Mapping knowledge structure and themes trends in geriatric spine surgery: A bibliometric analysis.

To analyze the status, hotspots, and frontiers of spine surgery in the geriatric using bibliometric method, the Web of Science Core Collection was searched for all papers concerning the use of spine surgery in the elderly from January 1, 1982 to August 3, 2022. VOSviewer and R software were used to perform the bibliometric analysis, which included retrieving the country, institution, author, journal, and keyword. A total of 663 articles were identified. The investigation revealed a growing number of publications over the past 20 years. The country with the highest number of publications was the United States (195 papers). The institution with the highest number of publications was the University of California (31 papers). H. Hassanzadeh and A. Jain were the most productive authors (14 publications), while R. A. Deyo was the most co-cited author. The journal with the most published papers was Spine (67 papers). According to Bradford Low, Spine, World Neurosurgery, and European Spine Journal were core journals in the field of geriatric spine surgery. The most recent trend topic was "readmission," "vertebroplasty," "kyphoplasty," "risk," "osteoporosis," "outcomes," "surgery," "complications," "scoliosis," and "management." In particular, osteoporosis has been a topic of attention in the field of geriatric spine surgery since 2005. Over time, research on spinal surgery in the elderly and allied topics has grown in importance and scope, indicating a tendency toward globalization. Researchers should pay more attention to the outcomes, complications, and management associated with spine surgery in the elderly.

Comparison of Full Endoscopic Lumbar Diskectomy Using the Transforaminal Approach versus Interlaminar Approach for L5-S1 Lumbar Disk Herniation Treatment: A Meta-Analysis.

BACKGROUND: Numerous studies have examined the clinical effectiveness of transforaminal full endoscopic lumbar diskectomy (T-FELD) and interlaminar full endoscopic lumbar diskectomy (I-FELD) for L5-S1 lumbar disk herniation (LDH), with mixed findings. The goal of this systematic review and meta-analysis was to evaluate the perioperative outcomes, clinical results, and complications of T-FELD and I-FELD to determine their efficacy and safety for treating L5-S1 LDH and to examine the features of complications in depth. METHODS: Several databases were searched for articles that matched all of the inclusion criteria. The visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to assess the clinical results. Information on perioperative outcomes and complications was gathered and analyzed. RESULTS: Eight studies with 756 participants were included. There were no significant differences in postoperative bed time (p = 0.44) and hospitalization time (p = 0.49) between T-FELD and I-FELD. When compared with I-FELD, T-FELD was associated with substantially longer fluoroscopy time (p < 0.0001) and operating time (p < 0.0001). There were no significant differences in the preoperative and postoperative VAS and ODI scores between T-FELD and I-FELD. The rates for overall complications, postoperative dysesthesia, postoperative lower extremity pain, incomplete decompression, recurrence, and conversion to open surgery were comparable for T-FLED and I-FELD. CONCLUSION: T-FELD and I-FELD had equal clinical results and safety for treatment of L5-S1 LDH. Fluoroscopy and operative times were shorter for I-FELD than for T-FELD.

A decreased number of circulating regulatory T cells is associated with adverse pregnancy outcomes in patients with systemic lupus erythematosus.

OBJECTIVE: As an autoimmune disease affecting women of reproductive age, systemic lupus erythematosus (SLE) is linked to adverse fetal and maternal outcomes. However, the status of peripheral lymphocytes in SLE patients with different pregnancy outcomes is unclear. This retrospective cross-sectional study explored the relationship between lymphocyte subpopulations and pregnancy outcomes in married SLE female patients. METHODS: The absolute numbers of peripheral T, helper T (Th)1, Th2, Th17, regulatory T (Treg), B, and natural killer (NK) cell subpopulations from 585 female SLE patients and 91 female healthy controls (HCs) were assessed. We compared the lymphocyte subpopulations in SLE patients with HCs and analyzed the absolute number and ratio of Treg cells according to pregnancy outcome in SLE patients. RESULTS: SLE patients had decreased numbers of T, B, NK, Th1, Th2, Th17, and Treg cells and an imbalance in pro- and anti-inflammatory cells (p < .05), as well as adverse pregnancy outcomes. In abortion patients, the number of Treg cells (p = .008) decreased, leading to an imbalance in effector T and Treg cells. The ratio of Treg cells was higher in SLE patients with nulliparity than in those with one or two parities. CONCLUSIONS: The absolute numbers of lymphocyte subpopulations in SLE patients decreased, which was associated with abortion and parity (p < .05). These results suggest that a loss of immune tolerance mediated by Tregs triggers pregnancy loss.

Azvudine is a thymus-homing anti-SARS-CoV-2 drug effective in treating COVID-19 patients.

Azvudine (FNC) is a nucleoside analog that inhibits HIV-1 RNA-dependent RNA polymerase (RdRp). Recently, we discovered FNC an agent against SARS-CoV-2, and have taken it into Phase III trial for COVID-19 patients. FNC monophosphate analog inhibited SARS-CoV-2 and HCoV-OC43 coronavirus with an EC50 between 1.2 and 4.3 µM, depending on viruses or cells, and selective index (SI) in 15-83 range. Oral administration of FNC in rats revealed a substantial thymus-homing feature, with FNC triphosphate (the active form) concentrated in the thymus and peripheral blood mononuclear cells (PBMC). Treating SARS-CoV-2 infected rhesus macaques with FNC (0.07 mg/kg, qd, orally) reduced viral load, recuperated the thymus, improved lymphocyte profiles, alleviated inflammation and organ damage, and lessened ground-glass opacities in chest X-ray. Single-cell sequencing suggested the promotion of thymus function by FNC. A randomized, single-arm clinical trial of FNC on compassionate use (n = 31) showed that oral FNC (5 mg, qd) cured all COVID-19 patients, with 100% viral ribonucleic acid negative conversion in 3.29 ± 2.22 days (range: 1-9 days) and 100% hospital discharge rate in 9.00 ± 4.93 days (range: 2-25 days). The side-effect of FNC is minor and transient dizziness and nausea in 16.12% (5/31) patients. Thus, FNC might cure COVID-19 through its anti-SARS-CoV-2 activity concentrated in the thymus, followed by promoted immunity.

Dalbavancin binds ACE2 to block its interaction with SARS-CoV-2 spike protein and is effective in inhibiting SARS-CoV-2 infection in animal models.

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic worldwide. Currently, however, no effective drug or vaccine is available to treat or prevent the resulting coronavirus disease 2019 (COVID-19). Here, we report our discovery of a promising anti-COVID-19 drug candidate, the lipoglycopeptide antibiotic dalbavancin, based on virtual screening of the FDA-approved peptide drug library combined with in vitro and in vivo functional antiviral assays. Our results showed that dalbavancin directly binds to human angiotensin-converting enzyme 2 (ACE2) with high affinity, thereby blocking its interaction with the SARS-CoV-2 spike protein. Furthermore, dalbavancin effectively prevents SARS-CoV-2 replication in Vero E6 cells with an EC50 of ~12 nM. In both mouse and rhesus macaque models, viral replication and histopathological injuries caused by SARS-CoV-2 infection are significantly inhibited by dalbavancin administration. Given its high safety and long plasma half-life (8-10 days) shown in previous clinical trials, our data indicate that dalbavancin is a promising anti-COVID-19 drug candidate.

Metabolic syndrome emerges after artificial selection for low baroreflex sensitivity.

AIMS: It is unclear whether the impaired BRS plays a key role in the incidence of cardiovascular diseases. The molecular mechanism of impaired BRS remains to be fully elucidated. We hypothesized that selection of rats based on deficient and normal intrinsic BRS would yield models that reflect cardiovascular diseases risk. METHODS AND RESULTS: Twenty generations of selection produced arterial baroreflex low rats and normal rats that differed in BRS by about 2.5-fold change. Metabolic syndrome (including hypertension, overweight, hyperlipemia, and hyperglycemia) emerged in ABR-DRs. Although ABR-DRs consumed less food, they gained significantly more body weight. CONCLUSION: Our study demonstrated that intrinsic low BRS induced hypertension and metabolic disorder. Restoration of impaired BRS might be a potent target of therapeutic intervention in metabolic syndrome.

The Combination of Scopolamine and Psychostimulants for the Prevention of Severe Motion Sickness.

BACKGROUND AND AIMS: Severe motion sickness is a huge obstacle for people conducting precise aviation, marine or emergency service tasks. The combination of scopolamine and d-amphetamine is most effective in preventing severe motion sickness. However, this combination is not included in any present pharmacopoeia due to the abuse liability of d-amphetamine. We wanted to find a combination to replace it for the treatment of severe motion sickness. METHODS AND RESULTS: We compared the efficacy of scopolamine, diphenhydramine, and granisetron (representing three classes of drugs) with different doses, and found that scopolamine was the most effective one. We also found scopolamine inhibited central nervous system at therapeutic doses and caused anxiety. Then, we combined it with different doses of psychostimulants (d-amphetamine, modafinil, caffeine) to find the best combination for motion sickness. The efficacy of scopolamine with modafinil (1 + 10 mg/kg) was equivalent to that of scopolamine with d-amphetamine (1 + 1 mg/kg); This combination also excited central nervous system and abolished the anxiety caused by scopolamine. CONCLUSIONS: The optimal dose ratio of scopolamine and modafinil is 1:10. This combination is beneficial for motion sickness and can abolish the side effects of scopolamine. So, it might be a good replacement of scopolamine and d-amphetamine for severe motion sickness.

Effects of exercise therapy on knee joint function and synovial fluid cytokine levels in patients with knee osteoarthritis.

The aims of this study were to observe the effect of exercise therapy on the function of the knee joint and the levels of cytokines and cytokine-related genes, specifically tumor necrosis factor-α (TNF-α), high sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-3 (MMP-3), in the synovial joints of patients with knee osteoarthritis (KOA) and to explore its mechanism of action. A total of 100 KOA patients were divided into a treatment group (n=50) and a control group (n=50) according to the order of admission. The patients in the treatment group were treated with diclofenac sodium combined with exercise therapy and the patients in the control group were treated with diclofenac sodium only. The function of the knee joint and the therapeutic efficacy was evaluated and the TNF-α, hs-CRP and MMP-3 levels in the synovial fluid were measured following 4 weeks of treatment. The results revealed that the knee joint index score and the TNF-α, hs-CRP and MMP-3 levels in the synovial fluid decreased significantly in the KOA patients of the two groups following treatment (P<0.05). Compared with the control group, the knee joint index score and the TNF-α, hs-CRP and MMP-3 levels in the synovial joints were lower and the therapeutic efficacy was increased in the patients of the treatment group (P<0.05). In brief, exercise therapy may decrease cytokine and cytokine-related gene levels in the synovial fluid and inhibit inflammatory factor-mediated cartilage degradation in KOA patients, thus, effectively improving the clinical symptoms of KOA.

Construction of recombinant Newcastle disease virus Italien strain for oncolytic virotherapy of tumors.

Newcastle disease virus (NDV) is a naturally oncolytic virus that has been shown to be safe and effective for cancer therapy. Tumor virotherapy using NDV emerged in the 1950s and has advanced more recently by the increased availability of reverse genetics technology. In this study, we constructed a reverse genetics system based on the virulent and oncolytic NDV Italien strain, and generated two recombinant NDVs carrying a gene encoding either enhanced green fluorescent protein or firefly luciferase. We evaluated the replication and antitumor characteristics of these viruses in vitro and in vivo. Our data showed that the insertion of exogenous reporter genes did not affect NDV replication and sensitivity to type I interferon. The recombinant NDVs kept the property of tumor-selective replication both in vitro and in vivo and strongly induced syncytium formation leading to cell death. Moreover, the recombinant NDVs significantly prolonged the survival of tumor-bearing athymic mice (p=0.017) and suppressed the loss of body weight after intratumoral injection. Taken together, our study provides a novel platform to develop recombinant oncolytic viruses based on the NDV Italien strain and shows the efficiency of recombinant NDV Italien for oncolytic virotherapy of tumors.

HER-2/neu and TOPIIa expression in gastric cancer reflect disease severity.

BACKGROUND/AIMS: Gastric cancer is associated with high morbidity and mortality, but reliable diagnostic and prognostic markers have not been established. Here we explored the clinical significance of two proteins, HER-2/neu and TOPIIa-associated with development and progression of various tumor types-in gastric cancer. We also analyzed the correlation between expression of these proteins and clinicopathological parameters of gastric tumors. METHODOLOGY: Tumor and adjacent normal tissue samples were collected from 62 patients with gastric cancer and subjected to immunohistochemistry with anti-HER-2/neu and -TOPIIa antibodies. RESULTS: HER-2/neu (21.0%) and TOPIIa (80.6%) were expressed more commonly in gastric cancer than in normal gastric tissue (9.7% and 60.3%, respectively; p<0.05). However, there was no correlation between HER-2/neu and TOPIIa expression in gastric tumors. Further analysis showed a correlation between HER-2/neu expression and lymph node metastasis, distant metastases and tumor stage (p<0.05); TOPIIa was correlated with infiltration depth, distant metastases and tumor stage (p<0.05). CONCLUSIONS: HER-2/neu and TOPIIa are over expressed in gastric tumors and may promote disease progression. These proteins may therefore be useful as prognostic markers in evaluation of patients with gastric cancer.

Expression of MMP-3 and TIMP-3 in gastric cancer tissue and its clinical significance.

The present study aimed to investigate the expression of matrix metalloproteinase-3 (MMP-3) and the tissue inhibitor of metalloproteinase-3 (TIMP-3) in gastric cancer tissue, as well as to analyze the correlation between their expression and the occurrence of gastric cancer. Immunohistochemistry was used to determine the expression of MMP-3 and TIMP-3 in the gastric cancer tissue from 18 patients with early-stage gastric cancer (early-stage group) and 26 patients with advanced-stage gastric cancer (advanced-stage group). Transmission electron microscopy (TEM) was used to observe the lymphocytes and tumor cells in gastric cancer tissue. The results showed that the expression of TIMP-3 was significantly higher, whereas that of MMP-3 and MMP-3/TIMP-3 was lower in gastric cancer tissue of the early-stage group than in that of the advanced-stage group (P<0.05). The TEM images revealed increased lymphocytes and inconspicuous tumor cells penetrating the basement membrane in gastric cancer tissue of the early-stage group, and decreased lymphocytes and obvious tumor cells penetrating the basement membrane in the advanced-stage group. In conclusion, MMP-3 and TIMP-3 may be used as indices for the invasion and metastasis of gastric cancer and possess marked clinical significance in the prognostic judgment of gastric cancer.

[Distribution characteristics of common syndrome types and syndrome elements extracted by experts' experience in perimenopausal and postmenopausal women].

OBJECTIVE: To compare the distribution characteristics of common syndrome types and syndrome elements of menopause syndrome in perimenopausal and postmenopausal women on the basis of standardized syndrome differentiation extracted by experts' experiences. METHODS: A total of 1 582 outpatients with menopause syndrome who met with the diagnosis and inclusion criteria in seven grade 3 hospitals from October 2006 to June 2007 were included. A clinical epidemiological survey in the patients was carried out. The syndrome elements of disease location and characteristics were extracted and analyzed statistically by standardizing the syndrome differentiation of experts' experience in traditional Chinese medicine. RESULTS: There were 105 syndrome types after initial standardization, and the common syndrome types were kidney yin deficiency, deficiency of liver and kidney yin, stagnation of liver qi, and deficiency of both kidney yin and yang. Six syndrome elements of the disease location were extracted, among which the common elements were kidney, liver, spleen and heart. Seventeen syndrome elements of the disease characteristics were extracted, among which the common elements were yin deficiency, qi stagnation, qi deficiency, yang deficiency and deficiency. Syndrome types of stagnation of liver qi, deficiency of spleen and kidney, and qi stagnation were more frequently diagnosed during perimenopausal period, while the syndrome type of kidney yin deficiency was more frequently diagnosed during postmenopausal period, and the kidney was the main disease location. The distribution characteristics of the other syndrome types and elements were similar during the two periods. CONCLUSION: The syndrome type distribution in women with menopause syndrome is complex, while the syndrome element distribution is simple. Generally, the syndrome type and syndrome element distributions during perimenopausal and postmenopausal periods are similar, but there are significant differences in some syndrome types and syndrome elements between the two periods. All of these can give support for revealing the distribution rule of the common syndrome types and syndrome elements and give a theoretical basis for clinical treatment of menopause syndrome.

Effects of osthole on apoptosis and TGF-beta1 of hypertrophic scar fibroblasts.

Osthole, 7-methoxy-8-[3-methylpent-2-enyl]coumarin (1), was extracted from a Chinese herb Cnidium monnieri (L.) Cuss. It showed immunity strengthening, anti-tumor, anti-hepatitis, and anti-osteoporosis activities in previous studies. Our goals are to study the effects of 1 on cell proliferation and TGF-beta of hypertrophic scar fibroblasts. Our results showed that 1 induced apoptosis and inhibited cell proliferation in hypertrophic scar fibroblasts. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay showed that its IC(50) value toward hypertrophic scar fibroblasts was 15.5 +/- 2.2 micromol/l. Furthermore, the results of cell growth curve matched with the above results. Inducing apoptosis by 1 in hypertrophic scar fibroblasts was assessed by various morphological and biochemical characteristics, including cell shrinkage, chromatin condensation, membrane blebbing, formation of apoptotic bodies, and DNA ladder formation. A typical 'Sub-G(1) peak' was also checked through flow cytometry. We used immunohistochemistry to observe the expression of TGF-beta(1). Also, we found that 1 could obviously inhibit the expression of TGF-beta(1) of fibroblasts derived from hypertrophic scar compared with the control group (P < 0.05). These results suggest that 1 inhibits the growth of hypertrophic scar fibroblasts through apoptosis and decreases the expression of TGF-beta(1).

Phylogenetic analysis of eight genes of H9N2 subtype influenza virus: a mainland China strain possessing early isolates' genes that have been circulating.

H9N2 subtype influenza virus has become worldwide and prevalent in China. Previous studies illustrated that at least three sublineages had been established in terrestrial poultry of Eurasian avian. In this presentation, eight full-length genes of an H9N2 strain, A/Chicken/Shanghai/F/98 (Ck/SH/F/98) were obtained. Sequence analysis and phylogenetic studies were conducted by comparing eight genes with those of all the available H9N2 strains from the GenBank. The results showed that four genes (HA, NA, M and NS genes) of Ck/SH/F/98 were incorporated into the sublineage represented by the early mainland China strain, Ck/BJ/1/94. However, the other four of RNP genes of Ck/SH/F/98 did not show close relationship with those of the three known sublineages' viruses. Therefore, Ck/SH/F/98 was a natural reassortant between different sublineages. In addition, comparison showed that Ck/SH/F/98 could be a putative precursor of a later isolate from southern China, Dk/ST/1605/01, with at least six genes of both closely related, indicating genes of Ck/SH/F/98 and early isolates had ever been circulating. Further comparison in terms of molecular markers of species specificity of HA1 revealed that DK/ST/1605/01 also resembled Ck/SH/F/98 more than a common earlier duck strain. The results supported the idea of two-way transmission between terrestrial and aquatic birds that emphasized the importance to raise concerns on the natural evolution of all the eight genes of H9N2 avian influenza viruses.

[Application of fasciocutaneous flap in repairing III degree burn wound in facio-cervical region].

OBJECTIVE: To evaluate the clinical efficacy of fasciocutaneous flap in the repair of the III degree burn wound in the facio-cervical region. METHODS: From January 1997 to October 2001, 11 cases of III degree burn wounds in the facio-cervical region were repaired with the cervical-thoracic fasciocutaneous flap ranging from 18 cm x 8 cm to 13 cm x 5 cm. Donor sites were covered with "Z" plasty or skin grafting. RESULTS: Except for partial necrosis of distal end of the flap in 1 case, the flaps in the other 10 cases all survived and presented satisfactory appearance and function during the following up. CONCLUSION: The fasciocutaneous flap in the cervical-thoracic region may provide a large area of flap, and can be easily transferred. It's an ideal flap for the repair of skin defect in the facio-cervical region, especially for the repair of the wounds with infection or exposure of vessel, nerve and tendon.