The area ratio of Modic changes has predictive value for postoperative surgical site infection in lumbar spine surgery: a retrospective study.

BACKGROUND: Increasing evidence suggests an association between Modic changes (MC) and subclinical infection and inflammatory reactions. However, the relationship between preoperative MC and surgical site infection (SSI) has not been fully explored. This study aims to investigate the correlation between MC and SSI. METHODS: A retrospective analysis was conducted on patients (n = 646) who underwent single-level lumbar spine surgery for lower back pain in our hospital between 2018 and 2023. According to the Centers for Disease Control and Prevention (CDC) criteria, the patients were divided into an SSI group (n = 40) and a Non-SSI group (n = 606). Univariate analysis was performed to determine the statistical differences in variables between the two groups, and the variables with significant differences were included in a multivariable logistic regression analysis to identify independent risk factors for SSI. Receiver operating characteristic (ROC) curve analysis was performed on the independent risk factors. RESULTS: The SSI group and the Non-SSI group exhibited significant differences in diabetes prevalence, MC prevalence, Total endplate score (TEPS) and area ratio of MC (P < 0.05). Age, gender, American Society of Anesthesiologists(ASA)score, hypertension, coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), MC classification, and the location of MC in the endplate showed no significant differences (P > 0.05). Multivariate binary logistic regression analysis was performed on the variables with significant differences, and the results indicated a significant correlation between TEPS (P = 0.009) and the area ratio of MC changes (P = 0.001) with SSI. ROC curve analysis was performed on the TEPS and area ratio of MC changes, and the results showed that the diagnostic value of TEPS (AUC: 0.641; CI: 0.522-0.759) is lower than the area ratio of MC (AUC: 0.722; CI: 0.621-0.824), and the combined diagnosis did not significantly improve the diagnostic value (AUC: 0.747; CI: 0.653-0.842). The area ratio of MC had moderate diagnostic value for SSI (AUC: 0.722; CI: 0.621-0.824), with a cut-off value of 24.62% determined by the Youden index (sensitivity: 69.2%; specificity: 73.1%), and for every 1% increase in the area ratio of MC changes, the risk of SSI in MC patients increased by 10.3% (OR = 1.103; CI: 1.044-1.167). CONCLUSION: The area ratio MC and the TEPS are independent risk factors for SSI after lumbar spine surgery. The predictive value of the area ratio of MC is greater than TEPS, and when the two are combined, the predictive value is not significantly improved. When the rate of MC exceeds 24.62%, caution should be exercised regarding the occurrence of SSI.

Evaluation of the effect of herbal agents as management of radiodermatitis in breast cancer patients: A systematic review and meta-analysis.

OBJECTIVE: To evaluate the effectiveness of herbal agents in the prevention and therapy of radiodermatitis in breast cancer patients. METHODS: Randomized controlled trials were searched from databases such as PubMed, Web of Science, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure (CNKI) to assess the effectiveness of herbal agents compared to a standard medication or placebo in prevention or treatment of radiodermatitis in breast cancer. RESULTS: Data from 16 studies involving 1994 patients were included. This meta-analysis included 10 clinical trials of 562 breast cancer patients treated with calendula, silymarin, or aloe vera for the prevention of radiodermatitis. Silymarin showed positive effects in ameliorating the damage of radiodermatitis, whereas the efficacy of calendula and aloe vera in the treatment of radiodermatitis lacks sufficient evidence. CONCLUSIONS: Herbal medicine may show therapeutic effects on radiodermatitis in breast cancer, but more comprehensive investigations and clinical trials are required in the future.

Application of 3D-ASL in hemodynamic analysis and prognosis evaluation of vascular cognitive impairment.

OBJECTIVE: To investigate the application of magnetic resonance 3D arterial spin labeling (3D-ASL) imaging in the hemodynamic analysis and prognostic assessment of vascular cognitive impairment (VCI). METHODS: Using a retrospective research method, 108 patients with ischemic cerebrovascular disease diagnosed in the Department of Neurology of Lianyungang Hospital of Traditional Chinese Medicine from January 2021 to April 2022 were chose as the research subjects. The Montreal cognitive assessment (MoCA) was used to evaluate cognitive function. The patients were divided into a VCI group (n=54, 28 males and 26 females) and a normal cognitive function group (NCF group, n=54, 30 males and 24 females). The 3D-ASL cerebral perfusion imaging was performed on the two groups of patients using different post label delay (PLD) (1525 ms, 2525 ms). The cerebral blood flow (CBF) values of bilateral frontal lobe, temporal lobe, temporal parietal junction, parietal lobe, and hippocampus were analyzed under different PLDs in the two groups. The two sets of MoCA scale scores were compared. The receiver operating characteristic curve (ROC) of CBF of VCI patients was drawn, and the area under curve (AUC), specificity and sensitivity under different PLDs was compared. RESULTS: There was no statistical significance between the two groups in terms of sex, average age, hypertension, diabetes, coronary heart disease, smoking history, and drinking history (P>0.05). CBF 1525 values and CBF 2525 values in the bilateral frontal lobes, temporal lobes, temporoparietal junction, parietal lobes, and hippocampus were significantly reduced in the VCI group under different PLD (all P<0.05). There was no significant difference in the CBF 1525 value and CBF 2525 value of the bilateral frontal lobe and temporal lobe in the VCI group (all P<0.05). The language, delayed memory, executive ability, attention and calculation ability, naming, abstract thinking, orientation, and total scores of the VCI group were significantly lower than those of the NCF group (all P<0.05). The ROC analysis revealed that the AUC, specificity, and sensitivity of CBF (bilateral frontal, temporal, temporoparietal junction, parietal, and hippocampus) at PLD 1525 ms were lower than those of CBF at PLD 2525 ms (P<0.05). CONCLUSION: Non-invasive 3D-ASL technology can be used to detect cerebral hemodynamics and predict prognosis in VCI patients. PLD 1525 ms was more sensitive to detect cerebral hypoperfusion. PLD 2525 ms showed a more accurate hypoperfusion range. This guides and adjusts treatment methods.

Transport and retention of nano emulsified vegetable oil in porous media: Effect of pore straining, roughness wedging, and interfacial effects.

Emulsified vegetable oil (EVO), as one of the novel green substrates, has been widely used in subsurface remediation. In these applications, the retention behavior of EVO presents a challenge to remediation efficiency as mechanism insights into the retention of EVO is limited. Herein, Brinell funnels experiments with X-ray microtomography (XMT) were conducted to examine the drainage and retention of nanoscale EVO in porous media, with a specific focus on investigating the impact of pore straining, grain surface roughness, and interfacial effects on Nano-EVO (NEVO) retention. This study demonstrated that the retention of NEVO in porous media is the synergistic result of pore straining, roughness wedging, and interface attachment. With the action of these effects, three residual states of NEVO, incorporating retention at porous ganglia, grain-grain contacts, and grain surface, were identified by XMT in porous media. After multiple periods of drainage and imbibition, the NEVO arrived at stable retention proportions of 46.3%, 72.2%, and 85.9% in three independent systems with coarse, medium, and fine sand as porous media, respectively. The interfacial effects, including the attachment of solid-phase and air-liquid interface, are confirmed as the dominant factors for the retention of NEVO in porous media, which contributed 35.63-47.33% of total retention for the conditions employed. Correspondingly, the contributions of pore straining and roughness wedging only ranged 3.78-24.06% and 3.87-9.94%, respectively. The consistency of the contributions between the actual measurement of XMT and computational evaluation further confirmed the rationality and reliability of the results. In such the dominant factor, interfacial tension, contact angle, and capillary radius play an essential role in NEVO retention, which could be reflected by capillary rise height. These findings advance our understanding on NEVO retention caused by substrate-media interaction and also offer a promising direction for subsurface remediation.

Access to 3-Amino-[1,2,4]-triazolo Pyridines and Related Heterocycles via Electrochemically Induced Desulfurative Cyclization.

An efficient, one-pot approach has been established for synthesizing a wide range of 3-amino-[1,2,4]-triazolo pyridines and related heterocycles from the electrochemically induced desulfurative cyclization of 2-hydrazinopyridines with isothiocyanates. The protocol allows for the formation of C-N bonds under simple conditions without transition metals or external oxidants. The practicability of this strategy is demonstrated by its broad substrate scope, good functional group compatibility, and gram-scale synthesis. The late-stage modification of 3-amino-[1,2,4]-triazolo pyridines enables us to obtain several molecules with potent anticancer activity.

Comprehensive Analysis of the Expression, Prognosis, and Biological Significance of OVOLs in Breast Cancer.

BACKGROUND: The study aimed to investigate the expression of OVOLs in breast cancer (BRCA) tissues and their value in prognosis. METHODS: ONCOMINE was used to analyze the expressions of OVOL1, OVOL2, and OVOL3 mRNA between BRCA tissues and normal breast tissues. The Wilcoxon rank sum test and t-test were used to assess the expression of OVOLs between BRCA tissues and unpaired/paired normal breast tissues. GEPIA and ROC curves were used to analyze the relationship between OVOLs expression and clinical pathological stage. Kaplan-Meier plotter was used to analyze prognosis. cBioPortal was used to analyze the mutation of OVOLs. GEPIA was used to analyze the co-expression of OVOLs. GO and KEGG analyses were performed by the DAVID software to predict the function of OVOLs co-expression genes. RESULTS: The expression of OVOL1/2 was significantly higher in BRCA tissues than in normal breast tissues. The OVOL3 expression correlated with tumor stage. The AUC of OVOLs was 0.757, 0.754, and 0.537, respectively. OVOL1 high expression was associated with shorter overall survival (HR: 1.48; 95% CI: 1.07-2.04; P=0.018). The OVOLs were associated with pathways including axon guidance, thyroid hormone signaling pathway, and ubiquinone and other terpenoid-quinone biosynthesis. CONCLUSION: OVOL1 is a new potential marker of prognosis in BRCA, and OVOL1/2 are potential therapeutic targets in BRCA.

Formation Process of Silicate-Iron Oxyhydroxide Complex and Its Influence on the Distribution of Heavy Metals in Mining Area.

Silicate-iron oxyhydroxide complex formed by mineral weathering has an important influence on the geochemical reactions of heavy metals in mining areas. In this work, tailings were collected from an abandoned iron tailings pond, and the physicochemical properties and distribution of heavy metals were studied under natural weathering and hydraulic processes. The results showed that Fe2+ in the iron tailings were transported to the surface during the weathering process, and then the iron oxyhydroxide formed by mineralization adsorbed Cu2+ and Zn2+. Silicic acid and exchangeable acid were released during the formation of binary agglomerates between hydroxy iron oxide and kaolin, then they migrated to the lower area of a tailing pond via surface runoff. Finally, silicate-iron oxyhydroxide complex were formed. The heavy metals were replaced by H+ and penetrated to the bottom layer with water. This research provides an important scientific basis for the prevention and control of heavy metal pollution in mining areas.

Comparison of the application value of two commonly used minimally invasive spinal surgery in the treatment of lumbar disc herniation.

The aim of the study was to compare the application value of percutaneous transforaminal endoscopic discectomy (PTED) and microendoscopic discectomy (MED) in the treatment of lumbar disc herniation (LDH). From January 2017 to July 2018, 108 LDH patients undergoing surgical treatment in our hospital were collected and divided into PTED group (treated with PTED, n=50) and MED group (treated with MED, n=58). The operation parameter index level, complications, recurrence and pain score (VAS), Oswestry disability index (ODI) and Japanese Orthopaedic Association Scale (JOA) were compared between the two groups. VAS, ODI and JOA scores of the two groups were significantly decreased after operation (P<0.05), but there was no significant difference between the two groups (P>0.05). Complications and recurrence of the two groups were similar (P>0.05). MED was superior to PTED in the number of intraoperative fluoroscopy and operation time, while PTED was superior to MED in intraoperative blood loss, incision length, length of hospital stay and bed rest time (P<0.05). Both PTED and MED can effectively treat LDH. Referring to clinical data, PTED may be the first choice for LDH treatment.

Pore-scale identification of residual morphology and genetic mechanisms of nano emulsified vegetable oil in porous media using 3D X-ray microtomography.

The application of emulsified vegetable oil (EVO) has attracted widespread attention in environmental remediation. Residual morphology is an important factor affecting its migration and mass transfer. However, proper identification of the EVO residual morphology at pore-scale has still remained a challenging task. Hence, this study aimed to identify the residual morphology of nanoscale EVO (NEVO) through developing a method combining natural breaks with 3D X-ray microtomography, then further explore the genetic mechanism of each residual morphology to verify the rationality of this method. The results showed that the natural breaks method can effectively classify the residual morphology of NEVO. Four morphologies including cluster, throat, corner, and membrane state were obtained from coarse, medium, and fine sands with a total proportion of 18.3%, 26.2%, and 30.8%. The cluster state was the main residual morphology, accounting for 10.0- 16.2%, then followed by corner-throat state and membrane state. Pore radius, throat radius, and length were confirmed providing sufficient evidences for cluster residues, because these factors determined the connectivity of porous media for the trapping of droplets. Comparison of the theoretical and actual results implied that capillarity coupling pore-throat shape jointly controlled corner and throat residues. Grain surface roughness and specific surface area were the main factors of membrane residue. The different residual morphologies of NEVO identified by the natural breaks method can reasonably explain their magnitude and controlling mechanisms, which in turn confirms the rationality of this method. Although the proportions of each form are related to the experimental conditions, the classification method and mechanism are of great significance for understanding NEVO residues.

Surgical treatment for posterior rim separation of the lumbar and sacral vertebrae.

OBJECTIVE: The posterior rim separation of the lumbar and sacral vertebrae has been ascribed to various mechanisms. The procedure of operative treatment is still controversial. The authors' objective was to study the therapeutic methods of posterior vertebral rim separation. METHODS: Thirty-four patients, including 23 males and 11 females whose ages ranged from 24 to 65 years (mean 41.3 years), were treated for posterior vertebral rim separation by various methods. All patients had discectomy and removal of bony fragment. Wide fenestration or hemilaminectomy was performed for 24 type I-III lesions, laminectomy for four type II and one type III lesion, and bilateral fenestration for 5 of 17 type II lesions. Posterior lumbar interbody fusion (PLIF) was performed in 11 patients using autogenous iliac bone or poly (ether-ether-ketone) (PEEK) spacer implant. RESULTS: Follow-up studies were performed for all patients ranging from 11 months to 4.6 years with an average period of 2.7 years. There were no serious intra-operative or postoperative complications. Satisfactory results were achieved in all patients except two with type III lesions, mostly because of a long history of hypaesthesia of the leg and a drop foot. Eleven patients who had PLIF exhibited bony fusion at final follow-up. CONCLUSIONS: Early operative treatment should be performed on patients after a brief trial of conservative treatment. A proper surgical operation must be based on the type and location of the separated bony fragment and clinical symptoms.

The effect of secondhand smoke exposure on markers of elastin degradation.

BACKGROUND: Tobacco smoke is a major risk factor in the development of COPD. Secondhand smoke (SHS) exposure is a known risk factor in asthma, bronchitis, and coronary artery disease. Elastin is a recognized target for injury in COPD, and the amino acids desmosine and isodesmosine (D/I), which are specific for elastin degradation, are elevated in COPD. This study determined whether exposure to SHS affects elastin degradation in asymptomatic individuals. METHODS: Two cohorts of asymptomatic individuals without evidence of respiratory or circulatory disease, exposed to SHS, were studied. Both cohorts comprised normal nonsmokers, active smokers, and those exposed to SHS. D/I were measured in plasma and quantified by high-performance liquid chromatography and tandem mass spectrometry by published methods. Plasma cotinine, a metabolite of nicotine, was also measured. RESULTS: In each cohort, the levels of D/I in plasma were statistically significantly higher in secondhand-smoke-exposed subjects than in the normal nonexposed subjects. Smokers had the highest levels of D/I but their levels were not statistically significantly higher than those of the secondhand-smoke-exposed. Cotinine levels were elevated in secondhand-smoke-exposed subjects and active smokers but not in most nonsmoking control subjects. CONCLUSIONS: Results indicate a tissue matrix effect of degradation of body elastin from SHS exposure and possible lung structure injury, which may result in COPD. Long-term studies of individuals exposed to SHS for the development of COPD are warranted.

Spectroscopic investigation of Ginkgo biloba terpene trilactones and their interaction with amyloid peptide Abeta(25-35).

The beneficial effects of Ginkgo biloba extract in the "treatment" of dementia are attributed to its terpene trilactone (TTL) constituents. The interactions between TTLs and amyloid peptide are believed to be responsible in preventing the aggregation of peptide. These interactions have been investigated using infrared vibrational absorption (VA) and circular dichroism (VCD) spectra. Four TTLs, namely ginkgolide A (GA), ginkgolide B (GB), ginkgolide C (GC) and bilobalide (BB) and amyloid Abeta(25-35) peptide, as a model for the full length peptide, are used in this study. GA-monoether and GA-diether have also been synthesized and investigated to help understand the role of individual carbonyl groups in these interactions. The precipitation and solubility issues encountered with the mixture of ginkgolide+Abeta peptide for VA and VCD studies were overcome using binary ethanol-D(2)O solvent mixture. The experimental VA and VCD spectra of GA, GB, GC and BB, GA-monoether and GA-diether have been analyzed using the corresponding spectra predicted with density functional theory. The time-dependent experimental VA and VCD spectra of Abeta(25-35) peptide and the corresponding experimental spectra in the presence of TTLs indicated that the effect of the TTLs in modulating the aggregation of Abeta(25-35) peptide is relatively small. Such small effects might indicate the absence of a specific interaction between the TTLs and Abeta(25-35) peptide as a major force leading to the reduced aggregation of amyloid peptides. It is possible that the therapeutic effect of G. biloba extract does not originate from direct interactions between TTLs and the Abeta(25-35) peptide and is more complex.

Characterization of dihydro-A2PE: an intermediate in the A2E biosynthetic pathway.

Bisretinoid lipofuscin pigments that accumulate in retinal pigment epithelial cells are implicated in the etiology of several forms of macular degeneration, including juvenile onset Stargardt disease, Best vitelliform macular degeneration, and age-related macular degeneration. One of these compounds, A2E, is generated by phosphate hydrolysis of a phosphatidyl-pyridinium bisretinoid (A2PE) that forms within photoreceptor outer segments. Here, we demonstrate that the formation of the aromatic pyridinium ring of A2PE follows from the oxidation of a dihydropyridinium intermediate. Time-dependent density functional theory calculation, based on the structure of dihydro-A2E, produced a simulated UV-visible absorbance spectrum characterized by maxima of 494 and 344 nm. Subsequently, a compound exhibiting similar UV-visible absorbance maxima (lambdamax 490 and 330 nm) was identified in the A2E biomimetic reaction mixture. By liquid chromatography-mass spectrometry (LC-MS) this bischromophore had the expected mass of the dihydro-pyridinium bisretinoid. The compound also exhibited the behavior of a biosynthetic intermediate since it formed in advance of the final product A2E and was consumed as A2E accumulated. Moreover, under deoxygenated conditions, conversion to the aromatic pyridinium bisretinoid was inhibited. Taken together, these findings indicate that A2E biosynthesis involves the oxidation of a dihydropyridinium intermediate dihydro-A2PE. An understanding of the biosynthetic pathways of retinal pigment epithelial lipofuscin pigments is critical to the development of therapies for macular degeneration that are based on limiting the formation of these damaging compounds.

[Degradation of volatile chlorinated aliphatics by zero-valent iron].

Tetrachloroethene (PCE), trichloroethene (TCE) and carbon tetrachloride (CT) were selected as target contaminants in this paper. Experiments were conducted to determine the effectiveness of zero-valent iron on dechlorination reaction and reaction-affecting factors in different mixing conditions. The results show that selected iron scrapes were effective in the dechlorination of chlorinated aliphatics, especially for chlorinated alkanes, and dechlorination reaction was pseudo first order. When PCE and TCE coexist, the reaction rate constant (K) was 0.0624 mL.(m2.h)-1 and 0.0357 mL.(m2.h)-1 respectively, showing the higher the chlorinated degree the quicker the reaction. When CT and PCE coexist, K was 0.1341 mL.(m2.h)-1 and 0.0129 mL.(m2.h)-1 respectively; compared with PCE, CT was degraded much more quickly and thoroughly giving an account of alkane was prior to alkene in dechlorination when at the same chlorinated degree. Either chlorinated alkanes or alkenes, their degradation half-lives were lower in monocomponent condition than coexisting with other component.