistance in S. frugiperda to chlorantraniliprole.

Meta-Analysis of the Efficacy and Safety of Tranexamic Acid in Spinal Surgery.

Objective: The safety and effectiveness of topical tranexamic acid in spinal surgery has not yet been reached, and further research is needed to confirm it. This study is aimed at detecting the effectiveness and safety on the tranexamic acid in spinal surgery. Methods: The Cochrane Library, PubMed, Embase, CNKI, and other databases were searched. The search time was from 2016 to 2019. All randomized controlled trials comparing the topical tranexamic acid group and the control group were collected. The experimental group used topical application. Tranexamic acid was used to treat bleeding after spinal surgery. The control group was no tranexamic acid or isotonic saline. The total bleeding, blood transfusion rate, and the occurrence of deep vein thrombosis were compared between the two groups. Rev Man 5.2.0 software was used for meta-analysis. Results: A total of 8 randomized controlled trials were included, including 884 patients. Meta-analysis results showed that the total bleeding volume of the tranexamic acid group was lower than that of the control group, and the difference was statistically significant weighted mean difference ((WMD) = -360.27 mL, 95% confidence interval (CI) (-412.68, -307.87) mL, P < 0.00001). The blood transfusion rate in the tranexamic acid group was lower than that in the control group (odds ratio (OR) = 0.22, 95% CI (0.14, 0.33), P < 0.00001). There was no significant difference in the incidence of deep vein thrombosis between the two groups: OR = 1.48, 95% CI (0.41, 5.34), P = 0.55. Conclusion: Tranexamic acid can significantly reduce perioperative total blood loss, intraoperative blood loss, and blood transfusion rate during spinal surgery but has no significant effect on blood transfusion and thrombosis.

Mechanisms for multiple resistances in field populations of rice stem borer, Chilo suppressalis (Lepidoptera: Crambidae) from Sichuan Province, China.

Chilo suppressalis Walker (Lepidoptera: Crambidae) is a widely destructive pest occurring in rice, particularly in the rice-growing regions of Asia. In recent years, C. suppressalis has developed resistance to several insecticides because of the extensive use of insecticides. The resistance levels to four insecticides were determined among populations from different regions of Sichuan Province, China, using a drop-method bioassay. Based on LC50 values of a laboratory susceptible strain, all field populations showed moderate level of resistance to triazophos (23.9- to 83.5-fold) and were either susceptible or had a low level of resistance to abamectin (2.1- to 5.8-fold). All field-collected populations had a low or moderate level of resistance to chlorpyrifos (1.7- to 47.1-fold) and monosultap (2.7- to 13.5-fold). The synergism experiment indicated that the resistance of the XW19 to triazophos may be associated with cytochrome P450 monooxygenases (P450s), with the highest synergistic ratio (SR) of 3.05-fold and increased ratio (IR) of 2.28-fold for piperonylbutoxide (PBO). The P450 activity of the TJ19 population was the greatest among the six field populations. Moreover, the relative expression levels of four resistance-related P450 genes were detected with qRT-PCR, and the results indicated that CYP324A12, CYP321F3 and CYP9A68 were overexpressed in the resistant population, especially in the XW19 population (by 1.2-, 3.4 -, and 18.0-fold, respectively). In addition, the relative expression levels of CYP9A68 among the CZ19 and TJ19 populations were also enhanced 10.5- and 24.9-fold, respectively. These results suggested that CYP324A12, CYP321F3 and CYP9A68 may be related to the resistance development of C. suppressalis to triazophos.

Status of insecticide resistance and biochemical characterization of chlorpyrifos resistance in Sogatella furcifera (Hemiptera:Delphacidae) in Sichuan Province, China.

The white-backed planthopper, Sogatella furcifera (Horváth) (Hemiptera, Delphacidae), is an energetic rice insect pest in rice production or rice-growing areas. Due to excessive use of the chemical insecticide, S. furcifera has produced the high resistance to some frequently used insecticides. In this paper, the resistance levels of S. furcifera from the eight different areas of Sichuan Province against the five chemicals were monitored by using the rice seedling dipping during 2017-2018 to understand the resistance levels. The results showed that most of all populations have developed low or moderate level of resistance for chlorpyrifos (3.4 to 44.3-fold) and thiamethoxam (3.9- to 15.5-fold), the populations in the LS (1.7 to 5.4- fold)and WS (1.6 to 5.0- fold) regions were still sensitive or low resistance levels compared with other local populations. Almost all populations displayed the susceptible to imidacloprid (0.9- to 5.0-fold), buprofezin (0.9- to 4.3-fold) or low levels of resistance to pymetrozine (1.5- to 6.8-fold). The synergism experiment indicated that P450 enzymes may be important contributed to the metabolic detoxification of chlorpyrifos. The cross-resistance bioassay showed that there was no cross-resistance between chlorpyrifos and triflumezopyrim, but for sulfoxaflor, in the XY17 population. The relative expression level of twelve insecticide resistant-related P450 genes were analyzed by using qRT-PCR and found that CYP4C77, CYP418A1, CYP418A2, CYP408A3 and CYP6ER4 were significantly more expressed in the 3rd-instar nymph of the XY17 and XY18 field populations. To determine the main resistant-related P450 gene for chlorpyrifos, the relative expression level of five P450 genes were detected by using qRT-PCR from the G2 and G4 generation of XY17 under the pressure with LC50 of chlorpyrifos. The results showed that CYP6ER4 was significantly up-regulated expression in XY17 G2 and G4 generations population over 700-fold (P < 0.01). The full length and proteins tertiary structure were also cloned and predicted. Meanwhile, the function of CYP6ER4 was analyzed by RNA interference and the results indicated that the relative expression of CYP6ER4 in the XY17 (G4) population after injected dsRNA was lower than that in the dsGFP injected group. Moreover, the mortality rates of the S. furcifera treated with the LC50 concentration of chlorpyrifos after dsRNA microinjection was significantly higher than that of the dsGFP injected group 72 h after treatment (P < 0.01). Therefore, the overexpression of CYP6ER4 may be one of the primary factors in the development of chlorpyrifos resistance in S. furcifera.

Sinomenine ameliorates intervertebral disc degeneration via inhibition of apoptosis and autophagy in vitro and in vivo.

BACKGROUND: Aberrant apoptosis in nucleus pulposus (NP) cells is the primary cause of intervertebral disc degeneration (IDD). In contrast, a large number of studies have confirmed that autophagy may protect NP cells from apoptosis. Sinomenine is an alkaloid monomer, which has been reported to stimulate cell autophagy. Therefore, the aim of the present study was to investigate the effects of sinomenine on IDD. METHODS: The effects of sinomenine on the proliferation and apoptosis of NP cells were evaluated with the CCK-8 assay and Annexin V/PI staining, respectively. RESULTS: The data obtained from the present study demonstrated that sinomenine could notably reverse TBHP-induced growth inhibition and apoptosis in rat NP cells. In addition, sinomenine significantly induced autophagy in rat NP cells, which was completely inhibited by 3-methyladenine (3MA). In addition, the protective effect of sinomenine against TBHP in rat NP cells was abolished following treatment with 3MA. Finally, an in vivo study further confirmed that sinomenine could ameliorate rat IDD. CONCLUSION: Taken together, the results of the present study indicated sinomenine could ameliorate rat IDD via induction of autophagy in vitro and in vivo. These findings suggest the therapeutic potential of sinomenine in the prevention of IDD.

MiR-143 regulates the proliferation and migration of osteosarcoma cells through targeting MAPK7.

Accumulating documents have been suggested that microRNA-143 (miR-143) function as a tumor suppressor, involved in many biological processes including tumor initiation and progression. However, the biological function and molecular mechanism of miR-143 in Osteosarcoma (OS) still remains to be further investigated. Despite many efforts have been made, the prognosis of OS is still unsatisfied. Thus, exploring the underlying mechanism of OS and finding new treatment targets is essential for improving the survival rate of OS patients. In our study, we determined the level of miR-143 in clinical OS tissues and cells, and explored its function and underlying mechanisms in the tumorigenesis of OS. Our findings revealed that miR-143 expression was significantly downregulated in OS tissues and cell lines. Gain-of-function assays indicated that forced expression of miR-143 in OS cells inhibited cell proliferation and migration/invasion. Bioinformatics and luciferase reporter assays confirmed that MAPK7 was targets gene of miR-143. The results of the present study indicated that miR-143 could be a potential target for treating OS.

Cullin-1 regulates MG63 cell proliferation and metastasis and is a novel prognostic marker of osteosarcoma.

BACKGROUND: There is no reliable marker available for early detection, diagnostic confirmation or disease prognosis of osteosarcoma. Cullin-1 (CUL1) is a newly reported tumor-related gene, and we aimed to unravel its role in osteosarcoma. METHODS: We used immunohistochemistry to analyze the correlation between CUL1 expression and clinicopathological variables and patient survival. To evaluate the function of CUL1, a group of 28 osteosarcoma patients were recruited for this study. The role of regulation of CUL1 in osteosarcoma was studied in vitro and in vivo. In addition, we further investigated the signaling pathway of CUL1 in osteosarcoma progression. RESULTS: We first discovered that CUL1 expression was up-regulated in human osteosarcoma tissues and inversely correlated with osteosarcoma differentiation. In addition, CUL1 promotes osteosarcoma cell proliferation in vitro and in vivo. We also found that CUL1 promotes osteosarcoma cell invasion and metastasis in vitro and in vivo. High levels of CUL1 promote osteosarcoma progression via up-regulation of MMP9 expression. CONCLUSIONS: Our results demonstrate that increased CUL1 expression is significantly correlated with poor prognosis of patients with osteosarcoma. CUL1 might be an important marker and a therapeutic target for osteosarcoma.