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Intervertebral disc degeneration (IVDD) is a degenerative disease accompanied by the loss of nucleus pulposus cells and the degradation of extracellular matrix (ECM), which tends to be associated with lower back pain. The ECM and various types of cell death in IVDD are regulated by multiple factors, such as inflammatory responses and oxidative stress. The glutathione (GSH) redox system is the most important antioxidant defense system in cells. GSH is one of the most abundant thiol antioxidants in mammalian cells, which functions directly and indirectly by scavenging peroxides through the GSH redox system. In these reactions, GSH is oxidized by electrophilic substances, such as reactive oxygen species and free radicals, to form glutathione disulfide to exert antioxidative effects. It has been reported that GSH can protect cells against the damage of oxidative stress and various pathophysiological stimulus that can lead to different types of cell death. In addition, it was reported that the level of GSH widely participates in apoptosis, autophagy, ferroptosis, and oxidative stress in many diseases including osteoarthritis and IVDD. Therefore, we summarized the effects of GSH on ECM metabolism and cells' functions during IVDD. In addition, we summarized the regulatory effects of small molecule compounds on GSH to explore potential ways to regulate the level of GSH. Better understanding the underlying role of GSH in regulating IVDD will facilitate the goal of preventing and retarding the progress of IVDD in the future. [ABSTRACT FROM AUTHOR]

Objectives: Dysphagia, an impairment in swallowing, is a frequent and debilitating complication for patients undergoing anterior cervical discectomy and fusion (ACDF), a common surgical treatment for degenerative cervical myelopathy (DCM). This retrospective study aimed to assess the efficacy of modified tracheal traction exercise (MTTE) in alleviating postoperative dysphagia and improving clinical outcomes for these patients. Methods: A cohort of 143 patients underwent multilevel fusions, equally distributed between MTTE (n = 75) and traditional tracheal traction exercise (TTTE) (n = 68) groups. Demographic parity was observed in gender distribution, age averages (MTTE: 51.43 ± 11.25 years; TTTE: 52.35 ± 10.43 years), body mass index (BMI), comorbidities, fusion segments, and preoperative hospitalization days. Surgical duration differences were assessed. Clinical outcomes, dysphagia incidence, blood loss, postoperative complications, Cervical Japanese Orthopedic Association (c‐JOA) scores, and functional outcome swallowing scale evaluations were conducted. Univariate and multivariate logistic regression analyses were used to explore factors influencing dysphagia. Results: Modified tracheal traction exercise demonstrated advantages with a significantly lower dysphagia incidence (25.33% vs. 44.12%, p = 0.018), reduced blood loss (102.03 ± 17.04 vs. 113.46 ± 14.92, p < 0.001), shorter surgical durations (159.04 ± 9.82 vs. 164.41 ± 12.22 min, p = 0.004), and fewer postoperative complications (choking cough, cerebrospinal fluid leakage, and hoarseness). Postoperative c‐JOA scores at 2 and 6 weeks favored MTTE, but no significant differences were observed at 12 and 24 weeks. Functional outcome swallowing scale evaluations favored MTTE with significantly higher percentages of "normal" and lower incidences of "mild" and "moderate dysphagia" at various postoperative intervals compared to TTTE. Factors significantly associated with dysphagia included MTTE, age, and BMI according to logistic regression analyses. Conclusion: Modified tracheal traction exercise demonstrates superior short‐term outcomes in multilevel ACDF, showcasing reduced dysphagia incidence, blood loss, and specific postoperative complications. Notably, factors contributing to dysphagia, including operation technique and patient‐related variables, emphasize the significance of MTTE and patient characteristics in optimizing postoperative outcomes in multilevel ACDF procedures. [ABSTRACT FROM AUTHOR]

This paper studied the spatial pattern of supergentrification in the core area of Shanghai. The area is divided into 23 subdistricts based on the standard pattern of subdistrict division provided by CREIS (China Real Estate Index System) and then the 23 subdistricts are taken as objects for analysis. By establishing the evaluation index system of supergentrification level, the integrated analysis method entropy weight method and exploratory spatial data analysis is used to explore the general characteristics of the spatial pattern, spatial agglomeration characteristics, and spatial agglomeration hotspots of supergentrification in the core area of Shanghai. The research results of the spatial pattern reveal that the level of supergentrification in the core area of Shanghai is high in Puxi and low in Pudong. The Puxi district, represented by the People's Square subdistrict, West Nanjing Road subdistrict, and Hengshan Road subdistrict, has a higher level of supergentrification, while the Pudong district, represented by the Tangqiao subdistrict, Yangjing subdistrict, and Huamu subdistrict, has a lower level of supergentrification. The results of spatial autocorrelation analysis reveal that supergentrification in the core area of Shanghai presents obvious spatial agglomeration characteristics on the subdistrict scale and that the significantly high-high subdistricts are mainly distributed in the core area of Puxi. [ABSTRACT FROM AUTHOR]

Study Design: A retrospective study. Objective: To develop a new MRI scoring system to assess patients' clinical characteristics, outcomes and complications. Methods: A retrospective 1-year follow-up study of 366 patients with cervical spondylosis from 2017 to 2021. The CCCFLS scores (cervical curvature and balance (CC), spinal cord curvature (SC), spinal cord compression ratio (CR), cerebrospinal fluid space (CFS). Spinal cord and lesion location (SL). Increased Signal Intensity (ISI) were divided into Mild group (0-6), Moderate group (6-12), and Severe group (12-18) for comparison, and the Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS), numerical rating scale (NRS), Neck Disability Index (NDI) and Nurick scores were evaluated. Correlation and regression analyses were performed between each variable and the total model in relation to clinical symptoms and C5 palsy. Results: The CCCFLS scoring system was linearly correlated with JOA, NRS, Nurick and NDI scores, with significant differences in JOA scores among patients with different CC, CR, CFS, ISI scores, with a predictive model (R2 = 69.3%), and significant differences in preoperative and final follow-up clinical scores among the 3 groups, with a higher rate of improvement in JOA in the severe group (P <.05), while patients with and without C5 paralysis had significant differences in preoperative SC and SL (P <.05). Conclusion: CCCFLS scoring system can be divided into mild (0-6). moderate (6-12), severe (12-18) groups. It can effectively reflect the severity of clinical symptoms, and the improvement rate of JOA is better in the severe group, while the preoperative SC and SL scores are closely related to C5 palsy. Level of Evidence: III [ABSTRACT FROM AUTHOR]

Background: Ossification of the posterior longitudinal ligament (OPLL) is a prevalent condition in orthopedics. While death-associated protein kinase 2 (DAPK2) is known to play roles in cellular apoptosis and autophagy, its specific contributions to the advancement of OPLL are not well understood. Methods: Ligament fibroblasts were harvested from patients diagnosed with OPLL. Techniques such as real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) and Western blot analysis were employed to assess DAPK2 levels in both ligament tissues and cultured fibroblasts. The extent of osteogenic differentiation in these cells was evaluated using an alizarin red S (ARS) staining. Additionally, the expression of ossification markers and autophagy markers was quantified. The autophagic activity was further analyzed through LC3 immunofluorescence and transmission electron microscopy (TEM). An in vivo heterotopic bone formation assay was conducted in mice to assess the role of DAPK2 in ossification. Results: Elevated DAPK2 expression was confirmed in both OPLL patient tissues and derived fibroblasts, in contrast to non-OPLL controls. Silencing of DAPK2 significantly curtailed osteogenic differentiation and autophagy in these fibroblasts, evidenced by decreased levels of LC3 , and Beclin1 , and reduced autophagosome formation. Additionally, DAPK2 was found to inhibit the mechanistic target of the rapamycin complex 1 (mTORC1) complex's activity. In vivo studies demonstrated that DAPK2 facilitates ossification, and this effect could be counteracted by the mTORC1 inhibitor rapamycin. Conclusion: DAPK2 enhances autophagy and osteogenic processes in OPLL through modulation of the mTORC1 pathway. [ABSTRACT FROM AUTHOR]