Relation Between Neck Pain and Modic Changes in Cervical Spondylotic Myelopathy.

BACKGROUND Modic changes on magnetic resonance imaging (MRI) represent lesions in the bone marrow of the vertebral body that may be associated with pain. This study investigated the relationship between neck pain and cervical Modic changes, and risk factors for neck pain (NP). MATERIAL AND METHODS This study included 168 patients diagnosed with cervical spondylotic myelopathy between February 2013 and April 2017. Basic patient information about demographic and lifestyle variables was obtained from medical records. Radiographic images provided cervical alignment (C2-C7 Cobb), T1 slope and C7 slope. All patients underwent MRI to evaluate the presence of Modic changes. Univariate analyses identified the variables as potential factors. Variables with a p<0.10 were included in the multivariate logistic regression analysis models. P-values <0.05 were statistically significant. RESULTS Only 93 patients (55.4%) had NP. Modic changes in patients with NP were significantly higher than those without Modic changes (p=0.002). Eighty-five patients had Modic changes types I, II, III; 41 (48.2%), 29 (34.1%), 15 (17.6%), respectively. The distribution of these Modic changes varied with NP (p<0.001). Type I Modic changes were seen with NP more frequently than other types of Modic changes. Univariate and multivariate analyses showed that age (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.02-1.16) and Modic changes (OR 1.25; 95% CI, 0.09-1.46) were significant independent factors for NP. CONCLUSIONS In cervical spondylosis, age and Modic changes were associated with NP. Modic change type I is more likely to occur with NP.

Predictors of Deterioration in Sagittal Balance Following Long Fusion Arthrodesis to L5 in Patients with Adult Scoliosis.

BACKGROUND The aim of this study was to identify the predictors of deterioration in sagittal balance in patients with adult scoliosis following long fusion arthrodesis to L5. MATERIAL AND METHODS A retrospective clinical study included 63 patients with adult scoliosis who underwent long fusion arthrodesis to L5, between February 2005 and May 2015. Radiological imaging values included the angle of lumbar lordosis (LL), and the angle of pelvic incidence (PI). The patients were divided into two cohorts, according to the threshold of average loss of sagittal vertical axis (SVA): a cohort with stable sagittal balance (SSB) and a cohort with deteriorated sagittal balance (DSB). Multivariate logistic regression analysis and the receiver operating characteristic (ROC) curve were used to identify the predictors of clinical outcome. RESULTS There were significant differences between the SSB and DSB cohorts in age (p<0.001), preoperative SVA (p<0.001), last follow-up SVA (p<0.001), preoperative LL (p=0.001), last follow-up LL (p<0.001), subsequent L5-S1 disc degeneration (p<0.001) and PI (p=0.028). Patient age >61.5 years (OR=1.251, 95% CI, 1.055-1.484) (P=0.010), preoperative SVA >3.54 cm (OR=1.844, 95% CI, 1.249-2.732) (P=0.002) and preoperative LL <19.0 degrees (OR=0.922, 95% CI, 0.869-0.979) (P=0.008) were identified as predictors of deterioration in sagittal balance. CONCLUSIONS Deterioration in sagittal balance following long fusion arthrodesis to L5 in patients with adult scoliosis was associated with subsequent L5-S1 disc degeneration and loss of LL, age >61.5 years, preoperative SVA >3.54 cm, and preoperative LL <19.0 degrees.

Role of FSCN1 in the tumor microenvironment of lung squamous cell carcinoma.

Tumor microenvironment (TME) regulated the development of the Lung squamous cell carcinoma (LUSC). To know more about the LUSC, this study tried to figure the role of fscin actin-bundling protein 1 (FSCN1) in the TME. We identified the FSCN1 as the hub immune gene in LUSC, with the use of weighted gene co-expression network analysis (WGCNA) and the Human Protein Atlas. Furthermore, we verified the higher expression of FSCN1 in LUSC compared with the normal tissues by quantitative reverse transcription PCR (qRT-PCR) and immunohistochemistry. We then explored the associations among FSCN1, immune infiltrations, and inflammatory factors with the use of Gene Expression Profiling Interactive Analysis (GEPIA) and Tumor IMmune Estimation Resource (TIMER). As a result, the expressions of FSCN1 was negatively related to the immune infiltrations, and positively related to the expressions of IL1A, IL1B, TGFB1 and TGFA. Moreover, we used the single-cell RNA-sequencing (scRNA-seq) data of LUSC to figure out the expressions level of FSCN1, IL1A, IL1B, TGFB1 and TGFA in the different cell type's of the TME. Finally, through the cytological experiments, we found that FSCN1 affected by TGFB1 contributes to the proliferation, anti-apoptotic effect, migration and invasion of the LUSC cells. In summary, this study Identified FSCN1 as the potential therapeutic target of LUSC, and reveals a complicated immune and inflammatory net in the TME.

Long Tunneled External Ventricular Drains with Shunt Valves: A Technical Note.

BACKGROUND: External ventricular drain (EVD) is a basic operation in neurosurgery. Due to the limitation of its safe duration, some patients need to receive multiple drainage operations. We describe the long tunneled EVD (LTEVD) with shunt valves that effectively avoid multiple operations as a technical note. METHODS: The difference is that the middle part of the drainage tube is connected by an externalized shunt valve. The drainage tube is buried under the skin and the outlet is in the abdomen. The technique and more details are described. RESULTS: The connection between the LTEVD and the shunt valve is simple and the required materials are easily accessible. Externalized valves allow the cerebrospinal fluid to be visualized and more controllable, making it easier for physicians to manage the cerebrospinal fluid. No drainage tube failure or secondary infection was observed. The indwelling time of the drainage tube was greatly extended. CONCLUSIONS: LTEVD is effective and simple. It allows visual control of drainage flow, prolonging catheter indwelling time and eliminating the need for multiple surgeries.

Synthesis of magnetic/luminescent alginate-templated composite microparticles with temperature-dependent photoluminescence under high-frequency magnetic field.

Highly magnetic luminescent alginate-templated composite microparticles were successfully synthesized by a novel process combining emulsification and layer-by-layer self-assembly techniques. The composite microparticles were characterized by ζ-potential analyzer, transmission electron microscope, X-ray diffraction, Fourier transform infrared spectroscope, fluorescence spectrophotometer, and vibrating sample magnetometer. Experimental observations indicated that the composite microparticles had excellent magnetic properties, and its photoluminescence could be precisely controlled by varying the number of deposition cycles of polyelectrolytes and CdTe/polyelectrolyte multilayers. Moreover, the composite microparticles could be heated up in a high-frequency magnetic field and demonstrated linear temperature-dependent photoluminescence over the range from room temperature to hyperthermia temperature. The composite microparticles are expected to be promising candidates for biomedical applications, such as immunoassay, biosensing and imaging, and cancer diagnosis and treatment.

The preoperative predictors for subsequent degeneration in L5-S1 disc after long fusion arthrodesis terminating at L5 in patients with adult scoliosis: focus on spinopelvic parameters.

BACKGROUND: The subsequent L5-S1 disc degeneration associated with long fusion arthrodesis terminating at L5 in patients with adult scoliosis has been a common concern. However, few studies paid attention to its preoperative predictors, especially in spinopelvic parameters. The purpose of the present study was to clarify the preoperative predictors of subsequent L5-S1 disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis on spinopelvic parameters. METHODS: In this retrospective study, we enrolled 67 patients with adult scoliosis, and the patients were divided into disc degeneration group (DD) and no disc degeneration group (NDD), based on the presence or absence of subsequent L5-S1 disc degeneration. The status of L5-S1 disc was evaluated by a modified version of radiographic classification. Characteristics and spinopelvic parameters of preoperative patients were collected as potential predictors for subsequent lumbosacral disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis. Multivariate logistic regression analysis and the receiver operating characteristic curve were used to identify the preoperative predictors, with an adjusted odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Thirty-six patients (53.73%) with subsequent L5-S1 disc degeneration were divided into group DD (preoperative score 0.81 ± 0.57, last follow-up score 1.83 ± 0.60, P <  0.001), and the other 31 patients were divided into group NDD (preoperative and last follow-up score 0.87 ± 0.49). There was no statistical difference in preoperative score (P = 0.583) of lumbosacral disc between two groups; however, significant statistical difference showed in last follow-up score (P <  0.001). Multivariate logistic regression identified three preoperative predictors: pelvic incidence (PI) (P = 0.018), sagittal vertical axis (SVA) (P = 0.024), and sacrum-femoral distance (SFD) (P = 0.023). PI < 48.5° (OR = 0.911, 95% CI = 0.843-0.984), SVA > 4.43 cm (OR = 1.308, 95% CI = 1.036-1.649), and SFD > 5.65 cm (OR = 1.337, 95% CI = 1.041-1.718) showed satisfied accuracy for predicting subsequent L5-S1 disc degeneration. CONCLUSION: The prevalence of the subsequent L5-S1 disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis was 57.3% (36 of 67 patients). PI < 48.5°, SVA > 4.43 cm, and SFD > 5.65 cm were preoperative predictors for the subsequent L5-S1 disc degeneration. More attention should be paid to prevent the L5-S1 disc from degeneration when these preoperative predictors exist, especially with two or more.

Active-target T1-weighted MR Imaging of Tiny Hepatic Tumor via RGD Modified Ultra-small Fe3O4 Nanoprobes.

Developing ultrasensitive contrast agents for the early detection of malignant tumors in liver is highly demanded. Constructing hepatic tumors specific targeting probes could provide more sensitive imaging information but still faces great challenges. Here we report a novel approach for the synthesis of ultra-small Fe3O4 nanoparticles conjugated with c(RGDyK) and their applications as active-target T1-weighted magnetic resonance imaging (MRI) contrast agent (T1-Fe3O4) for imaging tiny hepatic tumors in vivo. RGD-modified T1-Fe3O4 nanoprobes exhibited high r1 of 7.74 mM(-1)s(-1) and ultralow r2/r1 of 2.8 at 3 T, reflecting their excellent T1 contrast effect at clinically relevant magnetic field. High targeting specificity together with favorable biocompatibility and strong ability to resist against non-specific uptake were evaluated through in vitro studies. Owing to the outstanding properties of tumor angiogenesis targeting with little phagocytosis in liver parenchyma, hepatic tumor as small as 2.2 mm was successfully detected via the T1 contrast enhancement of RGD-modified T1-Fe3O4. It is emphasized that this is the first report on active-target T1 imaging of hepatic tumors, which could not only significantly improve diagnostic sensitivity, but also provide post therapeutic assessments for patients with liver cancer.

High-performance PEGylated Mn-Zn ferrite nanocrystals as a passive-targeted agent for magnetically induced cancer theranostics.

An effective magnetic nanocrystals (MNCs)-mediated theranostics strategy as a combination of simultaneous diagnostics and heating treatment of tumors by using magnetic resonance imaging (MRI) and alternating current magnetic field (ACMF) is successfully developed. In this strategy, we had firstly synthesized a well-established Mn-Zn ferrite MNCs coated with PEG-phospholipids (1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethylene glycol copolymers, DSPE-PEG2000). The monodisperse PEGylated MNCs with core-shell structure (15 nm) exhibited excellent performance, such as high magnetism of 98 emu g(-1) Fe, relaxivity coefficient (r2) of 338 mm(-1) s(-1), and specific absorption rate (SAR) value of 324 W g(-1) Fe. It was proved that the obtained MNCs with an average diameter of 48.6 nm can drastically minimize the recognition and phagocytosis of macrophages, simultaneously improve their biocompatibility in vitro. These advantages endowed them with efficient passive targeting ability in vivo for prominent tumor MRI and magnetically induced heating when exposed to ACMF, based on enhanced permeability and retention (EPR) effects. To ensure sufficient accumulation of MNCs within tumors for targeted hyperthermia, we described the use of MNCs with a well-tolerated intravenous single dose of 18 mg Fe/kg mouse body weight, achieving repeatedly injection and hyperthermia within a subcutaneous breast cell carcinoma mouse model. With an ACMF of 12 A at 390 kHz, the tumor surface sites could be heated to approximately 43 °C in 30 min based on MNCs-mediated intravenous injections. The long-lasting hyperthermia could effectively induce the apoptosis of tumor cells, inhibit the angiogenesis of tumor vessels, and finally suppress the tumor growth within a certain period of time.