Comparative Study of Unilateral Biportal Endoscopic and Traditional Open Surgery in the Treatment of Lumbar Disc Herniation.

Objective: We aimed to compare the efficacy of unilateral biportal endoscopic (UBE) surgery and traditional open surgery in the treatment of lumbar disc herniation (LDH). The complications and learning curve of UBE surgery are also discussed. Methods: Clinical data from 66 patients with single-level LDH admitted to Dezhou Hospital, Qilu Hospital of Shandong University in China from May 2020 to December 2021 were retrospectively analyzed. The patients were divided into the UBE surgery group and the traditional open surgery group according to patient choice. Intraoperative bleeding; surgery duration; length of hospital stay; preoperative visual analogue scale (VAS); VAS score 1 week after surgery, 1 month after surgery, 3 months after surgery and 6 months after surgery; early complications; chronic low back pain 1 year after surgery; Oswestry Disability Index (ODI) before surgery and 6 months after surgery were compared between the 2 groups. Results: Postoperative VAS and ODI scores in the 2 groups were significantly lower than before surgery (P < .05). There were significant differences in intraoperative bleeding, duration of surgery, length of hospital stay, VAS score 1 week after operation and 1 month after operation, postoperative white blood cells (WBCs), early complications and long-term chronic low back pain in the 2 groups (P < .05). There was no significant difference in VAS score 3 or 6 months after surgery or ODI score 6 months after surgery between the 2 groups (P > .05). Conclusion: Both UBE and traditional open surgery are effective in the treatment of LDH. Early pain relief was significantly better in the UBE surgery group than the traditional open surgery group, and the UBE group had a lower incidence of long-term chronic low back pain than the traditional open surgery group. However, but the number of early complications in the UBE group was higher than in the traditional open surgery group.

Melatonin through blockade of Hif-1α signaling mediates the anti-fibrosis under hypoxia in canine Sertoli cells.

The hypoxic microenvironment of cryptorchidism is an important factor in the impairment and fibrosis of Sertoli cells which result in blood-testis barrier (BTB) destruction and spermatogenesis loss. Recent studies have shown that melatonin, a well-known pineal hormone exerts beneficial effects against pathological fibrosis in a various of organs. However, it is still unknown whether melatonin can regulate hypoxia-induced fibrosis of Sertoli cells. In this study we evaluate melatonin levels, and its synthesizing enzymes, AANAT and HIOMT expression patterns in canine cryptorchidism and contralateral normal testis. Results show abdominal testes presented low melatonin levels and AANAT and HIOMT expression compared with testes located in the scrotum. Moreover, we established a hypoxia-induced fibrosis model in canine Sertoli cells induced by cobalt chloride (CoCl2) and found that melatonin inhibited the EMT markers expression and ECM production as well as Hif-1α expression of Sertoli cells in a dose-dependent manner. Furthermore, use of Lificiguat (synonyms YC-1, Hif-1α inhibitor) to interfere with the Hif-1α pathway showed a similar effect with melatonin suppression of the fibrosis in Sertoli cells. The results indicate that melatonin supplementation can alleviate the fibrosis process of Sertoli cells caused by hypoxia, which is associated with regulating the inhibition of Hif-1α signaling.