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The widespread utilization of plastic and cobalt alloy products in industries and medicine has led to the increased presence of their degradation byproducts, microplastics (MPs), and cobalt nanoparticles (Co NPs), in the environment and organisms. While these particles can circulate throughout the body via the circulatory system, their specific adverse effects and mechanisms on the vascular system remain unclear. Employing scanning electron microscope (SEM) analysis and other methodologies, we demonstrate the potential adsorption and aggregation phenomena between MPs and Co NPs. In vitro experiments illustrate that ingestion of either MPs or Co NPs compromises vascular endothelial cell function and induces the generation of reactive oxygen species (ROS). Notably, this effect is markedly attenuated when a combination of MPs and Co NPs is administered compared to MPs alone. Additionally, zebrafish experiments validate our in vitro findings. Mechanistic studies have demonstrated that both MPs and Co NPs induce aberrant Nuclear factor erythroid 2-related factor 2 (Nrf2) signaling. Intriguingly, a weaker activation level is observed when these agents are administered in combination compared to when they are administered individually. Our study provides novel insights into the interaction between MPs and Co NPs and their detrimental effects on vascular endothelial cells.
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Many advanced super-resolution reconstruction methods have been proposed recently, but they often require high computational and memory resources, making them incompatible with low-power devices in reality. To address this problem, we propose a simple yet efficient super-resolution reconstruction method using waveform representation and multi-layer perceptron (MLP) for image processing. Firstly, we partition the original image and its down-sampled version into multiple patches and introduce WaveBlock to process these patches. WaveBlock represents patches as waveform functions with amplitude and phase and extracts representative feature representations by dynamically adjusting phase terms between tokens and fixed weights. Next, we fuse the extracted features through a feature fusion block and finally reconstruct the image using sub-pixel convolution. Extensive experimental results demonstrate that SRWave-MLP performs excellently in both quantitative evaluation metrics and visual quality while having significantly fewer parameters than state-of-the-art efficient super-resolution methods.
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BACKGROUND: Selenium nanoparticles (SeNPs) are increasingly gaining attention due to its characteristics of low toxicity, high activity, and stability. Additionally, Bacillus licheniformis, as a probiotic, has achieved remarkable research outcomes in diverse fields such as medicine, feed processing, and pesticides, attracting widespread attention. Consequently, evaluating the activity of probiotics and SeNPs is paramount. The utilization of probiotics to synthesize SeNPs, achieving large-scale industrialization, is a current hotspot in the field of SeNPs synthesis and is currently the most promising synthetic method. To minimize production costs and maximize yield of SeNPs, this study selected agricultural by-products that are nutrient-rich, cost-effective, and readily available as culture medium components. This approach not only fulfills industrial production requirements but also mitigates the impact on downstream processes. RESULTS: The experimental findings revealed that SeNPs synthesized by B. licheniformis F1 exhibited a spherical morphology with diameters ranging from 110 to 170 nm and demonstrating high stability. Both the secondary metabolites of B. licheniformis F1 and the synthesized SeNPs possessed significant free radical scavenging ability. To provide a more robust foundation for acquiring large quantities of SeNPs via fermentation with B. licheniformis F1, key factors were identified through single-factor experiments and response surface methodology (RSM) include a 2% seed liquid inoculum, a temperature of 37 â, and agitation at 180 rpm. Additionally, critical factors during the optimization process were corn powder (11.18 g/L), soybean meal (10.34 g/L), and NaCl (10.68 g/L). Upon validating the optimized conditions and culture medium, B. licheniformis F1 can synthesize nearly 100.00% SeNPs from 5 mmol/L sodium selenite. Subsequently, pilot-scale verification in a 5 L fermentor using the optimized medium resulted in a shortened fermentation time, significantly reducing production costs. CONCLUSION: In this study, the efficient production of SeNPs by the probiotic B. licheniformis F1 was successfully achieved, leading to a significant reduction in fermentation costs. The exploration of the practical applications of this strain holds significant potential and provides valuable guidance for facilitating the industrial-scale implementation of microbial synthesis of SeNPs.
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Bacillus licheniformis , Medios de Cultivo , Fermentación , Probióticos , Selenio , Bacillus licheniformis/metabolismo , Selenio/metabolismo , Medios de Cultivo/química , Probióticos/metabolismo , Nanopartículas/química , Nanopartículas del Metal/químicaRESUMEN
PURPOSE: Tractography of the facial nerve based on diffusion MRI is instrumental before surgery for the resection of vestibular schwannoma, but no excellent methods usable for the suppression of motion and image noise have been proposed. The aim of this study was to effectively suppress noise and provide accurate facial nerve reconstruction by extend a fiber trajectory distribution function based on the fourth-order streamline differential equations. METHODS: Preoperative MRI from 33 patients with vestibular schwannoma who underwent surgical resection were utilized in this study. First, T1WI and T2WI were used to obtain mask images and regions of interest. Second, probabilistic tractography was employed to obtain the fibers representing the approximate facial nerve pathway, and these fibers were subsequently translated into orientation information for each voxel. Last, the voxel orientation information and the peaks of the fiber orientation distribution were combined to generate a fiber trajectory distribution function, which was used to parameterize the anatomical information. The parameters were determined by minimizing the cost between the trajectory of fibers and the estimated directions. RESULTS: Qualitative and visual analyses were used to compare facial nerve reconstruction with intraoperative recordings. Compared with other methods (SD_Stream, iFOD1, iFOD2, unscented Kalman filter, parallel transport tractography), the fiber-trajectory-distribution-based tractography provided the most accurate facial nerve reconstructions. CONCLUSION: The fiber-trajectory-distribution-based tractography can effectively suppress the effect of noise. It is a more valuable aid for surgeons before vestibular schwannoma resection, which may ultimately improve the postsurgical patient's outcome.
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Imagen de Difusión Tensora , Nervio Facial , Neuroma Acústico , Humanos , Neuroma Acústico/diagnóstico por imagen , Neuroma Acústico/cirugía , Imagen de Difusión Tensora/métodos , Nervio Facial/diagnóstico por imagen , Femenino , Masculino , Persona de Mediana Edad , Adulto , Anciano , Algoritmos , Procesamiento de Imagen Asistido por Computador/métodos , Cuidados Preoperatorios/métodos , Adulto JovenRESUMEN
Acting as a growth regulator, Indole-3-acetic acid (IAA) is an important phytohormone that can be produced by several Bacillus species. However, few studies have been published on the comprehensive evaluation of the strains for practical applications and the effects of selenium species on their IAA-producing ability. The present study showed the selenite reduction strain Bacillus altitudinis LH18, which is capable of producing selenium nanoparticles (SeNPs) at a high yield in a cost-effective manner. Bio-SeNPs were systematically characterized by using DLS, zeta potential, SEM, and FTIR. The results showed that these bio-SeNPs were small in particle size, homogeneously dispersed, and highly stable. Significantly, the IAA-producing ability of strain was differently affected under different selenium species. The addition of SeNPs and sodium selenite resulted in IAA contents of 221.7 µg/mL and 91.01 µg/mL, respectively, which were 3.23 and 1.33 times higher than that of the control. This study is the first to examine the influence of various selenium species on the IAA-producing capacity of Bacillus spp., providing a theoretical foundation for the enhancement of the IAA-production potential of microorganisms.
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Bacillus , Ácidos Indolacéticos , Selenio , Ácidos Indolacéticos/metabolismo , Bacillus/metabolismo , Bacillus/efectos de los fármacos , Selenio/química , Selenio/farmacología , Selenio/metabolismo , Nanopartículas/química , Tamaño de la PartículaRESUMEN
Mild traumatic brain injury (mTBI) is a known risk factor for neurodegenerative diseases, yet the precise pathophysiological mechanisms remain poorly understand, often obscured by group-level analysis in non-invasive neuroimaging studies. Individual-based method is critical to exploring heterogeneity in mTBI. We recruited 80 mTBI patients and 40 matched healthy controls, obtaining high-resolution structural MRI for constructing Individual Differential Structural Covariance Networks (IDSCN). Comparisons were conducted at both the individual and group levels. Connectome-based Predictive Modeling (CPM) was applied to predict cognitive performance based on whole-brain connectivity. During the acute stage of mTBI, patients exhibited significant heterogeneity in the count and direction of altered edges, obscured by group-level analysis. In the chronic stage, the number of altered edges decreased and became more consistent, aligning with clinical observations of acute cognitive impairment and gradual improvement. Subgroup analysis based on loss of consciousness/post-traumatic amnesia revealed distinct patterns of alterations. The temporal lobe, particularly regions related to the limbic system, significantly predicted cognitive function from acute to chronic stage. The use of IDSCN and CPM has provided valuable individual-level insights, reconciling discrepancies from previous studies. Additionally, the limbic system may be an appropriate target for future intervention efforts.
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Conmoción Encefálica , Cognición , Sistema Límbico , Imagen por Resonancia Magnética , Humanos , Masculino , Femenino , Adulto , Sistema Límbico/diagnóstico por imagen , Sistema Límbico/fisiopatología , Conmoción Encefálica/diagnóstico por imagen , Conmoción Encefálica/fisiopatología , Conmoción Encefálica/psicología , Conmoción Encefálica/complicaciones , Persona de Mediana Edad , Conectoma , Adulto Joven , Disfunción Cognitiva/diagnóstico por imagen , Disfunción Cognitiva/etiología , Disfunción Cognitiva/fisiopatología , Estudios de Casos y ControlesRESUMEN
Monkeypox cases continue to increase globally, and there is an urgent need to develop a highly effective vaccine against monkeypox. This study investigated the binding and authentic-virus neutralizing activities of sera from mice immunized with EEV (extracellularly enveloped viruses) antigens B6R and A35R, and IMV (intrinsic material viruses) antigens M1R, A29L, E8L, and H3L against monkeypox virus. The results showed that immunizations of A35R and E8L could only induce lower titers of binding antibodies, in contrast, immunization of M1R induced the highest titers of binding antibodies, while immunization of B6R, H3L, and A29L induced moderate titers of binding antibodies. For the live monkeypox virus neutralization assay, the results showed that immunization with two doses of EEV antigen B6R did not effectively induce humoral immune responses to neutralize monkeypox live virus, immunization with EEV-A35R only induced weak monkeypox-neutralizing antibodies. In contrast, the immunization of the four types of monkeypox virus IMV antigens can all induce neutralizing antibodies against authentic monkeypox virus, among them, A29L and H3L induced the highest neutralizing antibody titers. The results of this study provide important references for the selection of antigens in the development of the next generation of monkeypox vaccines.
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Realizing durative dense, dendrite-free, and no by-product deposition configuration on Zn anodes is crucial to solving the short circuit and premature failure of batteries, which is simultaneously determined by the Zn interface chemistry, electro-reduction kinetics, mass transfer process, and their interaction. Herein, this work unmasks a domino effect of the ß-alanine cations (Ala+) within the hydrogel matrix, which effectively triggers the subsequent electrostatic shielding and beneficial knock-on effects via the specifical adsorption earliest event on the Zn anode surface. The electrostatic shielding effect regulates the crystallographic energetic preference of Zn deposits and retards fast electro-reduction kinetics, thereby steering stacked stockier block morphology and realizing crystallographic optimization. Meanwhile, the mass transfer rate of Zn2+ ions was accelerated via the SO4 2- anion immobilized caused by Ala+ in bulk electrolyte, finally bringing the balance between electroreduction kinetics and mass transfer process, which enables dendrite-free Zn deposition behavior. Concomitantly, the interfacial adsorbed Ala+ cations facilitate the electrochemical reduction of interfacial SO4 2- anions to form the inorganic-organic hybrid solid electrolyte interphase layer. The above domino effects immensely improve the utilization efficiency of Zn anodes and long-term stability, as demonstrated by the 12â times longer life of Zn||Zn cells (3650â h) and ultrahigh Coulombic efficiency (99.4 %).
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Feature selection aims to select crucial features to improve classification accuracy in machine learning and data mining. In this paper, a new binary grasshopper optimization algorithm using time-varying Gaussian transfer functions (BGOA-TVG) is proposed for feature selection. Compared with the traditional S-shaped and V-shaped transfer functions, the proposed Gaussian time-varying transfer functions have the characteristics of a fast convergence speed and a strong global search capability to convert a continuous search space to a binary one. The BGOA-TVG is tested and compared to S-shaped and V-shaped binary grasshopper optimization algorithms and five state-of-the-art swarm intelligence algorithms for feature selection. The experimental results show that the BGOA-TVG has better performance in UCI, DEAP, and EPILEPSY datasets for feature selection.
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Periodontitis drives irreversible destruction of periodontal tissue and is prone to exacerbating inflammatory disorders. Systemic immunomodulatory management continues to be an attractive approach in periodontal care, particularly within the context of 'predictive, preventive, and personalized' periodontics. The present study incorporated genetic proxies identified through genome-wide association studies for circulating immune cells and periodontitis into a comprehensive Mendelian randomization (MR) framework. Univariable MR, multivariable MR, subgroup analysis, reverse MR, and Bayesian model averaging (MR-BMA) were utilized to investigate the causal relationships. Furthermore, transcriptome-wide association study and colocalization analysis were deployed to pinpoint the underlying genes. Consequently, the MR study indicated a causal association between circulating neutrophils, natural killer T cells, plasmacytoid dendritic cells, and an elevated risk of periodontitis. MR-BMA analysis revealed that neutrophils were the primary contributors to periodontitis. The high-confidence genes S100A9 and S100A12, located on 1q21.3, could potentially serve as immunomodulatory targets for neutrophil-mediated periodontitis. These findings hold promise for early diagnosis, risk assessment, targeted prevention, and personalized treatment of periodontitis. Considering the marginal association observed in our study, further research is required to comprehend the biological underpinnings and ascertain the clinical relevance thoroughly.
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Estudio de Asociación del Genoma Completo , Periodontitis , Humanos , Teorema de Bayes , Calgranulina B , Células DendríticasRESUMEN
Objective.Automated segmentation of vestibular schwannoma (VS) using magnetic resonance imaging (MRI) can enhance clinical efficiency. Though many advanced methods exist for automated VS segmentation, the accuracy is hindered by ambivalent tumor borders and cystic regions in some patients. In addition, these methods provide results that do not indicate segmentation uncertainty, making their translation into clinical workflows difficult due to potential errors. Providing a definitive segmentation result along with segmentation uncertainty or self-confidence is crucial for the conversion of automated segmentation programs to clinical aid diagnostic tools.Approach.To address these issues, we propose a U-shaped cascade transformer structure with a sliding window that utilizes multiple sliding samples, a segmentation head, and an uncertainty head to obtain both the segmentation mask and uncertainty map. We collected multimodal MRI data from 60 clinical patients with VS from Xuanwu Hospital. Each patient case includes T1-weighted images, contrast-enhanced T1-weighted images, T2-weighted images, and a tumor mask. The images exhibit an in-plane resolution ranging from 0.70 × 0.70 to 0.76 × 0.76 mm, an in-plane matrix spanning from 216 × 256 to 284 × 256, a slice thickness varying between 0.50 and 0.80 mm, and a range of slice numbers from 72 to 120.Main results.Extensive experimental results show that our method achieves comparable or higher results than previous state-of-the-art brain tumor segmentation methods. On our collected multimodal MRI dataset of clinical VS, our method achieved the dice similarity coefficient (DSC) of 96.08% ± 1.30. On a publicly available VS dataset, our method achieved the mean DSC of 94.23% ± 2.53.Significance.The method efficiently solves the VS segmentation task while providing an uncertainty map of the segmentation results, which helps clinical experts review the segmentation results more efficiently and helps to transform the automated segmentation program into a clinical aid diagnostic tool.
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Procesamiento de Imagen Asistido por Computador , Neuroma Acústico , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Neuroma Acústico/diagnóstico por imagen , Incertidumbre , Imagen por Resonancia Magnética/métodos , Imagen MultimodalRESUMEN
BACKGROUND: Osteoporosis is a systemic skeletal disorder characterized by decreased bone density and the degradation of bone tissue microarchitecture. Ginsenoside Rg1, derived from Panax ginseng, has been a part of traditional Chinese medicine in China for centuries, particularly for treating osteoporosis. However, there remains limited research on the osteogenic potential of Rg1 within the glucocorticoid-induced osteoporosis (GIOP) model and its specific mechanisms. PURPOSE: The primary objective of this study is to investigate the osteogenic potential of Rg1 within the GIOP model and explore the signaling pathways associated with its in vivo and in vitro effects. METHODS: Cell proliferation, differentiation and mineralization were evaluated by the Cell counting kit 8(CCK8) assay, alkaline phosphatase (ALP) test and Alizarin Red S staining, respectively. The qPCR technique was used to determine the relative expression of mRNA and the western blot was used to determine the relative expression of protein. In vivo experiments, spinal vertebrae staining in zebrafish larvae was accomplished by alizarin red S staining. RESULTS: Zebrafish larvae's hatching, survival, malformation, and heart rate were unaffected by 50 µM of Rg1 in vivo, while the MEC3T3-E1 cell line's proliferation was unaffected by 50 µM of Rg1 in vitro. Meanwhile, Rg1 was shown to improve osteogenic differentiation or bone formation as well as the level of mRNA expression of osteogenic markers in vivo and in vitro. Treatment with Rg1 significantly increased the expression of G protein-coupled estrogen receptor (GPER) and pAKT. In addition, the GPER inhibitor G15 could significantly reduce the mRNA and protein expression levels of GPER and phosphorylated AKT, LY294002, a PI3K/AKT pathway inhibitor, markedly suppresses the expression of phosphorylated AKT, yet shows no significant impact on GPER expression. Both G15 and LY294002 can significantly blocked the Rg1-mediated enhancement of osteogenesis capacity in the GIOP model. In contrast, when both the agonists G1 of GPER and LY294002 were added, G1 increased the relative expression of mRNA and protein of GPER, but not the expression of osteogenic capacity and osteogenic markers. CONCLUSIONS: This study investigates the mineralization effects and mechanisms of Ginsenoside Rg1 both in vitro and in vivo. For the first time, we propose that Rg1 might regulate osteogenesis by modulating AKT phosphorylation through mediating GPER expression within the PI3K/AKT pathway in the GIOP model. This discovery introduces novel targets and avenues for osteoporosis treatment.
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Antraquinonas , Ginsenósidos , Osteogénesis , Osteoporosis , Animales , Proteínas Proto-Oncogénicas c-akt/metabolismo , Fosfatidilinositol 3-Quinasas/metabolismo , Pez Cebra/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Diferenciación Celular , Estrógenos/farmacología , Glucocorticoides , ARN MensajeroRESUMEN
The recent prevalence of monkeypox has led to the declaration of a Public Health Emergency of International Concern. Monkeypox lesions are typically ulcers or pustules (containing high titers of replication-competent virus) in the skin and mucous membranes, which allow monkeypox virus to transmit predominantly through intimate contact. Currently, effective clinical treatments for monkeypox are lacking, and strategies for blocking virus transmission are fraught with drawbacks. Herein, this work constructs a biomimetic nanotemplate (termed TBD@M NPs) with macrophage membranes as the coat and polymeric nanoparticles loading a versatile aggregation-induced emission featured photothermal molecule TPE-BT-DPTQ as the core. In a surrogate mouse model of monkeypox (vaccinia-virus-infected tail scarification model), intravenously injected TBD@M NPs show precise tracking and near-infrared region II fluorescence imaging of the lesions. Upon 808 nm laser irradiation, the virus is eliminated by the photothermal effect and the infected wound heals rapidly. More importantly, the inoculation of treated lesion tissue suspensions does not trigger tail infection or inflammatory activation in healthy mice, indicating successful blockage of virus transmission. This study demonstrates for the first time monkeypox theranostics using nanomedicine, and may bring a new insight into the development of a viable strategy for monkeypox management in clinical trials.
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Mpox , Nanopartículas , Animales , Ratones , Terapia Fototérmica , Biomimética , Macrófagos , Nanopartículas/uso terapéuticoRESUMEN
BACKGROUND: Food is crucial for maintaining vital human and animal activities. Disorders in appetite control can lead to various metabolic disturbances. Alterations in the gut microbial composition can affect appetite and energy metabolism. While alterations in the gut microbiota have been observed in high-temperature and high-humidity (HTH) environments, the relationship between the gut microbiota during HTH and appetite remains unclear. METHODS: We utilised an artificial climate box to mimic HTH environments, and established a faecal bacteria transplantation (FMT) mouse model. Mendelian randomisation (MR) analysis was used to further confirm the causal relationship between gut microbiota and appetite or appetite-related hormones. FINDINGS: We found that, in the eighth week of exposure to HTH environments, mice showed a decrease in food intake and body weight, and there were significant changes in the intestinal microbiota compared to the control group. After FMT, we observed similar changes in food intake, body weight, and gut bacteria. Appetite-related hormones, including ghrelin, glucagon-like peptide-1, and insulin, were reduced in DH (mice exposed to HTH conditions) and DHF (FMT from mice exposed to HTH environments for 8 weeks), while the level of peptide YY initially increased and then decreased in DH and increased after FMT. Moreover, MR analysis further confirmed that these changes in the intestinal microbiota could affect appetite or appetite-related hormones. INTERPRETATION: Together, our data suggest that the gut microbiota is closely associated with appetite suppression in HTH. These findings provide novel insights into the effects of HTH on appetite. FUNDING: This work was supported by the National Natural Science Foundation of China and Guangzhou University of Chinese Medicine.
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Microbioma Gastrointestinal , Humanos , Animales , Ratones , Apetito , Humedad , Temperatura , Peso CorporalRESUMEN
Objective: ChatGPT, an advanced language model developed by OpenAI, holds the opportunity to bring about a transformation in the processing of clinical decision-making within the realm of medicine. Despite the growing popularity of research related on ChatGPT, there is a paucity of research assessing its appropriateness for clinical decision support. Our study delved into ChatGPT's ability to respond in accordance with the diagnoses found in case reports, with the intention of serving as a reference for clinical decision-making. Methods: We included 147 case reports from the Chinese Medical Association Journal Database that generated primary and secondary diagnoses covering various diseases. Each question was independently posed three times to both GPT-3.5 and GPT-4.0, respectively. The results were analyzed regarding ChatGPT's mean scores and accuracy types. Results: GPT-4.0 displayed moderate accuracy in primary diagnoses. With the increasing number of input, a corresponding enhancement in the accuracy of ChatGPT's outputs became evident. Notably, autoimmune diseases comprised the largest proportion of case reports, and the mean score for primary diagnosis exhibited statistically significant differences in autoimmune diseases. Conclusion: Our finding suggested that the potential practicality in utilizing ChatGPT for clinical decision-making. To enhance the accuracy of ChatGPT, it is necessary to integrate it with the existing electronic health record system in the future.
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Hepatocellular carcinoma (HCC) is a prevalent malignancy and there is a lack of effective biomarkers for HCC diagnosis. Living organisms are complex, and different omics molecules interact with each other to implement various biological functions. Genomics and metabolomics, which are the top and bottom of systems biology, play an important role in HCC clinical management. Fatty acid metabolism is associated with malignancy, prognosis, and immune phenotype in cancer, which is a potential hallmark in malignant tumors. In this study, the genes and metabolites related to fatty acid metabolism were thoroughly investigated by a dynamic network construction algorithm named EWS-DDA for the early diagnosis and prognosis of HCC. Three gene ratios and eight metabolite ratios were identified by EWS-DDA as potential biomarkers for HCC clinical management. Further analysis using biological analysis, statistical analysis and document validation in the discovery and validation sets suggested that the selected potential biomarkers had great clinical prognostic value and helped to achieve effective early diagnosis of HCC. Experimental results suggested that in-depth evaluation of fatty acid metabolism from different omics viewpoints can facilitate the further understanding of pathological alterations associated with HCC characteristics, improving the performance of early diagnosis and clinical prognosis.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/metabolismo , Multiómica , Biomarcadores de Tumor/genética , Pronóstico , Ácidos GrasosRESUMEN
BACKGROUND: Many patients with neuromuscular scoliosis (NMS) experience a variety of difficult medical problems that aggravate the development effects of progressive scoliosis and pelvic obliquity (PO). The objective of the current study was to assess the safety and effectiveness of multi-rod posterior correction only (MRPCO) with halo-femoral traction (HFT) for the management of adult NMS (> 100°) with severe PO. METHODS: From 2012 to 2017, 13 adult patients who suffered from NMS (> 100°) with severe PO underwent MRPCO with HFT. The radiography parameters in a sitting position, such as the coronal Cobb angle of the main curve, the PO and the trunk shift (TS), were measured at the preoperative, postoperative and final follow-up stages. The preoperative and final follow-up assessment of the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) was taken. RESULTS: The average follow-up span was 68.15 ± 6.78 months. There was decreased postoperative coronal Cobb angle with an average mean of 125.24° ± 11.78° to 47.55° ± 12.10°, with a correction rate of 62.43%; the PO was reduced to 6.25° ± 1.63° from 36.93° ± 4.25° with a correction rate of 83.07%; the TS was reduced to 2.41 cm ± 1.40 cm from 9.19 cm ± 3.07 cm. There was significant improvement in all parameters compared to the preoperative data. The VAS score reduced from 4.77 ± 0.93 to 0.69 ± 0.75, and the ODI score reduced from 65.38 ± 16.80 to 28.62 ± 12.29 at the final follow-up. CONCLUSIONS: Treatment of adult NMS (> 100°) with severe PO could be safe and effective with MRPCO with HFT. In order to obtain the optimum sitting balance, this could reduce the prevalence of complications and rectify the curvature and the correction of PO.
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Enfermedades Neuromusculares , Escoliosis , Fusión Vertebral , Humanos , Adulto , Escoliosis/diagnóstico por imagen , Escoliosis/cirugía , Escoliosis/complicaciones , Tracción , Estudios de Seguimiento , Resultado del Tratamiento , Estudios Retrospectivos , Enfermedades Neuromusculares/complicaciones , Fusión Vertebral/efectos adversosRESUMEN
Klebsiella pneumoniae is a ubiquitous human pathogen, and its clinical treatment faces two major challenges: multidrug resistance and the pathogenesis of hypervirulent K. pneumoniae. The discovery and study of conditionally essential (CE) genes that can function as potential antimicrobial targets has always been a research concern due to their restriction in the development of novel antibiotics. However, the lack of essential functional genomic data has hampered the study of the mechanisms of essential genes related to antimicrobial susceptibility. In this study, we developed a pooled CE genes mobile clustered regularly interspaced short palindromic repeat (CRISPR) interference screening method (Mobile-CRISPRi-seq) for K. pneumoniae to identify genes that play critical roles in antimicrobial fitness in vitro and host immunity in vivo. Targeting 870 predicted CE genes in K. pneumoniae, Mobile-CRISPRi-seq uncovered the depletion of tetrahydrofolate synthesis pathway genes folB and folP under trimethoprim pressure. Our screening also identified genes waaE and fldA related to polymyxin and ß-lactam susceptibility by applying a screening strategy based on Mobile-CRISPRi-seq and comparative genomics. Furthermore, using a mouse infection model and Mobile-CRISPRi-seq, multiple virulence genes were identified, and among these genes, pal, yciS, and ribB were demonstrated to contribute to the pathogenesis of K. pneumoniae. This study provides a simple, rapid, and effective platform for screening potential antimicrobial targets and virulence genes in K. pneumoniae, and this broadly applicable system can be expanded for high-throughput functional gene study in multiple pathogenic bacteria, especially in gram-negative bacteria. IMPORTANCE The discovery and investigation of conditionally essential (CE) genes that can function as potential antimicrobial targets has always been a research concern because of the restriction of antimicrobial targets in the development of novel antibiotics. In this study, we developed a pooled CE gene-wide mobile clustered regularly interspaced short palindromic repeat (CRISPR) interference sequencing (Mobile-CRISPRi-seq) strategy in Klebsiella pneumoniae to identify genes that play critical roles in the fitness of antimicrobials in vitro and host immunity in vivo. The data suggest a robust tool to screen for loss-of-function phenotypes in a pooled gene knockdown library in K. pneumoniae, and Mobile-CRISPRi-seq may be expanded to multiple bacteria for screening and identification of genes with crucial roles in the fitness of antimicrobials and hosts.