Motor unit number index detects the effectiveness of surgical treatment in improving distal motor neuron loss in patients with incomplete cervical spinal cord injury.

BACKGROUND: Recovery of motor dysfunction is important for patients with incomplete cervical spinal cord injury (SCI). To enhance the recovery of muscle strength, both research and treatments mainly focus on injury of upper motor neurons at the direct injury site. However, accumulating evidences have suggested that SCI has a downstream effect on the peripheral nervous system, which may contribute to the poor improvement of the muscle strength after operation. The aim of this study is to investigate the impact of early vs. delayed surgical intervention on the lower motor neurons (LMNs) distal to the injury site in patients with incomplete cervical SCI. METHODS: Motor unit number index (MUNIX) was performed on the tibialis anterior (TA), extensor digitorum brevis (EDB) and abductor hallucis (AH) in 47 patients with incomplete cervical SCI (early vs. delayed surgical-treatment: 17 vs. 30) and 34 healthy subjects approximately 12 months after operation. All patients were further assessed by American spinal injury association (ASIA) motor scales and Medical Research Council (MRC) scales. RESULTS: There are no difference of both ASIA motor scores and MRC scales between the patients who accepted early and delayed surgical treatment (P > 0.05). In contrast, the patients undergoing early surgical treatment showed lower MUSIX values in both bilateral EDB and bilateral TA, along with greater MUNIX values in both right-side EDB and right-side TA, compared to the patients who accepted delayed surgical treatment (P < 0.05). CONCLUSIONS: Cervical SCI has a negative effect on the LMNs distal to the injury site. Early surgical intervention in Cervical SCI patients may improve the dysfunction of LMNs distal to the injury site, reducing secondary motor neuron loss, and eventually improving clinical prognosis.

Antibiotic-impregnated cement spacer as definitive management for osteomyelitis.

BACKGROUND: Osteomyelitis is a challenge for orthopaedic surgeons. There is a lack of scientific evidence to guide treatment. The purpose of this study was to report the clinical outcome of unplanned retention of antibiotic-impregnated cement spacer (ACS) in the management of osteomyelitis. METHODS: Eight patients (7 with tibial infections and 1 with a calcaneal infection) with osteomyelitis received radical debridement and insertion of an ACS into the bone defect as the definitive management. The mean follow-up period was 2 years (6 months to 4 years). All of these patients had a cement spacer in place. RESULTS: No patient exhibited radiographic evidence of excessive bone loss. The patients reported no or occasional mild pain and exhibited complete weight-bearing abilities, with the exception of one patient who required a crutch because of a spinal cord injury. Signs of recurrence of the osteomyelitis were not noted in any of the patients, and no fractures occurred at last follow-up. CONCLUSION: Our study suggests that a proportion of patients with unplanned retention of ACS appear to function well without necessarily requiring further surgical intervention.

Highly Efficient and Selective Gold Recovery Based on Hypercross-Linking and Polyamine-Functionalized Porous Organic Polymers.

With the continuous increase of electronic products, there is an urgent need to effectively recover gold from e-waste and other secondary resources other than the original mine. Here, hypercross-linking and polyamine-functionalized porous organic polymers (Pc-POSS-POP) were designed and facially synthesized based on multiple azo-coupling polymerizations between 2,9,16,23-tetraaminophthalocyanine (H2Pc(NH2)4) and octa(aminophenyl)-t8-silsesquioxane (OAPS) for the first time. The reaction requires no metal as a catalyst, thereby benefiting the purification of the product and the industrial scalability. Pc-POSS-POPs possess a hypercross-linking structure, highly conjugated frameworks, nitrogen-rich active sites, and extensively visible and near-infrared light absorption, which was utilized as an absorbent to retrieve Au (III). The results demonstrated that Pc-POSS-POPs have a high adsorption capacity (862.07 mg g-1) and a rapid adsorption rate toward gold recycling. The maximum adsorption capacity could reach up to 1026.87 mg g-1 as in the case of light irradiation. Due to the strong N coordination sites and the electronic interaction between the -NH4+ groups of Pc-POSS-POPs and AuCl4-, Pc-POSS-POPs also exhibited excellent selectivity toward gold over several coordinated metals [Cr (VI), Co (II), Cd (II), Ni (II), and Hg (II)]. These properties together with the good regenerative ability and superior recyclability demonstrated that Pc-POSS-POPs possess promising potential as hypercross-linking polymers for capturing and recycling of Au (III).

Mineralized Enzyme-Based Biomaterials with Superior Bioactivities for Bone Regeneration.

The formation and metabolic balance of bone tissue is a controllable process of biomineralization, which is regulated by various cells, biomolecules, and ions. Enzyme molecules play an important role in this process, and alkaline phosphatase (ALP) is one of the most critical factors. In this study, inspired by the process of bone biomineralization, a biomimetic strategy is achieved for the preparation of mineralized ALP nanoparticles (MALPNs), by taking advantages of the unique reaction between ALP and calcium ions in Dulbecco's modified Eagle's medium. Benefiting from the mild biomineralization reaction, the MALPN system highly maintains the activity of ALP. Furthermore, the in vitro studies show that the MALPN system significantly enhances the proliferation of bone marrow mesenchymal stem cells and upregulates their osteogenic differentiation. When evaluated as synthetic graft materials for bone regeneration, the MALPN-incorporated gelatin methacryloyl graft shows excellent mechanical properties, a sustained release profile of ALP, and high biocompatibility and efficacy in guiding bone regeneration and vascularization for critical-sized rat calvarial defect. Moreover, we also demonstrate that the biomimetic mineralization strategy can be adopted for other proteins such as acid phosphatase, bovine serum albumin, fibrinogen, and gelatin, suggesting its universality for constructing mineralized protein-/enzyme-based bioactive materials for the application of tissue regeneration.

Anatomical Study of the Clavicles in a Chinese Population.

BACKGROUND: A reemergence of interest in clavicle anatomy was prompted because of the advocacy for operative treatment of midshaft clavicle fractures. Several anatomical studies of the clavicle have been performed in western population. However, there was no anatomical study of clavicle in Chinese population. PATIENTS AND METHODS: 52 patients were included in the present study. Three-dimensional reconstructions of the clavicles were generated. The length of the clavicle, the widths and thicknesses of the clavicle, curvatures of the clavicle, the areas of the intramedullary canal, and sectional areas of the clavicle were measured. All the measurements were compared between genders and two sides. RESULTS: The mean length of the clavicles was 144.2 ± 12.0 mm. Clavicles in males were longer, wider, and thicker than in females; also males have different curvatures in both planes compared with females. The men's intramedullary canals and sectional areas of the clavicle were larger than those of women. No significant difference between the sides was found for all the measurements. CONCLUSION: This study provided an anatomical data of the clavicle in a Chinese population. These clavicle dimensions can be applied to the modifications of the contemporary clavicle plate or a new development for the Chinese population.