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Zi-Long Zhang,1,2,* Jun-Song Yang,1,* Ding-Jun Hao,1 Tuan-Jiang Liu,1 Qi-Ming Jing2,* 1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China; 2Graduate School of Xi’an Medical University, Xi’an, Shaanxi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Ding-Jun HaoDepartment of Spine Surgery, HongHui Hospital, Xi’an Jiaotong University, Xi’an City, Shaanxi Province, People’s Republic of ChinaEmail 1684047601@qq.comPurpose: To analyze the risk factors for new vertebral fractures after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures (OVCFs).Patients and Methods: We retrospectively reviewed the records of patients with symptomatic OVCFs who underwent PVP in our hospital, from January 2014 to January 2019. Demographic and lifestyle data on the presence of underlying chronic disease, preoperative bone mineral density, details of vertebral fractures, postoperative osteoporosis treatment, and new fracture development were collected. Patients were divided into postoperative fracture and non-fracture groups. To identify the independent risk factors for new vertebral fracture development, variables significant on univariate analysis were included in a multivariate regression model.Results: Of the 2202 patients treated with PVP, 362 (16.43%) had a new postoperative vertebral fracture. All patients were followed up for > 12 months (mean 14.7 months). Univariate analysis revealed no significant difference in height; body weight; preoperative bone mineral density; number of fractured vertebrae; injection volume of bone cement in a single vertebra; leakage rate of bone cement; or presence of hypertension, coronary heart disease, and chronic obstructive pulmonary disease between the fracture and non-fracture groups (P> 0.05). Age, sex, smoking, alcohol consumption, diabetes mellitus, postoperative exercise, and postoperative osteoporosis treatment were associated with new vertebral fractures (all P< 0.05). A multivariate analysis showed that age (odds ratio [OR]=1.212, P< 0.0001), female sex (OR=1.917, P< 0.0001), smoking (OR=1.538, P=0.026), and diabetes (OR=1.915, P< 0.0001) were positively correlated with new vertebral fracture development, whereas postoperative exercise (OR=0.220, P< 0.0001) and osteoporosis treatment (OR=0.413, P< 0.0001) were negatively correlated.Conclusion: Elderly patients, females, and those with a history of smoking and diabetes are at high risk of new vertebral fracture after PVP. Patients should be encouraged to stop smoking and consuming alcohol, control blood glucose level, participate in sufficient physical activity, and adhere to osteoporosis treatment to prevent new vertebral fractures.Keywords: aged, fractures, compression, osteoporosis, risk factors, spinal fractures, vertebral body

Core–shell nanocomposites based on polyaniline/Ni–Zn ferrite (PANI-NZFO) were successfully fabricated by a method of in situ oxidative polymerization, and the aggregation of Ni–Zn ferrite (NZFO) nanospheres can be controlled through adjusting the weight ratio of NZFO/aniline (NZFO/ANI). As a result, the sample with NZFO/ANI weight ratio of 3:100 exhibits the optimal reflection loss (RL) value of − 46.5 dB. Particularly, PANI-NZFO present excellent dielectric loss (0.18

Background: Resection of the ossification of the thoracic ligamentum flavum (OTLF) with a high-speed burr may cause a high rate of perioperative complications, such as dural laceration and/or iatrogenic spinal cord injury. Objectives: The aim of this study was to investigate the safety and feasibility of the endoscopicmatched ultrasonic osteotome in full-endoscopic spinal surgery for direct removal of OTLF. Study Design: Retrospective study. Setting: All data were from Honghui Hospital in Xi’an. Methods: This study conducted between December 2017 and December 2018, included 27 consecutive patients who met the study criteria, had single-level OTLF, and underwent fullendoscopic decompression under local anesthesia. The postoperative follow-up was scheduled at 1, 3, 6, and 12 months postoperatively. Outcomes evaluations included the Visual Analog Scale (VAS) score for lower extremity pain and the modified Japanese Orthopaedic Association (mJOA) score and improvement rate for the assessment of thoracic myelopathy. Removal of OTLF was measured by comparing the pre- and postoperative computed tomography (CT) and magnetic resonance imaging (MRI) scans. Results: The operation was completed in all patients without conversion to open surgery. The operation time ranged from 65 to 125 minutes (average, 83.7 ± 12.3 minutes). All patients were followed up for 12 to 18 months, with an average follow-up of 14.3 ± 1.3 months. Satisfactory neurologic decompression was confirmed by postoperative CT and MRI, and no revision surgery was required. The VAS and mJOA scores showed statistically higher improvement at the 1-month follow-up and the last follow-up compared with the preoperative assessment (P < 0.05). According to the improvement rate at the final follow-up, 20 cases were classified as good, 6 cases were fair, and 1 case remained unchanged. Limitations: A single-center, noncontrol study. Conclusions: The endoscopic-matched ultrasonic osteotome can be considered quite safe and feasible for direct removal of OTLF during full-endoscopic spinal surgery in strictly selected patients, as this allows for effective direct decompression of OTLF while minimizing trauma and instability. In addition, because of the design characteristics of the ultrasonic osteotome, surgical complications, especially dural tears and spinal cord injury, can also be effectively controlled. Key words: Percutaneous endoscopic spinal surgery, ultrasonic osteotome, ossification of thoracic ligamentum flavum, microsurgery, thoracic myelopathy, minimally invasive procedures

Objective: To construct and validate a predictive model for predicting the risk of major adverse cardiovascular events (maces) in elderly patients with ST-segment elevation myocardial infarction (STEMI) undergoing PCI within 3 years. Methods: This study is a retrospective cohort study. 1745 subjects were randomly divided into modeling cohort and verification cohort according to a ratio of 3:1. LASSO regression model and multivariate Cox regression were used to analyze independent risk factors of major adverse cardiovascular events in elderly STEMI patients who received PCI treatment within 3 years. R software (version 3.5.3) was used to construct a nomogram model to predict the risk of major adverse cardiovascular events in elderly STEMI patients receiving PCI treatment within 3 years, and to compare and verify the model. Results: The results of LASSO regression model and multivariate Cox regression analysis showed that age, history of diabetes, history of atrial fibrillation, cardiac function classification, coronary angiography results, and GRACE risk score were the major adverse cardiovascular diseases in elderly STEMI patients who received PCI treatment within 3 years. Independent risk factors for event risk. The prediction model was verified internally and externally. The AUC value in the modeling cohort was 0.890 (95% CI: 0.856-0.924); the AUC value in the verification cohort was 0.861 (95% CI: 0.830-0.957). The Hosmer-Lemeshow test results indicate that the prediction model has good stability. Conclusion: The simple and easyto- use nomogram model in this study can effectively predict the individualized risk of major adverse cardiovascular events in elderly STEMI patients undergoing PCI treatment within 3 years.

We previously found that Shen-yuan exerted cardioprotective activities in rodent and porcine myocardial infarction (MI) models because of its antioxidative and anti-apoptotic properties. This study aimed to investigate whether the cardioprotective effects from Shen-yuan are due to regulation of haemodynamics and inflammation in a porcine model of acute MI. Myocardial infarction was induced by left anterior descending coronary artery ligation. Low, moderate, and high doses of Shen-yuan treatment were started 1 week before MI and continued for 2 weeks after MI. Whole blood viscosity at 15 s−1 and platelet aggregation rate were significantly increased in the MI group, but were markedly attenuated by high doses of Shen-yuan. A moderate dose of Shen-yuan also restored decreased values of the peak rise of left ventricular pressure and left ventricular mean pressure after MI. Expression of the T regulatory cell marker forkhead box P3 (Foxp3)+ at 14 days post-MI was lower than that in the sham-operated group. Foxp3 was significantly up-regulated in the infarcted and non-infarcted zones of the left ventricle in the Shen-yuan treatment groups. Plasma interleukin-10 and transforming growth factor-β levels were elevated by Shen-yuan treatment in a dose-dependent manner. Shen-yuan elicits cardiovascular protection by its haemodynamic stabilization and anti-inflammatory effects after onset of MI in a porcine model.

Four phenolic compounds were isolated from the roots of Sanguisorba officinalis L. by silica gel column chromatography and preparative HPLC. On the basis of chemical and spectroscopic methods, their structures were identified as methyl 4-O-β-D-glucopyranosy-5-hydroxy-3-methoxylbenzoate (1), 3,3′,4′-tri-O-methylellagic acid (2), fisetinidol-(4α-8)-catechin (3), and (+)-catechin (4). Compound 1 is a new phenolic glycoside and compounds 2 and 3 were isolated from the Sanguisorba genus for the first time. Compounds 1–4 were also assayed for their antioxidant activities using the DPPH free radical assay.

Guided by a hemostasis bioassay, seven terpene glycosides were isolated from the roots of Sanguisorba officinalis L. by silica gel column chromatography and preparative HPLC. On the grounds of chemical and spectroscopic methods, their structures were identified as citronellol-1-O-α-l-arabinofuranosyl-(1→6)-β-d-glucopyranoside (1), geraniol-1-O-α-l-arabinofuranosyl-(1→6)-β-d-glucopyranoside (2), geraniol-1-O-α-l-arabinopyranosyl-(1→6)-β-d-glucopyranoside (3), 3β-[(α-l-arabinopyranosyl)oxy]-19α-hydroxyolean-12-en-28-oic acid 28-β-d-glucopyranoside (4), 3β-[(α-l-arabinopyranosyl)-oxy]-19α-hydroxyurs-12-en-28-oic acid 28-β-d-glucopyranoside (ziyu-glycoside I, 5), 3β,19α-hydroxyolean-12-en-28-oic acid 28-β-d-glucopyranoside (6) and 3β,19α-di-hydroxyurs-12-en-28-oic acid 28-β-d-glucopyranoside (7). Compound 1 is a new mono-terpene glycoside and compounds 2, 3 and 5 were isolated from the Sanguisorba genus for the first time. Compounds 1–7 were assayed for their hemostatic activities with a Goat Anti-Human α2-plasmin inhibitor ELISA kit, and ziyu-glycoside I (5) showed the strongest hemostatic activity among the seven terpene glycosides. This is the first report that ziyu-glycoside Ι has strong hemostatic activity.

Diabetes, as a serious metobolic disorder, poses global threat to human health. It is estimated that over 50 million individuals are already affected by diabetes. Currently, diabetes-related osteoporosis has been a research hotspot due to its high incidence rate in older individuals. Osteoprotegerin, as an important protein for the prevention of osteoporosis, has been proven to be key to the suppression of osteoporosis. Hence, the loss of function of osteoprotegerin may promote the development of osteoporosis. Bergapten, as a natural anti-inflammatory and anti-tumor agent isolated from bergamot essential oil, other citrus essential oils, and grapefruit juice, has been proven to have the ability to attenuate a number of metabolic disorders. In view of these findings, in this study, we used a high-fat diet to construct a mouse model of diabetes-related osteoporosis and a mouse model of diabetes-related osteoporosis using osteoprotegerin knockout mice. Enzyme-linked immunosorbent assay (ELISA), qPCR, western blot analysis, immunohistochemical assay, H&E staining, Oil Red O staining, Masson's staining and other biochemical analyses were used to evaluate the related signaling pathways involved in the development of diabetes-related osteoporosis. We also examined the role of osteoprotegerin in the activation of these pathways and in the development of osteoporosis, as well as the protective effects of bergapten against diabetes-related osteoporosis and on the activation of related signaling pathways. Our results revealed that in diabetes-related osteoporosis, the phosphoinositide 3-kinase (PI3K)/AKT, c-Jun N-terminal kinase (JNK)/mitogen-activated protein kinase (MAPK) and nuclear factor-κB (NF-κB) signaling pathways were activated and the expression levels of related indicators were increased. At the same time, osteoprotegerin knockout further promoted the activation of these pathways. By contrast, bergapten exerted effects similar to those of osteoprotegerin. Bergapten exhibited the ability to significantly inhibit RANKL-RANK signaling transduction, and to suppress the activation of the PI3K/AKT, JNK/MAPK and NF-κB signaling pathways, thus protecting trabecular structure and decreasing osteoclastogenic differentiation.

Experimental studies on the compressive behavior of composite laminates after low velocity impact was carried out with two test methods. One is SACMA Standard, and the other is a small dimensional specimen test method. Impact damage distributions, compressive failure process after impact, quasi-static indentation and compression of laminates with a hole were brought into comparison between these two test methods. The results showed that there is a great difference between these two test methods. Compressive behavior of laminates after impact varies with different test methods. Residual compressive strength of laminates after low velocity impact measured with SACMA Standard can reflect stiffness properties of composite resins more wholely than that measured with the other method can do. Small dimensional specimen test method should be improved on as an experimental standard of compressive strength after impact.

To evaluate the long-term therapeutic effects of atorvastatin via cytochrome P450 (CYP)3A4 pathway or a non-CYP 3A4 pathway statin, pravastatin, combined with clopidogrel for the patients undergoing coronary stenting.Between February 2006 and March 2007, a total of 1275 patients undergoing successful coronary stenting were randomly assigned to receive atorvastatin 20 mg/d (n = 638) or pravastatin 20 mg/d (n = 637). All patients received standard clopidogrel therapy. The primary end point was cardiac and cerebral ischemic events at 12 months, defined as a composite of cardiac death, non-fatal myocardial infarction (MI) or stroke. The secondary end points were major adverse cardiac and cerebral events (MACCE), stent thrombosis and TIMI hemorrhagic events at 12 months.The baseline clinical characteristics, angiographic and PCI result were comparable between two groups. At 12 month follow-up, no significant difference was observed in cardiac and cerebral ischemic events between two groups (4.7% vs 5.5%, P0.05). Also no significant difference existed in rate of cardiac death (1.9% vs 2.5%, P0.05), non-fatal MI (0.5% vs 0.3% , P0.05), stroke (2.4% vs 2.7%, P0.05) and TVR (7.7% vs 5.5%, P0.05) between two groups. The rates of MACCE (12.4% vs 11.0%, P0.05), stent thrombosis (2.0% vs 2.5%, P0.05) and hemorrhagic events (13.0% vs 12.2%, P0. 05) were similar between two groups.The 12 month clinical outcomes were similar between patients receiving atorvastatin 20 mg/d or pravastatin 20 mg/d combined with clopidogrel after coronary stenting. It confirmed the efficacy and safety of the combination of clopidogrel with statins via different metabolic pathways.

Objectives To examine the effect of ginsenoside Re (G-Re) on autophagy in H9c2 cardiomyocyte cells under starvation. Methods H9c2 cells were cultured in glucose-free and serum-free medium for several hours as the glucose deprivation (GD) stimulation. To measure the amount of autophagosome formation, we determined the membrane-bound form of autophagy-related protein LC3B-2 by immunoblotting. To evaluate the situation of autophagy flux, we added 10 nmol/l bafilomycin A 1 (BafA1) into the medium to block the fusion processes between autophagosomes and lysosomes. H9c2 cells under GD were treated with 100 µmol/l G-Re. LC3B-2 measurement and immunofluorescence were conducted to display the effect of G-Re on autophagy in these cells. Cell viability, ATP content, malondialdehyde level and superoxide dismutase activity in cultured medium were determined to appreciate the physiological relevance of autophagy changes due to G-Re treatment. We also assayed phosphorylated AMPKα and mTOR to explore the mechanisms underlying the effect of G-Re on autophagy in cells under GD. Results In H9c2 cells under GD, LC3B-2 increased in a time-dependent manner in association with the decrease of cell viability and cellular ATP content. In H9c2 cell under GD and treated with 100 µmol/l G-Re, LC3B-2 expression decreased, accompanied by the rescue of cell death, the increase of cellular ATP content, and the relief of oxidative stress. The higher p-AMPKα in H9c2 cell under GD decreased when they were treated with 100 µmol/l G-Re, probably relating to the mechanisms underlying the inhibition of autophagosomal formation by G-Re. Conclusions Starvation induced autophagy in H9c2 cells and led to cell injury. Treatment of 100 µmol/l G-Re inhibited autophagosomal formation in the cells, which may be beneficial to the cardiomyocytes under starvation.