Is reduction better than arthrodesis in situ in surgical management of low-grade spondylolisthesis? A system review and meta analysis.

PURPOSE: To compare the clinical and radiographic outcomes of arthrodesis in situ with arthrodesis after reduction in low-grade spondylolisthesis. METHODS: We performed a comprehensive search of both observational and randomized clinical trials published up to April 2016 in PubMed, MEDLINE, Cochrane Library, and Embase databases. The outcomes included age, sex, operative time, blood loss, and at least 2 years clinical results of Oswestry disability index (ODI), visual analogue scale (VAS), lumbar lordosis, slippage, fusion rate, the rate of good and excellent and the complication rate. Two authors independently extracted the articles and the predefined data. RESULTS: Seven eligible studies, involving four RCTs and three cohort studies were included in this systematic review and meta-analysis. Patients who underwent reduction did achieved better slippage correction comparing with arthrodesis in situ (P < 0.00001). However, there was no significant difference in the case of operative time, blood loss, VAS (P = 0.36), ODI (P = 0.50), lumbar lordosis (P = 0.47), the rate of good and excellent (P = 0.84), fusion rate (P = 0.083) and complication rate (P = 0.33) between the arthrodesis in situ group and the reduction group. CONCLUSIONS: On the basis on this review, arthrodesis after reduction of low-grade spondylolisthesis potentially reduced vertebral slippage. Reduction was neither associated with a longer operative time nor more blood loss. There was no significant difference in the outcomes between reduction and arthrodesis in situ group. Both procedures could be expected to achieve good clinical result. LEVEL OF EVIDENCE: Therapeutic Level IIa.

Identify essential genes based on clustering based synthetic minority oversampling technique.

Prediction of essential genes in a life organism is one of the central tasks in synthetic biology. Computational predictors are desired because experimental data is often unavailable. Recently, some sequence-based predictors have been constructed to identify essential genes. However, their predictive performance should be further improved. One key problem is how to effectively extract the sequence-based features, which are able to discriminate the essential genes. Another problem is the imbalanced training set. The amount of essential genes in human cell lines is lower than that of non-essential genes. Therefore, predictors trained with such imbalanced training set tend to identify an unseen sequence as a non-essential gene. Here, a new over-sampling strategy was proposed called Clustering based Synthetic Minority Oversampling Technique (CSMOTE) to overcome the imbalanced data issue. Combining CSMOTE with the Z curve, the global features, and Support Vector Machines, a new protocol called iEsGene-CSMOTE was proposed to identify essential genes. The rigorous jackknife cross validation results indicated that iEsGene-CSMOTE is better than the other competing methods. The proposed method outperformed λ-interval Z curve by 35.48% and 11.25% in terms of Sn and BACC, respectively.

Case Report: Tachycardia, Hypoxemia and Shock in a Severely Burned Pediatric Patient.

Background: Severely burned children are at high risk of secondary intraabdominal hypertension and abdominal compartment syndrome (ACS). ACS is a life-threatening condition with high mortality and requires an effective, minimally invasive treatment to improve the prognosis when the condition is refractory to conventional therapy. Case presentation: A 4.5-year-old girl was admitted to our hospital 30 h after a severe burn injury. Her symptoms of burn shock were relieved after fluid resuscitation. However, her bloating was aggravated, and ACS developed on Day 5, manifesting as tachycardia, hypoxemia, shock, and oliguria. Invasive mechanical ventilation, vasopressors, and percutaneous catheter drainage were applied in addition to medical treatments (such as gastrointestinal decompression, diuresis, sedation, and neuromuscular blockade). These treatments did not improve the patient's condition until she received continuous renal replacement therapy. Subsequently, her vital signs and laboratory data improved, which were accompanied by decreased intra-abdominal pressure, and she was discharged after nutrition support, antibiotic therapy, and skin grafting. Conclusion: ACS can occur in severely burned children, leading to rapid deterioration of cardiopulmonary function. Patients who fail to respond to conventional medical management should be considered for continuous renal replacement therapy.

Relation between eardrum flap area and healing outcome of traumatic eardrum perforation.

OBJECTIVE: To retrospectively study the clinical effects of eardrum flap area on the healing outcome following traumatic perforation. METHODS: Totally 291 traumatic eardrum perforations with in-/everted edges were included in this study. They were randomly divided into three groups and received conservative treatment, epidermal growth factor (EGF) via Gelfoam patching, or edge-approximation plus Gelfoam patching respectively. Patients in each group were further divided into two subgroups according to the eardrum flap area less than or equal to 1/2 or >1/2 of the perforation size. The healing rate and mean closure time after tympanic membrane perforation were evaluated at three months. RESULTS: Of the total 291 participants, 281 were included in the final statistical analysis. The area of curled edge did not affect the healing outcome significantly in any groups (P>0.05). The healing rate varied slightly: 90.7% vs 92.3% in spontaneous healing group, 98.2% vs 97.4% in EGF via Gelfoam patching group, and 96.5% vs 100% in edge-approximation plus Gelfoam patching group. In addition, in all groups the area of curled edge did not affect the mean closure time significantly (P>0.05). The closure time was (32.3+/-2.4) d vs (30.6+/-3.1) d in sponaneous healing group, (13.4+/-2.5) d vs (13.1+/-1.9) d in EGF via Gelfoam patching group, and (11.9+/-3.1) d vs (12.2+/-2.1) d in edge-approximation plus Gelfoam patching group. CONCLUSION: The eardrum flap area of traumatic eardrum perforation does not significantly affect the clinical outcomes.

A Method of Secure Compressed Sensing for Physiological Signals in Healthcare Internet-of-Things Applications.

With the increasing demand forinformation interaction and data transmission in medical and healthcare Internet of Things applications, effective and secure transmissions of data become particularly important. To address this problem, this paper focuses on a novel method of secure compressed sensing, which can be readily applied to physiological signals and other kinds of health signals. The method is able to efficiently reduce the sampling data and at the same time secure them without an extra significant computational cost, where a key is bound to the compressed sensing process with a symmetric cryptography design. Different from traditional methods, the novelty of this method is to combine the compression and encryption processes in an efficient way. Results of experimental analyses show that the proposed method can provide good security at the same compression rate.

* Coculture with Partial Digestion Notochordal Cell-Rich Nucleus Pulposus Tissue Activates Degenerative Human Nucleus Pulposus Cells.

Recent studies suggested that notochordal cells (NCs) and NC-conditioned medium (NCCM) can stimulate cell viability and matrix production of nucleus pulposus cells (NPCs). However, the potential of notochordal cell-rich nucleus pulposus (NRNP) incorporating the native environment of the intervertebral disc (IVD) has not been evaluated. The objective of this study was to develop an optimal NRNP model and test whether it can allow a significant level of NPC activation in vitro. Rabbit NRNP explants were divided into three groups according to different digestion time: digestion NRNP of 8 h, partial digestion NRNP of 2 h, and natural NRNP. Cell viability and NC phenotype were compared between these groups after 14 days of incubation. The products of the selected partial digestion NRNP group were then cocultured with human degenerated NPCs for 14 days. NPC viability, cell proliferation and senescence, the production of glycosaminoglycan (GAG) found in extracellular matrix, and NP matrix production by NPCs were assessed. The results showed that coculturing with partial digestion NRNP significantly improved the cell proliferation, cell senescence, and disc matrix gene expression of NPCs compared with those in the monoculture group. In addition, GAG/DNA ratio in the coculture group increased significantly, while the level of collagen II protein remained unchanged. In this study, we demonstrated that partial digestion NRNP may show a promising potential for NPC regeneration in IVD tissue engineering.

Use of Limiting Dilution Method for Isolation of Nucleus Pulposus Mesenchymal Stem/Progenitor Cells and Effects of Plating Density on Biological Characteristics and Plasticity.

OBJECTIVES: To evaluate the effects of the limiting dilution method and plating density in rat nucleus pulposus mesenchymal stem/progenitor cells (NPMSCs). MATERIALS AND METHODS: Nucleus pulposus tissues were isolated from 12-week-old male Sprague-Dawley rats and NPMSCs were isolated using limiting dilution method. Cells were then classified into 3 groups according to plating density. Cell morphologies were observed, and colony-forming units, migration abilities, proliferative capacities, cell cycle percentages, multilineage differentiation capacities, stem cell biomarker expression levels, and immunophenotyping were also examined in each group. RESULTS: Low density group (LD) had higher morphological homogeneity, stronger colony-forming ability, higher cell proliferation capacity, and enhanced cell migration ability relative to the other two groups (p < 0.05). Moreover, LD had more cells entering S phase, with fewer cells arrested in G0/G1 phase (p < 0.05). While all three density groups showed a multilineage differentiation potential, LD showed a higher degree of observed and semiquantified lineage specific staining (p < 0.05). Furthermore, LD displayed higher expression levels of stem cell biomarkers (Nanog, Oct4, and Sox2) and showed higher percentages of CD29+, CD44+, and CD90+ cells (p < 0.05) following flow cytometry analysis. CONCLUSIONS: Limiting dilution method is suggested when isolating NPMSCs as a means of improving cell activity and plasticity.