Breaking Through the Trade-Off Between Wide Band Gap and Large SHG Coefficient in Mercury-Based Chalcogenides for IR Nonlinear Optical Application.

It is substantially challenging for non-centrosymmetric (NCS) Hg-based chalcogenides for infrared nonlinear optical (IR-NLO) applications to realize wide band gap (Eg > 3.0 eV) and sufficient phase-matching (PM) second-harmonic-generation intensity (deff > 1.0 × benchmark AgGaS2 ) simultaneously due to the inherent incompatibility. To address this issue, this work presents a diagonal synergetic substitution strategy for creating two new NCS quaternary Hg-based chalcogenides, AEHgGeS4 (AE = Sr and Ba), based on the centrosymmetric (CS) AEIn2 S4 . The derived AEHgGeS4 displays excellent NLO properties such as a wide Eg (≈3.04-3.07 eV), large PM deff (≈2.2-3.0 × AgGaS2 ), ultra-high laser-induced damage threshold (≈14.8-15 × AgGaS2 ), and suitable Δn (≈0.19-0.24@2050 nm), making them highly promising candidates for IR-NLO applications. Importantly, such excellent second-order NLO properties are primarily attributed to the synergistic combination of tetrahedral [HgS4 ] and [GeS4 ] functional primitives, as supported by detailed theoretical calculations. This study reports the first two NCS Hg-based materials with well-balanced comprehensive properties (i.e., Eg > 3.0 eV and deff > 1.0 × benchmark AgGaS2 ) and puts forward a new design avenue for the construction of more efficient IR-NLO candidates.

Rational Design of a Rare-Earth Oxychalcogenide Nd3 [Ga3 O3 S3 ][Ge2 O7 ] with Superior Infrared Nonlinear Optical Performance.

Inorganic chalcogenides have been studied as the most promising infrared (IR) nonlinear optical (NLO) candidates for the past decades. However, it is proven difficult to discover high-performance materials that combine the often-incompatible properties of large energy gap (Eg ) and strong second harmonic generation (SHG) response (deff ), especially for rare-earth chalcogenides. Herein, centrosymmetric Cs3 [Sb3 O6 ][Ge2 O7 ] is selected as a maternal structure and a new noncentrosymmetric rare-earth oxychalcogenide, namely, Nd3 [Ga3 O3 S3 ][Ge2 O7 ], is successfully designed and obtained by the module substitution strategy for the first time. Especially, Nd3 [Ga3 O3 S3 ][Ge2 O7 ] is the first case of breaking the trade-off relationship between wide Eg (>3.5 eV) and large deff (>0.5 × AgGaS2 ) in rare-earth chalcogenide system, and thus displays an outstanding IR-NLO comprehensive performance. Detailed structure analyses and theoretical studies reveal that the NLO effect originates mainly from the cooperation of heteroanionic [GaO2 S2 ] and [NdO2 S6 ] asymmetric building blocks. This work not only presents an excellent rare-earth IR-NLO candidate, but also plays a crucial role in the rational structure design of other NLO materials in which both large Eg and strong deff are pursued.

Vertebroplasty combined with facet joint block vs. vertebroplasty alone in relieving acute pain of osteoporotic vertebral compression fracture: a randomized controlled clinical trial.

OBJECTIVE: The study objective was to compare the efficacy and safety of percutaneous vertebroplasty (PVP) combined with facet joint block (FB) and vertebroplasty alone in relieving acute pain on osteoporotic vertebral compression fractures (OVCFs). METHODS: A prospective, randomized controlled study was conducted. One hundred ninety-eight patients of OVCFs undergoing surgery were randomly divided into two groups: Group P (PVP, n = 97), Group PF (PVP + FB, n = 101). The Visual analogue scale (VAS) and Oswestry disability index (ODI) were measured during pre-operation, 1 day, 1, 3, 6 and 12 months after the operation, respectively. The hospitalization time, operation time, complications, recurrence, the mean amount of cement injected and the number of patients who applied Cox-2 inhibitors within 3 days after operation were compared in the two groups. RESULTS: The VAS and ODI scores at each observation point of the post-operation were significantly decreased than that at the pre-operation in both groups (P < 0.05). The VAS and ODI scores in Group PF were significantly lower than that in Group P 1 day and 1 month after the operation (P < 0.05). The number of patients who applied Cox-2 inhibitors within 3 days after operation in group PF was significantly lower that in Group P (P < 0.001). There was no significant difference in hospitalization time, operation time, the mean amount of cement injected, complication rate, VAS and ODI scores at the pre-operation (P > 0.05). CONCLUSION: Both PVP combined with FB and PVP alone are effective treatment methods for OVCFs. But PVP combined with FB showed better back pain relief than PVP alone in the short term after the operation for OVCFs.

Comparison of clinical outcomes with proximal femoral nail anti-rotation versus bipolar hemiarthroplasty for the treatment of elderly unstable comminuted intertrochanteric fractures.

BACKGROUND: Although proximal femoral nail anti-rotation (PFNA) and bipolar hemiarthroplasty (BHA) are selected by most of the orthopaedic surgeons for elderly intertrochanteric fractures (ITFs) patients, there is still no consensus on the superiority of PFNA and BPH for the elderly with unstable comminuted ITFs. The study aims to compare the curative effects of PFNA and cementless BHA on unstable comminuted ITFs in the elderly. METHODS: From January 2012 to December 2016, we retrospectively reviewed 62 ITFs patients up to the inclusion and exclusion criteria in the study. Depending on the type of surgery, the patients were divided into two groups: Group BHA (n= 30) and Group PFNA (n = 32). The ITFs were classified according to Evans-Jensen. Hospitalization time, operation time, bleeding loss, weight bearing duration, Harris hip scores, 10-m walking speed, gait and postoperative complications were compared between the two groups. RESULTS: There was no significant difference between the groups in hospital stay (P > 0.05). The BHA group trended to have a shorter operation time and a larger volume of blood loss (P < 0.01).The weight bearing duration was shorter in the BHA group than the PFNA group (P < 0.05).The Harris hip score was higher, the 10-m walking speed was faster and the gait was better in group BHA than group PFNA at three months postoperatively (P < 0.05), but there was no significant difference between the two groups at 6 and 12 months postoperatively (P > 0.05). There was no significant difference in postoperative complications between the two groups (P > 0.05). CONCLUSION: The BHA allows an earlier return to weight-bearing activity, but ultimately has the same effective treatments as the PFNA for the elderly with unstable comminuted ITFs.

Transforaminal epidural steroid injection combined with radio frequency for the treatment of lumbar disc herniation: a 2-year follow-up.

BACKGROUND: To assess the therapeutic efficacy of transforaminal epidural steroid injection (TFESI) combined with radio frequency (RF) for the treatment of lumbar disc herniation (LDH). METHODS: A total of 230 patients participated in the study: TFESI (Group T, n = 110), TFESI combined with RF (Group TR, n = 120). Visual analogue scale (VAS), Oswestry disability index (ODI) and Global perceived effect (GPE) scale were measured pre-operation, 1, 3, 6, 12 and 24 months after the operation. Hospitalization time, treatment time, complications, and recurrence were compared between the two groups. RESULTS: The VAS and ODI at each observation point of the post-operation were significantly decreased compared with the pre-operation in both groups (P < 0.05). There was no statistically difference of VAS and ODI between the two groups at 1 and 3 months of the post-operation (P > 0.05). However, The VAS and ODI scores in Group TR were significantly lower than that in Group T at 6, 12 and 24 months of the post-operation (P < 0.05). The GPE in group TR was high in the early days, while that at 1 and 3 months after treatment was significantly higher than that in group T (P < 0.05). The recurrence rate in Group TR was lower than that in Group T (P = 0.002). There was no significant difference in hospitalization time, complications, VAS and ODI score at the pre-operation between the two groups (P > 0.05). CONCLUSION: These findings suggest that TFESI combined with RF could effectively improve the pain and function, and had a long-term satisfactory effect for the treatment of LDH.

Retracted: Inhibition of microRNA-940 suppresses the migration and invasion of human osteosarcoma cells through the secreted frizzled-related protein 1-mediated Wnt/ß-catenin signaling pathway.

Osteosarcoma (OS) is the most common malignant tumor of bone with a high potential for metastasis. This study intends to explore whether microRNA-940 (miR-940) affects the development of OS cells and the underlying mechanism. OS and adjacent normal tissues were collected from OS patients; the OS cell line with the highest expression of miR-940 was selected, which was then subjected to transfection of miR-940 mimic, miR-940 inhibitor, siRNA-secreted frizzled-related protein 1 (SFRP1) or LiCl (agonists of Wnt/ß-catenin pathway) to identify regulation of miR-940 to OS cells through SFRP1. The targeting relationship between miR-940 and SFRP1 was verified using dual-luciferase reporter gene assay. Reverse-transcription quantitative polymerase chain reaction and Western blot assay were performed to determine miR-940, SFRP1, ß-catenin, and cyclinD1 and apoptosis-related genes Fas, Bax, and Bcl-2. MTT (3-(4, 5-dimethylthiazol-2-Yl)-2, 5-diphenyltetrazolium bromide) assay, scratch test, transwell assay, and flow cytometry were carried out to detect proliferation, migration, invasion, and apoptosis, respectively. Nude mice models were established to observe the tumor formation. Higher expression of miR-940, ß-catenin, and cyclinD1 and lower SFRP1 expression were identified in OS tissues. miR-940 targeted and negatively regulated SFRP1 expression. Furthermore, upregulated miR-940 expression activated the Wnt/ß-catenin signaling pathway in OS. With the treatment of miR-940 mimic, LiCL, or siRNA-SFRP1, OS cells showed promoted proliferation, migration, invasion, tumor formation, and impeded apoptosis (further reflected by elevated Bcl-2 expression and reduced Fas and Bax expression). The study demonstrates that miR-940 can promote the proliferation, migration, and invasion but suppress the apoptosis of human OS cells by downregulating SFRP1 through activating Wnt/ß-catenin signaling pathway.

A Microfluidic Strategy for Controllable Generation of Water-in-Water Droplets as Biocompatible Microcarriers.

Droplet microfluidics has been widely applied in functional microparticles fabricating, tissue engineering, and drug screening due to its high throughput and great controllability. However, most of the current droplet microfluidics are dependent on water-in-oil (W/O) systems, which involve organic reagents, thus limiting their broader biological applications. In this work, a new microfluidic strategy is described for controllable and high-throughput generation of monodispersed water-in-water (W/W) droplets. Solutions of polyethylene glycol and dextran are used as continuous and dispersed phases, respectively, without any organic reagents or surfactants. The size of W/W droplets can be precisely adjusted by changing the flow rate of dispersed and continuous phases and the valve switch cycle. In addition, uniform cell-laden microgels are fabricated by introducing the alginate component and rat pancreatic islet (ß-TC6) cell suspension to the dispersed phase. The encapsulated islet cells retain high viability and the function of insulin secretion after cultivation for 7 days. The high-throughput droplet microfluidic system with high biocompatibility is stable, controllable, and flexible, which can boost various chemical and biological applications, such as bio-oriented microparticles synthesizing, microcarriers fabricating, tissue engineering, etc.

Unilateral Biportal Endoscopic Discectomy versus Percutaneous Endoscopic Interlaminar Discectomy for Lumbar Disc Herniation.

Background: As the latest endoscopic spine surgery, percutaneous endoscopic interlaminar discectomy (PEID) and unilateral biportal endoscopic (UBE) discectomy have distinct technical characteristics. This study aimed to evaluate the clinical outcomes of PEID and UBE discectomy in the treatment of single-level lumbar disc herniation (LDH). Methods: Between February 2019 and April 2022, 115 patients with single-level LDH at L4-5 or L5-S1 received PEID or UBE discectomy. The patients were separated into two groups based on the surgical method used: Group 1 (the PEID group) (n = 60) and Group 2 (the UBE group) (n = 55). Various parameters, including operative time, hospitalization time, fluoroscopy frequency, total costs, complications, visual analogue scale (VAS), and Oswestry Disability Index (ODI), were evaluated and compared between the two groups. Results: There were no significant differences in the VAS and ODI scores in 12 months after the operation between two groups (P > 0.05). However, the VAS of lower back pain on the first day after the operation in Group 2 (2.53±0.89) was higher than that in Group 1 (2.19±0.74) (P < 0.05). There were no significant differences in the operation time and incidence of complications between two groups (P > 0.05). But total costs in Group 2 (43,121±4280) were significantly higher than those in Group 1 (30,069±3551) (P < 0.05). Conclusion: Both UBE and PEID procedures have similar efficacy in alleviating pain and improving functional ability in patients with LDH. However, UBE surgery results in higher costs than PEID surgery.

Limits to sustained energy intake. XVIII. Energy intake and reproductive output during lactation in Swiss mice raising small litters.

Limits to sustained energy intake (SusEI) during lactation in Swiss mice have been suggested to reflect the secretory capacity of the mammary glands. However, an alternative explanation is that milk production and food intake are regulated to match the limited growth capacity of the offspring. In the present study, female Swiss mice were experimentally manipulated in two ways - litter sizes were adjusted to be between 1 and 9 pups and mice were exposed to either warm (21°C) or cold (5°C) conditions from day 10 of lactation. Energy intake, number of pups and litter mass, milk energy output (MEO), thermogenesis, mass of the mammary glands and brown adipose tissue cytochrome c oxidase activity of the mothers were measured. At 21 and 5°C, pup mass at weaning was almost independent of litter size. Positive correlations were observed between the number of pups, litter mass, asymptotic food intake and MEO. These data were consistent with the suggestion that in small litters, pup requirements may be the major factor limiting milk production. Pups raised at 5°C had significantly lower body masses than those raised at 21°C. This was despite the fact that milk production and energy intake at the same litter sizes were both substantially higher in females raising pups at 5°C. This suggests that pup growth capacity is lower in the cold, perhaps due to pups allocating ingested energy to fuel thermogenesis. Differences in observed levels of milk production under different conditions may then reflect a complex interplay between factors limiting maternal performance (peripheral limitation and heat dissipation: generally better when it is cooler) and factors influencing maximum pup growth (litter size and temperature: generally better when it is hotter), and may together result in an optimal temperature favouring reproduction.

3-MCPD exposure enhances ovarian fibrosis and reduces oocyte quality in mice.

3-monochloro-1,2-propanediol (3-MCPD) is a food contaminant believed to be harmful to human health. Previous studies showed that 3-MCPD exerts toxic effects in multiple tissues, but whether 3-MCPD affects female reproductive function remained unknown. Here, using mouse gastric lavage models, we report that 3-MCPD exposure for four weeks affected body growth, decreased the ovary/body weight ratio, and increased atretic follicle numbers. Expression levels of follicular development-related factors decreased. Further studies found that ovaries from 3-MCPD exposed mice had activated the Transforming Growth Factor-ß (TGF-ß) signaling pathway and promoted ovarian fibrosis. Increased TNF-α, IL-1 and NF-κB expression also indicated the occurrence of ovarian inflammation. Exposure to 3-MCPD stimulated the caspase pathway and enhanced granulosa cell apoptosis. Consistent with disrupted ovarian homeostasis, 3-MCPD exposure interfered with mitochondrial function, generated more reactive oxygen species, increased ferrous ion and lipid peroxidation levels, and resulted in decreased oocyte development potential. Collectively, these findings indicated that 3-MCPD exposure induced ovarian inflammation and fibrosis, and caused disorders of mitochondrial function and ferrous ion homeostasis in oocytes, which consequently disturbed follicle maturation and reduced oocyte quality.

Z-Guggulsterone Relieves Neuropathic Pain by Inhibiting the Expression of Astrocytes and Proinflammatory Cytokines in the Spinal Dorsal Horn.

Objective: The study objective was to investigate whether Z-guggulsterone can relieve neuropathic pain in sciatic nerve chronic constriction injury (CCI) mice by inhibiting the expression of astrocytes and proinflammatory cytokines in the spinal dorsal horn. Methods: Neuropathic pain was induced and assessed in CCI mice. Z-guggulsterone was administered multiple times via intraperitoneal injection. Pain behaviour assessments were made by conducting paw withdrawal mechanical threshold (PWMT) and thermal withdrawal latency (TWL) tests. The expression level of the glial fibrillary acidic protein (GFAP) in the spinal dorsal horn was observed by immunofluorescence. The levels of the proinflammatory cytokines, IL-1ß, IL-6 and TNF-α in the spinal cord were measured by ELISA. Data were analysed using one-way ANOVA or two-way ANOVA. Results: The PWMT and TWL were higher on the 5th, 7th, 10th and 14th days after CCI, the expression level of GFAP in the spinal dorsal horn was lower, and the levels of IL-1ß, IL-6 and TNF-α in the spinal cord were lower in the CCI+Z-GS-L, CCI+Z-GS-M and CCI+Z-GS-H groups than in the CCI+Veh group in a dose-dependent manner (P < 0.05). Conclusion: Z-guggulsterone can relieve neurological pain in CCI mice, which may be related to the inhibition of astrocytes and proinflammatory cytokines in the spinal dorsal horn.

The efficacy of Yiqi Huoxue method in treating coronary artery disease after percutaneous coronary intervention: A meta-analysis in accordance with PRISMA guideline.

BACKGROUND: Percutaneous coronary intervention (PCI), the most common method in treating coronary artery disease (CAD), has a variety of side effects. Yiqi Huoxue therapy (YQHX) can effectively alleviate the symptoms of patients and reduce the side effects. However, a reliable and systematic assessment of the methodologies is not available. METHODS: Seven electronic databases were searched to identify randomized controlled trials of YQHX method for CAD after PCI. The quality assessment of the trials included was performed by employing the Cochrane Risk of Bias tool. RESULTS: One thousand eight hundred sixty-eight patients from 23 randomized controlled trials were included in this review. The aggregated results showed that the experimental group got better effect in increasing ORR, TCMSRR, ECG, HDL-C, and in lowering the level of CRP, TC, and MACE in comparison with the control group. CONCLUSION: YQHX method is a valid complementary and alternative therapy in the management of CAD after PCI, and is an effective and safe therapy for CAD.

Recent progress in oxychalcogenides as IR nonlinear optical materials.

Currently, non-centrosymmetric oxychalcogenides, a class of newly developed heteroanionic compounds, have emerged as promising candidates for IR nonlinear optical (NLO) materials due to the fact that they can combine the impressive second-harmonic generation (SHG) responses of chalcogenides with the wide energy gaps of oxides. Moreover, multiple combinations of chalcogens and the oxygen element would, in principle, lead to more new frequency-doubling building units, enabling the extensive seeking and design of new NLO-active oxychalcogenides. In this Frontiers article, the recent developments of oxychalcogenides as IR-NLO candidates are summarized. These materials can be grouped into three types in terms of their structural dimensions: (i) two-dimensional layered CaZnOS, SrZn2OS2, Sr8Ga8O3S14, Sr6Cd2Sb6O7S10 and Sr4Pb1.5Sb5O5Se8; (ii) one-dimensional chain-typed AEGeOQ2 (AE = Sr and Ba; Q = S and Se); and (iii) zero-dimensional molecular Sr3Ge2O4Se3 and α-Na3PO3S. We discuss the rich coordination environment of mixed-anion frequency-doubling building units focusing on the correlations between their non-centrosymmetric structures and NLO properties, as well as their synthetic methods. Finally, the present challenges and future perspectives in this field are also proposed.

The Rise of Infrared Nonlinear Optical Pnictides: Advances and Outlooks.

Infrared (IR) nonlinear optical (NLO) materials are the core devices to realize IR laser output, which are of vital importance in civilian and military fields. Non-centrosymmetric chalcogenide and pnictide compounds have already been widely accepted as favorable systems for IR-NLO materials. Compared to the extensively investigated IR-NLO chalcogenides during the past few decades, the research of non-centrosymmetric phosphides as IR-NLO materials is relatively scarce. In this frontier article, the recent progress of pnictides as emerging IR-NLO candidates has been highlighted based on the perspective of new crystal exploration. These IR-NLO pnictides recently reported were divided into three groups from binary to quaternary according to their chemical compositions. The synthetic methods, structural chemistry, and structure-activity relationships are analyzed and summarized in detail. Finally, current problems and the future development of this field are also proposed.

The cardioprotective effect of the sodium-glucose cotransporter 2 inhibitor dapagliflozin in rats with isoproterenol-induced cardiomyopathy.

Sodium-glucose cotransporter 2 inhibitor (SGLT2i) has been reported to improve glycemic control. This study was designed to investigate the effects of SGLT2i dapagliflozin (dapa) on cardiomyopathy induced by isoproterenol (ISO) and its potential mechanisms. Fifty male Sprague Dawley rats were randomly assigned to the control (n=10) and the ISO (2.5 mg/kg/day)-treated groups (n=40). After 2 weeks, the 28 surviving rats with obvious left ventricular dysfunction in the ISO group were randomized into three medication groups, including the angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan group (S/V, n=9), the dapa group (n=9), and the ISO group (n=10) for 4 weeks. Next, electrical programmed stimulation was performed in all the groups to evaluate their susceptibility to ventricular arrhythmias (VAs). Compared to the ISO rats, the dapa administration not only effectively reduced the cumulative risk of death, the myocardial fibrosis, the plasma angiotensin II levels and its functional receptor AT1R protein expressions in the heart, and the proinflammatory cytokine levels in the cardiac tissue of the ISO-treated rats, but it also improved their cardiac function and inhibited oxidative stress. These effects were similar to S/V. However, dapa showed a greater efficacy than S/V in reducing the left ventricular end-diastolic volumes, lowing the heart rates and VAs, and decreasing the body weights and plasma glucose levels. The mechanisms by which dapa exerts protective effects on cardiomyopathy may be related to its indirect antioxidant capacity and direct hypoglycemic action.

Salt-inclusion chalcogenides: an emerging class of IR nonlinear optical materials.

Non-centrosymmetric metal chalcogenides such as AgGaS2 and AgGaSe2 are two of the commercial nonlinear optical (NLO) crystals widely used in the infrared (IR) region. Nevertheless, the inherent incompatibility between the wide energy gap (Eg) and large second-harmonic generation (SHG) efficiency (dij) hinders their high-power laser applications. Recently, the development of salt-inclusion chalcogenides with non-centrosymmetric structures has attracted more and more attention and interest owing to their intensive potential applications originating from their wide Eg, strong dij, ultrahigh laser-induced damage thresholds (LIDTs) and large IR transmission range. In this frontier paper, we review the recent progress of salt-inclusion chalcogenides (including 28 related compounds) as favourable candidates for IR-NLO materials, which can be divided into 3 types according to their chemical compositions and structural characteristics: (i) the [RaXb][GanQ2n] type and its derivatives, (ii) [NaBa4Cl][Ge3S10] and its derivatives, and (iii) the [A3X][MB12(MQ4)3] type. The relationships between the non-centrosymmetric structures and NLO properties of these 3 types of compounds are summarized and briefly remarked. In addition, the present challenges of creating new IR-NLO salt-inclusion chalcogenides and future perspectives in this field are discussed.

[Efficacy evaluation of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in treating lumbar disc herniation with lumbar instability].

OBJECTIVE: To evaluate the clinical effects of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in the treatment of lumbar disc herniation with lumbar instability. METHODS: The clinical data of 146 patients with unilateral lumbar disc herniation with lumbar instability underwent surgical treatment from March 2008 to March 2013 were retrospectively analyzed. Patients were divided into two groups according to osteotomy replantation pattern. There were 77 patients in the traditional group (underwent traditional lamina osteotomy replantation), including 42 males and 35 females with an average age of (49.4±18.5) years;the lesions occurred on L4,5 in 46 cases, on L55S1 in 31 cases. There were 69 patients in modified group (underwent modified lamina osteotomy replantation), including 37 males and 32 females with an average age of (49.8±17.9) years;the lesions occurred on L4,5 in 40 cases, on L5S1 in 29 cases. The operation time, intraoperative blood loss, complication rate during operation, lamina healing rate, recurrence rate of low back and leg pain were compared between two groups. Visual analogue scales (VAS) and Japanese Orthopadic Association (JOA) scores were used to evaluate the clinical effects. RESULTS: The operation time and intraoperative blood loss were similar between two group (P>0.05). There was significantly different in nerve injury rate(5.80% vs 16.9%) and dural injury rate(1.45% vs 9.09%) between modified group and traditional group(P<0.05). The recurrent rate of low back pain of modified group was higher (91.30%, 63/69) than that of traditional group (76.62%, 59/77), and the intervertebral fusion rate of modified group was lower(8.70%, 6/69) than that of traditional group (29.9%, 23/77) at 3 years after operation. Postoperative VAS scores of all patients were significantly decreased at 6 months, 1, 2, 3 years, and JOA scores were obviously increased (P<0.05). At 1, 2, 3 years after operation, VAS scores of modified group were significantly lower than that of traditional group(P<0.05), and JOA scores of modified group were higher than that of traditional group(P<0.05). CONCLUSIONS: Modified lamina osteotomy replantation has better long-term efficacy(in the aspect of recurrent rate of low back pain, intervertebral fusion rate, VAS and JOA score at three years follow-up) in treating lumbar disc herniation with instability.

Alterations of serum osteocalcin levels in patients with Legg-Calvé-Perthes.

BACKGROUND: Legg-Calvé-Perthes disease (LCPD) is a paediatric form of osteonecrosis that ultimately heals but will cause femoral head and acetabular deformities. The purpose of this study was to investigate the early serum measurement of osteocalcin in children with femoral head necrosis compared with that of healthy children. METHODS: 20 patients with LCPD (4 girls and 16 boys) and 20 healthy volunteers (5 girls and 15 boys) were enrolled. All patients did not have additional treatment. Blood samples were obtained from all patients preoperatively in the morning. All cases had hip radiographs. The serum levels of osteocalcin comparisons between the LCPD patients and the healthy volunteers were performed using Wilcoxon signed-rank test. The Spearman rank correlation was used to assess correlation between LCPD grade and serum osteocalcin levels. Significance was set at p = 0.05. RESULTS: The 20 patients with LCPD (72.75 ± 24.92 ng/ml) had significantly higher serum osteocalcin levels compared with the healthy group (16.80 ± 4.04 ng/ml) (p<0.01). Serum osteocalcin levels of different LCPD grades were significantly different (Spearman's p = 0.540, p = 0.014). CONCLUSIONS: We observed a significant correlation between serum osteocalcin levels and LCPD. These results may be meaningful in clinical practice and to future studies.

[Posterior debridement and bone grafting via intervertebral space combined with internal fixation for the treatment of lumbosacral tuberculosis].

OBJECTIVE: To explore the clinical effects of posterior debridement, bone grafting via intervertebral space combined with internal fixation for the treatment of lumbosacral tuberculosis. METHODS: The clinical data of 32 patients with lumbosacral tuberculosis underwent the procedure of one-stage posterior intervertebral debridement, bone grafting and internal fixation from January 2007 to July 2013 were retrospectively analyzed. There were 17 males and 15 females, aged from 27 to 63 years with an average of (49.8±9.2) years. The course of disease was from 5 to 18 months with the mean of (10.7±3.2) months. There was involved the vertebral body of L5 in 1 case, the intervertebral space of L5S1 in 8 cases, and the vertebral body of L5 or S1 combined with intervertebral space of L5S1 in 23 cases. VAS, ESR, CRP, the lumbosacral angle, the height of intervertebral space of L5S1, and ASIA grade were used to evaluate clinical effects. RESULTS: All the patients were followed up from 18 to 39 months with an average of 21.6 months. Operative time was 120 to 260 min with the mean of 175 min, and intraoperative bleeding was 700 to 1 450 ml with the mean of 1 050 ml. VAS before operation was 8.4±1.6, then descended to 3.5±0.8(P<0.05) on the 3rd month after operation and redescended to the level of 1.7±0.6(P<0.05) at the final follow-up. The ESR and CRP before operation were (48.8±10.2) mm and (58.6±5.6) mg/L, respectively, then decreased to (35.6±6.9) mm and (22.5±4.3) mg/L (P<0.05) at the 3rd month after operation and returned to the normal level at the final follow-up. The height of intervertebral space of L5S1 and lumbosacral angle before operation were (7.7±0.4) mm and (19.3±1.2)°, respectively, then improved to (10.3±0.3) mm and (22.4±1.5)° on the 3rd month after operation(P<0.05), and maintained such level, no obvious lost at later. According to ASIA grade, 8 cases were grade C, 19 were grade D, 5 were grade E before operation, and at final follow-up, 1 case still was grade D, others were grade E. CONCLUSIONS: The procedure of posterior debridement, bone grafting via intervertebral space combined with internal fixation is an effective and safe method in treating lumbosacral tuberculosis, it can effectively debride tuberculose focus, maintain the spinal stability, and improve the dysfunction with less complication.

[Effects of artificial disc replacement with angles on stress of adjacent intervertebral disc].

OBJECTIVE: To evaluate stress changes of intervertebral space and adjacent intervertebral space after artificial disc replacement with angles. METHODS: Artificial disc replacement with angles were designed according to existing data. Axial pressure, flexion/extension, lateral bending and torsion loading were applied on finite element models of normal cervical discs on C4,5 segments, C4,5 segments with 0 degrees artificial cervical discs and C4,5 segments with 10 degrees artificial cervical discs, then stress changes of C4,5 space was observed. The same loadings were applied on finite element models of normal cervical discs on C4-C6 segments, C4,5 segments with 0 degrees, C4,5 segments with 10 degrees, then stress changes of replaced segments space and adjacent segment space were observed. RESULTS: For C4,5 segments, 80 MPa/0 degrees artificial discs and 80 MPa/10 degrees artificial discs had the similar equivalent shear stress (Se), and were both larger than that of normal discs, when lateral bending were performed, 80 MPa/0 degrees artificial discs were closed to normal discs when axial pressure and flexion/extension were carried out, while 80 MPa/10 degrees artificial discs had a larger Se than that of normal ones,when torsion loading were applied, Szx/Szy stress of 80 MPa/0 degrees and 80 MPa/10 degrees artificial discs were closed to normal ones. For C4-C6 segments, the axial pressure, flexion/extension and lateral bending of C5,6 were all lower than normal discs after C4,5 discs were replaced by 80 MPa/10 degrees artificial discs, while Szx/Szy of torsion loading were closed to normal ones. CONCLUSION: Artificial discs with 10 degrees have less influences on stress of adjacent intervertebral space and closer to mechanical property after being implanted into intervertebral space.