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OBJECTIVE: To investigate factors influencing the long-term prognosis of patients with sacral Tarlov syndrome after nerve root cuff reconstruction. METHODS: A total of 42 patients with sacral Tarlov cysts who underwent nerve root cuff reconstruction at the First Medical Center of the Chinese PLA General Hospital between December 2015 and December 2021 were retrospectively reviewed. All cases were confirmed using magnetic resonance imaging and pathology. All patients were followed up for 24 months after surgery. Improvement in self-evaluation of health was defined as a good prognosis, while a decline in self-evaluation of health was defined as a poor prognosis. The demographic characteristics and clinical data were compared between patients with good and poor prognoses. Multivariate logistic regression analysis was performed, taking poor prognosis as the dependent variable and parameters with P < 0.1 in the univariate analysis as independent variables to identify the risk factors. RESULTS: Significant differences were observed in disease duration, lower limb weakness, defecation dysfunction, and defecation dysfunction between patients with good and poor prognoses. Multivariate logistic regression analysis showed that disease duration (Odds ratio: 0.961, 95% confidence interval: 0927-0.995) and defecation dysfunction (Odds ratio: 0.005, 95% confidence interval: 0.0-0.368) were independent risk factors for poor prognosis after nerve cuff reconstruction in patients with sacral Tarlov cysts (all P < 0.05). CONCLUSIONS: Patients with sacral Tarlov cysts undergoing nerve root cuff reconstruction, particularly those with longer preoperative disease duration and dysuria, are at increased risk of poor long-term prognosis.
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BACKGROUND: Although pandemic-related experiences have been linked to the psychological well-being of mothers, the effects of the COVID-19 pandemic on infant neurodevelopmental outcomes have not been sufficiently studied. AIMS: To assess whether maternal COVID-19-related experiences (i.e., COVID-19-related health, risk, resource worries, and feelings of grief), parenting stress, and maternal self-efficacy are associated with infant neurodevelopment as measured by the Ages and Stages Questionnaire, Third Edition (ASQ-3) maternal report when infants were between 8 to 10 months of age. Furthermore, this study examined the moderating effect of maternal self-efficacy between maternal COVID-19-related experiences and infant neurodevelopment. METHODS: This cross-sectional study included 122 women who were drawn from the Perinatal Experiences and COVID-19 Effects (PEACE) Study, with online surveys administered between November 2020 and August 2022. RESULTS: After controlling for maternal anxiety and depression symptoms and demographic factors, hierarchical regression analysis indicated that parenting stress showed no effect on ASQ-3 scores. However, more adverse COVID-19-related experiences and higher levels of maternal self-efficacy were associated with better infant neurodevelopment. Moreover, there was a significant interaction effect between maternal self-efficacy and COVID-19-related experiences on infant neurodevelopment. For mothers with moderate to high levels of self-efficacy, more adverse COVID-19-related experiences were associated with better infant neurodevelopment. For mothers with low levels of self-efficacy, more adverse COVID-19-related experiences were associated with poorer developmental outcomes in infants. CONCLUSIONS: Under adverse conditions, confidence in caregiving may afford more optimal infant neurodevelopment. Interventions aimed at fostering maternal self-efficacy and addressing specific stressors can be valuable in promoting positive developmental trajectories for infants born during the pandemic.
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COVID-19 , Desarrollo Infantil , Madres , Responsabilidad Parental , Autoeficacia , Estrés Psicológico , Humanos , COVID-19/psicología , COVID-19/epidemiología , Femenino , Adulto , Estrés Psicológico/epidemiología , Estrés Psicológico/psicología , Lactante , Responsabilidad Parental/psicología , Madres/psicología , Masculino , Estudios TransversalesRESUMEN
INTRODUCTION: Coparenting in unmarried families is a protective factor for positive adolescent adjustment. Although the relations between coparenting and adolescent outcomes have been investigated, it remains unclear whether the specific patterns of maternal and paternal coparenting are associated with adolescent behavioral outcomes. METHODS: The present study includs a longitudinal cohort of 1143 triads of unmarried parents and their adolescents to examine the associations between different patterns of coparenting and adolescent behavioral problems and delinquency. The data were drawn from the Future of Families and Child Wellbeing Study in the United States. Our study used six waves of publicly available data at children's birth, ages 1, 3, 5, 9, and 15. RESULTS: The latent profile analyses identified four coparenting profiles of maternal and paternal coparenting perceived by the other unmarried parent. Comparing average levels of coparenting between mothers and fathers, the profiles were entitled Low Mom-Low Dad, High Mom-Medium Dad, Low Mom-Medium Dad, and High Mom-High Dad. Parents characteristics, such as cohabitation and marital status, predicted the likelihood of being in cooperative coparenting profiles. Furthermore, all the identified coparenting profiles predicted adolescent externalizing behavioral problems; only the high mom cooperative coparenting profiles predicted adolescent internalizing behavioral problems; none of the coparenting profiles predicted adolescent delinquency. CONCLUSIONS: Our study adds empirical evidence for coparenting research by revealing that coparenting patterns vary in unmarried families and that cooperative coparenting benefits child behavioral outcomes. The findings encourage introducing different coparenting training programs targeting unmarried parents' diverse needs, thus promoting positive adolescent adjustment.
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Conducta del Adolescente , Delincuencia Juvenil , Responsabilidad Parental , Humanos , Adolescente , Femenino , Masculino , Delincuencia Juvenil/estadística & datos numéricos , Delincuencia Juvenil/psicología , Responsabilidad Parental/psicología , Estudios Longitudinales , Conducta del Adolescente/psicología , Niño , Problema de Conducta/psicología , Estados Unidos , Preescolar , Ilegitimidad/estadística & datos numéricos , LactanteRESUMEN
CONTEXT: Sepsis-induced acute lung injury (ALI) is associated with high morbidity and mortality. Rhodiola rosea L. (Crassulaceae) (RR) and its extracts have shown anti-inflammatory, antioxidant, immunomodulatory, and lung-protective effects. OBJECTIVE: This study elucidates the molecular mechanisms of RR against sepsis-induced ALI. MATERIALS AND METHODS: The pivotal targets of RR against sepsis-induced ALI and underlying mechanisms were revealed by network pharmacology and molecular docking. Human umbilical vein endothelial cells (HUVECs) were stimulated by 1 µg/mL lipopolysaccharide for 0.5 h and treated with 6.3, 12.5, 25, 50, 100, and 200 µg/mL RR for 24 h. Then, the lipopolysaccharide-stimulated HUVECs were subjected to cell counting kit-8 (CCK-8), enzyme-linked immunosorbent, apoptosis, and Western blot analyses. C57BL/6 mice were divided into sham, model, low-dose (40 mg/kg), mid-dose (80 mg/kg), and high-dose (160 mg/kg) RR groups. The mouse model was constructed through caecal ligation and puncture, and histological, apoptosis, and Western blot analyses were performed for further validation. RESULTS: We identified six hub targets (MPO, HRAS, PPARG, FGF2, JUN, and IL6), and the PI3K-AKT pathway was the core pathway. CCK-8 assays showed that RR promoted the viability of the lipopolysaccharide-stimulated HUVECs [median effective dose (ED50) = 18.98 µg/mL]. Furthermore, RR inhibited inflammation, oxidative stress, cell apoptosis, and PI3K-AKT activation in lipopolysaccharide-stimulated HUVECs and ALI mice, which was consistent with the network pharmacology results. DISCUSSION AND CONCLUSION: This study provides foundational knowledge of the effective components, potential targets, and molecular mechanisms of RR against ALI, which could be critical for developing targeted therapeutic strategies for sepsis-induced ALI.
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Lesión Pulmonar Aguda , Rhodiola , Sepsis , Humanos , Animales , Ratones , Ratones Endogámicos C57BL , Fosfatidilinositol 3-Quinasas , Proteínas Proto-Oncogénicas c-akt , Lipopolisacáridos/toxicidad , Simulación del Acoplamiento Molecular , Farmacología en Red , Estrés Oxidativo , Sepsis/complicaciones , Sepsis/tratamiento farmacológico , Lesión Pulmonar Aguda/tratamiento farmacológico , Lesión Pulmonar Aguda/etiología , Células Endoteliales de la Vena Umbilical HumanaRESUMEN
OBJECTIVE: The purpose of this study was to identify significant prognostic factors associated with facial paralysis after vestibular schwannoma (VS) surgery and develop a novel nomogram for predicting facial nerve (FN) outcomes. METHODS: Retrospective data were retrieved from 355 patients who underwent microsurgery via the retrosigmoid approach for VS between December 2017 and December 2022. Univariate and multivariate logistic regression analysis were used to construct a radiographic features-based nomogram to predict the risk of facial paralysis after surgery. RESULTS: Following a thorough screening process, a total of 185 participants were included. The univariate and multivariate logistic regression analysis revealed that tumor size (p = 0.005), fundal fluid cap (FFC) sign (p = 0.014), cerebrospinal fluid cleft (CSFC) sign (p < 0.001), and expansion of affected side of internal auditory canal (IAC) (p = 0.033) were independent factors. A nomogram model was constructed based on these indicators. When applied to the validation cohort, the nomogram demonstrated good discrimination and favorable calibration. Then we generated a web-based calculator to facilitate clinical application. CONCLUSION: Tumor size, FFC and CSFC sign, and the expansion of the IAC, serve as good predictors of postoperative FN outcomes. Based on these factors, the nomogram model demonstrates good predictive performance.
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Parálisis Facial , Neuroma Acústico , Humanos , Neuroma Acústico/diagnóstico por imagen , Neuroma Acústico/cirugía , Nervio Facial/diagnóstico por imagen , Nervio Facial/cirugía , Estudios Retrospectivos , Parálisis Facial/diagnóstico por imagen , Parálisis Facial/etiología , NomogramasRESUMEN
Introduction: Observational studies have yielded inconsistent findings regarding the correlation between bone mineral density (BMD) and various spinal disorders. To explore the relationship between total-body BMD and various spinal disorders further, we conducted a Mendelian randomization analysis to assess this association. Methods: Two-sample bidirectional Mendelian randomization (MR) analysis was employed to investigate the association between total-body BMD and various spinal disorders. The inverse-variance weighted (IVW) method was used as the primary effect estimate, and additional methods, including weighted median, MR-Egger, simple mode, and weighted mode, were used to assess the reliability of the results. To examine the robustness of the data further, we conducted a sensitivity analysis using alternative bone-density databases, validating the outcome data. Results: MR revealed a significant positive association between total-body BMD and the prevalence of spondylosis and spinal stenosis. When total-body BMD was considered as the exposure factor, the analysis demonstrated an increased risk of spinal stenosis (IVW odds ratio [OR] 1.23; 95% confidence interval [CI], 1.14-1.32; P < 0.001) and spondylosis (IVW: OR 1.24; 95%CI, 1.16-1.33; P < 0.001). Similarly, when focusing solely on heel BMD as the exposure factor, we found a positive correlation with the development of both spinal stenosis (IVW OR 1.13, 95%CI, 1.05-1.21; P < 0.001) and spondylosis (IVW OR 1.10, 95%CI, 1.03-1.18; P = 0.0048). However, no significant associations were found between total-body BMD and other spinal disorders, including spinal instability, spondylolisthesis/spondylolysis, and scoliosis (P > 0.05). Conclusion: This study verified an association of total-body BMD with spinal stenosis and with spondylosis. Our results imply that when an increasing trend in BMD is detected during patient examinations and if the patient complains of numbness and pain, the potential occurrence of conditions such as spondylosis or spinal stenosis should be investigated and treated appropriately.
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Enfermedades de la Columna Vertebral , Estenosis Espinal , Espondilosis , Humanos , Densidad Ósea/genética , Análisis de la Aleatorización Mendeliana , Reproducibilidad de los ResultadosRESUMEN
Neuroblastoma (NB) is a leading cause of death in children. It usually occurs in the adrenal gland and rarely in the spinal canal. Here, we report the case of a 48-year-old male patient with abnormal thickening of the cauda equina nerve as revealed by lumbosacral magnetic resonance imaging. The patient's main clinical manifestations were numbness and pain in both lower limbs. The patient underwent surgical treatment; however, intraoperatively, an unclear border was observed between the cauda equina nerve and the tumor; therefore, the tumor was not forcibly excised. The postoperative pathological results were reported as NB. The disease known as NB, which is extremely rare. We believe that a pathological biopsy is extremely vital for diagnosing NB, and aggressive post-operative radio-chemotherapy could potentially prolong the patient's survival time.
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Objective: To investigate the incidence of complications and types of chemoradiotherepy induces symptom clusters in patients with nasopharyngeal carcinoma (NPC) who were first diagnosed after treatment and discharged from hospital. Methods: After their discharge home, 130 NPC patients who had been treated with chemoradiotherapy were asked to complete a modified Chinese version of the Quality of Life Questionnaire-Head and Neck Module developed by the European Organization for the Research and Treatment of Cancer in the Head and Neck. Symptom clusters in patients were identified through exploratory factor analysis. Results: The most serious symptoms for discharged NPC patients who had received chemoradiotherapy were dental problems, a sense of obstruction while swallowing, embarrassment in physical contact with family members and friends, difficulty in speaking with others, and embarrassment in public. The six symptom clusters identified through exploratory factor analysis were (1) painful eating, (2) social difficulties, (3) psychological disorders, (4) symptomatic shame, (5) teeth/throat injuries, and (6) sensory abnormalities. The total contribution rate of variance was 65.73%. Conclusion: NPC patients who are treated with chemoradiotherapy can experience adverse symptom clusters that continue after discharge. Nurses should evaluate the patients' symptoms before discharge and provide targeted health education services which would reduce the patients' complications and improve the quality of life at home. Besides, medical staff should evaluate the complications in a timely and comprehensive manner and provide individualized health education for the affected patients to help them manage chemoradiotherapy side effects.
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BACKGROUND: This study aimed to investigate the diagnosis and treatment of thoracic anterior spinal cord herniation, a rare condition. METHODS: Clinical data of 7 patients diagnosed with thoracic anterior spinal cord herniation were analyzed. All patients were diagnosed with a complete preoperative examination and scheduled for surgical treatment. In addition, regular follow-up was performed after the surgery, and the operation's efficacy was evaluated according to clinical symptoms, imaging findings, and improvement in neurologic function. RESULTS: All patients underwent spinal cord release with an anterior dural patch. Notably, no severe postoperative surgical complications were observed. All patients were followed up for 12-75 months, with an average duration of approximately 46.5 months. Post-operative pain symptoms were controlled, neurological dysfunction and related symptoms improved to varying degrees, and anterior spinal cord herniation did not recur. The modified Japanese Orthopedic Association score at the last follow-up was significantly higher than the preoperative score. CONCLUSIONS: Clinicians should avoid misdiagnosing patients with thoracic anterior spinal cord herniation with intervertebral disc herniation, arachnoid cysts, and other related diseases, and patients should undergo surgical treatment as early as possible. In addition, surgical treatment can protect the neurologic function of patients and effectively prevent the aggravation of clinical symptoms.
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Desplazamiento del Disco Intervertebral , Enfermedades de la Médula Espinal , Humanos , Resultado del Tratamiento , Vértebras Torácicas/diagnóstico por imagen , Vértebras Torácicas/cirugía , Recurrencia Local de Neoplasia , Médula Espinal/diagnóstico por imagen , Médula Espinal/cirugía , Hernia/diagnóstico por imagen , Enfermedades de la Médula Espinal/diagnóstico por imagen , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/cirugía , Desplazamiento del Disco Intervertebral/diagnóstico por imagen , Desplazamiento del Disco Intervertebral/cirugía , PronósticoRESUMEN
Background: Macrophage polarization and microRNA play crucial roles in the development of atherosclerosis (AS). The M1 macrophage phenotype contributes to the formation of plaques, while the M2 macrophage phenotype resolves inflammation and promotes tissue repair. MiR-126 has been found to play a role in regulating macrophage polarization in the context of AS. However, the exact mechanism of miR-126 requires further research. Methods: The foam cell model was established by stimulating THP-1 with oxidized low-density lipoprotein (ox-LDL). We transfected foam cells with miR-126 mimic and its negative control. The transfection of miR-126 was implemented by riboFECT CP transfection kit. The levels of miR-126 and M1/M2 associated genes in foam cells were quantified using reverse transcription-quantitative PCR (RT-qPCR). Additionally, the expressions of CD86+ and CD206+ cells in foam cells were determined by flow cytometry. Western blotting and RT-qPCR were used to determine the protein and mRNA levels of the vascular endothelial growth factor A (VEGFA) and the transcriptional regulator Krüppel-like factor 4 (KLF4), respectively. Additionally, we detected endothelial cell migration after co-culturing endothelial cells and macrophages. MG-132 was used to indirectly activate the expression of VEGFA, and the expression of KLF4 was also evaluated. Results: The activation of apoptosis and production of foam cells were boosted by the addition of ox-LDL. We transfected foam cells with miR-126 mimic and its negative control and observed that miR-126 greatly suppressed foam cell development and inhibited phagocytosis. Moreover, it caused pro-inflammatory M1 macrophages to switch to the anti-inflammatory M2 phenotype. This was reflected by the increase in anti-inflammatory gene expression and the decrease in pro-inflammatory gene expression. Additionally, miR-126 dramatically decreased the expressions of VEGFA and KLF4. The protein-protein interaction network analysis showed a significantly high correlation between miR-126, VEGFA, and KLF4. MiR-126 may also promote EC migration by activating macrophage PPAR γ expression and effectively suppressing macrophage inflammation. MG-132 indirectly activated the expression of VEGFA, and the expression of KLF4 also significantly increased, which indicates a direct or indirect relationship between VEGFA and KLF4. Conclusion: Our study shows that miR-126 can reverse ox-LDL-mediated phagocytosis and apoptosis in macrophages. Consequently, the potential role of miR-126 was manifested in regulating macrophage function and promoting vascular endothelial migration.
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Aterosclerosis , MicroARNs , Humanos , Factor 4 Similar a Kruppel , Factor A de Crecimiento Endotelial Vascular/genética , Células Endoteliales/metabolismo , Macrófagos , MicroARNs/genética , Aterosclerosis/metabolismo , Fenotipo , Inflamación/metabolismoRESUMEN
Investigations on the bidirectional relationships between parenting stress and child behavior problems are important to inform intervention strategies; however, prior research has provided inconsistent findings. Using a national sample of multi-stressed single-mother families from the Fragile Families and Child Wellbeing study, the present study examined the bidirectional relationships between maternal parenting stress and children's behavioral problems spanning from early childhood through adolescence at the child's ages 3, 5, 9, and 15. Reciprocal transactions were found between parenting stress and behavior problems in early childhood between the ages 3 and 5. From age 5 to age 15, our findings also suggest that children's behavior problems at an earlier time point predict mothers' parenting stress at a later time point. Unexpectedly, the lagged effects of parenting stress on child behavior problems in school ages were not significant in our sampled data. Early childhood interventions should address mitigating both parenting stress and their toddlers' behavior problems. During middle childhood and adolescence, interventions to directly address children's behavior problems are critical both to the well-being of mothers and to assist in the reduction in levels of behavior problems.
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Madres , Problema de Conducta , Niño , Femenino , Adolescente , Humanos , Preescolar , Responsabilidad Parental , Conducta InfantilRESUMEN
The conus medullaris is the distal tapering end of the spinal cord, and the filum terminale (FT) is regarded as a bundle of nonfunctional fibrous tissue; therefore, some scholars call it the spinal ligament, while others describe the human FT as "remnants of the spinal cord." It was later found that in the human spinal cord, the FT is composed of an intradural segment and an epidural segment, and the end of the FT is connected to the coccyx periosteum. Because some nerve tissue is also found in the FT, as research progresses, FT may have the potential for transplantation. A lack of exhaustive overviews on the FT in the present literature prompted us to conduct this review. Considering that a current comprehensive review seemed to be the need of the hour, herein, we attempted to summarize previous research and theories on the FT, elucidate its anatomy, and understand its pathological involvement in various diseases.
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Cauda Equina , Cauda Equina/patología , Cauda Equina/cirugía , Humanos , Médula Espinal/patología , Médula Espinal/cirugía , Columna VertebralRESUMEN
BACKGROUND: Adolescent depression and anxiety are major mental health concerns. Adverse childhood experiences (ACEs) are risk factors for depression and anxiety in adolescence and positive childhood experiences at home, school, and neighborhood are protective factors. Few studies, however, have compared the longitudinal effects of these two sets of contextual risk and protective factors on depression and anxiety among adolescents by framing them together. METHODS: This study used data on a subsample of 3426 socioeconomically disadvantaged adolescents collected at their birth, ages one, three, five, nine, and fifteen. Logistic regression was used to examine the longitudinal effects of ACEs, focusing on childhood maltreatment and family dysfunctions, and positive childhood experiences with family, school, and neighborhood on the risks of depression and anxiety. Adolescents' characteristics and their families' socioeconomic status were adjusted. RESULTS: In the two ACEs subcategories, childhood maltreatment exposures increased the risks only for later anxiety; family dysfunction increased the risks for both later depression and anxiety. In the three contexts, positive childhood experiences at family and school protected at-risk adolescents against both mental health concerns, whereas neighborhood collective efficacy protected adolescents only against depression. LIMITATIONS: Resilience was examined as an outcome only; it can also be examined as a process. Neither teachers' nor grandparents' supports were included. CONCLUSIONS: ACEs maltreatment and family dysfunction are two different risk dimensions for adolescent depression and anxiety. Positive childhood experiences at family are the strongest protective factors for children exposed to ACEs, followed by these in school and neighborhood. Early interventions building positive relationships may benefit adolescent mental health.
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Experiencias Adversas de la Infancia , Adolescente , Ansiedad/epidemiología , Niño , Depresión/epidemiología , Humanos , Salud Mental , Instituciones AcadémicasRESUMEN
The coparenting subsystem is important for the psychosocial development of young children. In this article, we used cross-lagged structural equation modeling to assess the bidirectional relations between unmarried parents' cooperative coparenting and their children's behavioral problems. Using a subsample of 788 dyads of poor, unmarried parents and their children from the Fragile Families and Child Wellbeing data, we examined trends in coparenting and behavioral problems over time (in children ages 1, 3, 5, and 9 years) and the reciprocal effects between these 2 variables. All pathways from coparenting at 1 time point to the children's behavioral problems at the following time point were significant, indicating that cooperative coparenting at earlier time points is likely to result in fewer behavioral problems in children at later time points. A cross-lagged path from behavioral problems to coparenting in the preschool years was also statistically significant. Implications for interventions and next steps for further research are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Trastornos de la Conducta Infantil/psicología , Ilegitimidad/estadística & datos numéricos , Responsabilidad Parental/psicología , Adulto , Niño , Trastornos de la Conducta Infantil/etiología , Preescolar , Conducta Cooperativa , Composición Familiar , Femenino , Humanos , Ilegitimidad/psicología , Lactante , Estudios Longitudinales , Masculino , Relaciones Padres-Hijo , Pobreza , Padres SolterosRESUMEN
MicroRNAs (miRNAs) have been proven to have important effects on the proliferation and metastasis of multiple cancers, including hepatocellular carcinoma (HCC). In the present study, our aim was to explore the biological function of miR-106b in HCC cell proliferation and metastasis. qPCR analysis showed that miR-106b was expressed at higher levels, while disabled homolog 2 (DAB2) was expressed at lower levels in HCC tissues and cells. Moreover, the aberrant miR-106b expression in HCC affected the cell proliferative and migratory ability by MTT and Transwell assay. DAB2 was identified as a specific target of miR-106b in HCC by luciferase reporter assay and regression analysis showed a negative correlation between DAB2 and miR-106b expression. In addition, DAB2 may attenuate the miR-106b promotion effect on HCC cell proliferation and migration. In short, miR-106b may promote HCC cell proliferation and migration by targeting DAB2.