Hyperforin improves matrix stiffness induced nucleus pulposus inflammatory degeneration by activating mitochondrial fission.

OBJECTIVE: The continuously increasing extracellular matrix stiffness during intervertebral disc degeneration promotes disease progression. In an attempt to obtain novel treatment methods, this study aims to investigate the changes in nucleus pulposus cells under the stimulation of a stiff microenvironment. DESIGN: RNA sequencing and metabolomics experiments were combined to evaluate the primary nucleus pulposus and screen key targets under mechanical biological stimulation. Additionally, small molecules work in vitro were used to confirm the target regulatory effect and investigate the mechanism. In vivo, treatment effects were validated using a rat caudal vertebrae compression model. RESULTS: Our research results revealed that by activating TRPC6, hyperforin, a herbaceous extract can rescue the inflammatory phenotype caused by the stiff microenvironment, hence reducing intervertebral disc degeneration (IDD). Mechanically, it activates mitochondrial fission to inhibit PFKFB3. CONCLUSION: In summary, this study reveals the important bridging role of TRPC6 between mechanical stiffness, metabolism, and inflammation in the context of nucleus pulposus degeneration. TRPC6 activation with hyperforin may become a promising treatment for IDD.

The Role of Immunocyte Infiltration Regulatory Network Based on hdWGCNA and Single-Cell Bioinformatics Analysis in Intervertebral Disc Degeneration.

Immune infiltration plays a crucial role in intervertebral disc degeneration (IDD). In this study, we explored the immune microenvironment of IDD through single-cell bioinformatics analysis. Three single-cell datasets were integrated into this study. Nucleus pulposus cells (NPCs) were divided into subgroups based on characteristic genes, and the role of each subgroup in the IDD process was analyzed through pseudo-time trajectory analysis. The hub genes were obtained using hdWGCNA, further identified by bulk datasets and pseudo-time sequence. The expression of the hub genes defined the NPCs related to immune infiltration, and the interaction between these NPCs and immunocytes was explored. The NPCs were divided into four subgroups: reserve NPCs, HCL-NPCs, response NPCs, and support NPCs, which, respectively, dominate the four processes of IDD: non, mild, moderate, and severe degeneration. SPP1 and ICAM1 were identified as the nucleus pulposus immune infiltration hub genes. Macrophages and myelocytes played pro-inflammatory roles in the SPP1-ICAM both-up NPC group through the SPP1-CD44 pathway and ICAM1-ITGB2 ligand-receptor pathway, respectively. At the same time, both-up NPCs sought self-help inflammation remission from neutrophils through the ANXA1-FPR1 pathway. The systematic analysis of the differentiation and immune infiltration landscapes helps to understand IDD's overall development process. Our data suggest that SPP1 and ICAM1 may be new targets for the treatment of inflammatory infiltration in IDD.

LncRNA RP11-59J16.2 aggravates apoptosis and increases tau phosphorylation by targeting MCM2 in AD.

Alzheimer's disease (AD) is a degenerative disease of central nervous system with unclear pathogenesis, accounting for 60%-70% of dementia cases. Long noncoding RNAs (LncRNAs) play an important function in the development of AD. This study aims to explore the role of differentially expressed lncRNAs in AD patients' serum in the pathogenesis of AD. Microarray analysis was performed in the serum of AD patients and healthy controls to establish lncRNAs and mRNAs expression profiles. GO analysis and KEGG pathway analysis revealed that G1/S transition of mitotic cell cycle might be involved in the development of AD. The result showed that RP11-59J16.2 was up-regulated and MCM2 was down-regulated in serum of AD patients. SH-SY5Y cells were treated with Aß 1-42 to establish AD cell model. Dual luciferase reporter gene analysis verified that RP11-59J16.2 could directly interact with 3'UTR of MCM2 and further regulate the expression of MCM2. Inhibition of RP11-59J16.2 or overexpression of MCM2, CCK-8 assay and Annexin V FITC/PI apoptosis assay kit results showed that RP11-59J16.2 could reduce cell viability, aggravate apoptosis and increase Tau phosphorylation in AD cell model by inhibiting MCM2. In short, our study revealed a novel lncRNA RP11-59J16.2 that could promote neuronal apoptosis and increase Tau phosphorylation by regulating MCM2 in AD model, and indicated that lncRNA RP11-59J16.2 might be a potential target molecule for AD development.

Comparison between gravity drainage group and suction drainage group after cervical laminoplasty: a retrospective STROBE-compliant cohort study.

OBJECTIVES: A retrospective study was conducted to compare gravity drainage and suction drainage after cervical laminoplasty. PATIENTS AND METHODS: A total of 375 patients who underwent laminoplasty between January 2011 and December 2015 were engaged in this analysis. We investigated the patients' basic characteristics, drainage characteristics and postoperative complications. RESULTS: During the initial 24 h after laminoplasty, the drainage volume in the suction drainage group was 177.31 ± 92.02 mL, and the drainage volume in the gravity drainage group was 133.33 ± 92.40 mL. The drainage volume showed significant difference (p < 0.01). The total drainage volume was 357.49 ± 195.16 mL and 250.16 ± 27.44 mL in the suction drainage group and gravity drainage group, respectively. The total drainage volume between the two groups was statistically different (p = 0.03). The postoperative Hb was significantly different between the gravity group and suction group on the first day after the operation (108.37 ± 23.92 mL vs. 87.32 ± 21.53 mL, p = 0.02). The number of patients required blood transfusion was significantly different between the two groups as well (p = 0.04). Two cases had symptomatic epidural hematomas (SEH) after laminoplaty. However, the occurrence of SEH among the two groups was not different significantly. Twelve patients had surgical site infection (SSI). Of these 12, nine had applied gravity drainage and three suction drainage. The rate of SSI was similar between the two groups (p = 0.71). CONCLUSION: The initial 24 h' drainage volume and the total drainage volume increased significantly in the suction drainage group. The postoperative Hb was lower in the suction group than the gravity drainage group the first postoperative day. More patients needed blood transfusion if suction drainage was performed. The application of suction drainage cannot decrease the incidence of SSI and SEH after laminoplasty. Gravity drainage is recommended for laminoplasty.

Predictor of Surgical Outcomes in Ankylosing Spondylitis Cervical Spinal Fracture: An At Least 2 Years Follow-Up Retrospective Study.

STUDY DESIGN: Retrospective study. OBJECTIVE: A retrospective study was conducted to clarify the prognostic factors of postoperative for cervical spine fractures patients with ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: Now the high probability of cervical fractures in patients with AS is unanimously recognized. Fractures mostly occur in the lower cervical spine and two-thirds of patients are accompanied by spinal cord injury. But there are few studies on treatment of AS patients with cervical fracture and it is unclear whether the surgical method, timing of surgery, basic treatment of AS, and different doses of steroids therapy have an impact on the prognosis. Thus, this study aims to evaluate the impact of perioperative factors on the prognosis of traumatic cervical fractures in surgical patients with AS. METHODS: Preoperative and postoperative spinal cord function were assessed according to the Japanese Orthopaedic Association (JOA) Scores and Improvement rate were calculated. The neck pain severity were rated using a visual analogue scale (VAS) score. The t test and v2-test were used for comparison of clinical data between the preoperative and postoperative groups. Logistic univariate and multivariate regression analysis were used to obtain adjusted odds ratios. Pearson correlation coefficients were used to evaluate the relationship between variables. RESULTS: The degree of fracture displacement in cervical spine fractures patients with AS was most common at the neck-chest junction (26.1%). Patients with degree of cervical fracture displacement less than 50% had significantly improved JOA scores after surgery (P = 0). The incidence of spinal cord injury (SCI) due to fracture was high (52.2%). Patients with combined anterior and posterior is helpful for neurological recovery (P = 0.01). Basic AS treating before injury would be benefit for neurological improvement (P = 0). CONCLUSION: Basic AS treatment, SCI, and surgical methods are independent factors that affect the prognosis of cervical spine fractures patients with AS. It is controversial to perform surgery and preoperative steroid application as soon as possible. LEVEL OF EVIDENCE: 3.

Transdural Approach to Resection of Intraspinal Extradural Ventral Cysts in the Lumbar Spine.

BACKGROUND: Intraspinal extradural ventral cysts in the lumbar spine can cause back pain and neurological deficits of the lower extremities. For the resection of this type of space-occupying lesion, the transdural approach has not been reported in the literature. CASE DESCRIPTION: A 66-year-old man presented, suffering from progressive radiation pain of his bilateral lower extremities. Imaging examination revealed a cystic lesion in ventral side of lumbar spinal canal. We conducted the excision of the cyst with the transdural approach. The symptoms of the patient disappeared immediately after the operation and recurrence of the symptoms has not been observed in the 3-month follow-up. CONCLUSIONS: This operation approach is safe and effective. Compared with the previous surgical approach reported in the literature, by this approach surgeons could achieve less injury, shorter operation time, and the same surgical outcomes in the short term. Therefore, we would like to present this approach to provide an alternative to deal with similar lesions.

Risk factors of postoperative low back pain for low-grade isthmic spondylolisthesis: a retrospective study.

OBJECTIVE: To investigate the risk factors of postoperative low back pain (LBP) following posterior lumbar interbody fusion (PLIF) surgery for low-grade isthmic spondylolisthesis (IS). METHODS: This retrospective study enrolled patients with IS that underwent PLIF between January 2011 and January 2016. Demographic, clinical, surgical and radiological characteristics were analysed to determine associations between these characteristics and LBP as measured using a visual analogue scale (VAS) pain score. RESULTS: A total of 192 patients were enrolled in the study. The mean VAS pain score of LBP decreased significantly after surgery. The mean preoperative VAS pain score was significantly greater in patients with symptoms of ≤3 years duration compared with those with symptoms lasting >3 years. The postoperative VAS pain score was significantly lower in patients with grade 1 slippage compared with those with grade 2 slippage. There was a significant correlation between preoperative to postoperative change of VAS pain score and postoperative disc height (r = 0.99). CONCLUSION: PLIF significantly improved LBP in patients with low-grade IS, although patients still reported some postoperative LBP. The grade of slippage was a risk factor for postoperative LBP. Restoring the disc height appeared to improve LBP.