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Zhi-Lin Zhang,* Kang-Jia Chen,* Hui Chen,* Miao-Miao Zhu, Jing-Jing Gu, Li-Shuai Jiang, Lan Zheng, Shu-Guang Zhou Department of Gynecology and Obstetrics, Maternal and Child Medical Center of Anhui Medical University, The Fifth Affiliated Clinical College of Anhui Medical University, Anhui Women and Children’s Medical Center, Hefei, Anhui, People’s Republic of China*These authors contributed equally to this workCorrespondence: Shu-Guang Zhou, Email zhoushuguang@ahmu.edu.cn; Lan Zheng, Email zhenglan2022@163.comBackground: Fear of childbirth (FOC) is a psychological state of fear and distress that pregnant women experience when they approach labor. This fear can have significant negative effects on both the mother and the newborn, making it crucial to study the influencing factors of FOC to implement early interventions.Objective: First, identify the risk factors for FOC occurrence, then construct a predictive model for FOC and evaluate its predictive efficiency.Methods: A total of 901 pregnant women who underwent regular prenatal check-ups at Anhui Women and Children’s Medical Center were selected. Participants completed questionnaires. General information and relevant medical data of the patients were collected for data aggregation. The data was randomly divided into a training set (n = 632) and a testing set (n = 269) in a 7:3 ratio. Univariate analysis of risk factors for FOC was performed on the training set data. Using univariate logistic regression and multivariate logistic regression to analyze the risk factors associated with the occurrence of FOC, we constructed a FOC risk predictive model via ten different machine learning methods and evaluated the predictive performance of the model.Results: Our study indicated that educational level, history of adverse pregnancy outcomes, history of cesarean section, planned pregnancy, assisted reproduction, income, payment, SAS scores, and age are independent risk factors for FOC. The risk predictive model included six factors, such as gravidity, history of adverse pregnancy outcomes, history of cesarean section, planned pregnancy, payment, and SSRS scores. The model was built using ten types of machine learning and was evaluated to perform well.Conclusion: Gravidity, history of adverse pregnancy outcomes, history of cesarean section, planned pregnancy, payment method, and SSRS score are risk factors for FOC in late-pregnancy women. The risk predictive model established in this study has a high clinical reference value.Keywords: fear of childbirth, FOC, machine learning, risk factors, predictive model

Various mechanical stresses in vivo induce disc cell apoptosis and intervertebral disc (IVD) degeneration, but the underlying molecular mechanism is not fully known. The aim of this study was to investigate the role of endoplasmic reticulum stress in cyclic stretch-induced apoptosis of rat annulus fibrosus (AF) cells. Flexercell Tension Plus system was used to apply cyclic stretch to rat annulus fibrosus cells at a frequency of 0.5 Hz with 20% elongation for 12, 24, 36, or 48 h. Apoptosis was detected by flow cytometry, and nuclei morphologic changes were visualized by Hoechst 33258 staining and caspase-8, 9 activity assays. The expression of the markers of endoplasmic reticulum stress including CHOP, GRP78, and caspase-12 were determined by RT-PCR and Western blot. Mitochondrial membrane potential change was observed by JC-1 staining in situ. In addition, the levels of the nitric oxide (NO) were determined with the Griess reaction and fluorescence staining. The results indicated that cyclic stretch at a frequency of 0.5 Hz with 20% elongation-induced apoptosis in rat AF cells. Prolonged exposure of the unphysiologically cyclic stretch to AF cells caused NO overproduction, up-regulation of endoplasmic reticulum stress markers including CHOP, GRP78, and caspase-12, depolarization of mitochondria and activation of caspase-9. However, cyclic stretch at this level had no effect on caspase-8 activity. In addition, specific inhibitor of caspase-12 (Z-ATAD-FMK) and caspase-9 (Z-LEHD-FMK) partly suppressed cyclic stretch-induced AF cell apoptosis and the anti-apoptotic effects of the caspase inhibitors were additive. Our data suggest that endoplasmic reticulum stress, likely mediated by NO, contributes to the AF cell apoptosis induced by cyclic stretch in addition to the mitochondrial pathway. These findings could be helpful to understand the mechanism of disc cell apoptosis, the root cause of IVD degeneration. [ABSTRACT FROM AUTHOR]

Cervical spondylotic amyotrophy is characterized with weakness and wasting of upper limb muscles without sensory or lower limb involvement. Two different mechanisms have been proposed in the pathophysiology of cervical spondylotic amyotrophy. One is selective damage to the ventral root or the anterior horn, and the other is vascular insufficiency to the anterior horn cell. Cervical spondylotic amyotrophy is classified according to the most predominantly affected muscle groups as either proximal-type (scapular, deltoid, and biceps) or distal-type (triceps, forearm, and hand). Although cervical spondylotic amyotrophy always follows a self-limited course, it remains a great challenge for spine surgeons. Treatment of cervical spondylotic amyotrophy includes conservative and operative management. The methods of operative management for cervical spondylotic amyotrophy are still controversial. Anterior decompression and fusion or laminoplasty with or without foraminotomy is undertaken. Surgical outcomes of distal-type patients are inferior to those of proximal-type patients. [ABSTRACT FROM AUTHOR]

STUDY DESIGN.: An in vitro and in vivo experimental study. OBJECTIVE.: This study was undertaken to evaluate differences in the capability of inducing an implant-centered infection between Staphylococcus aureus and Mycobacterium tuberculosis. SUMMARY OF BACKGROUND DATA.: Bacterial infection is still one of the most serious and devastating complications after orthopedic implant surgery despite the advent of new antibiotics and treatment methods. METHODS.: S. aureus and M. tuberculosis were separately cultured with titanium plates. The bacteria colonized on the plates were isolated and cultured on culture medium. They were evaluated and compared by colony-forming units enumeration. Scanning electron microscopy was used to evaluate the difference in the colonization features of the 2 pathogens. In the in vivo experiment, 22 dogs were used to assess the susceptibility to infection after a local bacterial challenge with either S. aureus or M. tuberculosis. RESULTS.: S. aureus showed heavy adhesion and multiplication on the surface of titanium plates in vitro, whereas M. tuberculosis rarely adhered to the surface of the plates. Under scanning electron microscopy, S. aureus colonization was observed: the coccoid was widespread on the surface of the plates but only a few M. tuberculosis cells scattered on the surface of the plates. In in vivo test, the infection rateforthe S. aureus inoculation was higher than that for the M. tuberculosis challenge. The infection rate for the entire test population (n = 44 sites) was 39.58% (19/48). The infection rates were 54.17% (13/24) for the S. aureus challenge and 25% (6/24) for the M. tuberculosis challenge, respectively (P < 0.05). CONCLUSION.: It is less likely for M. tuberculosis to adhere and form a biofilm on an implant surface than S. aureus. Under otherwise identical conditions, M. tuberculosis contamination following instrumented spine surgery might lead to less occurrence of infection than S. aureus contamination. [ABSTRACT FROM AUTHOR]

STUDY DESIGN: A randomized, controlled follow-up study to review patients with acute thoracolumbar burst fractures treated by anterior instrumentation and reconstruction. OBJECTIVE: The objective of this study was to evaluate the results of anterior instrumentation in the treatment of thoracolumbar burst fractures and to determine whether anterior-only approach would be sufficient for highly unstable burst fractures. In this prospective follow-up study, we also compared the results of anterior reconstruction with structural grafting and with titanium mesh cage in a randomized fashion. SUMMARY OF BACKGROUND DATA: Anterior decompression and reconstruction supplemented with instrumentation is generally believed to be superior to fixation with posterior pedicle screw instrumentation for a highly unstable burst fracture, but the indications and methods for anterior approach has not been fully documented. METHODS: A total of 65 patients undergoing anterior plating for a thoracolumbar burst fracture with a load-sharing score of 7 or more between 2000 and 2003 were included this study. They were randomized to receive iliac crest autograft (group A, n = 32) or titanium mesh cages (group B, n = 33). The patients were similar in the distribution of 3-column injuries (n = 8 in group A vs. n = 9 in group B). During the minimum 4-year (range, 4-7 years) follow-up period, all patients were prospectively evaluated for clinical and radiologic outcomes. The Frankel scale, the ASIA motor score, and the Short Form 36 were used for clinical evaluation, whereas the fusion status and the loss of kyphosis correction for the local kyphosis angle were examined for radiologic outcome. RESULTS: All patients in this study achieved solid fusion, with significant neurologic improvement and no significant correction loss as defined by loss of kyphosis correction. The clinical and radiologic results were not significantly different (P > 0.05) at all time points between the 2 groups A and B. Twenty-six of 32 patients in group A still complained of donor site pain to some degree at the final follow-up. No significant impact of 3-column injuries (P > 0.05) were identified on the results for all comparisons. CONCLUSION: Anterior-only instrumentation and reconstruction with structural autograft or titanium mesh cages is sufficient for surgical treatment of thoracolumbar burst fractures with a load-sharing score of > or = 7 and even with 3-column injuries. [ABSTRACT FROM AUTHOR]

Background: The impact of fusion as a supplement to short-segment instrumentation for the treatment of thoracolumbar burst fractures is unclear. We conducted a controlled clinical trial to define the effect of fusion on lumbar spine and patient-related functional outcomes.Methods: From 2000 to 2002, seventy-three consecutive patients with a single-level Denis type-B burst fracture involving the thoracolumbar spine and a load-sharing score of Results: No significant difference in radiographic or clinical outcomes was noted between the patients managed with the two techniques. Both operative time and blood loss were significantly less in the nonfusion group compared with the fusion group (p < 0.05). Twenty-five of the thirty-seven patients in the fusion group still had some degree of donor-site pain at the time of the latest examination.Conclusions: Posterolateral bone-grafting is not necessary when a Denis type-B thoracolumbar burst fracture associated with a load-sharing score of

For patients with ossification of the posterior longitudinal ligament (OPLL) who have neurological-symptoms, surgery is necessary but not always effective. Various clinical factors influence the surgical outcome. The studies identifying these factors have been inconclusive and conflicting. It is essential for surgeons to understand the significance of the factors and choose the optimal therapeutic strategy for OPLL. The objective of this review is to determine the clinical factors predictive of the surgical outcome of cervical OPLL. The authors conducted a review of literature published in the English language. They examined studies in which the correlation between clinical factors and outcome were statistically evaluated. The results showed that the traverse area of the spinal cord, the spinal cord-evoked potentials (SCEPs), the increase of the range of motion in the cervical spine (ROM), diabetes, history of trauma, the onset of ossification of the ligament flavum (OLF) in the thoracic spine, snake-eye appearance (SEA) and incomplete decompression may be predictive factors. Age at surgery seems to be closely related to the outcome of posterior surgical procedure. Whether the neurological score, OPLL type, pre-operative duration of symptoms, focal intra-medullar high signal intensity in T2-weighted (IMHSI) and progression of OPLL or kyphosis and expansion of the spinal canal predict the surgical outcome remains unclear. The use of uniform neurological score and proper statistic analysis should facilitate comparison of data from different studies. It is important to analyze the effect of each factor on groups with different surgical procedures as well as patients with different compressive pathology. Research on the etiology and pathology of cervical myelopathy due to OPLL should be helpful in precisely understanding these clinical factors and predicting surgical outcome. [ABSTRACT FROM AUTHOR]

Study Design: A prospective, randomized clinical study comparing beta-tricalcium phosphate (beta-TCP) with autograft bone graft with follow-up of 3 years. Objective: To determine the efficacy of beta-TCP as a bone graft substitute combined with local autograft obtained from decompression compared with the use of autologous iliac crest bone graft in single-level instrumented posterolateral lumbar fusion. Summary Of Background Data: A variety of bone graft substitutes have been used in posterolateral lumbar fusion with different efficacy reported, but no controlled study was conducted on the clinical performance of beta-TCP in instrumented posterolateral lumbar fusion. Methods: Sixty-two patients with symptomatic degenerative lumbar spinal stenosis were treated with single-level instrumented posterolateral lumbar fusion. They were randomly assigned to fusion with beta-TCP combined with local bone obtained from the decompression (group A, n = 32) or autogenous iliac crest bone graft plus decompression bone (group B, n = 30). The patients were observed up for 3 years after surgery. The results were assessed clinically and radiographically. Results: There were no significant differences in recovery rate of Japanese Orthopedic Association score and SF-36 score at all time intervals. Successful radiographic fusion was documented in all patients in both treatment groups. All patients in group B, however, complained bone graft donor site pain although significant improvement of pain was observed during the follow-up. Conclusion: Instrumented posterolateral fusion with beta-TCP combined with local autograft results in the same radiographic fusion rates and similar improvement of clinical outcomes and life quality compared with autograft alone. The authors therefore recommend the use of beta-TCP as bone graft substitute for instrumented posterolateral fusion of lumbar spine to eliminate the need of bone grafting harvesting from the ilium. [ABSTRACT FROM AUTHOR]

A variety of bone graft substitutes, interbody cages, and anterior plates have been used in cervical interbody fusion, but no controlled study was conducted on the clinical performance of beta-tricalcium phosphate (beta-TCP) and the effect of supplemented anterior plate fixation. The objective of this prospective, randomized clinical study was to evaluate the effectiveness of implanting interbody fusion cage containing beta-TCP for the treatment of cervical radiculopathy and/or myelopathy, and the fusion rates and outcomes in patients with or without randomly assigned plate fixation. Sixty-two patients with cervical radiculopathy and/or myelopathy due to soft disc herniation or spondylosis were treated with one- or two-level discectomy and fusion with interbody cages containing beta-TCP. They were randomly assigned to receive supplemented anterior plate (n = 33) or not (n = 29). The patients were followed up for 2 years postoperatively. The radiological and clinical outcomes were assessed during a 2-year follow-up. The results showed that the fusion rate (75.0%) 3 months after surgery in patients treated without anterior cervical plating was significantly lower than that (97.9%) with plate fixation (P < 0.05), but successful bone fusion was achieved in all patients of both groups at 6-month follow-up assessment. Patients treated without anterior plate fixation had 11 of 52 (19.2%) cage subsidence at last follow-up. No difference (P > 0.05) was found regarding improvement in spinal curvature as well as neck and arm pain, and recovery rate of JOA score at all time intervals between the two groups. Based on the findings of this study, interbody fusion cage containing beta-TCP following one- or two-level discectomy proved to be an effective treatment for cervical spondylotic radiculopathy and/or myelopathy. Supplemented anterior plate fixation can promote interbody fusion and prevent cage subsidence but do not improve the 2-year outcome when compared with those treated without anterior plate fixation. [ABSTRACT FROM AUTHOR]

Extreme lateral lumbar disc herniations (ELLDHs) occur more frequently among elderly patients, with a peak incidence in the sixth decade, and are rarely found in children. The patient presented is a 12-year-old boy with a 3-month history of right-sided leg pain. Computerized tomography and magnetic resonance imaging demonstrated an extreme lateral disc herniation on the right at L4-L5 with compression of the L4 nerve root. He subsequently underwent removal of extreme lateral herniated disc through an intertransverse approach under general anesthesia. At 11-month follow-up, the patient maintained resolution of preoperative symptoms and a neurological examination revealed no sensory or motor deficit. Surgical intervention may be indicated for patients with ELLDHs that fail with conservative treatment. [ABSTRACT FROM AUTHOR]

Traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process is very rare, and only ten cases have been previously reported. The objective of this paper was to describe a case of traumatic posterior atlantoaxial dislocation without related fracture of the odontoid process, and its management with atlantoaxial transarticular screw fixation and bony fusion through an anterior retropharyngeal approach, and to review the relevant literature. The patient's medical and radiographic history is reviewed as well as the relevant medical literature. Posterior atlantoaxial dislocation was confirmed in a 48-year-old male struck by an automobile through conventional radiography, computed tomography and magnetic resonance imaging. No related fracture of the odontoid process or neurological deficit was found in this patient. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach was performed after several unsuccessful attempts of closed reduction. At the latest follow-up, the lateral cervical spine radiography in flexion and extension demonstrated no instability of the atlantoaxial complex 21 months after the operation. In conclusion, patients with posterior atlantoaxial dislocation without fracture may survive with few or no-long term neurological deficit. Routine CT and MRI of the cervical spine should be carried out in patients with head or neck trauma to prevent missing of this rare clinical entity. Transarticular screw fixation of the atlantoaxial articulation through anterior retropharyngeal approach is safe and useful in case the management of dislocation is unsuccessful under closed reduction. [ABSTRACT FROM AUTHOR]

Objectives: Various percent canal occlusion measurement methods have been used to assess the spinal canal stenosis following a thoracolumbar burst fracture. However, there are no studies performed comparing these techniques. The objective of this study was to determine the reliability of three techniques used to measure the spinal canal stenosis in thoracolumbar burst fractures on lateral radiograph and CT scans, and to identify the most reliable and practical method of assessment. Methods: Fifty preoperative lateral radiographs and axial computed tomography (CT) scans of thoracolumbar burst fractures were analyzed by five observers in two sessions. The three measurement techniques were tested: the ratio of sagittal diameter of spinal canal at the injury level to that at the adjacent level on lateral plain radiographs (Ratio 1) and on axial CT scans (Ratio 2); and the ratio of cross-sectional area of spinal canal at the injury level to that at the adjacent level on axial CT scans (Ratio 3). Interobserver and intraobserver reliability for each measure was assessed. Results: Greater coefficient of variation (CV) of measurement was founded for the Ratio 1 obtained from lateral plain radiographs than the other two ratios (Ratio 2 and 3) from CT scans (P<0.05), while no differences of CV were noted between the Ratio 2 and Ratio 3 with CT scans (P>0.05). There was no significant improvement (P>0.05) of the interobserver agreement after a 3-month interval for all three methods. A high significant positive correlation was observed between Ratio 1 and Ratio 2, Ratio 1 and Ratio 3, and Ratio 2 and Ratio 3 (P<0.05 for all). Conclusions: CT scans are more reliable than plain radiographs in the evaluation of spinal canal occlusion in thoracolumbar burst fractures although the agreement might be acceptable for the latter. Measurement of sagittal diameter of spinal canal using CT scan might be a more reasonable choice than of cross-sectional area of spinal canal because of its simplicity and comparable measurement reliability. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects and potential mechanisms of chemokine-like factor-like MARVEL transmembrane domain-containing Protein 3 (CMTM3) on the proliferation and migration of glioblastoma (GBM) cells. Methods: Using CMTM3 expression data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) databases, we analyzed the differential expression of CMTM3 in GBM tissues and its impact on the prognosis of GBM patients. Immunohistochemical staining and protein content determination of CMTM3 was performed on GBM and adjacent non-cancerous tissue samples from 11 GBM patients who underwent surgical treatment at the Affiliated Hospital of Guizhou Medical University between November 3, 2022 and March 15, 2023. Additionally, the expression of CMTM3 was validated in GBM cell lines U87, U251, LN229, and the human astrocyte (NHA) cell line using real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot analyses. Stable cell lines with silenced and overexpressed CMTM3 (sh-CMTM3 group and OE-CMTM3 group) were constructed using U251 cells. The effect of CMTM3 expression on cell proliferation was assessed using the Cell Counting Kit-8 (CCK-8) assay. Flow cytometry was employed to examine the impact of CMTM3 expression on the cell cycle. Transwell assays were conducted to evaluate the influence of CMTM3 expression on cell migration. Bioinformatics analysis, Western blotting, NF-κB activation-nuclear translocation assays, and the NF-κB pathway inhibitor pyrrolidine dithiocarbamate ammonium (PDTC) were used to validate the effect of CMTM3 on the NF-κB pathway. Finally, a subcutaneous tumorigenesis assay in nude mice was performed to observe the impact of CMTM3 expression on the in vivo growth of U251 cells. Results: Bioinformatics analysis revealed that CMTM3 is highly expressed in GBM tissues. Patients with a high CMTM3 expression had lower overall survival (OS) and disease-free survival (DFS) rates compared with those with a low CMTM3 expression (with P values of 0.010 and 0.032, respectively). Among the 11 GBM pathological specimens, 10 samples exhibited higher CMTM3 protein expression levels in the cancerous tissue compared with the adjacent non-cancerous tissue. The average CMTM3 protein expression in these samples was 0.44±0.09, significantly higher than that in the adjacent non-cancerous tissues (0.12±0.02, P ＜0.001). In one sample, the difference in CMTM3 protein expression between the cancerous and adjacent non-cancerous tissues was not statistically significant ( P =0.750).The RT-qPCR results showed that the mRNA expression level of CMTM3 in NHA cells was 1.0±0.1, whereas in GBM cells U87, LN229, and U251, the levels were 2.1±0.3, 3.4±0.5, and 3.7±0.8, respectively, all significantly higher than that in NHA cells (all P ＜0.01). Western blot results demonstrated that the protein expression levels of CMTM3 in GBM cells U87, LN229, and U251 were 1.5±0.2, 1.8±0.2, and 1.9±0.1, respectively, also higher than that in NHA cells (0.7±0.2, all P ＜0.01), with the highest level observed in U251 cells. The CCK-8 assay, Flow cytometry, and Transwell migration experiments indicated that cell viability was inhibited in the sh-CMTM3 group, with an increase in the proportion of cells in the G 0 /G 1 phase ( P ＜0.01) and a decrease in the S phase ( P ＜0.01), and the number of migrated cells was 233.6±35.5, lower than that in the sh-NC group ( P ＜0.001). Conversely, the OE-CMTM3 group showed enhanced cell viability, a reduction in the proportion of cells in the G 0 /G 1 phase ( P ＜0.01), and an increase in the S phase ( P ＜0.01), and the number of migrated cells was 1212.0±20.8, higher than that in the OE-NC group ( P ＜0.001). However, in the OE-CMTM3+PDTC group, cell viability, cell cycle distribution (G 1 , S, and G 2 phases), and cell migration numbers showed no significant changes (all P ＞0.05). Western blot analysis and NF-κB activation-nuclear translocation assay results indicated that in the sh-CMTM3 group, the p-p65/p65 ratio was 0.51±0.04 and the p-IκBα/IκBα ratio was 0.39±0.03, both lower than those in the sh-NC group (both P ＜0.01). The cytoplasmic staining rate was (49.29±1.98)%, higher than that in the sh-NC group ( P ＜0.01). In the OE-CMTM3 group, the p-p65/p65 ratio was 2.27±0.10 and the p-IκBα/IκBα ratio was 2.14±0.15, both higher than those in the OE-NC group (both P ＜0.01). The cytoplasmic staining rate was (18.96±1.44)%, lower than that in the OE-NC group ( P ＜0.01). In the OE-CMTM3+PDTC group, there were no significant differences in the p-p65/p65 ratio, p-IκBα/IκBα ratio, and cytoplasmic staining rate compared with the OE-NC group (all P ＞0.05). The subcutaneous tumorigenesis assay in nude mice showed that the tumor volume in the sh-CMTM3 group was (408.9±96.2) mm³, smaller than that in the sh-NC group ( P =0.003). The tumor volume in the OE-CMTM3 group was (1 514.5±251.5) mm³, larger than that in the OE-NC group ( P =0.005). Conclusions: In GBM, CMTM3 is highly expressed and negatively correlated with both OS and DFS of patients. CMTM3 regulates the proliferation and migration abilities of U251 cells through the NF-κB signaling pathway.

Trace contaminants are toxic and their widespread presence in the environment potentially threatens human health. The levels of these pollutants are often difficult to determine directly using instruments owing to the complexities of environment matrices. Hence, pretreatment steps, such as sample purification and concentration, are key along with various processes that enhance the accuracy and sensitivity of the detection method. To date, researchers have successfully developed a variety of efficient and reliable sample-pretreatment techniques that are based on different principles. Among these, magnetic solid-phase extraction (MSPE) is a rapid and efficient sample-pretreatment technology that is based on the similar solid-phase-extraction (SPE) principle, which mainly enriches target analytes by exploiting their interactions with functional groups on the surfaces of magnetic materials, thereby achieving rapid separation when an external magnetic field is applied. MSPE has been a focus of attention in the environmental-sample-pretreatment, food-analysis, and other fields owing to advantages that include ease of operation, low cost, and high enrichment efficiency. The selection of the magnetic material is key to MSPE process because traditional magnetic materials exhibit certain functionality limitations. Accordingly, designing and synthesizing green and efficient functionalized magnetic materials have become a research focus in this field, with researchers having extensively explored multiple ways of preparing functionalized modified magnetic materials through the introduction of a variety of emerging materials, including metal-organic frameworks (MOFs), covalent organic frameworks (COFs), carbon nanotubes (CNTs), graphene oxide (GO), and other specific functional groups to modify magnetic materials and effectively expanded the applications scope of MSPE. Among these, COFs are porous crystalline materials consisting of light elements (C, N, H, O and B, etc.) linked through covalent bonds. COFs are mainly classified as imine COFs, boronic-acid COFs, triazine COFs, and ketenimine COFs according to bonding type. Moreover, it is worth mentioning that COFs can be synthesized from a number of monomers, and the functional groups exposed on the COF surface can also be used for further modification purposes. COFs are versatile and modifiable; consequently, they have attracted significant research attention, with a series of COF-functionalized magnetic materials having been designed and synthesized. The magnetic COFs (MCOFs) combine the advantages of COFs and magnetic materials. MCOFs are not only endowed with the large specific surface areas, high porosities, and good stabilities that are characteristic of COFs, but also exhibit the rapid separation and reusability characteristics of magnetic material, thereby quickly and efficiently enriching targets through hydrogen bonding, hydrophobicity, π-π stacking, and van der Waals forces, making them ideal sample-pretreatment materials. MCOFs have also been converted into more-versatile functional materials using post-modification strategies. Combining MCOFs with advanced analytical techniques, such as high performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) has effectively improved the limits of detection (LODs) for various analytes as well as method accuracy; these techniques have been widely used to enrich and detect trace pollutants. However, some material design and synthesis challenges remain and need to be overcome, despite the promising potential of MCOFs. Future research needs to focus on exploring novel synthetic strategies that reduce experimental costs and improve the functionalities of MCOFs while expanding their applicabilities to broader sample matrices. In this review, we first introduce and discuss the construction and functionalized designs of various MCOF composites, and then summarize their use in applications that include the enrichment and detection of pesticides, endocrine disruptors (EDCs), pharmaceuticals, and personal care products (PPCPs), and finally provide an outlook on future developmental prospects.

Objective: Coronal malalignment is a common feature of adult spinal deformity, and accurate classification is essential for diagnosis and treatment planning. However, variations in interpretation among clinicians can impact classification consistency. By assessing the reliability and applicability of these systems across different medical experts, this study seeks to establish a standardized approach to enhance clinical outcomes. This study aimed to evaluate the inter- and intra-observer agreement of two classification systems for coronal malalignment in adult spinal deformity patients, as proposed by Qiu et al. and Obeid et al., Methods: We analyzed 70 cases of adult spinal deformity collected between January 1, 2010, and April 20, 2023, using the classification systems proposed by Qiu et al. and Obeid et al. To assess inter- and intra-rater agreement, the same group of researchers re-evaluated all cases in a random order after a 4-week interval. We used the kappa statistic (κ) for inter- and intra-rater agreement assessment., Results: Qiu's classification system: Inter-rater agreement: Substantial agreement (κ = 0.76; 95% CI: 0.72-0.80) for Type A, Type B, and Type C. Intra-rater agreement: Nearly perfect agreement (κ = 0.83; 95% CI: 0.78-0.89) within raters for Type A, Type B, and Type C. Obeid's classification system: Inter-rater agreement: Almost perfect agreement (κ = 0.85; 95% CI: 0.83-0.87) for Type 0, Type 1, and Type 2. Complete system: Substantial agreement (κ = 0.68; 95% CI: 0.65-0.71) for all types and subtypes. Intra-rater agreement: Almost perfect at the type level (κ = 0.88; 95% CI: 0.83-0.93) and substantial at the subtype level (κ = 0.75; 95% CI: 0.65-0.85)., Conclusions: The research findings indicate a high level of agreement between the classification system described by Qiu et al. and the classification system proposed by Obeid et al. This agreement supports the widespread adoption and utilization of these classification systems in future clinical studies., (© 2025 The Author(s). Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Objective: To investigate the effects of physiotherapeutic scoliosis-specific exercises (PSSE) on coronal, horizontal, and sagittal deformities of the spine in adolescent idiopathic scoliosis (AIS) as well as how curve severity, intervention duration, and intervention type could modify these effects., Data Sources: Data sources included PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases, which were searched from their inception to September 5, 2023., Study Selection: Clinical controlled trials reporting the effects of PSSE on the Cobb angle, angle of trunk rotation (ATR), thoracic kyphosis (TK), or lumbar lordosis in patients with AIS aged 10-18 years. The experimental groups received PSSE; the control groups received standard care (observation or bracing) or conventional exercise such as core stabilization exercise, Pilates, proprioceptive neuromuscular facilitation, and other nonspecific exercises., Data Extraction: Two researchers independently extracted key information from eligible studies. The quality of the studies was assessed using the Cochrane Handbook version 5.1.0 risk of bias assessment and the JBI Center for Evidence-Based Health Care (2016) of quasi-experimental research authenticity assessment tool. The level and certainty of evidence were rated according to the Grading of Recommendations, Assessment, Development, and Evaluation framework. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The protocol for this study was registered in PROSPERO (CRD42023404996)., Data Synthesis: Twelve randomized controlled trials (RCTs) and 5 non-RCTs were meta-analyzed separately. The results indicated that compared with other nonsurgical management, PSSE significantly improved the Cobb angle, ATR, and TK, whereas the lumbar lordosis improvement was not statistically significant. Additionally, the efficacy of PSSE on Cobb angle was not significant in patients with curve severity ≥30° compared with controls. Nevertheless, the pooled effect of PSSE on Cobb angle was not significantly modified by intervention duration and intervention type and that on ATR was not significantly modified by intervention duration. The overall quality of evidence according to Grading of Recommendations, Assessment, Development, and Evaluation was moderate to low for RCT and very low for non-RCT., Conclusions: PSSE exhibited positive benefits on the Cobb angle, ATR, and TK in patients with AIS compared with other nonsurgical therapies. In addition, the effectiveness of PSSE may be independent of intervention duration and intervention type but may be influenced by the initial Cobb angle. However, more RCTs are needed in the future to validate the efficacy of PSSE in moderate AIS with a mean Cobb angle ≥30°. Current evidence is limited by inconsistent control group interventions and small sample size of the studies., (Copyright © 2024. Published by Elsevier Inc.)

Black garlic has a variety of biological activities, but many consumers cannot accept it because of the garlic odor and the bitter taste. In this study, fermentation with yeast Wickerhamomyces anomalus was adopted to improve the flavor of black garlic juice. Although fermentation reduced antioxidant activities, the garlicky odor and bitter taste were weakened. Metabolomic analysis revealed 141 metabolites were significantly differentially regulated. The upregulated metabolites were mainly related to nucleotides, organic acids and their derivatives, while the downregulated metabolites were mainly related to amino acids, lipids and their derivatives. Flavoromics analysis revealed that 137 metabolites were significantly differentially regulated, particularly garlicky and pungent volatiles were significantly downregulated. Correlation analysis indicated that esters are most closely related to nonvolatile metabolites, and lipids degradation was significantly correlated with volatiles. The results indicated that W. anomalus fermentation is an effective strategy to improve the flavor of black garlic juice., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Reduced feed intake in early lactation prompts increased fat mobilization to meet dairy cow energy needs for milk production. The increased lipolysis in cows presents significant health risks with unclear mechanisms. The objectives of our study were to compare the longitudinal profiles of metabolites and lipids of serum from high- and low-lipolysis cows. Forty multiparous Holstein dairy cows were enrolled in the retrospective study. Serum samples were collected on d 7 before expected calving, as well as on d 5, 7, 14, and 21 postpartum. Dairy cows were grouped according to mean serum nonesterified fatty acids on d 5 and 7 after parturition as low (<0.600 mmol/L; n = 8; LFM) and high (>0.750 mmol/L; n = 8; HFM), indicating fat mobilization during early lactation. Lactational performance and serum metabolic parameters related to glucose and lipid metabolism, liver functions, oxidative status, and inflammatory responses were determined. Serum samples were subjected to liquid chromatography-MS-based metabolomics and lipidomics. Despite differences in postpartum BW change, there were no observed variations in milk yield and composition between the 2 groups. Serum β-hydroxybutyric acid, glucose, leptin, aspartate aminotransferase, IL-6, and tumor necrosis factor alpha were greater in cows with HFM than in cows with LFM. Serum adiponectin, revised quantitative insulin sensitivity check index, and albumin were lower in cows with HFM than in cows with LFM. Intensified fat mobilization in the HFM cows came along with reduced estimated insulin sensitivity, impaired liver functions, and increased oxidative stress and inflammatory responses. Differences in metabolic patterns were observed across the transition period when comparing serum blood matrixes (e.g., in different amino acids, acylcarnitines, and sphingolipids). The serum metabolome of the HFM cows was characterized by higher concentrations of glycine, acylcarnitines, carnosine, Cer(d20:0/18:0), Cer(d18:1/16:0), and Cer(t18:0/24:0) compared with LFM cows. The differential serum metabolites and lipids at different sampling times during the peripartum period were enriched in the sphingolipid metabolism. Differences in serum metabolic status parameters suggest that cows adopt varied metabolic adaptation strategies to cope with energy deficits postpartum. Our investigation found a comprehensive remodeling of the serum metabolic profiles in transition dairy cattle, highlighting the significance of alterations in sphingolipid species, as they play a crucial role in insulin resistance and metabolic disorders., (The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Fresh yak meat is highly nutritious and prone to spoilage, so developing suitable preservation methods is crucial. In this study, hydrogel coatings composed of konjac glucomannan, Lactiplantibacillus plantarum and gallic acid (KGX) were applied to preserve fresh yak meat under ice temperature (-1 °C). After 16 days, KGX group showed lowest total viable count (5.3 ± 0.1 log cfu/g) and total volatile basic nitrogen (13.02 ± 1.40 mg/100 g), which did not exceed the relevant standards of fresh meat. Combined assessments of color, texture, pH, drip loss rate, and thiobarbituric acid reactive substances indicated that KGX coating effectively prolonged yak meat preservation. High-throughput sequencing revealed that KGX coating effectively reduced the abundance of Pseudomonas and Candida . The application of L. plantarum hydrogel coatings in conjunction with ice temperature increased the shelf life of fresh yak meat to 16-20 days, suggesting its potential as a viable preservation method for fresh meat., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purpose: Bone metastasis (BoM) has been closely associated with increased morbidity and poor survival outcomes in patients with non-small cell lung cancer (NSCLC). Given its significant implications, this study aimed to systematically compare the biological characteristics between advanced NSCLC patients with and without BoM. Methods: In this study, the genomic alterations from the tumor tissue DNA of 42 advanced NSCLC patients without BoM and 67 patients with BoM and were analyzed by a next-generation sequencing (NGS) panel. The serum concentrations of 18 heavy metals were detected by inductively coupled plasma emission spectrometry (ICP-MS). Results: A total of 157 somatic mutations across 18 mutated genes and 105 somatic mutations spanning 16 mutant genes were identified in 61 out of 67 (91.05%) patients with BoM and 37 of 42 (88.10%) patients without BoM, respectively. Among these mutated genes, NTRK1 , FGFR1 , ERBB4 , NTRK3 , and FGFR2 stood out exclusively in patients with BoM, whereas BRAF , GNAS , and AKT1 manifested solely in those without BoM. Moreover, both co-occurring sets of genes and mutually exclusive sets of genes in patients with BoM were different from those in patients without BoM. In addition, the serum concentrations of Cu and Sr in patients with BoM were significantly higher than in patients without BoM. One of our aims was to explore how these heavy metals associated with BoM interacted with other heavy metals, and significant positive correlations were observed between Cu and Co, between Cu and Cr, between Sr and Ba, and between Sr and Ni in patients with BoM. Given the significant impacts of molecular characteristics on patients' prognosis, we also observed a noteworthy negative correlation between EGFR mutations and Co, alongside a significant positive correlation between TP53 mutations and Cd. Conclusions: The genomic alterations, somatic interactions, key signaling pathways, functional biological information, and accumulations of serum heavy metals were markedly different between advanced NSCLC patients with and without BoM, and certain heavy metals (e.g., Cu, Sr) might have potentials to identify high-risk patients with BoM., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Campylotropis xinfeniae , a new species from the dry-hot valley of the Jinsha River in the Yunnan province, China, is described and illustrated. It is morphologically similar to C. wilsonii and C. brevifolia in having glabrescent old branches, absent stipels, 3-foliolate leaves, and adaxially puberulent leaflets, while it differs from the latter two in having often paniculate inflorescences, obviously white standard, not incurved sickle keel, larger narrowly oblique legumes, and longer legume beak. The complete chloroplast genome of this new species is 149,073 bp in length and exhibits a typical quadripartite structure. Phylogenetic analyses based on the complete chloroplast genome also supported C. xinfeniae as a new species located at the basal distinct clade of the genus Campylotropis , clearly separated from the remaining members of the genus and its allied genera. A conservation assessment of data deficient (DD) is recommended for the new species without extensive exploring of similar habitats according to the IUCN Categories and Criteria., Competing Interests: There is no conflict of interest to declare., (© 2024 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.)

Three previously undescribed compounds including a polyketide (1) and two lactams (2 and 3) were obtained from Tuber indicum. The structures of new findings were elucidated by HRESIMS, NMR as well as NMR and ECD calculations. Transcriptome analysis through RNA-seq revealed that compound 2 exhibits immunosuppressive activity. Lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages were employed as a model to explore the effect of these compounds in immunosuppressive activity. The results showed that 2 could reduce the generation of inflammatory mediators including nitric oxide (NO), reactive oxygen species (ROS), interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), cyclooxygenase 2 (COX-2) and inducible nitric oxide synthase (iNOS). Western blotting analysis demonstrated that 2 could suppressed the PI3K pathway by decreasing the levels of p-PI3K and p-Akt, while increasing the levels of p-PTEN. The anti-inflammatory activity of 2 was further confirmed using a zebrafish in vivo model., Competing Interests: Declaration of Competing Interest The authors did not report any potential conflicts of interest., (Copyright © 2023. Published by Elsevier B.V.)

Purpose: To investigate the effect of endoscopy-aided non-incisional periodontal regeneration technique (NIT) in the treatment of alveolar bone angular resorption., Methods: Thirteen patients with severe periodontitis(13 diseased teeth) were selected. All patients had alveolar bone angular resorption on adjacent surface. The patients received NIT treatment 6 weeks after periodontal primary therapy. The visualization of subgingival environment was acquired by the periodontal endoscopy. Following the removal of the subgingival plaque, calculus and intra-bony granulation tissue, bone grafting materials were placed into the intra-bony defects with the assistance of a delicate gingival protector. No flap was elevated and no sutures were applied. Probing depth (PD), gingival recession (GR), clinical attachment level (CAL), as well as radiographic parameters were evaluated at baseline and 2 years after treatment. SPSS 22.0 software package was used for data analysis., Results: At 2-years follow-up, an average CAL gain of (3.65±2.10) mm (P＜0.001), PD reduction of (4.42±1.66) mm (P＜0.001), and minimal increase in GR of (0.38±0.87) mm (P=0.25) were observed. Alveolar bone was significantly improved at 2-years follow-up on radiographs (P＜0.001)., Conclusions: For angular resorption site of alveolar bone, NIT treatment can obtain good periodontal regeneration results without flap inversion.

Background: In a randomized trial, Lianhuaqingwen (LHQW) capsule was effective for accelerating symptom recovery among patients with coronavirus disease 2019 (COVID-19). However, the lack of blinding and limited sample sizes decreased the level of clinical evidence., Objectives: To evaluate the efficacy and safety of LHQW capsule in adults with mild-to-moderate COVID-19., Methods: We conducted a double-blind randomized controlled trial in adults with mild-to-moderate COVID-19 (17 sites from China, Thailand, Philippine and Vietnam). Patients received standard-of-care alone or plus LHQW capsules (4 capsules, thrice daily) for 14 days. The primary endpoint was the median time to sustained clinical improvement or resolution of nine major symptoms., Results: The full-analysis set consisted of 410 patients in LHQW capsules and 405 in placebo group. LHQW significantly shortened the primary endpoint in the full-analysis set (4.0 vs. 6.7 days, hazards ratio: 1.63, 95% confidence interval: 1.39-1.90). LHQW capsules shortened the median time to sustained clinical improvement or resolution of stuffy or runny nose (2.8 vs. 3.7 days), sore throat (2.0 vs. 2.6 days), cough (3.2 vs. 4.9 days), feeling hot or feverish (1.0 vs. 1.3 days), low energy or tiredness (1.3 vs. 1.9 days), and myalgia (1.5 vs. 2.0 days). The duration to sustained clinical improvement or resolution of shortness of breath, headache, and chills or shivering did not differ significantly between the two groups. Safety was comparable between the two groups. No serious adverse events were reported., Interpretation: LHQW capsules promote recovery of mild-to-moderate COVID-19 via accelerating symptom resolution and were well tolerated. Trial registration ChiCTR2200056727 ., (© 2023. The Author(s).)

Purpose: To assess the safety and efficacy of the extra-facet puncture technique applied in unilateral percutaneous vertebroplasty (PVP) for treating osteoporotic vertebral compression fractures., Methods: Demographics (age, gender, body mass index and underlying diseases) were recorded for analyzing. Visual analog scale (VAS) and Oswestry Disability Index (ODI) scores as well as their corresponding minimal clinically important difference (MCID) were used to evaluate clinical outcomes. The segmental kyphotic angle, the vertebral compression ratio and bone cement distribution pattern were evaluated by the plain radiographs. The facet joint violation (FJV) was defined by the postoperative computed tomography scan. Binary logistic regression analysis was performed to investigate relationships between multiple risk factors and residual back pain., Results: VAS and ODI scores in both traditional puncture group and extra-facet puncture group were significantly decreased after PVP surgery (p < 0.05). However, no significant difference was observed between the two groups according to VAS and ODI scores. The proportion of patients achieving MCID of VAS and ODI scores was higher in extra-facet puncture group as compared to traditional puncture group within a month (p < 0.05). Finally, multivariate logistic regression analysis showed that FJV (odds ratio 16.38, p < 0.001) and unilateral bone cement distribution (OR 5.576, p = 0.020) were significant predictors of residual back pain after PVP surgery., Conclusions: Extra-facet puncture percutaneous vertebroplasty can decrease the risk of FJV and it also has the advantage of more satisfied bone cement distribution., (© 2023. The Author(s).)

Phenolic acids are commonly used as food biological preservatives. Grafting phenolic acids onto polysaccharides could effectively enhance their biological activities and environmental stability to varying degrees. However, grafting methods and raw materials could affect the physical properties and biological activities of the phenolic acid-grafted polysaccharides. In this study, caffeic acid (CA) and gallic acid (GA) were grafted onto oat β-glucan (OG) and hydrolyzed oat β-glucan (OGH) through N,N'-carbonyldiimidazole-mediated (CDI) and 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide hydrochloride coupling N-hydroxysuccinimide (EDC/NHS) methods. Graft modification decreased the crystallinity and thermal stability of the conjugates, but retained good bioactivities for the conjugates. The antioxidant and bacteriostatic activities of the conjugates prepared by the EDC method were better than those of the CDI method, and the OGH-conjugates showed better biological activities than OG-conjugates. EDC-GAOGH showed best DPPH (89.78%) and ABTS (92.32%) scavenging activities. The inhibitory effect of EDC-GAOGH on Escherichia coli was significantly better than that of EDC-CAOGH, but for Staphylococcus aureus, the results are opposite, which indicating that different phenolic acid grafting products have different inhibitory effects on pathogenic microbes. In general, grafting phenolic acids onto OGH using EDC method is an effective strategy for preparing food biological preservative., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: The prophylactic effect of exogenous melatonin and melatonin receptor agonists (MMRAs) on postoperative delirium (POD) in elderly patients remains controversial., Objective: This study aimed to assess the prophylactic effect of MMRAs on POD by conducting a systemic review and meta-analysis of randomized controlled trials (RCTs)., Methods: We systematically searched four electronic databases including PubMed, Web of Science, Cochrane Library, and Embase for the eligible studies up to February 28, 2023. The Cochrane risk of bias tool was used for assessing the risk of bias in the included RCTs. The occurrence of POD was the primary outcome. The quality of evidence was evaluated by Grading of Recommendations Assessment, Development, and Evaluation., Results: A total of 11 RCTs comprising patients (MMRA group: 777 patients and placebo group: 781 patients) were included. The results of the meta-analysis showed that the MMRA group had a lower occurrence of POD than the placebo group (risk ratio = 0.70, 95% confidence interval: 0.51-0.97, P < 0.05, I 2  = 59%). The subgroup analysis showed that melatonin significantly reduced the occurrence of POD (moderate-quality evidence), whereas ramelteon and tryptophan had no significant impact (moderate-quality evidence)., Conclusion: Existing evidence suggested that perioperative use of melatonin can prevent POD in elderly patients., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objective: Lumbar disc degeneration (LDD) is a common cause of low back pain and disability, and its prevalence increases with age. The aim of this study is to investigate whether endplate Hounsfield unit (HU) values have an effect on lumbar disc degeneration (LDD) after transforaminal lumbar interbody fusion (TLIF) surgery in patients with degenerative lumbar stenosis., Methods: This study was a retrospective analysis of patients who underwent TLIF surgery in January 2016 to October 2019. One hundred and fifty-seven patients who underwent TLIF surgery for degenerative lumbar stenosis were enrolled in this study. Demographic data was recorded. VAS and ODI values were compared to assess the surgical outcomes in patients with or without process of LDD after TLIF surgery. Correlation analysis was performed to investigate associations between LDD and endplate HU value. Binary logistic regression analysis was carried out to study relationships between the DDD and the multiple risk factors., Results: There was a statistically significant correlation between LDD, body mass index (BMI), age, paraspinal muscle atrophy, and total endplate scores (TEPS). Also, a strong and independent association between endplate HU value and LDD was found at every lumbar disc level (p < 0.01). After conditioning on matching factors, multivariate logistic regression analysis showed that higher endplate HU (odds ratio [OR]: 1.003, p = 0.003), higher TEPS (OR: 1.264, p = 0.002), higher BMI (odds ratio [OR]: 1.202, p = 0.002), a smaller cross-sectional area (CSA) of the paraspinal muscle preoperatively (OR: 0.096, p < 0.001) were significant predictors of LDD development after TLIF surgery., Conclusions: There is a significant association between LDD and endplate HU value after TLIF surgery in patients with degenerative lumbar stenosis. Beyond that, results from this study provide a mechanism by which high endplate HU value predisposes to LDD after TLIF surgery., (© 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Purpose: There have been many studies in the operative management of pyogenic spondylodiscitis with foreign materials. However, it still remains an issue of debate on whether the allografts may be used in pyogenic spondylodiscitis. This study sought to evaluate the safety and effectiveness of PEEK cages and the cadaveric allograft in transforaminal lumbar interbody fusion (TLIF) for treating lumbar pyogenic spondylodiscitis., Methods: From January 2012 to December 2019, 56 patients underwent surgery for lumbar pyogenic spondylodiscitis. The posterior debridement of all patients and their fusion with allografts, local bone grafts, and bone chip cages were performed before posterior pedicle screw fusion. An assessment of the residual pain, the grade of neurological injury, and the resolution of infection was conducted on 39 patients. The clinical outcome was evaluated using a visual analog scale (VAS) and the Oswestry Disability Index (ODI), and neurological outcomes were appraised based on Frankel grades. The radiological outcomes were evaluated via focal lordosis, lumbar lordosis, and the state of the fusion., Results: Staphylococcus aureus and Staphylococcus epidermidis were the most common causative organisms. The mean preoperative focal lordosis was -1.2° (-11.4° to 5.7°), and the mean postoperative focal lordosis increased to 10.3° (4.3°-17.2°). At the final follow-up, there were five cases with subsidence of the cage, no case of recurrence, and no case with cage and screw loosening or migration. The mean preoperative VAS and ODI scores were 8.9 and 74.6%, respectively, and improvements in VAS and ODI were 6.6 ± 2.2 and 50.4 ± 21.3%, respectively. The Frankel grade D was found in 10 patients and grade C in 7. Following the final follow-up, only one patient improved from Frankel grade C to grade D while the others recovered completely., Conclusion: The PEEK cage and cadaveric allograft combined with local bone grafts is a safe and effective choice for intervertebral fusion and restoring sagittal alignment without increased incidence of relapse for treating lumbar pyogenic spondylodiscitis., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2023 Huo-Liang Zheng et al.)

Objective: To investigate the clinical efficacy, safety and feasibility of "double-portal" video-assisted thoracoscopic surgical(VATS) decortication among patients with stage Ⅲ tuberculous empyema, and then to evaluate the recovery of chest deformity. Method: This study was a single center retrospective study. A total of 49 patients with stage Ⅲ tuberculous empyema who underwent VATS pleural decortication at the Department of Thoracic Surgery, Public Health Clinical Center of Chengdu between June 2017 and April 2021 were enrolled, including 38 males, and 11 females, aged 13-60 (27.5±10.4) years. The safety and feasibility of VATS were further evaluated. The inner circumference of the chest on sternal and xiphoid planes on chest CT scans before and 1, 3, 6, 12months after decortication were collected through the measuring software of the CT. The samples in-pair test was used to compare the changes in the chest to reflect the recovery of the chest deformity. Results: In the 49 patients, The surgical time was (186±61) min, and the volume of blood loss was (366±267) ml. There were 8 cases (16.33%) with postoperative complications during the perioperative period. Constant air leak and pneumonia were the main postoperative complications. No relapse of empyema or dissemination of tuberculosis occured during the period of follow-up. Before surgery, the inner thoracic circumference of the thorax at the level of the carina plane was (655±54) mm, and the inner thoracic circumference of the thorax at the level of the xiphoid plane was (720±69) mm. Patients were followed for 12-36 months. The inner thoracic circumference of the thoracic cavity at the level of carina was (666±51), (667±47) and (671±47) mm at the 3rd, 6th and 12th months after operation, which were significantly larger than that at the level of carina before operation (all P <0.05). The inner thoracic circumference diameter of the thoracic cavity measured at the xiphoid level at the 3rd, 6th and 12th months after the operation was (730±65), (733±63) and (735±63) mm respectively(all P <0.05).The inner thoracic circumference of the thoracic cavity increased significantly than that before surgery ( P <0.05). At 6 months after operation, there was significant difference in the improvement of the inner thoracic circumference of the carina plane in patients with age less than 20 years and FEV 1 % less than 80% ( P =0.015, P =0.003). The improvement in the inner thoracic circumference of the carina plane in patients with pleural thickening≥8 mm compared with those with less than 8 mm was not statistically different( P =0.070). Conclusions: For some patients with stage Ⅲ tuberculous empyema, pleural decortication under thoracoscopy is safe and feasible, and can significantly restore the inner thoracic circumference of the patient's chest, improve the collapse of the patient's chest, and have significant clinical effect. The "double-portal VATS" surgical technology has the advantage of less trauma, wide operation field, large operation space and is easy to master, which is worth further exploring for clinical application.

There have been an increasing number of patients with degenerative disc diseases due to the aging population. In light of this, studies on the pathogenesis of intervertebral disc degeneration have become a hot topic, and gene knockout mice have become a valuable tool in this field of research. With the development of science and technology, constitutive gene knockout mice can be constructed using homologous recombination, zinc finger nuclease, transcription activator-like effector nuclease technology and clustered regularly interspaced short palindromic repeats/Cas9 (CRISPR/Cas9) system, and conditional gene knockout mice can be constructed using the Cre/LoxP system. The gene-edited mice using these techniques have been widely used in the studies on disc degeneration. This paper reviews the development process and principles of these technologies, functions of the edited genes in disc degeneration, advantages, and disadvantages of different methods and possible targets of the specific Cre recombinase in intervertebral discs. Recommendations for the choice of suitable gene-edited model mice are presented. At the same time, possible technological improvements in the future are also discussed., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. JOR Spine published by Wiley Periodicals LLC on behalf of Orthopaedic Research Society.)

Purpose: The current study attempts to investigate the role of anterior cervical discectomy and fusion (ACDF) in alleviating symptoms in patients with cervical vertigo associated with cervical instability., Methods: The patients of cervical instability with vertigo and dizziness who underwent ACDF between January 2011 and December 2019 were followed-up for more than two years. Demographic data (age, sex, follow up period and levels of instable cervical segments) were assessed; Symptoms of vertigo and dizziness before and after surgery were assessed by the 15-item version of the Vertigo Symptom Scale (VSS) and the 25-item Dizziness Handicap Inventory (DHI). The severity and frequency of other symptoms like neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache, diplopia and blurring of vision before and after surgery were also assessed., Results: A total of 92 patients underwent ACDF for cervical instability with vertigo and dizziness between January 2011 and December 2019, of which 79 patients were included in the final analysis. The number of instable levels had no correlation with VSS and DHI scores before surgery ( p  > 0.05), while patients with C3/4 instability suffering a severer vertigo than other levels. Both DHI and VSS scores were significantly reduced after ACDF and this was sustained within two years after surgery ( p  < 0.001). Although there was no statistical difference in the ratio of patients with vertigo relief, patients with one-level cervical instability demonstrated a more rapid recovery than patients with multi-level cervical instability ( p  = 0.048). Also, there was improvement in other symptoms such as neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache and blurring of vision after surgery., Conclusions: Vertigo caused by C3/4 instability was severer than other levels such as C4/5 and C5/6. During 2 years' follow-up the significant relief of vertigo and dizziness was observed after anterior cervical surgery. Other accompanying symptoms except hypomnesia were also extenuated in follow-up period., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Zheng, Li, Song, Chen, Jiang and Jiang.)

The aim of this study was to evaluate the effects of Lactiplantibacillus plantarum SCS4 (L. plantarum SCS4) on oxidative stress in streptozocin-induced hyperglycemic mice. After establishment of the hyperglycemic model, control group mice were gavaged daily with phosphate-buffered saline, while different experimental groups (AG, BG, and CG) mice were gavaged with L. plantarum SCS4 suspension, cellular inclusion suspension, and inactivated inclusion suspension for 10 weeks, respectively. Compared with the model group (MG) group, the results showed that fasting blood glucose levels in BG and CG groups decreased, and postprandial 2-h blood glucose levels in BG groups decreased, whereas glucose tolerance improved. Meanwhile, ROS and MDA levels in serum of AG mice were decreased significantly (P < 0.05). Compared with the MG group, serum levels of GPx, HO-1, and NQO1 were increased in the BG group, whereas serum levels of CAT, HO-1, and GSH were increased in the CG group. Our results indicate that L. plantarum SCS4 can alleviate oxidative stress induced by hyperglycemia, and there may be synergistic effects among the different treatments., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Intervertebral disc degeneration (IVDD) is the most common contributor to low back pain (LBP). Recent studies have found that oxidative stress and reactive oxygen species (ROS) play an important role in IVDD. As a by-product of aerobic respiration, ROS is mainly produced in the mitochondria by the electron transport chain and other mitochondrial located proteins. With the excessive accumulation of ROS, mitochondria are also the primary target of ROS attack in disc cells. A disrupted balance between intracellular ROS production and antioxidant capacity will lead to oxidative stress, which is the key contributor to cell apoptosis, cell senescence, excessive autophagy, and mitochondrial dysfunction. As the pivotal ingredient of oxidative stress, mitochondrial dysfunction manifests as imbalanced mitochondrial dynamics and dysregulated mitophagy. Mitochondria can alter their own dynamics through the process of fusion and fission, so that disabled mitochondria can be separated from the mitochondrial pool. Moreover, mitophagy participates by clearing these dysfunctional mitochondria. Abnormality in any of these processes either increases the production or decreases the clearance of ROS, leading to a vicious cycle that results in the death of intervertebral disc cells in large quantities, combined with degradation of the extracellular matrix and overproduction of matrix metalloproteinase. In this review, we explain the changes in mitochondrial morphology and function during oxidative stress-mediated IVDD and highlight the important role of mitochondria in this process. Eventually, we summarize the IVDD therapeutic strategies targeting mitochondrial dysfunction based on current understanding of the role of oxidative stress in IVDD., (© 2022 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd.)

Aeromonas hydrophila was a common bacterial pathogen in aquaculture resulting in considerable losses to the striped catfish aquaculture industry. As an emergent antimicrobial peptide (AMP), NK-lysin (NKL) had activity against various microorganisms. However, the antibacterial activity of NKL from striped catfish (Pangasianodon hypophthalmus) both in vitro and vivo remains unclear. In this study, the cDNA sequence of P. hypophthalmus NK-lysin gene (PhNK-lysin) was cloned and characterized. The amino acid sequence of PhNK-lysin contains a signal peptide sequence of 17 amino acid (aa) residues and a mature peptide composed of 130 aa. The saposin B domain of mature peptide comprised six conserved cysteines forming three putative disulfide bonds. Phylogenetic analysis revealed that the PhNK-lysin was most closely related to that of the channel catfish (Ictalurus punctatus) NK-lysin. The transcriptional levels of the PhNK-lysin were significantly upregulated in response to A. hydrophila infection in various tissues including heart, liver, spleen, head kidney, trunk kidney and gill. The synthetic PhNK-lysin-derived peptide consisting of 38aa showed antibacterial activity against Vibrio harveii, Aeromonas hydrophila and Escherichia coli. The MIC for V. harveii, A. hydrophila and E. coli were 15.625 μM, 250 μM and 31.25 μM respectively. Besides, the synthetic PhNK-lysin decreased the bacterial load of liver and trunk kidney in vivo as well as increased the survival rate of A. hydrophila infected striped catfish. Hence, these data suggest that PhNK-lysin had antimicrobial effect and protects the host from pathogenic infection., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Percutaneous left atrial appendage occlusion (LAAO) provides an alternative for poor candidates for long-term oral anticoagulation (OAC). To prevent device-related thrombosis (DRT), OAC should be continued for the first 45 days to allow complete endothelialization post-LAAO implantation. Whereas, evidence is limited on the feasibility and safety of direct oral anticoagulants (DOACs) used after LAAO., Methods: This was a retrospective observational single-center study of AF patients undergoing LAAO with a Watchman device and receiving either low-dose dabigatran (110mg twice daily) or warfarin in the peri- and post-procedural period for 45 days. Transesophageal echocardiography was scheduled to perform at 6 weeks, 6 months, and 12 months after the procedure to assess the stability of the device and to detect DRT. Incidence of thromboembolic and bleeding events were also evaluated during the follow-up period., Results: There were a total of 84 patients who successfully underwent Watchman implantation, with 38 patients (45.2%) receiving low-dose dabigatran and 46 patients (54.8%) using warfarin post-LAAO. Peri-procedural complications occurred in 10 patients, with 3 patients in the dabigatran group and 7 patients in the warfarin group (7.9% vs. 15.2%, p  = 0.30). During the 12-month follow-up, 1 patient experienced major bleeding and 16 patients suffered minor bleeding in the warfarin group, while 5 patients treated with dabigatran had minor bleeding (34.8% vs. 13.2%, p  = 0.02). Besides, 6 DRT (15.8%) were detected in dabigatran groups, and the incidence was higher than in the warfarin group (15.8% vs. 2.2%, p  = 0.03). No DRT-related ischemic events were found., Conclusions: This study suggested that short-term low-dose dabigatran (110 mg twice daily) could significantly decrease the risk of bleeding compared with warfarin at the expense of increased risk of DRT post-LAAO. Therefore, low-dose dabigatran should be used with caution for post-implant anticoagulation of LAAO. Further studies are urgently needed on the feasibility and safety of DOACs post-LAAO.

Background: Abnormal Smad7 expression can lead to apoptosis in different cell types. Previously, we found high expression of Smad7 in rat degenerative discs. However, the exact role of Smad7 in the apoptosis of disc cells and the possible underlying mechanism remain unclear., Methods: Degenerative and nondegenerative human lumbar intervertebral discs were collected from patients during operation. The expressions of SMAD7 mRNA and protein in the different components of these discs were measured with real-time PCR and Western blotting, respectively. Annulus fibrosus (AF) cells were isolated and cultivated from the discs of young healthy rats. Smad7 in the AF cells was overexpressed with adenovirus and knocked down with siRNA. IL-1β was used to induce apoptosis in the AF cells. Loss-and-gain cell function experiments were performed to show the effect of Smad7 on the apoptosis of AF cells. The function recovery experiments were performed to verify whether Smad7 regulates the apoptosis of AF cells through the mitochondria-mediated pathway., Results: Both the mRNA and protein expressions of Smad7 were significantly higher in the different components of human degenerative discs than in those of the nondegenerative discs. IL-1β stimulated apoptosis while upregulating the Smad7 expression in the AF cells in vitro . Overexpression of Smad7 in AF cells exaggerated the IL-1β -induced apoptosis in the cells while knockdown of Smad7 expression suppressed this apoptosis. With the exaggerated apoptosis in the AF cells with Smad7 overexpression, both active cleaved caspase-3 and cleaved caspase-9, the ratio of Bax/Bcl-2, and Cyt-c increased significantly. However, the inhibitor of caspase-9, Z-LEHD-FMK, significantly diminished the apoptosis in these cells., Conclusion: Smad7 is highly expressed in human degenerative discs and participates in IL-1β-induced apoptosis of rat AF cells via the mitochondria pathway. Smad7 may be a potential target for the prevention and treatment of degenerative disc disease., Competing Interests: The authors confirm no conflicts of interest., (Copyright © 2022 Bo Li et al.)

The genus Campylotropis Bunge (Desmodieae, Papilionoideae) comprises about 37 species distributed in temperate and tropical Asia. Despite the great potential in soil conservation, horticulture, and medicine usage, little is known about the evolutionary history and phylogenetic relationships of Campylotropis due to insufficient genetic resources. Here, we sequenced and assembled 21 complete chloroplast genomes of Campylotropis species. In combination with the previously published chloroplast genomes of C. macrocarpa and closely related species, we conducted comparative genomics and phylogenomic analysis on these data. Comparative analysis of the genome size, structure, expansion and contraction of inverted repeat (IR) boundaries, number of genes, GC content, and pattern of simple sequence repeats (SSRs) revealed high similarities among the Campylotropis chloroplast genomes. The activities of long sequence repeats contributed to the variation in genome size and gene content in Campylotropis chloroplast genomes. The Campylotropis chloroplast genomes showed moderate sequence variation, and 13 highly variable regions were identified for species identification and further phylogenetic studies. We also reported one more case of matK pseudogene in the legume family. The phylogenetic analysis confirmed the monophyly of Campylotropis and the sister relationship between Lespedeza and Kummerowia , the latter two genera were then sister to Campylotropis . The intrageneric relationships of Campylotropis based on genomic scale data were firstly reported in this study. The two positively selected genes ( atpF and rps19 ) and eight fast-evolving genes identified in this study may help us to understand the adaptation of Campylotropis species. Overall, this study enhances our understanding of the chloroplast genome evolution and phylogenetic relationships of Campylotropis ., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Feng, Gao, Zhang, Jiang, Li, Deng, Liao and Xu.)

Background: Treating periodontally hopeless teeth with advanced bone resorption and severe tooth mobility is a great challenge for both orthodontists and periodontists. Biofilm-induced periodontal inflammation and occlusal trauma-related inflammation may synergistically aggravate tooth mobility. This case report illustrates that even periodontally hopeless teeth can be saved and have long-term stability with comprehensive periodontal treatment to control periodontal inflammation and promote periodontal bone regeneration and intricate orthodontic mechanical control to correct cross bite and occlusal trauma., Case Summary: A 27-year-old female patient whose chief complaint was severe tooth mobility and discomfort of the maxillary incisor was diagnosed with severe aggressive periodontitis by clinical and radiographic examinations. To reduce tooth mobility and establish stable occlusion, we combined orthodontic treatment with periodontal therapy to preserve the tooth. Orthodontic treatment was performed after basic periodontal therapy and periodontal surgery. The loosened upper right central incisor was successfully retained, and the periodontal tissue remained stable during follow-up., Conclusion: Teeth with severe mobility and bone loss can be saved through interdisciplinary treatment when periodontal inflammation is strictly controlled., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to report., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)

The Hengduan Mountains region is an important hotspot of alpine plant diversity and endemism. Acanthochlamys bracteata is a species of a threatened monotypic genus endemic to the Hengduan Mountains. In this study, we present a high-quality, chromosome-level reference genome for A. bracteata, constructed using long reads, short reads and Hi-C technology. We characterized its genetic diversity, population structure, demographic history and gene flow by resequencing individuals collected across its distribution. Comparative genomics analyses based on sequence information from single-copy orthologous genes revealed that A. bracteata and Dioscorea rotundata diverged ~104.5 million years ago. Whole-genome resequencing based on population genetic analysis revealed that the division of the 14 populations into 10 distinct clusters reflected geographical divergence, and three separate high levels of gene flow occurred sequentially between isolated populations of the Hengduan Mountains, a finding which is consistent with the turnover between ice ages and interglacial periods. Our findings indicate that Quaternary climatic changes played an important role in shaping the genetic structure and demographic trajectories of A. bracteata, and provide critical insights into the genetic status and evolutionary history of this poorly understood species, and possibly other alpine plants with a similar distribution. This study demonstrates the usefulness of population genomics for evaluating the effects of past climatic changes and identifying conservation units for the conservation and management of threatened species. Our high-quality genome represents a valuable resource for future studies of the underlying molecular mechanisms of adaptive evolution and provides insight for further comparative genomic analysis with other Velloziaceae species., (© 2021 John Wiley & Sons Ltd.)

A healthy microenvironment of the intervertebral disc tissue is characterized by hypoxia owing to its sparse vascular distribution. Oxidative stress plays a pivotal role in the pathological development of intervertebral disc degeneration (IVDD). We found that the expression of prolyl endopeptidase (PREP) increased in degenerative nucleus pulposus (NP) tissues. The purpose of this study was to determine whether PREP is involved in oxidative-stress-induced IVDD. Tertbutyl hydroperoxide can inhibit the expression of PREP by activating the PI3K/AKT signaling pathway at low concentrations in NP cells. Knockdown of PREP protected NP cells from apoptosis induced by oxidative stress, whereas overexpression of PREP exacerbated the apoptosis of NP cells. We also investigated the connection between the PI3K/AKT signaling pathway and PREP and found that the activation of the PI3K/AKT signaling pathway downregulated the expression of PREP by inhibiting p53. As a crucial transcription factor, p53 binds to the PREP promoter region and promotes its transcription. Overexpression of PREP also impairs protein secretion in the extracellular matrix of NP cells. Furthermore, the in vivo knockout of PREP could attenuate puncture-induced IVDD. These findings suggested that the downregulation of PREP might maintain the viability of NP cells and attenuate IVDD under oxidative stress., Competing Interests: The authors confirm no conflicts of interest., (Copyright © 2022 Huo-Liang Zheng et al.)

Two new phenolic glycosides 7 R ,8 R -threo-4,7,9,9'-tetrahydroxy-3-methoxy-8- O -4'-neolignan-3'- O -(3''-α-L-arabinofuranosyl)- β -D-glucopyranoside. ( 1 ), 4-(4'-hydroxyphenyl)-2-butanone-4''- O -(6- β -D-xylosyl)-β- D -glucopyranoside ( 2 ), along with two known related analogues 7 R ,8 R -threo-4,7,9,9'-tetrahydroxy-3-methoxy-8- O -4'-neolignan-3'- O -β- D -glucopyranoside ( 3 ), 4-(4'-hydroxyphenyl)-2-butanone-4'- O -β- D -glucopyranoside ( 4 ) were obtained from the roots of Sanguisorba o ffi cinalis . Combined with acid hydrolysis derivatization, the absolute configurations of these new compounds were elucidated by comprehensive analyses of spectroscopic data including nuclear magnetic resonance (NMR), electrospray ionization high resolution mass (HRESIMS) as well as circular dichroism (CD). Compounds 1 - 4 exhibited anti-inflammatory properties in vitro by attenuating the production of inflammatory mediators, such as nitric oxide (NO) as well as tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).