Gray Matter Abnormalities in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies.

BACKGROUND: Numerous studies utilizing voxel-based morphometry (VBM) have documented gray matter (GM) alterations in patients with chronic low back pain (CLBP) compared to healthy controls. However, the inconsistency in GM abnormalities observed across different studies has hindered their potential application as objective neuroimaging biomarkers or therapeutic targets. To address this issue, we conducted a comprehensive meta-analysis of VBM studies to identify robust GM differences between CLBP patients and healthy controls. METHODS: The databases including PubMed, Embase, and Web of Science were systematically searched from January 2000 to September 2022 to identify eligible neuroimaging studies. In this coordinate-based meta-analysis of VBM studies, the Seed-based d Mapping with Permutation of Subject Images method was used to quantitatively assess regional differences in GM between CLBP patients and healthy controls. RESULTS: Thirteen VBM studies, involving a total of 574 CLBP patients and 1239 healthy controls, were included in the meta-analysis. The findings revealed that CLBP patients exhibited increased GM in the left striatum and left postcentral gyrus and decreased GM in the left superior frontal gyrus, left cerebellum, right striatum, left insula, and right middle occipital gyrus compared to healthy controls. The jackknife sensitivity analysis confirmed the robustness of these neuroimaging findings. CONCLUSIONS: This study provides new insights into potential treatment strategies for CLBP and identifies neuroimaging biomarkers for pain chronification. These findings highlight the importance of considering regional GM abnormalities in the development of clinical interventions for CLBP.

[Analysis of clinical effects and risk factors of short implant followed up for 7-9 years].

PURPOSE: To evaluate the long-term clinical efficacy of short implants and analyze the influencing factors of the survival rate. METHODS: A total of 178 patients who received implant therapy in the Department of Stomatology, the Fourth Affiliated Hospital of Nanchang University from January 2010 to December 2014 were selected, including 334 short implants of Bicon (implant length ≤6 mm). The basic condition, restoration design, short implant survival rate and complications were observed and analyzed. SPSS 24.0 software package was used for data analysis. RESULTS: The average follow-up time of short implants was 96±17 months. During the observation period, 20 implants failed, 1 implant had mechanical complications and 6 implants had biological complications. Based on the analysis of implants and patients, the long-term cumulative survival rate of short implants was 94.0%(over 5 years survival rate was 96.4%) and 90.4% respectively. There was no significant difference between the survival rate of short implants and the patient's gender, age, whether to use special operation and the type of jaw teeth(P＜0.05). Smoking and periodontitis were risk factors for failure of short implants(P＜0.05).The difference of short implant survival rate between short implants restoration with combined crowns and single crowns was statistically significant(P＜0.05). The survival rate of short implant in mandible was higher than that in maxilla(P＜0.05). CONCLUSIONS: Under the standards clinical program and operation, short implant can be used to shorten the implant restoration cycle and avoid complicated bone augmentation which can achieve good long-term clinical effect. Short implant should be used to strictly control the risk factors that affect the survival of short implant.

SESN1 is a FOXO3 effector that counteracts human skeletal muscle ageing.

Sarcopenia, a skeletal muscle disorder in which loss of muscle mass and function progresses with age, is associated with increased overall frailty, risk of falling and mortality in the elders. Here, we reveal that SESN1 safeguards skeletal muscle from ageing downstream of the longevity gene FOXO3, which we recently reported is a geroprotector in primate skeletal muscle. Knockdown of SESN1 mimicked the human myotube ageing phenotypes observed in the FOXO3-deficient human myotubes, whereas genetic activation of SESN1 alleviated human myotube senescence. Of note, SESN1 was identified as a protective secretory factor against muscle atrophy. Administration of recombinant SESN1 protein attenuated senescence of human myotubes in vitro and facilitated muscle regeneration in vivo. Altogether, we unveil a key role of SESN1 downstream of FOXO3 in protecting skeletal muscle from ageing, providing diagnostic biomarkers and intervention strategies for counteracting skeletal muscle ageing and related diseases.

Single-nucleus profiling unveils a geroprotective role of the FOXO3 in primate skeletal muscle aging.

Age-dependent loss of skeletal muscle mass and function is a feature of sarcopenia, and increases the risk of many aging-related metabolic diseases. Here, we report phenotypic and single-nucleus transcriptomic analyses of non-human primate skeletal muscle aging. A higher transcriptional fluctuation was observed in myonuclei relative to other interstitial cell types, indicating a higher susceptibility of skeletal muscle fiber to aging. We found a downregulation of FOXO3 in aged primate skeletal muscle, and identified FOXO3 as a hub transcription factor maintaining skeletal muscle homeostasis. Through the establishment of a complementary experimental pipeline based on a human pluripotent stem cell-derived myotube model, we revealed that silence of FOXO3 accelerates human myotube senescence, whereas genetic activation of endogenous FOXO3 alleviates human myotube aging. Altogether, based on a combination of monkey skeletal muscle and human myotube aging research models, we unraveled the pivotal role of the FOXO3 in safeguarding primate skeletal muscle from aging, providing a comprehensive resource for the development of clinical diagnosis and targeted therapeutic interventions against human skeletal muscle aging and the onset of sarcopenia along with aging-related disorders.

Characteristics of Sciatic Scoliotic List in Lumbar Disc Herniation.

STUDY DESIGN: Retrospective radiological study. OBJECTIVES: Physical examination reveals sciatic scoliotic list (SSL) in some patients with lumbar disc herniation (LDH). We aimed to evaluate the coronal and sagittal parameters of the SSL curve, describe their characteristics, and establish a new classification system. METHODS: We retrospectively reviewed 230 patients (SSL group = 96; non-SSL group = 134) diagnosed with single-segment LDH from January 2018 to December 2020. The control group comprised 70 healthy volunteers. Radiographic parameters were compared between the groups. RESULTS: In the SSL group, the Cobb's angle was 12.5 ± 5.3° (4.2-31.2), trunk shift 26.2 ± 17.9 mm (.0-88.2 mm), and apical vertebral translation 31.7 ± 16.0 mm (1.18-8.58 mm). Further, 62.5% of patients had L4/5 disc herniation, 76.0% had disc herniation at the convex side of the lumbosacral scoliosis, and 81.3% had disc herniation at the opposite side of the trunk shift. Compared to the control group, lumbar lordosis and thoracic kyphosis decreased, pelvic tilt increased, and the sagittal vertical axis moved forward in the other patients. The sagittal imbalance in the SSL group exacerbated. Using the positional relationship between vertebrae and the central sacral vertical line (CSVL), we identified two main SSL patterns with which 95.8% of the patients were defined as Type 1. CONCLUSIONS: The SSL curve is characterized by a long thoracic or thoracolumbar curve, with a relatively straight sagittal profile and little rotation. Further, the lumbar and thoracic vertebrae shifts are on the same side as the CSVL. These features of the SSL curve differentiate it from other types of structural scoliosis.

Genome-wide identification and expression profiling of odorant receptor genes in the malaria vector Anopheles sinensis.

BACKGROUND: The olfactory system plays a crucial role in regulating insect behaviors. The detection of odorants is mainly mediated by various odorant receptors (ORs) that are expressed in the dendrites of olfactory neurons of chemosensilla. Anopheles sinensis is a major malaria vector in Eastern Asia and its genome has recently been successfully sequenced and annotated. In this study, we present genome-wide identification and expression profiling of OR genes in different chemosensory tissues of An. sinensis. METHODS: The OR genes were identified using the available genome sequences of An. sinensis. A series of bioinformatics analyses were conducted to investigate the structure, genome distribution, selective pressure and phylogenetic relationships of OR genes, the conserved domains and specific functional sites in the OR amino acid sequences. The expression levels of OR genes were analyzed from transcriptomic data from An. sinensis antennae, proboscis and maxillary palps of both sexes. RESULTS: A total of 59 putative OR genes have been identified and characterized in An. sinensis. This number is significantly less than that in An. gambiae. Whether this difference is caused by the contraction or expansion of OR genes after divergence of the two species remains unknown. The RNA-seq analysis showed that AsORs have obvious tissue- and sex-specific expression patterns. Most AsORs are highly expressed in the antennae and the expression pattern and number of AsORs expressed in antennae are similar in males and females. However, the relative levels of AsOR transcripts are much higher in female antennae than in male antennae, which indicates that the odor sensitivity is likely to be increased in female mosquitoes. Based on the expression patterns and previous studies, we have speculated on the functions of some OR genes but this needs to be validated by further behavioral, molecular and electrophysiological studies. Further studies are necessary to compare the olfactory-driven behaviors and identify receptors that respond strongly to components of human odors that may act in the process of human recognition. CONCLUSIONS: This is the first genome-wide analysis of the entire repertoire of OR genes in An. sinensis. Characterized features and profiled expression patterns of ORs suggest their involvement in the odorous reception of this species. Our findings provide a basis for further research on the functions of OR genes and additional genetic and behavioral targets for more sustainable management of An. sinensis in the future.

CRISPR/Cas9 mediates efficient site-specific mutagenesis of the odorant receptor co-receptor (Orco) in the malaria vector Anopheles sinensis.

BACKGROUND: Anopheles sinensis is the most widely distributed mosquito species and is the main transmitter of Plasmodium vivax malaria in China. Most previous research has focused on the mechanistic understanding of biological processes in An. sinensis and novel ways of interrupting malaria transmission. However, the development of functional genomics and genetics-based vector control strategies against An. sinensis remain limited because of insufficient site-specific genome editing tools. RESULTS: We report the first successful application of the CRISPR/Cas9 mediated knock-in for highly efficient, site-specific mutagenesis in An. sinensis. The EGFP marker gene driven by the 3 × P3 promoter was precisely integrated into the odorant receptor co-receptor (Orco) by direct injections of Cas9 protein, double-stranded DNA donor, and Orco-gRNA. We achieved a mutation rate of 3.77%, similar to rates in other mosquito species. Precise knock-in at the intended locus was confirmed by polymerase chain reaction (PCR) amplification and sequencing. The Orco mutation severely impaired mosquito sensitivity to some odors and their ability to locate and discriminate a human host. CONCLUSION: Orco was confirmed as a key mediator of multiple olfactory-driven behaviors in the An. sinensis life cycle, highlighting the importance of Orco as a key molecular target for malaria control. The results also demonstrated that CRISPR/Cas9 was a simple and highly efficient genome editing technique for An. sinensis and could be used to develop genetic control tools for this vector. © 2022 Society of Chemical Industry.

Hybrid surgery with PEEK rods for lumbar degenerative diseases: a 2-year follow-up study.

BACKGROUND: Finite element analyses and biomechanical tests have shown that PEEK rods promote fusion and prevent adjacent segment degeneration. The purpose of this study was to evaluate the effects and complications of hybrid surgery with PEEK rods in lumbar degenerative diseases. METHODS: From January 2015-December 2017, 28 patients who underwent lumbar posterior hybrid surgery with PEEK rods were included in the study. The patients were diagnosed with lumbar disc herniation, lumbar spinal stenosis, or degenerative grade I spondylolisthesis. Before the operation and at the last follow-up, the patients completed lumbar anteroposterior and lateral X-ray, dynamic X-ray, MRI examinations. In addition, at the last follow-up the patients also completed lumbar CT examinations. The radiographic parameters, clinical visual analog scale (VAS) score and Oswestry disability index (ODI) score were compared. RESULTS: The average age of the patients was 44.8 ± 12.6 years, and the average follow-up duration was 26.4 ± 3.6 months. The VAS score improved from 6.3 ± 1.6 to 1.0 ± 0.9, and the ODI score decreased from 38.4 ± 10.8 to 6.8 ± 4.6. The fusion rate of the fused segment was 100%. There were no significant changes in the modified Pfirrmann classifications or disc height index for the nonfused segments and the upper adjacent segments from pre- to postoperatively. No cases of screw loosening, broken screws, broken rods or other mechanical complications were found. CONCLUSION: Hybrid surgery with PEEK rods for lumbar degenerative diseases can yield good clinical results and effectively reduce the incidence of complications such as adjacent segment diseases.

Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion for Highly Migrated Lumbar Disc Herniation.

OBJECTIVE: To describe minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for highly migrated lumbar disc herniation (LDH) and assess its clinical outcomes. PATIENTS AND METHODS: This research retrospectively assessed 25 patients who were diagnosed with one-segmental highly migrated LDH and underwent MIS-TLIF in Peking University First Hospital from June 2015 to September 2019. Demographic data, perioperative parameters, complications, recurrence, and surgical outcomes were assessed. RESULTS: Twelve males and 13 females, with a mean age of 56.68 years old, were involved and the follow-up period was at least one year. The mean operation time was 222.16 minutes, the mean intraoperative hemorrhage was 250.00 mL, and the mean post-operative hospitalization was 5.76 days. The improvements in visual analog scale (VAS) and Oswestry disability index (ODI) were statistically significant. In addition, based on the MacNab criteria, 22 patients (88.0%) acquired satisfactory (good or excellent) results. One patient underwent post-operative epidural hematoma and recovered after evacuation of the hematoma. No recurrence was found. CONCLUSION: MIS-TLIF is safe and effective and it can provide satisfactory clinical outcomes for highly migrated LDH.

Comparison of Percutaneous Endoscopic Lumbar Discectomy with Minimally Invasive Transforaminal Lumbar Interbody Fusion as a Revision Surgery for Recurrent Lumbar Disc Herniation after Percutaneous Endoscopic Lumbar Discectomy.

OBJECTIVE: The purpose of this study was to compare the outcomes between percutaneous endoscopic lumbar discectomy (PELD) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) for the revision surgery for recurrent lumbar disc herniation (rLDH) after PELD surgery. PATIENTS AND METHODS: A total of 46 patients with rLDH were retrospectively assessed in this study. All the patients had received a PELD in Peking University First Hospital between January 2015 and June 2019, before they underwent a revision surgery by either PELD (n=24) or MIS-TLIF (n=22). The preoperative data, perioperative conditions, complications, recurrence condition, and clinical outcomes of the patients were compared between the two groups. RESULTS: Compared to the MIS-TLIF group, the PELD group had significantly shorter operative time, less intraoperative hemorrhage, and shorter postoperative hospitalization, but higher recurrence rate (P<0.05). Complication rates were comparable between the two groups. Both groups had satisfactory clinical outcomes at a 12-month follow-up after the revision surgery. The PELD group also showed significantly lower visual analog scale (VAS) scores of back pain and Oswestry disability index (ODI) in one month after the revision surgery, whereas the difference was not detectable at six- and 12-month follow-ups. CONCLUSION: Both PELD and MIS-TLIF are effective as a revision surgery for rLDH after primary PELD. PELD is superior to MIS-TLIF in terms of operative time amount of intraoperative hemorrhage and postoperative hospitalization. However, its higher postoperative recurrence rate must be considered and patients should be well informed, when making a decision between the two surgical approaches.

Sodium dehydroacetate induces coagulation dysfunction by inhibiting liver vitamin K epoxide reductase complex subunit 1 in Wistar rats.

Sodium dehydroacetate (Na-DHA), an antibiotic agent that combats growth of bacteria, fungi, and yeast, is used as a preservative in animal feed, food, and cosmetics. We previously reported that Na-DHA induces coagulation anomalies in Wistar rats, but the anticoagulant mechanism of Na-DHA remains to be established. Here we report that Na-DHA prolonged prothrombin time (PT) and activated partial thromboplastin time (APTT) in male and female Wistar rats. In addition, Na-DHA decreased vitamin K (VK) levels and increased the levels of protein induced by vitamin K absence/antagonist-II (PIVKA-II) in rat serum. Moreover, we found that treatment with VK not only reversed Na-DHA-decreased serum VK and -increased PIVKA-II levels, but also attenuated Na-DHA-prolonged PT and APTT, suggesting that Na-DHA-decreased serum VK level contributes to the anticoagulation due to Na-DHA. Further we found that Na-DHA inhibited vitamin K epoxide reductase complex subunit 1 (VKORC1), a key enzyme in VK recycling, in the liver tissue of Wistar rats, as evidenced by reduced mRNA and protein levels of VKORC1 following Na-DHA treatment. Taken together, our data indicate that Na-DHA inhibits liver VKORC1, resulting in a decrease of serum VK levels, leading to abnormal coagulation in rats.

Surgical treatment of sacral fractures following lumbosacral arthrodesis: Case report and literature review.

Sacral fractures following posterior lumbosacral fusion are an uncommon complication. Only a few case series and case reports have been published so far. This article presents a case of totally displaced sacral fracture following posterior L4-S1 fusion in a 65-year-old patient with a 15-year history of corticosteroid use who underwent open reduction and internal fixation using iliac screws. The patient was followed for 2 years. A thorough review of the literature was conducted using the Medline database between 1994 and 2014. Immediately after the revision surgery, the patient's pain in the buttock and left leg resolved significantly. The patient was followed for 2 years. The weakness in the left lower extremity improved gradually from 3/5 to 5/5. In conclusion, the incidence of postoperative sacral fractures could have been underestimated, because most of these fractures are not visible on a plain radiograph. Computed tomography has been proved to be able to detect most such fractures and should probably be performed routinely when patients complain of renewed buttock pain within 3 mo after lumbosacral fusion. The majority of the patients responded well to conservative treatments, and extending the fusion construct to the iliac wings using iliac screws may be needed when there is concurrent fracture displacement, sagittal imbalance, neurologic symptoms, or painful nonunion.

[Analysis of sagittal parameters about senior thoracolumbar proximal junctional kyphosis after lumbar long segment fusion].

OBJECTIVE: To explore the radiographic risk factors of senior thoracolumbar proximal junctional kyphosis (PJK) after lumbar long segment fusion. METHODS: From January 2009 to December 2011, the PJK group enrolled 9 patients who satisfied the following criteria: being older than 60 years, having lumbar fusion operation no less than 4 levels, upper instrumented vertebrae being L1 or L2, emerging PJK in 2-year follow-up, and the control group enrolled 10 matched patients without PJK. Their sagittal parameters including sagittal vertical axis, thoracic kyphosis, lumbar lordosis, upper instrumented vertebral angle, pelvic incidence, sacral slope, pelvic tilt, lumbo-pelvic lordosis on full length spine lateral film were measured, the oswestry disability index (ODI ) scores of the two groups in the last follow up recorded, and the parameters and ODI scores of two groups compared. RESULTS: The phenomena of PJK emerged average 7.9 months post-operation. The patients' lumbar lordosis reduced and compensatory pelvic appeared backward obviously after PJK emerged. Compared with the control group, lumbar lordosis, pelvic radius-T12 (PR-T12), upper instrumented vertebral angle were small in the PJK group, suggesting more severe lumbar pelvic imbalance. The ODI scores of the PJK group and contral group were 40.6 ± 15.9 and 21.5 ± 15.0 respectively, and the difference was significant. CONCLUSION: PJK after lumbar long segment fixation of elderly patients can aggravate the sagittal imbalance and reduce functional scores. The operator should pay great attention to restoring the lumbo-pelvic lordosis.

[Retrospective study of complication of interspinous implants for degenerative lumbar disease].

OBJECTIVE: To summarize and analyze the complications of interspinous implants for degenerative lumbar disease. METHODS: From September 2007 to September 2011, 177 cases with degenerative lumbar diseases were treated with interspinous implants. There were 99 male patients and 78 female patients, the average age was 44.5 years (26 - 71 years). According to the application interspinous dynamic stabilization system type were divided into the Wallis group (136 cases) and Coflex group (41 cases). The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopedic Association (JOA) score and Prolo functional score. The radiological results including segmental lodosis and segement movement degree were assessed by lumbar X ray and dynamic X ray. Summarize and analyze the complications both during operation and post operation. Quantitative datas were compared by paried-samples t test and complication rate was compared by χ(2) test. RESULTS: There were 168 cases had completed follow-up and the average time was 34.7 months (3 - 50 months). In the final follow-up, lumbar pain VAS, lower limber pain VAS, lumbar JOA score and Prolo functional score were better than pre-operation (t = 10.7, 7.9, 13.4 and 8.8, P < 0.01). Segment lodosis angles was 14° ± 4° which was less than pre-operation 19° ± 4° (t = 9.4, P < 0.01).Segment movement degree was larger in Coflex group (12.6° ± 3.1°) than in Wallis group (9.7° ± 2.7°) (t = 8.6, P < 0.05). Complication rate was 10.7% (18/168), which of Wallis group was 6.2% (8/130) and Coflex group was 26.3% (10/38) (χ(2) = 12.5, P < 0.01). In Wallis group, there were 3 cases with dura tear and cerebrospinal fluid leakage, 1 case with nerve root injury and foot drop, 2 cases with spacer breakage when implantation and change the implants and 2 cases with recurrence of lumbar disc herniation. In Coflex group, there was 1 case with dura tear and cerebrospinal fluid leakage, 2 cases with mild displacement post operation, 1 case with debridement for aseptic wound exudates, 1 case with implant removal for breakage 1 week post operation, 4 cases with recurrence of lumbar disc herniation and 1 case with lumbar disc herniation 6 months post operation of lumbar stenosis. CONCLUSIONS: The application of interspinous implants for degenerative lumbar diseases is effective and relative safe, but would suffer from the risk of complications.

[Clinical characteristics and reoperation of symptomatic adjacent segment degeneration postoperation of lumbar fusion].

OBJECTIVE: To evaluate the clinical characteristics and reoperation of symptomatic adjacent segment degeneration postoperation of lumbar fusion. METHODS: In the study, 28 cases of symptomatic adjacent segment degeneration postoperation of lumbar fusion from May 2007 to April 2012 were retrospectively reviewed,with an average age of (64.3±8.7) years. The mean period between reoperation and primary fusion surgery was (47.5±30.8) months. Symptomatic adjacent segment degeneration located in cephalic segments in 12 cases, in caudal segments in 14 cases and in both segments in 2 cases. Of all the 28 patients, 12 suffered from lumbar stenosis, other 13 from lumbar disc herniation and still other 3 from both lumbar stenosis and disc herniation, of whom 11 were together with segment instability. Localization diagnoses of 19 cases were clear and other 9 received diagnostic nerve root block. The cases were divided into two groups by the type of reoperation,of which 8 cases were in adjacent degenerative segment nonfusion group and the other 20 cases in adjacent degenerative segment fusion group. The clinical results were assessed by lumbar pain visual analog score (VAS) and lower limber pain VAS,lumbar Japanese Orthopedic Association (JOA) score and Prolo functional score before operation and in the final follow-up. RESULTS: In adjacent degenerative segment nonfusion group, the average operation time was (86.3±17.1) min and average blood volume was (125.0 ±37.8) mL of reoperation and 1 case with dural injury; and in adjacent degenerative segment fusion group, the average operation time was (201.6 ±71.0) min and average blood volume was (313.6±218.9) mL of revision surgery and 4 cases with dural injury. The average follow-up period was 25.5 months. In the final follow-up,lumbar pain VAS,lower limber pain VAS,lumbar JOA score and Prolo functional score of adjacent degenerative segment nonfusion group were 2.4±1.2, 2.8±1.4,23.5±4.2 and 8.2±1.5,which were better than preoperation 5.5±2.9, 6.8±2.5, 13.7±5.2 and 4.3±2.1, P<0.001; lumbar pain VAS, lower limber pain VAS,lumbar JOA score and Prolo functional score of adjacent degenerative segment nonfusion group were 3.3±1.9, 3.1±1.2, 22.2±4.4 and 7.7±1.6, which were better than preoperation 5.4±2.7, 7.0±2.4, 13.0±5.6 and 3.9±1.9, P<0.001.In the final follow up, lumbar pain VAS of adjacent degenerative segment nonfusion group was better than that adjacent degenerative segment fusion group(P=0.028). CONCLUSION: Symptomatic adjacent segment degeneration postoperation of lumbar fusion is difficult for diagnosis and treatment. Appropriate reoperation could get the good results.

Improvement of intertrochanteric bone quality in osteoporotic female rats after injection of polylactic acid-polyglycolic acid copolymer/collagen type I microspheres combined with bone mesenchymal stem cells.

PURPOSE: Osteoporosis mainly involves cancellous bone, and the spine and hip, with their relatively high cancellous bone to cortical bone ratio, are severely affected. Studies of bone mesenchymal stem cells (BMSCs) from osteoporotic patients and animal models have revealed that osteoporosis is often associated with reduction of BMSCs' proliferation and osteogenic differentiation. Our aim was to test whether polylactic acid-polyglycolic acid copolymer(PLGA)/collagen type I(CoI) microspheres combined with BMSCs could be used as injectable scaffolds to improve bone quality in osteoporotic female rats. METHODS: PLGA microspheres were coated with CoI. BMSCs of the third passage and were cultured with PLGA/CoI microspheres for seven days. Forty three-month-old female non-pregnant SD rats were ovariectomized to establish osteoporotic animal models. Three months after being ovariectomized, the osteoporotic rats were randomly divided into five groups: SHAM group, PBS group, cell group, microsphere (MS) group, and cell+MS group. Varying materials were injected into the intertrochanters of each group's rats. Twenty rats were sacrificed at one month and three months post-op, respectively. The femora were harvested in order to measure the intertrochanteric bone mineral density (BMD) with DEXA and trabecular thickness (Tb.Th), percentage of trabecular area (%Tb.Ar), bone volume fraction (BV/TV) and trabecular spacing (Tb.Sp) with Micro CT. One-way ANOVA and Kruskal-Wallis tests were used. RESULTS: BMSCs seeded on PLGA/CoI microspheres had a nice adhesion and proliferation. At one month post-op, the BMD (0.33 ± 0.01 g/cm(2)), Tb.Th (459.65 ± 28.31 µm), %Tb.Ar (9.61 ± 0.29 %) and Tb.Sp (2645.81 ± 94.91 µm) of the cell+ MS group were better than those of the SHAM group and the cell group. At three months post-op, the BMD (0.32 ± 0.01 g/cm(2)), Tb.Th (372.81 ± 38.45 µm), %Tb.Ar (6.65 ± 0.25 %), BV/TV (6.62 ± 0.25 %) and Tb.Sp (1559.03 ± 57.06 µm) of the cell + MS group were also better than those of the SHAM group and the cell group. CONCLUSION: The PLGA/CoI microspheres combined with BMSCs can repair bone defects more quickly. This means that PLGA/CoI microspheres combined with BMSCs can promote trabecular reconstruction and improve bone quality in osteoporotic rats. This scaffold can provide a promising minimally invasive surgical tool for enhancement of bone fracture healing or prevention of fracture occurrence which will in turn minimize complications endemic to patients with osteoporosis.

Occurrence and fate of pharmaceuticals and personal care products in drinking water in southern China.

Occurrence and fate of pharmaceuticals and personal care products (PPCPs) in drinking water was investigated in southern China. Fifteen and twelve PPCPs were detected with concentrations of 0-36 ng L(-1) in source water and of 0-20 ng L(-1) in treated water, respectively. Four PPCPs were detected with concentrations of approximately 1 ng L(-1) in drinking water of distribution network. Conventional water treatment processes removed the types and average concentrations of PPCPs by 30% and above 50%, respectively. Advanced water treatment processes were more efficient in the removal of most PPCPs, with the types and concentrations reduced by 50% and approximately 90%, respectively. Molecular properties of PPCPs had an important influence on their behaviors during water treatment. pK(a) (acidity coefficient) and K(oc) (organic carbon partition coefficient) of PPCPs appeared to have a combined effect on PPCPs removal during coagulation and oxidation. Adsorption and biodegradation were two possible mechanisms responsible for PPCPs removal during sand filtration.

[Biomechanical study of interspinous fixational effect on the stiffness of adjacent segments].

OBJECTIVE: To discuss the effect of interspinous fixation (Wallis) on the stiffness of adjacent segments by biomechanical measurements. METHODS: The surgical segments of all 23 patients were L4/5 lumbar disc herniation with or without lumbar stenosis. Thirteen patients (experimental group) underwent interspinous (Wallis) fixation, and ten patients (control group) underwent PLIF. L3/4 and L5/S1 segmental stiffness and displacement were measured by a spine stiffness gauge (SSG) device during surgery when the vertebral plate was exposed or during spinal decompression or internal fixation. RESULTS: Stiffness of adjacent segments L3/4 and L5/S1 showed no significant difference between the L4/5 segment decompression and the exposure of the vertebral plate. After interspinous (Wallis) fixation of L4/5, the stiffness of the cephalad adjacent segment L3/4 was (45.8 ± 10.7) N/mm, which was 20.5% more than that after exposure of the vertebral plate (P=0.025); After L4/5 PLIF, the stiffness of L3/4 was (35.3 ± 10.7) N/mm and was decreased by 12.4% less than that after exposure of the vertebral plate (P=0.033). The stiffness of the cephalad adjacent segment L3/4 after fixation in the Wallis group was significantly higher than that of the PLIF group (P=0.037). CONCLUSION: After interspinous (Wallis) fixation, the stiffness and the stability of the cephalad adjacent segment increased. The interspinous fixation system (Wallis) has a protective effect on cephalad adjacent segments.

[Prevention for venous thromboembolism prophylaxis after spinal surgery].

OBJECTIVE: To investigate the efficacy and safety of venous thrombus embolism (VTE) prophylaxis according to risk stratifications after spinal surgery. METHODS: From June 2008 to June 2009, we separated 298 spinal patients who had different VTE risk factors into low-, medium- and high-risk groups for 22 cases, 48 cases and 228 cases respectively. Physical prevention measures such as thigh-length thromboembolic deterrent stockings (TEDS) and pneumatic sequential compression device (PSCD) were used in low- and medium-risk groups. In high-risk groups, low molecular weight heparin(LMWH) was applied in addition to physical prevention measures. Lower limb vascular doppler ultrasonography was used to monitor thrombosis pre- and postoperatively. Simultaneously the occurrences of epidural or wound hematoma, mucosal bleeding, thrombocytopenia caused by low molecular heparin and nerve damage caused by extradural hemorrhage were monitored. RESULTS: Among the 298 cases of patients with spinal surgery, DVT occurred in 23 cases, the incidence of DVT was 7.7%. There were 0, 2 and 21 patients with positive findings of deep vein thrombosis on duplex ultrasonograph respectively in low-, medium- and high-risk groups. There was no case of PE. All DVT was thrombosis in calf which was distal to the knee. There was no clinical symptom of VTE. The DVT needed no therapy. The vein with thrombosis was recanalized 3 months after operation. No case caught epidural or wound hematoma, mucosal bleeding, thrombocytopenia caused by low molecular heparin or nerve damage caused by extradural hemorrhage. CONCLUSION: Individual VTE prophylaxis was taken according to risk stratifications. No VTE of clinical value or no complications from prophylaxis happened. So our prophylaxis is effective and safe. But more prospective, case-control studies are needed to assess the efficacy and safety of VTE prophylaxis.