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BACKGROUND: Osteoporotic vertebral compression fractures (OVCF) may necessitate percutaneous vertebral augmentation (PVA), a procedure not without its risks. One notable complication is cement leakage (CL), which can cause significant distress in patients. Despite its clinical importance, there remains a paucity of meta-analyses investigating these complications and their management in the existing literature. MATERIAL AND METHODS: We systematically reviewed PubMed, Cochrane Library, Embase, and Web of Science databases up to February 2024 to identify studies examining CL following PVA treatment in OVCF. We assessed the quality of eligible cohort studies using the Newcastle-Ottawa Scale (NOS), extracted data on incidence, identified risk factors for CL, and conducting meta-analysis with Revman 5.2 software. We calculated odd ratios (OR) and Mean Differences (MD) with 95% confidence interval (CI) applying random effects models. RESULTS: We identified twelve cohort studies that matched our strict inclusion criteria. These studies included a total of 2388 patients and 3392 vertebrae. CL was identified in 1132 vertebrae. Notable risk factors for CL included compromised cortical bone integrity (OR 5.00, 95% CI 3.01~8.29, P<0.00001), presence of intravertebral vacuum clefts (OR 1.68, 95% CI 1.07~2.65, P=0.03), basivertebral foramen sign (OR 1.77, 95% CI 1.09~2.89, P=0.02), and volume of cement used (MD 0.75, 95% CI 0.41~1.10, P<0.0001). CONCLUSION: Our findings underscore the significance of cortical bone integrity, intravertebral vacuum cleft, basivertebral foramen sign, and cement volume as principal determinants of CL risk in PVA for OVCF. These insights advocate for tailored surgical strategies to mitigate the risk of CL in this patient population.
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OBJECTIVE: The study investigates how cage positions in oblique lumbar interbody fusion (OLIF) combined with posterior percutaneous pedicle screw internal fixation (PPSF) affect lumbar canal and foraminal decompression and postoperative outcomes, providing guidance for optimal placement and efficacy assessment. METHODS: This investigation assesses radiologic outcomes and follow-up data in relation to cage position variability among 80 patients who underwent L4/5 single-segment OLIF + PPSF from 2018 to 2022. RESULTS: In the study involving 80 participants, the combination of OLIF and PPSF significantly improved lower back and leg symptoms in patients, leading to positive clinical outcomes during follow-up. The intervertebral disk height increased from an average of 8.10 ± 2.79 mm before surgery to 11.75 ± 2.14 mm after surgery (P < 0.001). Additionally, this surgical technique notably increased the FH (P < 0.001) and expanded the DCSA from 68.81 ± 53.89 mmË2 before surgery to 102.91 ± 60.46 mmË2 after surgery (P < 0.001). Linear results suggest that changes in the position of the cage do not affect spinal imaging parameters. There is no significant difference in the correction of spinal parameters or prognosis whether the cage is back, middle, ahead. CONCLUSIONS: In the OLIF + PPSF procedure, strict requirements for cage position are not necessary to achieve predetermined spinal biomechanical parameters. The practice of repeated fluoroscopy to adjust cage position postimplantation does not provide added clinical benefits to the patient.
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BACKGROUND: The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis. The purpose of this study was to compare the effects of the application of Zero-P and new conventional plates (ZEVO, Skyline) in ACDF on the sagittal imaging parameters of cervical spondylosis patients and to analyze their clinical efficacy. METHODS: We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success. RESULTS: There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2âC7 Cobb angle, C0âC2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2âC7 Cobb angle, C0âC2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05). CONCLUSION: In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.
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Placas Óseas , Vértebras Cervicales , Discectomía , Fusión Vertebral , Espondilosis , Humanos , Femenino , Estudios Retrospectivos , Masculino , Fusión Vertebral/métodos , Fusión Vertebral/instrumentación , Persona de Mediana Edad , Discectomía/métodos , Discectomía/instrumentación , Vértebras Cervicales/cirugía , Vértebras Cervicales/diagnóstico por imagen , Resultado del Tratamiento , Espondilosis/cirugía , Espondilosis/diagnóstico por imagen , Anciano , Adulto , Equilibrio Postural/fisiología , Estudios de SeguimientoRESUMEN
Osteoporosis (OP) is a bone metabolism disease that is associated with inflammatory pathological mechanism. Nonetheless, rare studies have investigated the diagnostic effectiveness of immune-inflammation index in the male population. Therefore, it is interesting to achieve early diagnosis of OP in male population based on the inflammatory makers from blood routine examination. We developed a prediction model based on a training dataset of 826 Chinese male patients through a retrospective study, and the data was collected from January 2022 to May 2023. All participants underwent the dual-energy X-ray absorptiometry (DXEA) and blood routine examination. Inflammatory markers such as systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) was calculated and recorded. We utilized the least absolute shrinkage and selection operator (LASSO) regression model to optimize feature selection. Multivariable logistic regression analysis was applied to construct a predicting model incorporating the feature selected in the LASSO model. This predictive model was displayed as a nomogram. Receiver operating characteristic (ROC) curve, C-index, calibration curve, and clinical decision curve analysis (DCA) to evaluate model performance. Internal validation was test by the bootstrapping method. This study was approved by the Ethic Committee of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Ethic No. JY2023012) and conducted in accordance with the relevant guidelines and regulations. The predictive factors included in the prediction model were age, BMI, cardiovascular diseases, cerebrovascular diseases, neuropathy, thyroid diseases, fracture history, SII, PLR, C-reactive protein (CRP). The model displayed well discrimination with a C-index of 0.822 (95% confidence interval: 0.798-0.846) and good calibration. Internal validation showed a high C-index value of 0.805. Decision curve analysis (DCA) showed that when the threshold probability was between 3 and 76%, the nomogram had a good clinical value. This nomogram can effectively predict the incidence of OP in male population based on SII and PLR, which would help clinicians rapidly and conveniently diagnose OP with men in the future.
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Inflamación , Nomogramas , Osteoporosis , Humanos , Masculino , Osteoporosis/diagnóstico , Osteoporosis/sangre , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Inflamación/sangre , Inflamación/diagnóstico , China/epidemiología , Factores de Riesgo , Biomarcadores/sangre , Absorciometría de Fotón , Curva ROC , Adulto , Medición de Riesgo/métodosRESUMEN
Low back pain (LBP) is a common condition that has substantial consequences on individuals and society, both socially and economically. The primary contributor to LBP is often identified as intervertebral disc degeneration (IVDD), which worsens and leads to significant spinal problems. The conventional treatment approach for IVDD involves physiotherapy, drug therapy for pain management, and, in severe cases, surgery. However, none of these treatments address the underlying cause of the condition, meaning that they cannot fundamentally reverse IVDD or restore the mechanical function of the spine. Nanotechnology and regenerative medicine have made significant advancements in the field of healthcare, particularly in the area of nanodrug delivery systems (NDDSs). These approaches have demonstrated significant potential in enhancing the efficacy of IVDD treatments by providing benefits such as high biocompatibility, biodegradability, precise drug delivery to targeted areas, prolonged drug release, and improved therapeutic results. The advancements in different NDDSs designed for delivering various genes, cells, proteins and therapeutic drugs have opened up new opportunities for effectively addressing IVDD. This comprehensive review provides a consolidated overview of the recent advancements in the use of NDDSs for the treatment of IVDD. It emphasizes the potential of these systems in overcoming the challenges associated with this condition. Meanwhile, the insights and ideas presented in this review aim to contribute to the advancement of precise IVDD treatment using NDDSs.
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Degeneración del Disco Intervertebral , Dolor de la Región Lumbar , Humanos , Degeneración del Disco Intervertebral/tratamiento farmacológico , Sistemas de Liberación de Medicamentos , Manejo del Dolor , Liberación de Fármacos , Sistema de Administración de Fármacos con NanopartículasRESUMEN
BACKGROUND: Neuropsychiatric symptoms (NPSs) of Parkinson's disease (PD) have received increasing attention, but effective treatment options remain limited. Acupuncture may have clinical benefits for NPSs in PD patients, but high-quality evidence supporting this possibility still needs to be discovered. Therefore, we conducted a meta-analysis to evaluate the effect of acupuncture treatment on NPSs in PD patients. METHODS: Randomized controlled trials (RCTs) of acupuncture treatment for PD retrieved from the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, and Scopus, were used to evaluate NPSs of PD patients. The Cochrane Intervention System Evaluation Manual assessed the methodological quality. RESULTS: A total of 13 RCTs involving 719 patients were included. The results showed that compared with medication alone or sham acupuncture, acupuncture improved sleep quality in PD patients, with Parkinson's Disease Sleep Scale (PDSS) [standardized mean difference (SMD)= 0.48, 95% confidence interval (CI)= 0.242 to 0.793, P = 0.001]. The I scores and total scores on Unified Parkinson's Disease Rating Scale (UPDRS) indicated acupuncture treatment was effective (SMD=-0.66, 95%CI=-0.66 to -0.18, P = 0.042; SMD=-0.77, 95%CI=-1.31 to -0.23, P = 0.005). Results of the Epworth Sleepiness Scale (ESS) and Parkinson's Disease Questionnaire-39 (PDQ-39) showed no statistically significant differences (SMD=-0.27, 95%CI=-0.08 to 0.62, P = 0.128; SMD=-0.20, 95%CI=-0.42 to 0.01, P = 0.554). Anxiety and depression research had no significant differences due to the excessive inter-study bias. CONCLUSION: Acupuncture treatment can improve sleep quality, psychological and behavioral alterations, and the overall condition of PD patients. However, the study revealed no significant positive intervention effects on anxiety, depression, and quality of life, underscoring the necessity for continued research to elucidate these domains' intricacies and develop productive therapeutic approaches.
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Terapia por Acupuntura , Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/terapia , Enfermedad de Parkinson/tratamiento farmacológico , Resultado del Tratamiento , Ansiedad , Trastornos de Ansiedad , Calidad de VidaRESUMEN
OBJECTIVE: Foraminoplasty is an important step in transforaminal endoscopic lumbar discectomy (TELD). A trephine is widely used in foraminoplasty. However, foraminoplasty using a trephine alone sometimes fails to remove the resected bone, resulting in the bone remaining in the foramen or spinal canal, which can potentially cause neurological irritation or injury. The objective of this study is to introduce a self-designed tool, referred to as an anchoring drill, for use with a trephine in foraminoplasty in TELD and to evaluate its advantages. METHODS: A retrospective review was performed to identify patients who underwent L4-5 TELD between January 2019 to January 2022. Foraminoplasty was performed in all patients. Depending on whether the anchoring drill was used or not, patients were divided into two groups. Surgery-related parameters and complications were reviewed. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were also assessed for all patients. SPSS statistical software was used for statistical calculation. RESULTS: A total of 100 patients were included (55 in the anchoring drill group and 45 in the trephine group). The incidence of residual bone fragments after foraminoplasty of the anchoring drill group was 9.09%, which was lower than that of the trephine group, at 33.33% (p < 0.05). The mean endoscopic operation time of the anchoring drill group was shorter than that of the trephine group (p < 0.05). The mean fluoroscopy time and duration of foraminoplasty showed no significant differences between the two cohorts. The total perioperative complication incidence was lower in the anchoring drill group, in which the neural irritation incidence showed a significant difference (anchoring drill group: 3.64%, trephine group: 17.78%, p < 0.05). VAS and JOA scores were significantly improved after the operation for all patients (p < 0.001), however, no statistical differences were found between the two groups at each follow-up visit. CONCLUSION: The combination of a trephine with an anchor drill was demonstrated to be safe and effective in foraminoplasty in TELD, improving the success rate of foraminoplasty and reducing neurological complications compared to using trephine alone.
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Discectomía Percutánea , Desplazamiento del Disco Intervertebral , Humanos , Estudios Retrospectivos , Desplazamiento del Disco Intervertebral/cirugía , Resultado del Tratamiento , Vértebras Lumbares/cirugía , Endoscopía/métodos , Discectomía/métodos , Discectomía Percutánea/métodosRESUMEN
OBJECTIVE: To examine the association between vertebral cancellous Hounsfield units (HUs), age, bone mineral density, and T-score in a sample of Chinese adults. METHODS: The study included a sample of 739 participants. Age, bone mineral density, and T-score of each participant were recorded, and HUs were measured in the L1-L4 vertebrae. RESULTS: Data analysis revealed that HUs of vertebral cancellous bone across the pedicle level decreased with age, with women having higher values than men up to age 50 and vice versa thereafter. Furthermore, a positive correlation was found between HUs of vertebral cancellous bone across the pedicle level and bone mineral density/T-score in the L1-L4 vertebrae, but with a weaker correlation in the L4 vertebrae. Additionally, HU values for participants with osteoporosis were significantly lower than HU values for participants with osteopenia and normal bone health. CONCLUSIONS: From the findings of this study, it can be concluded that HUs may be a potential predictor of bone health, with implications for presurgical assessment of the quality of bone-screw interfaces for spinal surgery.
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Enfermedades Óseas Metabólicas , Osteoporosis , Adulto , Masculino , Humanos , Femenino , Persona de Mediana Edad , Densidad Ósea , Tomografía Computarizada por Rayos X , Osteoporosis/diagnóstico por imagen , Enfermedades Óseas Metabólicas/diagnóstico por imagen , Enfermedades Óseas Metabólicas/epidemiología , Vértebras Lumbares/diagnóstico por imagen , China , Estudios Retrospectivos , Absorciometría de FotónRESUMEN
The design of orthodontic arch wires is a prerequisite for orthodontic treatment that determines the subsequent orthodontic effects. Current methods for designing orthodontic arch wires are often based on traditional manual techniques, which suffer from problems such as low accuracy and efficiency. To address these issues, a digital orthodontic arch wire design system has been developed using Unity 3D and C#. This system allows for the interactive adjustment and intelligent optimization of the shape of digital orthodontic arch wires. The developed system includes modules for curve design, contour construction, and collision detection of orthodontic arch wires, which can be customized interactively to meet the personalized needs of patients. In addition, an energy-constrained method is employed to optimize the shape of certain regions of the arch wire, which helps overcome distortion and interference issues caused by unreasonable interaction. The effectiveness of the developed system has been evaluated through experiments on digital design and optimization of orthodontic arch wires. Results demonstrate that the system can achieve accurate and efficient digital design of orthodontic arch wires, effectively reduce distortion, and is expected to improve the orthodontic effect.
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Alambres para Ortodoncia , Humanos , Diseño de EquipoRESUMEN
Assessing the health risks of sensitive population, such as children and teenagers, through multiple exposure routes (MERs) such as ingestion, inhalation, and dermal contact is critical for policy creation that protects or reduces exposure to pollutants for all populations. Heavy metal (HM) contents in food and environmental media in Beijing, capital of China, were collected. Furthermore, on the basis of considering the bioavailability of HMs, we evaluated the multiple environmental routes and health risks to HMs in children and teenagers of eight age groups (2-<3, 3-<4, 4-<5, 5-<6, 6-<9, 9-<12, 12-<15, and 15-<18) in Beijing, China by Monte Carlo simulation approach. The main findings are as follows: lead exposure in children aged 2-<3 years exceeds the exposure dose (0.3 µg·kg-1·d-1) of 0.5 point reduction in intelligence quotient. Moreover, children aged 2-<3 and 6-<9 years have relatively high non-carcinogenic risk (NCR) of 1.32 and 1.30, respectively. The carcinogenic risk (CR) for children aged 6-<9 and 9-<12 years is 2.73×10-6 and 2.39×10-6, respectively. Specifically, the contributions of oral ingestion, dermal contact, and inhalation to the NCR were 69.5%, 18.9%, and 11.6%, respectively. Moreover, the combined NCR contributions of copper, cadmium, mercury, and arsenic (As) were about 69.4%. The contributions of the above three routes to the CR were 93.4%, 4.1%, and 2.5%, in that order, with the largest CR contribution of As being about 92.0%. This study can provide new ideas for accurately assessing the exposure and health risks of HMs in the population, and we believe that it is necessary to update the national standards for food and soil based on the bioavailability of HMs.
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Arsénico , Metales Pesados , Contaminantes del Suelo , Niño , Humanos , Adolescente , Beijing , Disponibilidad Biológica , Monitoreo del Ambiente , Metales Pesados/análisis , Arsénico/análisis , Medición de Riesgo , Cadmio , China , Carcinógenos/análisis , Carcinogénesis , SueloRESUMEN
OBJECTS: Oblique lumbar interbody fusion (OLIF) has gained increasing popularity recently. However, complications resulting from intraoperative retraction of psoas major (PM) sometimes occur. The aim of this study is to evaluate the degree of PM swelling by developing a scoring system called the Psoas Major Swelling Grade (PMSG), and to investigate the correlation between the PMSG and clinical outcomes after OLIF. METHODS: Patients who underwent L4-5 OLIF at our hospital from May 2019 to May 2021 were reviewed and all data were recorded. The extent of postoperative PM swelling was determined by calculating the percentage of change in the PM area before and after surgery on MRI and divided into three grades subsequently. Swelling within the range of 0% to 25% was defined as grade I, 25%-50% was grade II, and more than 50% was grade III. All patients were grouped into the new grade system and followed up for at least 1 year, during which the visual analog scale (VAS) and Oswestry disability index (ODI) scores were recorded. Categorical data were analyzed using chi-square and Fisher's exact tests, while continuous variables were assessed with one-way ANOVA and paired t-tests. RESULTS: Eighty-nine consecutive patients were enrolled in this study, with a mean follow-up duration of 16.9 months. The proportion of female patients in the PMSG I, II, and III groups was 57.1%, 58.3%, and 84.1%, respectively (p = 0.024). Furthermore, the total complication rate was 43.2% in the PMSG III group, significantly higher than 9.5% and 20.8% in the PMSG I and II groups (p = 0.012). The incidence of thigh paraesthesia was also considerably higher in the PMSG III group at 34.1% (p = 0.015), compared to 9.5% and 8.3% in the PMSG I and II groups. Among the patients, 12.4% exhibited a teardrop-shaped PM, with the majority (90.9%) belonging to the PMSG III group (p = 0.012). Additionally, the PMSG III group demonstrated a higher estimated blood loss (p = 0.007) and significantly worse clinical scores at the 1-week follow-up assessment (p < 0.001). CONCLUSION: PM swelling adversely affects the OLIF prognosis. Female patients with teardrop-shaped PM are more likely to develop swelling after OLIF. A higher PMSG is associated with a higher complication rate of thigh pain or numbness and worse short-term clinical outcomes.
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Vértebras Lumbares , Fusión Vertebral , Humanos , Femenino , Estudios Retrospectivos , Vértebras Lumbares/cirugía , Fusión Vertebral/métodos , Región Lumbosacra/cirugía , Dolor , Resultado del TratamientoRESUMEN
OBJECTIVE: Since endoscopic lumbar interbody fusion procedure has established, the insertion of cage requires a large working tube, which may lead to nerve root irritation. A novel nerve baffle was used for endoscopic lumbar interbody fusion (ELIF) and its short-term outcomes were analyzed. METHODS: A total of 62 patients (32 cases in tube group, 30 cases in baffle group) with lumbar degenerative diseases who underwent endoscopic lumbar fusion surgery from July 2017 to September 2021 were retrospectively analyzed. Clinical outcomes were measured using pain visual analogue scale (VAS), Oswestry disability index (ODI), Japanese Orthopedic Association Scores (JOA), and complications. Perioperative blood loss was calculated using the Gross formula. Radiologic parameters included lumbar lordosis, surgical segmental lordosis, cage position, and fusion rate. RESULTS: There were significant differences in VAS, ODI, and JOA scores postoperatively, 6 months after operation, and at the last follow-up (P < 0.05) within the 2 groups. The VAS and ODI score and hidden blood loss were significantly lower (P < 0.05) for the baffle group. There was no significant difference in lumbar lordosis and segmental lordosis (P > 0.05). Postoperative disc height was significantly higher than preoperative and follow-up disc heights (P < 0.05) for both groups. There was no statistical difference in fusion rate and cage position parameters or subsidence rate. CONCLUSIONS: Endoscopic lumbar interbody fusion using the novel baffle has more advantages in nerve protection and hidden blood loss reduction than traditional ELIF with working tube. Compared with the working tube procedure, it has similar or even better short-term clinical outcomes.
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Lordosis , Fusión Vertebral , Humanos , Estudios de Seguimiento , Estudios Retrospectivos , Resultado del Tratamiento , Fusión Vertebral/métodos , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugíaRESUMEN
There are limited studies on the translocation and bioaccumulation of selenium (Se) in weak alkaline cultivated Se-enriched soil, and the sources and speciation of Se in wheat grains remain unclear. In this study, we measured the Se levels in soils, roots, stems, and wheat grains from Se-enriched cultivated land in Ci County, China, which has a high incidence of esophageal cancer. The Se levels in the roots were higher than those in the soils, indicating that wheat plants bioaccumulated high concentrations of Se from the soil (enrichment coefficient [EC] range from the soil to the root: 0.94-3.29). Redundancy analysis indicated that the bioaccumulated factor, translocation coefficient, and EC were mainly controlled by phosphorus, pH, and Fe2O3 (contribution rates: 37.5%, 19.5%, and 15.9%, respectively). Linear regression analysis revealed that the sources of Se in grains were mainly from the water-soluble fraction (R2 = 0.55, at p < 0.05), the weakly acidic fraction (R2 = 0.84, at p < 0.05), the reducible fraction (R2 = 0.84, at p < 0.05), and the oxidizable fraction (R2 = 0.70, at p < 0.05), as well as from atmospheric deposition (R2 = 0.37, at p < 0.01). There is a significant correlation between the Se from atmospheric deposition and the oxidizable fraction (R2 = 0.62, at p < 0.01) and the residual fraction (R2 = 0.33, at p < 0.01). The contribution of Se input flux from atmospheric deposition was 5.50 g/hm2 for one year. Furthermore, the average content of organic Se in wheat grains was 58.93%. The Se concentrations found in wheat grains were considered beneficial for human health based on a comparison with the Chinese Society of Nutrition standard and worldwide levels. The results of this study will increase the overall knowledge on the theme, which could help prevent and control the harmful effects of undesirable concentrations of Se on human health.
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Selenio , Contaminantes del Suelo , Humanos , Selenio/análisis , Bioacumulación , Suelo/química , China , Triticum/química , Contaminantes del Suelo/análisisRESUMEN
BACKGROUND: Full endoscopic lumbar interbody fusion (Endo-LIF) is a representative recent emerging minimally invasive operation. The hidden blood loss (HBL) in an Endo-LIF procedure and its possible risk factors are still unclear. METHODS: The blood loss (TBL) was calculated by Gross formula. Sex, age, BMI, hypertension, diabetes, ASA classification, fusion levels, surgical approach type, surgery time, preoperative RBC, HGB, Hct, PT, INR, APTT, Fg, postoperative mean arterial pressure, postoperative heart rate, Intraoperative blood loss (IBL), patient blood volume were included to investigate the possible risk factors by correlation analysis and multiple linear regression between variables and HBL. RESULTS: Ninety-six patients (23 males, 73 females) who underwent Endo-LIF were retrospective analyzed in this study. The HBL was 240.11 (65.51, 460.31) mL (median [interquartile range]). Fusion levels (p = 0.002), age (p = 0.003), hypertension (p = 0.000), IBL (p = 0.012), PT (p = 0.016), preoperative HBG (p = 0.037) were the possible risk factors. CONCLUSION: Fusion levels, younger age, hypertension, prolonged PT, preoperative HBG are possible risk factors of HBL in an Endo-LIF procedure. More attention should be paid especially in multi-level minimally invasive surgery. The increase of fusion levels will lead to a considerable HBL.
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Oblique lumbar interbody fusion (OLIF) has been driven to the maturity stage in recent years. However, postoperative symptoms such as thigh paresthesia resulting from intraoperative retraction of the psoas major (PM) have sometimes occurred. The aim of this study was to assess the different positions and morphology of PM muscles and their relationship with clinical outcomes after OLIF by introducing the Moro zones. Patients who underwent L4-5 OLIF at our institution between April 2019 and June 2021 were reviewed and all data were recorded. All patients were grouped by Moro zones into a Moro A cohort and a Moro I and II cohort based on the front edges of their left PM muscles. A total of 94 patients were recruited, including 57 in the Moro A group and 37 in the Moro I and II group. Postoperative thigh pain or numbness occurred in 12 (21.1%) and 2 (5.4%) patients in the Moro A group and the Moro I and II group, respectively. There was no difference in the psoas major transverse diameter (PMTD) between groups preoperatively, while longer PMTD was revealed postoperatively in the Moro A group. The operating window (OW) and psoas major sagittal diameter (PMSD) showed significant differences within and between groups. Thirteen patients had teardrop-shaped PM muscles, with 92.3% in the Moro A group showing significantly worse clinical scores at 1-week follow-up. The Moro zones of the PM affected the short-term outcomes after OLIF. Preoperative measurements and analysis of OW, PMSD and PM morphology should be performed as necessary to predict short-term outcomes.
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Global agricultural intensification leads to a decline in soil quality; however, the extent to which long-term rice cultivation adversely impacts soil, based on chemical and microbial perspectives, remains unclear. The present study was conducted on a seed multiplication farm in Wuchang, Heilongjiang Province, China, to quantify changes in the nutrient properties and microbial profiles of meadow soil in cultivated (rhizosphere and bulk soil) and uncultivated paddy plots from spring to winter. A non-parametric method was used to compare carbon metabolism characteristics among the three groups of soil samples. Principal component analysis was used to distinguish soil chemical properties and carbon source utilization profiles among the soil samples across different seasons. Under rice cultivation, pH, organic matter, total nitrogen, and alkali-hydrolyzed nitrogen concentrations were generally higher in rhizosphere soils than in bulk or uncultivated soils. However, microbial biomass in cultivated soils was consistently lower than in uncultivated soils. There was a discernible difference in carbon substrate preference between summer and other seasons in the three sample groups. In conclusion, agricultural activities in rice cultivation could reshape soil microbial communities in the long term. Notably, specific cultivation activity may induce distinct soil microbial responses, which are more sensitive than chemical responses.
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An interesting remote δ-C 1,6-addition and an isomerization cascade reaction for phosphine-catalyzed activated alkynes have been disclosed. The products featuring a functional diene and a 1,1-diaryl methyl motif have been obtained in moderate to good yields (30-86%) by applying para-quinone methides (p-QMs) and δ-substituted alkynoate with tributylphosphine (PnBu3) catalysis, along with high regioselectivity and stereoselectivity (dr > 20:1). The wide scope of compatible substrates (35 examples), such as indolyl, oxindolyl, ester, and cinnamyl, expand the utility of this methodology. A plausible mechanism and some applications of it have also been presented.
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Indolquinonas , Alquinos , Catálisis , FosfinasRESUMEN
Antibiotic-heavy metal multi-pollutants are produced by intensive livestock farming and become an increasingly prominent problem. In this study, the transport behavior of tetracycline (TC) and its chelate with copper ions (Cu-TC) in saturated sand column with and without graphene oxide (GO) prefilled was investigated by laboratory breakthrough experiments. The effects of pH, ionic strength, and the cotransport with GO were studied detailedly. The results showed that the prepared nano-GO had a single- or multilayered sheet structure with a diameter of several µm. The surface of GO contained abundant oxygen-containing functional groups, which imparted it strong hydrophilicity and electronegativity. Pollutant transport experiments showed that decrease of H+ weakened the transport ability of TC and Cu-TC. Both Na+ and Ca2+ promoted the transport of TC, with Ca2+ having a much greater effect. The presence of Na+ inhibited the transport of Cu-TC, while Ca2+ promoted Cu-TC transport. The addition of Cu2+ was more favorable for the transport of Cu-TC than TC alone. In the GO-prefilled column, the effluent concentrations of TC and Cu-TC greatly decreased due to adsorption onto GO surfaces. The transport of Cu-TC was more related to GO concentration than TC alone due to the high affinity between GO and Cu-TC. Moreover, the transport behavior of GO in the sand column was consistent with that of the corresponding TC or Cu-TC, indicating that GO could cotransport with TC and Cu-TC multi-pollutants. Our study showed that the GO would interact with TC and Cu-TC and thus have significant influences on the fate and transport of these pollutions in porous media.
Asunto(s)
Contaminantes Ambientales , Grafito , Adsorción , Antibacterianos , PorosidadRESUMEN
The high toxicity of As can cause serious health risks for humans; therefore, understanding the behavior of As in weakly alkaline soil conditions relevant to agricultural plains is important. To investigate the mobility and total risks of multiple fractions of As, 230 pairs of soil (including soil cores) and, wheat grain, and corresponding groundwater samples and 38 atmospheric deposition samples were collected from agricultural soil in the Beijing-Tianjin-Hebei region, China, which is a typical wheat-growing area. Seven fractions of As, namely, water-soluble (As1), exchangeable (As2), carbonate-bound (As3), humic acid-bound (As4), Fe-Mn oxide-bound (As5), organic matter-bound (As6), and residual (As7) As, were analyzed using a sequential extraction procedure to better understand and confirm the relationship among these different forms. Correlation and principal components analyses showed a significant relationship among As1-As5, and As in atmospheric deposits and As in groundwater and soil samples showed a positive relationship. As found in wheat, therefore, mainly originated from the soil and atmospheric deposits, and indirectly from the groundwater. As in the soil samples was mainly controlled by Mn and Fe2O3 based on the vertical distribution of soil cores and correlation analysis. The health risk assessments showed that As in the multiple fractions did not form a potential non-cancer risk for children and adults. However, residents could still face the risk of developing cancer by ingesting wheat and drinking the groundwater. The findings of this study have important implications for understanding the hydrological/geochemical behavior of As and the soil and water quality in a wide range of environmental settings. Additionally, our findings provided arguments for decreasing the concentrations of As in the wheat production system and to remind residents to decrease ingestion of their staple food (wheat) and drink less of the local groundwater.