Delayed neurological dysfunction following posterior laminectomy with lateral mass screw fixation: A case report and review of literature.

BACKGROUND: While most complications of cervical surgery are reversible, some, such as symptomatic postoperative spinal epidural hematoma (SEH), which generally occurs within 24 h, are associated with increased morbidity and mortality. Delayed neurological dysfunction is diagnosed in cases when symptoms present > 3 d postoperatively. Owing to its rarity, the risk factors for delayed neurological dysfunction are unclear. Consequently, this condition can result in irreversible neurological deficits and serious consequences. In this paper, we present a case of postoperative SEH that developed three days after hematoma evacuation. CASE SUMMARY: A 68-year-old man with an American Spinal Injury Association (ASIA) grade C injury was admitted to our hospital with neck pain and tetraplegia following a fall. The C3-C7 posterior laminectomy and the lateral mass screw fixation surgery were performed on the tenth day. Postoperatively, the patient showed no changes in muscle strength or ASIA grade. The patient experienced neck pain and subcutaneous swelling on the third day postoperatively, his muscle strength decreased, and his ASIA score was grade A. Magnetic resonance imaging showed hypointense signals on T1 weighted image (T1WI) and T2WI located behind the epidural space, with spinal cord compression. Emergency surgical intervention for the hematoma was performed 12 h after onset. Although hypoproteinemia and pleural effusion did not improve in the perioperative period, the patient recovered to ASIA grade C on day 30 after surgery, and was transferred to a functional rehabilitation exercise unit. CONCLUSION: This case shows that amelioration of low blood albumin and pleural effusion is an important aspect of the perioperative management of cervical surgery. Surgery to relieve the pressure on the spinal cord should be performed as soon as possible to decrease neurological disabilities.

Daidzein ameliorated concanavalin A-induced liver injury through the Akt/GSK-3ß/Nrf2 pathway in mice.

BACKGROUND: Daidzein is a soybean isoflavone that has been shown in previous studies to have anti-inflammatory and antioxidant effects. However, it remains unknown whether daidzein plays a protective role against concanavalin A (Con A)-induced autoimmune hepatitis (AIH). METHODS: In this study, an animal model of AIH was constructed by intravenous injection of Con A (15 mg/kg). Daidzein (200 mg/kg/d) was intraperitoneally administered to mice for 3 days before the Con A injection. Alpha mouse liver 12 (AML-12) cells were incubated in the absence or presence of daidzein to determine whether daidzein can alleviate Con A-induced hepatotoxicity. RESULTS: The findings showed that pretreatment with daidzein significantly reduced Con A-induced oxidative stress and hepatocyte apoptosis in Con A-induced liver injury. Pretreatment with daidzein significantly prevented the decrease of intrahepatic protein levels of phosphorylated Akt (p-Akt), phosphorylated GSK3ß (p-GSK3ß), nuclear factor erythroid 2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), and NOQ1 (NAD(P)H quinone dehydrogenase 1) in response to Con A administration. Meanwhile, malondialdehyde (MDA) production was reduced, and glutathione peroxidase (GPX), superoxide dismutase (SOD) activity, and SOD2 mRNA expression were elevated in daidzein-pretreated livers. In in vitro experiments, daidzein pretreatment prevented Con A-induced murine hepatocyte death. This effect was partly diminished by an inhibitor of the phosphatidylinositol 3-kinase (PI3K)/Akt pathway. CONCLUSIONS: These results indicate that daidzein pretreatment attenuates Con A-induced liver injury through the Akt/GSK3ß/Nrf2 pathway. Our findings provide new insights into the use of plant-derived products for AIH treatment beyond immunosuppression.

Arthroscopic Internal Drainage with Cyst Wall Resection and Arthroscopic Internal Drainage with Cyst Wall Preservation to Treat Unicameral Popliteal Cysts: A Retrospective Case-Control Study.

OBJECTIVE: To compare the clinical efficacy and safety of arthroscopic internal drainage for the treatment of unicameral popliteal cysts with or without cyst wall resection. METHODS: This was a retrospective case-control study of 73 patients diagnosed with unicameral popliteal cysts from January 2012 to January 2019 who received arthroscopic treatment. The study included 38 cases with cyst wall resection (CWR group) and 35 cases with cyst wall preservation (CWP group). The CWR group consisted of 14 men and 24 women with an average age of 51.8 years, while the CWP group consisted of 13 men and 22 women with an average age of 52.0 years. All patients were examined for intra-articular lesions and communicating ports by magnetic resonance imaging (MRI) prior to surgery, and recurrence of cysts was evaluated at the last follow-up examination. Rauschning and Lindgren grade (R-L grade) and Lysholm score were used to evaluate clinical outcomes. In addition, operation time and complications were recorded. RESULTS: The average length of follow-up was 24.2 months (range, 16 to 32 months). There were no considerable differences in age, gender, cyst size, Lysholm score, R-L grade and concomitant intra-articular cases between the CWR group and CWP group prior to surgery (P > 0.05). The last follow-up MRI scans showed that in the CWR group, the cyst disappeared in 25 cases and shrunk in 13 cases. In the CWP group, the cyst disappeared in 22 cases, shrunk in 12 cases and persisted in one case. There was no obvious difference in recurrence rate between the two groups (0% vs 2.9%, P = 0.899). At the last follow-up, there were no differences in the R-L grade (P = 0.630) and Lysholm score (88.3 ± 5.6 points vs 90.1 ± 3.8 points, P = 0.071) between the two groups. Compared with the CWP group, operation time was significantly prolonged in the CWR group (38.3 ± 3.1 min vs 58.3 ± 4.4 min, P < 0.05). In the CWR group, three cases occurred fluid infiltration under the gastrocnemius muscle, which improved after pressure bandaging and cold compress. In another three cases, hematoma was found. The incidence of complications in the CWR group was markedly higher than that in the CWP group (15.8% vs 0%, P < 0.05). During the follow-up period, none of the patients developed serious complications such as neurovascular injury, deep venous thrombosis, or infection. CONCLUSION: For unicameral popliteal cysts, arthroscopic internal drainage combined with resection of the cyst wall did not further improve the clinical outcomes or reduce the recurrence rate, while prolonging the operation time and increasing the possibility of complications.

[Effects of Adding Straw and Biochar with Equal Carbon Content on Soil Respiration and Microbial Biomass Carbon and Nitrogen].

In order to investigate the response of soil respiration, soil microbial biomass carbon and nitrogen, and hydrothermal factors to the addition of biochar and straw, we used an LI-8100 soil carbon flux meter (LI-COR, Lincoln, USA) to study changes in soil respiration and microbial biomass under four treatments:conventional fertilization (CK), conventional fertilization +2.25t·hm-2 biochar-C (T1), conventional fertilizer +2.25t·hm-2 straw-C (T2), and conventional fertilizer +2.25t·hm-2 (biochar-C+straw-C), biochar-C:straw-C=1:1 (T3). The results showed that:① the addition of biochar and straw significantly increased the soil respiration rate and total CO2 emissions, with the largest increase in T3 and the smallest increase in T1. The effect of T1 on soil respiration was promoted in the early stage and later inhibited. ② The microbial biomass carbon and nitrogen and the number of functional bacterial colonies increased significantly with biochar and straw amendments. T1 had a significant promotion effect on nitrogen-fixing bacteria, while T2 had no significant effect on the number of fungi, and T3 showed a positive interaction effect. Soil respiration rates were significantly and positively related to soil microbial biomass carbon and nitrogen as well as to the number of bacteria and actinomycetes. ③ The 5 cm soil temperature of T3 significantly increased by 4.53%. The soil respiration rate and soil temperature showed a significant exponential correlation. To sum up, adding straw and biochar with equal carbon content can significantly increase the soil respiration rate and microbial biomass, and the interaction effect between biochar and straw is positive. Compared with that of the straw treatments, the application of biochar can reduce carbon mineralization to a certain extent, and the effect of carbon sequestration is better.

The complete chloroplast genome of Drymocallis saviczii (Rosaceae: Potentilleae).

The complete chloroplast genome of Drymocallis saviczii was reported in the present study. The chloroplast genome of D. saviczii was a circular DNA molecule with a size of 154,487 bp in length. The genome had a typical quadripartite structure composed of a pair of inverted repeats (IRa and IRb) of 25,991 bp separated by a large single-copy (LSC) region of 84,332 bp and a small single-copy (SSC) region of 18,173 bp. The genome encoded a set of 129 genes, comprising 84 protein-coding genes, 37 tRNA genes, and eight rRNA genes. Phylogenetic analysis demonstrated that D. saviczii was closer to D. glandulosa in current sampling.

The glucagon-like peptide-1 (GLP-1) analog liraglutide attenuates renal fibrosis.

Renal fibrosis is recognized as the common route of all chronic kidney disease (CKD) progressing to end-stage renal disease (ESRD). Additionally, accumulating evidence suggests that epithelial-mesenchymal transition (EMT) plays a significant role in the process of renal fibrogenesis. Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog that has been widely used to treat type 2 diabetes. Recent studies have demonstrated that the GLP-1 analogs could also exert protective effects in cardiac fibrosis models. However, the effects of liraglutide on the progression of CKD remain largely unknown. In the present study, we investigated the effects of liraglutide on the progression to renal fibrosis induced by unilateral ureteral obstruction (UUO) and EMT of rat renal tubular epithelial cells (NRK-52E) induced with recombinant transforming growth factor-beta 1 (TGF-ß1). The results indicated that UUO increased collagen deposition and the mRNA expression of fibronectin (FN) and collagen type I alpha 1 (Col1α1) in the obstructed kidney tissues. The effects were blunted in liraglutide-treated UUO mice compared with control mice. The upregulation of Snail1 and alpha smooth muscle actin (α-SMA), and downregulation of E-cadherin revealed that EMT occurred in the UUO kidneys, and these effects were ameliorated following liraglutide treatment. Additionally, liraglutide treatment decreased the expression of TGF-ß1 and its receptor (TGF-ß1R) and inhibited the activation of its downstream signaling molecules (pSmad3 and pERK1/2). The in vitro results showed that the EMT and extracellular matrix (ECM) secretion of NRK-52E cells were induced by TGF-ß1. In addition, the Smad3 and ERK1/2 signaling pathways were highly activated in cells cultured with TGF-ß1. All these effects were attenuated by liraglutide treatment. However, the protective effects of liraglutide were abolished by co-incubation of the GLP-1 receptor (GLP-1R) antagonist exendin-3 (9-39). These results suggest that liraglutide attenuates the EMT and ECM secretion of NRK-52E cells induced by TGF-ß1 and EMT and renal fibrosis induced by UUO. The potential mechanism involves liraglutide binding to and activating GLP-1R, which prevents EMT by inhibiting the activation of TGF-ß1/Smad3 and ERK1/2 signaling pathways, thereby decreasing the ECM secretion and deposition. Therefore, liraglutide is a promising therapeutic agent that may halt the progression of renal fibrosis.

Oxidation and pH responsive nanoparticles based on ferrocene-modified chitosan oligosaccharide for 5-fluorouracil delivery.

Stimuli-responsive nanoparticles based on biodegradable and biocompatible saccharides are potentially superior carriers under different physical conditions. In this study, we present a detailed investigation on the oxidation and pH responses of ferrocene-modified chitosan oligosaccharide (FcCOS) nanoparticles for 5-Fluorouracil (5-FU) Delivery. The dispersion of FcCOS nanoparticles depends strongly on pH change. NaClO, H2O2 and oxygen, as oxidant models, in a weak acid solution displayed varying accelerations as the disassembly progressed. 5-FU, as a drug model, is efficiently uploaded in FcCOS nanoparticle (approximately 238 nm). The in vitro release of 5-FU from FcCOS nanoparticles studies show that the accumulative release increased with the decrease of pH under bubbled N2. Interestingly, the sample under bubbled air has a higher accumulative release up to 59.64% at pH 3.8, compared with samples under bubbled N2 just 49.02%. The results suggested that FcCOS nanoparticles disassembled faster and the release of drug molecules was accelerated because of the synergistic effect of oxidative agent and low pH. Thus, FcCOS can be developed as an effective pH and oxidation dual-responsive carrier to enhance drug efficacy for cancer treatment.