Comparison of biportal endoscopic technique and uniportal endoscopic technique in Unilateral Laminectomy for Bilateral Decomprssion (ULBD) for lumbar spinal stenosis.

OBJECTIVE: Unilateral laminotomy for bilateral decompression (ULBD) has been adopted widely to treat lumbar spinal stenosis (LSS). The objective of the study is to investigate clinical and radiological outcomes of the biportal endoscopic ULBD (BE-ULBD) and uniportal endoscopic ULBD (UE-ULBD). METHODS: We collected retrospectively 65 patients' data who met the inclusion criteria (July 2019-June 2021). 33 patients underwent BE-ULBD surgery, and 32 patients underwent the UE-ULBD surgery, and were followed up for at least 1 year. The following preoperative and postoperative outcomes were compared between groups: the visual analog scale (VAS) for pain, the Oswestry disability index (ODI) for nerve function, and modified Macnab criteria for satisfaction, the cross-sectional area of the dural sac (DSCSA), the mean angle of facetectomy. RESULTS: Age, BMI, gender, levels of involvement and duration of symptoms were not significantly different at baseline in this study. Clinical data showed that postoperative ODI, VAS scores and Modified Macnab Criteria were not statistically different between the two groups. The BE-ULBD group had a shorter operation time than the UE-ULBD group (P < 0.001). Patients in the BE-ULBD group had a larger postoperative expansion of DSCSA expansion postoperatively (85.58 ± 3.16 mm2 VS 71.43 ± 3.35 mm2, P < 0.001) and a larger contralateral facetectomy angle (63.95 ± 3.34° vs 57.80 ± 3.43°, P < 0.001) compared with patients in the UE-ULBD group. There were no statistical differences in the incidence of postoperative complications between the two groups. CONCLUSION: Both the BE-ULBD and the UE-ULBD yielded clinical improvement in terms of pain and stenosis symptoms. The BE-ULBD technique has the advantages of the shorter operation time, larger DSCSA expansion and larger contralateral facetectomy angle.

[Clinical Effect of Unilateral Biportal Endoscopic Lumbar Interbody Fusion and Minimally Invasive Transforaminal Lumbar Interbody Fusion on Single-segment Lumbar Stenosis with Instability].

Objective To compare the early clinical effects of unilateral biportal endoscopic lumbar interbody fusion (ULIF) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)on single-segment lumbar stenosis with instability. Methods The patients who had single-segment lumbar spinal stenosis with instability and were treated in our hospital from August 2020 to May 2021 were selected.According to the operation methods,they were classified into ULIF group and MIS-TLIF group.The operation duration,hospital stay after operation,perioperative blood loss (drainage volume 48 h after operation,total blood loss),creatine kinase,inflammatory cytokines (C-reactive protein,interleukin-6),D-dimer,and the incidence of lower-extremity venous thrombosis were compared between the two groups.The visual analogue scale and Oswestry disability index were used to evaluate the functional recovery of the two groups in 1 week,1 month,and 3 months after operation. Results The ULIF group had longer operation duration (P<0.001) and shorter hospital stay after operation (P=0.022)than the MIS-TLIF group.The drainage volume 48 h after operation and total blood loss in ULIF group were lower than those in MIS-TLIF group (all P<0.001).The levels of creatine kinase (all P<0.001),C-reactive protein (P<0.001,P=0.002),and interleukin-6 (P=0.003,P<0.001) in ULIF group were lower than those in MIS-TLIF group on the 1st and 3rd day after operation.However,the D-dimer in ULIF group was insignificantly different from that in MIS-TLIF group on the 1st and 3rd day after operation (P=0.117,P=0.683).Lower-extremity venous thrombosis occurred in neither group.The score of visual analogue scale showed no significant difference between the two groups 1 week,1 month,and 3 months after operation (P=0.447,P=0.578,P=0.538),so did the Oswestry disability index (P=0.832,P=0.797,P=0.619). Conclusion ULIF shows similar clinical effect on single-segment lumbar stenosis with instability to MIS-TLIF,which features less bleeding,mild inflammation,mild muscle injury,but long operation duration.

Extracellular vesicles derived from astrocytes facilitated neurite elongation by activating the Hippo pathway.

Spinal cord injury (SCI) often causes severe neurological dysfunction, and facilitating neurite elongation is particularly important in its treatment. Astrocytes (AS) play an important role in the central nervous system (CNS), and their high plasticity and versatility provide a feasible entry point for relevant research. Our purpose was to explore whether extracellular vesicles (EVs) from astrocytes (AS-EVs) and lipopolysaccharide (LPS)-preactivated astrocytes (LPAS-EVs) facilitate neurite elongation, to explore the underlying mechanism, and to verify whether these EVs promote locomotor recovery in rats. We used LPS to preactivate astrocytes and cocultured them with PC12 cells to observe neurite changes, then extracted and identified AS-EVs and LPAS-EVs and the role and mechanism of these EVs in facilitating neurite elongation was examined in vivo and vitro. We demonstrated that AS-EVs and LPAS-EVs facilitated the elongation of neurites and the recovery of rats with SCI. LPAS-EVs had a stronger effect than AS-EVs, by activating the Hippo pathway, promoting monopole spindle binding protein 1 (MOB1) expression, and reducing Yes-associated protein (YAP) levels. The data also suggest a feedback regulation between MOB1 and p-YAP/YAP. In sum, AS-EVs and LPAS-EVs can play an active role in facilitating neurite elongation by activating the Hippo pathway. These findings provide a new strategy for treating SCI and other CNS-related injuries.

Highly Emissive Self-Assembled BODIPY-Platinum Supramolecular Triangles.

Light-emitting supramolecular coordination complexes (SCCs) have been widely studied for applications in the chemical and biological sciences. Herein, we report the coordination-driven self-assembly of two highly emissive platinum(II) supramolecular triangles (1 and 2) containing BODIPY-based bridging ligands. The metallacycles exhibit favorable anticancer activities against HeLa cells (IC50 of 6.41 and 2.11 µM). The characteristic ∼570 nm fluorescence of the boron dipyrromethene (BODIPY) moieties in the metallacycles permits their intracellular visualization using confocal microscopy. Additionally, the BODIPY fluorophore is an excellent photodynamic agent, making the metallacycles as ideal therapeutics for photodynamic therapy (PDT) and chemotherapy. In vitro studies demonstrate that the combination indexes against HeLa cells are 0.56 and 0.48 for 1 and 2, respectively, confirming their synergistic anticancer effect. More importantly, these SCCs also exhibit superior anticancer efficacy toward cisplatin-resistant A2780cis cell line by combining PDT and chemotherapy, showing promise in overcoming drug resistance. This study exploits a multicomponent approach to self-assembled metallacages that enables design of effective theranostic agents wherein the platinum acceptors are toxic chemotherapeutics and the BODIPY donors are imaging probes and photosensitizers. Since each piece may be independently tuned, i.e., Pt(II) polypyridyl fragment swapped for Pt(II) phosphine, the activity may be optimized without a total redesign of the system.

Effect of Calcium-sensing Receptor on the Apoptosis of Rat Spinal Cord Neurons in Anoxia/Reoxygenation Injury and Its Significance.

Objective To investigate the effect and significance of calcium-sensing receptor (CaSR) on the apoptosis of rat spinal cord neurons in anoxia/reoxygenation(A/R) injury. Methods The spinal cells were in ischemia and hypoxia environment for 1 h and in normal environment for 24 h to establish a model of A/R. After spinal A/R model was established,the spinal cells were divided into four groups randomly:the control group,A/R group,A/R+GdCl3 group,and A/R+NPS-2390 group. The expression of CaSR in each group was detected by immunofluorescence and Western blotting. The concentration of intracellular calcium was measured by laser confocal scanning microscopy. The expressions of Caspase-3,Bax,and Bcl-2 were detected by using Western blotting. The apoptotic rate of spinal cells was detected by Tunel assay. Results Compared to the control group, there was a significant increase in the level of CaSR (t=5.462, P=0.006), the concentration of intracellular calcium (t=8.573, P=0.001), the apoptotic rate (t=4.899, P=0.008), Caspase-3 (t=5.118, P=0.007), and Bax (t=10.930,P=0.001) in A/R group. Compared to the A/R group, there was a significant increase in the level of CaSR (t=4.975, P=0.008),the concentration of intracellular calcium (t=4.899, P=0.008), the apoptotic rate (t=7.746, P=0.002), Caspase-3 (t=4.776, P=0.009), and Bax (t=5.281, P=0.006) in A/R+GdCl3 group. Compared to the A/R group, there was a significant decrease in the level of CaSR (t=3.674,P=0.021), the concentration of intracellular calcium (t=3.846, P=0.018), the apoptotic rate (t=4.281,P=0.013), Caspase-3 (t=3.521, P=0.024), and Bax(t=3.473, P=0.026) in A/R+NPS-2390 group. However, compared to the control group, there was a significant decrease in the level of Bcl-2 (t=6.242,P=0.003) in A/R group. Compared to the A/R group, there was a significant decrease in the level of Bcl-2(t=3.028, P=0.004) in A/R+GdCl3 group. Compared to the A/R group, there was a significant increase in the level of Bcl-2 (t=2.840, P=0.047) in A/R+NPS-2390 group.Conclusion During the process of A/R injury in rat spinal cord neurons,the expression of calcium sensing receptor increases,along with increase in intracellular calcium and spinal neuron apoptosis.

Correlation Between Expression of High Temperature Requirement Serine Protease A1 (HtrA1) in Nucleus Pulposus and T2 Value of Magnetic Resonance Imaging.

BACKGROUND Degrading enzymes play an important role in the process of disc degeneration. The objective of this study was to investigate the correlation between the expression of high temperature requirement serine protease A1 (HtrA1) in the nucleus pulposus and the T2 value of the nucleus pulposus region in magnetic resonance imaging (MRI). MATERIAL AND METHODS Thirty-six patients who had undergone surgical excision of the nucleus pulposus were examined by MRI before surgery. Pfirrmann grading of the target intervertebral disc was performed according to the sagittal T2-weighted imaging, and the T2 value of the target nucleus pulposus was measured according to the median sagittal T2 mapping. The correlation between the Pfirrmann grade and the T2 value was analyzed. The expression of HtrA1 in the nucleus pulposus was analyzed by RT-PCR and Western blot. The correlation between the expression of HtrA1 and the T2 value was analyzed. RESULTS The T2 value of the nucleus pulposus region was 33.11-167.91 ms, with an average of 86.64±38.73 ms. According to Spearman correlation analysis, there was a rank correlation between T2 value and Pfirrmann grade (P<0.0001), and the correlation coefficient (rs)=-0.93617. There was a linear correlation between the mRNA level of HtrA1 and T2 value in nucleus pulposus tissues (a=3.88, b=-0.019, F=112.63, P<0.0001), normalized regression coefficient=-0.88. There was a linear correlation between the expression level of HtrA1 protein and the T2 value in the nucleus pulposus tissues (a=3.30, b=-0.016, F=93.15, P<0.0001) and normalized regression coefficient=-0.86. CONCLUSIONS The expression of HtrA1 was strongly related to the T2 value, suggesting that HtrA1 plays an important role in the pathological process of intervertebral disc degeneration.

Observation of the long-lived triplet excited state of perylenebisimide (PBI) in C

Perylenebisimide (PBI) was used to prepare C^N cyclometalated Ir(III) complexes that show strong absorption of visible light and it is the first time the long-lived triplet excited state of PBI chromophore was observed in a transition metal complex (τT = 22.3 µs). Previously, the lifetime of the triplet state of PBI in transition metal complexes was usually shorter than 1.0 µs. Long-lived triplet excited states are useful for applications in photocatalysis or other photophysical processes concerning triplet-triplet-energy-transfer. PBI and amino-PBI were used for preparation of cyclometalated Ir(III) complexes (Ir-2 and Ir-3), in which the PBI chromophore was connected to the coordination center via C≡C π-conjugation bond. The new complexes show strong absorption in visible region (ε = 34,200 M(-1) cm(-1) at 541 nm for Ir-2, and ε = 19,000 at 669 nm for Ir-3), compared to the model complex Ir(ppy)(bpy)[PF6] Ir-1 (ε < 5000 M(-1) cm(-1) in the region beyond 400 nm). The nanosecond time-resolved transient absorption and DFT calculations indicated that PBI-localized long-lived (3)IL states were populated for Ir-2 and Ir-3 upon photoexcitation. The complexes were used as triplet photosensitizers for (1)O2-mediated photooxidation of 1,5-dihydronaphthalene to produce juglone, an important intermediate for preparation of anti-cancer compounds. (1)O2 quantum yields (Φ(Δ)) up to 91% were observed for the new Ir(III) complexes and the overall photosensitizing ability is much higher than the conventional Ir(III) complex Ir-1, which shows the typical weak visible light absorption in visible region. Our results are useful for preparation of transition metal complexes that show strong absorption of visible light and long-lived triplet excited state and for the application of these complexes in photocatalysis.

Visible light-absorbing rhenium(I) tricarbonyl complexes as triplet photosensitizers in photooxidation and triplet-triplet annihilation upconversion.

We prepared N^N Re(I) tricarbonyl chloride complexes (Re-1 and Re-2) that give very strong absorption of visible light. To this end, it is for the first time that boron dipyrimethane (Bodipy) was used to prepare Re(I) tricarbonyl chloride complexes. The π-conjugation linker between the π-conjugation framework of the antenna Bodipy and the Re(I) coordination centre ensures efficient intersystem crossing (ISC). Re-0 without visible light-harvesting ligand was prepared as a model complex in the photophysical studies. Re-1 (with Bodipy) and Re-2 (with carbazole-ethynyl Bodipy) show unprecedented strong absorption of visible light at 536 nm (ε = 91700 M(−1) cm(−1)) and 574 nm (ε = 64,600 M(−1) cm(−1)), respectively. Interestingly, different from Re-0, Re-1 and Re-2 show fluorescence of the ligand, not the phosphorescence of the Re(I) coordination centre. However, long-lived triplet excited states were observed upon visible light excitation (τ(T) = 104.0 µs for Re-1; τ(T) = 127.2 µs for Re-2) vs. the short lifetime of Re-0 (τ(T) = 26 ns). With nanosecond time-resolved transient absorption spectroscopy and DFT calculations, we proved that the triplet excited states of Re-1 and Re-2 are localized on the Bodipy ligands. The complexes were used as triplet photosensitizers for two triplet­triplet-energy-transfer (TTET) processes, i.e.(1)O(2) mediated photooxidation and triplet­triplet annihilation (TTA) upconversion. With the strong visible light-harvesting ability, Re-1 proved to be a better (1)O(2) photosensitizer than the conventional triplet photosensitizer tetraphenylporphyrin (TPP). Significant upconversion was observed with Re-1 as the triplet photosensitizer. Our result is useful for preparation of Re(I) tricarbonyl chloride complexes that show strong absorption of visible light and long-lived triplet excited states and for the application of these complexes as triplet photosensitizers in photocatalysis, photodynamic therapy and TTA upconversion.

Rhenium(I) tricarbonyl polypyridine complexes showing strong absorption of visible light and long-lived triplet excited states as a triplet photosensitizer for triplet-triplet annihilation upconversion.

The preparation of rhenium(I) tricarbonyl polypyridine complexes that show a strong absorption of visible light and long-lived triplet excited state and the application of these complexes as triplet photosensitizers for triplet-triplet annihilation (TTA) based upconversion are reported. Imidazole-fused phenanthroline was used as the N^N coordination ligand, on which different aryl groups were attached (Phenyl, Re-0; Coumarin, Re-1 and naphthyl, Re-2). Re-1 shows strong absorption of visible light (ε = 60,800 M(-1) cm(-1) at 473 nm). Both Re-1 and Re-2 show long-lived T(1) states (lifetime, τ(T), is up to 86.0 µs and 64.0 µs, respectively). These properties are in contrast to the weak absorption of visible light and short-lived triplet excited states of the normal rhenium(I) tricarbonyl polypyridine complexes, such as Re-0 (ε = 5100 M(-1) cm(-1) at 439 nm, τ(T) = 2.2 µs). The photophysical properties of the complexes were fully studied with steady state and time-resolved absorption and emission spectroscopes, as well as DFT calculations. The intra-ligand triplet excited state is proposed to be responsible for the exceptionally long-lived T(1) states of Re-1 and Re-2. The Re(I) complexes were used as triplet photosensitizers for TTA based upconversion and an upconversion quantum yield up to 17.0% was observed.