Rational Design of Liquid-Liquid Microdispersion Droplet Microreactors for the Controllable Synthesis of Highly Uniform and Monodispersed Dextran Microspheres.

Hydrogel microspheres are biocompatible materials widely used in biological and medical fields. Emulsification and stirring are the commonly used methods to prepare hydrogels. However, the size distribution is considerably wide, the monodispersity and the mechanical intensity are poor, and the stable operation conditions are comparatively narrow to meet some sophisticated applications. In this paper, a T-shaped stepwise microchannel combined with a simple side microchannel structure is developed to explore the liquid-liquid dispersion mechanism, interfacial evolution behavior, satellite droplet formation mechanism and separation, and the eventual successful synthesis of dextran hydrogel microspheres. The effect of the operation parameters on droplet and microsphere size is comprehensively studied. The flow pattern and the stable operation condition range are given, and mathematical prediction models are developed under three different flow regimes for droplet size prediction. Based on the stable operating conditions, a microdroplet-based method combined with UV light curing is developed to synthesize the dextran hydrogel microsphere. The highly uniform and monodispersed dextran microspheres with good mechanical intensity are synthesized in the developed microfluidic platform. The size of the microsphere could be tuned from 50 to 300 µm with a capillary number in the range of 0.006-0.742. This work not only provides a facile method for functional polymeric microsphere preparation but also offers important design guidelines for the development of a robust microreactor.

Breaking down barriers: rationalisations and motivation to stop among Chinese male smokers under cigarette dependence.

BACKGROUND: Smoking rationalisation beliefs are a huge barrier to quitting smoking. What types of rationalisations should be emphasised in smoking cessation interventions? Although past literature has confirmed the negative relationship between those beliefs and motivation to stop smoking, little is known regarding the importance and performance of those beliefs on motivation with varying cigarette dependence. The study aimed to ascertain rationalisations that are highly important for motivation yet perform poorly in different cigarette dependence groups. METHODS: The cross-sectional study was conducted from November 19 to December 9, 2023 in Guiyang City, China. Adult male current smokers were enrolled. Partial least squares structural equation modelling was used to test the hypothesis. The multi-group analysis was used to determine the moderating effect of cigarette dependence, and the importance-performance map analysis was utilised to assess the importance and performance of rationalisations. RESULTS: A total of 616 adult male current smokers were analysed, and they were divided into the low cigarette dependence group (n = 297) and the high cigarette dependence group (n = 319). Except for risk generalisation beliefs, smoking functional beliefs (H1: -ß = 0.131, P < 0.01), social acceptability beliefs (H3: ß = -0.258, P < 0.001), safe smoking beliefs (H4: ß = -0.078, P < 0.05), self-exempting beliefs (H5: ß = -0.244, P < 0.001), and quitting is harmful beliefs (H6: ß = -0.148, P < 0.01) all had a significant positive influence on motivation. Cigarette dependence moderated the correlation between rationalisations and motivation. In the high-dependence group, the social acceptability beliefs and smoking functional beliefs were located in the "Concentrate Here" area. In the low-dependence group, the social acceptability beliefs were also situated in there. CONCLUSIONS: Social acceptability beliefs and smoking functional beliefs showed great potential and value for improvement among high-dependence smokers, while only social acceptability beliefs had great potential and value for improvement among low-dependence smokers. Addressing these beliefs will be helpful for smoking cessation. The multi-group analysis and the importance-performance map analysis technique have practical implications and can be expanded to other domains of health education and intervention practice.

Phenylboronic acid functionalized dextran loading curcumin as nano-therapeutics for promoting the bacteria-infected diabetic wound healing.

Chronic bacterial infections, excessive inflammation, and oxidative stress significantly hinder diabetic wound healing by prolonging the inflammatory phase and complicating the healing process. In this study, phenylboronic acid functionalized dextran (PODP) was developed to encapsulate curcumin, referred to as PODP@Cur. Experimental results indicate that PODP significantly improves the water solubility of curcumin and exhibits synergistic biological activity both in vitro and in vivo. PODP@Cur is capable of accelerating drug release under the pathological microenvironment with ROS accumulation. Furthermore, phenylboronic acid (PBA) has demonstrated potential for targeted bacterial drug delivery, enhancing antibacterial efficacy and trapping free LPS/PGN from dead bacteria to reduce undesirable inflammation. In a diabetic mouse model, PODP@Cur exhibits an excellent antibacterial, anti-inflammatory and antioxidant activities to ultimately promote the efficient and safe wound healing. Due to the specific interaction between PBA and LPS, PODP@Cur could enhance antibacterial activity against bacteria, reduce toxic side effects on normal cells, and alleviate the LPS-mediated pro-inflammatory pathological microenvironment. Therefore, PODP@Cur is capable of being exploited as an efficient and safe candidate for promoting the bacteria-infected diabetic wound healing.

Prognostic value of the systemic immune-inflammation index in critically ill elderly patients with hip fracture: evidence from MIMIC (2008-2019).

Background: The systemic immune-inflammation index (SII) showed an extensive link between immunological dysfunction and the activation of systemic inflammation. Several studies have confirmed the application of SII to orthopedic diseases. However, the significance of SII in critically ill elderly individuals with hip fracture who require intensive care unit (ICU) admission is not yet known. This study centered on exploring the relationship between SII and clinical outcomes among critically ill elderly hip fracture individuals. Methods: The study centered around elderly patients experiencing severe illness following hip fractures and requiring admission to the ICU. These patients from the MIMIC-IV database formed the basis of this study's cohort. We stratified them into quartiles according to their SII levels. The results involved the mortality at 30 days and 1 year post-admission. Then we employ Cox proportional hazards regression analysis as well as restricted cubic splines to explore the association between the SII and clinical results in critically ill elderly patients with hip fracture. Results: The study encompassed 991 participants, among whom 63.98% identified as females. Notably, the mortality rates attributed to any cause within 30 days and 1 year after hospitalization stood at 19.68 and 33.40%, respectively. The multivariate Cox proportional hazards model disclosed a significant correlation between an elevated SII and all-cause mortality. Following adjustments for confounding variables, individuals with a high SII showed a notable correlation with 30-day mortality [adjusted hazard ratio (HR), 1.065; 95% confidence interval (CI), 1.044-1.087; p < 0.001] and 1-year mortality (adjusted HR, 1.051; 95% CI, 1.029-1.074; p < 0.001). Furthermore, the analysis of restricted cubic splines demonstrated a progressive increase in the risk of all-cause death as the SII value rose. Conclusion: Among critically ill elderly patients with hip fracture, the SII exhibits a non-linear association that positively correlates with both 30-day and 1-year all-cause mortality rates. The revelation indicates that the SII may play a vital role in identifying patients with hip fractures who face an escalated risk of mortality due to any cause.

Acoustofluidic one-step production of plasmonic Ag nanoparticles for portable paper-based ultrasensitive SERS detection of bactericides.

SERS measurements for monitoring bactericides in dairy products are highly desired for food safety problems. However, the complicated preparation process of SERS substrates greatly impedes the promotion of SERS. Here, we propose acoustofluidic one-step synthesis of Ag nanoparticles on paper substrates for SERS detection. Our method is economical, fast, simple, and eco-friendly. We adopted laser cutting to cut out appropriate paper shapes, and aldehydes were simultaneously produced at the cutting edge in the pyrolysis of cellulose by laser which were leveraged as the reducing reagent. In the synthesis, only 5 µL of Ag precursor was added to complete the reaction, and no reducing agent was used. Our recently developed acoustofluidic device was employed to intensely mix Ag+ ions and aldehydes and spread the reduced Ag nanoparticles over the substrate. The SERS substrate was fabricated in 1 step and 3 min. The standard R6G solution measurement demonstrated the excellent signal and prominent uniformity of the fabricated SERS substrates. SERS detection of the safe concentration of three bactericides, including tetracycline hydrochloride, thiabendazole, and malachite green, from food samples can be achieved using fabricated substrates. We take the least cost, time, reagents, and steps to fabricate the SERS substrate with satisfying performance. Our work has an extraodinary meaning for the green preparation and large-scale application of SERS.

Does the novel artificial cervical joint complex resolve the conflict between stability and mobility after anterior cervical surgery? a finite element study.

Background and objective: Our group has developed a novel artificial cervical joint complex (ACJC) as a motion preservation instrument for cervical corpectomy procedures. Through finite element analysis (FEA), this study aims to assess this prosthesis's mobility and stability in the context of physiological reconstruction of the cervical spine. Materials and methods: A finite element (FE)model of the subaxial cervical spine (C3-C7) was established and validated. ACJC arthroplasty, anterior cervical corpectomy and fusion (ACCF), and two-level cervical disc arthroplasty (CDA) were performed at C4-C6. Range of motion (ROM), intervertebral disc pressure (IDP), facet joint stress (FJS), and maximum von Mises stress on the prosthesis and vertebrae during loading were compared. Results: Compared to the intact model, the ROM in all three surgical groups demonstrated a decline, with the ACCF group exhibiting the most significant mobility loss, and the highest compensatory motion in adjacent segments. ACJC and artificial cervical disc prosthesis (ACDP) well-preserved cervical mobility. In the ACCF model, IDP and FJS in adjacent segments increased notably, whereas the index segments experienced the most significant FJS elevation in the CDA model. The ROM, IDP, and FJS in both index and adjacent segments of the ACJC model were intermediate between the other two. Stress distribution of ACCF instruments and ACJC prosthesis during the loading process was more dispersed, resulting in less impact on the adjacent vertebrae than in the CDA model. Conclusion: The biomechanical properties of the novel ACJC were comparable to the ACCF in constructing postoperative stability and equally preserved physiological mobility of the cervical spine as CDA without much impact on adjacent segments and facet joints. Thus, the novel ACJC effectively balanced postoperative stability with cervical motion preservation.

Macrophage Membrane-Encapsulated Dopamine-Modified Poly Cyclodextrin Multifunctional Biomimetic Nanoparticles for Atherosclerosis Therapy.

Atherosclerotic plaques exhibit high cholesterol deposition and oxidative stress resulting from high reactive oxygen species (ROS). These are the major components in plaques and the main pro-inflammatory factor. Therefore, it is crucial to develop an effective therapeutic strategy that can simultaneously address the multiple pro-inflammatory factors via removing cholesterol and inhibiting the overaccumulated ROS. In this study, we constructed macrophage membrane-encapsulated biomimetic nanoparticles (MM@DA-pCD@MTX), which not only alleviate cholesterol deposition at the plaque lesion via reverse cholesterol transport but also scavenge the overaccumulated ROS. ß-Cyclodextrin (ß-CD) and the loaded methotrexate (MTX) act synergistically to induce cholesterol efflux for inhibiting the formation of foam cells. Among them, MTX up-regulated the expression of ABCA1, CYP27A1, and SR-B1. ß-CD increased the solubility of cholesterol crystals. In addition, the ROS scavenging property of dopamine (DA) was perfectly preserved in MM@DA-pCD@MTX, which could scavenge the overaccumulated ROS to alleviate the oxidative stress at the plaque lesion. Last but not least, MM-functionalized "homing" targeting of atherosclerotic plaques not only enables the targeted drug delivery but also prolongs in vivo circulation time and drug half-life. In summary, MM@DA-pCD@MTX emerges as a potent, multifunctional therapeutic platform for AS treatment, offering a high degree of biosafety and efficacy in addressing the complex pathophysiology of atherosclerosis.

Clinical outcome and prognostic factors of T4N0M0 colon cancer after R0 resection: A retrospective study.

BACKGROUND: Paradoxically, patients with T4N0M0 (stage II, no lymph node metastasis) colon cancer have a worse prognosis than those with T2N1-2M0 (stage III). However, no previous report has addressed this issue. AIM: To screen prognostic risk factors for T4N0M0 colon cancer and construct a prognostic nomogram model for these patients. METHODS: Two hundred patients with T4N0M0 colon cancer were treated at Tianjin Medical University General Hospital between January 2017 and December 2021, of which 112 patients were assigned to the training cohort, and the remaining 88 patients were assigned to the validation cohort. Differences between the training and validation groups were analyzed. The training cohort was subjected to multivariate analysis to select prognostic risk factors for T4N0M0 colon cancer, followed by the construction of a nomogram model. RESULTS: The 3-year overall survival (OS) rates were 86.2% and 74.4% for the training and validation cohorts, respectively. Enterostomy (P = 0.000), T stage (P = 0.001), right hemicolon (P = 0.025), irregular review (P = 0.040), and carbohydrate antigen 199 (CA199) (P = 0.011) were independent risk factors of OS in patients with T4N0M0 colon cancer. A nomogram model with good concordance and accuracy was constructed. CONCLUSION: Enterostomy, T stage, right hemicolon, irregular review, and CA199 were independent risk factors for OS in patients with T4N0M0 colon cancer. The nomogram model exhibited good agreement and accuracy.

In vivo study of a novel 3D-printed motion-preservation artificial cervical corpectomy construct: short-term imaging and biocompatibility evaluations in a goat model.

BACKGROUND: Nonfusion technologies, such as motion-preservation devices, have begun a new era of treatment options in spine surgery. Motion-preservation approaches mainly include total disc replacement for anterior cervical discectomy and fusion. However, for multisegment fusion, such as anterior cervical corpectomy and fusion, the options are more limited. Therefore, we designed a novel 3D-printed motion-preservation artificial cervical corpectomy construct (ACCC) for multisegment fusion. The aim of this study was to explore the feasibility of ACCC in a goat model. METHODS: Goats were treated with anterior C3 corpectomy and ACCC implantation and randomly divided into two groups evaluated at 3 or 6 months. Radiography, 3D CT reconstruction and MRI evaluations were performed. Biocompatibility was evaluated using micro-CT and histology. RESULTS: Postoperatively, all goats were in good condition, with free neck movement. Implant positioning was optimal. The relationship between facet joints was stable. The range of motion of the C2-C4 segments during flexion-extension at 3 and 6 months postoperatively was 7.8° and 7.3°, respectively. The implants were wrapped by new bone tissue, which had grown into the porous structure. Cartilage tissue, ossification centres, new blood vessels, and bone mineralization were observed at the porous metal vertebrae-bone interface and in the metal pores. CONCLUSIONS: The ACCC provided stabilization while preserving the motion of the functional spinal unit and promoting bone regeneration and vascularization. In this study, the ACCC was used for anterior cervical corpectomy and fusion (ACCF) in a goat model. We hope that this study will propel further research of motion-preservation devices.

Insight into the effect of UVC-based advanced oxidation processes on the interaction of typical microplastics and their derived disinfection byproducts during disinfection.

The 10 µm polystyrene and polyethylene-terephthalate microplastics (MPs), prevalent in finished drink water, were employed to investigate the effect of normal dosage UVC-based advanced-oxidation-processes (UVC-AOPs) on the interaction between MPs and their derived disinfection-byproducts (DBPs) during subsequent chlorination-disinfection, in the presence of Br-, for the first time. The results indicated that UVC/H2O2 caused higher leaching of microplastic-derived dissolved-organic-matter (MP-DOM), with smaller and narrower molecular-weight-distribution than UVC and UVC/peroxymonosulfate (UVC/PMS). The trihalomethanes (as dominant DBPs) molar-formation-potentials (THMs-MFPs) for MP-DOM leached in different UVC-AOPs followed the order of UVC/H2O2>UVC/PMS>UVC. The adsorption of formed THMs, especially Br-THMs, back on MPs was observed in all MPs suspensions with or without UVC-AOPs pre-treatment. The Cl-THMs adsorption by MPs is more sensitive to UVC-AOPs than Br-THMs. The adsorption experiments showed that UVC-AOPs reduce the capacity but increase the rate of THMs adsorption by MPs, suggesting the halogen and hydrogen bonding forces governed the THMs adsorption rate while hydrophobic interaction determines their adsorption capacity. The UVC-AOPs pre-treatment sharply increased the total yield of THMs via both indirectly inducing MP-DOM leaching and directly increasing the THMs-MFPs of MPs by oxidation. 21.36-41.96% of formed THMs adsorbed back on the UVC-AOPs-pretreated MPs, which might increase the toxicity of MPs.

Acoustophoresis-driven particle focusing and separation with standard/inverse Chladni patterns.

Manipulating objects with acoustics has been developed for hundreds of years since Chladni patterns in gaseous environments were exhibited. In recent decades, acoustic manipulation in microfluidics, known as acoustofluidics, has rapidly thrived and many sophisticated technologies were born. However, the basic background motion of particles under acoustic excitation is usually neglected and the classical Chladni patterns haven't been reproduced in an aqueous environment. In this study, we investigated the basic mechanism and the motion of suspended particles and sinking particles in a plain microchamber under low-frequency excitation (3-5 kHz). The mechanisms were clearly distinguished by comparing the differences among colored fluids, suspended particles, and sinking particles. The suspended particles rotated around the antinode with a speed up to 55.1 µm s-1 at 100 Vpp by the acoustic streaming and they approached each other by the secondary acoustic radiation force. The sinking particles concentrated at the node with a speed up to 22.3 µm s-1 at 100 Vpp by bouncing on the vibrating surface and the primary acoustic radiation force. We have reproduced the classical standard/inverse Chladni patterns in an aqueous environment for the first time, and they were leveraged to separate SiO2 particles with different sizes. The big particles with an average diameter of 9.68 µm were concentrated at the node while the small particles with an average diameter of 2.72 µm were collected at the antinode within 2 min. These results not only provide insightful perspectives of basic mechanisms, but also open up new possibilities for advanced acoustic tweezers.

Droplet Microfluidic Devices: Working Principles, Fabrication Methods, and Scale-Up Applications.

Compared with the conventional emulsification method, droplets generated within microfluidic devices exhibit distinct advantages such as precise control of fluids, exceptional monodispersity, uniform morphology, flexible manipulation, and narrow size distribution. These inherent benefits, including intrinsic safety, excellent heat and mass transfer capabilities, and large surface-to-volume ratio, have led to the widespread applications of droplet-based microfluidics across diverse fields, encompassing chemical engineering, particle synthesis, biological detection, diagnostics, emulsion preparation, and pharmaceuticals. However, despite its promising potential for versatile applications, the practical utilization of this technology in commercial and industrial is extremely limited to the inherently low production rates achievable within a single microchannel. Over the past two decades, droplet-based microfluidics has evolved significantly, considerably transitioning from a proof-of-concept stage to industrialization. And now there is a growing trend towards translating academic research into commercial and industrial applications, primarily driven by the burgeoning demands of various fields. This paper comprehensively reviews recent advancements in droplet-based microfluidics, covering the fundamental working principles and the critical aspect of scale-up integration from working principles to scale-up integration. Based on the existing scale-up strategies, the paper also outlines the future research directions, identifies the potential opportunities, and addresses the typical unsolved challenges.

Transplantation of human neural stem cell prevents symptomatic motor behavior disability in a rat model of Parkinson's disease.

Parkinson's disease (PD) is a ubiquitous brain cell degeneration disease and presents a significant therapeutic challenge. By injecting 6-hydroxydopamine (6-OHDA) into the left medial forebrain bundle, rats were made to exhibit PD-like symptoms and treated by intranasal administration of a low-dose (2 × 105) or high-dose (1 × 106) human neural stem cells (hNSCs). Apomorphine-induced rotation test, stepping test, and open field test were implemented to evaluate the motor behavior and high-performance liquid chromatography was carried out to detect dopamine (DA), 3,4-dihydroxyphenylacetic acid (DOPAC), serotonin, and 5-hydroxyindole-3-acetic acid in the striatum of rats. Animals injected with 6-OHDA showed significant motor function deficits and damaged dopaminergic system compared to the control group, which can be restored by hNSCs treatment. Treatment with hNSCs significantly increased the tyrosine hydroxylase-immunoreactive cell count in the substantia nigra of PD animals. Moreover, the levels of neurotransmitters exhibited a significant decline in the striatum tissue of animals injected with 6-OHDA when compared to that of the control group. However, transplantation of hNSCs significantly elevated the concentration of DA and DOPAC in the injured side of the striatum. Our study offered experimental evidence to support prospects of hNSCs for clinical application as a cell-based therapy for PD.

Diffusion of active Brownian particles under quenched disorder.

The motion of a single active particle in one dimension with quenched disorder under the external force is investigated. Within the tailored parameter range, anomalous diffusion that displays weak ergodicity breaking is observed, i.e., non-ergodic subdiffusion and non-ergodic superdiffusion. This non-ergodic anomalous diffusion is analyzed through the time-dependent probability distributions of the particle's velocities and positions. Its origin is attributed to the relative weights of the locked state (predominant in the subdiffusion state) and running state (predominant in the superdiffusion state). These results may contribute to understanding the dynamical behavior of self-propelled particles in nature and the extraordinary response of nonlinear dynamics to the externally biased force.

The salt-tolerance of perennial ryegrass is linked with root exudate profiles and microflora recruitment.

Salinity poses a significant threat to plant growth and development. The root microbiota plays a key role in plant adaptation to saline environments. Nevertheless, it remains poorly understood whether and how perennial grass plants accumulate specific root-derived bacteria when exposed to salinity. Here, we systematically analyzed the composition and variation of rhizosphere and endophytic bacteria, as well as root exudates in perennial ryegrass differing in salt tolerance grown in unsterilized soils with and without salt. Both salt-sensitive (P1) and salt-tolerant (P2) perennial ryegrass genotypes grew better in unsterilized soils compared to sterilized soils under salt stress. The rhizosphere and endophytic bacteria of both P1 and P2 had lower alpha-diversity under salt treatment compared to control. The reduction of alpha-diversity was more pronounced for P1 than for P2. The specific root-derived bacteria, particularly the genus Pseudomonas, were enriched in rhizosphere and endophytic bacteria under salt stress. Changes in bacterial functionality induced by salt stress differed in P1 and P2. Additionally, more root exudates were altered under salt stress in P2 than in P1. The content of important root exudates, mainly including phenylpropanoids, benzenoids, organic acids, had a significantly positive correlation with the abundance of rhizosphere and endophytic bacteria under salt stress. The results indicate that the interactions between root-derived bacteria and root exudates are crucial for the salt tolerance of perennial ryegrass, which provides a potential strategy to manipulate root microbiome for improved stress tolerance of perennial grass species.

Acoustofluidics-Assisted Multifunctional Paper-Based Analytical Devices.

Microfluidic paper-based analytical devices (µPADs) feature an economic and sensitive nature, while acoustofluidics displays contactless and versatile virtue, and both of them gained tremendous interest in the past decades. Integrating µPADs with acoustofluidic techniques provides great potential to overcome the inherent shortcomings and make appealing achievements. Here, we present acoustofluidics-assisted multifunctional paper-based analytical devices that leverage bulk acoustic waves to realize multiple applications on paper substrates, including uniform colorimetric detection, microparticle/cell enrichment, fluorescence amplification, homogeneous mixing, and nanomaterial synthesis. The glucose detection in the range of 5-15 mM was conducted to perform uniform colorimetric detection. Various types (brass powder, copper powder, diamond powder, and yeast cells) and sizes (5-200 µm) of solid particles and biological cells can be enriched on paper in a few seconds or minutes; thus, fluorescence amplification by 3 times was realized with the enrichment. The high-throughput and homogeneous mixing of two fluids can be achieved, and based on the mixing, nanomaterials (ZnO nanosheets) were synthesized on paper. We analyzed the underlying mechanisms of these applications in the devices, which are attributed to Faraday waves and Chladni patterns. With their simple fabrication and prominent effectiveness, the devices open up new possibilities for paper-based microfluidic devices.

Diabetes-related Screw Loosening: The Distinction of Surgical Sites and the Relationship among Diabetes, Implant Stabilization and Clinical Outcomes.

OBJECTIVES: Diabetes mellitus (DM) is correlated with poor clinical outcomes in spinal surgery. However, the effect of it on screw stabilization has not been investigated. The aim of this study was to evaluate the screw loosening rate and postoperative outcomes in diabetic patients and to identify potential risk factors associated with loosening. METHODS: This was a retrospective study. Two hundred and forty-three patients who received cervical or lumbar internal fixation between 2015 and 2019 were enrolled. Screw loosening was assessed on radiography, and clinical outcomes were evaluated by the improvement of visual analogue scale (VAS), Oswestry disability index (ODI) or Japanese Orthopaedic Association (JOA) scores. The relationship of DM, screw loosening and clinical outcomes were analyzed with chi-square tests and regression analyses. RESULTS: One hundred and twenty-two patients (50.2%) with diabetes were included in this study. Diabetes led to the increase of the rate of screw loosening in the lumbar spine, while the loosening rate did not vary significantly in the cervical spine. The occurrence of screw loosening in the lumbar spine was more likely to be associated with clinical outcomes for motor performance including walking and sitting. However, no significant effect on JOA and VAS scores in the cervical spine of screw loosening was found. Moreover, the history of DM affected the outcomes of the patients who underwent spinal surgery. CONCLUSION: DM had an adverse effect on screw stabilization. The impaired improvement of clinical outcomes in diabetics after spinal surgery was related to screw loosening. In addition to the direct effects on operative wounds and neural function, the impact on the screws due to DM was also worth noting.

[Research progress in separation surgery combined with stereotactic radiotherapy of spinal metastases].

With the continuous improvement of cancer treatment, the survival of patients with spinal metastases has been significantly prolonged. Currently, the treatment of spinal metastases presents a trend of multi-mode. Clinical surgical methods include vertebral tumor resecting spinal canal decompression and internal fixation surgery, separation surgery, minimally invasive surgery and percutaneous ablation technology, etc. Radiotherapy techniques include traditional external radiation therapy, stereotactic radiotherapy and brachytherapy, etc. The risk of vertebral tumor resecting spinal canal decompression and internal fixation surgery, and the incidence of intraoperative and postoperative complications is high. The extension of postoperative recovery period may lead to delay of follow-up radiotherapy and other medical treatment, which has a serious impact on patients' survival and treatment confidence. However, the precision of traditional external radiation therapy is not high, and the limitation of tolerance of spinal cord makes it difficult to achieve the goal of controlling insensitive tumor. With the development of radiotherapy and surgical technology, stereotactic radiotherapy with higher accuracy and separation surgery with smaller surgical strike have become the focus of many clinical experts at present. This article reviews the progress of Hybrid treatment of separation surgery combined with stereotactic radiotherapy.

Dual gene-activated dermal scaffolds regulate angiogenesis and wound healing by mediating the coexpression of VEGF and angiopoietin-1.

The vascularization of dermal substitutes is a key challenge in efforts to heal deep skin defects. In this study, dual gene-activated dermal scaffolds (DGADSs-1) were fabricated by loading nanocomposite particles of polyethylenimine (PEI)/multiple plasmid DNAs (pDNAs) encoding vascular endothelial growth factor and angiopoietin-1 at a ratio of 1:1. In a similar manner, DGADSs-2 were loaded with a chimeric plasmid encoding both VEGF and Ang-1. In vitro studies showed that both types of DGADSs released PEI/pDNA nanoparticles in a sustained manner; they demonstrated effective transfection ability, leading to upregulated expression of VEGF and Ang-1. Furthermore, both types of DGADSs promoted fibroblast proliferation and blood vessel formation, although DGADSs-1 showed a more obvious promotion effect. A rat full-thickness skin defect model showed that split-thickness skin transplanted using a one-step method could achieve full survival at the 12th day after surgery in both DGADSs-1 and DGADSs-2 groups, and the vascularization time of dermal substitutes was significantly shortened. Compared with the other three groups of scaffolds, the DGADSs-1 group had significantly greater cell infiltration, collagen deposition, neovascularization, and vascular maturation, all of which promoted wound healing. Thus, compared with single-gene-activated dermal scaffolds, DGADSs show greater potential for enhancing angiogenesis. DGADSs with different loading modes also exhibited differences in terms of angiogenesis; the effect of loading two genes (DGADSs-1) was better than the effect of loading a chimeric gene (DGADSs-2). In summary, DGADSs, which continuously upregulate VEGF and Ang-1 expression, offer a new functional tissue-engineered dermal substitute with the ability to activate vascularization.