Selection of bone graft type for the surgical treatment of thoracolumbar spinal tuberculosis based on the spinal instability neoplastic score: a retrospective single-center cohort study.

OBJECTIVES: This study aimed to establish a standard for selecting bone graft type for thoracolumbar spinal tuberculosis surgery based on the spinal instability neoplastic score (SINS). METHODS: Patients with thoracolumbar tuberculosis who underwent one-stage debridement posteriorly and instrumentation were divided into a structural bone graft group (SBG) (51 cases) and a non-structural bone graft group (NSBG) (54 cases) according to their SINS. SBG was performed when the SINS was ≥ 13 and NSBG was performed when it was 7 ≤ SINS ≤ 12. Baseline data, clinical outcomes, and imaging outcomes were collected and statistically analyzed between the two groups. RESULTS: Significant improvements in clinical and imaging outcomes were achieved in both groups. Compared to the SBG group, the operation time of the NSBG group was shorter, the intraoperative blood loss of the NSBG group was less, the bone fusion time of the NSBG group was faster. CONCLUSION: Non-structural and structural bone grafting can achieve comparable therapeutic effects in patients with spinal tuberculosis, and a suitable selection of bone grafts based on quantitative SINS will make full use of the advantages of different bone grafts.

Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective study of risk factors and clinical outcomes.

OBJECTIVE: The objective of this research was to investigate the risk factors of cement leakage in patients with metastatic spine tumors following percutaneous vertebroplasty (PVP). METHODS: Sixty-four patients with 113 vertebrae were retrospectively reviewed. Various clinical indexes, including age, sex, body mass index (BMI), smoking history, drinking history, chemotherapy history, radiotherapy history, primary cancer, location, other metastases, collapse, posterior wall defects, the laterality of injection, and the injected cement volume were analyzed as potential risk factors. Multivariate analyses were conducted to identify the independent risk factors. RESULTS: The cement leakage was found 64 in 113 treated vertebrae (56.63%), in which the incidence of each type was shown as below: spinal canal leakage 18 (15.93%), intravascular leakage around the vertebrae 11 (9.73%), and intradiscal and paravertebral leakage 35 (30.97%). Tomita classification (P = 0.019) and posterior wall destruction (P = 0.001) were considered strong risk factors for predicting cement leakage in general. The multivariate logistic analysis showed that defects of the posterior wall (P = 0.001) and injected volume (P = 0.038) were independently related to the presence of spinal canal leakage. The postoperative visual analog scale (VAS) and activities of daily living (ADL) scores showed significant differences compared with the pre-operative parameters (P < 0.05). No significant differences were found in every follow-up time between the leakage group and the non-leakage group for pain management and improvement of activities in daily life. CONCLUSION: In our study, Tomita classification and the destruction of the posterior wall were independent risk factors for leakage in general. The defects of the posterior wall and injected volume were independently related to the presence of spinal canal leakage. The PVP procedure can be an effective way to manage the pain.

Reliability of different smartphones measuring the hallux valgus parameters in a new rapid method: a follow-up study.

OBJECTIVE: This study aimed to further compare the abilities to measure hallux valgus parameters in different smartphones using the intrinsic photograph-editing function. METHODS: We retrospectively reviewed 61 patients (100 feet) of hallux valgus without medical or surgical interventions at our department. The radiographic parameters were assessed and measured via the Picture archiving and communication systems (PACS), iPhone, and Android. The accuracy, reliability, and the time-taken were compared and analyzed between each two methods. RESULTS: The mean value of measured hallux valgus parameters were as follow: hallux valgus angle (HVA): 33.71 ± 7.25°; the first and second intermetatarsal angle (IMA): 12.84 ± 3.62° in PACS; HVA: 33.59 ± 7.18° and IMA: 12.80 ± 3.65° in Android; HVA: 33.63 ± 7.23° and IMA: 12.87 ± 3.60° in iPhone. No significant difference was found among the average results measured by PACS, Android and iPhone (F = 0.008, P = 0.992 in HVA; F = 0.009, P = 0.991 in IMA). For measurements by PACS, Android smartphone, and iPhone, the variability of HVA (F = 0.061, P = 1.000) and IMA (F = 0.133, P = 1.000) was similar. The intraclass correlation coefficients (ICCs) of the mean results of four times measurements of HVA and IMA as follows: PACS vs Android: 0.995 (0.993-0.997) and 0.982 (0.973-0.988); PACS vs iPhone:0.997 (0.995-0.998) and 0.974 (0.962-0.982); Android vs iPhone:0.997 (0.995-0.998) and 0.981 (0.971-0.987). The interobserver and intraobserver reliability was very good for Android smartphones and iPhone in measuring hallux valgus parameters. The mean time of measurement by PACS, Android smartphone, and iPhone were 25.34 ± 1.18 s, 20.10 ± 0.92 s, and 19.92 ± 0.99 s respectively. The measurement time of smartphones is significantly faster than that of PACS by about 5 seconds (P = 0.000). The measurement time of iPhone was slightly faster than that of Android smartphone, while no significant difference was found (P = 0.24). CONCLUSION: It is more convenient and faster to use smartphones when compared with PACS, at the same level of accuracy. Furthermore, the abilities of different smartphone platforms are proven to be of no significant difference.

A novel rapid measurement of hallux valgus parameters using the built-in photo edit function of smartphones.

OBJECTIVE: The objective of this study was to assess the accuracy and reliability of and time taken by a novel method using the built-in photo-edit function of smartphones compared with PACS in measuring hallux valgus parameters. METHODS: Seventy patients (124 ft) admitted to our hospital with a diagnosis of hallux valgus without previous surgical procedures were retrospectively reviewed. The foot radiographs of all the patients were extracted from PACS. The hallux valgus angle (HVA) and the first and second intermetatarsal angles (IMAs) were measured by PACS and by this novel method using the built-in photo-edit function of a smartphone. The results of these two methods were compared, and the accuracy and reliability were assessed between these two methods. RESULTS: The average parameters measured by PACS were as follows: HVA average: 37.43 ± 9.61°; IMA average: 13.37 ± 4.01°. The average parameters measured by smartphones were as follows: HVA average: 37.09 ± 9.52° and IMA average: 13.49 ± 3.91°. When compared by the independent-samples T test, the average parameters between PACS and smartphones were not significantly different (HVA PACS vs HVA smartphones: P = 0.776; IMA PACS vs IMA smartphones: P = 0.816). The variability of the HVA (F = 0.166, P = 0.992) and IMA (F = 0.215, P = 0.982) measurements was similar for the PACS and smartphones. The ICCs of the average parameters of four measurements of HVA and IMA between PACS and smartphones were 0.995 (0.991-0.997) and 0.970 (0.958-0.979), indicating that the two methods were highly correlated. For the smartphone measurement, the interobserver and intraobserver reliability was very good for HVA and IMA. The average measurement time of PACS was 25.41 ± 0.86 s, and the average measurement time of smartphones was 20.29 ± 1.22 s. The smartphone time was significantly faster than that of PACS by approximately 5 s (P<0.001). CONCLUSION: This novel method using the built-in photo-edit function of smartphones is accurate, reliable, convenient and time-saving in measuring the angles of hallux valgus.

Clinical efficacy of three types of autogenous bone grafts in treatment of single-segment thoracic tuberculosis: A retrospective cohort study.

A retrospective study investigated and compared the results of lamina with spinous process (LSP), transverse process strut (TPS) and iliac graft (IG) as bone graft in thoracic single-segment spinal tuberculosis(TB) with the one-stage posterior approach of debridement, fusion and internal instrumentation. 99 patients treated from January 2012 to December 2015 were reviewed. LSP was performed in 35 patients (group A), TPS was undertaken in 33 patients (group B), and IG was carried out in 31 patients (group C). Surgical time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, intervertebral height and bone fusion time were compared between preoperative and final FU. All the patients were followed up for a mean 43.90±10.39 months in group A, 45.30±6.20 months in group B, 44.32±7.17 months in group C without difference(P>0.05). The mean age was younger, the blood loss was less, the hospitalization time and the surgical time were shorter in group A than those in group B and C (P<0.05). The drainage volume was less in group A than that in group B and group C. The CRP, ESR, VAS, and ODI were significantly decreased and there were no significant difference among the groups at the final FU. The neurological function after surgery was improved compared with preoperation among the groups. The bony fusion at a mean time 12.90±3.91 months in group A was longer than that in group B (6.75±1.55 months) and group C (5.52±1.64 months) (P<0.05). No significant difference was found at the mean segmental angle, mean intervetebral height of preoperation and final FU among the groups (P>0.05). In conclusion, the LSP and TPS as bone graft are reliable, safe, and effective for single-segment stability reconstruction for surgical management of thoracic TB and TPS could be new bone graft methods.

Complications rate of and risk factors for the unplanned reoperation of degenerative lumbar spondylolisthesis in elderly patients: a retrospective single-Centre cohort study of 33 patients.

BACKGROUND: The study was to investigate the complications rate of and risk factors for unplanned reoperation among elderly patients who underwent posterior lumbar fusion (PLF) for degenerative lumbar spondylolisthesis (DLS). METHODS: A total of 1100 DLS patients who were older than 60 years were reviewed from January 2006 to December 2016. 33 patients underwent unplanned reoperations and were analysed and divided into two groups (group A: posterolateral fusion, 650 patients; group B: intervertebral fusion, 450 patients). Sex, body mass index (BMI), radiographic data and clinical outcome data were analysed to evaluate the complications rate of and the risk factors for unplanned reoperations. RESULTS: A total of 33 patients underwent unplanned reoperations (3%). The patients were followed up for an average of 4.20 ± 2.25 years (group A) and 4.32 ± 2.54 years (group B) without a significant difference. Significant differences were found in mean age, levels of involvement, hospital stay, surgery time, and blood loss between the groups. The causes of unplanned operation were wound infection, screw misplacement, neurological deficit, nonunion, and screw fracture, which were significant except for wound infection between the groups. Higher BMI (obesity), diabetes mellitus (DM), more bleeding and sex (female) were risk factors for complications. Cases of screw misplacement, neurological deficit, nonunion and screw fracture in group A were more significant than those in group B. CONCLUSION: Patients with higher BMI, DM, older age, posterolateral fusion, and female sex predicted a higher incidence of unplanned reoperations. Spine surgeons may need to pay more attention to their preoperative training and to improving surgical techniques that could reduce the reoperation rate.

Construction of biomimetic cell-sheet-engineered periosteum with a double cell sheet to repair calvarial defects of rats.

Background: The periosteum plays a crucial role in the development and injury healing process of bone. The purpose of this study was to construct a biomimetic periosteum with a double cell sheet for bone tissue regeneration. Methods: In vitro, the human amniotic mesenchymal stem cells (hAMSCs) sheet was first fabricated by adding 50 â€‹µg/ml ascorbic acid to the cell sheet induction medium. Characterization of the hAMSCs sheet was tested by general observation, microscopic observation, live/dead staining, scanning electron microscopy (SEM) and hematoxylin and eosin (HE) staining. Afterwards, the osteogenic cell sheet and vascular cell sheet were constructed and evaluated by general observation, alkaline phosphatase (ALP) staining, Alizarin Red S staining, SEM, live/dead staining and CD31 immunofluorescent staining for characterization. Then, we prepared the double cell sheet. In vivo, rat calvarial defect model was introduced to verify the regeneration of bone defects treated by different methods. Calvarial defects (diameter: 4 â€‹mm) were created of Sprague-Dawley rats. The rats were randomly divided into 4 groups: the control group, the osteogenic cell sheet group, the vascular cell sheet group and the double cell sheet group. Macroscopic, micro-CT and histological evaluations of the regenerated bone were performed to assess the treatment results at 8 weeks and 12 weeks after surgery. Results: In vitro, hAMSCs sheet was successfully prepared. The hAMSCs sheet consisted of a large number of live hAMSCs and abundant extracellular matrix (ECM) that secreted by hAMSCs, as evidenced by macroscopic/microscopic observation, live/dead staining, SEM and HE staining. Besides, the osteogenic cell sheet and the vascular cell sheet were successfully prepared, which were verified by general observation, ALP staining, Alizarin Red S staining, SEM and CD31 immunofluorescent staining. In vivo, the macroscopic observation and micro-CT results both demonstrated that the double cell sheet group had better effect on bone regeneration than other groups. In addition, histological assessments indicated that large amounts of new bone had formed in the calvarial defects and more mature collagen in the double cell sheet group. Conclusion: The double cell sheet could promote to repair calvarial defects of rats and accelerate bone regeneration. The translational potential of this article: We successfully constructed a biomimetic cell-sheet-engineered periosteum with a double cell sheet by a simple, low-cost and effective method. This biomimetic periosteum may be a promising therapeutic strategy for the treatment of bone defects, which may be used in clinic in the future.

A novel rapid measurement method of cervical sagittal parameters based on the integrated inclinometer of a smartphone: a validity and reliability study.

Objectives: A new method was introduced using a smartphone's integrated inclinometer for rapid measurement of sagittal cervical parameters. The present study aims to compare the validity and reliability of the proposed method.Methods: We retrospectively reviewed 120 patients with cervical spondylosis treated at our hospital. The C0-2 Cobb angle, C2-7 Cobb angle, T1-slope (T1S), and neck tilt (NT) were selected as representative sagittal angles for this study. Two methods, the smartphone's integrated inclinometer and picture archiving and communication system (PACS), were used to measure these four representative angles. Validity, reliability, and measurement times were recorded and compared.Results: The representative parameters (C0-2 Cobb angle, C2-7 Cobb angle, T1S, and NT), the ICC was 0.957 (0.939-0.970), 0.971 (0.958-0.979), 0.974 (0.963-0.982) and 0.949 (0.927-0.964) for validity respectively. For the aforementioned representative parameters, the ICC values were 0.972 (0.960-0.980), 0.979 (0.969-0.985), 0.972 (0.959-0.980), 0.942 (0.917-0.959) for intraobserver reliability respectively. For the representative parameters mentioned above, the ICC values were 0.947 (0.926-0.963), 0.964 (0.949-0.975), 0.956 (0.938-0.969), 0.916 (0.881-0.940) for interobserver reliability respectively. For the validity of the representative parameters mentioned above, the Bland-Altman plot displayed a mean difference of 0.2, 0.1, 0.1, and 0.4°with a 95% CI of 4.3, 4.5, 3.4, and 4.1°, respectively. The measurement by smartphone's integrated inclinometer (46.31 ± 3.99 s) was significantly quicker than that by PACS (69.48 ± 3.25 s) according to independent-samples T test (p < 0.001).Conclusion: This novel smartphone measurement based on the integrated inclinometer is accurate and reliable for measuring cervical sagittal parameters rapidly and conveniently.

Sagittal parameters of the cervical spine have been widely applied in many types of spinal disorders for disease diagnosis, assessment, classification, treatment choice, and follow-up, so accurate, rapid, and convenient measurement of cervical sagittal parameters is important.Traditional measurement of sagittal parameters of the cervical spine have their own disadvantages.This novel smartphone measurement based on the integrated inclinometer is accurate and reliable for measuring cervical sagittal parameters rapidly and conveniently.

Development and validation of a novel necroptosis-related gene signature for predicting prognosis and therapeutic response in Ewing sarcoma.

Ewing sarcoma (ES) is the second most common malignant bone tumor in children and has a poor prognosis due to early metastasis and easy recurrence. Necroptosis is a newly discovered cell death method, and its critical role in tumor immunity and therapy has attracted widespread attention. Thus, the emergence of necroptosis may provide bright prospects for the treatment of ES and deserves our further study. Here, based on the random forest algorithm, we identified 6 key necroptosis-related genes (NRGs) and used them to construct an NRG signature with excellent predictive performance. Subsequent analysis showed that NRGs were closely associated with ES tumor immunity, and the signature was also good at predicting immunotherapy and chemotherapy response. Next, a comprehensive analysis of key genes showed that RIPK1, JAK1, and CHMP7 were potential therapeutic targets. The Cancer Dependency Map (DepMap) results showed that CHMP7 is associated with ES cell growth, and the Gene Set Cancer Analysis (GSCALite) results revealed that the JAK1 mutation frequency was the highest. The expression of 3 genes was all negatively correlated with methylation and positively with copy number variation (CNV). Finally, an accurate nomogram was constructed with this signature and clinical traits. In short, this study constructed an accurate prognostic signature and identified 3 novel therapeutic targets against ES.

Genome Sequencing Highlights the Plant Cell Wall Degrading Capacity of Edible Mushroom Stropharia rugosoannulata.

The basidiomycetous edible mushroom Stropharia rugosoannulata has excellent nutrition, medicine, bioremediation, and biocontrol properties. S. rugosoannulata has been widely and easily cultivated using agricultural by-products showing strong lignocellulose degradation capacity. However, the unavailable high-quality genome information has hindered the research on gene function and molecular breeding of S. rugosoannulata. This study provided a high-quality genome assembly and annotation from S. rugosoannulata monokaryotic strain QGU27 based on combined Illumina-Nanopore data. The genome size was about 47.97 Mb and consisted of 20 scaffolds, with an N50 of 3.73 Mb and a GC content of 47.9%. The repetitive sequences accounted for 17.41% of the genome, mostly long terminal repeats (LTRs). A total of 15,726 coding gene sequences were putatively identified with the BUSCO score of 98.7%. There are 142 genes encoding plant cell wall degrading enzymes (PCWDEs) in the genome, and 52, 39, 30, 11, 8, and 2 genes related to lignin, cellulose, hemicellulose, pectin, chitin, and cutin degradation, respectively. Comparative genomic analysis revealed that S. rugosoannulata is superior in utilizing aldehyde-containing lignins and is possible to utilize algae during the cultivation.

Effect of early continuously intravenous tranexamic acid on perioperative blood loss in thoracolumbar burst fractures with neurological symptoms.

There is still a conflict between early surgical decompression and increased bleeding resulting from early surgery for thoracolumbar burst fractures (TBF) with neurological symptoms. The aim of this study is to investigate the effect of early continuously intravenous tranexamic acid (TXA) on perioperative blood loss in TBF with neurological symptoms who underwent early surgery. A retrospective comparative analysis was performed. The patients in study group were treated with intravenous TXA 15 mg/kg every 24 hours after admission besides intravenous TXA 15 mg/kg before skin incision and patients in control group were treated with intravenous TXA 15 mg/kg before skin incision only. Perioperative blood loss was compared between the 2 groups. The hemoglobin at admission, before surgery, 1 day and 3 days after surgery, the operation time, drainage time, blood transfusion and volume, incidence of complications and length of hospital stay were also compared. The operation time, preoperative, intraoperative, total, hidden amounts of blood loss in TXA group were significantly lower than those in control group (P < .001). The hemoglobin level in the TXA group was significantly higher than that in the control group before and 1 day after surgery (P < .05). The remove drainage time, hospitalization time, blood transfusion rate and volume in the TXA group were significantly lower than those in the control group (P < .001). There was no significant difference in the incidence of lower limb thrombosis between the 2 groups (P > .05). Early continuously intravenous TXA reduces the perioperative blood loss of patients with TBF who underwent early posterior fracture reduction, nerve decompression and pedicle screw fixation.

Visualized Analysis of Global Studies on Cervical Spondylosis Surgery: A Bibliometric Study Based on Web of Science Database and VOSviewer.

Purpose: This study used multiple type of bibliometric analysis for identifying and summarizing the publications regarding cervical spondylosis surgery, for clarifying the history of this field, predicting the future hotspots of this field and improving communication among researchers. Methods: Publications from Web of Science database between 1900 and 2019 were downloaded and analyzed by Excel 2016 and VOSviewer. Bibliometric maps of co-citations and maps of co-occurrence of keywords are constructed by VOSviewer software. Results: A total of 2110 publications were searched from Web of Science. The total sum of times cited is 40448 with the average citation per publication of 19.17 times. USA published most papers (652, 30.9%). The most productive organizations is University of Toronto (96 publications). Spine (308 publications) published the most publications in this field. In co-citations of references analysis, four clusters of references are constructed by VOSviewer. In co-occurrence of keywords analysis, three clusters of keywords are constructed by VOSviewer. The latest keyword "degenerative cervical myelopathy" appeared in 2017 in 42 papers. Other relatively new keywords include "surgical outcomes", "association", "sagittal alignment", "prognostic-factors" that appeared in 2016 in 33, 31, 34 and 37 papers respectively. Conclusion: USA dominates the research regarding cervical spondylosis surgery. University of Toronto is the most productive organization in this field. Spine, European Spine Journal and Journal of Neurosurgery Spine are the top three productive journals on publications of cervical spondylosis surgery. "Degenerative cervical myelopathy", "surgical outcomes", "association", "sagittal alignment" and "prognostic-factors" may be the new research hotspots in this field.

Rapid measurement of thoracolumbar kyphosis with the integrated inclinometer of a smartphone: a validity and reliability study.

The objective of this study was to evaluate the accuracy, reliability, and time requirements of two methods for measuring thoracolumbar kyphosis: a conventional method using a picture archiving and communication system (PACS) and this new method using the integrated inclinometer of a smartphone. The thoracolumbar kyphotic angles of one hundred consecutive patients were measured by a PACS and this novel smartphone method. The measured angles were analysed by multiple statistical methods, and the two measurement tools were compared in terms of accuracy, reliability, and time requirements. The mean result of thoracolumbar kyphosis measured by the PACS was 21.43 ± 12.96°, and the mean value measured by the smartphone was 21.03 ± 13.01°. A Bland-Altman plot for these two methods showed a mean difference of 0.4°, with the limits of agreement being -2.4° and 3.2°. One-way ANOVA showed no significant difference (F = 0.080, P = 0.999) among measurements by different observers and different methods. The intraclass correlation coefficients (ICCs) of the mean values of four repeated measurements of thoracolumbar kyphosis between these two methods were 0.997 (0.995-0.998), revealing that the two methods were highly correlated. The ICC results showed that the concordance between these two methods was very good for all measurements of thoracolumbar kyphosis, and the inter- and intra-observer reliability of the novel smartphone method were very good. The PACS method (36.95 ± 0.98 s) took significantly longer than the smartphone method (17.68 ± 0.97 s) when compared by an independent-samples t test (P = 0.000). This new method using the integrated inclinometer of a smartphone has satisfactory validity and reliability compared to the PACS method. Additionally, the new method took significantly less time than the PACS method. Measuring with a smartphone is more convenient than using a PACS, which is always rooted in a full-sized computer. In summary, this new method using the integrated inclinometer of a smartphone is rapid, convenient, accurate and reliable when measuring thoracolumbar kyphosis in osteoporotic vertebral compression fracture (OVCF) patients.

Polyunsaturated Fatty Acids Level and Bone Mineral Density: A Two-Sample Mendelian Randomization Study.

Background: This Mendelian randomization (MR) study aimed to explore the causal relationship between polyunsaturated fatty acids (PUFAs) and bone mineral density (BMD). Methods: We conducted a two-sample MR analysis to figure out if there is any causal effect of PUFAs on BMD through the summary data from the genome-wide association study (GWAS). Relationships were evaluated through inverse variance weighted (IVW), MR-Egger, weighted median, and maximum likelihood methods. The MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) test was performed to detect the horizontal pleiotropy. Results: Our findings revealed that omega-6 fatty acids were negatively related to the TB-BMD (beta-estimate: -0.0515; 95% confidence interval [CI]: -0.0911 to -0.0119; standard error [SE]: 0.0201; p-value: 0.0106). The reverse direction MR analysis showed that TB-BMD was linked to the omega-6 FAs (beta-estimate: -0.0699; 95% CI: -0.1304 to -0.0095; SE: 0.0308; p-value: 0.0265). No statistically significant correlations between PUFAs and BMD were observed after adjusting the interactions between metabolites. Conclusion: This two-sample MR analyses produced strong and new genomic evidence that there was a causal relationship between omega-6 FAs and BMD. Further investigations are still required to elucidate the potential mechanism.

Construct and Validate a Predictive Model for Surgical Site Infection after Posterior Lumbar Interbody Fusion Based on Machine Learning Algorithm.

Purpose: Surgical site infection is one of the serious complications after lumbar fusion. Early prediction and timely intervention can reduce the harm to patients. The aims of this study were to construct and validate a machine learning model for predicting surgical site infection after posterior lumbar interbody fusion, to screen out the most important risk factors for surgical site infection, and to explore whether synthetic minority oversampling technique could improve the model performance. Method: This study reviewed 584 patients who underwent posterior lumbar interbody fusion for degenerative lumbar disease at our center from January 2019 to August 2021. Clinical information and laboratory test data were collected from the electronic medical records. The original dataset was divided into training set and validation set in a 1 : 1 ratio. Seven machine learning algorithms were used to develop predictive models; the training set of each model was resampled using synthetic minority oversampling technique. Finally, the model performance was assessed in the validation set. Results: Of the 584 patients, 33 (5.65%) occurred surgical site infection. Stepwise logistic regression showed that preoperative albumin level (OR 0.659, 95% CI 0.563-0.756), diabetes (OR 9.129, 95% CI 3.816-23.126), intraoperative dural tear (OR 8.436, 95% CI 2.729-25.334), and rheumatic disease (OR 8.471, 95% CI 1.743-39.567) were significant predictors associated with surgical site infection. The performance of the AdaBoost Classification Trees model was the best among the seven machine learning models, and synthetic minority oversampling technique improved the performance of all models. Conclusion: The prediction model we constructed based on machine learning and synthetic minority oversampling technique can accurately predict surgical site infection, which is conducive to clinical decision-making and optimization of perioperative management.

Validity and reliability of a novel iPhone method to rapidly measure cervical sagittal parameters.

We introduced a novel method based on the iPhone's intrinsic photo edit function to measure sagittal parameters of the cervical spine. This study aimed to assess the validity of this new method compared with the picture archiving and communication system (PACS) method (the gold standard) and to test the reliability of this novel technique. One hundred consecutive patients admitted to our hospital diagnosed with cervical spondylotic myelopathy or cervical spondylotic radiculopathy were retrospectively reviewed. Four angles, including the C0-2 Cobb angle, C2-7 Cobb angle, T1S and neck tilt (NT), were assessed by iPhone and PACS. The validity and reliability were evaluated, and the time taken by both methods was compared. The ICCs of the validity of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.960, 0.976, 0.980 and 0.946, respectively. The ICCs of the intraobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.966, 0.983, 0.971 and 0.951, respectively. The ICCs of the interobserver reliability of the C0-2 Cobb angle, C2-7 Cobb angle, T1S and NT were 0.953, 0.972, 0.957 and 0.929, respectively. The Bland‒Altman plot of validity of the four angles revealed mean differences of 0.3, 0.2, 0.1, and 0.1 degrees with 95% CIs of 4.1, 4.1, 2.9, and 4.3 degrees, respectively. The iPhone measurement time (58.55 ± 4.17 s) was significantly less than that by the PACS (70.40 ± 2.92 s) when compared by the independent-samples T test (P < 0.001). This novel method using the iPhone's intrinsic photo edit function is accurate, reliable, fast and convenient when measuring cervical sagittal parameters.

Evidence for the Presence of Hyphae and Fruiting Body Calcium Oxalate Crystallites in the Split Gill Medicinal Mushroom Schizophyllum commune (Agaricomycetes).

Biomineralization is the phenomenon by which organisms form crystals. Studies have shown that many fungi can biomineralize, producing calcium oxalate crystals on their hyphae and fruiting body. Schizophyllum commune is a medicinal and edible fungus found worldwide, however, studies on biomineralization in this fungus are limited. Here, samples of Sch. commune fruiting bodies were collected from three different provinces in China and hyphal cells were cultured. Using light microscopy, FE-SEM, and EDAX, we identified crystals on the fruiting body and mycelium of each strain and analyzed their morphological characteristics and ion content. These data demonstrate that biomineralization occurs in Sch. commune in nature as well as during subsequent in vitro culture.

Harnessing hyaluronic acid for the treatment of osteoarthritis: A bibliometric analysis.

Background: Osteoarthritis (OA) is a common disease which usually occurs in middle-aged and elderly people. Hyaluronic acid (HA) has been widely used to treat OA and related researches on the efficacy and safety of HA in the treatment of OA have been published. Therefore, the purpose of this research was to investigate the subject characteristics of harnessing HA for the treatment of OA and to analyse the relevant trends and hotspots by using a bibliometric approach. Methods: The articles published from 1 January 2002 to 31 December 2021 were searched in the Web of Science Core Collection (WoSCC) and the relevant information of HA for the treatment of OA was extracted after screening. Then, a total of 2438 publications were analysed by using Microsoft Excel, CiteSpace 5.8.R3, VOSviewer 1.6.18 and the Online Analysis Platform of Literature Metrology (http://bibliometric.com/). Results: A total of 2438 articles were finally included for analysis. The number of publications increased year by year. A total of 83 coutries and 3319 institutions published 2438 manuscripts in the field of use HA for the treatment of OA. The most productive country was United States with total 689 publications and League of European Research Universities Leru (Belgium) was the leading institution with total 126 publicatios. In terms of authors, the most prominent author was KrausVB, who published 28 papers with the highest H-index (19). In addition, Osteoarthritis and Cartilage had the highest number of publications (152 articles) and the highest number of citations (6450 citations). The co-cited references analysis indicated that the article published by McAlindon in 2014 had the most highest number of citations (91co-citations). What's more, most research hotspots focused on the efficacy and safety of HA, and regenerative medicine researches such as platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) have attracted more and more attentions of researchers. Conclusion: This study visually analyzed the historical evolution and future trends of HA for the treatment of OA, and discussed the research priorities. At present, there are still different views on the efficacy of HA for the treatment of OA. Gradually, research hotspots of this field have focused on the regenerative medicine.

Risk factors for rapid progressive neurological deterioration in patients with cervical spondylotic myelopathy.

BACKGROUND: The rapid progressive cervical spondylotic myelopathy (rp-CSM) which had a course of CSM less than 1 month and suffered rapidly progressive neurological deterioration had few reports. Therefore, it is important for us to recognize the pathophysiology of CSM especially the rp-CSM. The study aimed to investigate the risk factors for rapidly progressive (rp) neurological deterioration in patients with cervical spondylotic myelopathy (CSM). METHODS: A total of 159 patients were reviewed and divided into an rp-CSM group and a chronic-CSM (c-CSM) group. Various clinical indexes, including age, sex, Japanese Orthopaedic Association (JOA) score, intramedullary MR T2-hyperintensity, congenital/degenerative spinal stenosis, and local type of ossification of the posterior longitudinal ligament (OPLL), were analyzed, and independent risk factors were investigated. RESULTS: Thirty-four of 159 patients (21.4%) were diagnosed with rp-CSM. All patients were followed up for a mean of 68.56 ± 14.00 months in the rp-CSM group and 62.66 ± 19.95 months in the c-CSM group. No significant difference was found in sex, mean age, smoking and drinking status, diabetes mellitus (DM), hypertension, surgery time, blood loss, JOA score, degenerative spinal stenosis, or OPLL (local). Univariate analyses demonstrated that rp-CSM patients tended to have MR T2-hyperintensity, longer hospital stay, shorter waiting time for surgery, more congenital spinal stenosis, and worse neurological function and to prefer more posterior surgeries than c-CSM patients. A multiple logistic regression analysis showed that congenital spinal stenosis and MR T2-hyperintensity were independently related to the presence of rp-CSM. CONCLUSIONS: MR T2-hyperintensity and congenital spinal stenosis were risk factors for rp-CSM. Although neurological function deteriorates rapidly, early surgical decompression is recommended and can achieve good neurological recovery after surgery, indicating that rp-CSM could be a reversible condition.

The CT assessment of uncovertebral joints degeneration in a healthy population.

BACKGROUND: A retrospective study investigated the degeneration trend of uncovertebral joints in a healthy population based on CT assessment. METHODS: A total of 200 males and 160 females, aged 21-79 years old (50.82 ± 17.06), who underwent CT examination in our hospital from September 2020 to March 2021 were enrolled. Sixty patients were included in each age group. According to the Kellgren and Lawrence classification and CT was used to evaluate the uncovertebral joints degeneration in different groups. RESULTS: With the increase of age, the degeneration of each segment was gradually aggravated. The uncovertebral joints started degenerating in the 20 s, and the C5-6 is the most degenerative segment, followed by the C4-5 and C6-7. Significant degeneration occurred in each segment between the 40 s and 60 s and became more severe after the 70 s. CONCLUSIONS: The modified Kellgren and Lawrence classification based on CT scan could provide a quantitative assessment of uncovertebral joints degeneration in a healthy population and could provide more details for artificial cervical arthroplasty.