Chronic cauda equina syndrome decompression surgery recovery is very "bad"? Based on patient self-assessment.

BACKGROUND: Symptoms of cauda equina syndrome (CES) secondary to degenerative lumbar spine diseases are sometimes mild and tend to be ignored by patients, resulting in delayed treatment. In addition, the long-term efficacy of surgery is unclear. OBJECTIVE: To determine the predictive factors of CES and post-operative recovery in patients with symptoms lasting > 3 months. METHODS: From January 2011 to December 2020, data of 45 patients with CES secondary to lumbar disk herniation/lumbar spinal stenosis were collected from a single center. The patients had bladder, bowel or sexual dysfunction and decreased perineal sensation that lasted for > 3 months. A 2-year post-operative follow-up was conducted to evaluate recovery outcomes, which were measured by validated self-assessment questionnaires conducted by telephone and online. RESULTS: Overall, 45 CES patients (57.8% female; mean age, 56 years) were included. The duration of pre-operative CES symptoms was 79.6 weeks (range, 13-730 weeks). The incidence of saddle anesthesia before decompression was 71.1% (n = 32), bladder dysfunction 84.4% (n = 38), bowel dysfunction 62.2% (n = 28) and sexual dysfunction 64.4% (n = 29). The overall recovery rate of CES after a 2-year follow-up was 64.4%. The rates of the residual symptoms at the last follow-up were as follows: saddle anesthesia 22.2%, bladder dysfunction 33.3%, bowel dysfunction 24.4% and sexual dysfunction 48.9%. Pre-operative saddle anesthesia, overactive bladder and sexual dysfunction were risk factors for poor prognosis after decompression. CONCLUSION: CES patients with symptoms lasting > 3 months may recover after surgery. Sexual dysfunction has a high residual rate and should not be ignored during diagnosis and treatment.

Hemin functionalized hybrid aerogel-enabled electrochemical chip for real-time analysis of H2O2.

Herein, a novel hemin functionalized hybrid aerogel (He@GMA) is synthesized and applied to an electrochemical chip for real-time analysis of hydrogen peroxide (H2O2). The He@GMA shows a typical three-dimensional morphology and excellent peroxidase-like catalytic performance. The He@GMA-enabled electrochemical chip presents satisfactory performance for H2O2 sensing with a low limit of detection (0.96 µM). Besides, the chip platform shows some advantages of less sample consumption and easier detection operation.

Enhancement of N-heterocyclic carbenes on rhodium catalyzed olefination of triazoles.

A few rhodium complexes of N-heterocyclic carbenes were prepared through carbene transfer reactions and their structures were characterized by X-ray diffraction analysis. The rhodium complexes of NHCs are found to be efficient catalysts for vinylation of various triazoles via C-H activation. A number of double vinylated triazoles can be obtained in good yields.

Copper-catalyzed cascade cyclization reaction of 2-haloaryltriazenes and sodium azide: selective synthesis of 2H-benzotriazoles in water.

A new approach to the synthesis of 2H-benzotriazoles is described. This strategy is based on the copper-catalyzed C-N coupling of 2-haloaryltriazenes or 2-haloazo compounds with sodium azide and the intramolecular addition of nitrene to N=N bonds. This approach allows the synthesis of various N-amino- and N-aryl-2H-benzotriazoles in water, in good to excellent yields. The procedure is simple and the starting materials and catalyst are easily available, offering a practical and convenient synthetic route to 2-substituted benzotriazoles.

Prevalence, distribution characteristic and risk factors of lumbar vertebral axial rotation in patients with lumbar disc herniation: a retrospective study.

This retrospective study aimed to investigate the impact of lumbar disc herniation (LDH) on vertebral axial rotation (VAR) in the lumbar spine, focusing on both close and distant neighboring vertebrae. A total of 516 patients with LDH and an equal number of healthy individuals were included in the study, matched for age and gender. The degree of axial rotation for each lumbar spine vertebra was assessed using the Nash-Moe index. The results revealed that the prevalence of VAR in the lumbar spine was significantly higher in the LDH group compared to the Control group (65.7% vs 46.7%, P < 0.001). Among the LDH group, the L2 vertebra had the highest frequency of VAR (49.5%), followed by L1 (45.1%), and then L3 to L5 (33.6%, 8.9%, 3.1%, respectively). A similar pattern was observed in the Control group (L2, 39.8%; L1, 34.6%; L3, 23.2%; L4, 3.1%; L5, 0.8%). Furthermore, the study found that disc herniation was associated with a higher incidence of VAR not only in close neighboring vertebrae but also in distant neighboring vertebrae. This indicates that the biomechanical influence of LDH extends beyond just the immediate adjacent vertebrae. To identify potential risk factors for VAR in LDH patients, multivariate analysis was performed. The results revealed that age was an independent risk factor for VAR (OR 1.022, 95% CI [1.011, 1.034], P < 0.001). However, the duration of symptoms and presence of back pain were not found to be significant risk factors for VAR.

How to assess the long-term recovery outcomes of patients with cauda equina syndrome before surgery: a retrospective cohort study.

BACKGROUND: Factors influencing recovery after decompression surgery for cauda equina syndrome (CES) are not completely identified. The authors aimed to investigate the most valuable predictors (MVPs) of poor postoperative recovery (PPR) in patients with CES and construct a nomogram for discerning those who will experience PPR. METHODS: Three hundred fifty-six patients with CES secondary to lumbar degenerative diseases treated at Xijing Hospital were randomly divided into training ( N =238) and validation ( N =118) cohorts at a 2:1 ratio. Moreover, 92 patients from the 970 th Hospital composed the testing cohort. Least Absolute Shrinkage and Selection Operator regression (LASSO) was used for selecting MVPs. The nomogram was developed by integrating coefficients of MVPs in the logistic regression, and its discrimination, calibration, and clinical utility were validated in all three cohorts. RESULTS: After 3 to 5 years of follow-up, the residual rates of bladder dysfunction, bowel dysfunction, sexual dysfunction, and saddle anesthesia were 41.9, 44.1, 63.7, and 29.0%, respectively. MVPs included stress urinary incontinence, overactive bladder, low stream, difficult defecation, fecal incontinence, and saddle anesthesia in order. The discriminatory ability of the nomogram was up to 0.896, 0.919, and 0.848 in the training, validation, and testing cohorts, respectively. Besides, the nomogram showed good calibration and clinical utility in all cohorts. Furthermore, the optimal cutoff value of the nomogram score for distinguishing those who will experience PPR was 148.02, above which postoperative outcomes tend to be poor. CONCLUSION: The first pretreatment nomogram for discerning CES patients who will experience PPR was developed and validated, which will aid clinicians in clinical decision-making.

Expression profiling of mRNA and functional network analyses of genes regulated by human papilloma virus E6 and E7 proteins in HaCaT cells.

Human papillomavirus (HPV) oncogenes E6 and E7 are essential for HPV-related cancer development. Here, we developed a cell line model using lentiviruses for transfection of the HPV16 oncogenes E6 and E7 and investigated the differences in mRNA expression during cell adhesion and chemokine secretion. Subsequently, RNA sequencing (RNA-seq) analysis was performed to explore the differences in mRNA expression. Compared to levels in the control group, 2,905 differentially expressed mRNAs (1,261 downregulated and 1,644 upregulated) were identified in the HaCaT-HPV16E6E7 cell line. To predict the functions of these differentially expressed genes (DEGs) the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes databases were used. Protein-protein interactions were established, and the hub gene was identified based on this network. Real-time quantitative-PCR (RT-qPCR) was conducted to confirm the levels of 14 hub genes, which were consistent with the RNA-seq data. According to this, we found that these DEGs participate in the extracellular matrix (ECM), cell adhesion, immune control, and cancer-related signaling pathways. Currently, an increasing number of clinicians depend on E6/E7mRNA results to make a comprehensive judgment of cervical precancerous lesions. In this study, 14 hub genes closely related to the expression of cell adhesion ability and chemokines were analyzed in HPV16E6E7-stably expressing cell lines, which will open up new research ideas for targeting E6E7 in the treatment of HPV-related cancers.

Automated, portable, and high-throughput fluorescence analyzer (APHF-analyzer) and lateral flow strip based on CRISPR/Cas13a for sensitive and visual detection of SARS-CoV-2.

COVID-19 has erupted and quickly swept across the globe, causing huge losses to human health and wealth. It is of great value to develop a quick, accurate, visual, and high-throughput detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we developed a biosensor based on CRISPR/Cas13a combined with recombinase polymerase amplification (RPA) to detect S and Orf1ab genes of SARS-CoV-2 within 30 min. Most important of all, we developed an automated, portable, and high-throughput fluorescence analyzer (APHF-analyzer) with a 3D-printed microfluidic chip for sensitively detecting SARS-CoV-2, which addressed aerosol contamination issue and provided a more accurate and high-throughput detection during the on-site detection process. The detection limits of S gene and Orf1ab gene were as low as 0.68 fM and 4.16 fM. Furthermore, we used the lateral flow strip to realize visualization and point of care testing (POCT) of SARS-CoV-2. Therefore, profit from the efficient amplification of RPA and the high specificity of CRISPR/Cas13a, APHF-analyzer and the lateral flow strip to simultaneous detection of S gene and Orf1ab gene would be applied as a promising tool in the field of SARS-CoV-2 detection.

Hemin-Functionalized Microfluidic Chip with Dual-Electric Signal Outputs for Accurate Determination of Uric Acid.

Herein, we develop a hemin-functionalized microfluidic chip with dual-electric signal outputs for accurate determination of uric acid (UA). Hemin is designed as the catalyst, which could trigger a built-in reference signal. Carbon nanotube (CNT) and alkalinized titanium carbide (alk-Ti3C2Tx) are used as attachment substrates to strengthen the signal. Benefiting from the synergistic action of hemin, CNT, and alk-Ti3C2Tx, the hybrid functionalized sensor shows prominent electrochemical capacity, desirable catalytic activity, and unique built-in signal ability. Through density functional theory calculations, the structure-reactivity relationship and possible signal output mechanism are deeply investigated. The functionalized sensor is further integrated into a microfluidic chip to prepare a portable electrochemical sensing platform, in which multiple sample processing steps including primary filtration, target enrichment, and reliable analysis can be conducted step-by-step. Based on the abovementioned designs, the developed functionalized microfluidic platform presents desirable performance in UA determination with a detection limit of 0.41 µM. Furthermore, it is capable of accurately detecting UA in urine samples, providing a promising idea for biomolecule monitoring.

Mechanism study of how lipid vesicle electroformation is suppressed by the presence of sodium chloride.

Giant lipid vesicles (GLVs) are usually adopted as models of cell membranes and electroformation is the most commonly used method for GLV formation. However, GLV electroformation are known to be suppressed by the presence of salt and the mechanism is not clear so far. In this paper, the lipid hydration and GLV electroformation were investigated as a function of the concentration of sodium chloride by depositing the lipids on the bottom substrates and top substrates. In addition, the electrohydrodynamic force generated by the electroosmotic flow (EOF) on the lipid phase was calculated with COMSOL Multiphysics. It was found that the mechanisms for the failure of GLV electroformation in salt solutions are: 1) the presence of sodium chloride decreases the membrane permeability to aqueous solution by accelerating the formation of well-packed membranes, suppressing the swelling and detachment of the lipid membranes; 2) the presence of sodium chloride decreased the electrohydrodynamic force by increasing the medium conductivity.

Efficient Approach to Mesoionic Triazolo[5,1-a]isoquinolium through Rhodium-Catalyzed Annulation of Triazoles and Internal Alkynes.

Rhodium-catalyzed annulation reactions between triazoles and internal alkynes, leading to various mesoionic isoquinoliums, are described. The reaction involves sequential triazole-directed C-H activation and C-C, C-N, and C-O bond formation processes in a one-pot manner. The starting materials and catalysts are easily available. The reaction offers a facile and practical approach to mesoionic isoquinolium derivatives.