Characteristics of two different immune infiltrating pyroptosis subtypes in ischemic stroke.

Background: Ischemic stroke (IS) is a serious health hazard and identified as the second leading cause of mortality around the world. However, the role of pyroptosis in the immune microenvironment regulation in IS is still unclear. Here, our study aims to elucidate the effect of pyroptosis on immune microenvironment in IS. Methods: The regulation mode of pyroptosis in IS was systematically evaluated, and its effects on immune microenvironment were explored, including infiltration of immune cells, immune response gene sets, and human leukocyte antigen (HLA) gene. The genes and drugs related to pyroptosis phenotype were also identified. An MCAO rat model was constructed, and the mRNA expression levels in the classifier model were validated by qRT-PCR. Results: The separator is composed of 11 pyroptosis genes, out of which 10 genes could distinguish between ischemic stroke and control samples. CHMP2A, CHMP4A, and NAIP genes are significantly related to immune infiltrating cells, immune response gene sets, and HLA. However, two different pyroptosis subtypes mediated by 10 pyroptosis genes were identified, which were different in immune cell abundance, HLA genes, and immune response gene sets. Furthermore, 199 genes associated with pyroptosis phenotype was identified along with the analysis of biological functions. Conclusion: These findings reveal the potential mechanism of pyroptosis in the immune microenvironment of IS, indicating that pyroptosis functions as a vital component in the complexity and diversity of the immune microenvironment in patients with IS.

Comparison of Anterior Controllable Antedisplacement and Fusion Versus Laminoplasty in the Treatment of Multisegment Ossification of Cervical Posterior Longitudinal Ligament: A Meta-Analysis of Clinical.

OBJECTIVE: This study aims to provide a comprehensive summary of the existing literature and conduct a systematic evaluation of the clinical outcomes associated with anterior controllable antedisplacement and fusion (ACAF) and posterior laminoplasty (LP) for the treatment of multisegment ossification of the cervical posterior longitudinal ligament (OPLL). METHODS: We conducted an electronic search of databases, including PubMed, Embase, Cochrane Library, and CNKI, from the inception of the initial database to March 2023. We analyzed various parameters, including demographic data, operation time, intraoperative blood loss, cervical curvature, Japanese Orthopaedic Association (JOA) scores, Visual Analog Scale (VAS) scores, and postoperative complications. Two independent reviewers screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was performed using RevMan 5.4 software. RESULTS: Our evaluation encompassed 7 studies involving a total of 467 patients. The patient cohort was divided into 2 groups: Group A (ACAF) comprised 226 patients, while Group B (LP) comprised 241 patients. Overall, our statistical analysis revealed significant differences between the 2 groups (P < 0.05) in terms of intraoperative blood loss, operative time, JOA score, JOA score improvement rate, postoperative VAS score, postoperative cervical curvature, and the incidence of certain postoperative complications (C5 nerve root paralysis, dysphagia, and axial symptoms). However, there was no statistically significant difference in the incidence of postoperative cerebrospinal fluid leakage and postoperative total complications between the 2 groups (P > 0.05). CONCLUSIONS: The findings of this study suggest that, in the treatment of multilevel cervical OPLL, ACAF yields superior outcomes compared to LP. Specifically, ACAF improves postoperative neurologic function, reduces postoperative pain, lowers intraoperative blood loss, improves postoperative cervical curvature, and decreases the incidence of C5 nerve root paralysis and postoperative axial symptoms. Nonetheless, ACAF is associated with longer operative times and a higher incidence of postoperative dysphagia, though the overall incidence of postoperative complications is similar. It is important to note that these conclusions should be interpreted cautiously due to the limited sample size and the variable quality of the included studies. Further research involving larger, high-quality studies is warranted to validate these findings.