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The cytosolic DNA sensor cyclic GMP-AMP synthase (cGAS) is essential to elicit type I interferon cascade response; thus, the activity of cGAS must be strictly regulated to boost the antiviral innate immunity. Here, we report that cGAS is responsible for the DNA-induced ISG15 conjugation system. The E3 HERC5 catalyzes the ISGylation of cytoplasmic cGAS at lysine 21, 187, 219, and 458, whereas Ubl carboxy-terminal hydrolase 18 removes the ISGylation of cGAS. The interaction of cGAS and HERC5 depends on the cGAS C-terminal domain and the RRC1-4 and RRC1-5 domains of HERC5. Mechanically, HERC5-catalyzed ISGylation promotes DNA-induced cGAS oligomerization and enhances cGAS enzymatic activity. Deficiency of ISGylation attenuates the downstream inflammatory gene expression induced by the cGAS-STING axis and the antiviral ability in mouse and human cells. Mice deficient in Isg15 or Herc6 are more vulnerable to herpes simplex virus 1 infection. Collectively, our study shows a positive feedback regulation of the cGAS-mediated innate immune pathway by ISGylation. [Display omitted] • HERC5 catalyzes the ISGylation of cytoplasmic cGAS • cGAS is ISGylated at lysine 21, 187, 219, and 458 • HERC5-catalyzed ISGylation enhances the cGAS oligomerization • Herc6 deficiency impairs the innate antiviral responses Chu et al. demonstrate that HERC5 catalyzes the ISGylation of cytoplasmic cGAS at lysine 21, 187, 219, and 458 upon foreign DNA stimulation, which facilitates cGAS oligomerization and ultimately enhances cGAS-STING antiviral immunity. This finding uncovers a positive feedback mechanism of the cGAS-STING pathway, which is boosted by ISGylation. [ABSTRACT FROM AUTHOR]

Fibrous membranes with asymmetric wettability have attracted great interest. Benefiting from the inspiration of biological paradigms and the development of fabrication techniques, many asymmetric wettability membranes with well-designed surface topologies and chemical compositions have been reported in the literature. In this review, different structures of asymmetric wetted fibrous membranes are discussed, including Janus, sandwich, gradient, and hierarchy structure. Various top-down and bottom-up methods for the construction of asymmetric wetted fibrous membranes are summarized, including template, etching, surface modification, phase separation, self-assembly, electrospinning/electrospraying, and various composite methods. Furthermore, biological applications of asymmetric wetted fibrous membranes, such as smart fabrics, sensors, drug release, wound dressings, and tissue patches, are reviewed. Future challenges for asymmetric wettability fibrous membranes are suggested. [Display omitted] • Outline structure, preparation and application of asymmetric wettability membrane. • Classify asymmetric into Janus, sandwich, gradient, and hierarchy structures. • Summarize top-down and bottom-up methods to construct asymmetric membranes. • List biomedical applications of asymmetric wettability membrane. [ABSTRACT FROM AUTHOR]

Objective To examine effects of percutaneous endoscopic débridement and allograft via the transforaminal approach combined with percutaneous pedicle screw fixation as treatment for single-level thoracic tuberculosis. Methods This multicenter retrospective analysis included 75 patients with single-level thoracic tuberculosis who underwent percutaneous endoscopic débridement and allograft via the transforaminal approach combined with percutaneous pedicle screw fixation and were followed for >36 months between January 2012 and December 2014. Results Follow-up was 36–48 months (average 41.1 ± 2.2 months). Intraoperative blood loss was low (average 30.5 ± 7.9 mL), and bed rest time was short (average 1.5 ± 0.3 days). No recurrence was observed in all 75 patients. Except for 3 patients, almost all patients (96%) achieved grade I or II fusion in interbody bone grafting. Segmental Cobb angle was 13.5° ± 4.1° before surgery, 10.5° ± 3.7° immediately after surgery, and 11.7° ± 3.9° at 36 months of follow-up. All patients achieved complete recovery of neurologic function (American Spinal Injury Association grade E), including 15 patients with spinal cord injury (American Spinal Injury Association grade D) before surgery. The visual analog scale and 36-Item Short-Form Health Survey scores significantly improved at 1, 3, 12, and 36 months of follow-up. No complications related to internal fixation occurred within the follow-up period; complication rate was 9.0%. Conclusions Median follow-up clinical experience with percutaneous endoscopic débridement and allograft via the transforaminal approach combined with percutaneous pedicle screw fixation indicates that the technique is safe, effective, feasible, and minimally invasive. [ABSTRACT FROM AUTHOR]

Objective To examine the effects of anterior transcorporeal percutaneous endoscopic cervical diskectomy (ATPECD) for the treatment of single-level cervical intervertebral disk herniation (CIDH) with a focus on its safety, feasibility, clinical efficacy, and specific possible complications. Methods A series of 35 patients with symptomatic single-level CIDH were enrolled to be treated with ATPECD. Neck and arm pain was measured using the visual analog scale. Quality of life was measured using the bodily pain and physical function on the SF-36. The average disk height and vertical vertebral body height were recorded. Bone healing was evaluated on the basis of postoperative computed tomography. Results Successful removal of the herniated disk was confirmed in all 35 cases. At 2 years, the patients showed a significant treatment effect in the visual analog scale and body pain and physical function portions of the SF-36 (1.14 ± 0.60 vs. 7.62 ± 0.61, 63.92 ± 6.74 vs. 32.55 ± 6.80, and 82.14 ± 6.22 vs. 34.43 ± 4.50, respectively, P < 0.01). Mean preoperative disk height was 6.79 ± 0.37 mm, which decreased to 6.34 ± 0.46 mm 2 years post operation (6.6% decrease). Preoperative surgical vertebral body height also decreased from preoperation (15.79 ± 0.52 mm) to 2 years post operation (15.12 ± 0.38 mm) (4.2% decrease). Three surgery-related complications were observed (8.6%). Conclusions Preliminary clinical experience with ATPECD shows that it is safe, effective, feasible, and minimally invasive. Although it has some disadvantages, such as the need for repeated fluoroscopy, some minor complications, and nonsymptomatic disk height decreases, ATPECD can supplement minimally invasive surgeries in selected cases of CIDH. [ABSTRACT FROM AUTHOR]

Abstract Currently the amount of data available on the effect of sand dune stabilization on species conservation in inter-dune lowland is very limited, especially for the sand dune systems in semi-arid regions. In this study, we determined whether the characteristics of above-ground vegetation, soil seed bank and their relationships with environmental factors changed with sand dune stabilization in the inter-dune lowlands in Horqin Sandy Land, China. Species composition, abundance and coverage of aboveground vegetation as well as soil seed bank composition and density were surveyed and their correlations with environmental factors (pH, organic matter content, total nitrogen and total phosphorus) were determined. The results showed that changes in the relationship between aboveground vegetation, soil seed bank and soil quality followed the changes in aboveground vegetation and soil seed banks. Aboveground vegetation species richness increased with sand dune stabilization, but soil seed bank species richness declined. The inter-dune lowland of active sand dunes could provide specific habitats for some endemic species and pioneer psammophyte species as indicated by data on aboveground vegetation and soil seed bank. Our results suggested that both active and stabilized sand dunes should be maintained since active sand dunes are essential for the survival of endemic or pioneer species and stabilized sand dunes are important for sustaining species richness. Graphical abstract This study contributes towards a better understanding of sand dune stabilization by showing the changes in the characteristics of above-ground vegetation and soil seed bank, including their correlations with environmental factors. Unlabelled Image Highlights • Aboveground vegetation species richness increased with sand dune stabilization. • Soil seed bank species richness declined with sand dune stabilization. • Inter-dune lowland of active sand dunes is suitable for some endemic species. • Conservation areas should be set up in active sand dunes to protect biodiversity. [ABSTRACT FROM AUTHOR]

Background Currently, anterior transdiscal access and posterior interlaminar approach are the main approaches for percutaneous endoscopic cervical discectomy (PECD). To overcome access shortcomings, we previously described a novel anterior endoscopic transcorporeal approach on a migrated cervical disc. We innovatively introduced bone wax into endoscopic surgery to aid hemostasis and facilitate the process of drilling an intracorporeal tunnel. Methods Five patients with cervical intervertebral disc herniation (CIDH) were treated by PECD via the anterior transcorporeal approach. During the operation, we marked the punctured tunnel with bone wax containing indigo carmine as a guide and smeared bone wax on the endoscopic burr to aid hemostasis. Results A satisfactory clinical outcome was observed in all 5 patients postoperatively; pain and neurologic condition were dramatically improved. Surgery-related complications, such as esophageal injury, vascular rupture, hematoma, intervertebral disc infection, or postoperative headache, were not encountered. A computed tomography scan was used to observe the process of bone healing. At 3-month postoperative follow-up, the bone defect within the drilling tunnel had partially shrank and was completely healed at 6 months postoperatively. Conclusions The anterior endoscopic transcorporeal approach for PECD is a novel, valuable alternative for the treatment of CIDH. Bone wax could indeed facilitate the operation by guiding the drilling process and instantly controlling the bleeding without obvious interference with bone healing. Long-term follow-up is warranted in further clinical studies. Highlights • A transcorporeal approach to remove a herniated disc at the C4-5 level under endoscopy is introduced. • Bone wax was introduced into endoscopic surgery to aid hemostasis and facilitate the process of drilling a tunnel. • Satisfactory clinical outcome was observed in all 5 patients postoperatively, with improved pain and neurologic condition. • With the process of osteogenesis, a phenomenon of self-repair was observed in the bone defect within the drill tunnel. • Because injury to the residual disc is mild, the probability of further intervertebral space collapsing is low. [ABSTRACT FROM AUTHOR]

Objective We sought to preliminarily explore the efficacy and safety of percutaneous endoscopic spinal surgery for epidural cement leakage. We report a case series of patients who underwent percutaneous retrieval of leaked epidural cement and achieved spinal decompression under endoscopy. Methods Five patients with neurologic impairment due to epidural cement leakage after percutaneous vertebroplasty were treated with percutaneous endoscopic spinal decompression. Computed tomography reconstruction and 3-dimensional imaging were used to evaluate the extruded material. During follow-up at 3, 6, and 12 months postoperatively, all patients were advised to undergo plain radiograph and computed tomography examinations. Results The leaked epidural cement was successfully removed in all patients under percutaneous endoscopy through a unilateral or bilateral approach. At the 12-month follow-up, the visual analog scale score of all patients improved. In addition, the neurologic function of each patient improved to at least 1 grade level, as evaluated using the American Spinal Injury Association. According to the modified MacNab criteria, 2 patients had excellent recovery, whereas the other 3 patients had good recovery. Conclusions We described a novel and minimally invasive procedure to ameliorate intractable epidural cement extrusion. As an alternative to conventional laminectomy, percutaneous endoscopic retrieval achieved the targeted decompression without damaging the posterior lamina. Moreover, the whole operation was performed under regional anesthesia accompanied with dexmedetomidine sedation, allowed real-time neural function evaluation, and had lower risks of anesthesia-related complications, compared with general anesthesia. Highlights • Generally, an urgent and extensive laminectomy was required to thoroughly remove the intraspinal extravasated comment. • Percutaneous endoscopic retrieval could achieve targeted decompression without damaging the posterior lamina. • It is not only capable of being monitored for efficacy but also avoids the risks associated with general anesthesia. [ABSTRACT FROM AUTHOR]

Background There are currently no high-quality studies on the optimal therapeutic approach for juxtafacet cyst, as treatment guidelines have not been developed. Herein, a novel technique in which we used an endoscopic transfacet approach to treat a patient with symptomatic lumbar synovial cyst is presented. Case Description An 87-year-old man presented with severe dull pain in the right anterior thigh. Lumbar magnetic resonance imaging revealed disc extrusion over the central canal zone at the L2–L3 and L4–L5 levels and an ovoid lesion with a hyperintense center plus a hypointense rim on the T2-weighted image. The lesion was located over the medial side of the right juxtafacet region at the L2–L3 level, causing thecal sac compression. After the operation, the visual analog pain scale improved with a value of 0–1/10, and straight leg raise test was negative. Microscopically, cystic fibrous tissue with focal myxoid degeneration, fibrin exudate, and scant synovial-like lining was observed. These findings were consistent with clinical synovial cyst. Three months later, lumbar magnetic resonance imaging was performed, and no evidence of cyst was disclosed. Lumbar computed tomography revealed the upper part of left L2–L3 facet joint was removed. The patient did not report any radicular pain during the 6-month follow-up period. Conclusions Percutaneous endoscopic lumbar surgery could be a new option for the management of lumbar synovial cysts, especially when general anesthesia is not appropriate for the patient. [ABSTRACT FROM AUTHOR]

Objectives To observe the therapeutic effects of Saussurea involucrata (Sau) injection against severe acute pancreatitis (SAP)-induced brain injury. Methods Sodium taurocholate-induced SAP-modeled rats were equally randomized into an SAP model group (SAP group) and a Sau treated group (Sau  +  S group). Healthy rats were equally randomized into a Sau treated group (Sau  +  H group) and a sham operation group (SO group). Serum amylase levels, endothelin-1 (ET-1) and nitric oxide (NO) contents were determined by optical turbidimetry, ELISA and nitrate reductase method respectively. Western blot was used to detect protein expression levels of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt), ET-1, inducible nitric oxide synthase (iNOS) and endothelial NOS (eNOS) while mRNA levels of these biomarkers in brain tissue were measured by quantitative real-time PCR. Furthermore, pathological changes, as well as all above indexes of pancreas and brain, were observed at 6, 24 and 48 h after administration. Results There was a significant difference in mortality between SAP and Sau  +  S groups ( P   <  0.05). Serum amylase levels, ET-1 and NO contents, ET-1/NO ratio, relative expression levels of ET-1 and iNOS protein/mRNA of brain tissue in Sau + S group were lower than those in SAP group at 24 and 48 h post-operation ( P   <  0.05 or 0.01), meanwhile, pancreas and brain pathological scores showed similar tendency ( P   <  0.01). However, both protein and mRNA levels of PI3K, Akt and eNOS of brain tissue in Sau + S group were higher than those in SAP group ( P   <  0.05 or P  <   0.01). There were no significant differences in all indexes between Sau + H and SO groups at all designated time points ( P   >  0.05). Conclusions Sau injection has therapeutic effects on SAP-induced brain injury in rats. [ABSTRACT FROM AUTHOR]

Rectifying properties of three cyano side group substituted arylethynylene thiolate molecules are theoretically investigated based on abinitio calculations. The current-voltage curves show that rectifying performance of the junctions correlates negatively with conjugation of the molecules, which reveals a much more pronounced rectification behavior for that with broken-conjugated dihydroanthracene core (sAH) than the counterpart with linearly-conjugated anthracene core (sAC) or cross-conjugated anthraquinone core (sAQ). It is demonstrated that the conjugation breaking induced localization of molecular orbital and asymmetric evolution of its spatial distribution under positive and negative biases play the key role for the rectification enhancement in sAH. [ABSTRACT FROM AUTHOR]

Background Context: With the continuous development of the spinal endoscopic technique in recent years, percutaneous endoscopic cervical discectomy (PECD) has emerged, which bridges the gap between conservative therapy and traditional surgery and has been mainly divided into the anterior transdiscal approach and the posterior interlaminar access. Because of the relatively greater violation to the anterior nucleus pulposus, there is a higher potential of postoperative intervertebral space decrease in the anterior transdiscal approach than in the posterior interlaminar access. In addition, when the herniated lesion is migrated upward or downward behind the vertebral body, both approaches, and even anterior cervical discectomy and fusion, are impractical, and corpectomy is commonly considered as the only efficacious treatment. Anterior transcorporeal approach under endoscopy could enable an individual and adjustable trajectory within the vertebral body under different conditions of disc herniation preserving the motion of adjacent segment, especially in a migrated or sequestered lesion.Purpose: This report aimed to first describe a novel anterior transcorporeal approach under endoscopy in which we addressed a migrated disc herniation at the C4-C5 levels.Study Design: A technical report was carried out.Patient Sample: A 37-year-old woman presented with posterior neck pain and weakness of extremities for 9 months. On neurologic examination, tingling sensation and numbness were not obvious. However, the power of extremities was dramatically decreased at a level of 3. Hoffmann sign was positive in the bilateral hand. Magnetic resonance imaging (MRI) showed a huge herniation of the C4-C5 disc compressing the median area of the spinal cord. Besides the C4-C5 disc herniation, preoperative computer tomography (CT) also detected that the herniated disc had partial calcification. A novel anterior transcorporeal approach of PECD, through the vertebral body of C5, was performed to address a migrated disc herniation at the C4-C5 levels.Outcome Measures: The posterior neck pain was measured using the visual analog scale (VAS).Methods: A novel anterior transcorporeal approach under endoscopy was performed to address a migrated disc herniation at the C4-C5 levels.Results: This operation was accomplished in 75 minutes. Postoperatively, the drainage tube was retained into the drilling hole for 24 hours to avoid the possibility of hematoma. The patient was advised to wear a neck collar for 3 weeks. Immediately after the operation, the posterior neck pain improved from VAS 7/10 preoperatively to 3/10, and the myodynamia of extremities improved stepwise. At 12 hours postoperatively, the range of motion was also improved. In the further follow-up, the patient has completely recovered from the preoperative symptoms, whose myodynamia of extremities is normal. Besides the postoperative MRI, a total removal of the herniated disc and the transcorporeal drilling tunnel are observed in CT. At postoperative 3-month follow-up, neither disc space narrowing nor instability was observed on CT, in which the bone defect after drilling tunnelwas partially decreased, indicating bone healing. There were no surgery-related complications, such as dysphagia, Horner syndrome, recurrent laryngeal nerve palsy, vagus nerve injury, tracheoesophageal injury, or cervical hematocele.Conclusions: As a supplement to the described surgical approach of PECD, the transcorporeal approach is a novel access for the treatment of cervical intervertebral disc herniation. Among the advantages of this approach are providing a clear visual field during microendoscopic surgery and decreasing the intraoperative iatrogenic injury to, as well as avoiding violation to the discal tissue. Theoretically, the potential of secondary decline of intervertebral height is low. However, as the limitation of one case shows, whether this transcorporeal approach is efficacious and reliable should be verified in a further comparative cohort study with a large volume of patients. [ABSTRACT FROM AUTHOR]

Objective To evaluate and compare the effects of neuromuscular electrical stimulation (NMES) acting on the sensory input or motor muscle in treating patients with dysphagia with medullary infarction. Design Prospective randomized controlled study. Setting Department of physical medicine and rehabilitation. Participants Patients with dysphagia with medullary infarction (N=82). Interventions Participants were randomized over 3 intervention groups: traditional swallowing therapy, sensory approach combined with traditional swallowing therapy, and motor approach combined with traditional swallowing therapy. Electrical stimulation sessions were for 20 minutes, twice a day, for 5d/wk, over a 4-week period. Main Outcome Measures Swallowing function was evaluated by the water swallow test and Standardized Swallowing Assessment, oral intake was evaluated by the Functional Oral Intake Scale, quality of life was evaluated by the Swallowing-Related Quality of Life (SWAL-QOL) Scale, and cognition was evaluated by the Mini-Mental State Examination (MMSE). Results There were no statistically significant differences between the groups in age, sex, duration, MMSE score, or severity of the swallowing disorder ( P >.05). All groups showed improved swallowing function ( P ≤.01); the sensory approach combined with traditional swallowing therapy group showed significantly greater improvement than the other 2 groups, and the motor approach combined with traditional swallowing therapy group showed greater improvement than the traditional swallowing therapy group ( P <.05). SWAL-QOL Scale scores increased more significantly in the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups than in the traditional swallowing therapy group, and the sensory approach combined with traditional swallowing therapy and motor approach combined with traditional swallowing therapy groups showed statistically significant differences ( P =.04). Conclusions NMES that targets either sensory input or motor muscle coupled with traditional therapy is conducive to recovery from dysphagia and improves quality of life for patients with dysphagia with medullary infarction. A sensory approach appears to be better than a motor approach. [ABSTRACT FROM AUTHOR]

Magnetic hyperthermia ablation is a new and minimally invasive modality for localized tumor removal. However, an inadequate ablation dosage can leave a residual tumor or cause a variety of complications. In addition, commonly used magnetic nanoparticles can easily escape from the tumor tissue, which present potential safety problems. In this study, a smart phase transitional and injectable implant based on biocompatible poly lactic-co-glycolic acid (PLGA) implant incorporating magnetic material (Fe powder) and anti-cancer drug (doxorubicin (DOX)) was developed. The magnetic-induced hyperthermia and release efficiency of DOX were evaluated in vitro . Drug release can be controlled under external alternating current magnetic field (AMF). The results of the in vivo tumor therapeutic efficacy showed that when exposed to external AMF, this smart injectable DOX/PLGA-Fe implant could converse magnetic energy into heat and accelerate the release of DOX, which leads to increasing the temperature to achieve tumor coagulative necrosis and accelerating the release of DOX to enhance residual tumor apoptosis. Furthermore, there was no leakage of magnetic material, as demonstrated using real-time ultrasound (US) and computerized tomography (CT) imaging, realizing the guidance and monitoring of tumor therapy. In conclusion, this smart phase transitional and injectable implant DOX/PLGA-Fe has the ability to improve the efficiency of this newly developed minimally invasive magnetic ablation of tumor treatment technique, and will provide a new avenue of developing minimally invasive synergistic tumor therapy. [ABSTRACT FROM AUTHOR]

Background context Percutaneous vertebroplasty (PVP) has proven to be a valuable palliative treatment option for patients with medically refractory painful osteolytic metastases of the spine. Percutaneous vertebroplasty of the atlas has been reported in only seven articles and has been performed with different techniques and approaches. Purpose To describe the technique we used to perform PVP of a lytic lesion of the lateral mass of C1 via anterior retropharyngeal approach guided by C-arm fluoroscopy. Study design A technical report. Patient sample It included a 75-year-old man with known metastatic lung carcinoma and incapacitating right suboccipital and neck pain refractory to conventional medical treatment. Radiologic evaluation showed revealed osteolytic destruction of C1 and C2, mainly invading the right lateral mass of C1 and the vertebral body of C2. Outcome measures The right suboccipital and neck pain was measured using the visual analog scale (VAS). Methods Under C-arm fluoroscopy, a novel anterior retropharyngeal approach, through the vertebral body of C2 into the metastatic osteolytic vertebral lesion of C1, was performed to achieve the PVP in C1 followed by a PVP in C2. Results Immediately after the operation, the patient reported substantial pain relief (from VAS 9/10 preoperatively to 3/10). At 12 hours postoperatively, the range of motion was also improved. There were no surgery-related complications. The immediately postoperative cervical plain film and computed tomography scan showed adequate filling of the osteolytic lesion without the obvious leakage of bone cement. Clinical follow-up at 3 months revealed that this pain condition was improved and maintained (VAS 1/10). Conclusions When the transoral approach is unsuitable or contraindicated, the anterior retropharyngeal approach could be an efficacious alternative in selected patients with C1 metastasis, providing adequate filling of bone cement and significant pain relief. Based on our preliminary exploration, only assisted by C-arm fluoroscopy, this approach is feasible to achieve PVP in C1 under local anesthesia and intravenous analgesia. Nevertheless, when considering the substantial potential risks, this technically challenging procedure should be performed by experienced operators. [ABSTRACT FROM AUTHOR]

Highlights: [•] The thermodynamic parameters and mass and heat balance equation were estimated. [•] A mathematical model on the pyrolysis of bio-oil was established. [•] The effects of temperature on the pyrolysis of bio-oil aqueous fraction were studied. [•] The comparison of the established model and the experimental results was performed. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate our pediatric renal transplant patient population at the Children''s Hospital of Pittsburgh to better understand the clinical significance of hydronephrosis. Materials and methods: We retrospectively reviewed records of patients who had received a renal transplant in 1998–2008. Exclusion criteria included multi-organ transplants and allograft failure within 3-months. We determined the incidence of hydronephrosis and compared serum creatinine, incidence of pyelonephritis, rejection and vesicoureteral reflux between the hydronephrotic and non-hydronephrotic cohorts. Data were analyzed using descriptive statistics, Student''s t-test and Pearson Chi–Square test. Results: 51 patients (35 male, 68.6%) were identified. The mean age at time of transplant was 8.7 ± 5.9 years and the mean follow-up period was 45.2 ± 45.4 months. Common causes of renal failure included posterior urethral valves, renal dysplasia, reflux and prune belly syndrome. Twenty-five (49%) patients developed hydronephrosis. This was associated with worsening renal function (p = 0.008). Hydronephrosis was also associated with pyelonephritis (p = 0.03) and male gender (p = 0.004). Age at transplant may be a predictor of pyelonephritis: median age of 10 patients with pyelonephritis was 4.6 years (range 0.6–19.9 years). Hydronephrotic cohort had increased rate of reflux and rejection; as not all patients underwent voiding cystourethrogram and/or allograft biopsy, this result was not significant. Conclusions: Pediatric renal graft hydronephrosis was correlated with worsening renal function and increased incidence of pyelonephritis. More aggressive preoperative and postoperative urological testing and management should help preserve renal function. [Copyright &y& Elsevier]

Objectives: To examine the effect of preoperative stent placement on total cost of ureteroscopic stone intervention. Passive ureteral dilation with a preoperative ureteral stent has been proposed as a method to facilitate both upper tract access and stone removal. Methods: We retrospectively reviewed the records of patients who underwent ureteroscopic stone intervention at our institution from 2005 to 2009. A sample of patients who had undergone stenting before ureteroscopy was selected and nonstented matched controls were used as a comparison group. A cost model was used to compare the total healthcare costs for the prestented and nonstented patients with a large (>1 cm) and small (≤1 cm) stone burden using the actual cost accrued for each patient. Sensitivity analyses were used to examine the robustness of the cost model. Results: A total of 104 patients were included in the present study (45 prestented, 59 not prestented). The median stone size was 1 cm (range 0.3-4). The overall stone clearance rate was 95.8%. The median number of procedures was 1. Pre-stenting significantly decreased the total healthcare cost in patients with stones >1 cm. The median cost for the prestented and nonstented cohorts was $17 706 and $27 806, respectively (P < .01). However, prestenting increased the total cost for smaller stones of ≤1 cm, although not significantly. The median cost for the prestented and nonstented cohorts was $10 872 and $12 344, respectively (P = .70). Sensitivity analysis confirmed that the model conclusions are robust. Conclusions: Preoperative stent placement is cost-effective for successful ureteroscopic treatment of stones >1 cm. [ABSTRACT FROM AUTHOR]

This study aims to introduce the unilateral biplanar screw-rod fixation (UBSF) technique (a hybrid fixation technique: 2 sets of atlantoaxial screws were placed on the same side), which serves as a salvage method for traditional posterior atlantoaxial fixation. To summarize the indications of this technique and to assess its safety, feasibility, and clinical effectiveness in the treatment of odontoid fractures. Patients with odontoid fractures were enrolled according to special criteria. Surgical duration and intraoperative blood loss were documented. Patients were followed up for a minimum of 12 months. X-ray and computerized tomography scans were conducted and reviewed at 1 day, and patients were asked to return for computerized tomography reviews at 3, 6, 9, and 12 months after surgery until fracture union. Recorded and compared the Neck Visual Analog Scale and Neck Disability Index presurgery and at 1 week and 12 months postsurgery. Between January 2016 and December 2022, our study enrolled 7 patients who were diagnosed with odontoid fractures accompanied by atlantoaxial bone or vascular abnormalities. All 7 patients underwent successful UBSF surgery, and no neurovascular injuries were recorded during surgery. Fracture union was observed in all patients, and the Neck Visual Analog Scale and Neck Disability Index scores improved significantly at 1 week and 12 months postoperative (P < 0.01). The UBSF technique has been demonstrated to be safe, feasible, and effective in treating odontoid fractures. In cases where the atlantoaxial bone or vascular structure exhibits abnormalities, it can function as a supplementary or alternative approach to the conventional posterior C1–2 fixation. [ABSTRACT FROM AUTHOR]

We sought to explore whether additional bone grafting of the atlantoaxial joint increases the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion surgery. From January 2012 to January 2016, a total of 78 patients who had basilar invagination with occipitalization of the atlas came to our tertiary spine center. Except for those lost to follow-up (10 cases) or who had a follow-up time <2 years (20 cases), there were 48 patients retrospectively included in this study. In the control group, a piece of autogenous iliac corticocancellous bone was placed between the occipital and C2 vertebral lamina for fusion. In the hybrid fusion group, besides posterior occipitocervical autograft, some granular bone harvested from the iliac crest was packed into the bilateral atlantoaxial joint. X-ray imaging and cervical computed tomography (CT) were performed during follow-up. The operations were completed successfully in all patients without intraoperative complications. Only 21 (87.5%) patients in the control group had confirmed posterior bony fusion on CT, while 24 (100%) patients in the hybrid fusion group had confirmed posterior bony fusion. There were postoperative implant-related complications in 2 patients. Both cases belonged to the control group (8.3%). Three patients (12.5%) complained of transient numbness in the posterior occipital region: 2 patients in the hybrid group and 1 patient in the control group. The mean duration to posterior occipitocervical fusion was 5.5 months in the hybrid fusion group versus 6.1 months in the control group (P = 0.757). Of note, in the hybrid fusion group, the process of atlantoaxial joint fusion was faster than that of posterior occipitocervical fusion (5.1 months vs. 5.5 months, P = 0.823). Additional bone grafting of the atlantoaxial joint could increase the bone fusion rate of iliac crest autograft in posterior occipitocervical fusion. [ABSTRACT FROM AUTHOR]

Introduction In several situations, the stability of the subaxial cervical spine is damaged and involves the lateral mass of 1 side; in these cases, a pedicle screw (PS) or lateral mass screw (LMS) may not be suitable for placement on the affected side. Therefore, salvage short-segment fixation with satisfactory stability is needed when bilateral fixation is not feasible. Methods Seven fresh-frozen human cervical spine specimens were used to test the 3-plane range of motion (ROM) of the C4-C5 segment. Quasistatic 2-Nm flexibility testing was performed in the following sequence: 1) intact; 2) destabilization (using 3-column injury models) treated with bilateral mass screws (BMSs); 3) destabilization treated with a unilateral PS combined with a contralateral translaminar screw (UPS+CTLS); and 4) destabilization treated with bilateral PSs (BPSs). Then, a pullout strength test was performed for the PSs, LMSs, and translaminar screws (TLSs) using 7 isolated C4 and C5 vertebrae. Results The UPS+CTLS group showed no significant difference from the BMS group in the 3-plane ROM or from the BPS group in the axial rotation or flexion-extension ROM but showed a significantly greater lateral bending ROM than did the BPS group. The pullout strength test showed that both C4 and C5 TLSs had strength similar to that of LMSs but poorer than that of PSs. Conclusions Fixation with the hybrid UPS+CTLS construct performed as well as BMS fixation in our biomechanical tests and may play a clinical role when BPS or BMS placement is not feasible for short-segment fixation. Highlights • The hybrid UPS+CTLS construct performs as well as BMS in a short-segment fixation. • Unilateral fixation reduced the disruption of the soft tissue, potentially reducing postoperative muscular complications. • The TLS technique is the safest regarding avoiding violation of the VA as it was initially designed. [ABSTRACT FROM AUTHOR]

Biochar is a beneficial soil amendment but the changes in its surface properties during the aging process, especially the oxygen-containing functional groups and the associated adsorption behaviors, are not well documented. In this paper, the aged wheat straw biochar was simulated by chemical oxidation with HNO 3 -H 2 SO 4 and NaOH-H 2 O 2 systems. Characterization results showed that carbon loss and oxygen incorporation ran throughout the aging process. Surface oxygen-containing functional groups were found to be increased in all treated biochars, especially for carboxyl. Much more developed mesopores were observed in aging biochar, specific surface area was increased by 126% for biochar treated with NaOH-H 2 O 2 , and 226% for biochar treated with 40% of HNO 3 -H 2 SO 4 . Thermogravimetric analysis showed that the increasing oxygen-containing functional groups led to 14% and 30% mass loss by treating biochar with alkali and acid, respectively. The improved biochar surface through the increase of oxygen-containing functional groups enhanced the cadmium sorption capacity, and the sorption capacity increased by 21.2% in maximum. Roughed surface from oxidation was another reason for increasing cadmium adsorption. Results indicated that the adsorption performance of biochar on pollutant would be changed during aging process along with the changing surface properties. [ABSTRACT FROM AUTHOR]

Effective treatment of osteomyelitis remains to be clinical challenge due to the recurrent and persistent nature of the disease. Studies have shown that borate glasses can serve as implants for local drug delivery in treating osteomyelitis, as well as aid in regenerating bone defects in vivo. However, both the kinetics of drug release from borate glass-based implants and the underlying molecular mechanism for promoting bone regeneration remain unclear. Here, delivery implants with varying amounts of antibiotics were fabricated by encapsulating gentamicin sulfate (GS) into a chitosan glue and applying it to borosilicate glass (BSG). Upon immersion in phosphate buffered saline (PBS), delivery implants degraded and converted into hydroxyapatite (HA). All delivery implants released GS sustainably over a period of around 25 days in both PBS and K2HPO4 solutions and displayed efficacious inhibition of E. coli and S. aureus in vitro. GS release occurred through diffusion for inhibition whereby Fickian diffusion was revealed to be the predominant release kinetic. Ions (B, Ca, P and Si) released from BSG supported the proliferation, differentiation, osteogenic gene expression and protein secretion of human bone marrow mesenchymal stem cells (hBMSCs) in vitro. When implanted in a rabbit tibial osteomyelitis model, osteomyelitis in the experimental group with delivery implants was effectively cured. Meanwhile, delivery implants have significant osteogenesis-promoting effects after implantation time of 12-weeks in vivo. Implantation of BSG-based drug delivery implants developed in this study may provide a promising method for treating osteomyelitis as well as for facilitating efficient bone regeneration. [ABSTRACT FROM AUTHOR]

Food and water security are crucial for sustainable development in arid regions. However, land use/cover change often leads to trade-offs between grain yield and water-related ecosystem services (ESs), threatening food and water security. Therefore, how to optimize ecological restoration patterns to ensure grain yield and ESs is an important issue in arid regions. This study evaluated the changes in grain yield, water yield (WY), and water purification (WP) from 2000 to 2020 in the Bosten Lake region, China. Then, planting vegetation (PV) scenarios on different slopes and riparian vegetation buffer (RVB) scenarios with different widths were established to reveal the effects of different ecological restoration rules on ESs. Finally, the optimal ecological restoration scenario was determined based on ES efficiency and trade-offs/synergies. The results showed that grain yield increased (23.83 %) at the expense of WP and WY (− 14.76 % and − 0.57 %) from 2000 to 2020. The agricultural development scenario further reduced WP (− 7.99 %). Grain yield increased and WP and WY decreased under the PV scenarios. The RVB scenarios had the potential to improve ESs, guarantee grain yield and eliminate ES trade-offs. The effect of forest restoration on ESs was greater than that of grassland restoration, and the effect of RVB scenarios on ES efficiency was greater than that of PV scenarios. With the increase in the riparian buffer zone, the WY efficiency increased nonlinearly, and the WP efficiency decreased nonlinearly. The riparian grass buffer scenarios achieved higher WP at the expense of less WY, with the 200 m wide riparian grass buffer being the best ecological restoration scenario. The ecological benefits varied with the type, location, and scale of vegetation restoration. This study proposed a framework to determine the optimal ecological restoration pattern. The results can provide a scientific reference for water resource management decision-making in arid regions. [Display omitted] • Impact of LULC change on grain yield and water-related ESs were evaluated. • Agricultural development would increase the trade-off between ESs and grain yield. • A framework was developed to determine the optimal ecological restoration pattern. • ES change and efficiency under different ecological restoration rules were explored. • Riparian grass buffer showed a great potential to guarantee water and food security. [ABSTRACT FROM AUTHOR]

The impacts of biochar addition on nitrogen (N) leaching, (ammonia) NH 3 volatilization from coastal saline soils are not well understood. In this soil column study, the effects of wheat straw biochar application at rates of 0.5%, 1%, 2% and 4% by weight to a coastal saline soil on N leaching, NH 3 volatilization, soil pH and N retention were investigated. Results showed that 0.5% and 1% biochar amendments reduce the NH 4 + –N, NO 3 − –N and total N concentrations of leachate and thereby significantly decrease their cumulative lost loads by 11.6–24.0%, 13.2–29.7%, and 14.6–26.0%, respectively, in compared with the control. The biochar-induced soil N leaching mitigation efficiency was weakened when the biochar application rates increased to 2% and 4%. However, the impact of biochar addition on cumulative NH 3 volatilizations were negative and significantly 25.6–53.6% higher NH 3 volatilizations in soils with 2% and 4% biochar amended than control were detected, which was mainly attributed to the averaged 0.53–0.88 units higher soil pH as results of biochar addition. On average, the total N concentrations of soil were kept same with 1.01–1.06 g kg − 1 under control and biochar treatments. Therefore, biochar application to the coastal saline soils with appropriate rates (i.e., 0.5% and 1% in current study) can reduce N leaching, keep soil N retention, and not increase NH 3 volatilization, which was beneficial for sustainable use of saline soils. [ABSTRACT FROM AUTHOR]

Abstract: Hydrogen will be an important energy carrier in the future and hydrogen production has drawn a great deal of attention to its advantages in efficiency and environmental benefit. Catalytic steam reforming in this study was carried out in a fixed bed tubular reactor with sepiolite catalysts. Sepiolite catalysts modified with nickel (Ni) and molybdenum (Mo) were prepared using the precipitation method. Influential parameters such as temperature, catalyst, steam to carbon ratio (S/C), the feeding space velocity (WHSV), reforming length, and activity of catalyst were investigated and the yields of H2, CO, CH4, and CO2 were obtained. The result of this experiment shows that the acidified sepiolite catalyst with addition of the Ni and Mo greatly improves the activities of catalyst and effectively increases the yield of hydrogen. The favorable reaction condition is as follows: reaction temperature is 700–800 °C; S/C is 16–18; the feeding space velocity is 1.5–2.2 h−1, respectively. [Copyright &y& Elsevier]

Hydrogen peroxide (H 2 O 2) solution is commonly used to irrigate wounds because of its hemostatic and antiseptic properties. Previous studies suggest that H 2 O 2 can result in toxicity to keratinocytes and fibroblasts, but complications after H 2 O 2 application, including oxygen embolism, which is one of the most severe, have rarely been reported. A 40-year-old woman was diagnosed with L4-5 lumbar spinal stenosis and subsequently underwent minimally invasive transforaminal lumbar interbody fusion treatment at another hospital. Hypotension, hypoxia, and a decrease in end-tidal carbon dioxide pressure occurred immediately after H 2 O 2 irrigation. After the operation, she was able to be extubated but remained comatose. Postoperative computed tomography scan revealed intracranial air trapping in the right frontal lobe and multiple cerebral infarction foci. When using a knee-prone surgical position or in cases of dural laceration, the application of undiluted H 2 O 2 solution should be avoided, especially in a surgical wound within a closed cavity. When hypotension, hypoxia, and a decrease in end-tidal carbon dioxide pressure occur immediately after H 2 O 2 irrigation, oxygen embolism should be strongly suspected. [ABSTRACT FROM AUTHOR]

We sought to compare the clinical and radiologic outcomes after anterior cervical surgery between zero-profile (Zero-P) cage and plate-cage construct (PCC). One-hundred and sixteen patients with single-level cervical disk herniation who underwent anterior cervical diskectomy and fusion between May 2015 and March 2017 were enrolled. They were divided into a Zero-P group (61 cases) and a PCC group (55 cases). At 1, 6, 12, and 24 months after the operation, routine follow-up evaluation was recommended including visual analog scale score and Japanese Orthopaedic Association score. The lateral x-ray film was performed at 1 and 24 months postoperatively. All 116 patients successfully completed the operation and achieved bone fusion. While there was no significant difference in the amount of bleeding between the 2 groups, the operation time of the Zero-P group was significantly shorter than that of the PCC group with statistically difference. The visual analog scale score and Japanese Orthopaedic Association score of the 2 groups at each follow-up interval postoperatively were significantly improved compared with that before operation; the difference was statistically significant (P < 0.05, respectively). While all the C2-7 cervical curvature, segmental Cobb angle, and height of adjacent vertebral body were lost at the 24-month follow-up, the significant difference was observed in the Zero-P group (P < 0.05, respectively). Compared with the Zero-P system, the PCC system provides a comparable clinical outcome. Although it showed the disadvantages in controlling the operation time and surgical bleeding, the radiologic outcome was better at the 2-year follow-up. [ABSTRACT FROM AUTHOR]

Besides the facet joints interlocking, the fibrous tissue or bony callus around the dislocated segments make the reduction for this kind of old injury to be more challenging and different from that of acute injuries. This study is aimed to present 4 cases of old subaxial cervical facet dislocations (SCFD) that were successfully treated with posterior unlocking under endoscopy followed by anterior decompression, reduction, and fixation. Between January 2017 and December 2017, 4 patients with old SCFD who underwent posterior unlocking of facet joints under endoscopy followed by anterior decompression, reduction, and fixation were enrolled. A cervical collar was prescribed for 4 weeks postoperatively. Postoperative follow-up evaluations were conducted at 2, 6, and 12 months, including neck visual analogue scale score and neck disability index, radiography, and computed tomography. The operative time averaged 145 minutes (range, 130–155 minutes). No deterioration of neural function, major vessel rupture, or iatrogenic injury to esophagus occurred. Intraoperative blood loss averaged 45 mL (range, 40–50 mL). Hospital stay for all patients was only 4 days. The neck visual analogue scale score and neck disability index were improved at the final follow-up, and interbody fusion was satisfactory without any radiologic sign of instability or internal failure. For patients with old SCFD, the unlocking of facet joints via the posterior approach under endoscopy followed by anterior decompression, reduction, and fixation is an alternative technique. [ABSTRACT FROM AUTHOR]

Juxtafacet cysts (JFCs) include both synovial and ganglion cysts adjacent to a spinal facet joint or arising from the ligamentum flavum of the spinal facet joints. Various treatments have been proposed; however, a surgical approach appears to be most effective. The aim of this study was to review patients with lumbar JFCs treated using a full endoscopic approach and elaborate the details of the surgical routes and techniques and their merits and pitfalls. All patients with lumbar JFCs underwent complete endoscopic cyst removal. Muscle power, visual analog scale score, modified MacNab criteria score, and magnetic resonance imaging were assessed during follow-up. The study enrolled 8 patients. Five patients received an interlaminar approach, 2 patients received a transforaminal approach, and 1 patient received a transfacet approach. Visual analog scale scores decreased from a mean of 7.75 (range, 5–10) before surgery to 0.625 (range, 0–2) after surgery, and modified MacNab criteria score ranged from good to excellent after surgery. No neurologic injuries were observed. JFCs could be effectively treated by full endoscopic surgery. The type of approach should be based on the anatomic site of the lesion and the condition of the patient. The interlaminar approach is appropriate for cysts located in the lower segment with larger interlaminar space. The transforaminal or transfacet approach is preferred for patients for whom general anesthesia is a high risk. [ABSTRACT FROM AUTHOR]

• The ERP has caused significant changes in the landscape pattern. • The impact of landscape patterns on WESs in different periods was assessed from a geospatial perspective. • Landscape composition has a greater impact on WESs than configuration. • PD and CONTAG are the main factors affecting WESs. Understanding the changes and drivers of water ecosystem services (WESs) can provide guidance for the management of ecological restoration programs (ERPs). This study analyzed the changes in WESs (water yield and water purification) and landscape patterns in the Jianghuai Ecological Economic Zone (JHEEZ) from 2000 to 2020 and revealed the effect of landscape patterns on WESs in different periods (development priority and ecological priority) through a geographic detector (GD) and geographic weighted regression (GWR). During the development priority period, there was an increase in landscape diversity and aggregation, as well as a decrease in landscape fragmentation and complexity. Additionally, the area of water bodies landscape decreased while the aggregation of cropland and built-up land increased. In contrast, during the ecological priority period, landscape diversity, fragmentation, and complexity increased, while landscape aggregation decreased. The water body area also increased, and cropland fragmentation increased. Water yield experienced an initial decrease and subsequent increase, while water purification continued to improve. Patch density and the contagion index are the main factors affecting WESs, and the improvement of water connectivity and the reduction of fragmented Landscape are of great significance to WESs. This study analyzed the impact of landscape pattern changes on WESs from a geospatial perspective and provided a reference for the sustainable development of ERPs in the JHEEZ. [ABSTRACT FROM AUTHOR]

Background The incidence of spinal epidural hematoma (SEH) is estimated to be 1 per 1,000,000 patients per year; SEH can be classified as idiopathic, spontaneous, and secondary. The cause of spontaneous SEH is uncertain but it may be associated with minor trauma. SEH can compress surrounding structures, shown by clinical symptoms and signs that affect the spinal cord or nerve roots. Surgical treatment may be considered if medical treatment fails. Case Description A 26-year-old man presented with lower back pain and significant radicular symptoms on the left side for a week. He denied previous lumbar trauma or the use of anticoagulation drugs. We used the full-endoscopic transforaminal approach (extraforaminal technique) to remove the SEH under local anesthesia. The patient was discharged home 2 days after surgery and the radicular pain disappeared completely. Three months later, follow-up magnetic resonance imaging showed that the dark-brown lesion had been totally removed. Conclusions Spontaneous SEHs are uncommon. Although lumbar laminectomy is the mainstream treatment in those with neurologic deficits caused by epidural hematomas, the percutaneous full-endoscopic transforaminal approach may be an option for certain SEHs. [ABSTRACT FROM AUTHOR]

Graphene-coupled flower-like nickel sulfide monoliths that exhibit ultra-light, mesoporous structures and uniform particle sizes are successfully prepared using an F127-assisted hydrothermal method and high-temperature pyrolysis. As an electrode material for supercapacitors, the as-prepared rGO-Ni 3 S 2 shows ultra-high specific capacitances of 1315 and 1050 F g −1 at 1 and 10 A g −1 , respectively. After 1000 charge/discharge cycles at a current density of 1 A g −1 , the specific capacitance increases by almost 15%, indicating the excellent capacitance and durability of rGO-Ni 3 S 2 . Further, an asymmetric supercapacitor using rGO-Ni 3 S 2 as positive electrode and active carbon as negative electrode exhibits high specific capacitance of 104.6 F g −1 at 0.5 A g −1 , and excellent cycling stability with 85.6% capacitance retention after 5000 cycles at a current density of 4 A g −1 . These promising supercapacitor performances demonstrate that the as-developed surfactant-assisted hydrothermal strategy can be widely used to prepare graphene-coupled metal sulfides for high-performance supercapacitor applications. [ABSTRACT FROM AUTHOR]

[Display omitted] • All organic PC 71 BM/g-C 3 N 4 photocatalysts were constructed by in situ self-assembly. • The heterostructures possess satisfactory biocompatibility. • The PC 71 BM served as the electron acceptor and photosensitizer. • · O 2 - acted as the main active species in the degradation process. Photocatalysis has been reported as a potential water purification technology for combating the pathogenic bacteria and degrading the hazardous chemicals. The photoactive organic semiconductors as the emerging class of an alternative to the traditional developed inorganic semiconductors are being widely pursued due to their tunable structures and low toxicity. Herein, the all-organic [6,6] -phenyl C 71 butyric acid methyl ester (PC 71 BM)/g-C 3 N 4 heterostructure have been created by introducing self-assembled n-type fullerene small molecule to the g-C 3 N 4 surface in situ. The absorption edge of the heterostructures with PC 71 BM as the photosensitizer extend from 450 to 650 nm. Moreover, the charge separation and transfer efficiencies of the photocatalysts are greatly promoted even with 1.0% amount of PC 71 BM because of its low reorganization energy and high reduction potential. All of these superiorities endow the heterostructures with over 99.7% antibacterial rates toward E. coli and S. aureus and excellent performance against their biofilms after irradiation for 135 and 180 min, respectively. Additionally, the heterostructures achieve excellent photocatalytic degradation ability for Rhodamine B and tetracycline. Importantly, the in vitro experiments reveal that the as-prepared heterostructures possess satisfactory biocompatibility and their toxicity is negligible. This study provides a new perspective for designing ecofriendly all-organic heterostructures with high photocatalytic activity. [ABSTRACT FROM AUTHOR]