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1.
Immunity ; 56(1): 58-77.e11, 2023 01 10.
Article in English | MEDLINE | ID: mdl-36521495

ABSTRACT

Obesity-induced chronic liver inflammation is a hallmark of nonalcoholic steatohepatitis (NASH)-an aggressive form of nonalcoholic fatty liver disease. However, it remains unclear how such a low-grade, yet persistent, inflammation is sustained in the liver. Here, we show that the macrophage phagocytic receptor TREM2, induced by hepatocyte-derived sphingosine-1-phosphate, was required for efferocytosis of lipid-laden apoptotic hepatocytes and thereby maintained liver immune homeostasis. However, prolonged hypernutrition led to the production of proinflammatory cytokines TNF and IL-1ß in the liver to induce TREM2 shedding through ADAM17-dependent proteolytic cleavage. Loss of TREM2 resulted in aberrant accumulation of dying hepatocytes, thereby further augmenting proinflammatory cytokine production. This ultimately precipitated a vicious cycle that licensed chronic inflammation to drive simple steatosis transition to NASH. Therefore, impaired macrophage efferocytosis is a previously unrecognized key pathogenic event that enables chronic liver inflammation in obesity. Blocking TREM2 cleavage to restore efferocytosis may represent an effective strategy to treat NASH.


Subject(s)
Non-alcoholic Fatty Liver Disease , Overnutrition , Humans , Non-alcoholic Fatty Liver Disease/pathology , Overnutrition/pathology , Liver/pathology , Inflammation/pathology , Obesity/pathology , Membrane Glycoproteins , Receptors, Immunologic
2.
Small ; 19(39): e2301917, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37264720

ABSTRACT

Two-Dimensional (2D) materials have attracted immense attention in recent years. These materials have found their applications in various fields, such as catalysis, adsorption, energy storage, and sensing, as they exhibit excellent physical, chemical, electronic, photonic, and biological properties. Recently, researchers have focused on constructing porous structures on 2D materials. Various strategies, such as chemical etching and template-based methods, for the development of surface pores are reported, and the porous 2D materials fabricated over the years are used to develop supercapacitors and energy storage devices. Moreover, the lattice structure of the 2D materials can be modulated during the construction of porous structures to develop 2D materials that can be used in various fields such as lattice defects in 2D nanomaterials for enhancing biomedical performances. This review focuses on the recently developed chemical etching, solvent thermal synthesis, microwave combustion, and template methods that are used to fabricate porous 2D materials. The application prospects of the porous 2D materials are summarized. Finally, the key scientific challenges associated with developing porous 2D materials are presented to provide a platform for developing porous 2D materials.

3.
BMC Musculoskelet Disord ; 24(1): 852, 2023 Oct 30.
Article in English | MEDLINE | ID: mdl-37899456

ABSTRACT

PURPOSE: To compare the outcomes and characteristics of oblique lumbar interbody fusion stand-alone (OLIF-SA) and OLIF with posterior pedicle screw fixation (OLIF-PPS) in the treatment of Grade I or Grade II degenerative lumbar spondylolisthesis. PATIENTS AND METHODS: Between January 2019 and May 2022, 139 patients with degenerative spondylolisthesis were treated with OLIF-SA (n = 85) or OLIF-PPS (n = 54). The clinical and radiographic records were reviewed. RESULTS: The clinical and radiographic outcomes were similar in both groups. The operative time and intraoperative blood loss in the OLIF-SA group were lower than those in the OLIF-PPS group (P < 0.05). However, the OLIF-PPS group had significantly better disc height (DH) and postoperative forward spondylolisthesis distance (FSD) improvement at 6 months (P < 0.05). The OLIF-PPS group had a significantly lower cage subsidence value than the OLIF-SA group (P < 0.05). Improvement of the lumbar lordotic angle (LA) and fusion segmental lordotic angle (FSA) in the OLIF-PPS group was significantly better than that in the OLIF-SA group (P < 0.05). In terms of fusion types, the OLIF-SA group tended to undergo fusion from the edge of the vertebral body. Fusion in the OLIF-PPS group began more often in the bone graft area of the central cage of the vertebral body. The fusion speed of the OLIF-SA group was faster than that of the OLIF-PPS group. CONCLUSION: OLIF-SA has the advantages of a short operative time, less intraoperative blood loss, and reduced financial burden, while PPS has incomparable advantages in the reduction of spondylolisthesis, restoration of lumbar physiological curvature, and long-term maintenance of intervertebral DH. In addition, the SA group had a unique vertebral edge fusion method and faster fusion speed.


Subject(s)
Pedicle Screws , Spinal Fusion , Spondylolisthesis , Humans , Blood Loss, Surgical/prevention & control , Treatment Outcome , Spondylolisthesis/diagnostic imaging , Spondylolisthesis/surgery , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Spinal Fusion/methods , Retrospective Studies
4.
Osteoporos Int ; 33(8): 1795-1806, 2022 Aug.
Article in English | MEDLINE | ID: mdl-35585277

ABSTRACT

Adjacent vertebral compression fracture (AVCF) is the primary factor affecting satisfaction after PKP surgery. In addition to osteoporosis, certain structural characteristics of the vertebral body itself also increase their risk. The purpose of this study was to explore the impact of biomechanical changes on AVCF after balancing other factors. INTRODUCTION: As a routine treatment of OVCF, the postoperative refracture of PKP is a serious problem. The aim of our study was to explore the impact of lumbar biomechanical changes on the risk of AVCF. A propensity score matching was performed to balance the interference of osteoporosis, which is the primary risk factor of AVCF. METHODS: A retrospective, single-center case-control study was performed. From September 2013 to March 2020, 1752 patients were enrolled, and AVCF was assessed in 80 of these patients. A propensity score matching (PSM) analysis was performed, and 5 potential confounding factors were matched (age, BMI, number of fractured vertebral bodies, fracture region, and HDL). The preoperative and postoperative radiological factors were measured in the matched cohort of 48 pairs. A conditional logistic regression analysis to adjust the comparative risks. RESULTS: The preoperative wedge angle and its postoperative recovery of the AVCF group were significantly higher than that of the non-AVCF group. The local kyphosis of the fractured vertebral body between the two groups was similar, but the recovery in the AVCF group was slightly higher than that in the non-AVCF group. The preoperative and postoperative relative anterior height (RAH) of the fractured vertebral body was familiar in two groups, so was the recovery of RAH. The preoperative spino-sacral angle (SSA) was significantly higher in the AVCF group than in the non-AVCF group. The preoperative wedge angle was identified as the only significant risk factor for AVCF in the multivariate analysis. CONCLUSION: In conclusion, a larger preoperative fracture vertebral wedge angle is a risk factor for AVCF. For such high-risk patients, surgeons should be cautious about surgical decisions. The postoperative active measures and tailored surveillance should be attached to great importance as well.


Subject(s)
Fractures, Compression , Kyphoplasty , Osteoporosis , Osteoporotic Fractures , Spinal Fractures , Bone Cements , Case-Control Studies , Fractures, Compression/complications , Fractures, Compression/surgery , Humans , Kyphoplasty/adverse effects , Osteoporosis/etiology , Osteoporotic Fractures/chemically induced , Osteoporotic Fractures/surgery , Propensity Score , Retrospective Studies , Spinal Fractures/complications , Spinal Fractures/surgery , Treatment Outcome
5.
Eur Spine J ; 31(10): 2597-2606, 2022 10.
Article in English | MEDLINE | ID: mdl-35748953

ABSTRACT

STUDY DESIGN: Clinical retrospective cohort study. OBJECTIVES: To explore the application of the electromagnetic navigation system in Endo-TLIF. MATERIALS AND METHODS: From May 2019 to March 2020, 76 patients with single-segment lumbar spondylolisthesis treated by electromagnetic navigation-assisted Endo-TLIF (NE group) and conventional Endo-TLIF (CE group) were enrolled in the study. Time of pedicle screw implantation, entire operation time, the number of intraoperative X-ray fluoroscopy exposures, total blood loss, incision length, ambulation time, accuracy of pedicle screws, complications, visual analog scale for back and leg pain, Oswestry Disability Index, Japanese Orthopedic Association score and postoperative fusion rates were recorded, respectively. RESULTS: There were no significant differences in preoperative demographics between the NE and CE groups (P > 0.05). The mean number of intraoperative X-ray fluoroscopy exposures, guidewires insertion, entire operation time, total blood loss and adjustment rate of screws in the NE group were significantly less compared with the CE group (P < 0.05, respectively). There were no significant differences in clinical parameters between the two groups at different time points in the follow-up period (P > 0.05). There was no statistical difference in fusion rates between the two groups. In addition, one case of cage subsidence was observed after surgery in the CE group. CONCLUSION: Electromagnetic navigation systems could be applied throughout the entire surgical course and ameliorate the shortcomings of the conventional Endo-TLIF technique to reduce radiation exposure, improve accuracy, avoid repetitive operations and shorten surgery time and the required learning curve of the procedure. LEVEL OF EVIDENCE I: Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.


Subject(s)
Pedicle Screws , Spinal Fusion , Spondylolisthesis , Cohort Studies , Cross-Sectional Studies , Electromagnetic Phenomena , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Minimally Invasive Surgical Procedures/methods , Retrospective Studies , Spinal Fusion/methods , Spondylolisthesis/diagnostic imaging , Spondylolisthesis/surgery , Treatment Outcome
6.
BMC Musculoskelet Disord ; 23(1): 522, 2022 Jun 01.
Article in English | MEDLINE | ID: mdl-35650587

ABSTRACT

Uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (Endo-TLIF) with percutaneous pedicle screw fixation is a promising, minimally invasive method for the treatment of lumbar spondylolisthesis. However, repeated radiation exposure from X-rays and the steep learning curve remain to be improved.


Subject(s)
Pedicle Screws , Spinal Fusion , Spondylolisthesis , Electromagnetic Phenomena , Humans , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Minimally Invasive Surgical Procedures/methods , Spinal Fusion/methods , Spondylolisthesis/diagnostic imaging , Spondylolisthesis/surgery , Treatment Outcome
7.
Br J Neurosurg ; : 1-6, 2022 Feb 03.
Article in English | MEDLINE | ID: mdl-35109723

ABSTRACT

OBJECTIVE: To identify the clinical characteristics of fractured hinges after open-door cervical laminoplasty for cervical canal stenosis and explore the relationship between hinge fractures and axial symptoms. METHODS: This was a retrospective study of patients with cervical myelopathy who underwent open-door laminoplasty between November 2014 and November 2016 at the Affiliated Hospital of Qingdao University. Cervical CT scans were performed after surgery and the Takeuchi criteria were applied to evaluate the postoperative axial symptoms. RESULTS: Of 223 opened laminae in 67 patients, 67 laminae (30.0%) in 30 patients (44.8%) showed fracture. The frequency of hinge fractures was higher at C6 (53.7%). Forty-nine fractured laminae (73.13%) were non-displaced and 18 were displaced. At 3 months, 33 fractured laminae (49.3%) showed bony union on CT, and union rates were 86.6% and 91.0% at 6 and 12 months, respectively, indicating that the union rate was lower for displaced fractures than for non-displaced fractures. Among the 67 patients, 14 had axial symptoms: three of 37 (8.1%) patients without hinge fractures and 11 of 30 (36.7%) patients with hinge fractures. One year later, the hinge fractures were healed in 24/30 patients. Among the six unhealed patients, five still suffered from axial symptoms. The frequency of axial symptoms was higher in the patients with three or more hinge fractures (66.7%) than in the patients with only one (16.7%) or two (46.7%) hinge fractures. CONCLUSIONS: Patients with hinge fractures may have an increased risk for axial symptoms after open-door cervical laminoplasty. The frequency of axial symptoms decreases with fracture healing.

8.
Neurol Sci ; 42(1): 267-274, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32643134

ABSTRACT

BACKGROUND: Deep-brain stimulation is a well-established, effective treatment for patients with advanced Parkinson's disease. Recent studies examining rates of suicide attempts and suicides after deep-brain stimulation in the bilateral subthalamic nucleus have reported varying results. Using this systematic review and meta-analysis, we aim to obtain a comprehensive understanding of suicidality in Parkinson's patients after subthalamic nucleus deep brain stimulation. METHODS: We systematically examined Medline, PubMed, Web of Science, and Embase databases to identify studies published before November 2019 that measured rates of suicidality in Parkinson's patients who underwent subthalamic nucleus stimulation. A meta-analysis of the data from the included studies was conducted using Stata 12.0. RESULTS: A total of 18 studies met the eligibility criteria of this study. We found that the pooled rate of suicidal ideation was 4% (95% CI 0.00-7.2%, range 2-17%). The pooled rate of suicide attempts was 1% (95% CI 1.0-2.0%), while the pooled rate of suicide was 1% (95% CI 0.0-1.0%). CONCLUSIONS: Our findings indicate a relatively high rate of suicidality among Parkinson's patients after subthalamic nucleus deep-brain stimulation. It is important for clinicians to carefully monitor psychiatric disorders, especially suicidal ideation and suicide attempts, in Parkinson's patients before and after subthalamic nucleus deep-brain stimulation.


Subject(s)
Deep Brain Stimulation , Parkinson Disease , Subthalamic Nucleus , Humans , Parkinson Disease/therapy , Suicide, Attempted , Treatment Outcome
9.
BMC Surg ; 21(1): 149, 2021 Mar 20.
Article in English | MEDLINE | ID: mdl-33743668

ABSTRACT

BACKGROUND: Uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (Endo-TLIF) with percutaneous pedicle screw fixation is a promising, minimally invasive method for the treatment of lumbar spondylolisthesis. However, repeated radiation exposure from X-rays and the steep learning curve remain to be improved. METHODS: This retrospective study explored the effects of electromagnetic navigation on improving Endo-TLIF with percutaneous pedicle screw fixation. Clinical information from 42 patients who had received Endo-TLIF with percutaneous pedicle screw fixation from May 2019 to November 2020 was analyzed retrospectively. The procedures were assisted under electromagnetic navigation. The rate of adjustment for guide wires, frequency of X-ray exposure, operative time, accuracy of pedicle screw location, and clinical outcomes were recorded. RESULTS: The mean follow-up for 42 patients was 11.9 ± 3.1 months. The mean age of the patients was 56.1 ± 9.26 years, with a female/male ratio of 25:17. According to postoperative CT scans and 3D reconstructions, the excellent and good rate of pedicle screws was 96.4%. The rate of adjustment for guide wires under the assistance of electromagnetic navigation was 1.78%, and the frequency of X-ray exposure was 8.27 ± 1.83. The operative time was 167.25 ± 28.16 min, including the duration of guide wire insertion (14.63 ± 5.45 min) and duration of decompression and cage placement (75.43 ± 13.97 min). The duration of hospitalization after operation was 2.59 ± 1.16 days. The preoperative VAS score was 7.51 ± 1.91, and the preoperative ODI was 82.42 ± 8.7%. At the last follow-up, the VAS score was 2.09 ± 0.59, and the ODI was 11.09 ± 3.2%. There were statistically significant improvements in the VAS score and ODI in all patients at the follow-up (p < 0.05). CONCLUSIONS: Electromagnetic navigation can provide accurate positioning and guidance in real time, which improves the surgical efficiency of percutaneous pedicle screw placement and endoscopic decompression in Endo-TLIF with reduced radiation exposures.


Subject(s)
Endoscopy , Lumbar Vertebrae , Minimally Invasive Surgical Procedures , Spinal Fusion , Aged , Decompression, Surgical , Electromagnetic Phenomena , Feasibility Studies , Female , Follow-Up Studies , Humans , Lumbar Vertebrae/surgery , Male , Middle Aged , Minimally Invasive Surgical Procedures/methods , Pedicle Screws , Retrospective Studies , Spinal Fusion/methods , Treatment Outcome
12.
J Microencapsul ; 34(8): 707-721, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29141479

ABSTRACT

In this research, firstly astaxanthin (ASX)-loaded nanoemulsions (NEs) were produced using a convenient low-energy emulsion phase inversion method. The optimised ASX-NEs were prepared in the presence of Cremophor® EL and Labrafil® M 1944 CS, with a surfactant-to-oil ratio of 4:6. The ASX-NE droplets were spherical with a mean droplet diameter below 100 nm and a small negative surface charge. The system was stable without alteration of mean droplet diameter for three months. Then, the ASX-NE was functionalised with carboxymethyl chitosan (CMCS) through direct CMCS (0.02%) incorporation during the preparation process. The ASX chemical stability and skin permeability increased in the following order: ASX solution control < ASX-NE < CMCS-ASX-NE. Cell viability assays on L929 cells revealed low cytotoxicity of blank NE, ASX-NE and CMCS-ASX-NE in the range from 5 to 500 µg mL-1. In conclusion, the CMCS-ASX-NE might be a promising delivery vehicle in dermal and transdermal products.


Subject(s)
Antioxidants/administration & dosage , Antioxidants/pharmacokinetics , Chitosan/analogs & derivatives , Pharmaceutical Vehicles/chemistry , Skin Absorption , Administration, Cutaneous , Animals , Antioxidants/chemistry , Chitosan/chemistry , Drug Stability , Emulsifying Agents/chemistry , Emulsions/chemistry , Male , Oils/chemistry , Particle Size , Rats, Sprague-Dawley , Skin/metabolism , Solubility , Water/chemistry , Xanthophylls/administration & dosage , Xanthophylls/chemistry , Xanthophylls/pharmacokinetics
13.
J Orthop Surg Res ; 19(1): 537, 2024 Sep 03.
Article in English | MEDLINE | ID: mdl-39223558

ABSTRACT

BACKGROUND: Posterolateral decompression and fusion with internal fixation is a commonly used surgical approach for treating degenerative lumbar spinal stenosis (DLSS). This study aims to evaluate the impact of preserving a portion of the unilateral facet joint during decompression on surgical outcomes and long-term recovery in patients. METHODS: This study analyzed 73 patients with DLSS accompanied by bilateral lower limb neurological symptoms who underwent single-level L4/5 posterolateral decompression and fusion surgery from January 2022 to March 2023. Patients were categorized into two groups based on the type of surgery received: Group A comprised 31 patients who underwent neural decompression without facet joint preservation, while Group B consisted of 42 patients who underwent neural decompression with preservation of partial facet joints on one side. Regular follow-up evaluations were conducted, including clinical and radiological assessments immediately postoperatively, and at 3 and 12 months thereafter. Key patient information was documented through retrospective chart reviews. RESULTS: Most patients in both groups experienced favorable surgical outcomes. However, four cases encountered complications. Notably, during follow-up, Group B demonstrated superior 1-year postoperative interbody fusion outcomes (P < 0.05), along with a trend towards less interbody cage subsidence and slower postoperative intervertebral disc height loss. Additionally, Group B showed significantly reduced postoperative hospital stay (P < 0.05). CONCLUSION: Under strict adherence to surgical indications, the posterior lateral lumbar fusion surgery, which preserves partial facet joint unilaterally during neural decompression, can offer greater benefits to patients.


Subject(s)
Decompression, Surgical , Lumbar Vertebrae , Spinal Fusion , Spinal Stenosis , Zygapophyseal Joint , Humans , Spinal Stenosis/surgery , Spinal Stenosis/diagnostic imaging , Spinal Fusion/methods , Male , Female , Retrospective Studies , Lumbar Vertebrae/surgery , Lumbar Vertebrae/diagnostic imaging , Aged , Middle Aged , Decompression, Surgical/methods , Zygapophyseal Joint/surgery , Zygapophyseal Joint/diagnostic imaging , Treatment Outcome , Lower Extremity/surgery , Follow-Up Studies
14.
Braz J Med Biol Res ; 57: e13152, 2024.
Article in English | MEDLINE | ID: mdl-38381883

ABSTRACT

The cure rates for osteosarcoma have remained unchanged in the past three decades, especially for patients with pulmonary metastasis. Thus, a new and effective treatment for metastatic osteosarcoma is urgently needed. Anlotinib has been reported to have antitumor effects on advanced osteosarcoma. However, both the effect of anlotinib on autophagy in osteosarcoma and the mechanism of anlotinib-mediated autophagy in pulmonary metastasis are unclear. The effect of anlotinib treatment on the metastasis of osteosarcoma was investigated by transwell assays, wound healing assays, and animal experiments. Related proteins were detected by western blotting after anlotinib treatment, ATG5 silencing, or ATG5 overexpression. Immunofluorescence staining and transmission electron microscopy were used to detect alterations in autophagy and the cytoskeleton. Anlotinib inhibited the migration and invasion of osteosarcoma cells but promoted autophagy and increased ATG5 expression. Furthermore, the decreases in invasion and migration induced by anlotinib treatment were enhanced by ATG5 silencing. In addition, Y-27632 inhibited cytoskeletal rearrangement, which was rescued by ATG5 overexpression. ATG5 overexpression enhanced epithelial-mesenchymal transition (EMT). Mechanistically, anlotinib-induced autophagy promoted migration and invasion by activating EMT and cytoskeletal rearrangement through ATG5 both in vitro and in vivo. Our results demonstrated that anlotinib can induce protective autophagy in osteosarcoma cells and that inhibition of anlotinib-induced autophagy enhanced the inhibitory effects of anlotinib on osteosarcoma metastasis. Thus, the therapeutic effect of anlotinib treatment can be improved by combination treatment with autophagy inhibitors, which provides a new direction for the treatment of metastatic osteosarcoma.


Subject(s)
Bone Neoplasms , Indoles , Lung Neoplasms , Osteosarcoma , Quinolines , Animals , Humans , Cell Proliferation , Osteosarcoma/drug therapy , Osteosarcoma/pathology , Autophagy , Epithelial-Mesenchymal Transition , Bone Neoplasms/drug therapy , Bone Neoplasms/pathology , Cytoskeleton/metabolism , Cell Line, Tumor , Cell Movement , Autophagy-Related Protein 5/pharmacology , Autophagy-Related Protein 5/therapeutic use
15.
Orthop Surg ; 16(2): 401-411, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38151861

ABSTRACT

OBJECTIVE: Traditional manual OLIF combined with pedicle screw implantation has many problems of manual percutaneous screw implantation, such as high difficulty of screw placement, many fluoroscopies, long operation time, and many adjustments, resulting in greater trauma. The robot can perform various types of screw placement in the lateral recumbent position, which allows OLIF combined with posterior screw placement surgery to be completed in a single position. To compare the screw accuracy and initial postoperative results of oblique anterior lumbar fusion with robot-assisted screw placement in the lateral position and screw placement in the prone position for the treatment of lumbar spondylolisthesis. METHODS: From May to June 2022, 45 patients with single-segment lumbar spondylolisthesis underwent Mazor X-assisted oblique lumbar fusion in one position and Renaissance-assisted surgery in two different positions, and screw accuracy was assessed on computed tomography scans according to a modified Gertzbein-Robbins classification. Patients were divided into a single position group and a bipedal position group (the lateral position for complete oblique lumbar fusion and then changed to the prone position for posterior screw placement), and the perioperative parameters, including operative time, number of fluoroscopies, and operative complications, were recorded separately. The results of the clinical indicators, such as the visual analog scale (VAS) for back and leg pain and the Oswestry Disability Index (ODI) score, were obtained. RESULTS: There were no significant differences in the patients' demographic data between the two groups. The single position group had a shorter operative time and fewer fluoroscopies than the bipedal position group; the single position group had a higher percentage of screw accuracy at the A level than the bipedal position group, but there was no statistically significant difference between the two groups at the acceptable level (A + B) (p > 0.05). The single-position group had better outcomes at the 1-week postoperative follow-up back pain VAS scores (p < 0.05). There was no statistically significant difference in the postoperative leg pain VAS scores or the ODI scores when compared to the control group. CONCLUSION: Robot-assisted lateral position oblique lumbar interbody fusion with pedicle screw placement has the same accuracy as prone positioning. Single position surgery can significantly shorten the operation time and reduce the fluoroscopy. There was no significant difference in the long-term efficacy between the two groups.


Subject(s)
Pedicle Screws , Robotics , Spinal Fusion , Spondylolisthesis , Humans , Spondylolisthesis/surgery , Fluoroscopy , Spinal Fusion/methods , Lumbar Vertebrae/surgery , Retrospective Studies , Pain , Treatment Outcome
16.
J Pain Res ; 17: 761-770, 2024.
Article in English | MEDLINE | ID: mdl-38414800

ABSTRACT

Objective: We explore the endoscopic revision and surgical techniques for L4/5 recurrent disc herniation (rLDH) after percutaneous endoscopic transforaminal discectomy (PETD). Methods: A retrospective study was conducted. From January 2016 to September 2022, 96 patients who underwent percutaneous endoscopic lumbar discectomy for L4/5 rLDH after PETD were enrolled in the study. Based on the revision approach, the patients were divided into PETD group (57 cases) and percutaneous endoscopic interlaminar discectomy (PEID) group (39 cases). Visual Analogue Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and modified MacNab standard were recorded to evaluate the clinical outcomes. Results: No significant differences were found in the demographic data and intraoperative blood loss between the two groups (P>0.05), but the time of operation and intraoperative X-ray fluoroscopy exposures in the PEID group were significantly less than that in the PETD group (P<0.05). The patients' postoperative clinical indexes gradually improved, and the VAS score, ODI index, and JOA score of the patients in both groups showed significant improvement compared with the preoperative period at the 1-week, 1-month, and 6-month postoperative follow-ups (P < 0.05). There was no serious complication observed during the follow-up. Conclusion: For recurrent LDH after PETD of L4/5 segments, percutaneous endoscopic revision can achieve satisfactory results. Among them, PEID has a shorter operative and fluoroscopy time and allows avoidance of the scar that forms after the initial surgery, so it can be considered preferred when both procedures can remove the disk well. However, for some specific types of herniation, a detailed surgical strategy is required.

17.
J Mater Chem B ; 12(7): 1816-1825, 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38291968

ABSTRACT

Photodynamic therapy (PDT) has shown great potential for tumor treatment as the method is noninvasive, highly selective, and causes minimal side effects. However, conventional type II PDT, which relies on 1O2, presents poor therapeutic efficacy for hypoxic tumors due to its reliance on oxygen. Here, CeO2/Ti3C2-MXene (CeO2@MXene) hybrids were successfully designed by growing CeO2in situ using Ti3C2-MXene (MXene) nanosheets. CeO2@MXene serves as a reduction-oxidation (REDOX) center due to the presence of Ce in the lattice of CeO2 nanoparticles. This REDOX center reacts with H2O2 to generate oxygen and weakens the hypoxic tumor cell environment, achieving type II PDT. At the same time, many other ROS (such as ⋅O2- and ⋅OH) can be produced via a type I photodynamic mechanism (electron transfer process). The CeO2@MXene heterojunction performs nanoenzymatic functions for synergistic type I and type II PDT, which improves cancer treatment.


Subject(s)
Bone Neoplasms , Nitrites , Osteosarcoma , Transition Elements , Humans , Hydrogen Peroxide , Hypoxia , Oxygen
18.
Global Spine J ; 13(5): 1243-1251, 2023 Jun.
Article in English | MEDLINE | ID: mdl-34519243

ABSTRACT

STUDY DESIGN: Retrospective database study. OBJECTIVES: To compare the accuracy and safety of 2 types of a computer-assisted navigation system for percutaneous pedicle screw placement during endoscopic lumbar interbody fusion. METHODS: From May 2019 to January 2020, data of 56 patients who underwent Endo-LIF with a robot-assisted system and with an electromagnetic navigation system were compared. The pedicles in all patients were subjected to postoperative CT scan to assess screw correction by measuring the perpendicular distance between the pedicle cortical wall and the screw surface. The registration and matching time, guide-wire insertion time, the entire surgery time, and X-ray exposure time were recorded. RESULTS: In the robot-assisted group, 25 cases with 100 percutaneous pedicle screws were included, and the excellent and good rate was 95%. In the electromagnetic navigation group, 31 cases with 124 screws were included, and the excellent rate was 97.6%. There was no statistical difference between the two groups (P > 0.05). The registration time and the total time for the surgery also showed no statistical differences (P > 0.05). The main difference between the two groups was the guide-wire insertion time and the X-ray exposure time (P < 0.05). CONCLUSIONS: Both electromagnetic navigation and robot-assisted are safe and efficient for percutaneous pedicle screw placement. Electromagnetic navigation system has obvious advantages over robot-assisted in terms of faster guide-wire placement and less X-ray exposure. Robot-assisted for percutaneous pedicle screw placement offers a preoperative planning system and a stable registration system, with obvious drawbacks of a strict training curve.

19.
Anticancer Res ; 43(8): 3389-3400, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37500144

ABSTRACT

Osteosarcoma is the most common primary bone malignancy, and surgical resection combined with neoadjuvant chemotherapy is the gold-standard treatment for affected patients. Although the overall survival rates for patients with osteosarcoma currently range from 60% to 70%, outcomes remain disappointing for patients with recurrent, metastatic, or unresectable disease. Irreversible electroporation (IRE) is a novel ablation technique with the potential to elicit an immune response in solid tumors. Dendritic cell (DC)-based tumor vaccines have shown promising therapeutic efficacy in preclinical studies focused on osteosarcoma; however, only limited therapeutic efficacy has been observed in clinical trials. Thus, there is considerable potential therapeutic value in developing combination osteosarcoma treatments that involve IRE and DC-based tumor vaccines. In this review, we discuss recent advances in preclinical and clinical DC-based immunotherapies, as well as potential combinations of DC-based vaccines and IRE, that may improve therapeutic outcomes for patients with osteosarcoma.


Subject(s)
Bone Neoplasms , Cancer Vaccines , Osteosarcoma , Humans , Cancer Vaccines/therapeutic use , Electroporation/methods , Osteosarcoma/therapy , Bone Neoplasms/therapy , Bone Neoplasms/pathology , Dendritic Cells , Treatment Outcome
20.
J Mater Chem B ; 11(17): 3808-3815, 2023 05 03.
Article in English | MEDLINE | ID: mdl-37014659

ABSTRACT

Treatment of large gaps in peripheral nerves is a major clinical challenge. Artificial nerve guidance conduits (NGCs) have provided new opportunities for guiding nerve regeneration. In this study, multifunctional black phosphorus (BP) hydrogel NGCs loaded with neuregulin 1 (Nrg1) were fabricated to support peripheral-nerve regeneration: they exhibited good flexibility and nerve regeneration-related cell induction, promoted Schwann-cell proliferation and accelerated neuron-branch elongation. Nrg1 induced the proliferation and migration of Schwann cells, which had beneficial roles in promoting nerve regeneration. In vivo immunofluorescence studies revealed BP hydrogel NGCs loaded with Nrg1 promoted sciatic-nerve regeneration and axon remyelination. Our method has great potential for promoting treatment of peripheral-nerve injuries.


Subject(s)
Hydrogels , Nerve Growth Factors , Rats , Animals , Hydrogels/pharmacology , Rats, Sprague-Dawley , Sciatic Nerve/physiology , Schwann Cells , Nerve Regeneration/physiology
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