Amyloid ß oligomer induces cerebral vasculopathy via pericyte-mediated endothelial dysfunction.

BACKGROUND: Although abnormal accumulation of amyloid beta (Aß) protein is thought to be the main cause of Alzheimer's disease (AD), emerging evidence suggests a pivotal vascular contribution to AD. Aberrant amyloid ß induces neurovascular dysfunction, leading to changes in the morphology and function of the microvasculature. However, little is known about the underlying mechanisms between Aß deposition and vascular injuries. Recent studies have revealed that pericytes play a substantial role in the vasculopathy of AD. Additional research is imperative to attain a more comprehensive understanding. METHODS: Two-photon microscopy and laser speckle imaging were used to examine cerebrovascular dysfunction. Aß oligomer stereotactic injection model was established to explain the relationship between Aß and vasculopathy. Immunofluorescence staining, western blot, and real-time PCR were applied to detect the morphological and molecular alternations of pericytes. Primary cultured pericytes and bEnd.3 cells were employed to explore the underlying mechanisms. RESULTS: Vasculopathy including BBB damage, hypoperfusion, and low vessel density were found in the cortex of 8 to 10-month-old 5xFAD mice. A similar phenomenon accompanied by pericyte degeneration appeared in an Aß-injected model, suggesting a direct relationship between Aß and vascular dysfunction. Pericytes showed impaired features including low PDGFRß expression and increased pro-inflammatory chemokines secretion under the administration of Aß in vitro, of which supernatant cultured with bEND.3 cells led to significant endothelial dysfunction characterized by TJ protein deficiency. CONCLUSIONS: Our results provide new insights into the pathogenic mechanism underlying Aß-induced vasculopathy. Targeting pericyte therapies are promising to ameliorate vascular dysfunction in AD.

Progression of cognitive dysfunction in NPC survivors with radiation-induced brain necrosis: A prospective cohort.

BACKGROUND AND PURPOSE: The evidence of longitudinal changes in cognition in nasopharyngeal carcinoma (NPC) survivors with radiation-induced brain necrosis (RIBN) after radiotherapy (RT) remained insufficient. We aimed to estimate the clinical progression rate of cognitive decline and identify patients with differential decline rates. MATERIALS AND METHODS: Based on an ongoing prospective cohort study, NPC patients aged ≥18 years old and diagnosed with RIBN were included in this current analysis if they finished the time frame of 3-year follow-up and had at least twice cognition assessments. The Chinese version of the Montreal Cognitive Assessment (MoCA) was used to assess the cognitive state. Linear mixed-effect models were used to analyze the annual progression rates of MoCA total and seven sub-items scores. RESULTS: Among 134 patients in this study, the transition probability from normal to mild/moderate cognitive dysfunction were 14.2 % (19/134) and 1.49 % (2/134) respectively during the median follow-up time of 2.35 years. The total MoCA score declined by -0.569 (SE 0.208) points annually (p = 0.008). Patients with ≤6 years of duration from RT to RIBN have higher annual progression rate of total scores [-0.851 (SE 0.321), p = 0.013; p for interaction = 0.041]. CONCLUSION: Our findings of the annual decline rate of cognition in NPC patients with RIBN from a 3-year longitudinal data, particularly for those who developed RIBN rapidly after RT, have important implications for the upcoming clinical trials designed to prevent or decrease cognitive decline in NPC patients with RIBN, regarding the selection of study patients and the calculation of sample size.

The global burden of traumatic amputation in 204 countries and territories.

Background: Traumatic amputation leads to disability and imposes a heavy health burden. This study aims to explore the current status and temporal trends of the global burden of traumatic amputation according to sex, age, amputation site, cause, and reginal level of social development. Methods: The data were extracted from the Global Burden of Diseases (GBD) Study 2019. Prevalence, incidence, years lived with disability (YLDs) and corresponding age-standardized rate were compared. Estimated annual percentage change (EAPC) was applied to reflect trends in age-standardized rates over a specific period. Spearman rank test and curve fitting methods were used to analyze the relationship between disease burden and Socio-Demographic Index (SDI). Results: Globally, the incidence and prevalence number of traumatic amputation increased from 11.37 million and 370.25 million in 1990, to 13.23 million and 552.45 million in 2019, with a raise of 16.4 and 49.2%, respectively. But the age-standardized incidence rate (ASIR) (EAPC = -0.56; 95%CI, -0.72 to -0.41) and age-standardize prevalence rate (ASPR) (EAPC = -0.63; 95%CI, -0.74 to -0.52) declined during this period. The YLDs count also increased by 39.2% globally (from 5.28 million to 7.35 million), while the age-standardize YLDs rate (ASYR) decreased by an average of 1.00% per year (95% CI, -1.10 to -0.90) from 1990 to 2019. The incidence, prevalence, and YLDs rate of traumatic amputation continue to increase with age. Traumatic amputations were most common in the fingers, while unilateral lower limb amputation caused the greatest burden of disability. ASIR and SDI were positively correlated (ρ = 0.442, p < 0.001), while ASYR and SDI were not significantly correlated (ρ = -0.030, p = 0.669), and EAPC in ASYR and SDI were negatively correlated (ρ = -0.275, p < 0.001). Exposure to mechanical forces and falls were the leading causes of traumatic amputation. Conclusion: Despite the declining trends in ASIR, ASPR, and ASYR, the incidence, prevalence, and YLDs counts of traumatic amputation have increased significantly worldwide, especially in the older adults population. With the population aging, targeted health policies are needed to address the increasing global burden of traumatic amputations in the future.

Different types of milk consumption and the risk of dementia: Analysis from a large-scale cohort study.

BACKGROUND & AIMS: Previous studies have investigated whether milk consumption has a role in preventing the development of cognitive impairment, but the results were inconsistent. Importantly, most of them have disregarded the role of different types of milk. This study aimed to examine the associations between different types of milk consumption and the risk of dementia. METHODS: In this large-scale cohort study, participants without cognitive impairment at baseline were included from the UK Biobank. The type of milk mainly used was self-reported at baseline, including full-cream milk, skimmed-milk, soy milk, other milk, and no milk. The primary outcome was all-cause dementia. Secondary outcomes included Alzheimer's disease and vascular dementia. RESULTS: Of the 307,271 participants included in the study (mean age 56.3 [SD 8.1] years), 3789 (1.2%) incident all-cause dementia cases were observed over a median follow-up of 12.3 years. After adjustment for potential confounders, only soy milk consumers had a statistically significantly lower risk of all-cause dementia compared with no milk consumers (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.54 to 0.90). When compared with soy milk non-consumers consisting of full-cream milk, skimmed-milk, and other milk consumers, soy milk consumers still showed a lower risk of all-cause dementia (HR, 0.76; 95% CI, 0.63 to 0.92), and there was no significant interaction with genetic risk for dementia (P for interaction = 0.15). Soy milk consumers showed a lower risk of Alzheimer's disease (HR, 0.70; 95% CI, 0.51 to 0.94; P = 0.02), while the association was not significant for vascular dementia (HR, 0.72; 95% CI, 0.47 to 1.12; P = 0.14). CONCLUSIONS: The main consumption of soy milk was associated with a lower risk of dementia, particularly non-vascular dementia. Additional studies are needed to investigate how this association varies with the dose or frequency of the consumption of soy milk and to examine the generalizability of these findings in different populations.

Ezetimibe attenuates functional impairment via inhibition of oxidative stress and inflammation in traumatic spinal cord injury.

Sustained inflammation after a traumatic spinal cord injury (TSCI) triggers oxidative stress and neuronal apoptosis, hindering functional recovery. Ezetimibe (EZE) has been reported to have anti-inflammatory and antioxidative properties in hepatology-related diseases, but its potential role in SCI remains unclear. In this study, we evaluated the therapeutic effect of EZE on inflammatory microglia and in an SCI model and elucidated the underlying mechanism. First, we stimulated the BV2 microglia cell line with LPS, and we also induced moderate spinal cord injuries in adult male C57BL/6 mice. Both the cells and mice were treated with EZE, and we investigated inflammation, oxidative stress, neurologic damage, and motor function in vitro and in vivo, respectively. Our findings demonstrated that EZE administration attenuates inflammation in microglia by regulating the AMPK/Nrf2 axis. Furthermore, EZE treatment reduced inflammation and oxidative stress levels in the injured spinal cord. Additionally, treatment with EZE decreased glial scarring and improved motor function recovery, indicating the protective role of EZE in SCI. EZE was found to have anti-inflammatory and antioxidative effects on SCI, and it modulated the AMPK/Nrf2 pathway in microglia. Moreover, EZE prevented histological destruction of the spinal cord tissue. In conclusion, EZE shows promise as a drug to protect neurologic integrity following post-SCI.

Medical Malpractice Litigation After Spine Surgery in Beijing Between 2013 and 2018.

OBJECTIVE: The aim of this study was to analyze the characteristics of alleged medical malpractice litigation involving spine surgery in Beijing between 2013 and 2018. METHODS: Two online legal databases, Wusong and Weike, were queried for court verdicts involving spine surgery from January 2013 to December 2018 in Beijing. For all included cases, data pertaining to defendants, plaintiffs, case outcomes, allegations, and verdicts were abstracted, and descriptive analyses were performed. RESULTS: A total of 186 legal cases were identified, and 122 cases were excluded because of irrelevance or insufficient information. Of the patients in the 64 cases included in this investigation, 40.6% were male. The mean age of the plaintiffs was 53.2 ± 18.6 years. The most common complaint addressed in this study is inadequate consent (53.1%; n = 34), followed by additional surgery required (40.2%; n = 26), being unsatisfied with the outcome of surgery (17.6%; n = 11), postoperative paralysis (15.6%; n = 10), and postoperative infection (15.6%; n = 10). The most common primary disease among all the cases is lumbar spinal stenosis (28.1%; n = 18), followed by spinal tumor (18.8%; n = 12), cervical spondylosis (17.2%; n = 11), vertebral fracture (14.1%; n = 9), deformity (12.5%; n = 8), and others (9.3%; n = 6). Spine surgeons successfully defended themselves in 13 cases (20.3%), which resulted in no indemnity payment. The remaining 51 cases (79.7%) were closed with an average verdict payout of U.S. $22,597, which was significantly lower than the average compensation claimed by the plaintiff (U.S. $11,3762) (P < 0.05). CONCLUSIONS: This study comprehensively summarized the medical alleged malpractice litigation after spine surgery in Beijing. Given the rapid growth rate of spine surgery and the burden of related alleged medical malpractice litigation, it is valuable for spine surgeons to understand the potential legal impact of spine surgery. The most common complaint addressed in this study is inadequate consent. The findings in the present study highlight that in China, spine surgeons should pay more attention to communication with patients and perform spine surgery based on abnormal imaging as opposed to what the history and physical examination dictate, which can help reduce the litigation rate and improve the patient experience.

GbCYP72A1 Improves Resistance to Verticillium Wilt via Multiple Signaling Pathways.

Verticillium dahliae is a fungal pathogen that causes Verticillium wilt (VW), which seriously reduces the yield of cotton owing to biological stress. The mechanism underlying the resistance of cotton to VW is highly complex, and the resistance breeding of cotton is consequently limited by the lack of in-depth research. Using quantitative trait loci (QTL) mapping, we previously identified a novel cytochrome P450 (CYP) gene on chromosome D4 of Gossypium barbadense that is associated with resistance to the nondefoliated strain of V. dahliae. In this study, the CYP gene on chromosome D4 was cloned together with its homologous gene on chromosome A4 and were denoted as GbCYP72A1d and GbCYP72A1a, respectively, according to their genomic location and protein subfamily classification. The two GbCYP72A1 genes were induced by V. dahliae and phytohormone treatment, and the findings revealed that the VW resistance of the lines with silenced GbCYP72A1 genes decreased significantly. Transcriptome sequencing and pathway enrichment analyses revealed that the GbCYP72A1 genes primarily affected disease resistance via the plant hormone signal transduction, plant-pathogen interaction, and mitogen-activated protein kinase (MAPK) signaling pathways. Interestingly, the findings revealed that although GbCYP72A1d and GbCYP72A1a had high sequence similarity and both genes enhanced the disease resistance of transgenic Arabidopsis, there was a difference between their disease resistance abilities. Protein structure analysis revealed that this difference was potentially attributed to the presence of a synaptic structure in the GbCYP72A1d protein. Altogether, the findings suggested that the GbCYP72A1 genes play an important role in plant response and resistance to VW.

Comparative efficacy of psychosocial interventions for opioid-dependent people receiving methadone maintenance treatment: A network meta-analysis.

AIMS: To estimate the efficacy of multiple psychosocial interventions for opioid-dependent people receiving methadone maintenance treatment (MMT). METHODS: Systematic review and network meta-analysis of randomized controlled trials (RCTs) reporting the effect of psychosocial intervention for opioid-dependent people receiving MMT in outpatient clinics. We searched multiple data sources (Medline, Embase, Web of Science, PsycINFO and Cochrane Library) from inception to January 2022, finding 21 RCTs evaluating a total of 2862 people with opioid dependence receiving MMT. The primary outcome was the opioid-positive rate (assessed by urinalysis) and the secondary outcome was treatment discontinuation (the number of patients who terminated the study for any reason). We performed random-effects Bayesian meta-analysis. We used relative ranking using surface under the cumulative ranking method and certainty of evidence using grading of recommendations, assessment, development and evaluations. RESULTS: Cognitive-behavioral therapy (CBT) [odds ratio (OR) = 0.66, 95% credible interval (CI) = 0.66-0.96; low certainty] and educational and behavioral counseling (EBC) (OR = 0.28, 95% CI = 0.12-0.25; high certainty) were more effective than treatment as usual (TAU) in efficacy. In terms of treatment discontinuation, at the end of the follow-up period there was no statistical significance among psychosocial interventions. According to the ranking probabilities, EBC might be the most effective treatment and behavioral couples' therapy (BCT) might be the best discontinuation treatment. CONCLUSIONS: Educational and behavioral counseling and cognitive-behavioral therapy appear to be the most effective psychosocial interventions for opioid-dependent people receiving methadone maintenance treatment.

Analysis of medical malpractice litigation following vertebral augmentation therapy in China from 2008 to 2018.

The first case of vertebral augmentation therapy in mainland China was reported in 2000. Since then, it has been widely used in China as a minimally invasive procedure to treat vertebral compression fractures. However, the characteristics of malpractice litigation involving vertebral augmentation therapy remains unclear. This study aims to analyze the characteristics of medical malpractice litigation involving vertebral augmentation therapy in mainland China for the past 10 years. Two online legal databases were queried for court verdicts involving vertebral augmentation therapy from Jan 2009 to Dec 2018 in mainland China. Each case file was then thoroughly reviewed and data pertaining to defendants, plaintiffs, case outcomes, allegations, and verdicts were abstracted, and descriptive analyses were performed. Level of evidence: LEVEL III. A total of 96 cases were enrolled for final analysis. The number of claims increased by five times during the past 10 years. More than two thirds (67.7%, n = 65) of the cases underwent percutaneous vertebroplasty, and 22.9% (n = 22) underwent percutaneous kyphoplasty, the rest (9.4%, n = 9) remained undefined. Paralysis was alleged in 35.4% of cases (n = 34), followed by significant physical injury (34.4%, n = 33). Cement leakage to spinal canal (44.8%, n = 43) is the most commonly cited reason for litigation, followed by incomplete informed consent (42.7%, n = 41), accidental dural puncture (20.8%, n = 20), unsatisfactory clinical outcome (18.8%, n = 18), and misdiagnosis (12.5%, n = 12). Acute pulmonary cement embolism (4.2%, n = 4), wrong-level vertebrae procedure (3.1%, n = 3) and postoperative infection (2.1%, n = 2) were less common causes for concern. Doctors successfully defended themselves only in 8 (8.3%) cases, which resulted in no indemnity payment. The rest 88 (91.7%) cases were closed with a mean verdict payout of 361,580 Yuan (51,654 US dollars). There is a quickly rising trend in the number of medical malpractice litigation involving vertebral augmentation therapy in China. Identifying the most common reasons for litigation and summarizing their characteristics may help decrease litigation rate and improve the patient experience.

Wearable Pressure Sensors with Capacitive Response over a Wide Dynamic Range.

At present, there are mainly two types of capacitive pressure sensors based on ordinary capacitance and electrical double layer (EDL) capacitance. However, few researchers have combined these two types of capacitors in pressure sensing to improve the dynamic range of a sensor under pressure. Here, we fabricated a capacitive pressure sensor with an asymmetric structure based on poly(vinylidene fluoride-co-hexafluoropropylene) using a simple electrospinning process. A layer of mixed ionic nanofiber membrane and a layer of pure nanofiber membrane were stacked and used as the dielectric layer of the sensor. Due to the porous structure and non-stickiness of the pure nanofiber membrane, it can be penetrated by the mixed ionic nanofiber membrane under pressure, realizing the reversible conversion from ordinary capacitance to EDL capacitance, thereby achieving a great change in the capacitance value. The sensitivities of the sensor are 55.66 and 24.72 kPa-1 in the pressure ranges of 0-31.11 and 31.11-66.67 kPa, respectively, with good cycle stability, fast loading-unloading response time, and an ultra-low pressure detection limit as low as 0.087 Pa. Finally, this sensor was used for the detection of human physiological signals, and the sensor would have potential applications in the fields of human tactile sensing systems, bionic robots, and wearable devices.

Membrane Localized GbTMEM214s Participate in Modulating Cotton Resistance to Verticillium Wilt.

Verticillium wilt (VW) is a soil-borne fungal disease caused by Verticillium dahliae Kleb, which leads to serious damage to cotton production annually in the world. In our previous study, a transmembrane protein 214 protein (TMEM214) gene associated with VW resistance was map-based cloned from Gossypium barbadense (G. barbadense). TMEM214 proteins are a kind of transmembrane protein, but their function in plants is rarely studied. To reveal the function of TMEM214s in VW resistance, all six TMEM214s were cloned from G. barbadense in this study. These genes were named as GbTMEM214-1_A/D, GbTMEM214-4_A/D and GbTMEM214-7_A/D, according to their location on the chromosomes. The encoded proteins are all located on the cell membrane. TMEM214 genes were all induced with Verticillium dahliae inoculation and showed significant differences between resistant and susceptible varieties, but the expression patterns of GbTMEM214s under different hormone treatments were significantly different. Virus-induced gene silencing analysis showed the resistance to VW of GbTMEM214s-silenced lines decreased significantly, which further proves the important role of GbTMEM214s in the resistance to Verticillium dahliae. Our study provides an insight into the involvement of GbTMEM214s in VW resistance, which was helpful to better understand the disease-resistance mechanism of plants.

The Correlation Between White Matter Hyperintensity Burden and Regional Brain Volumetry in Patients With Alzheimer's Disease.

Background: White matter hyperintensities (WMHs) and regional brain lobe atrophy coexist in the brain of patients with Alzheimer's disease (AD), but the association between them in patients with AD still lacks comprehensive investigation and solid imaging data support. Objective: We explored whether WMHs can promote the pathological process of AD by aggravating atrophy in specific brain regions and tried to explain the regional specificity of these relationships. Methods: A sample of 240 adults including 180 normal controls (NCs) and 80 cases with AD were drawn from the ADNI database. T1-weighted magnetic resonance imaging (MRI) and T2-weighted fluid-attenuated MRI of the participants were downloaded and were analyzed using AccuBrain® to generate the quantitative ratio of WMHs (WMHr, WMH volumes corrected by intracranial volume) and regional brain atrophy. We also divided WMHr into periventricular WMHr (PVWMHr) and deep WMHr (DWMHr) for the purpose of this study. The Cholinergic Pathways Hyperintensities Scale (CHIPS) scores were conducted by two evaluators. Independent t-test, Mann-Whitney U test, or χ2 test were used to compare the demographic characteristics, and Spearman correlation coefficient values were used to determine the association between WMHs and different regions of brain atrophy. Results: Positive association between WMHr and quantitative medial temporal lobe atrophy (QMTA) (r s = 0.281, p = 0.011), temporal lobe atrophy (r s = 0.285, p = 0.011), and insular atrophy (r s = 0.406, p < 0.001) was found in the AD group before Bonferroni correction. PVWMHr contributed to these correlations. By separately analyzing the relationship between PVWMHr and brain atrophy, we found that there were still positive correlations after correction in QMTA (r s = 0.325, p = 0.003), temporal lobe atrophy (r s = 0.298, p = 0.007), and insular atrophy (r s = 0.429, p < 0.001) in AD group. Conclusion: WMH severity tends to be associated with regional brain atrophy in patients with AD, especially with medial temporal lobe, temporal lobe, and insular lobe atrophy. PVWMHs were devoted to these correlations.

Lumbar Radiculopathy Caused by Epidural Gas Collection.

Background: Degenerated intervertebral discs in the lumbar spine are commonly found with vacuum phenomenon. In a few cases, gas can migrate into the lumbar spinal canal and compress the nerve root. Case Presentation. We report a case of lumbar radiculopathy caused by epidural gas collection in a 59-year-old woman. Originally, the gas was formed in the intervertebral disc and possibly migrated backward because of the motion of lumbar spine, forming a single large gas formation. The nerve root was freed from the gas-filled cyst after needle puncture was performed. Patient's symptoms in the leg were significantly relieved following surgery. Conclusion: There is still no satisfactory explanation for the pathogenesis of gas formation in the spinal canal. In our case, the presence of gas in the spinal canal and gas inside a narrowed disc suggests a communication between the two structures.

Giant Thermopower of Hydrogen Ion Enhanced by a Strong Hydrogen Bond System.

Ionic thermoelectric materials based on organic polymers are of great significance for low-grade heat harvesting and self-powered wearable temperature sensing. Here, we demonstrate a poly(vinyl alcohol) (PVA) hydrogel that relies on the differential transport of H+ in PVA hydrogels with different degrees of crystallization. After the inorganic acid is infiltrated into the physically cross-linked PVA hydrogel, the ionic conductor exhibits a huge ionic thermopower of 38.20 mV K-1, which is more than twice the highest value reported for hydrogen ion transport thermoelectric materials. We attribute the enhanced thermally generated voltage to the movement of H+ in the strong hydrogen bond system of PVA hydrogels and the restrictive effect of the strong hydrogen bond system on anions. This ionic thermoelectric hydrogel opens up a new way for thermoelectric conversion devices using H+ as an energy carrier.

Case Report: Adult degenerative scoliosis in two patients treated with percutaneous spinal endoscopic-assisted lumbar interbody fusion and percutaneous pedicle screw fixation.

Adult degenerative scoliosis (ADS) is a serious disease that often affects middle-aged and elderly people. ADS does not only cause sagittal and coronal deformity of the lumbar spine but also causes severe back and leg pain secondary to the compression of the neural structures. Open surgery remains the main method for correcting the occurring deformity and decompression of the neural structures; however, its benefit is limited in cases of large trauma. Minimally invasive spinal (MIS) surgery is an alternative method that has recently witnessed rapid development. It has the advantage of providing rapid recovery with less trauma as compared to conventional open surgery. We report two cases of ADS treated with percutaneous spinal endoscopic-assisted lumbar interbody fusion (EALIF) and percutaneous pedicle screw fixation. Both cases had moderate deformities of the lumbar spine (load-sharing classification 4-7 points) with severe back and leg pain, and they underwent successful MIS surgery. At 6 months of follow-up, the visual analog scale and Oswestry disability index scores of both patients improved and the deformity was corrected. For moderate ADS, percutaneous spinal EALIF and percutaneous pedicle screw fixation may achieve an effective correction of the deformity with direct decompression of neural structures.

Predictive models for the risk and prognosis of bone metastasis in patients with newly-diagnosed esophageal cancer: A retrospective cohort study.

Background: Esophageal cancer (EC) is a common malignant tumor worldwide, and patients with both EC and bone metastasis (BM) have a poor prognosis. We aimed to determine the risk and prognostic factors for BM in patients with newly diagnosed EC and to conduct two nomograms to predict the probability of BM and overall survival after BM. Methods: Data from patients with EC from 2010 to 2015 were reviewed in the Surveillance, Epidemiology, and End Results (SEER) database. We divided participants into training and validation cohorts using univariate and multivariate logistic regression analyses and Cox regression models to explore the risk and prognostic factors of BM, respectively. Moreover, two nomograms were developed for predicting the risk and prognosis of BM in patients with EC. Then we used receiver operating characteristic curves, decision curve analysis, and calibration curves to evaluate the nomogram models. The overall survival of patients with EC and BM was analyzed using the Kaplan-Meier method. Results: A total of 10,730 patients with EC were involved, 735 of whom had BM at the time of diagnosis. Histologic type, sex, age, N stage, primary site, liver, lung, and brain metastases, and tumor differentiation grade were identified as independent BM risk factors. Histological type, chemotherapy, brain, liver, and lung metastases were identified as prognostic risk factors for patients with EC and BM. We developed diagnostic and prognostic nomograms according to the results. Receiver operating characteristic curves, calibration, and Kaplan-Meier curves, and decision curve analysis all indicated that both nomograms had great clinical predictive ability and good clinical application potential. Conclusions: Two novel nomograms were constructed to predict the risk and prognosis of BM in patients with EC. These prediction models can effectively assist clinicians in clinical decision-making based on their good accuracy and reliability.

Vesselplasty versus vertebroplasty in the treatment of osteoporotic vertebral compression fractures with posterior wall rupture.

OBJECTIVE: This study was performed to compare the effectiveness and safety of vesselplasty versus vertebroplasty in the treatment of osteoporotic compression fractures with posterior wall rupture. METHODS: Patients who underwent treatment of a single osteoporotic vertebral compression fracture with posterior wall rupture from January 2016 to February 2020 were retrospectively reviewed. They were divided into a vesselplasty group (n = 17) and a vertebroplasty group (n = 43). Pain relief, radiographic outcomes, and bone cement leakage were compared between the two groups. RESULTS: There were no significant differences in the operation time, postoperative pain relief, vertebral compression recovery, or local Cobb angle improvement between the two groups. However, the overall bone cement leakage rate (29.4% vs. 67.4%) and spinal canal leakage rate (0.0% vs. 30.2%) were significantly lower in the vesselplasty group than vertebroplasty group. CONCLUSIONS: Vesselplasty offers similar pain relief and vertebral compression recovery but lower spinal canal leakage compared with vertebroplasty. Vesselplasty is thus a better option than vertebroplasty for patients with osteoporotic compression fractures with posterior wall rupture.