Risk factors for the outcome and prognosis of multiple myeloma patients with pathological fractures undergoing percutaneous vertebroplasty.

This study focuses on the clinical features affecting the outcome and prognosis of multiple myeloma (MM) associated with spinal fractures. We retrospectively analyzed the clinical data of 194 MM patients with pathologic thoracic or lumbar spine fractures admitted to Dongying People's Hospital from April 2005 to February 2021. Patients were categorized into effective and ineffective groups based on post-treatment pain scores and mobility to analyze the influencing factors on the efficacy. Univariate analysis showed that age ≥60 years, number of vertebral fractures ≥2, and conservative treatment were associated with the outcomes. The number of vertebral fractures ≥2 (OR=2.198, P=0.034) and conservative treatment (OR=1.685, P=0.012) were identified as independent risk factors. In addition, survival curves were depicted using the Kaplan-Meier method, and independent risk factors affecting 2-year survival included efficacy (HR=17.924, P<0.001), age (HR=3.544, P=0.003) and International Staging System staging (HR=10.770, P=0.001). Finally, we constructed a high-accuracy prognostic model for predicting 2-year survival of MM patients with pathologic fractures (AUC=0.756). In conclusion, this study identified independent risk factors affecting the outcome and survival of MM patients with morbid fractures by systematically analyzing clinical characteristics and constructing a survival prediction model, thus providing effective guideline for clinical treatment.

Ultrasonic bone curette-assisted unilateral approach for bilateral decompression with MIS-TLIF for severe lumbar spinal stenosis.

PURPOSE: We aimed to evaluate the clinical efficacy of bilateral decompression with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) assisted by an ultrasonic bone curette (UBC) for treating severe degenerative lumbar spinal stenosis (DLSS) and traditional tool laminectomy decompression MIS-TLIF for treating severe DLSS. METHODS: The clinical data of 128 patients with single-segment severe DLSS who were admitted between January 2017 and December 2021 were retrospectively analyzed. Among them, 67 patients were treated with unilateral fenestration and bilateral decompression MIS-TLIF using an ultrasonic bone curette (UBC group), whereas 61 patients were treated with unilateral fenestration and bilateral decompression MIS-TLIF using traditional tools (traditional group, control). A visual analog scale (VAS) was used to evaluate back and lower limb pain before the operation,immediate postoperative, and one week, 3, 6, 12, and 24 months after the operation. Oswestry disability index (ODI) and Zurich claudication score (ZCQ) were employed to evaluate the improvement in low back and lower limb function. At the last follow-up, the Bridwell bone graft fusion standard was utilized to evaluate bone graft fusion. RESULTS: The decompression time of laminectomy was significantly shorter in the UBC group than in the traditional group (control group), and the intraoperative blood loss and postoperative drainage volume were significantly less in those in the control group (P < 0.05). The VAS, ODI, and ZCQ scores of the two groups after the operation were significantly improved compared to those before the operation (P < 0.05). The UBC group had better VAS back scores than the control group immediate postoperative and one week after the operation(P < 0.05). The UBC group had better VAS lower limb scores than the control group immediate postoperative (P < 0.05).The incidence of perioperative complications, hospitalization time, dural sac cross-sectional area (CSA), and dural sac CSA improvement rate did not differ significantly between the two groups (P > 0.05). VAS and ODI scores did not differ significantly between the two groups before,three, six months, one year, and two years after surgery (P > 0.05). The ZCQ scores did not differ significantly between the two groups before the operation at one week, six months, one year, and two years after the operation (P > 0.05). According to the Bridwell bone graft fusion standard, bone graft fusion did not occur significantly between the two groups (P > 0.05) at the last follow-up. CONCLUSIONS: UBC unilateral fenestration bilateral decompression MIS-TLIF in treating severe DLSS can achieve clinical efficacy as traditional tool unilateral fenestration bilateral decompression MIS-TLIF and reduce intraoperative blood loss and postoperative drainage. It can also shorten the operation time, effectively reduce the work intensity of the operator, and reduce the degree of low back pain during short-term follow-ups. Therefore, this is a safe and effective surgical method.

Retraction: Structural characterization and anticancer potency of centipede oligopeptides in human chondrosarcoma cancer: inducing apoptosis.

[This retracts the article DOI: 10.1039/D0RA04811A.].

Gelsemium elegans cyclic peptide induces human cervical carcinoma cells apoptosis through intrinsic and extrinsic pathways.

Four novel Gelsemium elegans cyclic peptides (GEPs) were isolated in an antihuman cervical carcinoma activity tracking method, and their amino acid sequences were identified. The GEP-1 cyclic-(Trp-Leu-His-Val)-peptide inhibited HeLa cell proliferation in a dose- and time-dependent manner. GEP-1 induced intracellular reactive oxygen species (ROS) overproduction and induced HeLa cells apoptosis in a caspase-dependent manner. GEP-1 also induced collapse of the mitochondrial membrane potential and promoted the mitochondrial release of cytochrome c (cyt c), apoptosis-inducing factor (AIF), and endonuclease G (Endo G) in HeLa cells. Furthermore, GEP-1 triggered the extrinsic death receptor-dependent pathway, which was characterized by activating Fas and FADD. Notably, GEP-1 is a potential antihuman cervical carcinoma peptide.

Structural characterization and anticancer potency of centipede oligopeptides in human chondrosarcoma cancer: inducing apoptosis.

Anticancer oligopeptides are rarely studied because they are often present in very low concentrations in a complex matrix. In the current study, twelve oligopeptides were isolated and the amino acid sequence identified from the centipede. MTT results indicated that Trp-Gly-His-Glu (CO-10) showed excellent anti-proliferative potency against chondrosarcoma cells in vitro. Further study showed that CO-10 induced SW1353 cells apoptosis and blocked cell cycle in the G0/G1 phase. Further, results demonstrate that the apoptotic and cytotoxic effects of CO-10 are mediated by the intrinsic mitochondria-mediated apoptotic pathway, which in turn causes the release of cytochrome c and the activation of caspases. This study will be important for the development of pharmaceutical anticancer peptides from natural products as anticancer agents against chondrosarcoma.