Prevalence of C5 nerve root palsy after cervical decompressive surgery: a meta-analysis.

PURPOSE: To investigate the epidemiological prevalence of C5 palsy in patients following cervical decompressive surgery. METHODS: We searched the PUBMED database for relevant studies that mentioned the incidence of C5 palsy after cervical surgery. We also manually screened reference lists for additional qualified articles. Relevant prevalence estimates were calculated by an appropriate meta-analysis. Subgroup analysis, sensitivity analysis, and publication bias assessment were also performed, respectively. RESULTS: Finally, a total of 79 studies, with 704 C5 palsy cases in 13,621 patients, were included in our meta-analysis. The overall pooled prevalence of C5 palsy was 5.3% (95% CI 4.6-6.0%). Individuals after posterior cervical surgery (5.8%) had a slightly higher prevalence than those after anterior surgery (5.2%), and a similar trend was observed between ossification of posterior longitudinal ligament (OPLL) (5.8%) and cervical spondylotic myelopathy (CSM) (4.5%). The highest prevalence (11.0%) was found in patients who underwent laminectomy and fusion (LIF), while those who received anterior cervical discectomy and fusion (ACDF) had the lowest prevalence (3.3%). Other intermediate prevalence estimates increased gradually, from cervical laminoplasty-only (CLP-only) (5.1%), to CLP plus other posterior procedures (6.5%) and anterior cervical corpectomy and fusion (ACCF) (7.5%). The prevalence was significantly higher in male (5.2%) than in female (2.2%) patients. In most cases, C5 palsy was unilateral and transient, and diagnosed within 3 days (3.4%). CONCLUSION: Cervical surgery is associated with high risk of C5 palsy, particularly in patients who received LIF and in male patients. These figures may be useful in the estimation of the probability of C5 palsy following cervical surgery.

Effects of anti-osteoporosis treatment in elderly patients with osteoporosis and lumbar discectomy and fusion.

BACKGROUND: The effect of anti-osteoporosis treatment in elderly patients with osteoporosis and lumbar discectomy and fusion (LIF) for lumbar degenerative diseases is not well known. OBJECTIVE: This study aimed to evaluate the effect of perioperative anti-osteoporosis treatment in the patients with osteoporosis and LIF. METHODS: From January to December 2022, patients were divided into three groups according to the inclusive criteria: the normal group (Group A), the osteopenia group (Group B) and the osteoporosis group (Group C). Quantitative computed tomography (QCT), height of the intervertebral space (HIS), segmental sagittal angle (SSA), visual analogue scale (VAS) score and Oswestry Disability Index (ODI) were compared between the groups at the follow-up time. The serum Ca2 + , osteocalcin (OC), propeptide of type I procollagen (PINP) C-terminal cross-linking telopeptide of type I collagen (ß-CTX) and 25-OH vitamin D (25-OH VD) levels were compared between the groups at the time of follow-up. Interbody fusion was graded on the X-ray and CT images at the follow-up time. RESULTS: There were 165 patients in this study. There were significant differences in the mean age, mean score, HIS and SSA between the groups at the different follow-up times. There were significant differences in the concentrations of serum Ca2 + , OC, ß-CTX, 25-OH VD and PINP at the sixth month after surgery between the groups. There were significant differences in the concentrations of serum Ca2 + , ß-CTX and 25-OH VD between the pre-surgery and at six months after surgery in Group B and ß-CTX and 25-OH VD in Group C. There was a significant difference in the degree of fusion between Group B and C (χ2= 5.6243, P< 0.05). CONCLUSION: In elderly patients with LIF and osteoporosis, anti-osteoporosis therapy could reduce bone resorption and thus facilitate fusion. Anti-osteoporosis medication tends to enhance radiological, functional, and fusion short-term outcomes.

Whole genome sequencing of drug resistance Mycobacterium tuberculosis from extra-pulmonary sites.

This study aimed to determinate characteristics of drug resistance Mycobacterium tuberculosis from patients with extra-pulmonary tuberculosis (EPTB). Patients were retrospectively studied from January 2020 to December 2021. All the isolates were cultured, tested drug susceptibility, and detected the gene mutation using whole genome sequencing. The correlations of whole genome sequencing, pattern of DR, patients' distribution, and transmission were analyzed. 111 DR-EPTB isolates included pre-XDR-TB (53.2%), MDR-TB (29.7%), and poly-DR-TB (12.6%). The resistant drugs were INH followed by RFP and SM. The genotypes of 111 strains were lineage 2 and lineage 4. KatG_p.Ser315Thr was main gene mutation for resistance to INH; rpsL_p.Lys43Arg for SM, rpoB_p.Ser450Leu for rifampicin, embB_p.Met306Val for ethambutol, gyrA_p.Asp94Gly for FQs, and pncA_p.Thr76Pro for PZA. The residence was a significant risk factor for cluster transmission by patients and phenotypic DR types of strains for lineage 2 transmission. In the local area of southwest China INH, rifampicin and SM were main drugs in patients with DR-EPTB. KatG_p.Ser315, rpoB_p.Ser450Leu, and rpsL_p.Lys43Arg were main gene mutations. Phenotypic DR types and residence were main risk of transmission.

Expression and function of microRNA-497 in human osteosarcoma.

The expression and function of microRNA-497 (miR-497) has previously been reported in various types of human cancer; however, miR-497 has not previously been investigated in human osteosarcoma (OS). In the present study, the expression levels of miR­497 were analyzed by reverse transcription­quantitative polymerase chain reaction (RT­qPCR) in OS tissues and cell lines. In addition, post-transfection with miR­497, RT­qPCR, cell proliferation, migration and invasion assays, western blot analysis, and luciferase assays were performed in OS cell lines. The results of the present study demonstrated that miR­497 was downregulated in OS tissues and cells compared with normal controls. Furthermore, upregulation of miR­497 inhibited cell proliferation, migration and invasion in osteosarcoma cell lines compared with the negative control group. In addition, the present study demonstrated that miR­497 may function by directly targeting insulin­like growth factor 1 receptor in OS cells. These findings indicated that miR­497 may be useful as a therapeutic target for the treatment of OS.

SPAG9 is overexpressed in osteosarcoma, and regulates cell proliferation and invasion through regulation of JunD.

Sperm-associated antigen 9 (SPAG9) is a recently characterized oncoprotein that is considered to be involved in several forms of malignant tumor. However, its biological function and expression pattern in human osteosarcoma have not yet been elucidated. In the present study, SPAG9 expression was analyzed in 58 cases of human osteosarcoma by immunohistochemistry. The results demonstrated that SPAG9 was overexpressed in 63.8% (37/58) of osteosarcoma tissues, while normal bone tissues exhibited negative SPAG9 expression. SPAG9 small interfering RNA was employed in the U2OS cell line, which has high endogenous expression, and SPAG9 transfection was performed in the MG63 cell line, which has low endogenous expression. MTT and Matrigel invasion assays demonstrated that SPAG-9-knockdown significantly reduced U2OS cell invasion and proliferation, while SPAG9 transfection enhanced MG63 cell proliferation and invasion. Furthermore, it was observed that SPAG9 positively regulated cyclin D1, phosphorylated-c-Jun NH2-terminal kinase (JNK) and JunD expression. Treatment with the JNK inhibitor, SP600125, abolished the upregulatory effect of SPAG9 on JunD. Taken together, the present study identified SPAG9 as a critical oncoprotein involved in osteosarcoma proliferation and invasion, possibly functioning through JNK-JunD signaling.

[Comparative study on the shaping ability of canals with 2 new nickel- titanium rotary instruments].

PURPOSE: To compare the shaping ability of two nickel-titanium rotary systems: Mtwo and K3. METHODS: Thirty-six mesio-buccal root canals of maxillary first molars were divided into two groups: group A(> or =20> or =) and group B(<20 degrees ),according to the angle of the canal. Then, each group was randomly divided into two subsets and prepared by Mtwo,K3, respectively. All root canals were injected with the contrast medium and digital images of all canals were recorded before and after instrumentation. The computer assistant analyze image software was used to form the geometrical central line of pre-instrumented canals. Then the central line was imaged to the post-instrumented canals. The canal transportation and the decrease of curvature were measured. All the data was analyzed with SPSS11.0 software package. RESULTS: Difference between groups was compared using t test.When the curvature of canal > or =20 degrees ,the transportation at the beginning of the curvature and the decrease of curvature of Mtwo were significantly less than those of K3(P<0.05).When the curvature of canal <20 degrees there was no significant difference between Mtwo and K3 in the transportation and decrease of curvature(P>0.05). CONCLUSIONS: Both Mtwo and K3 systems show good preservation of the original geometry of the root canals, the Mtwo system can better preserve original curvature of canals, when the curvature of canal is larger than 20 degrees .

[Study on survival time of autogeneic BMSCs labeled with superparamagnetic iron oxide in rabbit intervertebral discs].

OBJECTIVE: To explore the survival time of autogeneic BMSCs labeled by superparamagnetic iron oxide (SPIO) in rabbit intervertebral discs and the rule of migration so as to prove bases of gene therapy preventing intervertebral disc degeneration. METHODS: Twelve rabbits were used in this experiment, aged 8-10 weeks, weighing 1.5-2.0 kg and neglecting their gender. BMSCs were separated from rabbits bone marrow by density gradient centrifugation and cultivated, and the 3rd generation of BMSCs were harvested and labeled with SPIO, which was mixed with poly-l-lysine. The labeling efficiency was evaluated by Prussian blue staining and transmission electron microscope. Trypanblau stain and MTT were performed to calculate the cell's activity. Rabbits were randomly divided into experimental group (n = 8) and control group (n = 4), the labeled BMSCs and non-labeled BMSCs (5 x 10(5)/mL) were injected into their own intervertebral discs (L1,2, L2,3, L3,4 and L4,5), respectively. At 2, 4, 6 and 8 weeks, the discs were treated with Perl's fluid to observe cell survival and distribution. RESULTS: The labeling efficiency of BMSCs with SPIO was 95.65% +/- 1.06%, the cell activity was 98.28% +/- 0.85%. There was no statistically significant difference in cell proliferation within 7 days between non-labeled and labeled cells (P > 0.05). After 8 weeks of operation, the injected cells was alive. CONCLUSION: Labeled BMSCs with SPIO is feasible in vitro and in vivo, and the cells can survive more than 8 weeks in rabbit discs.