TP53INP2 knockdown inhibits inflammatory response and apoptosis after spinal cord injury.

BACKGROUND: Spinal cord injury (SCI) is a traumatic neurological disorder with limited therapeutic options. Tumor protein p53-inducible nuclear protein 2 (TP53INP2) is involved in the occurrence and development of various diseases, and it may play a role during SCI via affecting inflammation and neuronal apoptosis. This study investigated the associated roles and mechanisms of TP53INP2 in SCI. METHODS: Mouse and lipopolysaccharide (LPS)-induced SCI BV-2 cell models were constructed to explore the role of TP53INP2 in SCI and the associated mechanisms. Histopathological evaluation of spinal cord tissue was detected by hematoxylin and eosin staining. The Basso, Beattie, and Bresnahan score was used to measure the motor function of the mice, while the spinal cord water content was used to assess spinal cord edema. The expression of TP53INP2 was measured using RT-qPCR. In addition, inflammatory factors in the spinal cord tissue of SCI mice and LPS-treated BV-2 cells were measured using enzyme-linked immunosorbent assay. Apoptosis and related protein expression levels were detected by flow cytometry and western blot analysis, respectively. RESULTS: TP53INP2 levels increased in SCI mice and LPS-treated BV-2 cells. The results of in vivo and in vitro experiments showed that TP53INP2 knockdown inhibited the inflammatory response and neuronal apoptosis in mouse spinal cord tissue or LPS-induced BV-2 cells. CONCLUSIONS: After spinal cord injury, TP53INP2 was upregulated, and TP53INP2 knockdown inhibited the inflammatory response and apoptosis.

Current situation and cost-effectiveness of 18F-FDG PET/CT for the diagnosis of fever of unknown origin and inflammation of unknown origin: A single-center, large-sample study from China.

PURPOSE: 18F-FDG PET/CT has an important role in the evaluation of fever of unknown origin (FUO) and inflammation of unknown origin (IUO). Our study was to investigate the current status of the inclusion of 18F-FDG PET/CT within FUO/ IUO diagnostic work-up and evaluate the cost-effectiveness of it in China. METHODS: A total of 741 FUO/IUO patients admitted to our hospital from January 2012 to December 2019 were retrospectively reviewed. The clinical characteristic, medical expenses to reach diagnosis and the proportion of definite etiological diagnosis achieved upon hospital discharge were compared between patients examined by 18F-FDG PET/CT (18F-FDG PET/CT group) and patients not examined by 18F-FDG PET/CT (non-18F-FDG PET/CT group). RESULTS: The mean age, proportion of critically-ill patients, proportion of rheumatologic diseases, the number of examinations and hospitalisation days to reach diagnosis in the 18F-FDG PET/CT group were significantly higher than those in the non-18F-FDG PET/CT group. The mean medical costs of 18F-FDG PET/CT group were significantly higher than those of non-18F-FDG PET/CT group, whereas the proportion of definite etiological diagnosis achieved upon hospital discharge of 18F-FDG PET/CT group was significantly higher than that of non-18F-FDG PET/CT group. The mean hospitalisation days and mean medical costs before diagnosis were significantly lower in patients who undertook 18F-FDG PET/CT ≤ 7 days after hospital admission than those in patients who undertook 18F-FDG PET/CT > 7 days after hospital admission. CONCLUSIONS: 18F-FDG PET/CT is mostly used in critically-ill and hard-to-diagnose FUO/IUO patients currently in China, which may conceal its cost-effective advantage. While the early use of 18F-FDG PET/CT according to patient characteristics and etiological clues could help to reduce hospitalization stay, limit medical costs, thus producing its diagnostic effect to the great extent.

MicroRNA­138­5p regulates the development of spinal cord injury by targeting SIRT1.

MicroRNAs (miRs) play an important role in the development and progression of spinal cord injury (SCI). The role of miR­138­5p in SCI was investigated in the present study. The anti­inflammatory effects of miR­138­5p and underlying mechanisms were investigated in an SCI rat model and in vitro model. Reverse transcription­quantitative PCR (RT­qPCR) was used to examine the expression of miR­138­5p in the SCI in vivo and in vitro models, as well as patients with SCI; it was found that miR­138­5p was significantly upregulated in SCI. Bioinformatics and dual­luciferase reporter assays were performed to predict and confirm the binding sites between miR­138­5p and the 3'untranslated region of sirtuin 1 (SIRT1). Then, the expression of SIRT1 was detected via RT­qPCR and western blotting, indicating downregulation of SIRT1 in SCI. PC12 cells were transfected with miR­138­5p inhibitor, inhibitor control or miR­138­5p inhibitor + SIRT1 small interfering RNA for 48 h, and then subjected to lipopolysaccharide (100 ng/ml) treatment for 4 h. Then, MTT assay, flow cytometry and ELISA experiments were performed to analyze cell viability, apoptosis, and the levels of tumor necrosis factor­α, interleukin (IL)­1ß and IL­6. Findings suggested that downregulation of miR­138­5p increased PC12 cell viability, inhibited cell apoptosis and attenuated proinflammatory responses, which may result in amelioration of SCI. However, all these effects were reversed by SIRT1 knockdown. Finally, it was observed that miR­138­5p altered the related protein expression of the PTEN/AKT pathway. These results indicated that miR­138­5p could regulate inflammatory responses and cell apoptosis in SCI models by modulating the PTEN/AKT signaling pathway via SIRT1, thus playing an important role in the development of SCI. Collectively, the present study demonstrated that miR­138­5p may be a novel therapeutic target for the treatment of SCI.

18F-FDG PET/CT in a Patient With Pregnancy and Lactation-Associated Osteoporosis.

A 33-year-old woman in the 6th month postpartum and breast-feeding period suffered from acute thoracolumbar pain for 1 month. She presented with slightly decreased serum calcium level. Other laboratory assessments were unremarkable. Considering the worsening symptom and her strong demand to exclude potential malignancy, F-FDG PET/CT was performed. Multiple FDG-avid foci in the thoracic and lumbar vertebra were detected on FDG PET, corresponding to vertebral compression fractures on CT, and diffuse FDG uptake was seen within bilateral breast, and dual-X ray absorptiometry showed markedly decreased bone mineral density, all of which supported the diagnosis of pregnancy and lactation-associated osteoporosis.

Percutaneous Endoscopic Interlaminar Discectomy for L5-S1 Adolescent Lumbar Disc Herniation.

AIM: L5/S1 Adolescent lumbar disc herniation (ALDH) is usually ignored for its low incidence. Recently, percutaneous endoscopic procedures have been widely used. To investigate the surgical techniques and clinical outcomes of percutaneous endoscopic interlaminar discectomy (PEID) in the treatment of adolescent L5-S1 disc herniation (ALDH). MATERIAL AND METHODS: A retrospective study was performed between May 2012 and September 2014, which included 23 adolescent patients who underwent PEID for L5/S1 lumbar disc herniation. Ten females and 13 males were included, with a mean age of 15.4 years and a mean BMI of 25.1 kg/m2. The pre- and postoperative visual analogue scale (VAS), Japanese Orthopaedic Association (JOA), and modified MacNab scores, as well as perioperative data, were collected. RESULTS: The mean follow-up period was 19.7 months. The average operation time and hospital stay were 80.9 ± 7.3 minutes and 5.8 ± 1.2 days, respectively. During the follow-up period, the VAS for back and leg pain decreased significantly, and JOA scores greatly increased (p < 0.05). In terms of modified MacNab criteria, 86.9% of patients showed excellent or good results. After surgery, two patients complained of leg numbness, and another patient underwent a subsequent open discectomy due to recurrent disc herniation. CONCLUSION: Considering specific anatomical peculiarities and expectation for rapid recovery, PEID is a safe and effective minimally invasive technique for ALDH at the L5-S1 level.

Three-year postoperative outcomes between MIS and conventional TLIF in1-segment lumbar disc herniation.

AIM: The aim of this study is to assess the long-term clinical and radiological outcomes between minimally invasive (MIS) and conventional transforaminal lumbar interbody fusion (TLIF) in treating one-segment lumbar disc herniation (LDH). MATERIAL AND METHODS: One-hundred and six patients treated by MIS-TLIF (50 cases) or conventional TLIF (56 cases) were included. Perioperative results were evaluated. Clinical outcomes were compared preoperatively and postoperatively. Radiologic parameters were based on a comparison of preoperative and three-year postoperative lumbar lordosis, segmental lordosis, sacral slope, the cross-sectional area of the paraspinal muscle and fusion rates. RESULTS: MIS TILF had significantly less blood, shorter operation time, mean return to work time and lower intramuscular pressure compared with the conventional group during the operation. VAS scores for lower back pain and ODI in MIS-TLIF were significantly decreased. The mean cross-sectional area of the paraspinal muscle was significantly decreased after surgery in the conventional TLIF group and no significant intragroup differences were established in the MIS-TLIF group. No significant differences were found in fusion rate, lumbar lordosis, segmental lordosis and sacral slope. CONCLUSIONS: Both MIS and conventional TLIF were beneficial for patients with LDH. However, MIS-TLIF manifests a great improvement in perioperative outcomes, low back pain, disability and preventing paraspinal muscle atrophy during the follow-up period observation.

Brain-derived neurotrophic factor expression in dorsal root ganglia of a lumbar spinal stenosis model in rats.

This study aimed to investigate the expression of brain-derived neurotrophic factor (BDNF) in dorsal root ganglia (DRG) of a rat model of lumbar spinal stenosis (LSS). Adult male rats were divided into the operation and sham operation groups. The operation group was comprised of the rat models of LSS. Walking distance and BDNF expression levels in DRG were measured in the two groups at different time points. The total BDNF protein levels and positive cell mean optical density (MOD) values in the operation group were significantly higher at each time point compared with that of the sham operation and preoperative control groups (P<0.05). The total BDNF protein levels and MOD values following sport in the operation group were significantly higher compared with those prior to sport (P<0.05). In the sham operation group, BDNF protein levels and MOD values before and after sport at each time point showed no significant differences than those of the operation group (P>0.05). Moreover, BDNF protein levels and MOD values in the operation group indicated a negative correlation with walking distance. The present study demonstrated that the expression of BDNF in rat models of LSS increased with time and was associated with a decrease in walking distance. BDNF was therefore important for the process of intermittent claudication caused by LSS.

Treatment of thoracolumbar fracture with pedicle screws at injury level: a biomechanical study based on three-dimensional finite element analysis.

The aim of this study was to investigate the biomechanical mechanisms of treatment of thoracolumbar compression fracture with pedicle screws at injury level based on a three-dimensional finite element method. We constructed one three-dimensional finite element model of T11-L1 in a patient with a compression fracture of the T12 vertebral body(anterior edges of vertebral body were compressed to 1/2, and kyphosis Cobb angle was 18.6°) fixed by four pedicle screws and another model fixed by six pedicle screws at the injured vertebrae, and then assigned different forces to the two models to account for axial compression, flexion, extension, left lateral bending, and rightward axial rotation by Ansys software. After different loading forces were applied to the models, we recorded stress measurements on the vertebral pedicle screws, as well as the maximum displacement of T11. The stress distribution suggested that stress concentration was appreciable at the root of the pedicle screws under different loading modalities. Under axial compression, flexion, extension, left lateral bending, and rightward axial rotation load, the stress for the superior screw was significantly greater than the stress for the inferior screw (P < 0.05). The stress in the six pedicle screw fixation model was significantly decreased compared to the four screw interbody fusion model (P < 0.05), but the maximum displacement of T11 between two models under different loadings was not statistically different. The use of pedicle screws at injured vertebral bodies may optimize internal fixation load and reduce the incidence of broken screws.

[Treatment of thoracolumbar fractures with transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae].

OBJECTIVE: To study the effectiveness of transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae for the treatment of thoracolumbar fractures. METHODS: Between February 2007 and January 2009, 25 patients with thoracolumbar fractures were treated by posterior short-segment fixation combined with transpedicular intervertebral bone graft and pedicle screw fixation in injured vertebrae. There were 18 males and 7 females with a mean age of 46 years (range, 28-63 years). The injured vertebrae were located at T10 in 1 case, T11 in 2 cases, T12 in 8 cases, L1 in 6 cases, L2 in 6 cases, L3 in 1 case, and L4 in 1 case. According to Denis classification, there were 14 cases of burst fractures and 11 cases of compression fractures. Based on Frankel classifications, 2 cases were rated as grade A, 4 cases as grade B, 8 cases as grade C, 7 cases as grade D, and 4 cases as grade E. The time between injury and operation was 6 hours to 7 days (mean, 4.6 days). The X-ray film was taken to measure the relative height of fractured vertebrae and Cobb angle, and Frankel classification was conducted to evaluate the function recovery of the spinal cord. RESULTS: The operations were performed successfully, and incisions healed primarily. All the patients were followed up 12-25 months (mean, 16 months). CT and X-ray films showed good bone graft healing and no loosening or breakage of screws and rods. The relative height of fractured vertebrae were 56.8% +/- 15.6% at preoperation, 91.2% +/- 10.7% immediately after operation, and 89.6% +/- 10.3% at 1 year after operation, showing significant differences between preoperation and postoperation (P < 0.01), while no significant difference between immediately after operation and 1 year after operation. The Cobb angles were (18.2 +/- 2.6), (7.5 +/- 1.4), and (8.7 +/- 1.1) degrees, respectively, showing significant differences between preoperation and postoperation (P < 0.01), while no significant difference between immediately and 1 year after operation. At 1 year after operation, the neural function in 16 cases was improved 1-3 grades. CONCLUSION: Treatment of thoracolumbar fractures with transpedicular intervertebral bone graft and pedicle screw fixation in injured vertebrae has satisfactory effectiveness, which can reconstruct vertebral body height, increase the stability of anterior and middle column of the injured vertebrae, and prevent height loss of the injured vertebrae and loosening of instrumentation.

Developing a High-Resolution Vehicular Emission Inventory by Integrating an Emission Model and a Traffic Model: Part 2-A Case Study in Beijing.

A grid-based, bottom-up method has been proposed by combining a vehicle emission model and a travel demand model to develop a high-resolution vehicular emission inventory for Chinese cities. Beijing is used as a case study in which the focus is on fuel consumption and emissions from hot-stabilized activities of light-duty gasoline vehicles (LGVs) in 2005. The total quantity of emissions, emission intensity, and spatial distribution of emissions at 1- by 1-km resolution are presented and compared with results from other inventory methods commonly used in China. The results show that the total daily fuel consumption and vehicular emissions of carbon dioxide, carbon monoxide, hydrocarbons, and oxides of nitrogen from LGVs in the Beijing urban area in 2005 were 1.95 × 107 L, 4.28 × 104 t, 1.97 × 103 t, 0.28 × 103 t, and 0.14 × 103 t, respectively. Vehicular fuel consumption and emissions show spatial variations that are consistent with the traffic characteristics. The grid-based inventory developed in this study reflects the influence of traffic conditions on vehicle emissions at the microscale and may be applied to evaluate the effectiveness of traffic-related measures on emission control in China.

Developing a high-resolution vehicular emission inventory by integrating an emission model and a traffic model: Part 2--A case study in Beijing.

A grid-based, bottom-up method has been proposed by combining a vehicle emission model and a travel demand model to develop a high-resolution vehicular emission inventory for Chinese cities. Beijing is used as a case study in which the focus is on fuel consumption and emissions from hot-stabilized activities of light-duty gasoline vehicles (LGVs) in 2005. The total quantity of emissions, emission intensity, and spatial distribution of emissions at 1- by 1-km resolution are presented and compared with results from other inventory methods commonly used in China. The results show that the total daily fuel consumption and vehicular emissions of carbon dioxide, carbon monoxide, hydrocarbons, and oxides of nitrogen from LGVs in the Beijing urban area in 2005 were 1.95 x 10(7) L, 4.28 x 10(4) t, 1.97 x 10(3) t, 0.28 x 10(3) t, and 0.14 x 10(3) t, respectively. Vehicular fuel consumption and emissions show spatial variations that are consistent with the traffic characteristics. The grid-based inventory developed in this study reflects the influence of traffic conditions on vehicle emissions at the microscale and may be applied to evaluate the effectiveness of traffic-related measures on emission control in China.

A bottom-up methodology to estimate vehicle emissions for the Beijing urban area.

Vehicle exhaust emissions have posed a serious threat in recent years to the urban air quality of Beijing. It is necessary to accurately estimate the magnitude and distribution of these emissions in order to reduce the uncertainty of local scale air quality modeling assessment. This paper provides a bottom-up approach by combining vehicle emission factors and vehicle activity data from a travel demand model estimated at the grid level to generate vehicle emissions data for the Beijing urban area in 2005. In that year, vehicular emissions of HC, CO and NOx were respectively 13.33x10(4), 100.02x10(4) and 7.55x10(4) tons. The grid-based emissions were also compared with the vehicular emission inventory developed by macro-scale approach. It shows this bottom-up approach can result in better estimates of the levels and spatial distribution of vehicle emissions than the macro-scale method that relies on more average and aggregated information.