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Lysosomes, a central regulator of autophagy, play a critical role in tumour growth. Lysosomal protease cathepsin D can initiate apoptosis when released from lysosomes into the cytosol. In this study, we observed that Musca domestica cecropin (Mdc) 1-8 (M1-8), a small anti-tumour peptide derived from Mdc, inhibits hepatoma cell growth by blocking autophagy-lysosome fusion. This effect is likely achieved by targeting lysosomes to activate lysosomal protease D. Additionally, we examined whether lysosomal content and cathepsin D release were involved in M1-8-induced apoptosis. After exposure to M1-8, human hepatoma HepG2 cells rapidly co-localized with lysosomes, disrupted lysosomal integrity, caused leakage of lysosomal protease cathepsin D, caspase activation and mitochondrial membrane potential changes; and promoted cell apoptosis. Interestingly, in M1-8-treated HepG2 cells, autophagic protein content increased and the lysosome-autophagosome fusion was inhibited, suggesting that M1-8 can cause apoptosis through autophagy and lysosomes. This result indicates that a small accumulation of autophagy and autolysosome inhibition in cells can cause cell death. Taken together, these data suggest a novel insight into the regulatory mechanisms of M1-8 in autophagy and lysosomes, which may facilitate the development of M1-8 as a potential cancer therapeutic agent.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Catepsina D/metabolismo , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/metabolismo , Péptidos Antimicrobianos , Apoptosis , Autofagia , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/metabolismo , Lisosomas/metabolismoRESUMEN
While China experienced a peak and decline in coronavirus disease 2019 (COVID-19) cases at the start of 2020, regional outbreaks continuously emerged in subsequent months. Resurgences of COVID-19 have also been observed in many other countries. In Guangzhou, China, a small outbreak, involving less than 100 residents, emerged in March and April 2020, and comprehensive and near-real-time genomic surveillance of SARS-CoV-2 was conducted. When the numbers of confirmed cases among overseas travelers increased, public health measures were enhanced by shifting from self-quarantine to central quarantine and SARS-CoV-2 testing for all overseas travelers. In an analysis of 109 imported cases, we found diverse viral variants distributed in the global viral phylogeny, which were frequently shared within households but not among passengers on the same flight. In contrast to the viral diversity of imported cases, local transmission was predominately attributed to two specific variants imported from Africa, including local cases that reported no direct or indirect contact with imported cases. The introduction events of the virus were identified or deduced before the enhanced measures were taken. These results show the interventions were effective in containing the spread of SARS-CoV-2, and they rule out the possibility of cryptic transmission of viral variants from the first wave in January and February 2020. Our study provides evidence and emphasizes the importance of controls for overseas travelers in the context of the pandemic and exemplifies how viral genomic data can facilitate COVID-19 surveillance and inform public health mitigation strategies.
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COVID-19 , SARS-CoV-2 , África , Prueba de COVID-19 , China/epidemiología , Genómica , HumanosRESUMEN
BACKGROUND: Osteopontin (OPN) is reportedly involved in bone desorption, formation and ectopic calcification. We sought to investigate the role of OPN gene polymorphism in the susceptibility to Cervical spondylotic myelopathy (CSM) and in predicting the outcome anterior cervical corpectomy and fusion (ACF). METHODS: A total of 187 patients diagnosed with CSM and 233 sex and age matched healthy controls were enrolled in this study. All CSM patients received ACF and were followed up for 24 months. The polymorphisms of OPN gene at 3 loci, namely, -156 G>GG, -443 C>T and -66T>G were determined. RESULTS: The -66T>G genotype was significantly different between CSM patients and controls. Compared to the -66TT carriers, the -66GG genotype carriers had a higher risk for developing CSM (adjusted Odd Ratio=2.58, adjusted P=0.001). In contrast, the genotype distributions of the -156G/GG and -443C/T loci were not significantly different between the CSM and control groups. OPN gene polymorphism did not determine the pre-operative severity of CSM patients, but the -66T>G genotype was significantly associated with the clinical outcome of CSM after ACF treatment. The -66T>G did not affect the serum OPN level, but affect the local expressions of OPN and a serious of key inflammatory factors in the intervertebral disc samples. CONCLUSION: Our study shows the OPN -66T>G genetic polymorphism contributes to patients' susceptibility to CSM and could be indicative of the outcome of ACF surgery.
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Predisposición Genética a la Enfermedad , Osteopontina/genética , Polimorfismo Genético , Enfermedades de la Médula Espinal/genética , Fusión Vertebral , Espondilosis/genética , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Médula Espinal/cirugía , Espondilosis/cirugíaRESUMEN
Recently, brain-inspired spiking neural networks (SNNs) have demonstrated promising capabilities in solving pattern recognition tasks. However, these SNNs are grounded on homogeneous neurons that utilize a uniform neural coding for information representation. Given that each neural coding scheme possesses its own merits and drawbacks, these SNNs encounter challenges in achieving optimal performance such as accuracy, response time, efficiency, and robustness, all of which are crucial for practical applications. In this study, we argue that SNN architectures should be holistically designed to incorporate heterogeneous coding schemes. As an initial exploration in this direction, we propose a hybrid neural coding and learning framework, which encompasses a neural coding zoo with diverse neural coding schemes discovered in neuroscience. Additionally, it incorporates a flexible neural coding assignment strategy to accommodate task-specific requirements, along with novel layer-wise learning methods to effectively implement hybrid coding SNNs. We demonstrate the superiority of the proposed framework on image classification and sound localization tasks. Specifically, the proposed hybrid coding SNNs achieve comparable accuracy to state-of-the-art SNNs, while exhibiting significantly reduced inference latency and energy consumption, as well as high noise robustness. This study yields valuable insights into hybrid neural coding designs, paving the way for developing high-performance neuromorphic systems.
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The field of bone regeneration has always been a hot and difficult research area, and there is no perfect strategy at present. As a new type of biodegradable material, magnesium alloys have excellent mechanical properties and bone promoting ability. Compared with other inert metals, magnesium alloys have significant advantages and broad application prospects in the field of bone regeneration. By searching the official Web sites and databases of various funds, this paper summarizes the research status of magnesium composites in the field of bone regeneration and introduces the latest scientific research achievements and clinical transformations of scholars in various countries and regions, such as improving the corrosion resistance of magnesium alloys by adding coatings. Finally, this paper points out the current problems and challenges, aiming to provide ideas and help for the development of new strategies for the treatment of bone defects and fractures.
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Regeneración Ósea , Magnesio , Regeneración Ósea/efectos de los fármacos , Magnesio/uso terapéutico , Magnesio/farmacología , Magnesio/química , Humanos , Aleaciones/química , Aleaciones/uso terapéutico , Materiales Biocompatibles/uso terapéutico , Materiales Biocompatibles/farmacología , Materiales Biocompatibles/química , Animales , Sustitutos de Huesos/uso terapéutico , Sustitutos de Huesos/química , Sustitutos de Huesos/farmacología , CorrosiónRESUMEN
Catheter-associated urinary tract infection (CAUTI) is a prevalent type of hospital-acquired infection, affecting approximately 15% to 25% of patients with urinary catheters. Long-term use of the catheter can lead to colonization of microorganisms and biofilm formation, and may develop into bacterial CAUTI. However, the frequent replacement of catheters in clinical settings can result in tissue damage, inflammation, ulceration, and additional complications, causing discomfort and pain for patients. In light of these challenges, a novel nanodrug-supported hydrogel coating called NP-AM/FK@OMV-P/H has been developed in this study. Through in vitro experiments, it is confirmed that OMV nano-loaded liquid gel coating has an effective reaction against E.coli HAase and releases antibacterial drugs. This coating has also demonstrated strong inhibition of E.coli and has shown the ability to inhibit the formation of bacterial biofilm. These findings highlight the potential of the OMV nanoparticle gel coating in preventing and treating bacterial infections. Notably, NP-AM/FK@OMV-P/H has exhibited greater efficacy against multidrug-resistant E.coli associated with UTIs compared to coatings containing single antimicrobial peptides or antibiotics. Additionally, it has demonstrated good biosecurity. In conclusion, the NP-AM/FK@OMV-P/H coating holds great potential in providing benefits to patients with CAUTI.
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Mesenchymal stem cells (MSCs), one of the most common types of stem cells, are involved in the modulation of the tumor microenvironment (TME). With the advancement of nanotechnology, exosomes, especially exosomes secreted by MSCs, have been found to play an important role in the initiation and development of tumors. In recent years, nanobiotechnology and bioengineering technology have been gradually developed to detect and identify exosomes for diagnosis and modify exosomes for tumor treatment. Several novel therapeutic strategies bioengineer exosomes to carry drugs, proteins, and RNAs, and further deliver their encapsulated cargoes to cancer cells through the properties of exosomes. The unique properties of exosomes in cancer treatment include targeting, low immunogenicity, flexibility in modification, and high biological barrier permeability. Nevertheless, the current comprehensive understanding of the roles of MSCs and their secreted exosomes in cancer development remain inadequate. It is necessary to better understand/update the mechanism of action of MSCs-secreted exosomes in cancer development, providing insights for better modification of exosomes through bioengineering technology and nanobiotechnology. Therefore, this review focuses on the role of MSCs-secreted exosomes and bioengineered exosomes in the development, progression, diagnosis, and treatment of cancer.
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Spiking neural networks (SNNs) represent the most prominent biologically inspired computing model for neuromorphic computing (NC) architectures. However, due to the nondifferentiable nature of spiking neuronal functions, the standard error backpropagation algorithm is not directly applicable to SNNs. In this work, we propose a tandem learning framework that consists of an SNN and an artificial neural network (ANN) coupled through weight sharing. The ANN is an auxiliary structure that facilitates the error backpropagation for the training of the SNN at the spike-train level. To this end, we consider the spike count as the discrete neural representation in the SNN and design an ANN neuronal activation function that can effectively approximate the spike count of the coupled SNN. The proposed tandem learning rule demonstrates competitive pattern recognition and regression capabilities on both the conventional frame- and event-based vision datasets, with at least an order of magnitude reduced inference time and total synaptic operations over other state-of-the-art SNN implementations. Therefore, the proposed tandem learning rule offers a novel solution to training efficient, low latency, and high-accuracy deep SNNs with low computing resources.
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Hepatocellular carcinoma (HCC) is a prevalent malignant tumor, with a growing incidence and death rate worldwide. The aims and challenges of treating HCC include targeting the tumor, entering the tumor tissue, inhibiting the spread and growth of tumor cells. M27-39 is a small peptide isolated from the antimicrobial peptide Musca domestica cecropin (MDC), whereas HTPP is a liver-targeting, cell-penetrating peptide obtained from the circumsporozoite protein (CSP) of Plasmodium parasites. In this study, M27-39 was modified by HTPP to form M(27-39)-HTPP, which targeted tumor penetration to treat HCC. Here, we revealed that M(27-39)-HTPP had a good ability to target and penetrate the tumor, effectively limit the proliferation, migration, and invasion, and induce the apoptosis in HCC. Notably, M(27-39)-HTPP demonstrated good biosecurity when administered at therapeutic doses. Accordingly, M(27-39)-HTPP could be used as a new, safe, and efficient therapeutic peptide for HCC.
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PURPOSE: To develop a bidirectional slide guide to assist screw placement in the axial lamina and to preliminarily discuss the accuracy and feasibility of auxiliary screw placement. METHODS: CT data from 40 randomly selected patients were imported into the software for modelling, and cross-pinning was used to simulate pinning. According to the different crossing methods of the upper and lower laminar screws, they are divided into two groups. In the software, the position of the needlepoint of each screw is accurately measured, and the needle point is kept unchanged to simulate the movable range of the screw tail under the condition that the body does not penetrate the cortical bone. The data were compared by grouping and gender. Finally, the guide was designed by combining the screw exit point and fine adjustment angle data of all patients with the centripetal principle of the slide rail. RESULTS: The needle exit data L1/L2/L3/L4 were 6.44 ± 0.52 mm, 7.05 ± 0.48 mm, 3.55 ± 0.75 mm and 5.09 ± 0.74 mm, respectively, and the fine adjustment angle of the slide rail was 10.51° ± 0.87°. There was no significant difference between the two groups or between men and women (p > 0.05). CONCLUSION: In this experiment, using the data obtained from the simulation of screw insertion, a two-way slide guide was designed to assist the insertion of axial laminar screws. The guide locks the screw outlet point to position and guides the screw inlet point, which improves the accuracy and safety of screw placement.
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Fijación Intramedular de Fracturas , Tornillos Pediculares , Fusión Vertebral , Masculino , Humanos , Femenino , Tornillos Óseos , Programas Informáticos , Hueso Cortical , Fusión Vertebral/métodosRESUMEN
OBJECTIVE: To assess the clinical and radiographic outcomes of posterior lumbar fixation and posterior interbody fusion or improved transforaminal lumbar interbody fusion for Meyerding grade II/III spondylolisthesis so as to address the suitability of a dynamic stabilization. METHODS: A total of 28 consecutive patients underwent posterior lumbar fixation and posterior interbody fusion or improved transforaminal lumbar interbody fusion for Meyerding grade II/III spondylolisthesis. Among them, 13 patients underwent posterior interface fusion (PLIF) and pedicle screw fixation. And improved transforaminal lumbar interbody fusion (ITLIF) and placement of the same system were performed in 15 patients. Their clinical, economic, functional, and radiographic data were recorded both pre- and postoperatively. RESULTS: The average changes of economic and functional scores on the Prolo scale were 1.36 and 1.48 respectively. In patients with posterior interbody fusion; the average preoperative vertebral slippage was 46.9% (range: 25 - 75%) versus 14.6% (range: 15 - 25%) postoperatively. In patients with ITLIF, the average changes in economic and functional scores were 1.75 and 1.63 respectively. And the average preoperative vertebral slippage was 45.2% (range: 28 - 78%) compared with 26.3% (range: 14 - 28%) postoperatively. When two fusion techniques were compared, an overall superior reliability and resistance of systems was associated with the ITLIF procedure. But their clinical outcomes did not differ greatly (P > 0.05). CONCLUSIONS: The application of a segmental pedicle screw fixation is both feasible and efficacious.
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Estenosis Espinal/cirugía , Espondilolistesis/cirugía , Anciano , Anciano de 80 o más Años , Humanos , Fijadores Internos , Vértebras Lumbares , Persona de Mediana Edad , Fusión Vertebral/métodos , Estenosis Espinal/complicaciones , Espondilolistesis/complicaciones , Resultado del TratamientoRESUMEN
Spiking neural networks (SNNs) have shown clear advantages over traditional artificial neural networks (ANNs) for low latency and high computational efficiency, due to their event-driven nature and sparse communication. However, the training of deep SNNs is not straightforward. In this paper, we propose a novel ANN-to-SNN conversion and layer-wise learning framework for rapid and efficient pattern recognition, which is referred to as progressive tandem learning. By studying the equivalence between ANNs and SNNs in the discrete representation space, a primitive network conversion method is introduced that takes full advantage of spike count to approximate the activation value of ANN neurons. To compensate for the approximation errors arising from the primitive network conversion, we further introduce a layer-wise learning method with an adaptive training scheduler to fine-tune the network weights. The progressive tandem learning framework also allows hardware constraints, such as limited weight precision and fan-in connections, to be progressively imposed during training. The SNNs thus trained have demonstrated remarkable classification and regression capabilities on large-scale object recognition, image reconstruction, and speech separation tasks, while requiring at least an order of magnitude reduced inference time and synaptic operations than other state-of-the-art SNN implementations. It, therefore, opens up a myriad of opportunities for pervasive mobile and embedded devices with a limited power budget.
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Algoritmos , Redes Neurales de la Computación , Aprendizaje , Aprendizaje Automático , NeuronasRESUMEN
PURPOSE: To explore the influence of irrigating fluid at different temperatures on patients' body temperature and local inflammatory mediators during spinal endoscopy. METHODS: 110 cases of intervertebral foramen surgery in our hospital from January 2019 to October 2021 were randomly divided into control group and observation group. Operations of both groups were performed by the same experienced chief physician. The observation group was irrigated with 37 °C constant temperature saline, while the control group was irrigated at room temperature. The effect was evaluated by monitoring the intraoperative temperature, postoperative VAS score and the levels of inflammatory factors, such as TNF-α, IL-1, IL-6 and IL-10 in drainage fluid. RESULTS: After 30 min of operation, overall temperature of the control group dropped significantly, and 50 cases (90.9%) had hypothermia, P < 0.05. There was no significant difference in preoperative VAS score between the two groups P > 0.05. The VAS score of observation group was significantly lower than that of control group at 6 h and 1 month after operation, P < 0.05. At 0, 3 and 6 h after operation, the values of TNF-α, IL-1, IL-6 and IL-10 in the observation group were significantly lower than those in the control group (P < 0.05). CONCLUSIONS: Isothermal flushing solution can reduce the incidence of hypothermia and effectively alleviate local inflammatory reaction.
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Discectomía Percutánea , Hipotermia , Desplazamiento del Disco Intervertebral , Temperatura Corporal , Discectomía/efectos adversos , Endoscopía/efectos adversos , Humanos , Hipotermia/cirugía , Interleucina-1 , Interleucina-10 , Interleucina-6 , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Temperatura , Factor de Necrosis Tumoral alfaRESUMEN
Spiking neural networks (SNNs) use spatiotemporal spike patterns to represent and transmit information, which are not only biologically realistic but also suitable for ultralow-power event-driven neuromorphic implementation. Just like other deep learning techniques, deep SNNs (DeepSNNs) benefit from the deep architecture. However, the training of DeepSNNs is not straightforward because the well-studied error backpropagation (BP) algorithm is not directly applicable. In this article, we first establish an understanding as to why error BP does not work well in DeepSNNs. We then propose a simple yet efficient rectified linear postsynaptic potential function (ReL-PSP) for spiking neurons and a spike-timing-dependent BP (STDBP) learning algorithm for DeepSNNs where the timing of individual spikes is used to convey information (temporal coding), and learning (BP) is performed based on spike timing in an event-driven manner. We show that DeepSNNs trained with the proposed single spike time-based learning algorithm can achieve the state-of-the-art classification accuracy. Furthermore, by utilizing the trained model parameters obtained from the proposed STDBP learning algorithm, we demonstrate ultralow-power inference operations on a recently proposed neuromorphic inference accelerator. The experimental results also show that the neuromorphic hardware consumes 0.751 mW of the total power consumption and achieves a low latency of 47.71 ms to classify an image from the Modified National Institute of Standards and Technology (MNIST) dataset. Overall, this work investigates the contribution of spike timing dynamics for information encoding, synaptic plasticity, and decision-making, providing a new perspective to the design of future DeepSNNs and neuromorphic hardware.
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Algoritmos , Redes Neurales de la Computación , Plasticidad Neuronal , Neuronas/fisiología , Potenciales SinápticosRESUMEN
OBJECTIVE: To evaluate the clinical efficacies, indications and application values of posterior fusion plus pedicle screw fixation in the treatment of upper cervical spine instability. METHODS: From May 2006 to December 2010, a total of 24 patients with atlantoaxial instability were treated with C1-2 pedicle screws and rod fixation under general anesthesia. There were 18 males and 6 females with a mean age of 49.8 years old (range: 17 - 69). RESULTS: The postoperative radiographs verified a good position of all screws with satisfactory atlantoaxial reduction. A mean follow-up period of 23 months (range: 3 - 45) showed no injury of spinal cord and vertebral artery or inter fixation failure. Atlantoaxial alignment and stability were restored without instrumentation-related complications. CONCLUSION: Posterior atlantoaxial pedicle screw and rod fixation provide immediate three-dimensional rigid fixation of atlantoaxial joint. It is a more effective technique than with previously reported techniques.
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Articulación Atlantoaxoidea/cirugía , Vértebras Cervicales , Fijación Interna de Fracturas/métodos , Inestabilidad de la Articulación/cirugía , Adolescente , Adulto , Anciano , Tornillos Óseos , Femenino , Humanos , Fijadores Internos , Masculino , Persona de Mediana Edad , Fusión Vertebral/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
With the development of minimally invasive spine concepts and the introduction of new minimally invasive instruments, minimally invasive spine technology, represented by foraminoscopy, has flourished, and percutaneous foraminoscopy has become one of the most reliable minimally invasive procedures for the treatment of lumbar disc herniation. Percutaneous foraminoscopy is a safe and effective minimally invasive spinal endoscopic surgical technique. It fully protects the paravertebral muscles and soft tissues as well as the posterior column structure of the spine, provides precise treatment of the target nucleus pulposus tissue, with the advantages of less surgical trauma, fewer postoperative complications, and rapid postoperative recovery, and is widely promoted and used in clinical practice. In this paper, we can view the location, morphology, structure, alignment, and adjacency relationships by performing coronary, CT, and diagonal reconstruction along the attachment of the yellow ligaments and performing 3D reconstruction or processing techniques after performing CT scans. This allows clinicians to observe the laminoplasty and the stenosis of the vertebral canal in a more intuitive and overall manner. It has clinical significance for the display of the sublaminar spine as well as the physician's judgment of the disease and the choice of surgery.
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Degeneración del Disco Intervertebral , Desplazamiento del Disco Intervertebral , Humanos , Desplazamiento del Disco Intervertebral/diagnóstico por imagen , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
PURPOSE: Tranexamic acid (TXA) has been widely used in hip and knee arthroplasty to reduce perioperative blood loss and blood transfusion, but the dosage and efficacy of TXA in posterior lumbar spinal surgery are not fully clear. The aim of this study was to investigate the efficacy and safety of TXA and to determine whether 2 doses of TXA could reduce the blood loss in primary single-segment or double-segment posterior lumbar fusion surgery. MATERIALS AND METHODS: A total of 150 patients with lumbar degenerative disease undergoing posterior lumbar interbody fusion surgery between October 2017 and February 2019 were randomized to 3 groups. Group A was treated with 0.9% normal saline solution without TXA, group B was treated with a 15 mg/kg loading dose intravenous infusion 30 minutes before surgery, and group C was treated with a 15 mg/kg loading dose intravenous infusion 30 minutes before surgery; then, the same dose was administered again 3 hours later. The assessed outcomes were the operation time, the total blood loss, the hidden blood loss, postoperative drainage, blood transfusions, incidence of venous thromboembolism, and incision infection. RESULTS: The total blood loss, the hidden blood loss, and postoperative drainage were the lowest in group C. The amount of intraoperative blood loss was similar among the 3 groups. The hemoglobin and hematocrit values of the third postoperative day were the highest in group C. No significant differences in the incidence of complications and adverse events from TXA use were observed among the 3 groups. The use of TXA, the operation time, and the number of fusion segments were identified as risk factors related to total blood loss. CONCLUSION: Two doses of TXA significantly reduced the total blood loss, the hidden blood loss and postoperative drainage, and decreased hemoglobin and hematocrit drop in patients undergoing posterior lumbar fusion without increasing the risk of complications.
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Antifibrinolíticos , Ácido Tranexámico , Antifibrinolíticos/uso terapéutico , Pérdida de Sangre Quirúrgica/prevención & control , Transfusión Sanguínea , Humanos , Región Lumbosacra , Ácido Tranexámico/uso terapéuticoRESUMEN
OBJECTIVE: To explore clinical application of the new three-dimensional foramen guide in percutaneous endoscopic lumbar discectomy. METHODS: Based on the principle of reverse positioning, a new three-dimensional foramen guide was designed. From May 2016 to May 2018, totally 40 patients with segmental lumbar disc herniation were underwent percutaneous endoscopic lumbar discectomy. The patients were divided into guide and control group, and 20 patients in each group. In guide group, there were 9 males and 11 females with an average age of (46.0±11.0) years old;5 patients on L3,4, 15 patients on L4,5; BMI was (25.4±3.2) kg /m2;three dimensional foramen guide was used to assist the operation. While in control group, there were 10 males and 10 females with an average age of (51.8±9.8) years old;4 patients on L3,4, 16 patients on L4,5;BMI was (24.8±3.5) kg /m2;the operation was completed with bare hands according to the experience. The puncture time, times of fluoroscopy and puncture between two groups were compared, as well as the preoperative and postoperative visual analogue scale (VAS) score and Japanese Orthopaedic Association (JOA) were compared. RESULTS: All patients had no serious complications, and successfully completed operation. Operation time, the times of fluoroscopy and puncture in guide group were better than those of control group (P<0.05). VAS score and JOA score between two groups were significantly relieved after operation (P<0.05), but there was no significant difference between two groups (P>0.05). CONCLUSION: The three dimensional foramen guide is compact in structure, simple in operation, which could reduce the time of puncture and damage of radiation, shorten the learning curve of puncture for beginners, and has certain clinical feasibility.
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Discectomía Percutánea , Desplazamiento del Disco Intervertebral , Adulto , Discectomía , Femenino , Humanos , Desplazamiento del Disco Intervertebral/cirugía , Vértebras Lumbares/cirugía , Región Lumbosacra , Masculino , Persona de Mediana EdadRESUMEN
Artificial neural networks (ANN) have become the mainstream acoustic modeling technique for large vocabulary automatic speech recognition (ASR). A conventional ANN features a multi-layer architecture that requires massive amounts of computation. The brain-inspired spiking neural networks (SNN) closely mimic the biological neural networks and can operate on low-power neuromorphic hardware with spike-based computation. Motivated by their unprecedented energy-efficiency and rapid information processing capability, we explore the use of SNNs for speech recognition. In this work, we use SNNs for acoustic modeling and evaluate their performance on several large vocabulary recognition scenarios. The experimental results demonstrate competitive ASR accuracies to their ANN counterparts, while require only 10 algorithmic time steps and as low as 0.68 times total synaptic operations to classify each audio frame. Integrating the algorithmic power of deep SNNs with energy-efficient neuromorphic hardware, therefore, offer an attractive solution for ASR applications running locally on mobile and embedded devices.
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Between January 1996 and December 2003, our department treated 16 patients (10 men and 6 women; average age 57.5 years) by performing a laminectomy for thoracic myelopathy caused by ossification of the ligamentum flavum (OLF). We followed up all patients for 36 to 86 months (mean follow-up time, 57.3 months). The mean (+/-standard deviation) Japanese Orthopaedic Association score increased from 5.0+/-1.4 points before the operation to 7.7+/-1.9 points at the last follow-up (p<0.01). The average values for pre-operative and post-operative kyphosis of the involved vertebrae were 5.8 degrees +/-4.1 degrees and 8.8 degrees +/-6.0 degrees , respectively; the mean increase in kyphosis was only 3.0 degrees +/-2.4 degrees . An intraoperative dural tear was the main complication and none of the patients developed severe neurological complications. We conclude that laminectomy was both effective and safe in the treatment of thoracic OLF, but it must be performed with great care because of frequent dural adhesions to the OLF. The increase in kyphosis after the laminectomy was minimal when most of the facet joints were left intact and when the patient followed a back extensor exercise program post-operatively.