Clinical Application and Curative Effect Analysis of Postural Awareness Surgical Tool Assisted Nail Placement in Adolescent Idiopathic Scoliosis.

OBJECTIVE: The pedicle screw technique has been widely used in adolescent idiopathic scoliosis orthopedic surgery, but misplacement of screws may damage important structures such as blood vessels and nerves around the pedicle, resulting in serious consequences. Therefore, our research team has independently developed a surgical tool to assist in the placement of pedicle screws. This study aims to investigate the safety and accuracy of postural awareness tool assisted nail placement in orthopedic surgery for adolescent idiopathic scoliosis. METHOD: A retrospective analysis was performed on 24 adolescent patients with idiopathic scoliosis admitted to our hospital from July 2019 to July 2022, including 10 males and 14 females, with an average age of 14.88 ± 2.36 years (10-19 years). The mean follow-up was 15.67 ± 2.20 months (12-20 months). We divided the patients into postural awareness group (n = 12) and C-arm group (n = 12) according to whether the postural awareness surgical tool was used during the operation. All patients were treated with posterior spinal orthopedic surgery. The postural awareness group was assisted by pedicle screw placement with a postural awareness surgical tool, while the C-arm group was given a pedicle screw placement with freehand technique. The operative time, intraoperative blood loss, intraoperative fluoroscopy times, nail placement related complications, nail placement accuracy, and scoliosis correction rate were recorded and compared between the two groups. RESULTS: The operative time, intraoperative blood loss and fluoroscopy times in the postural awareness group were significantly lower than those in the C-arm group, with statistical significance (p < 0.05). The postural awareness group implanted 163 screws with an accuracy rate of 91.41%, while the C-arm group implanted 159 screws with an accuracy rate of 83.02%. The accuracy rate of screw placement in the postural awareness group was higher than that in the C-arm group, with a statistically significant difference (p = 0.024). According to the imaging of the patients, there was no significant difference between the Cobb Angle of the main bend measured at three time points before surgery, 1 week after surgery and the last follow-up between the two groups. Similarly, there was no significant difference in the rate of lateral curvature correction between the two groups. CONCLUSION: The application of postural awareness surgical tool in posterior orthopedic surgery for adolescent idiopathic scoliosis can improve screw placement accuracy, shorten screw placement time, and make auxiliary screw placement safer and more accurate.

The complete mitochondrial genome of Slaty-backed Forktail, Enicurus schistaceus (Passeriformes: Muscicapidae) and phylogenetic analysis.

The complete mitogenome of the Slaty-backed Forktail (Enicurus schistaceus) was first sequenced using next-generation sequencing. It was 17,112 bp long, with a base composition of 14.17% G, 31.77% C, 30.73% A, and 23.33% T and an AT content of 54.06%. Similar to other mitochondrial genomes within the Muscicapidae family, E. schistaceus exhibited a relatively consistent mitogenome arrangement; it consisted of 22 tRNA genes, two rRNA genes, 13 protein-coding genes, and one control region. Notably, ND6 and eight tRNA genes were encoded on the light strand. Phylogenetic analysis of the 12 Muscicapidae mitogenomes substantiated the monophyly of all genera, including E. schistaceus. Furthermore, the analysis demonstrated a close relationship between Enicurus and Myophonus.

The Clinical and Imaging Outcome of the Tandem Growing Rod Technique in Early-Onset Scoliosis With the Proximal Upper Thoracic Curve Progression: A Modified Technique of Growing Rod.

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The orthopaedic ability of traditional GR for severe EOS is limited. The proximal upper thoracic curve may progress during the lengthening procedure, which may lead to coronal imbalance and inhibit the longitudinal growth of the spine. In this retrospective cohort study, we investigated the clinical outcome of tandem GR. METHODS: We modified the traditional technique by using two groups of GR devices to control the major and the proximal upper thoracic curve, connected the two groups of GR in series, and named it tandem GR. The clinical and imaging outcomes of the new technique were evaluated and compared with traditional technique. RESULTS: Twenty one patients were enrolled in the tandem GR group, and 30 patients were treated with traditional GR as the control. The baseline parameters were consistent between the two groups. In the tandem GR group, the secondary curve progressed from 24.9 ± 3.9° to 31.4 ± 3.2° (P = .006) in the procedure with the traditional GR and improved to 18.4 ± 4.5° (P = .001) after the switch. Meanwhile, the clavicular angle aggravated from 1.6 ± 1.0° to 2.6 ± .7° (P = .041), and improved to 1.7 ± .8° after changed to the tandem GR (P = .033). At the final of the follow-up, the secondary curve was higher in the control group (27.1 ± 8.3° vs 18.4 ± 4.5°, P = .034), the clavicle angle was 2.4 ± 1.1° in control and 1.7 ± .8° in the tandem GR group (P = .028), the T1-S1 height was 28.2 ± 4.8 cm in the control and 33.3 ± 3.0 cm in the tandem GR group (P = .027). The average growth rate was 1.0 ± .3 cm/year in the control and 1.2 ± .4 cm/year in the tandem GR group (P = .046). CONCLUSION: Tandem GR can effectively improve the proximal upper thoracic curve progression during the treatment of EOS. Compared with the traditional GR, tandem GR can achieve better curve correction, better shoulder balance, and retains more capacity for longitudinal spine growth.

A New Species of the Genus Gekko (Squamata: Sauria: Gekkonidae) from the Dabie Mountains, China.

This study describes a novel species of Gekko (Squamata: Gekkonidae) based on its distinct morphological features and molecular evidence, which was identified in the Dabie Mountains on the border of Anhui and Henan provinces of Central China. Gekko kaiyaisp. nov. could be distinguished from its congeners owing to its morphological characteristics, such as being a medium body sized gecko species (snout-vent length, 56.98-64.99 mm, n = 4, females; 50.03-61.56 mm, n = 11, males); nostrils scale in contact with rostral scale; tubercles on the dorsal and limb, while the upper forelimb is smooth with no tubercles; 22-33 interorbital scales between the anterior corners of the eyes; 157-209 ventral scales between mental and cloacal slit; 90-121 midbody scale rows; 30-43 ventral scale rows; 7-9 sub-digital lamellae on first fingers, 8-13 fourth fingers, 7-9 first toes, and 7-11 fourth toes; free of webbing in the fingers and toes; 9-12 pre-cloacal pores in males, which are absent in females; post-cloacal unilateral tubercles 1 (few 2); and a dorsum that is greyish white to dark brown, with 6-7 brown markings between the nape and sacrum. The phylogenetic tree based on the mitochondrial DNA sequences (16S, CYTB, and COI) indicated that Gekko kaiyaisp. nov. form an independent clade with strong support (100/1) and are a sister group to G. hokouensis. At the inter-species level, the genetic distances were all large, further confirming that an independent species had been identified. The discovery of this species implies that there are now 87 identified species in the genus Gekko, 22 of which can be found within China.

Consistency in responses to conspecific advertisement calls with various signal-to-noise ratios in both sexes of the Anhui tree frog.

Environmental noise has a significant negative impact on acoustic communication in most situations, as it influences the production, transmission, and reception of acoustic signals. However, how animals respond to conspecific sounds when there is interference from environmental noise, and whether males and females display convergent behavioral responses in the face of noise masking remain poorly understood. In this study, we investigated the effects of conspecific male advertisement calls with different signal-to-noise ratios on male-male competition and female choice in the Anhui tree frog Rhacophorus zhoukaiyae using playback and phonotaxis experiments, respectively. The results showed that (1) female Anhui tree frogs preferentially selected the conspecific calls with higher SNR compared to calls with lower SNR; (2) males preferentially responded vocally to the conspecific calls with higher SNR compared to calls with lower SNR; and (3) males' competitive strategies were flexible in the face of noise interference. These results suggest that preferences of both sexes converge in outcome, and that male competitive strategies may depend on predictable female preferences. This study will provide an important basis for further research on decision-making in animals.

The perception and interpretation of malaria among Chinese construction workers in sub-Saharan Africa: a qualitative study.

BACKGROUND: Cooperation between China and Africa is deepening, and business, trade, and people-to-people exchanges are growing closer together, especially in the infrastructure construction field. At the same time, malaria has become a serious health concern for Chinese construction workers in Africa, who are at increased risk of infection and complications due to lack of immunity and exposure to high-transmission environments. One of the biggest challenges in fighting malaria is their lack of knowledge and misinterpretations about the disease, which can impact their need for interventions, adherence to treatments, and health services. This study aims to determine the perception and interpretation of malaria among Chinese construction workers in sub-Saharan Africa. METHODS: Semi-structured interviews were conducted with 20 Chinese construction workers in sub-Saharan Africa. Some early respondents initially made contact through two Chinese construction companies in Africa, while the rest of the participants were engaged via a snowball method by the early participants. NVivo10, a qualitative research data management software and a thematic approach, was used to analyze the data and create themes. In order to achieve the general study goals, an inductive content analysis was applied. RESULTS: The study classified participants' perceptions and interpretations of malaria into four categories: flu-like malaria, the rumors of malaria, the hard-to-explain confusion about malaria, and the special interpretation of malaria. CONCLUSION: Malaria poses major health issues to Chinese construction workers in sub-Saharan Africa who lack immunity and live in an environment of high transmission. Their dearth of awareness and misunderstanding of malaria impacts their prevention and treatment behaviors and health outcomes. This study adopts qualitative methods to examine their perceptions and interpretations of malaria, which can serve as a source for future health management strategies.

Systematic Review of Published Cases of Primary Epithelioid Sarcoma of the Spine.

BACKGROUND Epithelioid sarcoma is rare, represents less than 1% of all sarcomas, usually occurs in the extremities, and rarely presents as a primary sarcoma of the spine. Publications are usually single reports or case series. We aimed to undertake a systematic review of publications of cases of primary epithelioid sarcoma of the spine to evaluate clinical presentation, diagnosis, management, and patient outcomes. MATERIAL AND METHODS We searched studies on spinal epithelioid sarcoma in the PubMed database. Only studies with secondary epithelioid sarcoma or without effective data for analysis were excluded. Cases in which epithelioid sarcoma first invaded other sites and then affected the spine were also excluded. RESULTS Twenty-three patients from 13 studies were included in the study, aged between 14 and 65 years, and the sex ratio of female to male was 1: 2.29. The survival time was 18.7±13.8 months. The survival time of males was longer than that of females (22.9±14.4 vs 9.0±4.6, P=0.027). The onset age was linearly correlated with the size of the lesion (size=-0.161*age+11.841).The lesions located in lumbar vertebra had the worst prognosis. Postoperative radiotherapy had a statistically significant effect on survival time (P=0.040). CONCLUSIONS This systematic review identified 23 published cases of primary epithelioid sarcoma of the spine. Pain was the main presenting symptom, and tumor size increased with patient age. Female sex and primary location in the lumbar spine were associated with poor survival. Although surgery was the first-line treatment, postoperative radiotherapy and chemotherapy may improve clinical outcomes.

Does the Microflora of Surgery Site Infection Change After Prophylactic Use of Vancomycin Powder in the Spine Surgery.

Study Design: Retrospective cohort study. Objective: This study aimed to investigate the characteristics of microflora in patients with deep spinal surgical site infection (SSI) after prophylactic use of vancomycin powder (VP). Methods: A retrospective analysis was performed on patients after spinal surgery. Patients were grouped according to whether VP use and only patients with deep SSI were included in this study. General information of the patients, the dose of vancomycin, bacterial culture results, drug sensitivity test results, and SSI treatment methods were recorded. The differences of microflora between the two groups were analyzed, and the sensitivity of bacteria in the +VP group to antibiotics was analyzed. Results: The infection rate in the +VP group was 4.9% (56/1124) vs 6.3% (93/1476) in the No-VP group (P < 0.05). The proportion of Gram-positive bacteria (GPB) in the +VP SSIs was 55.4% vs.74.1% in the No-VP group (P < 0.05). The percentage of Gram-negative bacteria (GNB) in the +VP SSIs was 46.4% vs.30.1% in the No-VP group (P < 0.05). More dose of VP cannot decrease the SSI, but the proportion of GNB in VP >1g SSIs was higher (59.0% vs 32.4%, P < 0.05). In the +VP SSIs, all of the GNB cultured were sensitive to meropenem, and linezolid covered most of the GPB cultured. Conclusion: Local use of vancomycin powder can reduce the incidence of SSI, but this may lead to changes in the bacterial flora. Once the SSI occurs, the case of GNB infection may be increased. The more dose of VP cannot decrease SSI but may increase the rate of GNB in the +VP SSIs. Once infections still occur after VP use, antibiotics covering GNB may be added. These findings may help guide choice of empiric antibiotics while awaiting culture data.

Which Is Better in Clinical and Radiological Outcomes for Lumbar Degenerative Disease of Two Segments: MIS-TLIF or OPEN-TLIF?

Objective: To compare the clinical and radiological outcomes of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and traditional open transforaminal lumbar interbody fusion (OPEN-TLIF) in the treatment of two-level lumbar degenerative diseases. Methods: The clinical data of 112 patients were retrospectively analyzed, and were divided into an MIS-TLIF group and OPEN-TLIF group. The operative time, intraoperative fluoroscopy, blood loss, postoperative drainage volume, bed rest time, the content of creatine kinase(CK) and complications, were recorded. VAS score and ODI index were used to evaluate clinical efficacy. Bridwell grading was used to evaluate postoperative interbody fusion. Screw position was evaluated by Rao grading. Results: Compared with the OPEN-TLIF group, the MIS-TLIF group had longer operation times, more intraoperative fluoroscopy times, but shorter postoperative bed times (p < 0.05). There were no significant differences in blood loss, postoperative drainage and postoperative CK content between the two groups (p > 0.05). There was no difference in VAS score and ODI index during the follow-up (p > 0.05). There was no significant difference in the interbody fusion rate between the two groups (p > 0.05). There was no significant difference in the distribution of type A screws, but the type B screw in the MIS-TLIF group was higher (p < 0.05). There was no difference in the incidence of complications between the two groups (p > 0.05). Conclusion: The postoperative quality of life score and radiological outcomes of the two types of surgery in two-level lumbar degenerative diseases was similar, and there was no significant difference in muscle injury and complications, but the operation time and intraoperative radiation exposurewere higher than in the OPEN-TLIF group, and the pedicle screws were more likely to deviate laterally out of the vertebral body. Therefore, OPEN-TLIF is recommended for patients with lumbar degenerative diseases of two segments.

A New Species of the Genus Microhyla (Amphibia: Anura: Microhylidae) from the Dabie Mountains, China.

Species belonging to the genus Microhyla are small-sized frogs that are widely distributed in southern, eastern, and south-eastern Asia. In China, the genus harbors many cryptic species, on two of which-M. beilunensis and M. fanjinshanensis-studies were recently published. In this study, we collected specimens from the Dabie Mountain range, which is at the junction of Anhui, Henan and Hubei Provinces, East China; these specimens belonged to a species previously identified as M. mixtura. Based on phylogenetic analyses, species delimitation analyses, morphological comparisons and advertisement calls comparisons, we found they were significantly different from other known congeners, and thus we describe them as a new species. This study enriches the diversity of Microhylidae, and clarifies the species of the genus Microhyla in the Dabie Mountains.

Correlation Analysis of the Characteristics of Spino-Pelvic Parameters and Health-Related Quality of Life After Long-Segment Fixation for Lenke-Silva Type 5 or 6 Degenerative Scoliosis.

Purpose: To retrospectively evaluate the characteristics of spino-pelvic parameters after long-segment fixation in patients with Lenke-Silva type 5 or 6 adult degenerative scoliosis and analyze the correlation between spino-pelvic parameters and health-related quality of life (HRQL). Methods: Thirty-two patients with degenerative scoliosis underwent long-segment posterior fixation were included. The spino-pelvic parameters were evaluated after surgery, and the HRQL scores were determined using the Scoliosis Research Society-22 (SRS-22), Oswestry Disability Index (ODI), and visual analog scale (VAS). Linear regression was used to analyze the correlation between changes in spino-pelvic parameters and improvements in HRQL. Results: Except for PI and TK, the other parameters showed significant differences after surgery (P < 0.05). All the scores of HRQL showed significant differences after surgery. The coefficient of correlation between ΔSVA and ΔVAS is 0.687 (P = 0.003), the coefficient of correlation between ΔSVA and ΔODI is 5.828 (P < 0.001). The coefficient of correlation between ΔLL and ΔVAS is -0.089 (P < 0.001), the coefficient of correlation between ΔLL and ΔODI is -1.553 (P = 0.003). The VAS score between the SVA ≥ 4cm and SVA < 4cm group have no significant difference, but have a significant difference in ODI. In PI-LL ≥ 20°and PI-LL < 20°group, the VAS and ODI all have a significant difference between the two groups. Conclusion: SVA and LL have an important role in maintaining the overall balance of the spine and closely related to the postoperative HRQL, better HRQL may be achieved by reducing SVA and increasing LL. Good preoperative design will help achieve the best clinical efficacy.

Mechanism of the two-dimensional WSeTe/Zr2CO2 direct Z-scheme van der Waals heterojunction as a photocatalyst for water splitting.

The direct Z-scheme van der Waals (vdW) heterojunctions based on biomimetic artificial photosynthesis are a promising strategy for enhancing photocatalytic activity. Therefore, the search for superior direct Z-scheme photocatalysts is an urgent task. Herein, we predicted the WSeTe/Zr2CO2 heterostructure as a potential direct Z-scheme photocatalyst based on density functional theory (DFT). The bands of the WSeTe/Zr2CO2 heterojunction follow a typical Type-II arrangement, where the interlayer band gap is smaller than that of the individual molecular layers, and staggered alignment of the large band-edge creates conditions that allow for a direct Z-scheme. The position of the Fermi energy levels of the two monolayers determines the formation of the built-in electric field pointing from WSeTe to Zr2CO2, promoting the desired interlayer electron-hole (e--h+) recombination and suppressing the undesired carrier recombination. Finally, in-plane biaxial strain can effectively modulate the optoelectronic properties of the catalyst, while compressive strain has a more pronounced effect on the overpotential driving force of the material. Therefore, the WSeTe/Zr2CO2 heterojunction is an effective new photocatalyst satisfying the direct Z-scheme charge transfer mechanism with its specific application.

A Novel Floating High-Voltage Level Shifter with Pre-Storage Technique.

This paper proposes a novel floating high-voltage level shifter (FHV-LS) with the pre-storage technique for high speed and low deviation in propagation delay. With this technology, the transmission paths from input to output are optimized, and thus the propagation delay of the proposed FHV-LS is reduced to as low as the sub-nanosecond scale. To further reduce the propagation delay, a pull-up network with regulated strength is introduced to reduce the fall time, which is a crucial part of the propagation delay. In addition, a pseudosymmetrical input pair is used to improve the symmetry of FHV-LS structurally to balance between the rising and falling propagation delays. Moreover, a start-up circuit is developed to initialize the output state of FHV-LS during the VDDH power up. The proposed FHV-LS is implemented using 0.3-µm HVCMOS technology. Post-layout simulation shows that the propagation delays and energy per transition of the proposed FHV-LS are 384 ps and 77.7 pJ @VH = 5 V, respectively. Finally, the 500-points Monte Carlo are performed to verify the performance and the stability.

Cemented versus uncemented hemiarthroplasty for elderly patients with displaced fracture of the femoral neck: A PRISMA-compliant meta-analysis of randomized controlled trial.

BACKGROUND: This meta-analysis was performed to incorporate newly published, high-quality randomized controlled trials (RCTs) to determine the effects of cemented versus uncemented hemiarthroplasty for elderly patients with displaced fracture of the femoral neck. METHODS: The following electronic databases were extensively searched from the inception of the database through December 2018: EMBASE, Medline, the Cochrane Library, and Web of Science. RCTs focusing on the outcomes of cemented and uncemented hemiarthroplasty were reviewed and screened for eligibility. We used the Cochrane Collaboration's Review Manager Software to perform meta-analyses. Two independent reviewers extracted the data and assessed the study quality and bias risk through the Cochrane Collaboration tool. Use fixed effect model or random effect model to pooled data. Cochran's Q statistic was used to evaluate heterogeneity, and I statistic was used to quantify heterogeneity. RESULTS: Fifteen RCTs were enrolled (n = 3790) (uncemented hemiarthroplasty group = 1015; cemented hemiarthroplasty group = 1037) (mean age ranged from 70-85.3 years; all patients > 65 years). The meta-analysis showed that cemented hemiarthroplasty has a longer operating time (weighted mean difference, 8.03; 95% confidence interval (CI) 4.83-11.23; P < .00001), less pain (odds ratio, 0.48; 95% CI 4.83-11.23; P = .02), lower mortality 1-year (odds ratio, 0.78; 95% CI 0.62-0.98; P = .03) and fewer implant-related complications (odds ratio, 0.20; 95% CI 0.13-0.30; P < .00001) than Uncemented hemiarthroplasty. However, there are still some limitations in our study, such as the uniformity of the surgery administration programme and rehabilitation scheme, and the small sample size of the included studies. CONCLUSIONS: Cemented hemiarthroplasty for elderly patients with displaced fracture of femoral neck may acquire better functional results.

Exploring the Key Genes and Pathways in the Formation of Corneal Scar Using Bioinformatics Analysis.

The Corneal wound healing results in the formation of opaque corneal scar. In fact, millions of people around the world suffer from corneal scars, leading to loss of vision. This study aimed to identify the key changes of gene expression in the formation of opaque corneal scar and provided potential biomarker candidates for clinical treatment and drug target discovery. We downloaded Gene expression dataset GSE6676 from NCBI-GEO, and analyzed the Differentially Expressed Genes (DEGs), Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment pathway analyses, and protein-protein interaction (PPI) network. A total of 1377 differentially expressed genes were identified and the result of Functional enrichment analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) identification and protein-protein interaction (PPI) networks were performed. In total, 7 hub genes IL6 (interleukin-6), MMP9 (matrix metallopeptidase 9), CXCL10 (C-X-C motif chemokine ligand 10), MAPK8 (mitogen-activated protein kinase 8), TLR4 (toll-like receptor 4), HGF (hepatocyte growth factor), EDN1 (endothelin 1) were selected. In conclusion, the DEGS, Hub genes and signal pathways identified in this study can help us understand the molecular mechanism of corneal scar formation and provide candidate targets for the diagnosis and treatment of corneal scar.

Efficacy and safety of intra-arterial chemotherapy combined with intravesical chemotherapy for high-risk non-muscle invasive bladder cancer: A protocol for a systematic review and meta-analysis.

BACKGROUND: Non-muscle invasive bladder cancer (NMIBC) is the most common bladder cancer. Many studies have reported that intra-arterial chemotherapy (IAC) combined with intravesical chemotherapy (IVC) could effectively reduce the recurrence rate of NMIBC. The purpose of this study is to assess the efficacy and safety of IAC combined with IVC for patients with high-risk NMIBC. METHODS: PubMed, Cochrane Library, Medline, Embase, Web of Science, and 4 Chinese databases will be searched for eligible studies published without language restrictions from their inception up August 31, 2019. Subgroup analysis will be mainly explored in study design, types of chemotherapy drugs, and sample size. Cochrane Collaboration Risk of bias Tool will be applied in evaluating the quality of enrolled articles. Statistical analysis will be carried out by the Stata version 14.0 software. RESULTS: The primary outcome is recurrence-free survival (RFS). The secondary outcomes include overall survival (OS), progression-free survival (PFS), adverse reactions and toxicity grade coded by common toxicity criteria for adverse events. CONCLUSION: The findings of this study will provide latest evidence to verify whether IAC combined with IVC is more effective and safer than IVC alone for patients with high-risk NMIBC. PROSPERO REGISTRATION NUMBER: CRD42019146847.