microRNA-365 attenuated intervertebral disc degeneration through modulating nucleus pulposus cell apoptosis and extracellular matrix degradation by targeting EFNA3.

This present study is aimed to investigate the role of microRNA-365 (miR-365) in the development of intervertebral disc degeneration (IDD). Nucleus pulposus (NP) cells were transfected by miR-365 mimic and miR-365 inhibitor, respectively. Concomitantly, the transfection efficiency and the expression level of miRNA were detected by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Meanwhile, NP cells apoptosis was measured through propidium iodide (PI)-AnnexinV-fluorescein isothiocyanate (FITC) apoptosis detection kit. Subsequently, immunofluorescence (IF) staining was performed to assess the expression of collagen II, aggrecan and matrix metalloproteinase 13 (MMP-13). In addition, bioinformatic prediction and Luciferase reporter assay were used to reveal the target gene of miR-365. Finally, we isolated the primary NP cells from rats and injected NP-miR-365 in rat IDD models. The results showed that overexpression of miR-365 could effectively inhibit NP cells apoptosis and MMP-13 expression and upregulate the expression of collagen II and aggrecan. Conversely, suppression of miR-365 enhanced NP cell apoptosis and elevated MMP-13 expression, but decreased the expression of collagen II and aggrecan. Moreover, the further data demonstrated that miR-365 mediated NP cell degradation through targeting ephrin-A3 (EFNA3). In addition, the cells apoptosis and catabolic markers were increased in NP cells when EFNA3 upregulated. More importantly, the vivo data supported that miR-365-NP cells injection ameliorated IDD in rats models. miR-365 could alleviate the development of IDD by regulating NP cell apoptosis and ECM degradation, which is likely mediated by targeting EFNA3. Therefore, miR-365 may be a promising therapeutic avenue for treatment IDD through EFNA3.

Long-term follow-up of pallidal deep brain stimulation for craniocervical dystonia: is the globus pallidus internus the best target?

OBJECTIVE: Craniocervical dystonia (CCD) is a common type of segmental dystonia, which is a disabling disease that has been frequently misdiagnosed. Blepharospasm or cervical dystonia is the most usual symptom initially. Although deep brain stimulation (DBS) of the globus pallidus internus (GPi) has been widely used for treating CCD, its clinical outcome has been primarily evaluated in small-scale studies. This research examines the sustained clinical effectiveness of DBS of the GPi in individuals diagnosed with CCD. METHODS: The authors report 24 patients (14 women, 10 men) with refractory CCD who underwent DBS of the GPi between 2016 and 2023. The severity and disability of the dystonia were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). The BFMDRS scores were collected preoperatively, 6 months postoperatively, and at the most recent follow-up visit. RESULTS: The mean age at onset was 52.0 ± 11.0 years (range 33-71 years) and the mean disease duration was 63.3 ± 73.3 months (range 7-360 months) (values for continuous variables are expressed as the mean ± SD). The mean follow-up period was 37.5 ± 23.5 months (range 6-84 months). The mean total BFMDRS motor scores at the 3 different time points were 13.3 ± 9.4 preoperatively, 5.0 ± 4.7 (55.3% improvement, p < 0.001) at 6 months, and 4.5 ± 3.6 (56.6% improvement, p < 0.001) at last follow-up. The outcomes were deemed poor in 6 individuals. CONCLUSIONS: Inferences drawn from the findings suggest that DBS of the GPi has long-lasting effectiveness and certain limitations in managing refractory CCD. The expected stability of the clinical outcome is not achieved. Patients with specific types of dystonia might consider targets other than GPi for a more precise therapy.

Efficacy of caudal pedunculopontine nucleus stimulation on postural instability and gait disorders in Parkinson's disease.

OBJECTIVES: Gait-related symptoms like postural instability and gait disorders (PIGD) inexorably worsen with Parkinson's disease (PD) deterioration and become refractory to current available medical treatment and deep brain stimulation (DBS) of conventional targets. Pedunculopontine nucleus (PPN) deep brain stimulation (DBS) is a promising method to treat PIGD. This prospective study aimed to clarify the clinical application of PPN-DBS and to explore effects of caudal PPN stimulation on PIGD. METHODS: Five consecutive PD patients with severe medication-resistant postural instability and gait disorders accepted caudal PPN-DBS. LEAD-DBS toolbox was used to reconstruct and visualize the electrodes based on pre- and postoperative images. Outcomes were assessed with Movement Disorder Society (MDS)-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), gait-specific questionnaires, and objective gait analysis with GAITRite system. RESULTS: MDS-UPDRS subitems 35-38 scores were improved at postoperative 6 months (mean, 4.40 vs 11.00; p = 0.0006) and 12 months (mean, 5.60 vs 11.00; p = 0.0013) compared with baseline, and scores at 6 months were slightly lower than scores at 12 months (mean, 4.40 vs 5.60; p = 0.0116). Gait and Falls Questionnaire, New Freezing of Gait Questionnaire, and Falls Questionnaire scores also significantly improved at postoperative 6 months and 12 months compared with baseline. In addition, cadence, bilateral step length, and bilateral stride length significantly increased when PPN On-stimulation compared with Off-stimulation. CONCLUSIONS: This study suggested that caudal PPN low-frequency stimulation improved PIGD for PD patients at the 6- and 12-month period.

Efficacy of intraoperative sedation combined with preemptive analgesia for single-level kyphoplasty under local anesthesia: A randomized clinical trial.

BACKGROUND: Kyphoplasty is widely used for Osteoporotic Vertebral Compression Fracture (OVCF) under general or local anesthesia, more attention was paid to its post-operative efficacy. Patients' pain and discomfort control strategies during surgery have not been taken seriously. OBJECTIVE: This study aimed at assessing the efficacy of preoperative preemptive analgesia combined with intraoperative sedation for pain and tension relief in OVCF patients undergoing kyphoplasty under local anesthesia. METHODS: We enrolled 128 patients with single-level OVCF who underwent kyphoplasty in our hospital from July 2013 to July 2016. The patients were randomly allocated into three groups: conventional group (i.e., local anesthesia with 0.5% lidocaine (1); n = 42), preemptive group (i.e, (1) + oral 200 mg Celecoxib on the night before surgery with intravenous 40 mg parecoxib sodium an hour before surgery (2); n = 43), and combined group (i.e., (1) + (2) + continuous intravenous 0.5 µg/kg/h dexmedetomidine intraoperatively; n = 43). Hemodynamic variations (heart rate, blood pressure, pulse oxygen saturation (SpO2)), Pain Visual Analogue Score (VAS), Ramsay score, and adverse events were recorded during perioperative period. RESULTS: Blood pressure and heart rate were more stable with significantly smaller values in the combined group than in the conventional and preemptive groups both intra- and postoperatively. In contrast, SpO2 showed no significant difference among the groups throughout the perioperative period. Intraoperative VAS scores revealed significant differences among the groups with the combined group having the smallest values followed by the preemptive group. Similarly, intraoperative Ramsay scores reflected significantly more favorable effects of sedation in the combined than in conventional group. Both VAS and Ramsay scores showed no significant differences among the groups postoperatively, and no differences in complication incidences were noted among the groups as well. CONCLUSIONS: For kyphoplasty under local anesthesia for single-level OVCF, intraoperative sedation combined with preemptive analgesia worked better in mitigating pain and tension intraoperatively and in preventing hemodynamic changes intra- and post-operatively, as compared to local anesthesia alone or additional preemptive analgesia.

Sensitive, High-Speed, and Broadband Perovskite Photodetectors with Built-In TiO2 Metalenses.

Monolithic integration of nanostructured metalenses with broadband light transmission and good charge transport can simultaneously enhance the sensitivity, speed, and efficiency of photodetectors. The realization of built-in broadband metalenses in perovskite photodetectors, however, has been largely challenged by the limited choice of materials and the difficulty in nanofabrication. Here a new type of broadband-transmitting built-in TiO2 metalens (meta-TiO2 ) is devised, which is readily fabricated by one-step and lithograph-free glancing angle deposition. The meta-TiO2 , which comprises of sub-100 nm TiO2 nanopillars randomly spaced with a wide range of sub-wavelength distances in 5-200 nm, shows high transmittance of light in the wavelength range of 400-800 nm. The meta-TiO2 also serves as an efficient electron transporting layer to prevent the exciton recombination and facilitate the photoinduced electron extraction and transport. Replacing the conventional mesoporous TiO2 with the meta-TiO2 comprehensively leads to enhancing the detection speed by three orders of magnitude to a few hundred nanoseconds, improving the responsivity and detectivity by one order of magnitude to 0.5 A W-1 and 1013 Jones, respectively, and extending the linear dynamic range by 50% to 120 dB.

Direct visualization of deep brain stimulation targets in patients with Parkinson's disease via 3-T quantitative susceptibility mapping.

BACKGROUND: The direct visualization of brain nuclei on magnetic resonance (MR) images is important for target localization during deep brain stimulation (DBS) in patients with Parkinson's disease (PD). We demonstrated the superiority of 3-T high-resolution submillimeter voxel size quantitative susceptibility mapping (QSM) for delineating the subthalamic nucleus (STN) and the globus pallidus internus (GPi). METHODS: Preoperative 3-T QSM and T2 weighted (T2w) images were obtained from ten patients with PD. Qualitative visualization scores were analyzed by two neurosurgeons on both images using a 4-point and 5-point scale, respectively. Images were also compared with regard to contrast-to-noise ratios (CNRs) and edge detection power for the STN and GPi. The Wilcoxon rank-sum test and the signed-rank test were used to compare measurements between the two images. RESULTS: Visualization scores for the STN and GPi, the mean CNR of the STN relative to the zona incerta (ZI) and the substantia nigra, and the mean CNR of the GPi relative to the internal capsule (IC) and the globus pallidum externum, were significantly higher on QSM images than on T2w images (P < 0.01). The edge detection powers of the STN-ZI and GPi-IC on QSM were significantly larger (by 2.6- and 3.8-fold, respectively) than those on T2w images (P < 0.01). QSM detected asymmetry of the STN in two patients. CONCLUSIONS: QSM images provided improved delineation ability for the STN and GPi when compared to T2w images. Our findings are important for patients with PD who undergo DBS surgery, particularly those with asymmetric bilateral nuclei.

Evaluation of changes in lumbar neuroforaminal dimensions in symptomatic young adults using positional MRI.

PURPOSE: To investigate the changes of lumbar neural foramina size during dynamic motion using positional MRI. METHODS: Two hundred and fifty neural foramina from 50 patients were analyzed. Lumbar foraminal height, width, and area parameters from L1 to S1 were evaluated for changes in extension, neutral, and flexion positions on T2 parasagittal positional MRI images, and were correlated to lumbar angular motion. One-way analysis of variance (ANOVA) and post hoc analysis were used to examine the differences between levels and positions. RESULTS: Compared to the neutral position, almost all lumbar foraminal parameters (height, width at inferior level, and area) increased in flexion and decreased in extension at all levels, except for L5-S1 foraminal width at superior and middle levels. The foraminal height and area in all lumbar segments except L5-S1 increased as the lumbar angular motion changed from extension to flexion in <40° group. The foraminal width increased significantly at L3-4 and L4-5 among all groups. CONCLUSION: Lumbar foraminal dimensions increased in flexion compared to neutral and extension positions. Lumbar angular motion contributed to the changes of foraminal height and area at most of the segments, while it affected foraminal width only at L3-4 and L4-5. This information can be useful in the understanding of patient symptoms and the correlation with the imaging studies with dynamic foraminal stenosis. Furthermore, data from our study may help with patient positioning for foraminal injections or endoscopic surgery.

Level of conus medullaris termination in adult population analyzed by kinetic magnetic resonance imaging.

PURPOSE: To investigate the change of conus medullaris termination (CMT) level in neutral, flexion and extension positions and to analyze the effects of age and gender on the CMT level. METHODS: The midline sagittal T2-weighted kinetic magnetic resonance imaging (kMRI) study of 585 patients was retrospectively reviewed to identify the level of CMT. All patients were in an upright position. A straight line perpendicular to the long axis of the cord was drawn from the tip of the cord and then subtended to the adjacent vertebra or disk space. The CMT level was labeled in relation to the upper, middle and lower segments of adjacent vertebra or disk space and assigned values from 0 to 12 [0 = upper third of T12 (T12U), and 12 = upper third of L3 (L3U)]. All parameters were collected for neutral, flexion and extension positions. RESULTS: The level of CMT had the highest incidence (17.61%) at L1 lower (L1L) in neutral position, 17.44% at L1 upper (L1U) in flexion, and 16.92% at L1 middle (L1M) in extension with no significant differences among three positions (p > 0.05) in weight-bearing status. Moreover, the level of CMT was not correlated with age (p > 0.05). In terms of gender, the level of CMT was lower in women than in men in neutral position, flexion, and extension (p < 0.05). Furthermore, when divided by age in decades, there was a significant difference between females and males in the age group 60-69 years in neutral, flexion and extension position, respectively (p < 0.05). CONCLUSIONS: The level of CMT in the neutral position was in accordance with previous cadaveric and supine-position MRI studies, and it did not change with flexion and extension. Women had lower CMT level than men, especially in the older population. This information can be very valuable when performing spinal anesthesia and spinal punctures.

Comparative Assessments of Dental Resin Composites: A Focus on Dense Microhybrid Materials.

The performance of dental resin composites is crucially influenced by the sizes and distributions of inorganic fillers. Despite the investigation of a variety of functional particles, glass fillers and nanoscale silica are still the predominant types in dental materials. However, achieving an overall improvement in the performance of resin composites through the optimization of their formulations remains a challenge. This work introduced a "dense" microhybrid filler system with 85 wt % filler loading, leading to the preparation of self-developed resin composites (SRCs). Comparative evaluations of these five SRCs against four commercial products were performed, including mechanical property, polymerization conversion, and shrinkage, along with water sorption and solubility and wear resistance. The results showed that among all SRC groups, SRC3 demonstrated superior mechanical performance, high polymerization conversion, reduced shrinkage, low water absorption and solubility, and acceptable wear resistance. In contrast to commercial products, this optimal SRC3 material was comparable to Z350 XT in flexural and diametral tensile strength and better in flexural modulus and surface hardness. The use of a "dense" microhybrid filler system in the development of resin composites provides a balance between physicochemical property and wear resistance, which may be a promising strategy for the development of composite products.

Eliminating the Adverse Impact of Composition Modulation in Perovskite Light-Emitting Diodes toward Ultra-High Brightness and Stability.

Excess ammonium halides as composition additives are widely employed in perovskite light-emitting diodes (PeLEDs), aiming to achieve high performance by controlling crystallinity and passivating defects. However, an in-depth understanding of whether excess organoammonium components affect the film physical/electrical properties and the resultant device instability is still lacking. Here, the trade-off between the performance and stability in high-efficiency formamidinium lead iodide (FAPbI3)-based PeLEDs with excess ammonium halides is pointed, and the underlying mechanism is explored. Systematic experimental and theoretical studies reveal that excess halide salt-induced ion-doping largely alters the PeLEDs properties (e.g., carrier injection, field-dependent ion-drifting, defect physics, and phase stability). A surface clean assisted cross-linking strategy is demonstrated to eliminate the adverse impact of composition modulation and boost the operational stability without sacrificing the efficiency, achieving a high efficiency of 23.6%, a high radiance of 964 W sr-1 m-2 (The highest value for FAPbI3 based PeLEDs), and a prolong lifetime of 106.1 h at large direct current density (100 mA cm-2), concurrently. The findings uncovered an important link between excess halide salts and the device performance, providing a guideline for rational design of stable, bright, and high efficiency PeLEDs.

Efficient Electrosynthesis of Hydrogen Peroxide Using Oxygen-Doped Porous Carbon Catalysts at Industrial Current Densities.

Metal-free carbon catalysts (MFCCs) are one of the commonly used catalysts for electrocatalytic two-electron oxygen reduction (2e- ORR) synthesis of hydrogen peroxide (H2O2). Oxygen doping is an effective means to improve the performance of MFCCs, but the performance of oxygen-doped carbon catalysts is still not high enough, and the contribution of different oxygen functional groups (OFGs) to the catalytic performance is still inconclusive. In this paper, carbon-based catalysts with different oxygen contents and ratios of OFGs were prepared, and the high 2e- ORR activity of COOH + C-OH was demonstrated by combining the results of experiments and theoretical calculations. The prepared oxygen-doped carbon-based catalyst C-0.1M80 achieved an onset potential of 0.795 V (vs RHE), a selectivity of up to 98.2% (0.6 V vs RHE), and a H2O2 oxidation current of 1.33 mA cm-2 (0.5 V vs RHE) in a rotating ring-disk electrode test (0.1 M KOH solution), which was an outstanding performance in MFCCs. In a solid electrolyte flow cell, C-0.1M80 achieved a Faraday efficiency of 97.5% at 200 mA cm-2 with a corresponding H2O2 production rate of 123.7 mg cm-2 h-1. In addition, a flow cell stability test was performed at an industrial current density (100 mA cm-2) with an astounding 200 h of uninterrupted operation, also achieving an outstanding average Faradaic efficiency (95.8%).

Impact of subthalamic nucleus deep brain stimulation at different frequencies on neurogenesis in a rat model of Parkinson's disease.

Neurogenesis, play a vital role in neuronal plasticity of adult mammalian brains, and its dysregulation is present in the pathophysiology of Parkinson's disease (PD). While subthalamic nucleus deep brain stimulation (STN-DBS) at various frequencies has been proven effective in alleviating PD symptoms, its influence on neurogenesis remains unclear. This study aimed to investigate the effects of 1-week electrical stimulation at frequencies of 60Hz, 130Hz, and 180Hz on neurogenesis in the subventricular zone (SVZ) of PD rats. A hemiparkinsonian rat model was established using 6-hydroxydopamine and categorized into six groups: control, PD, sham stimulation, 60Hz stimulation, 130Hz stimulation, and 180Hz stimulation. Motor function was assessed using the open field test and rotarod test after one week of STN-DBS at different frequencies. Tyrosine hydroxylase (TH) expression in brain tissue was analyzed via Western blot and immunohistochemistry. Immunofluorescence analysis was conducted to evaluate the expression of BrdU/Sox2, BrdU/GFAP, Ki67/GFAP, and BrdU/DCX in bilateral SVZ and the rostral migratory stream (RMS). Our findings revealed that high-frequency STN-DBS improved motor function. Specifically, stimulation at 130Hz increased dopaminergic neuron survival in the PD rat model, while significantly enhancing the proliferation of neural stem cells (NSCs) and neuroblasts in bilateral SVZ. Moreover, this stimulation effectively facilitated the generation of new NSCs in the ipsilateral RMS and triggered the emergence of fresh neuroblasts in bilateral RMS, with notable presence within the lesioned striatum. Conversely, electrical stimulation at 60Hz and 180Hz did not exhibit comparable effects. The observed promotion of neurogenesis in PD rats following STN-DBS provides valuable insights into the mechanistic basis of this therapeutic approach for PD.

Rolling forms the diversities of small molecular nonvolatile metabolite profile and consequently shapes the bacterial community structure for Keemun black tea.

The detailed dynamics of small molecular nonvolatile chemical and bacterial diversities, as well as their relationship are still unclear in the manufacturing process of Keemun black tea (KMBT). Herein, mass spectrometry-based untargeted metabolomics, Feature-based Molecular Networking (FBMN) and bacterial DNA amplicon sequencing were used to investigate the dense temporal samples of the manufacturing process. For the first time, we reveal that the pyrogallol-type catechins are oxidized asynchronously before catechol-type catechins during the black tea processing. Rolling is the key procedure for forming the small molecular nonvolatile metabolite profile (SMNMetProf), increasing the metabolite richness, and then shaping the bacterial community structure in the KMBT manufacturing process, which decreases both molecular weight and molecular polarity of the small molecular nonvolatile metabolites. The SMNMetProf of black tea is formed by the endogenous enzymatic oxidation of tea leaves, rather than bacterial fermentation.

Thiol-Functionalized Conjugated Metal-Organic Frameworks for Stable and Efficient Perovskite Photovoltaics.

Metal-organic frameworks (MOFs) have been investigated recently in perovskite photovoltaics owing to their potential to boost optoelectronic performance and device stability. However, the impact of variations in the MOF side chain on perovskite characteristics and the mechanism of MOF/perovskite film formation remains unclear. In this study, three nanoscale thiol-functionalized UiO-66-type Zr-based MOFs (UiO-66-(SH)2 , UiO-66-MSA, and UiO-66-DMSA) are systematically employed and examined in perovskite solar cells (PSCs). Among these MOFs, UiO-66-(SH)2 , with its rigid organic ligands, exhibited a strong interaction with perovskite materials with more efficient suppression of perovskite vacancy defects. More importantly, A detailed and in-depth discussion is provided on the formation mechanism of UiO-66-(SH)2 -assisted perovskite film upon in situ GIWAXS performed during the annealing process. The incorporation of UiO-66-(SH)2 additives substantially facilitates the conversion of PbI2 into the perovskite phase, prolongs the duration of stage I, and induces a delayed phase transformation pathway. Consequently, the UiO-66-(SH)2 -assisted device demonstrates reduced defect density and superior optoelectronic properties with optimized power conversion efficiency of 24.09% and enhanced long-term stability under ambient environment and continuous light illumination conditions. This study acts as a helpful design guide for desired MOF/perovskite structures, enabling further advancements in MOF/perovskite optoelectronic devices.

Enhanced performance of InGaN/GaN based solar cells with an In(0.05)Ga(0.95)N ultra-thin inserting layer between GaN barrier and In(0.2)Ga(0.8)N well.

The effect of ultra-thin inserting layer (UIL) on the photovoltaic performances of InGaN/GaN solar cells is investigated. With UIL implemented, the open-circuit voltage was increased from 1.4 V to 1.7 V, short-circuit current density was increased by 65% and external quantum efficiency was increased by 59%, compared to its counterparts at room temperature under 1-sun AM1.5G illumination. The improvements in electrical and photovoltaic properties are mainly attributed to the UIL which can boost the crystal quality and alleviate strain. Moreover, it can act as a transition layer for higher indium incorporation and an effective light sub-absorption layer in multiple quantum wells.

The Influence of the Strain Rate and Prestatic Stress on the Dynamic Mechanical Properties of Sandstone-A Case Study from China.

A series of conventional dynamic uniaxial compressive (CDUC) tests and coupled static dynamic loading (CSDL) tests were performed using a split Hopkinson compression bar (SHPB) system to explore the variable dynamic mechanical behavior and fracture characteristics of medium siltstone at a microscopic scale in the laboratory. In the CDUC tests, the dynamic uniaxial strength of the medium sandstone is rate-dependent in the range of 17.5 to 96.8 s-1, while the dynamic elastic modulus is not dependent on the strain rate. Then, this paper proposes a generalized model to characterize the rate-dependent strength from 17.5 to 96.8 s-1. In the CSDL tests, with increasing initial prestatic stress, the dynamic elastic modulus and dynamic strength increase nonlinearly at first and then decrease. The results show that two classical morphological types (i.e., Type I and Type II) are observed in the dynamic stress-strain response from the CDUC and CSDL tests. By scanning electron microscopy (SEM), microscopic differences in the post-loading microcrack characteristics in the behavior of Type I and Type II are identified. In Class I behavior, intergranular fracture (IF) usually initiates at or near the grains, with most cracks deflected along the grain boundaries, resulting in a sharp angular edge, and then coalesces to the main fracture surface that splits the specimen along the direction of stress wave propagation. In contrast, Class II behavior results from the combined IF and transgranular fracture (TF).

Dorsal Root Entry Zone Lesioning Following Unresponsive Spinal Cord Stimulation for Post-Traumatic Neuropathic Pain.

OBJECTIVE: Spinal cord stimulation (SCS) and dorsal root entry zone (DREZ) lesioning are important therapeutic options for intractable post-traumatic neuropathic pain (PNP). However, surgical choice is controversial due to the need to maximize pain relief and reduce complications. This study aims to retrospectively analyze the effect and complications of DREZ lesioning for patients with PNP who were unresponsive to SCS and provide a surgical reference. METHODS: Demographic data and surgical characteristics of patients with PNP who underwent DREZ lesioning after an unresponsive SCS were reviewed. Long-term outcomes including numeric rating scale, global impression of change, and long-term complications were assessed. Kaplan-Meier analysis was used to evaluate pain-free survival. RESULTS: Of 19 patients with PNP, 8 had brachial plexus injury (BPI), 7 had spinal cord injury, 2 had cauda equina injury, 1 had intercostal nerve injury, and 1 had lumbosacral plexus injury. All patients were unresponsive or had a recurrence of pain after SCS, with an average pain-relief rate of 9.3%. After DREZ lesioning, the mean numeric rating scale scores significantly decreased from 7.6 ± 1.5 to 1.8 ± 1.7, with an average pain-relief rate of 75.3%. Seven patients (36.8%) experienced worsened neurologic dysfunction at the last follow-up. Patients with BPI had a significantly better outcome than other pathologies (P < 0.001) after DREZ lesioning. CONCLUSIONS: DREZ lesioning is an effective alternative procedure to SCS for patients with PNP who have lost limb function. Particularly for those with BPI, DREZ lesioning has shown good efficacy and can be considered a preferred surgical option.

Radiomics features from 3D-MPRAGE imaging can differentiate temporal-plus epilepsy from temporal lobe epilepsy.

OBJECTIVE: This study aimed to differentiate temporal-plus epilepsy (TPE) from temporal lobe epilepsy (TLE) using extraction of radiomics features from three-dimensional magnetization-prepared rapid acquisition gradient echo (3D-MPRAGE) imaging data. METHODS: Data from patients with TLE or TPE who underwent epilepsy surgery between January 2019 and January 2021 were retrospectively analyzed. Thirty-three regions of interest in the affected hemisphere of each patient were defined on 3D-MPRAGE images. A total of 3531 image features were extracted from each patient. Four feature selection methods and 10 machine learning algorithms were used to build 40 differentiation models. Model performance was evaluated using receiver operating characteristic analysis. RESULTS: Eighty-two patients were included for analysis, 47 with TLE and 35 with TPE. The model combining logistic regression and the relief selection method had the best performance (area under the receiver operating characteristic curve, .779; accuracy, .875; sensitivity, .800; specificity, .929; positive predictive value, .889; negative predictive value, .867). SIGNIFICANCE: Radiomics analysis can differentiate TPE from TLE. The logistic regression classifier trained with radiomics features extracted from 3D-MPRAGE images had the highest accuracy and best performance.

Biocompatibility and osseointegration properties of a novel high strength and low modulus ß- Ti10Mo6Zr4Sn3Nb alloy.

Introduction: Ti6Al4V titanium alloy is widely used in producing orthopedic and maxillofacial implants, but drawbacks include high elastic modulus, poor osseointegration performance, and toxic elements. A new medical titanium alloy material with better comprehensive performance is urgently needed in the clinic. Methods: Ti10Mo6Zr4Sn3Nb titanium alloy (referred to as Ti-B12) is a unique medical ß titanium alloy material developed by us. The mechanical properties of Ti-B12 depict that it has advantages, such as high strength, low elastic modulus, and fatigue resistance. In our study, the biocompatibility and osseointegration properties of Ti-B12 titanium alloy are further studied to provide theoretical guidance for its clinical transformation. Results and Discussion: The titanium alloy Ti-B12 displays no significant effect on MC3T3-E1 cell morphology, proliferation, or apoptosis in vitro. Neither Ti-B12 titanium alloy nor Ti6Al4V titanium alloy depicts a significant difference (p > 0.05); Ti-B12 material extract injected into the abdominal cavity of mice does not cause acute systemic toxicity. The skin irritation test and intradermal irritation test reveal that Ti-B12 does not cause skin allergic reactions in rabbits. Compared to Ti6Al4V, Ti-B12 titanium alloy material has more advantages in promoting osteoblast adhesion and ALP secretion (p < 0.05). Although there is no significant difference in OCN and Runx2 gene expression between the three groups on the 7th and 14th days of differentiation induction (p > 0.05), the expression of Ti-B12 group is higher than that of Ti6Al4V group and blank control group. Furthermore, the rabbit in vivo test present that 3 months after the material is implanted in the lateral epicondyle of the rabbit femur, the Ti-B12 material fuses with the surrounding bone without connective tissue wrapping. This study confirms that the new ß-titanium alloy Ti-B12 not only has low toxicity and does not cause rejection reaction but also has better osseointegration performance than the traditional titanium alloy Ti6Al4V. Therefore, Ti-B12 material is expected to be further promoted in clinical practice.

Feasibility of Two-Screw Anterior Fixation for Odontoid Fractures in a Chinese Population: A Morphometric Study Based on Computed Tomography.

Background: To evaluate the feasibility of treating odontoid fractures in the Chinese population with two cortical screws based on computed tomography (CT) scans and describe a new measurement strategy to guide screw insertion in treating these fractures. Methods: A retrospective review of cervical computed tomographic scans of 128 patients (aged 18-76 years; men, 55 [43.0%]) was performed. The minimum external transverse diameter (METD), minimum external anteroposterior diameter (MEAD), maximum screw length (MSL), and screw projection back angle (SPBA) of the odontoid process were measured on coronal and sagittal CT images. Results: The mean values of METD and MEAD were 10.0 ± 1.1 mm and 12.0 ± 1.0 mm, respectively, in men and 9.2 ± 1.0 mm and 11.0 ± 1.0 mm, respectively, in women. Both measurements were significantly higher in men (p < 0.001). In total, 87 individuals (68%) had METD > 9.0 mm that could accommodate two 3.5-mm cortical screws. The mean MSL value and SPBA range were 34.4 ± 2.9 mm and 13.5°-24.2°, respectively, with no statistically significant difference between men and women. Conclusions: The insertion of two 3.5-mm cortical screws was possible for anterior fixation of odontoid fractures in 87 patients (68%) in our study, and there was a statistically significant difference between men and women.