Comparative efficacy of robotic-assisted and freehand techniques for pedicle screw placement in spinal disorders: a meta-analysis and systematic review.

The efficacy and safety of robotic-assisted pedicle screw placement compared to traditional fluoroscopy-guided techniques are of great interest in the field of spinal surgery. This systematic review and meta-analysis aimed to compare the outcomes of these two methods in patients with spinal diseases. Following the PRISMA guidelines, we conducted a systematic search across PubMed, Embase, Web of Science, and Cochrane Library. We included randomized controlled trials comparing robotic-assisted and fluoroscopy-guided pedicle screw placement in patients with spinal diseases. Outcome measures included the accuracy of pedicle screw placement, postoperative complication rates, intraoperative radiation exposure time, and duration of surgery. Data were analyzed using Stata software. Our analysis included 12 studies. It revealed significantly higher accuracy in pedicle screw placement with robotic assistance (odds ratio [OR] = 2.83, 95% confidence interval [CI] = 2.20-3.64, P < 0.01). Postoperative complication rates, intraoperative radiation exposure time, and duration of surgery were similar between the two techniques (OR = 0.72, 95% CI = 0.31 to 1.68, P = 0.56 for complication rates; weighted mean difference [WMD] = - 0.13, 95% CI = - 0.93 to 0.68, P = 0.86 for radiation exposure time; WMD = 0.30, 95% CI = - 0.06 to 0.66, P = 0.06 for duration of surgery). Robotic-assisted pedicle screw placement offers superior placement accuracy compared to fluoroscopy-guided techniques. Postoperative complication rates, intraoperative radiation exposure time, and duration of surgery were comparable for both methods. Future studies should explore the potential for fewer complications with the robotic-assisted approach as suggested by the lower point estimate.

Personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer.

BACKGROUND: Psychological factors are a risk factor for the incidence of breast cancer and have a significant impact on patient prognosis. OBJECTIVE: The present study aims to investigate the effects of personalised graded psychological intervention on negative emotion and quality of life in patients with breast cancer. METHODS: A total of 200 patients with breast cancer were randomly divided into two groups: an experimental group (n= 100) and control group (n= 100). Both groups received routine nursing care. The experimental group received personalised graded psychological intervention care, and the control group received routine nursing measures. After 2 months of standard treatment, the patients' quality of life and negative emotions were evaluated using the self-rating depression scale (SDS), self-rating anxiety scale (SAS), social support rating scale (SSRS) and quality of life measurement scale (FACT-B) scoring criteria. RESULTS: There were no significant differences in the general data between the two groups (p> 0.05). Furthermore, there were no significant differences in the SDS, SAS, SSRS and FACT-B scores between the two groups before personalised graded psychological intervention (p> 0.05). After the intervention, the experimental group exhibited an improved nursing effect compared with the control group. The SDS and SAS scores were lower in the experimental group than in the control group (p< 0.05); after the intervention, the SDS and SAS scores were significantly lower in the experimental group than in the control group (p< 0.05). The SSRS and FACT-B scores were higher in the experimental group than in the control group (p< 0.05), and the experimental group's post-intervention SSRS and FACT-B scores were significantly higher than before the intervention (p< 0.05). CONCLUSIONS: The use of personalised graded psychological intervention for the nursing of patients with breast cancer in clinical practice can significantly reduce patients' negative emotions as well as improve positive emotions and quality of life; thus, this method can be popularised in the nursing process.

Coarse-to-fine registration and time-intensity curves constraint for liver DCE-MRI synthesis.

Image registration plays a crucial role in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), used as a fundamental step for the subsequent diagnosis of benign and malignant tumors. However, the registration process encounters significant challenges due to the substantial intensity changes observed among different time points, resulting from the injection of contrast agents. Furthermore, previous studies have often overlooked the alignment of small structures, such as tumors and vessels. In this work, we propose a novel DCE-MRI registration framework that can effectively align the DCE-MRI time series. Specifically, our DCE-MRI registration framework consists of two steps, i.e., a de-enhancement synthesis step and a coarse-to-fine registration step. In the de-enhancement synthesis step, a disentanglement network separates DCE-MRI images into a content component representing the anatomical structures and a style component indicating the presence or absence of contrast agents. This step generates synthetic images where the contrast agents are removed from the original images, alleviating the negative effects of intensity changes on the subsequent registration process. In the registration step, we utilize a coarse registration network followed by a refined registration network. These two networks facilitate the estimation of both the coarse and refined displacement vector fields (DVFs) in a pairwise and groupwise registration manner, respectively. In addition, to enhance the alignment accuracy for small structures, a voxel-wise constraint is further conducted by assessing the smoothness of the time-intensity curves (TICs). Experimental results on liver DCE-MRI demonstrate that our proposed method outperforms state-of-the-art approaches, offering more robust and accurate alignment results.

Microbial Colonization of Capsular Traction Sutures in Hip Arthroscopic Surgery.

Background: A common practice in hip arthroscopic surgery is the utilization of capsular traction sutures that can be incorporated into the capsular repair site at the end of the procedure, potentially seeding the hip joint with colonized suture material. Purpose: To investigate the rate of the microbial colonization of capsular traction sutures used during hip arthroscopic surgery and to identify patient-associated risk factors for this microbial colonization. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 50 consecutive patients who underwent hip arthroscopic surgery with a single surgeon were enrolled. There were 4 braided nonabsorbable sutures utilized for capsular traction during each hip arthroscopic procedure. These 4 traction sutures and 1 control suture were submitted for aerobic and nonaerobic cultures. Cultures were held for 21 days. Demographic information was collected, such as age, sex, and body mass index. All variables underwent bivariate analysis, and variables with a P value <.1 underwent further analysis in a multivariate logistic regression model. Results: One of 200 experimental traction sutures and 1 of 50 control sutures had a positive culture. Proteus mirabilis and Citrobacter koseri were isolated in both these positive experimental and control cultures from the same patient. Age and traction time were not significantly associated with positive cultures. The rate of microbial colonization was 0.5%. Conclusion: The rate of the microbial colonization of capsular traction sutures used in hip arthroscopic surgery was low, and no patient-associated risk factors were identified for microbial colonization. Capsular traction sutures used in hip arthroscopic surgery were not a significant potential source of microbial contamination. Based on these results, capsular traction sutures can be incorporated in capsular closure with a low risk of seeding the hip joint with microbial contaminants.

Screening for urinary markers predicting hematopoietic stem cell injury induced by busulfan using genetically diverse mice.

BACKGROUND: Busulfan (BU) is an alkylating agent used as a conditioning agent prior to hematopoietic stem cell (HSC) transplantation as it is known to be cytotoxic to host hematopoietic stem and progenitor cells. The susceptibility of HSCs to BU injury plays an important role in the myeloablative efficacy of BU. Different susceptibilities were demonstrated in genetically diverse (GD) mice in our preliminary research. METHODS: Three strains of GD mice with different susceptibilities to BU-induced HSC injury were used for screening biological markers of HSC injury susceptibility in urine. The urine proteins were analyzed using liquid chromatography coupled with tandem mass spectrometry to screen for differentially expressed proteins. Screening for possible biomarkers based on differences in protein expression abundance was validated using enzyme-linked immunoassay (ELISA). RESULTS: Functional analysis showed that the differential proteins were all involved in a series of biological pathways related to cellular senescence, apoptosis, and angiogenesis; whereas the differential proteins of the high-susceptible strain were enriched for the regulation of bone marrow microenvironment pathways, those of low-susceptible strain were enriched for the proapoptotic effect of GTPase pathways. Based on protein abundance differences, several urinary proteins that may be indicative of susceptibility were screened, and ELISA validation results showed that angiotensin-converting enzyme may be a potential biomarker predicting HSC susceptibility for BU conditioning. CONCLUSIONS: This study indicates that urinary protein levels can reflect differences in susceptibility to BU-induced HSC injury. Using GD mice to construct genetic difference models will provide preclinical data for screening BU-related biological markers.

Effect of spermidine on radiation-induced long-term bone marrow cell injury.

OBJECTIVE: Spermidine, a natural polyamine, possesses anti-oxidant, autophagy-regulation, and anti-aging properties. Elevated levels of oxidative stress, which was mediated the senescence of hematopoietic stem cells (HSCs) induced by radiation exposure, may further contribute to long-term myelosuppression. Therefore, this study investigated the protective effect of spermidine on the long-term damage of the hematopoietic system caused by radiation exposure. METHODS: In vitro experiments, bone marrow mononuclear cells (BMMNCs) of C57BL/6 mice were isolated and incubated with 5 mM spermidine for 30 min, then irradiated by 2 Gy X ray. The survival rate, proliferation, and differentiation ability of BMMNCs were detected. In vivo experiment, mice received 4 Gy total body irradiation (TBI), 3 mM spermidine were administered in the drinking water every day for 14 days prior to irradiation and then continued for 30 days after irradiation. Peripheral blood, bone marrow cell typing, level of reactive oxygen species (ROS), colony-forming ability of HSC, and transplantation-reconstitution capability were detected. RESULTS: In vitro experiments, spermidine significantly improved the survival rate of BMMNCs as well as the proliferation and differentiation ability of HSCs exposure to ionizing radiation (IR). In vivo, spermidine reduced levels of ROS in HSCs; spermidine attenuated long-term myeloid differentiation deviation induced by TBI. Spermidine promoted the proliferation and differentiation ability of stem cells, but failed to ameliorate the decreased engraftment capacity of bone marrow cells in mice exposed to TBI. CONCLUSION: This study demonstrated that spermidine could promote the recovery of IR-induced inhibition of proliferation and differentiation ability of HSCs, partly through antioxidant effects. Whether combining spermidine with other radioprotectants could further increase protective efficacy and reduce the long-term bone marrow injury needs further investigation.

TGF-ß1 stimulated mesenchymal stem cells-generated exosomal miR-29a promotes the proliferation, migration and fibrogenesis of tenocytes by targeting FABP3.

BACKGROUND: Rotator cuff Tear (RCT) causes a lot of inconvenience for patients. In most cases, RCT injury does not heal back to bone after repair, and there is a high chance of retearing. Therefore, there is a need to explore more effective targeted therapies. Bone mesenchymal stem cell-derived exosome (BMSCs-Exo) has been proved to be beneficial to the proliferation of tendon cells, but its specific mechanism remains to be further explored. METHODS: BMSCs-Exo was isolated and identified by detecting the specific markers using flow cytometry and western blot assays. qRT-PCR and western blot were utilized to determine the gene or protein expressions, respectively. Cell proliferation, and migration in tenocytes were measured by CCK8, EdU and transwell assays. The interaction between miR-29a and FABP3 was analyzed using dual-luciferase reporter assay. RESULTS: Our findings demonstrated that miR-29a was expressed in BMSCs-Exo and could be significantly enriched after TGF-ß1 treatment. Moreover, TGF-ß1-modified BMSCs-Exo co-cultured could promote the proliferation, migration and fibrosis of tenocytes by carrying miR-29a. Upon miR-29a was reduced in BMSCs-Exo, the regulatory roles of BMSCs-Exo on tenocytes were reversed. Mechanistically, miR-29a negatively regulated FABP3 via interaction with its 3'-UTR. Enforced expression of FABP3 could reverse the modulation of exosomal miR-29a in tenocytes. CONCLUSION: Exosomal miR-29a derived from TGF-ß1-modified BMSCs facilitated the proliferation, migration and fibrosis of tenocytes through targeting FABP3.

Prevalence of femoroacetabular impingement in elite baseball players.

CAM-type femoroacetabular impingement continues to be an underrecognized cause of hip pain in elite athletes. Properties inherent to baseball such as throwing mechanics and hitting may enhance the risk of developing a cam deformity. Our goal is to gain an appreciation of the radiographic prevalence of cam deformities in elite baseball players. Prospective evaluation and radiographs of 80 elite baseball players were obtained during the 2016 preseason entrance examination. A sports medicine fellowship-trained orthopedic surgeon with experience treating hip disorders used standard radiographic measurements to assess for the radiographic presence of cam impingement. Radiographs with an alpha angle >55° on modified Dunn views were defined as cam positive. Of the 122 elite baseball players included in our analysis, 80 completed radiographic evaluation. Only 7.3% (9/122) of players reported hip pain and 1.6% (4/244) had a positive anterior impingement test. The prevalence of cam deformities in right and left hips were 54/80 (67.5%) and 40/80 (50.0%), respectively. The mean alpha angle for cam-positive right and left hips were 64.7 ± 6.9° and 64.9 ± 5.8°, respectively. Outfielders had the highest risk of right-sided cam morphology (Relative Risk (RR) = 1.6). Right hip cam deformities were significantly higher in right-handed pitchers compared with left-handed pitchers (P = 0.02); however, there was no significant difference in left hip cam deformities between left- and right-handed pitchers (P = 0.307). Our data suggest that elite baseball players have a significantly higher prevalence of radiographic cam impingement than the general population.

Vision-Based Detection of Bolt Loosening Using YOLOv5.

Bolted connections have been widely applied in engineering structures, loosening will happen when bolted connections are subjected to continuous cyclic load, and a significant rotation between the nut and the bolt can be observed. Combining deep learning with machine vision, a bolt loosening detection method based on the fifth version of You Only Look Once (YOLOv5) is proposed, and the rotation of the nut is identified to detect the bolt loosening. Two different circular markers are added to the bolt and the nut separately, and then YOLOv5 is used to identify the circular markers, and the rotation angle of the nut against the bolt is calculated according to the center coordinate of each predicted box. A bolted connection structure is adopted to illustrate the effectiveness of the method. First, 200 images containing bolts and circular markers are collected to make the dataset, which is divided into a training set, verification set and test set. Second, YOLOv5 is used to train the model; the precision rate and recall rate are respectively 99.8% and 100%. Finally, the robustness of the proposed method in different shooting environments is verified by changing the shooting distance, shooting angle and light condition. When using this method to detect the bolt loosening angle, the minimum identifiable angle is 1°, and the maximum detection error is 5.91% when the camera is tilted 45°. The experimental results show that the proposed method can detect the loosening angle of the bolted connection with high accuracy; especially, the tiny angle of bolt loosening can be identified. Even under some difficult shooting conditions, the method still works. The early stage of bolt loosening can be detected by measuring the rotation angle of the nut against the bolt.

Mycobacterium tuberculosis Induced Osteoblast Dysregulation Involved in Bone Destruction in Spinal Tuberculosis.

Disturbance of bone homeostasis caused by Mycobacterium tuberculosis (Mtb) is a key clinical manifestation in spinal tuberculosis (TB). However, the complete mechanism of this process has not been established, and an effective treatment target does not exist. Increasing evidence shows that abnormal osteoclastogenesis triggered by an imbalance of the receptor activator of NF-κB ligand (RANKL)/osteoprotegerin (OPG) axis may play a key role in the disturbance of bone homeostasis. Previous studies reported that RANKL is strongly activated in patients with spinal TB; however, the OPG levels in these patients were not investigated in previous studies. In this study, we investigated the OPG levels in patients with spinal TB and the dysregulation of osteoblasts caused by Mtb infection. Inhibition of the Mce4a gene of Mtb by an antisense locked nucleic acid (LNA) gapmer (Mce4a-ASO) was also investigated. Analysis of the serum OPG levels in clinical samples showed that the OPG levels were significantly decreased in patients with spinal TB compared to those in the group of non-TB patients. The internalization of Mtb in osteoblasts, the known major source of OPG, was investigated using the green fluorescent protein (GFP)-labeled Mycobacterium strain H37Ra (H37RaGFP). The cell-associated fluorescence measurements showed that Mtb can efficiently enter osteoblast cells. In addition, Mtb infection caused a dose-dependent increase of the CD40 mRNA expression and cytokine (interleukin 6, IL-6) secretion in osteoblast cells. Ligation of CD40 by soluble CD154 reversed the increased secretion of IL-6. This means that the induced CD40 is functional. Considering that the interaction between CD154-expressing T lymphocytes and bone-forming osteoblast cells plays a pivotal role in bone homeostasis, the CD40 molecule might be a strong candidate for mediating the target for treatment of bone destruction in spinal TB. Additionally, we also found that Mce4a-ASO could dose-dependently inhibit the Mce4a gene of Mtb and reverse the decreased secretion of IL-6 and the impaired secretion of OPG caused by Mtb infection of osteoblast cells. Taken together, the current finding provides breakthrough ideas for the development of therapeutic agents for spinal TB.

Liver DCE-MRI registration based on sparse recovery of contrast agent curves.

PURPOSE: Dynamic contrast-enhanced MRI (DCE-MRI) registration is a challenging task because of the effect of remarkable intensity changes caused by contrast agent injections. Unrealistic deformation usually occurs by using traditional intensity-based algorithms. To alleviate the effect of contrast agent on registration, we proposed a DCE-MRI registration strategy and investigated the registration performance on the clinical DCE-MRI time series of liver. METHOD: We reconstructed the time-intensity curves of the contrast agent through sparse representation with a predefined dictionary whose columns were the time-intensity curves with high correlations with respect to a preselected contrast agent curve. After reshaping 1D-reconstructed contrast agent time-intensity curves into a 4D contrast agent time series, we aligned the original time series to the reconstructed contrast agent time series through traditional free-form deformation (FFD) registration scheme combined with a residual complexity (RC) similarity and an iterative registration strategy. This study included the DCE-MRI time series of 20 patients with liver cancer. RESULTS: Qualitatively, the time-cut images and subtraction images of different registration methods did not obviously differ. Quantitatively, the mean (standard deviation) of temporal intensity smoothness of all the patients achieved 54.910 (18.819), 54.609 (18.859), and 53.391 (19.031) in FFD RC, RDDR, Zhou et al.'s method and the proposed method, respectively. The mean (standard deviation) of changes in the lesion volume were 0.985 (0.041), 0.983 (0.041), 0.981 (0.046), and 0.989 (0.036) in FFD RC, RDDR, Zhou et al.'s method and the proposed method. CONCLUSION: Our proposed method would be an effective registration strategy for DCE-MRI time series, and its performance was comparable with that of three advanced registration methods.

Functional magnetic resonance imaging progressive deformable registration based on a cascaded convolutional neural network.

BACKGROUND: Intersubject registration of functional magnetic resonance imaging (fMRI) is necessary for group analysis. Accurate image registration can significantly improve the results of statistical analysis. Traditional methods are achieved by using high-resolution structural images or manually extracting functional information. However, structural alignment does not necessarily lead to functional alignment, and manually extracting functional features is complicated and time-consuming. Recent studies have shown that deep learning-based methods can be used for deformable image registration. METHODS: We proposed a deep learning framework with a three-cascaded multi-resolution network (MR-Net) to achieve deformable image registration. MR-Net separately extracts the features of moving and fixed images via a two-stream path, predicts a sub-deformation field, and is cascaded three times. The moving and fixed images' deformation field is composed of all sub-deformation fields predicted by the MR-Net. We imposed large smoothness constraints on all sub-deformation fields to ensure their smoothness. Our proposed architecture can complete the progressive registration process to ensure the topology of the deformation field. RESULTS: We implemented our method on the 1000 Functional Connectomes Project (FCP) and Eyes Open Eyes Closed fMRI datasets. Our method increased the peak t values in six brain functional networks to 19.8, 17.8, 15.0, 16.4, 17.0, and 13.2. Compared with traditional methods [i.e., FMRIB Software Library (FSL) and Statistical Parametric Mapping (SPM)] and deep learning networks [i.e., VoxelMorph (VM) and Volume Tweening Network (VTN)], our method improved 47.58%, 11.88%, 18.60%, and 15.16%, respectively. CONCLUSIONS: Our three-cascaded MR-Net can achieve statistically significant improvement in functional consistency across subjects.

Surgical Intervention for Femoroacetabular Impingement Can Lead to Improvements in Both Hip and Back Function in Patients With Coexisting Chronic Back Pain at 1-Year Follow-Up.

PURPOSE: To determine whether patients with coexisting lumbar back pain experience back pain improvement after undergoing hip arthroscopy for femoroacetabular impingement (FAI). METHODS: An institutional review board-approved retrospective chart review compared patients undergoing hip arthroscopy for FAI with lumbar spine back pain to patients solely reporting hip pain. The modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) were recorded preoperatively and at 1-year follow up. The Oswestry Disability Index score, which quantifies disability from lower back pain, and visual analog scale were recorded from the hip-spine cohort alone. Statistical analysis was performed using paired sample t tests with P ≤ .05 considered significant. RESULTS: Sixty-eight patients who underwent hip arthroscopy between November 2016 and October 2018 were enrolled. Thirty-four patients with a mean age of 48.2 ± 14.0 years and body mass index of 26.6 ± 6.6 had a history of back pain and 34 patients were age- and sex-matched for the matched-control (MC) cohort. The MC cohort had lower mHHS and NAHS scores preoperatively. The MC cohort reported a larger increase in the mHHS (P = .01) and NAHS scores (P = .01) postoperatively. More patients in the MC cohort reached minimally clinically important difference with mHHS (P = .003) and NAHS (P = .06). Following surgery, the hip-spine cohort reported a lower Oswestry Disability Index score, indicating minimal disability (P = .01). CONCLUSIONS: Surgical intervention for FAI can lead to improvements in hip and back pain in patients with coexisting lumbar pathology. LEVEL OF EVIDENCE: III, retrospective comparative study.

Functional Intronic Variant in the Retinoblastoma 1 Gene Underlies Broiler Chicken Adiposity by Altering Nuclear Factor-kB and SRY-Related HMG Box Protein 2 Binding Sites.

The present study aimed to search for chicken abdominal fat deposition-related polymorphisms within RB1 and to provide functional evidence for significantly associated genetic variants. Association analyses showed that 11 single nucleotide polymorphisms (SNPs) in intron 17 of RB1, were significantly associated with both abdominal fat weight (P < 0.05) and abdominal fat percentage (P < 0.05). Functional analysis revealed that the A allele of g.32828A>G repressed the transcriptional efficiency of RB1 in vitro, through binding nuclear factor-kappa B (NF-KB) and SRY-related HMG box protein 2 (SOX2). Furthermore, RB1 mRNA expression levels in the abdominal fat tissue of individuals with the A/A genotype of g.32828A>G were lower than those of individuals with the G/G genotype. Collectively, we propose that the intronic SNP g.32828A>G of RB1 is an obesity-associated variant that directly affects binding with NF-KB and SOX2, leading to changes in RB1 expression which in turn may influence chicken abdominal fat deposition.

Mannan Oligosaccharide Protects against the Aflatoxin-B1-Promoted Influenza Replication and Tissue Damages in a Toll-Like-Receptor-4-Dependent Manner.

Our previous study reported that aflatoxin B1 (AFB1) promoted influenza replication. Mannan oligosaccharide (MOS), derived from the cell walls of yeast, is a potent immunomodulator. Here, we investigated the role of MOS in AFB1-promoted influenza replication and further explored the underlying mechanisms. In vitro and in vivo, the exposure to AFB1 alone resulted in significantly decreased weight gain and increased viral replication as well as lung and spleen damages. Increased influenza replication coupled with increases in toll-like receptor 4 (TLR4), phosphorylated nuclear factor κB, and tumor necrosis factor α (TNF-α) levels. However, MOS given in conjunction with exposure to AFB1 significantly reversed these above changes. A further study indicated that MOS activity was abolished by TLR4 knockout or TLR4 overexpression. Surprisingly, TNF-α played no role in the MOS-mediated protective effects. Collectively, our data suggest that MOS alleviates the AFB1-promoted influenza replication, inflammation, and tissue damages in a TLR4-dependent manner.

Rational use of antibacterials and drug sensitivity analysis in the repair of large lip defect with skin flap.

In this study the wound status of skin flap repair patients were closely observed, there were sign of infection. The secretion were taken for bacterial culture and sensitivity analysis and given sensitive antibiotics to active treatment. Patients received intravenous antibiotics 30 minutes before surgery to prevent infection. If postoperative infection occurred, according to susceptibility test results, patients were given sensitive antibiotics. Drug sensitivity analysis showed that 85.71% of gram-negative bacteria were sensitive to cefoperazone/shubatan and imipenem and 72.72% of gram-negative bacteria were sensitive to cefoperazone/tazobactam, so these 3 antibiotics were the first choice for treatment. And gram-positive bacteria were sensitive to teicoplanin and vancomycin. Therefore, scientific and rational use of antibiotics has great significance to effectively prevent postoperative infection and reduce the production of drugresistant bacteria. At the same time, L-extension deltopectoral flap was used to reconstruct a full-thickness labiomental defect concurrent infection. All the surgeries were successful without any necrosis. There are many kinds of pathogens for skin flap infection, and their sensitivity to antibiotics is not the same. Therefore, it is suggested that combination therapy should be carried out at the early stage, so as to ensure a good antibacterial effect.

Low-Level Aflatoxin B1 Promotes Influenza Infection and Modulates a Switch in Macrophage Polarization from M1 to M2.

BACKGROUND/AIMS: Swine influenza virus (SIV) is a major pathogen of both animals and humans. Afatoxin B1 (AFB1) is one of the most common mycotoxins in feed and food. However, the central contribution of AFB1 to SIV infection remains unclear. METHODS: Here, TCID50 assays, fluorescence-based quantitative real-time PCR, western blotting, immunofluorescence staining, histopathological examination, flow cytometry and scanning electron microscopy were performed to investigate the involvement and underlying mechanism of AFB1 in SIV infection in vivo and in vitro using mouse models and porcine alveolar macrophage (PAM) models, respectively. RESULTS: The in vivo study showed that low levels of AFB1 promoted SIV infection and increased its severity, as demonstrated by the increased mRNA expression of viral matrix protein (M); by the increased protein expression of nucleoprotein (NP), matrix protein 1 and ion channel protein; and by animal weight loss, lung index and lung histologic damage. In addition, the increased occurrence of SIV infection accompanied by increases in the level of IL-10 in sera and lungs, in the spleen index and in the number of CD206-positive mouse alveolar macrophages but decreases in the level of TNF-α in sera and lungs, in the thymus index and in the number of CD80-positive mouse alveolar macrophages was observed in SIV-infected mice after low-level AFB1 exposure. The in vitro study showed that low concentrations of AFB1 promoted SIV infection, as demonstrated by the increases in viral titers and viral M mRNA and NP expression levels in SIV-infected PAMs as well as by the number of cells positive for NP protein expression. Furthermore, AFB1 promoted the polarization of SIV-infected PAMs to the M1 phenotype at 8 hpi and to the M2 phenotype at 24 hpi, as measured by the increases in IL-10 expression and in the number of CD206-positive PAMs as well as by the morphological changes observed by scanning electron microscopy. The administration of the immune stimulant lipopolysaccharide (LPS) reversed the switch in PAM polarization from M2 to M1 and thereby counteracted the promotion of influenza virus infection induced by AFB1. CONCLUSION: Our results are the first to confirm that low-level exposure to AFB1 promotes SIV infection and modulates a switch in macrophage polarization from M1 to M2. The work reported here provides important data that point to a role for AFB1 in SIV infection, and it opens a new field of study.

Protective effects of zymosan on heat stress-induced immunosuppression and apoptosis in dairy cows and peripheral blood mononuclear cells.

Dairy cows exposed to heat stress (HS) show decreased performance and immunity, but increased heat shock protein expressions and apoptosis. Zymosan, an extract from yeast cell walls, has been shown to modulate immune responses and defense against oxidative stress. However, few literatures are available about the effects of zymosan on immune responses and other parameters of the dairy cows under HS. Here, both primary peripheral blood mononuclear cell (PBMC) and dairy cow models were established to assess the effects of zymosan on performance, immunity, heat shock protein, and apoptosis-related gene expressions of dairy cows under HS. In vitro study showed that proliferation, IL-2 production, and Bcl-2/Bax-α ratio of cow primary PBMC were reduced, whereas hsp70 mRNA and protein expressions, as well as Annexin V-bing, were increased when PBMCs were exposed to heat. In contrast, zymosan significantly reversed these above changes induced by the HS. In the in vivo study, 40 Holstein dairy cows were randomly selected and assigned into zymosan group (supplemental zymosan; n = 20) and control group (no supplemental zymosan; n = 20). The results showed that zymosan improved significantly the dry matter intake and milk yield, increased IgA, IL-2, and tumor necrosis factor-α (TNF-α) contents in sera, as well as hepatic Bcl-2/Bax-α ratio, but decreased respiration rate and hepatic hsp70 expressions in the dairy cows under HS. Taken together, zymosan could alleviate HS-induced immunosuppression and apoptosis and improve significantly the productive performance and immunity of dairy cows under HS.

Pentoxifylline intervention and drug action in scalping forehead flap for large temporal cutaneous defects.

Pentoxifylline is widely used in the treatment of cerebrovascular disease, at present, there are a variety of drugs in the clinical expansion of the role of the skin flap, by improving or promoting blood circulation, to ensure the survival of the flap. We designed scalping forehead flap to reconstruct large temporal cutaneous defects. This flap is reliable and can give us excellent postoperative result. This design has several advantages and is worth to be promoted. The scalping forehead flap we designed is reliable. The posterior auricular artery and it branches provided enough blood supply to the scalp and forehead tissue of the flap. The frontal muscle also make the flap have a high survival rate. Large temporal cutaneous defects can be reconstructed by this novel scalping forehead flap we described. This technique is useful especially for patients who suffered malignant tumor and can not choose free flap.

Nitroglycerin hypotensive effect and application in a combined surgery for reconstruction after ipsilateral maxillectomy and orbit evisceration.

The oral and maxillofacial region is rich in blood, and it is often difficult to stop bleeding during the operation of maxilla. Nitroglycerin is one of the most commonly used antihypertensive drugs in our hospital. We observed the effect of controlled hypotension in patients with maxillary resection. In group N, the patients had different degrees of tachycardia after using nitroglycerin only. In addition, nitroglycerin has the characteristics of rapid drug resistance. A combined reversed temporal muscle flap and random forehead flap technique was performed successfully to reconstruct the large defect after ipsilateral maxillectomy and orbit evisceration. There were 43 cases used this method during 2014-2016 without large side effects.