SEPHS1 attenuates intervertebral disc degeneration by delaying nucleus pulposus cell senescence through the Hippo-Yap/Taz pathway.

Nucleus pulposus cell (NPC) senescence is a major cause of intervertebral disc degeneration (IVDD). Oxidative stress and reactive oxygen species (ROS) play critical roles in regulating cell senescence. Selenophosphate synthetase 1 (SEPHS1) was reported to play an important role in mitigating oxidative stress in an osteoarthritis (OA) model by reducing the production of ROS, thereby, delaying the occurrence and development of osteoarthritis. In this study, we explored the, hitherto unknown, role of SEPHS1 in IVDD in vitro and in vivo using an interleukin-1ß (IL-1ß)-induced NPC senescence model and a rat needle puncture IVDD model, respectively. SEPHS1 delayed NPC senescence in vitro by reducing ROS production. Age-related dysfunction was also ameliorated by the overexpression of SEPHS1 and inhibition of the Hippo-Yap/Taz signaling pathway. In vivo experiments revealed that the overexpression of SEPHS1 and inhibition of Hippo-Yap/Taz alleviated IVDD in rats. Moreover, a selenium (Se)-deficient diet and lack of SEPHS1 synergistically aggravated IVDD progression. Taken together, our results demonstrate that SEPHS1 plays a significant role in NPC senescence. Overexpression of SEPHS1 and inhibition of Hippo-Yap/Taz can delay NPC senescence, restore the balance of extracellular matrix metabolism, and attenuate IVDD. SEPHS1 could be a promising therapeutic target for IVDD.NEW & NOTEWORTHY Selenophosphate synthetase 1 (SEPHS1) deficiency leads to an increase in reactive oxygen species levels and in the subsequent activation of the Hippo-Yap/Taz signaling pathway. In the rat model of intervertebral disc degeneration (IVDD), overexpression of SEPHS1 and inhibition of Hippo-YAP/Taz mitigated the progression of disc degeneration indicating the involvement of SEPHS1 in IVDD. SEPHS1 is a promising therapeutic target for IVDD.

Spatial Responses of Ecosystem Service Trade-offs and Synergies to Impact Factors in Liaoning Province.

Global ecosystem services (ESs) are experiencing a significant decline, necessitating the development of robust environmental governance policies. To address the lack of integrated planning with heavy industry as the research object and a lack of knowledge of ES trade-offs and synergies in China's ecological and environmental governance. In this study, the spatial and temporal variations of four ESs (water yield (WY), soil conservation (SC), carbon storage (CS), and habitat quality (HQ)) were determined in the study area of Liaoning Province. Explore the mechanisms that shape ecosystem service trade-offs and synergies and the factors that influence them. Spearman's correlation and difference analyses were proposed to determine the spatial and temporal distributions of trade-offs and synergistic relationships among ESs. In addition, we constructed a multiscale geo-weighted regression (MGWR) model to investigate driver spatial heterogeneity affecting trade-offs and synergies. The results revealed that (1) In the study area, ESs were on the rise in Liaoning Province. (2) Temporally, ESs were overwhelmingly dominated by synergies; at the spatial scale, ESs were dominated by trade-offs of varying degrees, with the area of synergy between WY and SC being the highest. (3) ESs demonstrated spatial heterogeneity in intensity and were more impacted by natural factors such as vegetation cover, elevation, and precipitation than by characteristics related to human activity. This study helps improve understanding of the interactions and dependencies among ESs and can provide a reference for ecological governance and improvements in Liaoning Province.

Stress Monitoring of Segment Structure during the Construction of the Small-Diameter Shield Tunnel.

Segmental stress during the construction process plays a pivotal role in assessing the safety and quality of shield tunnels. Fiber Bragg grating (FBG) sensing technology has been proposed for tunnel segment stress monitoring. A laboratory test was conducted to validate the reliable strain measurement of FBG sensors. The field in situ monitoring of a sewerage shield tunnel was carried out to examine the longitudinal and circumferential stresses experienced by the segments throughout the construction phase. The cyclic fluctuations in stress were found to be synchronized with the variations in shield thrust. A comparison was made between the longitudinal and circumferential stress variations observed during the shield-driving and segment-assembly processes. Additionally, the time required for the grouting to reach its full curing strength was estimated, revealing its impact on the stress levels and range of the pipe segment. The findings of this study offer an enhanced understanding of the stress state and health condition of small-diameter shield tunnels, which can help in optimizing the design and construction process of tunnel segments, as well.

Diagnostic value of the dual-modal imaging radiomics model for subpleural pulmonary lesions.

PURPOSE: To investigate the clinical value of the radiomics model of grayscale ultrasound (GUS) and contrast-enhanced ultrasound (CEUS) to diagnosis subpleural pulmonary tuberculosis and nonpulmonary tuberculosis based on GUS and CEUS images. METHODS: This study included 221 patients with 228 lesions diagnosed using the composite reference standard. The patients were randomly divided into training (n = 183) and test (n = 45) cohorts in an 8:2 ratio. The regions of interest of the GUS and CEUS images were manually segmented to extract the radiomic features. The GUS, CEUS and GUS+CEUS radiomics models were constructed via the multistep selection of highly correlated features. Receiver operating characteristic curves of the different models were plotted, and the area under the curve (AUC), accuracy, sensitivity, specificity, positive predictive value and negative predictive value (NPV) of the different models were compared. RESULTS: Following Least Absolute Shrinkage and Selection Operator dimension reduction we selected 4, 9, and 11 features to construct the GUS, CEUS, and GUS+CEUS radiomics models, respectively. The AUC values of the three groups in the test cohort were 0.689, 0.748 and 0.779, respectively, and they did not differ significantly. In the test cohort, the GUS+CEUS radiomics model exhibited the highest AUC (0.779), accuracy (75.56%), and NPV (68.7%) of the three models. CONCLUSIONS: The GUS+CEUS radiomics model possesses good clinical value in diagnosing pulmonary tuberculosis.

Radiographic analysis of dynamic lumbar motion during the five-repetition sit-to-stand test in degenerative lumbar spondylolisthesis.

BACKGROUND: To investigate the mechanisms of low back pain triggered by the five-repetition sit-to-stand test (5R-STS test) in degenerative lumbar spondylolisthesis (DLS) from radiographic perspective, as well as to determine the most useful diagnostic modalities in the evaluation of segmental instability. METHODS: We retrospectively performed a study of 78 patients (23 men and 55 women) with symptomatic DLS at L4/5 in our institution between April 2020 and December 2021. Each patient was assessed by using the 5R-STS test and received a series of radiographs including the upright standing, normal sitting, standing flexion-extension radiographs, and supine sagittal MR images. Enrolled patients were divided into two groups based on the 5R-STS test score: severe group and mild group. Translational and angular motion was determined by comparing normal sitting radiograph (N) with upright standing radiograph (U) (Combined, NU), flexion/extension radiographs (FE) as well as normal sitting radiograph (N) with a supine sagittal MR image (sMR) (Combined, N-sMR). RESULTS: Overall, 78 patients were enrolled, and there were 31(39.7%) patients in group S and 47(60.3%) patients in group M, with an average age of 60.7 ± 8.4 years. The normal sitting radiograph demonstrated the maximum slip percentage (SP) and the highest kyphotic angle both in group S and group M. Compared with group M, group S revealed significantly higher SP in the normal sitting position (24.1 vs 19.6; p = 0.002). The lumbar slip angular in group S with a sitting position was significantly higher than that in group M (-5.2 vs -1.3; p < 0.001). All patients in group S had objective functional impairment (OFI) and 28 patients of them were diagnosed with lumbar instability by using the combination of normal sitting radiograph (N) and supine sagittal MR image (sMR) (Combined, N-sMR). CONCLUSION: DLS patients with positive sign of the 5R-STS test is a distinct subgroup associated with lumbar instability. The modality of the combination of normal sitting radiograph (N) and supine sagittal MR image (sMR) had a significant advantage in terms of the ability to identify segmental instability.

Interleukin-4-induced FABP4 promotes lipogenesis in human skeletal muscle cells by activating the PPAR γ signaling pathway.

Chronic low back pain (CLBP) is a common symptom of lumbar degenerative disease. Degeneration of the lumbar paravertebral muscles causes a loss of muscle mass and strength, which is a vital factor causing CLBP and often accompanied by lipid infiltration. Tandem mass spectrometry (TMT) was used to identify differentially expressed proteins in lipid-infiltrated and normal muscles. The results show that fatty acid binding protein 4 (FABP4) participated in the peroxisome proliferator-activated receptor-γ (PPAR γ) signaling pathway as an up-regulated protein, which is related to lipogenesis in diverse cells. In addition, chronic inflammation is believed to be involved in lumbar muscle degeneration and lipogenesis, with interleukin-4 (IL-4) considered as the predominant contributor. In present study, we investigate the effect of FABP4 on lipogenesis in human skeletal muscle cells (HSMCs) stimulated by Interleukin-4 (IL-4) and explore the mechanistic basis. We found expression level of FABP4 in lipid-infiltrated muscles was significantly higher than that in normal muscles. Lipogenesis in HSMCs could be increased by IL-4 treatment, as well as by FABP4 overexpression. FABP4 inhibition suppressed IL-4-mediated lipogenesis in HSMCs, whereas the PPAR γ inhibitor alleviated lipogenesis in both IL-4-treated and FABP4-overexpressed HSMCs. Collectively, the results indicate that FABP4 induces lipogenesis in HSMCs stimulated with IL-4 via activating the PPAR γ signaling pathway. Our study offers a detailed perspective on the pathogenesis of muscle lipid infiltration and provides a potential target for the clinical treatment strategy of muscle lipid infiltration and CLBP.

Analysis of lumbar lateral instability on upright left and right bending radiographs in symptomatic patients with degenerative lumbar spondylolisthesis.

BACKGROUND: To evaluate lumbar mobility in various positions using upright left and right bending radiographs in patients with degenerative lumbar spondylolisthesis (DLS), as well as to assess the impact of lateral instability on patient-reported outcomes. METHODS: This study retrospectively reviewed a consecutive series of patients with DLS between January 2019 and October 2020. The enrolled patients were divided into two groups: the lateral instability group (group L) and non-lateral instability group (group NL). Translational and angular motion in both sagittal and coronal planes and patient-reported outcomes were compared between the two groups. RESULTS: There were 104 (59.8%) patients in group L and 70 (40.2%) patients in group NL, with an average age of 60.6 ± 7.8 years. Patients with a right bending posture in group L had a higher slip percentage (14.2 ± 7.4% vs 9.2 ± 3.2%, p = 0.01) and slip angle (6.3 ± 1.5° vs 2.2 ± 0.8°, p = 0.021). Compared with group NL, group L demonstrated significantly larger angular motion in the coronal plane (2.4 ± 1.3° vs 1.0 ± 0.7°, p = 0.008). Patients with lateral instability had worse preoperative back pain (6.1 ± 1.6 vs 2.7 ± 1.9, p = 0.01) and Oswestry Disability Index (ODI) scores (37.7 ± 5.5 vs 25.6 ± 2.6, p = 0.002). In terms of pain characteristics, group L was characterized by pain when getting out of a car, when rising from a chair, and when climbing stairs (all p values < 0.05). CONCLUSION: Lumbar lateral instability, that is, increased mobility in the coronal plane on lateral bending radiographs, translational and/or angular, correlates to more pronounced patient related symptoms in degenerative L4-5 spondylolisthesis. The existence of lumbar lateral instability leads to worse impacts on patient-reported outcomes when patients change their positions including getting out of a car, rising from a chair, and climbing stairs.

Synthesis, crystal structure and magnetic properties of poly[[diaqua{µ6-2-[bis-(carboxyl-atometh-yl)amino]-terephthalato}-dicobalt(II)] 1.6-hydrate].

The asymmetric unit of the polymeric title compound {[Co2(C12H7NO8)(H2O)2]·1.6H2O} n comprises two CoII ions, which are coordinated by fully deprotonated 2-aminodi-acetic terephthalic acid (adtp4-) and terminal water mol-ecules in distorted octa-hedral N1O5 and O6 coordination environments. The title compound features tetra-nuclear CoII units bridged by κ 3 O:O:O'- and κ 3 O:O,O'-carboxyl-ate groups, which are joined into ribbons via syn-anti carboxyl-ate bridges. The parallel adtp4- ligands with an alternately reversed arrangement further link adjacent CoII ribbons into (010) layers, which are assembled into a three-dimensional supra-molecular network via inter-molecular hydrogen bonds. The disordered water solvent mol-ecules are situated in channels parallel to [100]. Magnetic measurements and analyses reveal that the title compound displays anti-ferromagnetic behaviour. The purity of the title compound was characterized by X-ray powder diffraction.

Synthesis and crystal structure of catena-poly[[hexa-aqua{µ3-2-[bis-(carboxyl-atometh-yl)amino]-terephthalato}dicobalt(II)] penta-hydrate] containing water tapes and penta-mers.

The title coordination polymer, {[Co2(C12H7NO8)(H2O)6]·5H2O} n , was crystallized at room temperature from an aqueous solution of 2-aminodi-acetic terephthalic acid (H4adtp) and cobalt(II) nitrate. The asymmetric unit consists of one adtp4- ligand, one and two half CoII ions, six water ligands coordinated to CoII ions and five uncoordinated water mol-ecules. Two of the cobalt cations lie on centres of inversion and are coordinated in octa-hedral O2(OH2)4 environments, whereas the other adopts a slightly distorted octa-hedral NO3(OH2)2 environment. The crystal structure contains parallel stacked, one-dimensional zigzag chains, {[Co2(C12H7NO8)(H2O)6]} n , which assemble into a three-dimensional supra-molecular architecture via networks of hydrogen bonds involving the coordinated and free water mol-ecules. One-dimensional 'water tapes' are formed, containing alternating six-membered and twelve-membered rings of water mol-ecules, together with water penta-mers, in which a central uncoordinated water mol-ecule is hydrogen bonded to two coordinated and two free water mol-ecules in a tetra-hedral arrangement.

Role of ultrasound in the diagnosis of cervical tuberculous lymphadenitis in children.

BACKGROUND: To describe sonographic characteristics of cervical tuberculous lymphadenitis (CTBL) in children, clinical information, and sonograms of 348 lymph nodes (LNs) from 57 children with CTBL were retrospectively analyzed in this study. METHODS: We retrospectively reviewed the clinical data and sonograms of 348 LNs from 31 boys and 26 girls with CTBL, who were confirmed by pathology or laboratory examination, at the Hangzhou Red Cross Hospital between June 2014 and December 2020. The age of the children ranged from 1 to 14 years (average 7.1 ± 2.9 years). RESULTS: Night sweats, fatigue and loss of appetite were the most common clinical symptoms observed in children with CTBL. Unilateral LN involvements were common. Occasionally, CTBL was found in healthy children with no symptoms. On sonography, the hilus was absent or unclear in all LNs. The short-to-long axis (S/L) ratio was ≥ 0.5, and the edges were unclear in most LNs. Other accompanying findings included necrosis (47.4%), an echogenic thin layer (36.8%), surrounding soft-tissue edema (38.5%), multiple intra-nodal strong echo (28.2%), sinus (22.7%) and abscess formation (6.9%). The Doppler ultrasound showed that the majority of vascularity patterns of CTBL were capsular or peripheral (33.3%). CONCLUSIONS: Ultrasound is a recommended examination method for children from different age groups with cervical lymphadenitis. The ultrasonic signs of hilus absence, S/L ratio ≥ 0.5, unclear edge, necrosis, echogenic thin layer, strong echoes and capsular or peripheral vascularity may aid in the diagnosis of cervical tuberculous lymphadenitis.

Dysphagia in a patient with ankylosing spondylitis: A case report.

BACKGROUND: Ankylosing spondylitis (AS) is a systematic and rheumatic disease, which causes multiple symptoms. However, dysphagia due to the formation of a giant anterior cervical osteophyte is rare in patients with AS. CASE SUMMARY: We present the case of a 65-year-old male patient who was diagnosed with AS and visited the hospital with a complaint of progressive dysphagia. The appropriate imaging examinations indicated that a giant anterior cervical osteo-phyte at C3-4 caused esophageal compression, which led to dysphagia. An operation for resection was performed without complications. CONCLUSION: This case demonstrates that a large cervical osteophyte may be the cause of dysphagia in patients with AS, and early accurate diagnosis and surgical treat-ment are very important for the improvement of symptoms. Anterior cervical discectomy and fusion are extremely effective and should be taken into consideration.

Elimination of antibiotic resistance genes in waste activated sludge by persulfate treatment during the process of sludge dewatering.

Two sludge conditioning modes (nanoscale zero valent iron modified by Ginkgo biloba L. leaf (G-nZVI)/sodium persulfate (PS) conditioning with different ratios (1:0, 1:0.1, 1:1 and 1:10) and G-nZVI/PS conditioning with continuous addition) in reducing the specific resistance of filtration (SRF) and removing antibiotic resistant genes (ARGs) were investigated. After 3 min, the SRF values decreased in following order: 2.45 × 108 m/kg (1:10) > 5.95 × 106 m/kg (1:0.1) > 3.72 × 106 m/kg (1:0) > 4.92 × 105 m/kg (1:1). In the continuous addition (1:1), the SRF value decreased from 1.04 × 108 m/kg to 6.47 × 106 m/kg at 9 min. Removal efficiency of ARGs was 2-6 orders of magnitude and no regeneration of ARGs was observed in sludge and water phase. When treated samples were incubated for 36 h, dominant microflora was negatively correlated with ARGs. This study revealed persulfate treatment could achieve dewatering and remove ARGs, simultaneously.

Sulfidated nanoscale zero-valent iron is an efficient material for the removal and regrowth inhibition of antibiotic resistance genes.

Antibiotic resistance genes (ARGs) and mobile gene elements (MGEs), the emerging genetic contaminants, are regarded as severe risks to public health for impairing the inactivation efficacy of antibiotics. Secondary effluents from wastewater treatment plants are the hotspots for spreading these menaces. Herein, sulfidated nanoscale zero-valent iron (S-nZVI) was occupied to remove ARGs and MGEs in secondary effluents and weaken the regrowth capacity of their bacterial carriers. The effects of S/Fe molar ratios (S/Fe), initial pH and dosages on 16S rRNA and ARGs removal were also investigated. Characterization, mass balance and scavenging experiments were conducted to explore the mechanisms of the gene removal. Quantitative PCR (qPCR) and high throughput fluorescence qPCR showed more than 3 log unit of 16S rRNA and seven out of 10 ARGs existed in secondary effluent could be removed after S-nZVI treatment. The mechanisms might be that DNA accepted the electron provided by the Fe0 core of S-nZVI after being adsorbed onto S-nZVI surface, causing the decrease of 16S rRNA, ARGs and lost their regrowth capacity, especially for typical MGE (intI1) and further inhibiting the vertical gene transfer (VGT) and intI1-induced horizontal gene transfer (HGT). Fe0 core was oxidized to iron oxides and hydroxides at the same time. High throughput sequencing, network analysis and variation partitioning analysis revealed the complex correlations between bacteria and ARGs in secondary effluent, S/Fe could directly influence ARGs variations, and bacterial genera made the greatest contribution to ARGs variations, followed by MGEs and operational parameters. As a result, S-nZVI could be an available reductive approach to deal with bacteria and ARGs.

[Anti-inflammatory mechanism of Crepis crocea based on NF-κB signaling pathway and ~1H-NMR metabonomics].

Based on ~1H-NMR metabonomics technique and Western blot assay, the anti-inflammatory mechanism of Crepis crocea was discussed. In this study, male SD rats were treated with water extract(2.5 g·kg~(-1)) and dexamethasone acetate(6.25×10~(-4) g·kg~(-1)) for one week, and the inflammation model was induced by lipopolysaccharide(LPS). Then the counts of inflammatory cells white blood ceel(WBC), eosinophil(EO), lymphocyte(LY), basophils(BA) and neutrophils(NE) in whole blood of rats were observed. The levels of serum inflammatory factors tumor necrosis factor-α(TNF-α), interleukin-1ß(IL-1ß), IL-6 and the expression of nuclear factor-κB(NF-κB) signaling pathway p65 and p-IκBα proteins in lung tissues were detected, and the change rules of serum endogenous metabolites were analyzed by ~1H-NMR metabonomics technique. The levels of TNF-α, IL-1ß, IL-6 and NF-κB signaling pathway p65 and p-IκBα proteins were combined with ~1H-NMR metabonomics to study the anti-inflammatory mechanism of C. crocea. The results showed that the water extract of C. crocea significantly decreased the number of WBC, NE, EO, increased the number of BA and LY, decreased the levels of TNF-α, IL-1ß, IL-6 and the expression of p65 and p-IκBα protein in NF-κB signaling pathway, and effectively alleviated the inflammatory symptoms. In the correlation analysis of differential metabolites regulated of C. crocea, four significant metabolites were obtained, including glycine, creatine, methionine and succinic acid. The anti-inflammatory mechanism of C. crocea may be related to the decrease of TNF-α, IL-1ß, IL-6 levels and the protein expression of NF-κB signaling pathway, as well as the regulation of glycine, creatine, methionine and succinic acid metabolism.

DNA-based stable isotope probing identifies triclosan degraders in nitrification systems under different surfactants.

Three widely-used surfactants, rhamnolipid (RL), sophorolipid (SL) and sodium dodecyl benzene sulfonate (SDBS), were chosen to investigate their effects on the nitrification systems treating step-wised triclosan (TCS). Surfactants had little effects on nitrification. Surfactants could promote the desorption of TCS and enhance the TCS biodegradation in nitrification systems. And TCS biodegradation efficiencies obtained with RL, SL and SDBS were 1.25, 1.23 and 1.14 times higher than the control with 9.0 mg/L TCS, respectively. Illumina MiSeq sequencing showed that Amaricoccus could be resistant to TCS. And Amaricoccus, detected with RL, SL and SDBS, were more abundant than the control. DNA-based stable isotope probing assays revealed Amaricoccus was the major TCS degrader. And the addition of surfactants could obviously increase the diversity of active TCS degraders, especially for biosurfactants. It seems that the addition of surfactants showed positive effects for the nitrification systems treating TCS wastewater.

[Analysis of chemical components of Huanbei Zhike Prescription based on UPLC-Q-TOF-MS/MS technology].

To characterize the chemical constituents of Huanbei Zhike Prescription by ultra-high performance liquid chromatography-time of flight mass spectrometry( UPLC-Q-TOF-MS/MS). A Thermo Syncronls C18 column( 2. 1 mm×100 mm,1. 7 µm) was used with methanol( A)-0. 1% formic acid solution( B) as the mobile phase for gradient elution. The injection volume was 2 µL; the column temperature was 40 ℃; the flow rate was 0. 3 m L·min-1; and electrospray ionization( ESI) source was used to collect data in positive and negative ion modes. The ion scanning range was m/z 50-1 200,with capillary voltage of 3 000 V,ion source temperature of100 ℃,atomization gas flow rate of 50 L·h-1,desolvent gas flow rate of 800 L·h-1,desolvent temperature of 400 ℃,cone hole voltage of 40 V,with argon as the collision gas and the collision energy was 20-35 V. The excimer ion peak information was analyzed by Waters UNIFI data processing software. The molecular formula with error within 1×10-5 was compared with the data in database to identify the compounds. The secondary fragment ion information of the target compound was selected,and then compared with the retention time and fragmentation patterns provided by the database and the existing literature to further confirm the compositions and structures of the compounds. A total of 68 main compounds in Huanbei Zhike Prescription were identified,including 38 flavonoids,10 organic acids,6 terpenoids and 10 nitrogen-containing compounds,of which 12 compounds were verified by the control substances. This method is rapid and accurate,which provides a new strategy for the qualitative analysis of the chemical constituents of Huanbei Zhike Prescription,and lays a foundation for the further study and quality control of the compound pharmacodynamic substance.

Anterior cervical corpectomy decompression and fusion for cervical kyphosis in a girl with Ehlers-Danlos syndrome: A case report.

BACKGROUND: Spinal deformities in Ehlers-Danlos syndrome (EDS; type VI) are generally progressive and severe. Surgical treatment has been described for kyphoscoliosis in the thoracolumbar spine. However, there are few studies describing the consequences of an anterior approach in cervical kyphosis. An anterior approach may not be able to fully decompress the spinal canal and restore the normal curvature of the cervical spine. Therefore, the anterior approach for cervical kyphosis in young children is hard. We describe the first case in an EDS girl with cervical kyphosis who received satisfactory anterior cervical corpectomy decompression and fusion. CASE SUMMARY: The chief complaints of a 16-year-old girl with EDS were double upper limb weakness for 7 years and double lower limb walking instability for 2 years. Moreover, the imaging results revealed that the degree of kyphosis from cervical vertebra 2 to 4 accompanying with spinal cord compression was 30°. An anterior cervical corpectomy involving cervical vertebra 3 and a titanium mesh implant were performed with internal fixation. The results at 3 mo after surgery demonstrated that the anterior fusion was solid, and the kyphosis of the cervical spine was corrected. Additionally, the power of all four extremities was significantly improved. CONCLUSION: The incidence rate of cervical kyphosis in EDS is rare. The surgical treatment for these patients, especially an anterior approach, is challenging. Therefore, to develop safer and more effective strategies to treat cervical kyphosis in EDS, there is still much work to do.

Simultaneous adsorption and degradation of triclosan by Ginkgo biloba L. stabilized Fe/Co bimetallic nanoparticles.

Triclosan (TCS), an antimicrobial agent added in many pharmaceutical and personal care products, can cause some environmental problems due to its bioaccumulation, toxicity and potential antibiotic cross-resistance. In this study, Ginkgo biloba L. leaf extract was used as the green stabilizing agent to synthesize Fe/Co bimetallic nanoparticles (G-Fe/Co NPs), which were applied to remove TCS from aqueous solution. G-Fe/Co NPs were characterized by TEM, EDS, SEM, BET, FTIR, XRD and XPS. G. biloba L. leaf extract improved the dispersion and reduced the passivation of NPs. The TCS removal efficiency followed the order of G-Fe/Co NPs > G-Fe NPs > Co NPs > Fe/Co NPs > Fe NPs. G-Fe/Co NPs can be reused at least eight times. The Co leaching under different initial pH values was negligible. The factors affecting the TCS removal were investigated. The results indicated that the removal of TCS followed pseudo-second-order kinetics, and the removal rate constant decreased with increasing the initial pH value and the initial TCS concentration, and decreasing the Co loading of G-Fe/Co NPs and NPs dosage. The mass balance of TCS removal by G-Fe/Co NPs indicated that adsorption was dominant process and TCS degradation was an accumulative process.

Percutaneous endoscopic lumbar discectomy and microsurgical laminotomy : A prospective, randomized controlled trial of patients with lumbar disc herniation and lateral recess stenosis.

BACKGROUND: Sufficient decompression of the nerve root canal is still regarded as the method of choice when operating on patients with lumbar disc herniation (LDH) with lumbar lateral recess stenosis; however, tissue-sparing procedures are becoming more popular. Endoscopic techniques offer advantages and the benefits of rehabilitation, which have become the standard in many surgical operations when operating on the spine. A significant issue has been the upgrading of instruments to provide enough bone resection under continuous visual control. MATERIAL AND METHODS: We examined patients who had LDH with lateral recess stenosis and compared the results of nerve root canal decompression using percutaneous endoscopic lumbar discectomy (PELD) with a microsurgical laminotomy (ML) technique. In this study 40 patients with full endoscopic decompression or microsurgery were followed up for 2 years. In addition to general and specific parameters, the following two parameters were also used for the investigation: the Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Except for 1 patient in whom repair was done by fusion and 1 who was lost to follow-up, 38 patients remained in the study over the 2 years. The mean operating time in the PELD group was longer (p < 0.05), but intraoperative and postoperative blood loss was less than in the ML group (p < 0.05). The postoperative results were better than before surgery, and the VAS and ODI parameters indicated a clear improvement in leg pain and daily activities in both groups (p > 0.05). Of the patients three suffered increasing back pain (2 ML, 1 PELD). CONCLUSION: The results indicated that the PELD can provide an effective supplement and serve as an alternative for LDH with lateral recess stenosis compared with the ML technique when the indication criteria are fulfilled. The PELD also has the advantage of being a minimally invasive intervention.

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

OBJECTIVE: To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. METHODS: Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. RESULTS: All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were considered excellent for four cases and good for one case. The success rate was 100%. CONCLUSIONS: When planning a wrap-around flap and second toe transplant to reconstruct a thumb, both the donor and recipient sites can be modeled using 3D printing. This can shorten the operative time by supplying digital and accurate schematics for the operation. It can also optimize the function and appearance of the reconstructed thumb while minimizing damage to the donor site.