ABSTRACT
Purpose: To determine the risk factors for recompression after percutaneous transforaminal endoscopic decompression (PTED) for the treatment of degenerative lumbar spinal stenosis (DLSS) and compare the outcomes of PTED and posterior lumbar interbody fusion (PLIF) as revision surgery. Methods: We retrospectively evaluated 820 consecutive DLSS patients who underwent PTED at our institution. 26 patients developed postoperative recompression and underwent reoperation. In total, 208 patients with satisfactory clinical outcomes were enrolled in the control group. The demographic and imaging data of each patient were recorded. Univariate and multivariate analyses were performed to assess risk factors for recompression. Additionally, patients with recompression were divided into PTED and PLIF groups according to the reoperation procedure. The clinical outcomes of the two groups were compared using independent-sample t-tests. Results: The grade of surgical-level disc degeneration [odds ratio (OR): 2.551, p = 0.045] and the number of disc degeneration levels (OR: 11.985, p < 0.001) were independent risk factors for recompression after PTED. There was no significant difference in the visual analog score (VAS) and Oswestry disability index (ODI) two weeks postoperatively between the PTED and PLIF groups for surgical treatment. However, the mean VAS of back pain (14.1 vs. 20.5, p = 0.016) and ODI (16.0 vs. 21.8, p = 0.016) of patients in the PLIF group were smaller than those in the PTED group at the final follow-up. Conclusion: More severe degeneration and degenerated levels indicate a higher recompression rate after PTED. Although both PTED and PLIF could achieve immediate relief postoperatively in the treatment of recompression, the final follow-up results showed that the outcome of PLIF appeared better than that of PTED.
ABSTRACT
The gut fungi play important roles in human health and are involved in energy metabolism. This study aimed to examine gut mycobiome composition in obese subjects in two geographically different regions in China and to identify specific gut fungi associated with obesity. A total of 217 subjects from two regions with different urbanization levels [Hong Kong (HK): obese, n = 59; lean, n = 59; Kunming (KM): obese, n = 50; lean, n = 49. Mean body mass index (BMI) for obesity = 33.7] were recruited. We performed deep shotgun metagenomic sequencing on fecal samples to compare gut mycobiome composition and trophic functions in lean and obese subjects across these two regions. The gut mycobiome of obese subjects in both HK and KM were altered compared to those of lean subjects, characterized by a decrease in the relative abundance of Nakaseomyces, Schizosaccharomyces pombe, Candida dubliniensis and an increase in the abundance of Lanchanceathermotolerans, Saccharomyces paradox, Parastagonospora nodorum and Myceliophthorathermophila. Reduced fungal - bacterial and fungal - fungal correlations as well as increased negative fungal-bacterial correlations were observed in the gut of obese subjects. Furthermore, the anti-obesity effect of fungus S. pombe was further validated using a mouse model. Supplementing high-fat diet-induced obese mice with the fungus for 12 weeks led to a significant reduction in body weight gain (p < 0.001), and an improvement in lipid and glucose metabolism compared to mice without intervention. In conclusion, the gut mycobiome composition and functionalities of obese subjects were altered. These data shed light on the potential of utilizing fungus-based therapeutics for the treatment of obesity. S. pombe may serve as a potential fungal probiotic in the prevention of diet-induced obesity and future human trials are needed.
Subject(s)
Feces , Fungi , Gastrointestinal Microbiome , Mycobiome , Obesity , Obesity/microbiology , Humans , Animals , Fungi/classification , Fungi/isolation & purification , Fungi/genetics , Male , Mice , China , Female , Feces/microbiology , Adult , Bacteria/classification , Bacteria/isolation & purification , Bacteria/genetics , Middle Aged , Mice, Inbred C57BL , Body Mass IndexABSTRACT
A novel molecularly imprinted electrochemical aptasensor (MIEAS) was constructed for selective progesterone (P4) detection based on SnO2-graphene (SnO2-Gr) nanomaterial and gold nanoparticles (AuNPs). SnO2-Gr with a large specific area and excellent conductivity improved the adsorption capacity of P4. Aptamer, as biocompatible monomer, was captured by AuNPs on modified electrode through Au-S bond. An electropolymerized molecularly imprinted polymer (MIP) film consisted of p-aminothiophenol as chemical functional monomer and P4 as template molecule. Due to the synergetic effect of MIP and aptamer towards P4, this MIEAS exhibited better selectivity than the sensor with MIP or aptamer as single recognition element. The prepared sensor had a low detection limit of 1.73 × 10-15 M in a wide linear range from 10-14 M to 10-5 M. Satisfactory recovery obtained in tap water and milk samples proved that this sensor had great potential in environmental and food analysis.
Subject(s)
Metal Nanoparticles , Molecular Imprinting , Polymers/chemistry , Gold/chemistry , Progesterone , Electrochemical Techniques , Metal Nanoparticles/chemistry , Molecularly Imprinted Polymers , Limit of Detection , ElectrodesABSTRACT
Flowering is critical for sexual reproduction and fruit production. Several pear (Pyrus sp.) varieties produce few flower buds, but the underlying mechanisms are unknown. The circadian clock regulator EARLY FLOWERING3 (ELF3) serves as a scaffold protein in the evening complex that controls flowering. Here, we report that the absence of a 58-bp sequence in the 2nd intron of PbELF3 is genetically associated with the production of fewer flower buds in pear. From rapid amplification of cDNA ends sequencing results, we identified a short, previously unknown transcript from the PbELF3 locus, which we termed PbELF3ß, whose transcript level was significantly lower in pear cultivars that lacked the 58-bp region. The heterologous expression of PbELF3ß in Arabidopsis (Arabidopsis thaliana) accelerated flowering, whereas the heterologous expression of the full-length transcript PbELF3α caused late flowering. Notably, ELF3ß was functionally conserved in other plants. Deletion of the 2nd intron reduced AtELF3ß expression and caused delayed flowering time in Arabidopsis. AtELF3ß physically interacted with AtELF3α, disrupting the formation of the evening complex and consequently releasing its repression of flower induction genes such as GIGANTEA (GI). AtELF3ß had no effect in the absence of AtELF3α, supporting the idea that AtELF3ß promotes flower induction by blocking AtELF3α function. Our findings show that alternative promoter usage at the ELF3 locus allows plants to fine-tune flower induction.
Subject(s)
Arabidopsis Proteins , Arabidopsis , Circadian Clocks , Arabidopsis/metabolism , Arabidopsis Proteins/genetics , Arabidopsis Proteins/metabolism , Circadian Clocks/physiology , Plants/metabolism , Flowers/metabolismABSTRACT
PURPOSE: This updated meta-analysis aimed to compare single and dual growing rods, including both traditional growing rod and magnetically controlled growing rod (MCGR) used in the treatment of early-onset scoliosis (EOS) with regard to deformity correction, spinal growth, and complications. METHODS: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using articles extracted from PubMed, EMBASE databases, and Cochrane Library databases. Only articles reporting the complications and the imaging parameters before and after growing rods in the patients diagnosed with EOS were included. We extracted and statistically analyzed the data deemed relevant for this study, and used the Newcastle-Ottawa Scale to assess the risk of bias in each study. Data synthesis and statistical analyses were performed using R software. RESULTS: Fifteen eligible articles containing 409 participants (n = 185, single growing rods; n = 224, dual growing rods) were identified. The meta-analysis found no significant differences in the preoperative and postoperative major Cobb angle, T1-S1 distance, thoracic kyphosis, and coronal balance between single and dual rods groups. The final follow-up major Cobb angle (P = 0.01; standardized mean difference, - 0.42 [95% confidence interval (CI), - 0.74 to - 0.10]; I2 = 23%) was significantly smaller in dual rods group than single-rod group. However, no significant differences in the correction rate of angle (major Cobb angle and kyphosis angle) and changes in the T1-S1 distance between the two groups were observed. Moreover, there were no significant differences in the metalwork failure, infection, or proximal junctional kyphosis between single and dual rods groups. However, total complications (P = 0.03; risk ratio (RR), 0.79 [95% CI, 0.63-0.98]; I2 = 29%) and distraction failure in MCGR (P = 0.04; RR, 0.38 [95% CI, 0.14-0.98]; I2 = 11%) were significantly lower in dual rods group than single-rod group. CONCLUSION: This updated meta-analysis found that patients with dual growing rods had fewer complications, especially distraction failure in MCGR, than those with single growing rod. However, none of deformity correction, spinal growth, or other complications differed between single and dual growing rods. Therefore, we believe that dual growing rods do not provide strong advantages over single growing rod in the treatment of EOS.
Subject(s)
Kyphosis , Orthopedic Procedures , Scoliosis , Humans , Scoliosis/diagnostic imaging , Scoliosis/surgery , Treatment Outcome , Spine/surgery , Kyphosis/surgery , Orthopedic Procedures/methods , Retrospective Studies , Follow-Up StudiesABSTRACT
Phytophthora pathogens lead to numerous economically damaging plant diseases worldwide, including potato late blight caused by P. infestans and soybean root rot caused by P. sojae. Our previous work showed that Phytophthora pathogens may generate abundant phosphatidylinositol 3-phosphate (PI3P) to promote infection via direct association with RxLR effectors. Here, we designed a disease control strategy for metabolizing pathogen-derived PI3P by expressing secreted Arabidopsis thaliana phosphatidylinositol-4-phosphate 5-kinase 1 (AtPIP5K1), which can phosphorylate PI3P to PI(3,4)P2. We fused AtPIP5K1 with the soybean PR1a signal peptide (SP-PIP5K1) to enable its secretion into the plant apoplast. Transgenic soybean and potato plants expressing SP-PIP5K1 showed substantially enhanced resistance to various P. sojae and P. infestans isolates, respectively. SP-PIP5K1 significantly reduced PI3P accumulation during P. sojae and soybean interaction. Knockout or inhibition of PI3 kinases (PI3Ks) in P. sojae compromised the resistance mediated by SP-PIP5K1, indicating that SP-PIP5K1 action requires a supply of pathogen-derived PI3P. Furthermore, we revealed that SP-PIP5K1 can interfere with the action of P. sojae mediated by the RxLR effector Avr1k. This novel disease control strategy has the potential to confer durable broad-spectrum Phytophthora resistance in plants through a clear mechanism in which catabolism of PI3P interferes with RxLR effector actions.
Subject(s)
Phytophthora , Phytophthora/metabolismABSTRACT
BACKGROUD: Estrogen deficiency is the leading cause of postmenopausal osteoporosis(PMOP) and phytoestrogens soy isoflavones (SI) have been shown to improve PMOP. Equol (Eq), an in vivo metabolite of phytoestrogens soy isoflavones (SI), has a more stable structure and stronger biological activity than its parent compound and has the greatest estrogenic activity. However, there are few studies on the therapeutic effect of Eq on PMOP. PURPOSE: To explore the therapeutic effect and mechanisms of Eq on POMP. METHODS: Osteoblast-like cells ROS1728 were cultured with different doses of Eq, estradiol (E2), separately. The effect of Eq on the proliferation, apoptosis, cell cycle of osteoblasts were detected by CCK-8 and flow cytometry, and the expression of OPG/RANK/RANKL signaling pathway of osteoblasts was detected by Quantitative real-time PCR (qRT-PCR) and Western blot (WB), and RNA silencing technology were carried out to explore the receptors through which Eq plays a role. Then PMOP rat model was established and treated by Eq or E2 to further verification of the effect and mechanism of Eq on PMOP. RESULT: Eq promoted the proliferation and inhibited the apoptosis of osteoblasts and increased the proportion of osteoblasts in the S phase and G2/M phase in a dose-dependent manner. Mechanistically, Eq treatment upregulated the expression of OPG and OPG/RANKL ratio in osteoblasts and this regulatory effect was mainly mediated through the ERß receptor. Furthermore, in vivo study, Eq improved microstructure and BMD of the femur of PMOP rat model, which imitated the osteoprotective effect of E2. Moreover, the Eq or E2 treatment increased serum levels of Ca, 1,25(OH)2D3, bone Gla-protein(BGP), and Type I procollagen (PC1), and reduced serum levels of phosphorus (P), parathyroid hormone(PTH), pyridinol (PYD), tartrate-resistant acid phosphatase (TRAP) and urinary level of deoxypyridinoline (DPD) in the treatment OVX group compared with the untreated OVX group. Meanwhile, Eq or E2 markedly induced the mRNA and protein expression of OPG and OPG/RANKL ratio. CONCLUSION: Eq can combine with ERß and exert a protective effect on PMOP by upregulating OPG/RANKL pathway.
Subject(s)
Osteoporosis, Postmenopausal , Humans , Female , Rats , Animals , Osteoporosis, Postmenopausal/drug therapy , Osteoporosis, Postmenopausal/prevention & control , Osteoprotegerin/metabolism , Equol/pharmacology , Equol/metabolism , Estrogen Receptor beta/metabolism , Phytoestrogens/pharmacology , RANK Ligand/metabolism , OsteoblastsABSTRACT
Ligament augmentation has been applied during spinal surgery to prevent proximal junctional kyphosis (PJK), but the configuration and distal anchor strategies are diverse and inconsistent. The biomechanics of different ligament augmentation strategies are, therefore, unclear. We aimed to create a finite element model of the spine for segments T6-S1. Model Intact was the native form, and Model IF was instrumented with a pedicle screw from segments T10 to S1. The remaining models were based on Model IF, with ligament augmentation configurations as common (CM), chained (CH), common and chained (CHM); and distal anchors to the spinous process (SP), crosslink (CL), and pedicle screw (PS), creating SP-CH, PS-CHM, PS-CH, PS-CM, CL-CHM, CL-CH, and CL-CM models. The range of motion (ROM) and maximum stress on the intervertebral disc (IVD), PS, and interspinous and supraspinous ligaments (ISL/SSL) was measured. In the PS-CH model, the ROM for segments T9-T10 was 73% (of Model Intact). In the CL-CHM, CL-CH, CL-CM, PS-CM, and PS-CHM models, the ROM was 8%, 17%, 7%, 13%, and 30%, respectively. The PS-CH method had the highest maximum stress on IVD and ISL/SSL, at 80% and 72%, respectively. The crosslink was more preferable as the distal anchor. In the uppermost instrumented vertebrae (UIV) + 1/UIV segment, the CM was the most effective configuration. The PS-CH model had the highest flexion load on the UIV + 1/UIV segment and the CL-CM model provided the greatest reduction. The CL-CM model should be verified in a clinical trial. The influence of configuration and anchor in ligament augmentation is important for the choice of surgical strategy and improvement of technique.
ABSTRACT
Ferroptosis is a newly discovered form of cell death accompanied by iron accumulation and lipid peroxidation. Both biotic and abiotic stresses can induce ferroptosis in plant cells. In the case of plant interactions with pathogenic Phytophthora oomycetes, the roles of ferroptosis are still largely unknown. Here, we performed transcriptome analysis on soybean plants treated with the biocontrol agent Pythium oligandrum, a soilborne and non-pathogenic oomycete capable of inducing plant resistance against Phytophthora sojae infection. Expression of homologous soybean genes involved in ferroptosis and resistance was reprogrammed upon P. oligandrum treatment. Typical hallmarks for characterizing ferroptosis were detected in soybean hypocotyl cells, including decreased glutathione (GSH) level, accumulation of ferric ions, and lipid peroxidation by reactive oxygen species (ROS). Meanwhile, ferroptosis-like cell death was triggered by P. oligandrum to suppress P. sojae infection in soybean. Protection provided by P. oligandrum could be attenuated by the ferroptosis inhibitor ferrostatin-1 (Fer-1), suggesting the critical role of ferroptosis in soybean resistance against P. sojae. Taken together, these results demonstrate that ferroptosis is a P. oligandrum-inducible defence mechanism against oomycete infection in soybean.
Subject(s)
Ferroptosis , Phytophthora , Pythium , Glycine max/genetics , Plant Diseases/prevention & control , Plant Diseases/genetics , Disease Resistance/geneticsABSTRACT
Background: For patients with osteoporotic vertebral compression fractures (OVCFs) treated with percutaneous kyphoplasty (PKP), the occurrence and risk factors of intradiscal cement leakage should be characteristic of the presence of intravertebral cleft (IVC). This study aimed to identify risk factors for intradiscal leakage in individuals with OVCFs combined with IVC treated with PKP and build a powered and well-calibrated predictive nomogram. Methods: This study retrospectively reviewed consecutive patients who underwent PKP at our center between January 2016 and May 2021. Patients diagnosed with OVCFs combined with IVC were identified, and the incidence of different types of bone cement leakage was recorded. Risk factors for intradiscal leakage among the demographic, perioperative baseline, and radiologic data were identified, following which a nomogram was developed and verified. Results: A total of 109 eligible patients were included, and the intradiscal leakage rate was 32.1%. Compression rate (odds ratio [OR] 0.025; 95% confidence interval [CI] 0.002-0.264; P = 0.002) and cemented vertebral body fraction (OR 44.122; 95% CI 2.790-697.740; P = 0.007) were identified as independent risk factors. A predictive nomogram with good predictive power (C-statistic = 0.786) and fitness of data (Hosmer-Lemeshow goodness-of-fit test, P = 0.092) was established to build a quantitative relationship between the risk factors and intradiscal leakage. Conclusion: The incidence rate of intradiscal leakage in PKP for OVCFs combined with IVC was 32.1%. Compression rate and cemented vertebral body fraction were identified as independent risk factors. A powered and well-calibrated nomogram was established to accurately predict the probability of intradiscal leakage. Further prospective and multicenter studies are required to verify and calibrate our findings.
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Fecal microbiota transplantation (FMT) has shown promising results in animal models of obesity, while results in human studies are inconsistent. We aimed to determine factors associated with weight loss after FMT in nine obese subjects using serial multi-omics analysis of the fecal and mucosal microbiome. The mucosal microbiome, fecal microbiome, and fecal metabolome showed individual clustering in each subject after FMT. The colonic microbiome in patients showed more marked variance after FMT compared with the duodenal microbiome, characterized by an increased relative abundance of Bacteroides. Subjects who lost weight after FMT sustained enrichment of Bifidobacterium bifidum and Alistipes onderdonkii in the duodenal, colonic mucosal, and fecal microbiome and increased levels of phosphopantothenate biosynthesis and fecal metabolite eicosapentaenoic acid (EPA), compared with those without weight loss. Fecal levels of amino acid metabolism-associated were positively correlated with the fecal abundance of B. bifidum, and fatty acid metabolism-associated metabolites showed positive correlations with A. onderdonkii. We report for the first time the individualized response of fecal and mucosa microbiome to FMT in obese subjects and highlight that FMT is less capable of shaping the small intestine microbiota. These findings contribute to personalized microbe-based therapies for obesity.
ABSTRACT
Understanding the role of fecal microbiota transplantation (FMT) in the decolonization of multidrug-resistant organisms (MDRO) is critical. Specifically, little is known about virome changes in MDRO-infected subjects treated with FMT. Using shotgun metagenomic sequencing, we characterized longitudinal dynamics of the gut virome and bacteriome in three recipients who successfully decolonized carbapenem-resistant Enterobacteriaceae (CRE), including Klebsiella spp. and Escherichia coli, after FMT. We observed large shifts of the fecal bacterial microbiota resembling a donor-like community after transfer of a fecal microbiota dominated by the genus Ruminococcus. We found a substantial expansion of Klebsiella phages after FMT with a concordant decrease of Klebsiella spp. and striking increase of Escherichia phages in CRE E. coli carriers after FMT. We also observed the CRE elimination and similar evolution of Klebsiella phage in mice, which may play a role in the collapse of the Klebsiella population after FMT. In summary, our pilot study documented bacteriome and virome alterations after FMT which mediate many of the effects of FMT on the gut microbiome community. IMPORTANCE Fecal microbiota transplantation (FMT) is an effective treatment for multidrug-resistant organisms; however, introducing a complex mixture of microbes also has unknown consequences for landscape features of gut microbiome. We sought to understand bacteriome and virome alterations in patients undergoing FMT to treat infection with carbapenem-resistant Enterobacteriaceae. This finding indicates that transkingdom interactions between the virome and bacteriome communities may have evolved in part to support efficient FMT for treating CRE.
Subject(s)
Bacteriophages , Carbapenem-Resistant Enterobacteriaceae , Animals , Mice , Fecal Microbiota Transplantation , Virome , Escherichia coli , Pilot ProjectsABSTRACT
Electromechanical (EM) coupling-the conversion of energy between electric and mechanical forms-in ferroelectrics has been used for a broad range of applications. Ferroelectric polymers have weak EM coupling that severely limits their usefulness for applications. We introduced a small amount of fluorinated alkyne (FA) monomers (<2 mol %) in relaxor ferroelectric poly(vinylidene fluoride-trifluoroethylene-chlorofluoroethylene) (PVDF-TrFE-CFE) terpolymer that markedly enhances the polarization change with strong EM coupling while suppressing other polarization changes that do not contribute to it. Under a low-dc bias field of 40 megavolts per meter, the relaxor tetrapolymer has an EM coupling factor (k33) of 88% and a piezoelectric coefficient (d33) >1000 picometers per volt. These values make this solution-processed polymer competitive with ceramic oxide piezoelectrics, with the potential for use in distinct applications.
ABSTRACT
PURPOSE: We performed a bioinformatics analysis to identify the key genes that were differentially expressed between degenerative intervertebral disc (IVD) cells with and without exposure to interleukin-1ß and explore the related signaling pathways and interaction networks. METHODS: The microarray data were downloaded from the Gene Expression Omnibus (27,494). Then, analyses of the gene ontology, signaling pathways, and interaction networks for the differentially expressed genes (DEGs) were conducted using tools including the Database for Annotation, Visualization, and Integrated Discovery, Metascape, Gene Set Enrichment Analysis, Search Tool for the Retrieval of Interacting Genes, Cytoscape, Venn method, and packages of the R computing language. RESULTS: A total of 260 DEGs were identified, including 161 upregulated and 99 downregulated genes. Gene Ontology annotation analysis showed that these DEGs were mainly associated with the extracellular region, chemotaxis, taxis, cytokine activity, and cytokine receptor binding. A Kyoto Encyclopedia of Genes and Genomes signaling pathway analysis showed that these DEGs were mainly involved in the of cytokine-cytokine receptor interaction, rheumatoid arthritis, tumor necrosis factor signaling pathway, Salmonella infection, and chemokine signaling pathway. The interaction network analysis indicated that 10 hub genes, including CXCL8, CXCL1, CCL20, CXCL2, CXCL5, CXCL3, CXCL6, C3, PF4, and GPER1 may play key roles in IVD degeneration. CONCLUSIONS: Bioinformatic analysis showed that CXCL8 and other nine key genes may play a role in the development of disc degeneration induced by inflammatory reactions and can be used to identify potential target genes for therapeutic applications in IVD degeneration.
Subject(s)
Computational Biology , Intervertebral Disc Degeneration , Computational Biology/methods , Gene Expression Profiling/methods , Humans , Interleukin-1beta/genetics , Intervertebral Disc Degeneration/genetics , Signal Transduction/geneticsSubject(s)
Gastrointestinal Microbiome , Alopecia/chemically induced , Animals , Diet/adverse effects , Diet, High-Fat , Mice , Mice, Inbred C57BL , ObesityABSTRACT
BACKGROUND: Several factors have been reported to adversely affect clinical and structural outcomes after rotator cuff repair (RCR). However, the effects of smoking on rotator cuff healing and clinical outcomes remain controversial. The purpose of this study was to compare the clinical and structural outcomes after RCR between smokers and nonsmokers. We hypothesized that there would be no significant difference in the clinical scores after RCR and that smoking would be associated with a significantly increased risk of retear and reoperation. METHODS: This systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines using the PubMed, Cochrane Library, and Embase databases. We included only articles in which patients underwent arthroscopic and open RCR, the clinical outcome scores were reported for smokers and nonsmokers, and the number of rotator cuff retears and reoperations were reported. Data relevant to this study were extracted and statistically analyzed. We used the Newcastle-Ottawa Scale to assess the risk of bias in each study and calculated the I2 value to quantify the effect of heterogeneity. RESULTS: Fourteen eligible articles were identified, with 73,817 participants (8553 smokers and 65,264 nonsmokers). The meta-analysis demonstrated that there were no significant differences in the American Shoulder and Elbow Surgeons score (P = .10), Simple Shoulder Test score (P = .19), University of California-Los Angeles score (P = .09), or visual analog scale score (P = .19) between smokers and nonsmokers after surgery, but the Constant score was significantly lower (P = .005) for smokers. Smoking was significantly associated with an increased risk of retear (P = .002; risk ratio, 2.06 [95% confidence interval, 1.30-3.28]; I2 = 31%) and reoperation (P < .001; risk ratio, 1.29 [95% confidence interval, 1.20-1.40]; I2 = 36%) in patients after RCR. CONCLUSION: Besides the Constant score, which was lower in smokers, there were no significant differences in the clinical scores after RCR between smokers and nonsmokers. However, smoking was associated with a significantly increased risk of retear and reoperation.
Subject(s)
Rotator Cuff Injuries , Rotator Cuff , Arthroscopy , Humans , Rotator Cuff/surgery , Rotator Cuff Injuries/surgery , Smoking/adverse effects , Treatment OutcomeABSTRACT
BACKGROUND: This study aims to explore the effect of mobile phone-based telemedicine management of glycemic control of type 2 diabetes mellitus (T2DM). METHODS: Patients with T2DM were followed up in Chongqing Jiulongpo District Yuzhoulu Community Health Center, and randomly divided into the telemedicine group (n=47) and the control group (n=50). The control group received regularly routine intervention. The telemedicine management group used the mobile phone to manage their health condition remotely. RESULTS: Both groups had similar baseline characteristics. After a follow-up period of 12 months intervention, the weight, body mass index, waist circumference, systolic blood pressure, body fat percentage, body fat mass, body water and muscle mass, fasting blood glucose, glycosylated hemoglobin, total costs of diabetes treatment for 1 month and the quality-of-life score were significantly improved in the telemedicine group (P<0.05). And compared with the control group, body fat composition, fasting blood glucose, glycosylated hemoglobin and the cost of change shows a significant improvement (P<0.05). Positive correlation was detected between fasting blood glucose and body composition parameters, such as body fat percentage, lean body mass and body fat mass in the telemedicine group (r=0.56, P<0.05; r=0.37, P<0.05; r=0.56, P<0.05). CONCLUSIONS: Compared with conventional intervention, the mobile phone-based telemedicine management can help patients with T2DM to improve glycemic level and quality of life.
Subject(s)
Cell Phone , Diabetes Mellitus, Type 2 , Telemedicine , Blood Glucose , Diabetes Mellitus, Type 2/therapy , Glycated Hemoglobin/analysis , Humans , Quality of LifeABSTRACT
BACKGROUND: With the advancements in surgical methods, optical designs, and surgical instruments, percutaneous endoscopic transforaminal discectomy (PETD) has become an effective and minimally invasive procedure to treat lumbar spinal stenosis (LSS) in recent years. Few studies have focused on the complications associated with the treatment of LSS using percutaneous endoscopic lumbar discectomy (PELD). This study aimed to summarize the complications of PETD and identify the associated risk factors. METHODS: Complications in a total of 738 consecutive LSS patients who underwent single-level PETD were retrospectively recorded and analyzed between January 2016 and July 2020. In addition, a matched case-control study was designed, and according to the date of operation, the control group was matched with patients without complications, with a matching ratio of 1:3. Demographic parameters included age, sex, BMI, smoking and drinking status, comorbidity, and surgical level. The radiological parameters included grade of surgical-level disc degeneration, number of degenerative lumbar discs, grade of lumbar spinal stenosis, degenerative lumbar scoliosis, lumbar lordosis, disc angle, and disc height index. Univariate analysis was performed using independent samples t-test and chi-squared test. RESULTS: The incidence of different types of complications was 9.76% (72/738). The complications and occurrence rates were as follows: recurrence of LSS (rLSS), 2.30% (17/738); persistent lumbosacral or lower extremity pain, 3.79% (28/738); dural tear, 1.90% (14/738); incomplete decompression, 0.81% (6/738); surgical site infection, 0.41% (3/738); epidural hematoma, 0.27% (2/738); and intraoperative posterior neck pain, 0.27% (2/738). Univariate analysis demonstrated that age, the grade of surgical-level disc degeneration (P < 0.001) and the number of disc degeneration levels (P = 0.004) were significantly related to the complications. CONCLUSION: Complications in the treatment of LSS using PELD included rLSS, persistent pain of the lumbosacral or lower extremity, dural tear, incomplete decompression, surgical site infection, epidural hematoma, and intraoperative posterior neck pain. In addition, old age, severe grade of surgical-level disc degeneration and more disc degeneration levels significantly increased the incidence of complications.
Subject(s)
Diskectomy, Percutaneous , Intervertebral Disc Displacement , Spinal Stenosis , Case-Control Studies , Diskectomy , Diskectomy, Percutaneous/adverse effects , Endoscopy/adverse effects , Humans , Intervertebral Disc Displacement/diagnostic imaging , Intervertebral Disc Displacement/epidemiology , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/surgery , Retrospective Studies , Risk Factors , Spinal Stenosis/diagnostic imaging , Spinal Stenosis/epidemiology , Spinal Stenosis/surgery , Treatment OutcomeABSTRACT
BACKGROUND: Degenerative lumbar spondylolisthesis (DLS) occurs mainly in geriatric patients. Some authors have reported satisfactory short-term outcomes following percutaneous endoscopic lumbar discectomy (PELD) for DLS; however, the long-term clinical outcomes remain unknown. In addition, it remains unclear whether PELD causes further progression of spondylolisthesis over a long period of time. OBJECTIVES: To evaluate long-term clinical outcomes in patients who underwent PELD and to study the degree of slippage in DLS over a long period following minimally invasive surgery. STUDY DESIGN: Retrospective case series. SETTING: The study was conducted at the Beijing Chaoyang Hospital, Capital Medical University, China. METHODS: The study included 24 patients with DLS who complained of radicular pain and lower back pain who underwent PELD and were followed up for at least 5 years (mean duration of 6.1 years). Visual analog scale (VAS) scores, Oswestry disability index (ODI) scores, and the modified MacNab criteria were used to evaluate clinical outcomes. Preoperative imaging findings, including the percent slippage of spondylolisthesis (SR), disc height (DH), segmental lordosis angle (SL), and lumbar lordosis angle (LL), were compared with those obtained at follow-up. RESULTS: All operations were successfully completed; the mean operative incision length, intraoperative blood loss, and operation duration were 8.7 ± 0.6 mm, 11.3 ± 4.5 mL, and 121.8 ± 32.3 min, respectively. The mean VAS-back score, VAS-leg score, and ODI score were 6.5 ± 0.9, 6.0 ± 1.1, and 55.4 ± 4.4 points before surgery, respectively, and decreased to 2.6 ± 0.8, 2.2 ± 0.5, and 27.3 ± 5.3 points, respectively, at 3 months after surgery and 2.5 ± 0.9, 2.0 ± 0.5, and 21.1 ± 4.4 points, respectively, at the latest follow-up. The imaging variables related to DH were lower at the final follow-up before surgery; however, no significant differences in SR, SL, and LL were found. The proportion of excellent and good results following MacNab evaluation was 87.5%. Symptomatic re-herniation occurred in one patient, and cerebrospinal fluid leakage (CSFL) was found in another patient. LIMITATIONS: A small number of patients were included who were all treated by one surgeon. CONCLUSIONS: PELD maintained satisfactory clinical outcomes for the treatment of grade I and grade II DLS after a minimum 5-year follow-up; the operation did not cause further progression of spondylolisthesis. However, further large-scale multicenter studies are necessary.
Subject(s)
Diskectomy, Percutaneous , Intervertebral Disc Displacement , Spondylolisthesis , Aged , Diskectomy , Endoscopy , Follow-Up Studies , Humans , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Retrospective Studies , Spondylolisthesis/surgery , Treatment OutcomeABSTRACT
Multiple myeloma (MM) is a plasma cell malignancy of bone marrow. In the present study, we aimed to study the function and potential mechanism of the antisense non-coding RNA in the INK4 Locus (ANRIL) in MM. The expression levels of ANRIL in MM patients and healthy donors were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). The effects and mechanisms of ANRIL in MM were evaluated by cell viability assay, BrdU incorporation assay, tumor xenograft model, flow cytometry, western blot, RNA immunoprecipitation (RIP), transcriptome RNA sequencing, and chromatin immunoprecipitation (ChIP). We found that ANRIL was upregulated in MM patients and cell lines, and associated with advanced international staging system (ISS) stage and poor overall survival. Enforced ANRIL expression promoted proliferation and tumor xenograft growth of MM cells, while knockdown of ANRIL exhibited opposite effects. Moreover, ANRIL overexpression increased the half-maximal inhibitory concentration (IC50) of bortezomib and reduced bortezomib-induced apoptosis in MM cells. ANRIL was found to accumulate in the nuclei of MM cells, and interact with EZH2 by RIP assay. Transcriptome RNA sequencing identified PTEN as a target of ANRIL in MM cells. In the ChIP assay, knockdown of ANRIL reduced EZH2 occupancy and H3K27me3 binding to the promoter region of PTEN. Furthermore, EZH2 knockout or PTEN restoration abrogated the effects caused by ANRIL overexpression in MM cells. Our results indicated that ANRIL exerted oncogenic functions and conferred chemoresistance of MM cells by EZH2-mediated epigenetically silencing of PTEN.