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1.
Int Orthop ; 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32367234

RESUMO

PURPOSE: The aim of this study was to investigate the effect of lumbar spine selective nerve root block (SNRB) experience on the learning efficiency of percutaneous endoscopic lumbar discectomy (PELD) for junior trainees. METHODS: A total of 480 patients undergoing single-level PELD performed by eight junior trainees were included. The trainees were divided into two groups based on whether they had previous SNRB experience (group A, yes; group B, no). Surgical proficiency was defined as total operation time less than 65 minutes and cumulative radiation exposure time no more than 40 seconds. The learning curve was analyzed by cumulative summation (CUSUM) test. Clinical evaluations included Macnab classification, visual analog scale (VAS)-low back score, VAS-leg score, and Oswestry Disability Index (ODI). Follow-up information at 12 months was also obtained. RESULTS: Integral number of cases before achieving an acceptable surgical level in group A (47.75 ± 2.50 cases) was significantly smaller than that in group B (56.50 ± 1.29 cases, p < 0.05), along with less accumulated failure (18.75 ± 0.96 cases vs. 25.50 ± 1.75 cases, p < 0.05). The two groups were comparable in clinical outcomes. Forty-seven cases of complications were observed, with 17 in group A and 30 in group B (p < 0.05). CONCLUSION: Previous experience of SNRB improved the performance of PELD with shorter operation time and less radiation exposure. SNRB practice may reduce the complication rate without a significant effect on the recurrence of symptoms and reoperation.

2.
Spine (Phila Pa 1976) ; 45(8): 504-511, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32224806

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: To assess the long-term results of zero-profile spacer for 3-level anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA: Although widely used, there are still controversies about the long-term results of zero-profile spacer, especially in multilevel cases. METHODS: Cases received 3-level ACDF for cervical spondylotic myelopathy (CSM) using either zero-profile spacer (n = 27) (ZP Group), or plate and cages (n = 34) (PC Group), and with 5-year follow-up were reviewed. Neurological function and life quality were assessed by modified Japanese Orthopaedic Association (mJOA) score, Neck Disability Index (NDI), and Short-Form 36 (SF-36) score. Disc height, cervical lordosis, fusion rate, and surgical complications were observed. RESULTS: Neurological recovery and life quality improvement were similar in both groups. Disc height and cervical lordosis (C2-7 Cobb angle) were well restored after operations, but lost in both groups during follow-up. Loss of correction (LOC) in disc height was larger in ZP Group (11.38% vs 5.71%, P < 0.05) at 5-year follow-up. LOC of cervical lordosis in ZP group constantly grew from 11.28% to 48.13% during 5-year follow-up, significantly higher than that in the PC group (from 7.43% to 14.01%) (P < 0.05). The rate of postoperative dysphagia was no statistical difference between the two groups, and symptoms were all disappeared within 1 year. There were 10 levels of adjacent segment degeneration (1 in ZP Group, and 10 in PC Group, P = 0.02). Cage subsidence (11 of 81 levels, 13.58%) and screw migration (2 of 81 levels, 2.47%) were only observed in the ZP Group. The migrated screws in one case were surgically removed. Fusion was achieved in all cases. CONCLUSIONS: In long-term follow-up of 3-level ACDF for CSM, zero-profile spacer has the similar clinical results, but loss of correction of disc height and cervical alignment were significantly higher, compared with anterior plate and cages. LEVEL OF EVIDENCE: 3.

3.
Ecotoxicol Environ Saf ; 195: 110457, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32182529

RESUMO

The speciation of heavy metals, besides the total concentrations, urgently need to be considered when assessing the eco-toxicity and the bioavailability of heavy metals in environment. This paper aims to investigate the distribution and chemical speciation (e.g. the acid extractable fraction (F1), the reducible fraction (F2), the oxidizable fraction (F3), and the residual fraction (F4)) of heavy metals during the anaerobic digestion process of swine manure. The majority of six heavy metals from the manure was located in biogas residue in the order of decreasing concentration Zn > Cu > Ni > As > Pb > Cd. The transformation of heavy metals among four fractions was observed during the digestion process, and the change of bioavailable fraction of Zn, Cu, Ni, Cd, As and Pb were 9.71%, -6.04%, -19.24%, 13.62%, -16.48% and -7.22%, respectively. The heat map of correlation coefficients and the stepwise linear regressions model were established to describe the correlation between the bioavailability of the metals and the given digestion variables to predict the influence of the selected variables on the bioavailability of heavy metals. The variations of heavy metal bioavailable fractions are attributed to three key digestion variables, NH4+-N concentration, CH4% in biogas daily yield and pH. These results provide a new perspective for analysis and control of heavy metals during the anaerobic digestion process.

4.
FASEB J ; 34(3): 3554-3569, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31997395

RESUMO

Intervertebral disc degeneration (IDD) is the main cause of low back pain and the mechanism of which is far from fully revealed. Although inflammation directed nucleus pulposus (NP) extracellular matrix metabolism dysregulation is known to be the main cause of the degeneration process, few is known about the protective factors. Using high-throughput label-free proteomics, we found that inflammation-related autocrine factor Chitinase-3-like protein 1 (CHI3L1, or YKL-40) is highly expressed in the NP cells during degeneration. Immunohistochemical analysis show that the expression of CHI3L1 is NP tissue specific, and increase significantly during degeneration. Overexpression of CHI3L1 significantly decrease the catabolism, and increase the anabolism of extracellular matrix. Knockdown of CHI3L1 using siRNAs show the opposite results, which imply that the protective role of CHI3L1 in IDD. Using high-throughput RNA sequencing and functional analyses, we find that AKT3 expression and its phosphorylation is mainly regulated by CHI3L1. And lastly, the mechanism of which is also validated using human and mouse degenerated NP tissues. In summary, our findings show that the inflammation-related autocrine factor CHI3L1 is NP specific, and it protects IDD by promoting the AKT3 signaling, which may serve as a potential therapeutic target in intervertebral disc degeneration.

5.
World Neurosurg ; 130: e915-e925, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31301447

RESUMO

OBJECTIVE: To evaluate the clinical and radiographic outcomes of an anterior-only approach for the correction of severe cervical kyphotic deformities. METHODS: We performed a retrospective study of 33 consecutive patients with severe cervical kyphosis treated with an anterior cervical operation and preoperative and intraoperative skull traction. Cobb angle, kyphosis index (KI), kyphosis level, C2-7 sagittal vertical axis (SVA), and T1 slope were measured. The preoperative and postoperative Japanese Orthopedic Association (JOA) scores, visual analog scale (VAS) score for neck pain, Neck Disability Index (NDI) scores, and cervical alignment were compared. RESULTS: The mean angle of the kyphosis was 83.2 ± 20.4°. The mean Cobb angle of the operative region was 71.7 ± 18.5° preoperation, which was reduced to 10.6 ± 5.7° postoperation (mean correction, 85.2%). The mean KI was 75.1 ± 18.2 preoperation, which was reduced to 14.4 ± 9.1 postoperation (mean correction, 80.8%). The preoperative and postoperative mean C2-7 Cobb angle was 53.8 ± 16.5° and 14.7 ± 7.6°, respectively. The preoperative and postoperative mean C2-7 SVA was 3.9 ± 14.5 mm and 12.8 ± 7.3 mm, respectively. The preoperative and postoperative mean T1 slope was -9.4 ± 15.7° and 7.3 ± 13.1°, respectively. The average postoperative C2-7 Cobb angle, Cobb angle of the operative region, KI, C2-7 SVA, and T1 slope changed significantly compared with preoperative values (P < 0.05). The average postoperative JOA, VAS, and NDI scores improved significantly compared with preoperative scores (P < 0.05). CONCLUSIONS: Preoperative and intraoperative skull traction combined with anterior-only cervical operation may be a safe and effective technique for treating severe cervical kyphosis. If the postoperative correction is >80%, sufficient decompression could be achieved.


Assuntos
Vértebras Cervicais/cirurgia , Cuidados Intraoperatórios/métodos , Cifose/cirurgia , Cuidados Pré-Operatórios/métodos , Crânio/cirurgia , Tração/métodos , Adolescente , Adulto , Vértebras Cervicais/diagnóstico por imagem , Estudos de Coortes , Terapia Combinada/métodos , Terapia Combinada/tendências , Feminino , Humanos , Cuidados Intraoperatórios/tendências , Cifose/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/tendências , Estudos Retrospectivos , Índice de Gravidade de Doença , Crânio/diagnóstico por imagem , Tração/tendências , Resultado do Tratamento , Adulto Jovem
6.
Comput Intell Neurosci ; 2019: 4328653, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31182958

RESUMO

Recently, machine learning, especially deep learning, has been a core algorithm to be widely used in many fields such as natural language processing, speech recognition, object recognition, and so on. At the same time, another trend is that more and more applications are moved to wearable and mobile devices. However, traditional deep learning methods such as convolutional neural network (CNN) and its variants consume a lot of memory resources. In this case, these powerful deep learning methods are difficult to apply on mobile memory-limited platforms. In order to solve this problem, we present a novel memory-management strategy called mmCNN in this paper. With the help of this method, we can easily deploy a trained large-size CNN on any memory size platform such as GPU, FPGA, or memory-limited mobile devices. In our experiments, we run a feed-forward CNN process in some extremely small memory sizes (as low as 5 MB) on a GPU platform. The result shows that our method saves more than 98% memory compared to a traditional CNN algorithm and further saves more than 90% compared to the state-of-the-art related work "vDNNs" (virtualized deep neural networks). Our work in this paper improves the computing scalability of lightweight applications and breaks the memory bottleneck of using deep learning method on memory-limited devices.


Assuntos
Algoritmos , Aprendizado de Máquina , Memória , Processamento de Linguagem Natural , Aprendizado Profundo , Memória/fisiologia
7.
Chemosphere ; 232: 489-495, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31174007

RESUMO

Passive sampling by deploying organic polymers for 20-30 days in soils or sediments has been used for the assessment of bioavailability and mobility of hydrophobic organic contaminants. An important step in their interpretation is the estimation of the degree of equilibration, typically through the release of performance reference compounds (PRCs). This paper develops an improved modeling tool for predicting the behaviors of PRCs and contaminant compounds in devices in cylindrical geometry, such as polydimethylsiloxane (PDMS) fibers or dialysis samplers of cylindrical cross-section. The model is solved by both a numerically inverted Laplace domain solution and an asymptotic analytical solution. The solutions are verified with the numerically simulated results. A comparison of the developed model to existing models for the calibration of uptake/release rates and the estimation of soil or sediment transport properties is performed. The result suggests that the cylindrical model provides a more accurate prediction for the transient behavior of PRC and target compounds as well as a better estimate of transport properties in the media.


Assuntos
Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Modelos Teóricos , Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Químicos da Água/análise , Dimetilpolisiloxanos/química , Interações Hidrofóbicas e Hidrofílicas , Hidrocarbonetos Policíclicos Aromáticos/química
8.
Gene ; 704: 15-24, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30965128

RESUMO

OBJECTIVE: The objective of our study was to verify the hypothesis that the expression of connective tissue growth factor (CTGF/CCN2), a key molecule essential for the maintenance of nucleus pulposus (NP) matrix homeostasis, is regulated by osmolarity and intracellular calcium in NP cells. METHODS: Gene and protein expression levels of CCN2 were assessed using quantitative real-time PCR and western blot. Transfections and dual luciferase assays were performed to measure the effect of hyperosmolarity, tonicity enhancer binding protein (TonEBP) and Ca2+-calcineurin (Cn)-NFAT signaling on CCN2 promoter activity. RESULTS: Cultured in hyperosmotic media, there was a significant decrease in the levels of CCN2 promoter activity, gene and protein expression in NP cells. The JASPAR database was used to analyze the construction of human CCN2 promoter, we found conserved TonE and NFAT binding sites. We then investigated whether TonEBP controlled CCN2 expression. Forced expression of TonEBP in NP cells showed that TonEBP negatively regulated CCN2 promoter activity, while suppression of TonEBP induced CCN2 promoter activity and expression. We then examined if Ca2+-Cn-NFAT signaling participated in the regulation of CCN2 expression. Co-expression of CCN2 reporter with individual NFAT1-4 expression plasmids and/or calcineurin A/B constructs suggested this signaling pathway played a role in the regulation of CCN2expression in NP cells. CONCLUSIONS: Results of these studies illustrated that the expression of CCN2 in NP cells was regulated by the NFAT family through a signaling pathway network involving both activator (Ca2+-Cn-NFAT signaling) and suppressor (Hyperosmolarity-TonEBP) molecules.


Assuntos
Cálcio/farmacologia , Fator de Crescimento do Tecido Conjuntivo/genética , Núcleo Pulposo/efeitos dos fármacos , Núcleo Pulposo/metabolismo , Equilíbrio Hidroeletrolítico , Animais , Células Cultivadas , Fator de Crescimento do Tecido Conjuntivo/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Homeostase/efeitos dos fármacos , Homeostase/genética , Masculino , Fatores de Transcrição NFATC/fisiologia , Concentração Osmolar , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Equilíbrio Hidroeletrolítico/efeitos dos fármacos , Equilíbrio Hidroeletrolítico/fisiologia , Desequilíbrio Hidroeletrolítico/genética , Desequilíbrio Hidroeletrolítico/metabolismo
9.
Spine J ; 19(4): 735-743, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30352301

RESUMO

BACKGROUND CONTEXT: The presence of ossification of posterior longitudinal ligament (OPLL) can lead to symptomatic spinal cord compression and myelopathy. The surgical approach in patients with myelopathy is influenced by the presence of OPLL. Diagnose of OPLL currently requires computed tomography which incurs a large dose of radiation. Circulating disease-specific microRNAs (miRNAs) may serve as promising diagnostic markers with no radiation and easy accessibility for OPLL patients. PURPOSE: The purpose of this study is to evaluate the accuracy and significance of OPLL-specific microRNAs in discriminating OPLL from normal and intervertebral disc degenerated (IDD) patients by detecting the microRNAs' plasma level. STUDY DESIGN/PATIENT SAMPLES: The level of microRNAs in OPLL patients' plasma or serum were detected and compared to that of normal and IDD patients to evaluate the accuracy and significance of diagnosing OPLL. METHODS: Taking advantage of the high through-put microRNA sequencing data, we selectively tested the ten most differentially regulated microRNAs in patients with: (1) radiologically diagnosed OPLL (n = 68), (2) radiologically diagnosed disc herniated patients with no evidence of OPLL (n = 45), (3) non-OPLL and nonmyelopathy patients (n = 53).The feasibility of the biomarkers in identifying OPLL was assessed through analysis of sensitivity, specificity, accuracy, negative predictive value, positive predictive value, and area under the curve (AUC) values. RESULTS: Of the ten miRNAs validated, miR-10a-3p, miR-10a-5p, miR-563, miR-210-3p, and miR-218-3p showed significance between OPLL and non-OPLL blood samples. While miR-10a-5p, miR-563, and miR-210-3p showed high accuracy and significance in identifying OPLL from other groups individually, and an index that combines these miRNAs achieved the highest accuracy and AUC among these individual miRNAs. CONCLUSIONS: Analysis of miR-10a-5p, miR-563, and miR-210-3p may be of important value in diagnosing OPLL. These markers maybe useful in a clinical setting in the early detection of OPLL patients by blood testing.


Assuntos
MicroRNAs/sangue , Ossificação do Ligamento Longitudinal Posterior/diagnóstico , Idoso , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior/sangue
10.
World Neurosurg ; 122: e1449-e1456, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30465964

RESUMO

BACKGROUND: We retrospectively analyzed and report the clinical results of percutaneous endoscopic lumbar discectomy (PELD) in treating patients with calcified lumbar intervertebral disc herniation (CLDH). METHODS: The data from 40 patients with CLDH treated with PELD in our hospital from June 2013 to June 2017 were reviewed. Of the 40 patients, 27 (19 men; 8 women; average age, 45.5 ± 7.5 years) had undergone percutaneous endoscopic transforaminal discectomy and 13 (8 men, 5 women; average age, 46.9 ± 6.9 years) had undergone percutaneous endoscopic interlaminar discectomy. The Peak method was used for both groups. The preoperative demographic data of both groups were analyzed. The pre- and postoperative leg visual analog scale scores and Oswestry disability index were compared and complications were evaluated. RESULTS: All procedures were performed successfully, and follow-up data were obtained for all patients for 24 months. The leg visual analog scale and Oswestry disability index scores at the last follow-up visit had decreased in both groups and were significantly different statistically from the preoperative data. No nerve root injury, intestinal injury, intervertebral disc infection, or recurrence was detected in any patient. Dural tear and cerebrospinal fluid leakage were observed in 3 patients (2, percutaneous endoscopic transforaminal discectomy; 1, percutaneous endoscopic interlaminar discectomy), because of adhesions between the calcification and nerve root. However, their symptoms resolved, and they were discharged after 1 week of bed rest. CONCLUSIONS: With the application of Peak philosophy, PELD is safe and effective in treating patients with CLDH. The use of PELD results in good neurological recovery, pain relief, and a low incidence of complications.


Assuntos
Calcinose/cirurgia , Discotomia Percutânea/métodos , Endoscopia/métodos , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pós-Operatórios , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Cell Physiol Biochem ; 49(6): 2463-2482, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30261504

RESUMO

BACKGROUND/AIMS: Intervertebral discs consist of an extracellular matrix (ECM) with a central gelatinous nucleus pulposus (NP) enclosed in an outer layer known as the annulus fibrosus. ECM metabolic disorders result in loss of boundary between the annulus fibrosus and NP, which can lead to intervertebral disc degeneration (IDD). Proinflammatory cytokines, such as interleukin (IL)-1ß, mediate the progression of IDD. Nicotinamide phosphoribosyltransferase (Nampt) catalyzes the first step in the biosynthesis of nicotinamide adenine dinucleotide (NAD) and is known to be induced by IL-1ß. APO866 is an inhibitor of NAD biosynthesis and is involved in autophagy. LC3 (microtubule-associated protein 1 light chain 3) is a key regulator of autophagy and is used as an indicator of increased autophagy. Herein, we investigate the role of APO866 in regulating autophagy in NP cells and IL-1ß mediated NP cell degeneration and apoptosis. METHODS: NP cells were extracted from IDD tissues and cultured in DMEM/F12 medium. Nampt was induced by different concentrations of IL-1ß (0, 0.5, 1, 5, 10 ng/mL) for 24 h or NP cells were treated with 10 ng/mL IL-1ß for 0, 6, 12, 48 h. QRT-PCR and western blots were used to detect Nampt and ECM-related protein expression in NP tissue of patients with IDD and in NP cells. Confocal analysis was used to detect membrane-bound LC3, Aggrecan, and Collagen II. RESULTS: Nampt is expressed in NP tissue at higher levels in severe grades of IDD (Grade IV and V) compared with low grades (Grade II and III). In NP cells, 10 ng/mL IL-1ß induced Nampt expression for 48 h, increased expression of the degradative-associated proteins, ADAMTS4/5 and MMP-3/13, and decreased expression of ECM-related proteins, Aggrecan and Collagen II. However, the Nampt inhibitor APO866 blocked IL-1ß induction, and the knockdown of Nampt expression increased the expression of ECM proteins that were inhibited by IL-1ß. Moreover, evidence provided by the autophagic markers LC3 and Beclin-1 indicated that APO866 induced NP cell autophagy. Furthermore, although APO866 inhibited the downregulated expression of ECM-related proteins by IL-1ß, this function was blocked by autophagy inhibitor, 3-methyladenine. CONCLUSION: APO866 protects NP cells and induces autophagy by inhibiting IL-1ß-induced NP cell degeneration and apoptosis, which may have therapeutic potential in IDD.


Assuntos
Acrilamidas/farmacologia , Autofagia/efeitos dos fármacos , Interleucina-1beta/farmacologia , Degeneração do Disco Intervertebral/patologia , Nicotinamida Fosforribosiltransferase/metabolismo , Piperidinas/farmacologia , Proteína ADAMTS4/metabolismo , Agrecanas/metabolismo , Células Cultivadas , Colágeno Tipo II/metabolismo , Citocinas/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Feminino , Humanos , Degeneração do Disco Intervertebral/metabolismo , Masculino , Metaloproteinase 3 da Matriz/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Pessoa de Meia-Idade , Nicotinamida Fosforribosiltransferase/antagonistas & inibidores , Nicotinamida Fosforribosiltransferase/genética , Núcleo Pulposo/citologia , Núcleo Pulposo/efeitos dos fármacos , Núcleo Pulposo/metabolismo , Interferência de RNA , RNA Interferente Pequeno/metabolismo
12.
Sci Rep ; 8(1): 9225, 2018 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-29907859

RESUMO

Ossification of the posterior longitudinal ligament (OPLL) presents as pathological heterotopic ossification of the spinal ligaments. However, its underlying molecular mechanism is still unclear. Our previous findings suggested that altered microRNA regulatory network are critical for the development of OPLL. Here, we set out to unveiling the detailed mechanism of those altered OPLL-specific microRNAs. We screened a set of differentially expressed OPLL-specific microRNAs from the previous sequencing data and showed that microRNA-10a actively modulates the ossification of posterior ligament cells in vitro. Using a tissue-engineered scaffold grown from 4-week-old BALB/c homozygous nude mice, we found that altered microRNA-10a expression in posterior ligament cells indeed affected the heterotopic bone formation in vivo. Furthermore, computational analysis showed that the negative ossification regulator ID3 is a functional target gene of microRNA-10a, and its expression was also significantly altered during microRNA-10a modulation both in vitro and in vivo. Also, we have demonstrated that the ossification promoting function of microRNA-10a requires ID3, as ID3 actively inhibits RUNX2. Thus, we identified a critical role for highly altered OPLL-specific microRNA-10a in regulating the development of OPLL by modulating the ID3/RUNX2 axis.


Assuntos
Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Proteínas Inibidoras de Diferenciação/metabolismo , Ligamentos Longitudinais/metabolismo , MicroRNAs/metabolismo , Proteínas de Neoplasias/metabolismo , Ossificação do Ligamento Longitudinal Posterior/metabolismo , Ossificação Heterotópica/metabolismo , Animais , Células Cultivadas , Feminino , Humanos , Ligamentos Longitudinais/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Ossificação do Ligamento Longitudinal Posterior/patologia , Ossificação Heterotópica/patologia
13.
J Mater Chem B ; 6(43): 6936-6949, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-32254578

RESUMO

Magnesium (Mg) alloys are promising biodegradable materials but challenges remain due to their rapid degradation, especially in the potential use of Mg alloys as vascular stents. Surface modification techniques are the most straightforward way to address both the desired biocompatibility and inhibit the corrosion of Mg alloys. In this work, inspired by the functional moieties (catechols) of mussel adhesive proteins, a mimetic approach to construct organic protective conversion coatings on magnesium-zinc-manganese (MgZnMn) alloys is investigated. Based on the cross-linking of CA (catechol) and PEI (polyethyleneimine), a CA/PEI conversion coating is developed on a MgZnMn alloy. The CA/PEI conversion coating showed enhanced corrosion resistance due to the strong binding and aggregation of units. Moreover, such coatings could also provide enough primary amine groups, catechols and quinones, which can be used to immobilize further molecules. Heparin was further grafted onto the CA/PEI, endowing the conversion coating with the desired functionality. Vascular cell behavior on such a coating is also studied. The improved hemocompatibility, favorable anti-inflammatory ability, suppressed smooth muscle cell proliferation and enhanced endothelialization indicate the potential of such organic conversion coatings on MgZnMn alloys as vascular implants.

14.
Clin Spine Surg ; 30(5): E560-E566, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28525478

RESUMO

OBJECTIVE: The aim of this study was to analyze the radiologic features of adolescent idiopathic cervical kyphosis. SUMMARY OF BACKGROUND DATA: There are few previous reports about radiographic analysis of cervical sagittal alignment of adolescent idiopathic cervical kyphosis. A new method was proposed in this article to evaluate the severity of cervical kyphosis. PATIENTS AND METHODS: A total of 41 adolescent patients with cervical kyphosis were reviewed. Several angles were measured from the radiographs utilizing the 2-line Cobb method and Harrison posterior tangent method. Ishihara's Curvature Index (CI), Kyphosis Index (KI), kyphosis levels, and the apex of the kyphosis were also measured. RESULTS: The results showed that the apex of the kyphosis is located at the posterior-superior edge of C4 (70.7%) and C5 (29.3%). C2-C7 angles ranged from 4.7 to 71.3 degrees (36.2±13.6 degrees) and from 9.8 to 83.1 degrees (36.4±15.1 degrees) in the above 2 methods, respectively. Local angles of kyphotic area ranged from 21.8 to 96.3 degrees (50.5±23.7 degrees) in 2-line Cobb method and from 19.8 to 105.6 degrees (52.0±19.5 degrees) in Harrison posterior tangent method. CI and KI ranged from 8.6 to 79.8 (36.8±16.7) and 15.2 to 141.9 (50.6±23.7), respectively. Statistical analysis showed that there was significant positive correlation between KI and kyphosis angle. CONCLUSIONS: In adolescent idiopathic cervical kyphosis, the alteration of the sagittal profile only occurs on partial cervical alignment rather than the whole cervical spine. The apex of the kyphosis locates at posterior-superior edge of the vertebrae. It seems that KI can accurately depict the severity of cervical kyphosis.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Doença de Scheuermann/diagnóstico por imagem , Adolescente , Vértebras Cervicais/patologia , Criança , Feminino , Humanos , Masculino , Adulto Jovem
15.
Turk Neurosurg ; 26(2): 260-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26956823

RESUMO

AIM: We conducted a novel classification system of degenerative lumbar spinal stenosis (DLSS) based on clinical manifestations and imaging (computed tomography and magnetic resonance imaging) features. We chose different minimally invasive surgical procedures according to our system. Clinical parameters and radiological findings will be assessed in the article. MATERIAL AND METHODS: A retrospective study was conducted on 96 patients undergoing minimally invasive surgery for DLSS. We chose different surgical procedures according to our novel classification system based on clinical manifestations, imaging features, and concurrence with other spinal diseases. Clinical parameters and radiological findings were assessed pre- and postoperatively. RESULTS: The mean follow up period was 24 months (range, 15~36 months). There was a statistically significant improvement in the Visual Analogue Scale (VAS) score of low back pain and leg pain after surgery (p < 0.05). According to the Japanese Orthopaedic Association (JOA) scores, the operation efficacy was excellent in 57 cases, good in 36 cases, and fair in 3 cases. According to Bridwell's criterion, the fusion rate was 96% (48/50) in patients who underwent fusion surgery. There were no cages or pedicle screws related complications. CONCLUSION: Minimally invasive surgical treatment of DLSS has satisfactory outcomes according to the novel classification, but further long-term, prospective, randomized controlled studies involving a larger study group are needed to validate the long-term efficacy.


Assuntos
Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Fusão Vertebral/métodos , Estenose Espinal/classificação , Estenose Espinal/cirurgia , Adulto , Idoso de 80 Anos ou mais , Feminino , Humanos , Dor Lombar/cirurgia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Parafusos Pediculares , Estudos Retrospectivos , Resultado do Tratamento
16.
Sci Rep ; 6: 21580, 2016 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-26868491

RESUMO

Ossification of the posterior longitudinal ligament (OPLL) is a genetic disorder which involves pathological heterotopic ossification of the spinal ligaments. Although studies have identified several genes that correlated with OPLL, the underlying regulation network is far from clear. Through small RNA sequencing, we compared the microRNA expressions of primary posterior longitudinal ligament cells form OPLL patients with normal patients (PLL) and identified 218 dysregulated miRNAs (FDR < 0.01). Furthermore, assessing the miRNA profiling data of multiple cell types, we found these dysregulated miRNAs were mostly OPLL specific. In order to decipher the regulation network of these OPLL specific miRNAs, we integrated mRNA expression profiling data with miRNA sequencing data. Through computational approaches, we showed the pivotal roles of these OPLL specific miRNAs in heterotopic ossification of longitudinal ligament by discovering highly correlated miRNA/mRNA pairs that associated with skeletal system development, collagen fibril organization, and extracellular matrix organization. The results of which provide strong evidence that the miRNA regulatory networks we established may indeed play vital roles in OPLL onset and progression. To date, this is the first systematic analysis of the micronome in OPLL, and thus may provide valuable resources in finding novel treatment and diagnostic targets of OPLL.


Assuntos
Regulação da Expressão Gênica , Ligamentos Longitudinais/metabolismo , MicroRNAs/biossíntese , Ossificação do Ligamento Longitudinal Posterior/metabolismo , Células Cultivadas , Feminino , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Ligamentos Longitudinais/patologia , Masculino , Ossificação do Ligamento Longitudinal Posterior/diagnóstico , Ossificação do Ligamento Longitudinal Posterior/patologia
17.
Clin Spine Surg ; 29(1): E1-8, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24189485

RESUMO

STUDY DESIGN: A prospective randomized study was conducted. OBJECTIVE: The purpose of this study was to assess the radiographic outcomes of one-level minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with unilateral pedicle screw instrumentation for degenerative lumbar spine disease. SUMMARY OF BACKGROUND DATA: MI-TLIF has become an increasingly popular method of lumbar arthrodesis. Recent technological advances in spinal instrumentation have culminated in the development of MI-TLIF with unilateral pedicle screw fixation. However, there are few published studies on radiographic outcomes of the MI-TLIF with unilateral pedicle screw fixation. METHODS: A total of 65 patients with one-level degenerative lumbar spine disease were enrolled in this study. Patients were randomized into the unilateral or bilateral fixation group based on a computer-generated number list. Thirty-one patients (17 men and 14 women; average age, 57.3 y) were randomized to the unilateral group (group A) and 34 patients (16 men and 18 women; average age, 58.9 y) to the bilateral group (group B). All patients underwent minimally invasive decompression, interbody fusion, and pedicle screw fixation with the assistance of microscopic tubular retractor system (METRx-MD) and Sextant system. All patients were asked to follow-up at 3, 6, and thereafter once every 6 months after surgery. The visual analog scale (VAS), Oswestry disability index (ODI), and modified Prolo (mProlo) scores were obtained for all patients 24 hours before the operation and at each follow-up visit. The whole lumbar lordosis (WL), the segmental lordosis (SL), fusion level disk space angle, lumbar scoliosis angle, and segmental scoliosis angle were determined before and after surgery on standard x-rays. The disk height index (DI) and the lumber curvature index (LI) were also evaluated. RESULTS: The mean follow-up was 26.6 months, with a range of 18-36 months. All patients showed evidence of fusion at 12 months postoperatively. Statistically, there was no significant difference between the 2 groups in terms of demographic data. The average postoperative VAS, ODI, and mProlo scores improved significantly in each group. No significant differences were found between the 2 groups in relation to VAS, ODI, and mProlo scores at each follow-up time point. There were no significant differences between the 2 groups in relation to WL, SL, disk space angle, lumbar scoliosis angle, segmental scoliosis angle, DI, and LI. There was also no difference between postoperative different follow-up visits in terms of these radiographic parameters in both groups. There was a positive linear correlation between the LI and WL in both groups. CONCLUSIONS: One-level unilateral pedicle screw instrumented MI-TLIF provided similar radiologic and clinical outcomes to bilateral pedicle screw instrumented MI-TLIF. This study showed that MIS-TLIF with unilateral pedicle screw fixation would be sufficient in the management of preoperatively stable patients with lumbar degenerative disease.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Parafusos Pediculares , Feminino , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Radiografia , Recuperação de Função Fisiológica , Índice de Gravidade de Doença , Fusão Vertebral , Resultado do Tratamento
18.
J Clin Neurosci ; 21(9): 1612-6, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24814852

RESUMO

Minimally invasive transforaminal lumbar interbody fusion (MIS TLIF) has become an increasingly popular method of lumbar arthrodesis. However, there are few published studies comparing the clinical outcomes between unilateral and bilateral instrumented MIS TLIF. Sixty-five patients with degenerative lumbar spine disease were enrolled in this study. Thirty-one patients were randomized to the unilateral group and 34 to the bilateral group. Recorded demographic data included sex, age, preoperative diagnosis, and degenerated segment. Operative time, blood loss, hospital stay length, complication rates, and fusion rates were also evaluated. The Oswestry Disability Index (ODI) score and Visual Analog Scale (VAS) pain score data were obtained. All patients were asked to follow-up at 3 and 6 months after surgery, and once every 6 months thereafter. The mean follow-up was 26.6 months (range 18-36 months). The two groups were similar in sex, age, preoperative diagnosis, and operated level. The unilateral group had significantly shorter operative time, lower blood loss, and shorter hospital time than the bilateral group. The average postoperative ODI and VAS scores improved significantly in each group. No significant differences were found between the two groups in relation to ODI and VAS. All patients showed evidence of fusion at 12 months postoperatively. The total fusion rate, screw failure, and general complication rate were not significantly different. Results showed that single-level MIS TLIF with unilateral pedicle screw fixation would be sufficient in the management of preoperatively stable patients with lumbar degenerative disease. It seems that MIS TLIF with unilateral pedicle screw instrumentation is a better choice for single-level degenerative lumbar spine disease.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Parafusos Pediculares , Fusão Vertebral/métodos , Feminino , Seguimentos , Humanos , Degeneração do Disco Intervertebral/patologia , Vértebras Lombares/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/instrumentação , Medição da Dor , Parafusos Pediculares/efeitos adversos , Índice de Gravidade de Doença , Fusão Vertebral/efeitos adversos , Fusão Vertebral/instrumentação , Tomografia Computadorizada por Raios X , Resultado do Tratamento
19.
Int Orthop ; 38(4): 817-24, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24240484

RESUMO

PURPOSE: The purpose of this study was to compare the clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease. METHODS: We conducted a prospective cohort study of 82 patients, who underwent two-level minimally invasive or open transforaminal lumbar interbody fusion (TLIF) from March 2010 to December 2011. Forty-four patients underwent minimally invasive transforaminal lumbar interbody fusion (MITLIF) (group A) and 38 patients underwent the traditional open TLIF (group B). Demographic data and clinical characteristics were comparable between the two groups before surgery (p > 0.05). Peri-operative data, clinical and radiological outcomes between the two groups were compared. RESULTS: The mean follow-up period was 20.6 ± 4.5 months for group A and 20.0 ± 3.3 months for group B (p > 0.05). No significant difference existed in operating time between the two group (p > 0.05). X-ray exposure time was significantly longer for MITLIF compared to open cases. Intra-operative blood loss and duration of postoperatively hospital stay of group A were significantly superior to those of group B (p < 0.05). On postoperative day three, MITLIF patients had significantly less pain compared to patients with the open procedure. No statistical difference existed in pre-operative and latest VAS value of back pain (VAS-BP) and leg pain (VAS-LP), pre-operative and latest ODI between the two groups. The fusion rate of the two groups was similar (p < 0.05). Complications included small dural tear, superficial wound infection and overlong screws. When comparing the total complications, no significant difference existed between the groups (p > 0.05). CONCLUSIONS: MITLIF offers several potential advantages including postoperative back pain and leg pain, intra-operative blood loss, transfusion and duration of hospital stay postoperatively in treating two-level lumbar degenerative disease. However, it required much more radiation exposure.


Assuntos
Degeneração do Disco Intervertebral , Vértebras Lombares , Fusão Vertebral/métodos , Idoso , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Medição da Dor , Dor Pós-Operatória/prevenção & controle , Tomografia Computadorizada por Raios X
20.
Spine J ; 13(8): e17-20, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23541450

RESUMO

BACKGROUND: Tuberculosis (TB) of the cervical spine occurs rarely in younger children whereas the presentation and outcome are different from those of adult cervical spine. Because cervical spinal TB in younger children is rarely reported, the clinical characteristics, the treatments, and the expected outcome of treatments in younger children are still unknown. METHODS: We present a case of cervical spine TB in a 24-month-old boy that grounds severe vertebral destruction and an extradural abscess. This child presented with neurological deficit in the form of quadraparesis. We performed anterior cervical debridement for this patient; to our best knowledge, the child in this case is the youngest patient reported in the literature as having had cervical TB treated through anterior cervical surgery. RESULTS: The neurological deficits of this patient were recovered soon, and no evidence of recurrence of the tuberculous lesion or of the deformity was revealed by the 6-year follow-up magnetic resonance imaging. CONCLUSIONS: Based on our experiences in this case and a review of the literature, we propose that for patients of cervical spine TB in early childhood, anterior excision of diseased bone without grafting should be adequate as a surgical measure.


Assuntos
Vértebras Cervicais/cirurgia , Quadriplegia/cirurgia , Tuberculose da Coluna Vertebral/cirurgia , Antituberculosos/uso terapêutico , Vértebras Cervicais/patologia , Pré-Escolar , Desbridamento , Humanos , Imagem por Ressonância Magnética , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Quadriplegia/tratamento farmacológico , Quadriplegia/etiologia , Quadriplegia/patologia , Resultado do Tratamento , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/tratamento farmacológico , Tuberculose da Coluna Vertebral/patologia
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