Posterior Vertebrectomy via the Unilateral Pedicle or Bilateral Pedicle Approach in the Treatment of Lumber Burst Fracture with Neurological Deficits: A Comparative Retrospective Cohort Study.

BACKGROUND Posterior vertebrectomy with bilateral pedicle approach (BPA) is widely applied in lumber burst fracture (LBF). However, some disadvantages exist, such as a prolonged operation time, extensive soft tissue injury, and excessive blood loss. Posterior vertebrectomy with unilateral pedicle approach (UPA) is a novel technique for decompression of spinal canal. Thus, we explored the potential of UPA to achieve better outcomes than BPA. MATERIAL AND METHODS Of 47 patients who underwent posterior vertebrectomy for LBF, 23 patients were treated with UPA and 24 patients were treated with BPA. Clinical and radiographical outcomes were assessed with a follow-up of more than 24 months. Patients were evaluated before and after surgery according to the following parameter: duration of operation (DO), blood loss volume (BLV), the kyphotic angle (KA), the ratio of the height of anterior vertebral edge, the ratio of the sagittal injury, visual analog scale (VAS), Oswestry Disability Index (ODI), and Frankel scores. RESULTS The follow-up time ranged from 24 to 37 months (average 26.4 months). The UPA group had significantly decreased DO and BLV (P<0.05). The 2 cohorts showed similar performance at 6 months (P>0.05), 12 months (P>0.05), and 24 months (P>0.05) post-surgery, in terms of parameters including KA, the ratio of the vertebral anterior, the ratio of sagittal damage, Frankel scores, ODI, and VAS. CONCLUSIONS UPA and BPA had a similar clinical performance for LBF. However, the shorter DO and lower BLV achieved in the UPA cohort suggested UPA is a better alternative for LBF.

Experimental Investigation on the Pyrolysis and Conversion Characteristics of Organic-Rich Shale by Supercritical Water.

Organic-rich shale oil reservoirs with low-medium maturity have attracted increasing attention because of their enormous oil and gas potential. In this work, a series of experiments on pyrolysis of the particle and core samples were carried out in a self-made supercritical water pyrolysis apparatus to evaluate the feasibility and benefits of supercritical water in promoting the transformation efficiency and oil yield of the low-medium maturity organic-rich shale. Core samples had a mass loss of 8.4% under supercritical water pyrolysis, and many microcracks were generated, which increased the pyrolysis efficiency substantially. The oil yield of shale pyrolysis could reach 72.40% under supercritical water conditions at 23 MPa and 400 °C, which was 53.02% higher than that under anhydrous conditions. In supercritical water conditions, oxygen-containing compounds are less abundant than in anhydrous conditions, suggesting that supercritical water can inhibit their formation. Also, supercritical water conditions produced higher yields for light fraction, medium fraction, and heavy fraction shale oil than those under anhydrous conditions. These results indicate that supercritical water pyrolysis is feasible and has excellent advantages for low-medium maturity organic-rich shale.

Treating Lumbar Fracture Using the Mixed Reality Technique.

The mixed reality (MR) technique has recently been widely used in the orthopedic surgery with satisfactory results reported. However, few studies have focused on the application of MR in the Lumbar fracture (LF). In this retrospective study, our aim is to analyze some findings by investigating the feasibility of MR applied to lumbar fracture treatment. Posterior vertebrectomy has been operated on 7 patients. The MR-based intraoperative three-dimensional image-guided navigation system (MITINS) was used to assist implantation of pedicle screws. The feasibility and safety of pedicle screw implantation were assessed by postsurgery radiography. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to assess the pain level and recovery situation before and after surgery. 57 pedicle screws were safely and precisely placed into three-dimensional lumbar models by using MITINS. No screw was found outside the pedicle of the models, and it was not necessary for the X-ray to provide extra locative information during the operation with the use of MITINS. In summary, the application of MITINS is feasible, safe, and accurate while the lumbar fracture surgery is processing, providing satisfactory assistance for spine surgeons.

Lessons from a lumbar burst fracture patient infected with SARS-CoV-2.

In December 2019, the 2019 novel coronavirus (SARS-CoV-2) began spreading in China. At present, there are no special protocols for treating lumbar burst fracture (LBF) patients infected with SARS-CoV-2. Here, we present our lessons and experiences with a patient presenting with a severe LBF complicated by an occult SARS-CoV-2 infection. The clinical data for a 52-year-old male LBF patient were collected during the incubation period of COVID-19. The patient exhibited no obvious COVID-19-related symptoms prior to his surgery, and his vital signs were stable on the first day after the operation. By postoperative day 3, however, the patient was exhibiting chills and high fever. A chest CT showed a patchy high-density shadow surrounded by ground-glass opacity in the lower portion of his right lung. A nucleic acid test for SARS-CoV-2 was positive, and the patient was then transferred to the Department of Infectious Disease for further special treatment. This case taught that when treating patients with severe trauma within an epicenter of this pandemic, it is crucial for healthcare workers to be vigilant so as to avoid potential widespread outbreaks of COVID-19 within hospitals.

MicroRNA-21-3p accelerates diabetic wound healing in mice by downregulating SPRY1.

A variety of novel drugs and advanced therapeutic strategies have been developed for diabetic foot ulcers (DFUs); however, the clinical outcomes are unsatisfactory and the underlying mechanisms of DFU remain elusive. MicroRNAs (miRNA) regulate the pathological processes of many diseases. Fibroblasts are involved in each stage of wound healing, and the functions of fibroblasts may be regulated by miRNAs. In the present study, we found that the levels of miRNA-21-3p (miR-21-3p) were decreased in patients with diabetes as compared with those in the healthy control. Similarly, the level of miRNA-21-3p was decreased in fibroblasts that were stimulated with D-glucose as compared with that in the control fibroblasts. Furthermore, enhanced function was found in fibroblasts followed by the miR-21-3p agonist treatment, and a rapid wound healing process was achieved in the miR-21-3p agonist-treated mice. MiR-21-3p directly targeted protein sprout homolog 1 (SPRY1), and the miR-21-3p-regulated reduction in SPRY1 enhanced the function of fibroblasts and accelerated wound healing in vivo. These findings suggest that miR-21-3p may treat DFU by reducing SPRY1.