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This study aimed to compare the clinical efficacy and radiological results between unilateral pedicle screw fixation (UPSF) and bilateral pedicle screw fixation (BPSF) for treating two-level lumbar degenerative diseases. The study involved 106 patients with two-level lumbar degenerative diseases. In the UPSF group ( n  = 52), 28 underwent intervertebral fusion (IF), 17 underwent posterolateral fusion (PLF), and 7 underwent IF & PLF. In the BPSF group ( n  = 54), 43 underwent IF, 2 underwent PLF, and 9 underwent IF & PLF. The clinical efficacy and radiological data were evaluated and compared. The UPSF group was significantly lower than the BPSF group regarding operation time, intraoperative blood loss, and hospitalization expenses. Postoperative visual analog scale scores and oswestry disability index were significantly decreased in both groups compared with pre-surgery. At the last follow-up, the intervertebral disc height of the cranial adjacent segment decreased more in the UPSF group compared with the BPSF group. The incidence of screw loosening in the UPSF group was significantly higher compared with the BPSF group. Compared to BPSF, UPSF can achieve similar and satisfactory clinical efficacy for the treatment of two-level lumbar degenerative diseases with less operation time, muscle damage, blood loss, and hospitalization expenses. However, the occurrence of pedicle screw loosening was higher in the UPSF group.

This study was to develop a feasible and safe animal model for minimally invasive injectable lumbar interbody fusion using a novel biomaterial, mineralized collagen-polymethylmethacrylate bone cement (MC-PMMA), with unilateral pedicle screw fixation in an in vivo goat model. Eight goats (Capra aegagrus hircus) were divided into three groups: MC-PMMA, unmodified commercial-polymethylmethacrylate bone cement (UC-PMMA), and a control group (titanium cage filled with autogenous bone, TC-AB). Each group of goats was treated with minimally invasive lumbar interbody fusion at the L3/L4 and L5/L6 disc spaces (injected for MC-PMMA and UC-PMMA, implanted for TC-AB). The pedicle screws were inserted at the L3, L4, L5, and L6 vertebrae, respectively, and fixed on the left side. The characteristics of osteogenesis and bone growth were assessed at the third and the sixth month, respectively. The methods of evaluation included the survival of each animal, X-ray imaging, and 256-layer spiral computed tomography (256-CT) scanning, imaged with three-dimensional microfocus computed tomography (micro-CT), and histological analysis. The results showed that PMMA bone cement can be extruded smoothly after doping MC, the MC-PMMA integrates better with bone than the UC-PMMA, and all goats recovered after surgery without nerve damage. After 3 and 6 months, the implants were stable. New trabecular bone was observed in the TC-AB group. In the UC-PMMA group a thick fibrous capsule had formed around the implants. The MC-PMMA was observed to have perfect osteogenesis and bone ingrowth to adjacent bone surface. Minimally invasive injectable lumbar interbody fusion using MC-PMMA bone cement was shown to have profound clinical value, and the MC-PMMA showed potential application prospects.

The paper uses the convolutional neural network algorithm in the deep learning algorithm to explore the therapeutic effect of surgical treatment of hyperextension injuries associated with ossification of the posterior longitudinal ligament of the cervical spine. In this retrospectively analyzed study 27 patients with hyperextension injury of the posterior longitudinal ligament of the cervical spine were selected from our hospital between August 2018 to July 2020. It included 21 males and 6 females; aged 36-79 years, with an average of 55.9 years. Follow-up time of patients was 3-39 months, with an average of 17.4 months. The JOA score after surgery was significantly better than that before surgery (P<0.01), which was statistically significant; the improvement of JOA in patients undergoing anterior therapy was better than that in patients undergoing posterior therapy, which was statistically significant; the JOA improved in patients with minor violent injuries. The situation is significantly better than severe violent injuries, with statistical significance. The rate of postoperative JOA improvement was significantly correlated with the degree of nerve function retention of the injured spinal cord before surgery (P<0.01), and there was no significant correlation between the degree of spinal stenosis caused by ossification and the postoperative JOA improvement of patients. Convolutional neural network algorithm in the deep learning algorithm based on the cervical spine posterior longitudinal ligament ossification hyperextension injury was significantly improved after surgery. The less preoperative neurological damage, the postoperative neurological function, the degree of improvement, there was no significant correlation between the degree of spinal stenosis and the improvement of postoperative spinal cord function. For patients with ossification of the posterior longitudinal ligament, if there are neurological symptoms, early surgical treatment is recommended to relieve the compression, so as to prevent irreversible neurological damage caused by trauma.

Original Article Deep learning algorithm based on analyzing the effect of posterior cervical vertebral canal decompression angioplastyin the treatment of ossification of posterior longitudinalligament of cervical spine by CT image Yang Liu1, Jianjun Kong2 ABSTRACTObjective: The paper uses the convolutional neural network algorithm in the deep learning algorithm to explore the therapeutic effect of surgical treatment of hyperextension injuries associated with ossification of the posterior longitudinal ligament of the cervical spine. Methods: In this retrospectively analyzed study 27 patients with hyperextension injury of the posterior longitudinal ligament of the cervical spine were selected from our hospital between August 2018 to July 2020. It included 21 males and 6 females; aged 36-79 years, with an average of 55.9 years. Results: Follow-up time of patients was 3-39 months, with an average of 17.4 months. The JOA score after surgery was significantly better than that before surgery (P﹤0.01), which was statistically significant; the improvement of JOA in patients undergoing anterior therapy was better than that in patients undergoing posterior therapy, which was statistically significant; the JOA improved in patients with minor violent injuries. The situation is significantly better than severe violent injuries, with statistical significance. The rate of postoperative JOA improvement was significantly correlated with the degree of nerve function retention of the injured spinal cord before surgery (P﹤0.01), and there was no significant correlation between the degree of spinal stenosis caused by ossification and the postoperative JOA improvement of patients.Conclusion: Convolutional neural network algorithm in the deep learning algorithm based on the cervical spine posterior longitudinal ligament ossification hyperextension injury was significantly improved after surgery. The less preoperative neurological damage, the postoperative neurological function, the degree of improvement, there was no significant correlation between the degree of spinal stenosis and the improvement of postoperative spinal cord function. For patients with ossification of the posterior longitudinal ligament, if there are neurological symptoms, early surgical treatment is recommended to relieve the compression, so as to prevent irreversible neurological damage caused by trauma. KEYWORDS: Cervical spine, Ossification of posterior longitudinal ligament, Hyperextension injury, Spinal stenosis rate, JOA improvement rate. doi: https://doi.org/10.12669/pjms.37.6-WIT.4857How to cite this:Liu Y, Kong J. Deep learning algorithm based on analyzing the effect of posterior cervical vertebral canal decompression angioplasty in the treatment of ossification of posterior longitudinal ligament of cervical spine by CT image. Pak J Med Sci. 2021;37(6):1630-1635. doi: https://doi.org/10.12669/pjms.37.6-WIT.4857 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

As a minimally invasive surgery, percutaneous cement discoplasty (PCD) is now contemplated to treat lumbar disc degeneration disease in elder population. Here, we investigated whether the osteogenic mineralized collagen (MC) modified polymethylmethacrylate (PMMA) cement could be a suitable material in PCD surgery. Injectability, hydrophilicity and mechanical properties of the MC-modified PMMA (PMMA-MC) was characterized. The introduction of MC did not change the application and setting time of PMMA and was easy to be handled in minimally invasive operation. Hydrophilicity of PMMA-MC was greatly improved and its elastic modulus was tailored to complement mechanical performance of bone under dynamic stress. Then, PCD surgery in a goat model with induced disc degeneration was performed with implantation of PMMA-MC or PMMA. Three months after implantation, micro-computed tomography analysis revealed a 36.4% higher circumferential contact index between PMMA-MC and bone, as compared to PMMA alone. Histological staining confirmed that the surface of PMMA-MC was in direct contact with new bone, while the PMMA was covered by fibrous tissue. The observed gathering of macrophages around the implant was suspected to be the cause of fibrous encapsulation. Therefore, the interactions of PMMA and PMMA-MC with macrophages were investigated in vitro. We discovered that the addition of MC could hinder the proliferation and fusion of the macrophages. Moreover, expressions of fibroblast-stimulating growth factors, insulin-like growth factor, basic fibroblast growth factor and tumor necrosis factor-β were significantly down-regulated in the macrophages cocultured with PMMA-MC. Together, the promoted osteointegration and reduced fibrous tissue formation observed with PMMA-MC material makes it a promising candidate for PCD surgery.

[...]it is very important to ensure a broad and effective genetic base of resistance to this disease, and it is of great importance to breed wheat cultivars with durable resistance to Pm to improve food security and livelihoods. Furthermore, some major Pm resistance genes, such as Pro12, Pm13, Pm21 and Pm1c, which can combat against different isolates of wheat powdery mildew, are also greatly attractive to wheat breeders. [...]it is expected that new cultivars with multi-pathogen and durable resistances could be developed by marker-assisted pyramiding of these genes. [...]some resistance genes, e.g., Pm^3, Pm16 and Pm20 derived from alien wheat species, are highly resistant to powdery mildew but are not widely used for wheat improvement due to linkage drag142-431. Wild wheat relatives include a large number of species and are highly resistant to wheat powdery mildew diseases134'411. [...]novel Pm resistance genes in wheat, transferred through hybridization between wheat and its relatives, can be identified by inoculating Pm isolates at the seedling and adult plant stages of wheat.

In this paper, we derive the analytical expression for the sensitivity of grating-based surface plasmon resonance (SPR) sensors working in wavelength interrogation. The theoretical analysis shows that the sensitivity increases with increasing wavelength and is saturated beyond a certain wavelength for Au and Ag gratings, while it is almost constant for Al gratings in the wavelength range of 500 to 1000 nm. More importantly, the grating period (P) and the diffraction order (m) dominate the value of sensitivity. Higher sensitivity is possible for SPR sensors with a larger grating period and lower diffraction order. At long wavelengths, a simple expression of P/|m| can be used to estimate the sensor sensitivity. Moreover, we perform experimental measurements of the sensitivity of an SPR sensor based on an Al grating to confirm the theoretical calculations.

Background Postoperative cognitive dysfunction (POCD) is a common neurological complication of anesthesia and surgery in aging individuals. Neuroinflammation has been identified as a hallmark of POCD. However, safe and effective treatments of POCD are still lacking. Itaconate is an immunoregulatory metabolite derived from the tricarboxylic acid cycle that exerts anti-inflammatory effects by activating the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. In this study, we investigated the effects and underlying mechanism of 4-octyl itaconate (OI), a cell-permeable itaconate derivative, on POCD in aged mice. Methods A POCD animal model was established by performing aseptic laparotomy in 18-month-old male C57BL/6 mice under isoflurane anesthesia while maintaining spontaneous ventilation. OI was intraperitoneally injected into the mice after surgery. Primary microglia and neurons were isolated and treated to lipopolysaccharide (LPS), isoflurane, and OI. Cognitive function, neuroinflammatory responses, as well as levels of gut microbiota and their metabolites were evaluated. To determine the mechanisms underlying the therapeutic effects of OI in POCD, ML385, an antagonist of Nrf2, was administered intraperitoneally. Cognitive function, neuroinflammatory responses, endogenous neurogenesis, neuronal apoptosis, and Nrf2/extracellular signal-related kinases (ERK) signaling pathway were evaluated. Results Our findings revealed that OI treatment significantly alleviated anesthesia/surgery-induced cognitive impairment, concomitant with reduced levels of the neuroinflammatory cytokines IL-1β and IL-6, as well as suppressed activation of microglia and astrocytes in the hippocampus. Similarly, OI treatment inhibited the expression of IL-1β and IL-6 in LPS and isoflurane-induced primary microglia in vitro. Intraperitoneal administration of OI led to alterations in the gut microbiota and promoted the production of microbiota-derived metabolites associated with neurogenesis. We further confirmed that OI promoted endogenous neurogenesis and inhibited neuronal apoptosis in the hippocampal dentate gyrus of aged mice. Mechanistically, we observed a decrease in Nrf2 expression in hippocampal neurons both in vitro and in vivo, which was reversed by OI treatment. We found that Nrf2 was required for OI treatment to inhibit neuroinflammation in POCD. The enhanced POCD recovery and promotion of neurogenesis triggered by OI exposure were, at least partially, mediated by the activation of the Nrf2/ERK signaling pathway. Conclusions Our findings demonstrate that OI can attenuate anesthesia/surgery-induced cognitive impairment by stabilizing the gut microbiota and activating Nrf2 signaling to restrict neuroinflammation and promote neurogenesis. Boosting endogenous itaconate or supplementation with exogenous itaconate derivatives may represent novel strategies for the treatment of POCD.

Background S100 calcium binding protein A9 (S100A9) is a pro-inflammatory alarmin associated with several inflammation-related diseases. However, the role of S100A9 in lung injury in sepsis has not been fully investigated. Therefore, the present study aimed to determine the role of S100A9 in a lipopolysaccharide (LPS)-induced lung injury murine model and its underlying molecular mechanisms. Methods LPS was utilized to induce sepsis and lung injury in C57BL/6 or NOD-like receptor family pyrin domain containing 3 (NLRP3) −/− mice. To investigate the effects of S100A9 blockade, mice were treated with a specific inhibitor of S100A9. Subsequently, lung injury and inflammation were evaluated by histology and enzyme‑linked immunosorbent assay (ELISA), respectively. Furthermore, western blot analysis and RT-qPCR were carried out to investigate the molecular mechanisms underlying the effects of S100A9. Results S100A9 was upregulated in the lung tissues of LPS-treated mice. However, inhibition of S100A9 alleviated LPS-induced lung injury. Additionally, S100A9 blockade also attenuated the inflammatory responses and apoptosis in the lungs of LPS-challenged mice. Furthermore, the increased expression of NLRP3 was also suppressed by S100A9 blockade, while S100A9 blockade had no effect on NLRP3 −/− mice. In vitro, S100A9 downregulation mitigated LPS-induced inflammation. Interestingly, these effects were blunted by NLRP3 overexpression. Conclusion The results of the current study suggested that inhibition of S100A9 could protect against LPS-induced lung injury via inhibiting the NLRP3 pathway. Therefore, S100A9 blockade could be considered as a novel therapeutic strategy for lung injury in sepsis.

Skin stem cells can regenerate epidermal appendages; however, hair follicles (HF) lost as a result of injury are barely regenerated. Here we show that macrophages in wounds activate HF stem cells, leading to telogen–anagen transition (TAT) around the wound and de novo HF regeneration, mostly through TNF signalling. Both TNF knockout and overexpression attenuate HF neogenesis in wounds, suggesting dose-dependent induction of HF neogenesis by TNF, which is consistent with TNF-induced AKT signalling in epidermal stem cells in vitro . TNF-induced β-catenin accumulation is dependent on AKT but not Wnt signalling. Inhibition of PI3K/AKT blocks depilation-induced HF TAT. Notably, Pten loss in Lgr5 + HF stem cells results in HF TAT independent of injury and promotes HF neogenesis after wounding. Thus, our results suggest that macrophage-TNF-induced AKT/β-catenin signalling in Lgr5 + HF stem cells has a crucial role in promoting HF cycling and neogenesis after wounding. Hair can be regenerated after skin wounding. Here the authors show that inflammatory macrophages produce TNF that activates Wnt signalling in hair follicle stem cells to drive this hair regeneration after wound repair in mice.