Isolation and Complete Genome Sequence of a Novel Pseudoalteromonas Phage PH357 from the Yangtze River Estuary.

Phage PH357, a novel lytic Pseudoalteromonas lipolytica phage belonging to the Myoviridae family was isolated from the Yangtze River estuary. The microbiological characterization demonstrated that phage PH357 is stable from -20 to 60 °C and the optimal pH 7. The one-step growth curve showed a latent period of 20 min, a rise period of 20 min, and the average burst size was about 85 virions per cell. Complete genome of phage PH357 was determined. Genome of phage PH357 consisted of a linear, double-stranded 136,203 bp DNA molecule with 34.58% G + C content, and 242 putative open reading frames (ORFs) without tRNA. All the predicted ORFs were classified into eight functional groups, including DNA replication, regulation and nucleotide metabolism, transcription, translation, phage packaging, phage structure, lysis, host or phage interactions, and hypothetical protein. A phylogenetic analysis showed that phage PH357 had similarity to the previously published Pseudoalteromonas phage PH101 and Vibrio phages. Furthermore, the study of phage PH357 genome will provide useful information for further research on the interaction between phages and their hosts.

Risk factors for postoperative delirium after spine surgery in middle- and old-aged patients.

BACKGROUND: Postoperative delirium is a common complication following various operative procedures with an incidence rate of 10-77 %. AIM: To analyze various risk factors for postoperative delirium after spine surgery in the middle- and old-aged patients. METHODS: This study retrospectively reviewed 451 patients (226 males and 225 females, an average age of 65.1 ± 18.3 years) who underwent spinal surgery in our hospital between January 2010 and August 2015. Patients who had features of acute onset and fluctuating course and any two of the other features were diagnosed with delirium. Cognitive tests consisting of Clinical Dementia Rating and Global Deterioration Scale were performed to evaluate delirium. T tests were used for statistical analysis of the difference between the two groups, and logistic regression analyses were used for determining the risk factors. RESULTS: A total of 42 (9.3 %) patients were diagnosed with delirium. Delirious and non-delirious patients had no difference in age, gender, BMI, education level, drug treatment, comorbid disease history, surgical history, preoperative blood pressure, intraoperative blood loss, blood transfusion, use of surgical implants, surgical site, use of fentanyl and propofol, and preoperative VAS score. Intraoperative hypotension and use of dezocine were related to postoperative delirium (P = 0.03 and P = 0.07). The multiple regression equation was Y = -0.11 + 0.52 × X 0 + 0.21 × X 1, where X 0 = amount of dezocine, X 1 = instances of intraoperative hypotension. CONCLUSION: Postoperative delirium commonly occurs after spine surgery. Intraoperative hypotension <80 mmHg and intraoperative use of dezocine represent valuable new predictors of the risk of delirium.

Kinematic analysis of cervical spine canal diameter and its association with grade of degeneration.

OBJECTIVES: To investigate the cervical spinal canal diameters variance under positional MRI, and also the relationship between cervical canal diameter variance rate and grade of degeneration. METHODS: From January 2013 to January 2015, a consecutive of 273 symptomatic patients (166 males and 207 females) with an average age of 44.6 years (range 21-89 years) underwent positional cervical MRI. T2-weighted sagittal images of 1638 cervical intervertebral discs from 273 subjects were classified into five grades. The canal diameter and canal diameter variance rate at three positions and their comparison among five grade of degeneration were evaluated. The measurements were tabulated and analyzed using SPSS. 13.0. p values less than 0.05 were considered to indicate a statistically significant difference. RESULTS: The sagittal cervical canal diameter at the C5/6 level were the smallest compared with the other levels regardless of neutral, flexion or extension positions, C5/6 level had the largest canal diameter variance rate in both flexion and extension (8.14 ∓ 0.38 and 7.81 ∓ 0.31 %, respectively), second was C4/5 level (7.65 ∓ 0.39 and 7.67 ∓ 0.32 %, respectively). A total of 1638 discs were classified into 5 groups, each level showed the similar tendency that no matter what position, with the increasing grade of degenerative disc degree, spine canal diameter decreased gradually. For C5/6 under extension and flexion position, significant difference was also noted between grade 2 and 3; For C4/5 under extension position, significant difference existed between grade 1 and 2, grade 1 and 3, while under flexion position, significant difference existed between grade 2 and 4, and the results also showed no significant difference at the same degree of degeneration on both levels between extension and flexion position. CONCLUSIONS: C5/6 and C4/5 is of higher risk of suffering SCI than other levels, C4/5 level predispose SCI at earlier stage than C5/6, patients presenting with intermediate signal and slight decreased disc height on T2 weighted MRI at C4/5 level should be paid attention.

Intraoperative blood loss, postoperative drainage, and recovery in patients undergoing lumbar spinal surgery.

BACKGROUND: Spine surgery is widely accepted as an effective management for patients with lumbar disc herniation; however, the factors influencing intraoperative procedure and prognosis are not fully understood. The present study was aimed to identify the factors influencing intraoperative blood loss, postoperative drainage volume, and recovery in patients undergoing spinal surgery. METHODS: We retrospectively analyzed the clinical data of 183 consecutive patients with lumbar disc herniation who underwent spine surgery. The clinical characteristics, operation procedure, and outcome were documented and the correlations were analyzed. RESULTS: There were significant differences between one-level and two-level operations in the bleeding volumes of male (P = 0.005) and female (P = 0.002) patients, and in final drainage of male (P = 0.043) and female (P = 0.003) patients. The blood loss was correlated with the operation duration. There were differences in intraoperative bleeding and final drainage between groups with one-level and two-level operations. Additionally, there were differences in intraoperative autologous blood transfusion among various groups. There were significant differences in intraoperative bleeding between autologous blood transfusion and non-transfusion groups. CONCLUSIONS: The key factors affecting the intraoperative blood loss and postoperative drainage volume include operation methods, operation duration, blood-transfusion modes, and usage of anticoagulants. These results should be taken into consideration in the attempt to optimize operation procedure and improve post-operative recovery.

[Effects of different transfusion on intraoperative blood loss and postoperative drainage volume in posterior lumbar spinal surgery].

OBJECTIVE: To explore the effects of autotransfusion on intraoperative blood loss and postoperative drainage volume in posterior lumbar spinal surgery. METHODS: From June 2010 to January 2012, a total of 183 patients with lumbar disease were enrolled. There were 74 males and 109 females with an average age of 56.6 (31-81) years. There were lumbar disc herniation (n = 80), lumbar stenosis (n = 69), lumbar spondylolisthesis (n = 32) and discogenic pain (n = 2). And one-level (n = 83) and two-level (n = 100) operations were performed. The treatments were non-transfusion (n = 34), auto-blood (n = 109) and allogeneic blood (n = 20) and both (n = 20).Operative duration, operative level, intraoperative autologous blood transfusion, intraoperative allogeneic blood transfusion, intraoperative blood loss, immediate drainage volume, duration of drainage tube and final drainage volume were recorded. RESULTS: The mean intraoperative blood loss was (369.4 ± 284.0) ml and (568.8 ± 398.7) ml for two-level operation, there were significant differences between them(t = 3.94, P < 0.001). The final drainage volume was (186.3 ± 135.6) ml for one-level patients and (301.4 ± 286.8) ml for two-level patients, there were significant differences between them (t = 3.56, P < 0.05). The total intraoperative blood loss was (478.3 ± 364.3) ml and total final drainage volume was (249.2 ± 237.4) ml, there were significant differences between them(P < 0.001). There were significant differences in blood loss between autologous blood transfusion for non-transfusion groups (P < 0.001) .However, there was no difference for immediate drainage and final drainage comparing with other blood transfusion methods (P > 0.05) . CONCLUSION: Using autologous blood transfusion alone during operation has significant difference for inoperative blood loss compared with non-transfusion. Yet there is no effect on immediate or final drainage volume.

Dual-wavelength-excitation aerosol fluorescence spectra detection using combined spectrometer with Czerny-Turner design.

We developed a dual-wavelength-excitation aerosol fluorescence spectra detection device prototype. In our system, the 263 nm and 355 nm lasers are used to sequentially excite the fluorescence of aerosol stream, which is located spatially and temporally by two crossed infrared lasers; a bifurcated fiber bundle is applied to receive the fluorescence spectra of 274-463 nm and 374-565 nm. Besides, with a 32-channel photomultiplier tube as detector, a self-developed combined spectrometer with Czerny-Turner design is employed to detect the two band spectra in a preset timing sequence. Experiments show that the system can detect the fluorescence spectra, after dual-wavelength-excitation, of three intrinsic fluorophore samples and three bioaerosol samples.

Correlation between Lumbar Spine Facet Joint Orientation and Intervertebral Disk Degeneration: A Positional MRI Analysis.

BACKGROUND AND STUDY AIMS: The contribution of facet joint orientation (FO) to degeneration of the functional units of the lumbar spine remains unclear. The study used positional magnetic resonance imaging (MRI) to evaluate the association between intervertebral disk degeneration and FO at the L3-L4 to L5-S1 spinal segments. MATERIAL AND METHODS: This was a retrospective study of 450 outpatients admitted to the Spine Surgery Department of our hospital between January 2013 and January 2015 and with positional lumbar MRI data. Grade of intervertebral disk degeneration, FO relative to the midsagittal plane, vertebral translation (VT), and angular variation (AV) were assessed. RESULTS: No effect of baseline characteristics (age, sex, and body mass index) on intervertebral disk degeneration was observed. A significant difference in VT and AV was only present between grades 1 + 2 versus 4 at L5-S1 (both p = 0.005), and in FO only at L5-S1 between grades 1 + 2 versus 4 (p = 0.03) and grades 3 versus 4 (p = 0.04). AV and VT were correlated at all three lumbar segments (r = 0.224-0.309; p ≥ 0.01), with a correlation between FO and AV only at L3-L4 (r = 0.141; p = 0.035). CONCLUSION: Disk degeneration was associated with FO only at L5-S1. AV and VT of spinal segments of the mid to lower lumbar spine did not correlate with FO.

[Effect of hemoperfusion combined with continuous veno-venous hemofiltration on acute paraquat poisoning: a Meta-analysis].

OBJECTIVE: To comprehensively evaluate the clinical efficacy of hemoperfusion (HP) combined with continuous veno-venous hemofiltration (CVVH) on acute paraquat poisoning (APP). METHODS: Literatures of Chinese and English randomized controlled trials (RCTs), case control and cohort study on HP combined with CVVH in the treatment of APP from the PubMed, Embase, Wanfang, and CNKI up to November 2017 were enrolled (the subjects were > 16 years old). The obtained literatures were strictly screened and evaluated in quality, and data such as mortality, the life time of dead patients, inefficiency rate, incidence of multiple organ dysfunction syndrome (MODS) and acute respiratory distress syndrome (ARDS) were extracted. Meta-analysis was performed by RevMan 5.3. RESULTS: Twenty-one studies were included with 2 222 subjects, among whom 976 subjects were in HP combined with CVVH group (experimental group) and 1 246 subjects in HP group (control group). Compared with control group, the mortality in experimental group were significantly decreased [43.77% (362/827) vs. 55.26% (604/1 093), odds ratio (OR) = 0.68, 95% confidential interval (95%CI) = 0.56-0.82, P = 0.000 1], the life time of death patients was significantly prolonged [mean difference (MD) = 4.63, 95%CI = 2.60-6.66, P < 0.000 01], incidence of MODS [25.93% (70/270) vs. 55.36% (155/280), OR = 0.26, 95%CI = 0.14-0.49, P < 0.000 1], and incidence of ARDS [30.37% (82/270) vs. 51.07% (143/280), OR = 0.42, 95%CI = 0.30-0.61, P < 0.000 01], and inefficiency rate [8.72% (13/149) vs. 34.64% (53/153), OR = 0.17, 95%CI = 0.09-0.34, P < 0.000 01] were significantly reduced. Funnel chart showed that except the publication bias of mortality rate, there were less publication bias about other indicators among studies. CONCLUSIONS: HP combined with CVVH can significantly reduce the mortality of patients with APP compared with HP alone on the whole, prolong the life time and reduce the occurrence of MODS and ARDS, thus improving the treatment efficiency.

[Oblique nuclear chopping and nuclear extraction by binding procedure for cataract extraction].

OBJECTIVE: To investigate the effects of oblique nuclear chopping and nuclear extraction by binding procedure (ONCNEB) in cataract extraction. METHODS: Extracapsular cataract extraction by ONCNEB with foldable IOL implantation was performed in 86 senile cataract cases (97 eyes) by using a line-shaped cataract nuclear chopping apparatus developed by the authors. RESULTS: In 97 eyes treated with ONCNEB, there was posterior capsular rupture in 1 eye; anterior chamber hemorrhage in 2 eyes; elevated intraocular pressure in 6 eyes; mild corneal edema in 8 eyes which subsided within 5 days. Corrected visual acuity > or = 0.5 was obtained in 78 eyes (80.41%) one week and 91 eyes (93.81%) three months after the operation. Corrected visual acuity was > or = 1.0 in 66 eyes (68.04%) three months after the operation. Mean astigmatism one week and three months postoperatively showed not significant difference as compared with preoperative astigmatism. CONCLUSION: The ONCNEB can solve the problem of implanting foldable IOL through a small incision. This procedure is relatively simple and safe.

[Transtrochateric rotational osteotomy for osteonecrosis of the femoral head].

OBJECTIVE: To explore the indications, operative technique and clinical results of the transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH). METHODS: Nineteen patients (23 hips) with ONFH underwent TRO from October 1992 to May 2001 were reviewed. There were 14 males and 5 females. The age was ranging from 22 to 43 years old with an average age of 33.4 years old. The etiology were as followed: alcoholism 10 cases (12 hips); steroid 6 cases (7 hips); trauma 2 cases (2 hips); caisson disease 1 case (2 hips). Ficat stage: II 8 cases 8 hips; III 11 cases 15 hips. Harris hip score 46 to 74 with mean score 56 preoperatively. In order to determine the location and extent of osteonecrosis, A-P view and accurate lateral view (the film should be placed parallel to the femoral neck with the hip in precisely 90 degrees and flexion 45 degrees of abduction and neutral rotation) were taken in both hips preoperatively. The surgical technique described by Sugioka were used in all patients. RESULTS: Seventeen patients (19 hips) were followed up ranging from 18 to 11 years with mean 54 months. The Harris hip score was from 55 to 94 with mean 80.5. Fourteen hips score more than 80 and good to excellent rate was 73.2%. Harris score were less than 79 in 5 cases and 4 hips of these 5 hips were revised by total hip arthroplasty. The rotation angle was from 55 degrees to 80 degrees with mean 60 degrees . COMPLICATIONS: The circumflex femoral medial artery injury was found in 1 hip; subtrochanteric fracture was found in 2 hips and 1 osteotomy site nonunion occurred. CONCLUSION: TRO can be used to treat ONFH. The indications include: (1) younger patients (less than 45 years old). (2) Ficat stage II and III with more than one third intact articular surface of the femoral head. The better results could be obtained using posterior rotation and lager rotational angle. The Sugioka osteotomy should be used carefully because of its complicated surgical technique.

Vertigo-related cerebral blood flow changes on magnetic resonance imaging.

STUDY DESIGN: A prospective study using magnetic resonance imaging on a consecutive cohort of patients with cervical vertigo. OBJECTIVE: To quantitatively investigate the cerebral blood flow (CBF) changes associated with cervical vertigo by using 3-dimensional pseudocontinuous arterial spin labeling. SUMMARY OF BACKGROUND DATA: Previous studies reported blood flow velocity reduction in posterior circulation during vertigo. However, the detailed information of CBF related to cervical vertigo has not been provided. METHODS: A total of 33 patients with cervical vertigo and 14 healthy volunteers were recruited in this study. Three-dimensional pseudocontinuous arterial spin labeling was performed on each subject to evaluate the CBF before and after the cervical hyperextension-hyperflexion movement tests, which was used to induce cervical vertigo. Repeated-measures analysis of variance was conducted to assess the effect of subjects and tests. RESULTS: There were time effects of CBF in the territory of bilateral superior cerebellar artery, bilateral posterior cerebral artery, bilateral middle cerebral artery, and right anterior cerebral artery, but no group effect was observed. The analysis of CBF revealed a significant main effect of tests (P=0.024) and participants (P=0.038) in the dorsal pons. CONCLUSION: Cervical vertigo onset may be related to CBF reduction in the dorsal pons, which sequentially evokes the vestibular nuclei. LEVEL OF EVIDENCE: 2.