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Study Design: Biomechanical study.Purpose: To quantitatively investigate the effect of screw size on screw fixation in osteoporotic vertebrae with finite element analysis (FEA)Overview of Literature: Osteoporosis poses a challenge in spinal instrumentation; however, the selection of screw size is directly related to fixation and is closely dependent on each surgeon’s experience and preference.Methods: Total 1,200 nonlinear FEA with various screw diameters (4.5–7.5 mm) and lengths (30–50 mm) were performed on 25 patients (seven men and 18 women; mean age, 75.2±10.8 years) with osteoporosis. The axial pullout strength, and the vertebral fixation strength of a paired-screw construct against flexion, extension, lateral bending, and axial rotation were examined. Thereafter, we calculated the equivalent stress of the bone-screw interface during nondestructive loading. Then, using diameter parameters (screw diameter or screw fitness in the pedicle [%fill]), and length parameters (screw length or screw depth in the vertebral body [%length]), multiple regression analyses were performed in order to evaluate the factors affecting various fixations.Results: Larger diameter and longer screws significantly increased the pullout strength and vertebral fixation strength; further, they decreased the equivalent stress around the screws. Multiple regression analyses showed that the actual screw diameter and %length were factors that had a stronger effect on the fixation strength than %fill and the actual screw length. Screw diameter had a greater effect on the resistance to screw pullout and flexion and extension loading (β =0.38–0.43, p <0.01); while the %length had a greater effect on resistance to lateral bending and axial rotation loading (β =0.25–0.36, p <0.01) as well as mechanical stress of the bone-screw interface (β =−0.42, p <0.01).Conclusions: The screw size should be determined based on the biomechanical behavior of the screws, type of mechanical force applied on the corresponding vertebra, and anatomical limitations.

Recruitment, the addition of new individuals into a community, is an important factor that can substantially affect community composition and dynamics. We present a method for calibrating spatial models of plant recruitment that does not require identifying the specific parent of each recruit. This method calibrates seedling recruitment functions by comparing tree seedling distributions with adult distributions via a maximum likelihood analysis. The models obtained from this method can then be used to predict the spatial distributions of seedlings from adult distributions. We calibrated recruitment functions for 10 tree species characteristics of transition oak-northern hardwood forests. Significant differences were found in recruit abundances and spatial distributions. Predicted seedling recruitment limitation for test stands varied substantially between species, with little recruitment limitation for some species and strong recruitment limitation for others. Recruitment was limited due to low overall recruit production or to restricted recruit dispersion. When these seedlings recruitment parameters were incorporated into a spatial, individual-based model of forest dynamics, called SORTIE, alterations of recruitment parameters produced substantial changes in species abundance, providing additional support for the potential importance of seedling recruitment processes in community structure and dynamics.

Experimental animal study. This study aimed to assess effects of conditioned medium (CM) of dental pulp-derived stem cells loaded in collagen hydrogel on functional recovery following spinal cord injury (SCI). SCI affects sensory and motor functions, and behavioral recovery is the most essential purpose of therapeutic intervention. Recent studies have reported that CM from dental pulp-derived stem cells has therapeutic benefits. In addition, collagen hydrogel acts as a drug delivery system in SCI experiments. Stem cells from human exfoliated deciduous teeth (SHEDs) were cultured, and SHED-CM was harvested and concentrated. Collagen hydrogel containing SHED-CM was prepared. The rats were divided into five groups receiving laminectomy, compressive SCI with or without intraspinal injection of biomaterials (SHED-CM), and collagen hydrogel with or without SHED-CM. Basso, Beattie, and Bresnahan (BBB) scoring, inclined plane, cold allodynia, and beam walk tests were performed for 6 weeks to assess locomotor, motor, sensory, and sensory-motor performances, respectively. Scores of the rats receiving SHED-CM loaded in collagen hydrogel were significantly better than those of the other injured groups at 1-week post-injury for BBB, 2 weeks for inclined plane, 2 weeks for cold allodynia, and 4 weeks for beam walk tests (p <0.05). The differences remained significant throughout the study. Intraspinal administration of SHED-CM loaded in collagen hydrogel leads to improved functional recovery and proposes a cell-free therapeutic approach for SCI.

A biomechanical study of pedicle-screw pullout strength. To develop a decision tree based on pullout strength for evaluating pedicle-screw instrumentation. Clinically, a surgeon's understanding of the holding power of a pedicle screw is based on perioperative intuition (which is like insertion torque) while inserting the screw. This is a subjective feeling that depends on the skill and experience of the surgeon. With the advent of robotic surgery, there is an urgent need for the creation of a patient-specific surgical planning system. A learning-based predictive model is needed to understand the sensitivity of pedicle-screw holding power to various factors. Pullout studies were carried out on rigid polyurethane foam, representing extremely osteoporotic to normal bone for different insertion depths and angles of a pedicle screw. The results of these experimental studies were used to build a pullout-strength predictor and a decision tree using a machine-learning approach. Based on analysis of variance, it was found that all the factors under study had a significant effect (p <0.05) on the holding power of a pedicle screw. Of the various machine-learning techniques, the random forest regression model performed well in predicting the pullout strength and in creating a decision tree. Performance was evaluated, and a correlation coefficient of 0.99 was obtained between the observed and predicted values. The mean and standard deviation of the normalized predicted pullout strength for the confirmation experiment using the current model was 1.01±0.04. The random forest regression model was used to build a pullout-strength predictor and decision tree. The model was able to predict the holding power of a pedicle screw for any combination of density, insertion depth, and insertion angle for the chosen range. The decision-tree model can be applied in patient-specific surgical planning and a decision-support system for spine-fusion surgery.

Objective To investigate whether herb cake-insulated moxibustion affects the expression of cholesterol metabolism-related protein 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGR) and inhibits the development of atherosclerosis by regulating the exosomal miR-223 expression. Methods Thirty-six male New Zealand rabbits were randomly assigned to a normal group, a model group, and an herb cake-insulated moxibustion group, with 12 rabbits in each group. The model and the herb cake-insulated moxibustion groups were fed a high-fat diet for 8 weeks to induce an atherosclerosis model. Following successful modeling, the herb cake-insulated moxibustion group was subjected to bundling and herb cake-insulated moxibustion intervention, while the other two groups were subjected only to bundling without moxibustion. After 8 weeks of intervention, hematoxylin-eosin (HE) staining was used to observe aortic morphology; the serum levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) were detected using an automatic biochemical analyzer in each group. Exosome morphology was observed using the transmission electron microscope; Western blotting (WB) was used to detect the protein levels of serum exosomal CD63 and CD9 markers, as well as liver HMGR; additionally, real-time fluorescence quantitative polymerase chain reaction was used to quantify serum exosomal miR-223. Results HE staining showed thickened aortic intima, lipid infiltration, foam cell aggregation, and structural damage to the arterial wall in the model group. Meanwhile, after modeling, the serum levels of LDL-C, TC, and TG increased significantly in the model and herb cake-insulated moxibustion groups compared to the normal group ( P <0.05), suggesting successful atherosclerosis rabbit model preparation. The serum exosomes of rabbits in the model group exhibited a saucer-like or semi-concave spherical shape with diameters of 120–150 nm. WB detection results showed positive expression of the exosomal markers CD63 and CD9. After 8 weeks of intervention, the miR-223 level in the model group was significantly lower than that in the normal group ( P <0.01). In contrast, the herb cake-insulated moxibustion group demonstrated significantly reduced serum levels of TC, TG, and LDL-C ( P <0.05), increased miR-223 expression ( P <0.01), and decreased relative liver HMGR protein expression ( P <0.05) compared to the model group. Conclusion Herb cake-insulated moxibustion may alleviate the progression of atherosclerosis by up-regulating exosomal miR-223 expression and down-regulating HMGR protein expression, thereby inhibiting cholesterol anabolic metabolism.

Objective To compare the effects of manual acupuncture (MA), electroacupuncture (EA), and moxibustion on knee joint cartilage morphology, serum inflammatory factors interleukin (IL)-6 and IL-10, matrix metalloproteinase 13 (MMP13), and intestinal flora composition in knee osteoarthritis (KOA) model rats. Methods Forty male specific-pathogen-free Sprague-Dawley rats aged seven weeks were randomly divided into a normal group ( n =8) and a KOA modeling group ( n =32). The KOA model was established using sodium iodoacetate induction. The KOA modeling rats were further randomly divided into a model group, an MA group, an EA group, and a moxibustion group, with 8 rats in each group. In the MA, EA, and moxibustion groups, interventions targeting the right Futu (ST32) and Zusanli (ST36) were performed for 15 min, once every other day, for 14 sessions. The normal and model groups were bundled on the self-made fixation frame for 15 min. The rat knee joint diameter was measured on the 8th day of adaptive feeding, after successful modeling, and after the 14th intervention. Lequesne behavioral scoring was performed after successful modeling and after the 14th intervention. After the 14th intervention, hematoxylin-eosin (HE) staining and Masson staining were performed with the cartilage sections of the right knee joint. The pathomorphological changes of the rat joint cartilage were observed and quantified by Mankin’s score. Enzyme-linked immunosorbent assay was used to detect the rat serum levels of IL-6, IL-10, and MMP13. Additionally, 16S rDNA sequencing was used to detect the composition of rat fecal flora. Results Compared to the normal group, the right knee joint diameter and the Lequesne score were significantly increased in the model group ( P <0.01). Compared to the model group, the right knee joint diameter and the Lequesne score of rats in the MA, EA, and moxibustion groups were significantly reduced ( P <0.01), with no significant differences among the three intervention groups ( P >0.05). HE staining and Masson staining revealed disordered cartilage structure in the model group, which was improved following interventions in the MA group, EA group, and moxibustion group. Mankin’s score was significantly higher in the model group versus the normal group ( P <0.05) while significantly lower in the MA, EA, and moxibustion groups versus the model group ( P <0.05). Serum analysis showed elevated IL-6 and MMP13 levels and reduced IL-10 level in the model group versus the normal group ( P <0.05). Compared to the model group, the serum IL-6 level was significantly reduced ( P <0.05), and the IL-10 level was significantly increased ( P <0.05) in the MA, EA, and moxibustion groups, but without statistical differences among the three intervention groups ( P >0.05); moreover, the MMP13 level in the moxibustion group was significantly lower than that in the model group ( P <0.05). The alpha diversity analysis of intestinal flora showed no statistical difference in the number of operational taxonomic units (OTUs) and alpha diversity index among groups ( P >0.05). Intestinal flora beta diversity analysis revealed significant differences among groups ( P <0.05). Intestinal flora composition analysis showed significantly increased relative abundance of Lactobacillus ( P <0.05) and significantly decreased relative abundance of Eubacterium_coprostanoligenes ( P <0.05) in the model group compared to the normal group; compared to the model group, the relative abundances of Firmicutes, Lactobacillus , and Romboutsia in the MA, EA, and moxibustion groups were significantly reduced ( P <0.05); the relative abundance of Bacteroidetes and Lachnospiraceae_NK4A136 in the MA group increased significantly ( P <0.05); Bacteroidetes and Ruminococcaceaae_UGC-005 increased significantly in the moxibustion group ( P <0.05). Conclusion MA, EA, and moxibustion effectively reduced knee joint swelling, improved cartilage tissue morphology, optimized intestinal flora composition, down-regulated expression levels of serum pro-inflammatory factors IL-6 and MMP13, and increased expression level of anti-inflammatory factor IL-10 in KOA rats. Among them, moxibustion exhibited the most obvious regulatory effect on inflammatory factors.

Captopril, a well-established angiotensin-converting enzyme (ACE) inhibitor, has garnered attention for its cardioprotective effects in preventing heart remodeling and maintaining cardiac function, significantly improving life quality. However, recent studies have revealed that in addition to known hemodynamic alterations, captopril exhibits significant antioxidant, anti-inflammatory, and immunomodulatory effects that may underlie its protective mechanisms. Although it appeared to be overlooked in clinical practice, in recent years, additional efforts have been made to uncover the mechanisms of all drug effects, as recent research studies predict a wide spectrum of diseases beyond the recommended indications. This review thoroughly examines the mechanisms by which captopril mediates its protective effects, bridging basic biochemical observations with applied clinical investigation, especially during ischemic reperfusion (I/R) injury, hypertension, and heart failure (HF). Evidence points to captopril as a promising agent for modulating oxidative and inflammatory pathways that are crucial for cardiovascular medicine. Directions for future research are defined to determine the molecular targets of captopril further and to optimize its clinical utility in the management of cardiovascular and possibly other diseases.

Objective To observe the effects of acupuncture on the motor function of Parkinson disease (PD) model mice and to investigate the neuroprotective effects of acupuncture on PD from the perspective of cellular senescence. Methods C57BL/6J mice were randomly divided into a normal control (NC) group, a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) group, an acupuncture (ACU) group, and a rasagiline (RAS) group, with 6 mice in each group. Except for the mice in the NC group, all mice were injected intraperitoneally with MPTP [30 mg/(kg·bw)] to establish a PD mouse model. After the models were successfully established, mice in the ACU group received acupuncture at Baihui (GV20) and bilateral Yanglingquan (GB34) for 15 min, once a day for 14 consecutive days. Mice in the RAS group were treated with gavage of rasagiline mesylate [0.5 mg/(kg·bw)], once daily for 14 d. Mouse balance and motor functions were detected using the mouse fatigue rotating rod apparatus. Immunohistochemistry staining was used to detect the number of tyrosine hydroxylase (TH)-positive neurons and the protein expression levels of special AT-rich sequence-binding protein 1 (SATB1), p21, and p53 in the substantia nigra (SN) region of the mouse brain in each group. The glutathione peroxidase (GSH-Px) activity of mouse brain SN tissue was detected by enzyme-linked immunosorbent assay. The protein expression levels of interleukin (IL)-6 and senescence-associated β-galactosidase (SA-β-gal) in the SN tissue of mice in each group were detected by Western blotting. The relative expression of SATB1, p21, and p53 mRNA in the SN of each group was detected by real-time quantitative polymerase chain reaction. Results Compared with the NC group, the overall rod performance (ORP) score, the number of TH-positive neurons, and GSH-Px activity in the SN region were significantly lower in the mice in the MPTP group ( P <0.01); compared with the MPTP group, the ORP score, the number of TH-positive neurons, and GSH-Px activity were significantly increased in the ACU and RAS groups ( P <0.01 or P <0.05). Compared with the NC group, the protein levels of IL-6 and SA-β-gal in the SN tissue, the protein and mRNA expression levels of p21 and p53 were significantly increased ( P <0.01); compared with the MPTP group, the protein levels of IL-6 and SA-β-gal in the SN tissue, the protein and mRNA expression levels of p21 and p53 were significantly decreased in the ACU group and the RAS group ( P <0.01 or P <0.05). Compared with the NC group, the relative expression of SATB1 protein and mRNA in the SN of mice in the MPTP group was significantly decreased ( P <0.01); compared with mice in the MPTP group, mice in the ACU and RAS groups showed significant increases in the relative expression of SATB1 protein and mRNA ( P <0.01 or P <0.05). Conclusion Acupuncture can improve motor function and increase the number of TH-positive neurons in the SN of PD model mice. Its neuroprotective effect may relate to the regulation of the SATB1/p21 signaling pathway and the inhibition of cellular senescence-related biomarker expression in the SN.

Objective To investigate the effects of electroacupuncture on duodenal inflammation and intestinal mucosal barrier function in functional dyspepsia (FD) rats based on the Toll-like receptors 4 (TLR4)/myeloid differentiation factor 88 (Myd88) pathway. Methods Sixty male Sprague-Dawley rats were randomly divided into a blank group ( n =10) and a modeling group ( n =50). The FD model was induced in the modeling group using a multi-factor comprehensive intervention. Forty successful model rats were randomly allocated into a model (FD) group, an electroacupuncture (EA) group, a TLR4 inhibitor (TAK242) group, and an EA+TAK242 group, with 10 rats in each group. In the EA group, following acupuncture at Zusanli (ST36) and Taichong (LR3), a filiform needle was perpendicularly inserted 3 mm into the lateral side of Zusanli (ST36) bilaterally, positioned between the Stomach Meridian and the Gallbladder Meridian at the lateral edge of the tibia, serving as an auxiliary electrode. An EA instrument was then connected to Zusanli (ST36) and the auxiliary electrode on the same side for intervention. The TAK242 group received tail vein injections of TLR4 inhibitor TAK242 [0.5 mg/(kg·bw)], while the EA+TAK242 group received both TAK242 injections and EA intervention. Intragastric residual rate and small intestinal propulsion rate were observed in each group. Immunohistochemistry was used to detect tryptase expression in the duodenum; enzyme-linked immunosorbent assay was used to measure serum concentrations of 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HIAA); Western blotting was used to analyze TLR4, MyD88, zona occludens-1 (ZO-1), and junctional adhesion molecule A (JAM-A) protein expression in the duodenal tissue. Results In the FD group, the intragastric residual rate increased, small intestinal propulsion rate decreased, ZO-1 and JAM-A protein expression decreased, duodenal tryptase mean optical density increased, serum 5-HT and 5-HIAA levels increased significantly, and TLR4 and MyD88 protein expression increased significantly compared to the blank group ( P <0.01). Compared to the FD group, the EA, TAK242, and EA+TAK242 groups showed a decreased gastric residual rate, increased small intestinal propulsion rate, increased ZO-1 and JAM-A protein expression, decreased optical density of duodenal tryptase, and significantly reduced serum 5-HT and 5-HIAA, as well as decreased TLR4 and MyD88 protein levels ( P <0.01). Compared to the EA group, the TAK242 group had a higher intragastric residual rate and lower small intestinal propulsion rate ( P <0.05), decreased TLR4 protein expression ( P <0.05), no significant change in MyD88 protein expression ( P >0.05), increased optical density of duodenal tryptase ( P <0.05), increased serum 5-HT and 5-HIAA levels ( P <0.05), and decreased ZO-1 and JAM-A protein expression ( P <0.05). In the EA+TAK242 group, the intragastric residual rate was significantly lower, small intestinal propulsion rate was significantly higher, TLR4 and MyD88 protein expression was significantly lower, optical density of duodenal tryptase was significantly lower, and ZO-1 and JAM-A protein expression levels were significantly higher compared to the EA and TAK242 groups ( P <0.01). Conclusion EA promotes gastrointestinal motility, restores intestinal mucosal barrier function, and reduces inflammatory responses in FD rats, potentially through the down-regulation of the TLR4/Myd88 pathway.

Objective To observe the effects of moxibustion on the levels of glucose-6-phosphate dehydrogenase (G6PD) and reduced nicotinamide adenine dinucleotide phosphate (NADPH) in the plasma and spleen and the CD4 + T-cell number in the spleen of rats with adjuvant arthritis, thus to explore the mechanism in rheumatoid arthritis (RA) treatment with moxibustion by regulating the CD4 + T-cell proliferation through G6PD-mediated pentose phosphate pathway. Methods Twenty-seven male Sprague-Dawley rats were randomly divided into a blank group, a model group, and a moxibustion group, with 9 rats in each group. Incomplete Freund’s adjuvant was used to induce inflammation in the model group and the moxibustion group. The blank group and the model group were not intervened. In the moxibustion group, suspended moxibustion was performed at bilateral Zusanli (ST36), Guanyuan (CV4), and Ashi points for 30 min, once a day for 24 times in total. Hematoxylin-eosin staining was used to evaluate the histopathological changes of rat synovial tissue; the swelling degree of the rat toes was observed by measuring the toe volume; G6PD and NADPH in the spleen and plasma were detected by Western blotting and enzyme-linked immunosorbent assay. Flow cytometry was used to detect the CD4 + T-cell number in the spleen. Results Compared with the blank group, the levels of G6PD and NADPH in the plasma and spleen and the CD4 + T-cell number in the spleen were significantly increased in the model group ( P <0.01 or P <0.05). Compared with the model group, the NADPH level in the spleen and plasma and the CD4 + T-cell number in the spleen in the moxibustion group decreased significantly ( P <0.05 or P <0.01), and the G6PD level in the plasma decreased significantly ( P <0.05), but there was no significant difference in the G6PD level in the spleen ( P >0.05). Conclusion Moxibustion can regulate immunity and improve joint synovial inflammation in RA. The mechanism may be that the G6PD-mediated pentose phosphate pathway reduces the production of metabolite NAPDH in CD4 + T cells, thereby inhibiting the proliferation of naive CD4 + T cells.