Robot Versus Fluoroscopy-Assisted Vertebroplasty and Kyphoplasty for Osteoporotic Vertebral Compression Fractures: A Systematic Review and Meta-analysis.

OBJECTIVE: This study aimed to conduct a systematic review and meta-analysis to compare the clinical results and complications of robot-assisted (RA) versus fluoroscopy-assisted (FA) percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fractures (OVCFs). METHODS: A comprehensive search of online databases including PubMed, Embase, Cochrane Library, web of science, and core journals of China National Knowledge Infrastructure were performed to identify related studies reporting the clinical results and complications of RA versus FA-assisted PVA in the treatment of OVCFs. The rate of bone cement leakage was used to assess the complications. After the surgery, the clinical findings were analyzed using the Visual Analog Scale scores and the Oswestry Disability Index scores. The surgical time, intraoperative fluoroscopy frequency, and x-ray exposure duration were used to evaluate the perioperative results. Forest plots were constructed to investigate the results. RESULTS: RA-PVA had a significantly lower bone cement leakage rate, shorter fluoroscopy frequency, and shorter radiation exposure time of doctors compared with FA-PVA. However, no significant differences were found between RA-PVA and FA-PVA in operative time and radiation exposure time of patients. Furthermore, no statistically differences were found between the 2 groups in Visual Analog Scale and Oswestry Disability Index scores after surgery. CONCLUSIONS: This meta-analysis showed that RA-PVA can reduce bone cement leakage rate, fluoroscopy frequency, and doctors' radiation exposure time. With the advancement of RA technology, we anticipate more high-quality randomized controlled trials of RA versus FA-PVA in the future to validate and update the results of this analysis.

Integrated System for Purification and Assembly of PCV Cap Nano Vaccine Based on Targeting Peptide Ligand.

PURPOSE: The vaccine design has shifted from attenuated or inactivated whole pathogen vaccines to more pure and defined subunit vaccines. The purification of antigen proteins, especially the precise display of antigen regions, has become a key step affecting the effectiveness of subunit vaccines. MATERIALS AND METHODS: This work presents the application of molecular docking for a peptide ligand designed for PCV2 Cap purification and assembly in one step. Based on the PCV2 Cap protein affinity peptide (L11-DYWWQSWE), the amino terminal of PCV2 Cap was covalently coupled with the polylactic acid-glycolic acid copolymer (PLGA) carboxyl terminal through the EDC/NHS method. RESULTS: The PLGA had an average diameter of 106 nm. The average diameter increased to 122 nm after the PCV2 Cap protein conjugation, and the Zeta potential shifted from -13.7 mV to -9.6 mV, indicating that the PCV2 Cap protein stably binds to the PLGA. Compared with the free PCV2 Cap protein group, the neutralizing antibody titer was significantly increased on the 14th day after the PLGA-Cap immunization (P < 0.05). The neutralizing antibody level was extremely significant on the 28th day (P < 0.001). The CCK-8 analysis showed that PLGA-Cap had an obvious cytotoxic effect on RAW264.7 cells at the PLGA nanoparticle concentration up to 200 µg/mL but had no obvious cytotoxic effect on DC2.4 cells. Compared with the Cap protein group, the antigen-presenting cells had a stronger antigen uptake capacity and a higher fluorescence in the PLGA-Cap group. The immune effect showed that the level of the neutralizing antibody produced by this structure is much better than that of purified protein and helps improve the immune system response. CONCLUSION: This technology provides a potential new perspective for the rapid enrichment of the antigen protein with the affinity peptide ligand.

Profiles of antibiotic resistance genes and virulence genes and their temporal interactions in the membrane bioreactor and oxidation ditch.

Antibiotic resistance genes (ARGs) and virulence genes (VGs) in wastewater treatment plants (WWTPs) may pose a potential threat to public health if without proper treatment. In this study, GeoChip was used to reveal the differences in ARG/VG diversity between a membrane bioreactor (MBR) and an oxidation ditch (OD) and the temporal co-occurrence patterns between ARGs and VGs. Results showed that the diversity of ARGs and VGs was lower in MBR than that in OD in the short term due to the better disinfection capability of MBR. However, the differences in diversity between two reactors disappeared in the long term because of the great variation of temperature. Instead, time-decay relationship was observed and overall turnover rate was -0.0105. Co-occurrence patterns indicate that direct connections between ARGs and VGs reduced sharply with time increasing due to the different responses of ARGs and VGs to environmental variation.

Diversity and interactions of microbial functional genes under differing environmental conditions: insights from a membrane bioreactor and an oxidation ditch.

The effect of environmental conditions on the diversity and interactions of microbial communities has caused tremendous interest in microbial ecology. Here, we found that with identical influents but differing operational parameters (mainly mixed liquor suspended solid (MLSS) concentrations, solid retention time (SRT) and dissolved oxygen (DO) concentrations), two full-scale municipal wastewater treatment systems applying oxidation ditch (OD) and membrane bioreactor (MBR) processes harbored a majority of shared genes (87.2%) but had different overall functional gene structures as revealed by two datasets of 12-day time-series generated by a functional gene array-GeoChip 4.2. Association networks of core carbon, nitrogen and phosphorus cycling genes in each system based on random matrix theory (RMT) showed different topological properties and the MBR nodes showed an indication of higher connectivity. MLSS and DO were shown to be effective in shaping functional gene structures of the systems by statistical analyses. Higher MLSS concentrations resulting in decreased resource availability of the MBR system were thought to promote positive interactions of important functional genes. Together, these findings show the differences of functional potentials of some bioprocesses caused by differing environmental conditions and suggest that higher stress of resource limitation increased positive gene interactions in the MBR system.

Irradiation for locoregionally recurrent, never-irradiated oral cavity cancers.

BACKGROUND: The purpose of this study was to report the clinical outcomes and related prognostic factors of patients who underwent radiotherapy (RT) for the treatment of recurrent, never-irradiated oral cavity cancer (recurrent OCC). METHODS: The records of consecutive patients with nonmetastatic recurrent OCC who presented to and were treated with RT at our institution between 1989 and 2011 were reviewed. The Kaplan-Meier method was used to calculate overall survival (OS). The cumulative incidences of disease-specific death, local failure, regional failure, and distant metastasis were calculated with death as a competing risk. RESULTS: One hundred twenty-three patients were identified. Median follow-up for living patients was 54 months and 16 months for all patients. Ninety-one patients had salvage surgery followed by adjuvant RT. Definitive RT was utilized in the remaining 32 patients. The 5-year OS was 40%. The 5-year cumulative incidence of disease-specific death, local failure, regional failure, and distant metastasis was 55%, 34%, 22%, and 20%, respectively. Recurrent T classification and lack of salvage surgery were independently associated with worse disease-specific death and decreased OS, respectively. Subset analysis of patients who underwent salvage surgery demonstrated that age, recurrent T classification, and perineural invasion (PNI) were independently associated with decreased OS; recurrent T classification and thicker tumors were independently associated with worse disease-specific death; and positive/close margins and primary T classification were independently associated with increased local failure. CONCLUSION: In this group of patients with recurrent OCC, clinical outcomes were similar or improved when compared with other recurrent OCC-specific reports. In the salvage surgery subset, tumor thickness and PNI are recurrent pathologic features associated with outcomes that were only previously demonstrated in studies of primary disease. Because of the relatively worse outcomes in patients receiving definitive or adjuvant RT for recurrent OCC, we advocate for the appropriate use of postoperative RT in the initial management of oral cavity cancers.

Microbial community structures in different wastewater treatment plants as revealed by 454-pyrosequencing analysis.

In this study, 454-pyrosequencing technology was employed to investigate the microbial communities in 12 municipal wastewater treatment plants (WWPTs) with different treatment processes. In total, 202,968 effective sequences of the 16S rRNA gene were generated from 16 samples that widely represented the diversity of the microbial communities. While Proteobacteria was found to be the dominant phylum in some samples, in other samples it was Bacteroidetes. The Simpson's diversity index and evenness index were lowest in samples from membrane bioreactors (MBRs), possibly due to the long sludge retention time (SRT) and low food/microorganism ratio (F/M). For one WWTP which had two disparate treatment processes operating in parallel, the structures of microbial communities in the two systems were compared. The differences found between the two indicated that the treatment process likely had effects on the structure of microbial communities.

Reconstruction of curved mandibular angle defects using a new internal transport distraction device: an experiment in goats.

A new internal distraction device, comprising a square-bodied bow, a transport plate, a traction mechanism, and two stabilisers, was developed to allow transportation of bone around an arc. Eight adult goats were studied. A curved mandibulectomy 3cm long was made on the mandibular angle. The distractor was implanted to restore the defect. The bone was distracted at a rate of 1mm per day after a 5-day latent period. Distraction lasted 25 to 32 days. Curvilinear distraction was successful in six of the eight goats. After consolidation periods of four or eight weeks, smooth curved bone masses were restored in the distracted areas. Radiographically, there was considerable bone density in the distraction area and opaque columns streamed in the direction of distraction. Histological examination showed membranous bony regeneration in the restored bone. These results suggest that restoration of curved bone defects using the new internal transport distraction device was feasible in goats.