Percutaneous Endoscopic Lumbar Discectomy (PELD) via a Transforaminal and Interlaminar Combined Approach for Very Highly Migrated Lumbar Disc Herniation (LDH) Between L4/5 and L5/S1 Level.

BACKGROUND Percutaneous endoscopic lumbar discectomy (PELD) has become one of the most popular minimally invasive surgeries for lumbar disc herniation (LDH), however, very highly migrated LDH is still a tricky issue for PELD. This study reported a new endoscopic discectomy strategy for the treatment of very highly migrated LDH between the L4/5 and L5/S1 level. MATERIAL AND METHODS The current study retrospectively analyzed 12 patients who accepted PELD for very highly migrated LDH between the L4/5 and L5/S1 level. Under local anesthesia, the transforaminal approach was chosen for the L4/5 level and the interlaminar approach was chosen for the L5/S1 level. The 10-point visual analogue scale (VAS) was used to assess back pain (VAS-Back) and leg pain (VAS-Leg). Oswestry disability index (ODI) and Modified Mac Nab Criteria were adopted as the functional evaluation methods. All patients were followed in the outpatient department for at least 12 months after their operation. RESULTS Our study showed that very highly migrated disc between L4/5 and L5/S1 level could be removed completely by this strategy. Except for 1 case of postoperative dysesthesia and 1 case of dural tear, no severe complication occurred. At the last follow-up, the average VAS-Back score of the study patients was reduced from 5.17±2.12 to 2.08±1.08 (P<0.05) and the average VAS-Leg score was reduced from 7.25±1.48 to 1.33±0.89 (P<0.05). The average ODI scores improved from 48.50±10.59 to 13.00±2.76 (P<0.05). According to the Modified Mac Nab Criteria, 83.33% of patients (10 out of 12 patients) received an excellent or good recovery and no poor result was reported. No recurrence was observed during follow up. CONCLUSIONS PELD via a transforaminal and interlaminar combined approach provides an alternative option for select patients with very highly migrated LDH between the L4/5 and L5/S1 level.

An insight into anti-inflammatory effects of natural polysaccharides.

Inflammation is the first response of the body's immune system to injury, infection and stress. Chronic inflammation has close relationship with many diseases, such as arthritis, atherosclerosis and cancer. The traditional therapy strategy of inflammation mainly involves steroid and non-steroid anti-inflammatory drugs, both of which have increasingly prominent side-effects which cannot be ignored. Polysaccharides extracted from natural sources have attracted extensive attention in recent years owing to their safety, accessibility and potent anti-inflammatory activities, but systematic introduction about their function in anti-inflammation is still absent. So here, we summarized the recent reports of natural polysaccharides with anti-inflammatory effects, mainly focusing on the various pharmacological mechanisms and targets involved. The structure-anti-inflammatory activity relationships are also discussed in detail. It is supposed that our review will benefit the understanding of the value of polysaccharides in anti-inflammation and further provide guidance for the development and application of novel anti-inflammatory agents in clinic.

4,4'-(Anthracene-9,10-di-yl)dibenzoic acid dimethyl-formamide disolvate.

In the title compound, C(28)H(18)O(4)·2C(3)H(7)NO, the dihedral angle between the benzene rings and the anthracene system is 74.05 (12)°. A crystallographic inversion centre is located in the middle of the anthracene unit. The dimethyl-formamide solvent mol-ecules are partially disordered over two positions of approximately equal occupancy [0.529 (6):0.471 (6)]. Inter-molecular O-H⋯O hydrogen bonds with the major occupancy formamide O atom as acceptor result in the formation of 2:1 solvate-complex aggregates, which are alternately linked to shorter solvate units via weak inter-molecular C-H⋯O contacts generated from the rotational disorder of the formamide O atom (minor occupancy component). Weak C-H⋯π inter-actions between the solvent mol-ecules as the donor and the outer anthracene rings support these contacts in the crystal structure for both disorder components.

Structure and Physicochemical Properties of Malate Starches from Corn, Potato, and Wrinkled Pea Starches.

In this study, corn, potato, and wrinkled pea starches were esterified with malic acid under high temperatures for different lengths of time. The degree of substitution (DS), granule morphology, crystal structure, gelatinization properties, and the digestibility of the malate starch were investigated. Fourier transform infrared spectroscopy (FT-IR) suggested that the malate starch showed a new infrared absorption peak near 1747 cm-1, indicating the occurrence of an esterification reaction. With an increasing treatment time, the degree of substitution (DS) of the malate starch displayed an increasing trend. Scanning electron microscopy (SEM) demonstrated a significant change in the surface structure of the starch granules. X-ray diffractometry (XRD) reflected that the crystal structure of the malate starches was destroyed. The thermogravimetric (TG) curves showed that the maximum heat loss rate of the malate starch was ahead of that of native starch, which caused the decreased degree of crystallinity. These properties of malate starch could allow it to be used for the purpose of starch modification to produce resistant starch and to provide new applications for starch.