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To address the problem of underactuated surface vessel (USV) formation control in static obstacle environments with model uncertainties and time-varying external disturbances, a model-free formation control strategy is proposed in this paper. First, based on the guiding vector field (GVF), a composite GVF is developed to guide USV formation to the desired position and to avoid multiple static obstacles. Second, a flexible constraint strategy is introduced, and the constraint boundary conditions are appropriately relaxed to avoid singularities in the obstacle environment. Then, based on the Mexican hat wavelet function, the self-structuring fuzzy Mexican hat wavelet cerebellar model articulation controller (SCMAC), and a self-structuring fuzzy Mexican hat wavelet brain emotional learning controller (SBELC), are proposed to achieve model-free control. In addition, the self-structuring algorithm is embedded into SCMAC and SBELC to achieve autonomous optimization of the controller structure and to reduce the computational effort of the control system. The salient features in the proposed control strategy are as follows. First, the proposed model-free formation control strategy does not have to rely on accurate model information. Second, collisions are effectively avoided, and good control performance is guaranteed even under the influence of disturbances and static obstacles. Third, the proposed self-structuring algorithm achieves automatic construction of the controller structure. Finally, the signals in the control system are proven to be bounded, and the simulation results verify the feasibility and superiority of the proposed model-free control strategy.
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CO2 electroreduction holds great promise for addressing global energy and sustainability challenges. Copper (Cu) shows great potential for effective conversion of CO2 toward specific value-added and/or high-energy-density products. However, its limitation lies in relatively low product selectivity. Herein, we present that the CO2 reduction reaction (CO2RR) pathway on commercially available Cu can be rationally steered by modulating the microenvironment in the vicinity of the Cu surface with two-dimensional sulfonated covalent organic framework nanosheet (COF-NS)-based ionomers. Specifically, the selectivity toward methane (CH4) can be enhanced to more than 60% with the total current density up to 500 mA cm-2 in flow cells in both acidic (pH = 2) and alkaline (pH = 14) electrolytes. The COF-NS, characterized by abundant apertures, can promote the accumulation of CO2 and K+ near the catalyst surface, alter the adsorption energy and surface coverage of *CO, facilitate the dissociation of H2O, and finally modulate the reaction pathway for the CO2RR. Our approach demonstrates the rational modulation of reaction interfaces for the CO2RR utilizing porous open framework ionomers, showcasing their potential practical applications.
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OBJECTIVE: Evidence from prospective studies on the consumption of tea and risk of gout is conflicting and limited. We aimed to investigate the potential causal effects of tea intake on gout using Mendelian randomization (MR). METHODS: Genome-wide association studies in UK Biobank included 349 376 individuals and successfully discovered single-nucleotide polymorphisms linked to consumption of one cup of tea per day. Summary statistics from the Chronic Kidney Disease Genetics consortium included 13 179 cases and 750 634 controls for gout. Two-sample MR analyses were used to evaluate the relationship between tea consumption and gout risk. The inverse-variance weighted (IVW) method was used for primary analysis, and sensitivity analyses were also conducted to validate the potential causal effect. RESULTS: In this study, the genetically predicted increase in tea consumption per cup was associated with a lower risk of gout in the IVW method (OR: 0.90; 95% CI: 0.82-0.98). Similar results were found in weighted median methods (OR: 0.88; 95% CI: 0.78-1.00), while no significant associations were found in MR-Egger (OR: 0.89; 95% CI: 0.71-1.11), weighted mode (OR: 0.80; 95% CI: 0.65-0.99), and simple mode (OR: 1.01; 95% CI: 0.75-1.36). In addition, no evidence of pleiotropy was detected by MR-Egger regression (P=0.95) or MR-PRESSO analysis (P=0.07). CONCLUSION: This study provides evidence for the daily consumption of an extra cup of tea to reduce the risk of gout.
Subject(s)
Genome-Wide Association Study , Gout , Humans , Mendelian Randomization Analysis , Prospective Studies , Gout/epidemiology , Gout/genetics , TeaABSTRACT
In this paper, an event-triggered finite-time controller is proposed for solving the formation control problems of underactuated multiple autonomous surface vessels (ASVs), including asymmetric mass matrix, collision avoidance, maintaining communication distances and prescribed performance. First, to not only avoid collisions between the follower and leader but also maintain an effective communication distance, a desired tracking distance is designed to be maintained. Second, an improved barrier Lyapunov function (BLF) is proposed to implement the tracking error constraint. In addition, the relative threshold event-triggering strategy effectively solves the communication pressure problem and greatly saves communication resources. Finally, based on coordinate transformation, line of sight (LOS) and dynamic surface control (DSC), a comprehensive finite-time formation control method is proposed to avoid collisions and maintain communication distance. All the signals of the proposed control system can be stabilized in finite time (PFS). The numerical simulation results verify the effectiveness of the proposed control system.
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[This corrects the article DOI: 10.3389/fonc.2022.951589.].
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BACKGROUND: Mechanical ventilation remains one of the primary management measures for critically ill patients in intensive care units (ICUs). However, previous studies on the prognosis prediction of ICU patients received mechanical ventilation were limited. This study was to develop and validate a nomogram for predicting short- and long-term survival among patients who received mechanical ventilation in the ICU. METHODS: This was a retrospective cohort study with a 3-year follow-up. Demographic, laboratory, clinical data of 16,775 participants aged ≥18 years who received mechanical ventilation in the ICU were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. The outcomes of this study were 1-month, 3-month, 1-year, and 3-year survival. All eligible patients were randomly classified into the training and testing groups with a ratio of 7:3. A multivariate Cox regression in the training group was used to explore the predictors and develop the predictive nomogram. Internal and subgroup validations were performed, and the C-index was calculated to estimate the predictive performance of the nomogram. The time-dependent receiver operating characteristic curves were drawn, and corresponding areas under the curve (AUC) were calculated. RESULTS: Totally 6,291 patients died during the follow-up duration. Age, gender, ethnicity, ICU type, comorbidity, days of mechanical ventilation, white blood cell count, blood urea nitrogen, the fraction of inspiration O2, Sequential Organ Failure Assessment scores, and the Glasgow coma score were predictors of the survival of ICU patients who received mechanical ventilation (P<0.05). The C-index of the nomogram was 0.819 and was validated in the testing group at 0.816. The AUCs for the prognostic nomogram for 1-month, 3-month, 1-year, and 3-year survival were 0.889, 0.892, 0.882, and 0.866, respectively. CONCLUSIONS: This nomogram showed good predictive performance for short- and long-term survival in ICU patients treated with mechanical ventilation, which may be a useful tool for clinicians to assess the prognosis of patients and to adjust treatment strategies in time.
Subject(s)
Intensive Care Units , Respiration, Artificial , Adolescent , Adult , Cohort Studies , Humans , Prognosis , Retrospective Studies , Sample SizeABSTRACT
Purpose: The aim of this study was to improve the intratumoral accumulation of an antibody-drug conjugate (ADC) and minimize its off-target toxicity, SKB264, a novel anti-trophoblast antigen 2 (TROP2) ADC that was developed using 2-methylsulfonyl pyrimidine as the linker to conjugate its payload (KL610023), a belotecan-derivative topoisomerase I inhibitor. The preclinical pharmacologic profiles of SKB264 were assessed in this study. Methods: The in vitro and in vivo pharmacologic profiles of SKB264, including efficacy, pharmacokinetics-pharmacodynamics (PK-PD), safety, and tissue distribution, were investigated using TROP2-positive cell lines, cell-derived xenograft (CDX), patient-derived xenograft (PDX) models, and cynomolgus monkeys. Moreover, some profiles were compared with IMMU-132. Results: In vitro, SKB264 and SKB264 monoclonal antibody (mAb) had similar internalization abilities and binding affinities to TROP2. After cellular internalization, KL610023 was released and inhibited tumor cell survival. In vivo, SKB264 significantly inhibited tumor growth in a dose-dependent manner in both CDX and PDX models. After SKB264 administration, the serum or plasma concentration/exposure of SKB264 (conjugated ADC, number of payload units ≥1), total antibody (Tab, unconjugated and conjugated mAb regardless of the number of the payload units), and KL610023 in cynomolgus monkeys increased proportionally with increasing dosage from 1 to 10 mg/kg. The linker stability of SKB264 was significantly enhanced as shown by prolonged payload half-life in vivo (SKB264 vs. IMMU-132, 56.3 h vs. 15.5 h). At the same dose, SKB264's exposure in tumor tissue was 4.6-fold higher than that of IMMU-132. Conclusions: Compared with IMMU-132, the longer half-life of SKB264 had a stronger targeting effect and better antitumor activity, suggesting the better therapeutic potential of SKB264 for treating TROP2-positive tumors.
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INTRODUCTION: Saponin of Schizocapsa plantaginea Hance I (SSPH I), a novel bioactive phytochemical isolated from the rhizomes of Schizocapsa plantaginea, has been demonstrated to exhibit anti-cancer activity against various tumors in preclinical studies. However, the molecular mechanisms involved in the suppression of hepatocellular carcinoma (HCC) are poorly understood. The present study aimed at analyzing the effects of SSPH I on autophagy and apoptosis in vitro. METHODS: MTT and colony forming assays were used to detect cell viability and cell proliferation. Hoechst 33,258 staining and flow cytometry were used to determine apoptosis and ROS production. The apoptosis and autophagy-related protein expression levels were evaluated via Western blot assay. Characteristics of autophagy and apoptosis were observed by transmission electron microscopy. Lysosomal activity was stained with Lyso-Tracker Red and Magic Red Cathepsin B. RESULTS: The results showed that SSPH I exhibited potent anti-cancer activity and proliferation in HepG2 and BEL-7402 cells and inhibited HepG2 cells through inhibiting autophagy and promoting apoptosis. The mechanistic study indicated that the inhibition of autophagy of SSPH I was mediated by blocking autophagosome-lysosome fusion. Additionally, we found that SSPH I could mediate the activation of MAPK/ERK1/2 signaling pathway, and the use of NAC (ROS inhibitor) and U0126 (MEK1/2 inhibitor) converted the effect of SSPH I on apoptosis and autophagy in HepG2 cells. CONCLUSION: These data suggest that SSPH I induces tumor cells apoptosis and reduces autophagy in vitro by inducing ROS and activating MAPK/ERK1/2 signaling pathway, indicating that SSPH I might be a novel agent for the treatment of HCC.
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Continued reports of infections with infectious bronchitis virus (IBV) variants have occurred since its first isolation in the 1930s. Currently, QX-like IBVs are the predominant circulating genotype around the world. Here, the pathogenicity of QX-like IBV strain SD was characterized in chickens at different ages of exposure to the virus, and the protection efficacy of available vaccine combinations against IBV was evaluated. The results revealed that QX-like IBV strain SD was severely pathogenic in chickens, causing respiratory, urinary and reproductive infections, irrespective of age, based on clinical observations, viral distribution in tissues and a ciliostasis study. Severe respiratory signs, tracheal cilia injury, nephritis and abnormal development of the oviduct and ovarian follicles were evident throughout the experiment. A challenge experiment demonstrated that the homologous QX vaccine showed superior protection efficacy compared with other available vaccines, confirming the importance of IBV vaccine seed homology against the circulating IBV strains. Our findings aid an understanding of the pathogenicity of QX-like IBVs that may help to further control the infection.
Subject(s)
Chickens , Coronavirus Infections/veterinary , Infectious bronchitis virus/immunology , Poultry Diseases/prevention & control , Age Factors , Animals , Coronavirus Infections/prevention & control , Coronavirus Infections/virology , Poultry Diseases/virology , Specific Pathogen-Free Organisms , Vaccination/veterinary , Viral Vaccines/immunologyABSTRACT
Although recent studies have revealed that germline stem cells (GSCs) exist in the mouse postnatal ovary, how to efficiently obtain GSCs for regenerating neo-oogenesis is still a technical challenge. Here, we report that using in situ tissue culture we can efficiently accumulate large amounts of proliferating germ-like cells from mouse postnatal ovaries. Usually, more than 10,000 germ-like cells can be derived from one ovary by this method, and over 20% of these cells can grow into germ-like cells with self-renewal, which thus can serve as a good cell pool to isolate GSCs by other cell assorting methods such as FACS. This method is simple and time-saving, which should be useful for in future studies on mouse GSCs.
Subject(s)
Germ Cells/cytology , Ovary/cytology , Stem Cells/cytology , Tissue Culture Techniques , Animals , Cell Proliferation , Female , Mice , Mice, Inbred C57BLABSTRACT
Infectious coryza (IC), an acute respiratory disease of chickens, is caused by Avibacterium paragallinarum. Here, the current epidemiological status of IC was investigated in China over 5 yr (2013 to 2018). A total of 28 Av. paragallinarum field isolates were identified by PCR tests and by sequence analysis of the hemagglutinin gene. The pathogenicities of 4 field isolates, the efficacy of 2 commercial inactivated oil-emulsion IC vaccines and vaccines containing different Av. paragallinarum isolates were also evaluated. The PCRs revealed a high rate (51.5%) of sample positivity for Av. paragallinarum during 2013 to 2018. Phylogenetic analysis showed that most field strains fell into the same cluster and had a farther genetic relationship with the early isolates from China. Pathogenicity testing revealed that the Chinese Av. paragallinarum isolates were able to induce the typical clinical signs of IC; hence, they were clearly pathogenic to chickens. Vaccine efficacy tests revealed that the 2 commercial inactivated oil-emulsion IC vaccines we tested had low protection rates against 2 selected Av. paragallinarum isolates after a single immunization, whereas the inactivated vaccine containing the Av. paragallinarum BJ26 isolate generated a relatively high protection rate against the field isolates compared with other three tested vaccines. The results indicate that IC is currently prevalent in China, and that commercial vaccines have not counteracted its presence in this country.
Subject(s)
Bacterial Vaccines/immunology , Chickens , Haemophilus Infections/veterinary , Haemophilus paragallinarum/immunology , Poultry Diseases/prevention & control , Animals , China , Haemophilus Infections/prevention & control , Pasteurellaceae Infections/prevention & control , Pasteurellaceae Infections/veterinaryABSTRACT
Atherosclerosis (AS) is characterized by the significant accumulation of low-density lipoprotein (LDL)-cholesterol in macrophages that reside in the vessel wall and the resultant inflammatory response. Therefore, inhibition of LDL-induced inflammation is a promising interference for AS. Many traditional Chinese medicine prescriptions have been developed for AS treatment. Geniposide (GEN) is an iridoid glycoside mainly found in Gardenia jasminoides fruit. Although GEN has previously been shown to possess anti-atherosclerotic activities, its effects on the formation of macrophage-derived foam cells remain poorly characterized. In our current study, we demonstrated that GEN could significantly inhibit oxidized light-density lipoprotein (ox-LDL) induced macrophage foam cell formation and the expression of pro-inflammatory cytokines in a dose-dependent manner. In addition, treatment of GEN in bone-marrow derived macrophages repressed iNOS expression and NO expression. GEN could also alleviate ox-LDL-dependent up-regulation of CD36 expression by blocking the phosphorylation of p38 MAPK, ERK, JNK and NF-kB p65. The results of our current study demonstrate that GEN exhibits significant therapeutic effects against ox-LDA-induced foam cell formation and inflammation. Therefore, GEN is promising agent for treating AS.
Subject(s)
Foam Cells/drug effects , Iridoids/pharmacology , Lipoproteins, LDL/metabolism , NF-kappa B/metabolism , p38 Mitogen-Activated Protein Kinases/metabolism , Animals , Atherosclerosis/drug therapy , Male , Mice , Mice, Inbred C57BL , Primary Cell CultureABSTRACT
RATIONALE: Lumbar degeneration-related May-Thurner syndrome (dMTS) is characterized by venous compression induced by degenerated lower lumbar structures. Treatment strategies for May-Thurner syndrome (MTS) include clearing the thrombus and correcting venous compression. Despite having different etiological factors from other MTS types, treatments for dMTS are similar, including endovascular angioplasty and continuous anticoagulation therapies. Thus, a particular treatment was designed herein to focus on compressive lumbar structures instead of intravenous management. PATIENT CONCERNS: A 59-year-old female patient with dMTS, which was induced by inferior vena cava (IVC) stenosis compressed by L4-5 anterior disc herniation. DIAGNOSIS: The patient was diagnosed with IVC stenosis and L4-5 lumbar disc herniation based on abdominal computed tomography, ultrasound, and lumbar magnetic resonance imaging findings. INTERVENTIONS: Radiofrequency thermocoagulation (RF) was applied to the patient to decrease the compression caused by anterior disc herniation. OUTCOMES: After surgery, the patient's swelling started to improve within 5âhours and completely diminished after 48âhours. Postsurgical abdominal ultrasound showed that her IVC patency increased by 20%. On follow-up, her leg symptoms did not recur at 12 months after surgery. LESSONS: We provided a novel idea in the treatment of dMTS, in which we shifted the treatment focus from endovascular patency restoration to extravascular decompression. Our case proved that RF was effective in treating dMTS, which is a complementary treatment modality to angioplasty.
Subject(s)
Intervertebral Disc Displacement/surgery , Laser Coagulation/methods , May-Thurner Syndrome/surgery , Radiofrequency Therapy/methods , Female , Humans , Intervertebral Disc Displacement/complications , Lumbar Vertebrae/surgery , May-Thurner Syndrome/etiology , Middle AgedABSTRACT
BACKGROUND: This study aimed to evaluate the methylation of RUNX3 and RASSF1A gene promoter regions as a marker to distinguish between benign and malignant of small solitary pulmonary nodule (SPN) ≤10 mm in size. MATERIALS AND METHODS: A total of 147 patients with pathologically confirmed SPNs were enrolled. DNA samples were extracted from biopsy tissues or serum. Methylation of RUNX3 and RASSF1A gene promoter regions was detected by the methylation-specific polymerase chain reaction. The expression of RUNX3 and RASSF1A in SPN tissues was detected by western blot. RESULTS: Of the 147 patients, 89 had benign SPNs and 58 had malignant SPNs. The rate of serum RUNX3 and RASSF1A gene methylation in malignant SPNs was significantly higher than that in benign SPNs (65.5% vs. 12.3%, and 67.2% vs. 10.1%, respectively; P < 0.05). The expression of RUNX3 and RASSF1A in malignant SPN tissues was lower than that in benign SPN tissues. The hypermethylation status of RUNX3 or RASSF1A genes was not significantly associated with age, gender, and smoking. CONCLUSIONS: The methylation level of the RUNX3 and RASSF1A gene promoter regions is a promising marker for assessing SPNs.
Subject(s)
Biomarkers, Tumor/genetics , Core Binding Factor Alpha 3 Subunit/genetics , DNA Methylation , Gene Expression Regulation, Neoplastic , Lung Neoplasms/pathology , Solitary Pulmonary Nodule/pathology , Tumor Suppressor Proteins/genetics , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Lung Neoplasms/genetics , Male , Middle Aged , Prognosis , Promoter Regions, Genetic , Solitary Pulmonary Nodule/geneticsABSTRACT
In human sperm, a fraction of its chromatin retains nucleosomes that are positioned on specific sequences containing genes and regulatory units essential for embryonic development. This nucleosome positioning (NP) feature provides an inherited epigenetic mark for sperm. However, it is not known whether there is a structural constraint for these nucleosomes and, if so, how they are localized in a three-dimensional (3D) context of the sperm nucleus. In this study, we examine the 3D organization of sperm chromatin and specifically determine its 3D localization of nucleosomes using structured illumination microscopy. A fraction of the sperm chromatin form nucleosome domains (NDs), visible as microscopic puncta ranging from 40â µm to 700â µm in diameter, and these NDs are precisely localized in the post acrosome region (PAR), outside the sperm's core chromatin. Further, NDs exist mainly in sperm from fertile men in a pilot survey with a small sample size. Together, this study uncovers a new spatially-restricted sub-nuclear structure containing NDs that are consistent with NPs of the sperm, which might represent a novel mark for healthy sperm in human.
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Proportions of QX-like genotype infectious bronchitis virus (IBV) isolates have increased over time. Here, to better understand the epidemiology and pathogenicity of IBV in China and control the spread of infectious bronchitis (IB), we conducted sequence analyses and examined the pathogenicity of 5 field isolates from diseased flocks in 2017 and 2018. Sequence analyses revealed that all the 5 strains, as well as many recent field isolates from other researchers, belonged to the QX-like IBV genotype, which were distantly related to commercial vaccine strains. Viral pathogenicity experiments showed that the isolates caused high morbidity and severe ciliostasis in chickens, although they caused milder lethality. This provides further evidence that QX-like IBV emergence remains a major problem in the poultry industry, and information on IBV epidemiology and pathogenicity may help to control IB.
Subject(s)
Chickens , Coronavirus Infections/veterinary , Infectious bronchitis virus/physiology , Infectious bronchitis virus/pathogenicity , Animals , Bronchitis/epidemiology , Bronchitis/microbiology , Bronchitis/veterinary , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/microbiology , Phylogeny , Poultry Diseases/epidemiology , Poultry Diseases/microbiology , Prevalence , Random Allocation , Specific Pathogen-Free Organisms , Spike Glycoprotein, Coronavirus/analysis , VirulenceABSTRACT
To investigate cytokine expression in chicken embryo fibroblast (CEF) cells, a virulent avian avulavirus 1 (AAvV-1) strain called SG10 that rapidly causes 100% mortality in its host, and a vaccine strain (La Sota) were characterized. Real-time quantitative PCR was performed on RNA samples from CEF cells, which were collected at 0, 24, 48 and 72â¯h post-infection. The dynamic expression patterns of ten cytokines (TNF-α, IFN-α, IFN-ß, IL-1ß, IL-2, IL-6, IL-10, IL-13, IL-15 and IL-18) were investigated. The results showed that infection with lentogenic La Sota induced significantly higher levels of the antiviral cytokines IFN-α and IFN-ß, proinflammatory cytokines IL-2, IL-15 and IL-18, and the anti-inflammatory cytokine IL-10, than did infection with virulent SG10. Furthermore, the SG10 strain induced dramatically higher levels of the inflammatory cytokine IL-6 than those observed in cells infected with La Sota. However, the expression patterns of the other cytokines that were tested did not show any obvious trends or statistically significant differences between cells infected with the virulent and avirulent strains. These data show that infection with lentogenic La Sota induced more effective immune responses and anti-viral effects than did infection with virulent SG10 in CEFs. Our data provide distinct expression patterns of IFNs and proinflammatory and anti-inflammatory cytokines to AAvV-1 by virulence in CEF cells.
Subject(s)
Chick Embryo/immunology , Cytokines/metabolism , Fibroblasts/immunology , Newcastle Disease/immunology , Newcastle disease virus/immunology , Animals , Chickens/immunology , Chickens/metabolism , Cytokines/genetics , Gene Expression Profiling , Gene Expression Regulation , Host-Pathogen Interactions/genetics , Host-Pathogen Interactions/immunology , Newcastle Disease/virology , Viral Vaccines/immunologyABSTRACT
Titanium dioxide nanoparticles co-modified with CuOx (0≤x≤2) and carbonaceous materials were prepared with a simple hydrolysis and photo-reduction method for photocatalytic hydrogen generation. SEM/TEM and XPS analysis indicated that the carbonaceous materials were mostly coated on the TiO2 surface and clearly revealed that the Cu species exhibited multivalence states, existing as CuOx (0≤x≤2). The optimal catalyst showed a 56-fold enhanced hydrogen evolution rate compared with that of the pure C/TiO2 catalyst. Further, an intensive multiple electron transfer effect originating from CuOx and the carbonaceous materials is proposed to be responsible for the elevated photoactivity. CuOx species serve as electron donors facilitating charge carrier transfer and proton reduction sites. The carbonaceous materials function as the "bridge" that transfers the electrons of TiO2 to the CuOx species, which provides a new route for electron transfer and reinforces the effect of CuOx as a co-catalyst. In this study, the CuOx and C co-modified TiO2 catalyst was prepared with multiple electron transport pathways and enhanced hydrogen production evolution, which provides a deep understanding for the design of co-catalyst-based photocatalysts.
Subject(s)
Copper/chemistry , Hydrogen/chemistry , Models, Chemical , Nanoparticles/chemistry , Photochemical Processes , Titanium/chemistry , Catalysis , Electron TransportABSTRACT
RATIONALE: Lumbar disc herniation (LDH) is a degenerative disease and affects human health. Although percutaneous endoscopic lumbar discectomy (PELD) can redeem the living quality of patient with LDH rapidly, it appears weak to limit the recurrence rate of LDH. PATIENT CONCERNS: A 52-year-old male suffered lower back pain and lower limb paralysis for 20 years. However, conservative treatment could not relieve above-mentioned symptoms after doing heavy labor. DIAGNOSES: Computed tomography (CT) revealed a disc fragment had migrated to the inferior edge of the L5 pedicle. Magnetic resonance imaging (MRI) demonstrated a type 2 Modic change (MC) at L5 and spinal canal stenosis at L4-L5. Based on these findings, the patient was diagnosed with L4-L5 disc herniation and secondary lumbar stenosis. INTERVENTIONS: The patient underwent surgery twice for PELD at L4-L5 in 1 month. Symptoms were not improved effectively until the conventional posterior discectomy with fusion was performed. OUTCOMES: No signs of recurrence have been detected in 6 months of follow-up, except for mild lower back pain meeting the temperature change. LESSONS: Rapid decompression and instant therapeutic effect do not mean extending the indications of PELD. It is unreasonable to revise the recurrent LDH or treat the primary LDH with PELD under inadequate preoperative assessment.
Subject(s)
Diskectomy, Percutaneous/methods , Intervertebral Disc Displacement/diagnostic imaging , Intervertebral Disc Displacement/surgery , Lumbar Vertebrae/surgery , Humans , Lumbar Vertebrae/diagnostic imaging , Male , Middle Aged , Recurrence , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
In the present paper, agarose acetate (AGA) nanofibrous membranes containing different weight percentages of ß-tricalcium phosphate (ß-TCP) were successfully developed through electrospinning. The fibers in the nanofibrous membranes had a rough surface due to the ß-TCP particles which were uniformly dispersed within or on the surface of AGA fibers. Rat-bone marrow-derived mesenchymal stem cells (rBMSCs) were cultured on the AGA based nanofibrous membranes while showed a good adhesion and proliferation. It was found that more rBMSCs were differentiated to osteoblast-like cells on the ß-TCP containing nanofibrous membranes compared with the single AGA membrane, and more alkaline phosphatase (ALP) and mineralized matrix could be detected when rBMSCs were cultured on the ß-TCP containing nanofibrous membranes. The nanofibrous membranes were implanted into Sprague-Dawley (SD) rats for biocompatibility test. Gross examination and histological analysis of the AGA based nanofibrous membranes results showed that there was less inflammatory response. All of experimental results suggested that the AGA based nanofibrous membranes had the great potential application in bone tissue engineering.