Ruxolitinib improves the inflammatory microenvironment,restores glutamate homeostasis,and promotes functional recovery after spinal cord injury

The inflammatory microenvironment and neurotoxicity can hinder neuronal regeneration and functional recovery after spinal cord injury.Ruxolitinib,a JAK-STAT inhibitor,exhibits effectiveness in autoimmune diseases,arthritis,and managing inflammatory cytokine storms.Although studies have shown the neuroprotective potential of ruxolitinib in neurological trauma,the exact mechanism by which it enhances functional recovery after spinal cord injury,particularly its effect on astrocytes,remains unclear.To address this gap,we established a mouse model of T10 spinal cord contusion and found that ruxolitinib effectively improved hindlimb motor function and reduced the area of spinal cord injury.Transcriptome sequencing analysis showed that ruxolitinib alleviated inflammation and immune response after spinal cord injury,restored EAAT2 expression,reduced glutamate levels,and alleviated excitatory toxicity.Furthermore,ruxolitinib inhibited the phosphorylation of JAK2 and STAT3 in the injured spinal cord and decreased the phosphorylation level of nuclear factor kappa-B and the expression of inflammatory factors interleukin-1β,interleukin-6,and tumor necrosis factor-α.Additionally,in glutamate-induced excitotoxicity astrocytes,ruxolitinib restored EAAT2 expression and increased glutamate uptake by inhibiting the activation of STAT3,thereby reducing glutamate-induced neurotoxicity,calcium influx,oxidative stress,and cell apoptosis,and increasing the complexity of dendritic branching.Collectively,these results indicate that ruxolitinib restores glutamate homeostasis by rescuing the expression of EAAT2 in astrocytes,reduces neurotoxicity,and effectively alleviates inflammatory and immune responses after spinal cord injury,thereby promoting functional recovery after spinal cord injury.

体外循环变温水箱非结核分枝杆菌培养及鉴定研究

目的本研究旨在了解本中心体外循环变温水箱是否有非结核分枝杆菌(NTM)污染。方法在含氯消毒剂消毒水箱后次日,留取本中心1号楼19个水箱的水样,进行NTM培养。对于水样分枝杆菌培养阳性的水箱,用无菌拭子分别涂抹水箱内胆生物膜和水箱出风口处,做NTM培养和鉴定,采用rpoβ基因和16S rRNA基因片段聚合酶链反应扩增测序,将测序结果进行基本局部比对搜索工具(BLAST)比对以确定菌种。结果4个水箱的水样检测NTM阳性,2个水箱在内胆和出风口都检测到奇美拉分枝杆菌,1个水箱仅在内胆区检测到奇美拉分枝杆菌,1个水箱在内胆区和出风口分别检测到戈登分支杆菌和奇美拉分枝杆菌。结论本中心体外循环变温水箱存在NTM污染,以奇美拉分枝杆菌为主。应通过加强变温水箱NTM监测、使用过滤水、定期清除生物膜、定期消毒、合理摆放水箱等方法降低NTM污染和感染风险。

Extradural contralateral S1 nerve root transfer for spastic lower limb paralysis

The current study aims to ascertain the anatomical feasibility of transferring the contralateral S1 ventral root(VR)to the ipsilateral L5 VR for treating unilateral spastic lower limb paralysis.Six formalin-fixed(three males and three females)cadavers were used.The VR of the contralateral S1 was transferred to the VR of the ipsilateral L5.The sural nerve was selected as a bridge between the donor and recipient nerve.The number of axons,the cross-sectional areas and the pertinent distances between the donor and recipient nerves were measured.The extradural S1 VR and L5 VR could be separated based on anatomical markers of the dorsal root ganglion.The gross distance between the S1 nerve root and L5 nerve root was 31.31(±3.23)mm in the six cadavers,while that on the diffusion tensor imaging was 47.51(±3.23)mm in 60 patients without spinal diseases,and both distances were seperately greater than that between the outlet of S1 from the spinal cord and the ganglion.The numbers of axons in the S1 VRs and L5 VRs were 13414.20(±2890.30)and 10613.20(±2135.58),respectively.The cross-sectional areas of the S1 VR and L5 VR were 1.68(±0.26)mm2 and 1.08(±0.26)mm2,respectively.In conclusion,transfer of the contralateral S1 VR to the ipsilateral L5 VR may be an anatomically feasible treatment option for unilateral spastic lower limb paralysis.

Position and complications of pedicle screw insertion with or without image-navigation techniques in the thoracolumbar spine:a meta-analysis of comparative studies

Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications.However,some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques.Additionally,inconsistent conclusions have been drawn in various studies due to different population characteristics and methods used to assess the accuracy of screw placement.Moreover,it is not clear whether pedicle screw insertion with navigation techniques decreases the incidence of screw-related complications.Therefore,this study was sought to perform a meta-analysis of all available prospective evidence regarding pedicle screw insertion with or without navigation techniques in human thoracic and lumbar spine.We considered in vivo comparative studies that assessed the results of pedicle screw placement with or without navigation techniques.PubMed,Ovid MEDLINE and EMBASE databases were searched.Three published randomized controlled trials（RCTs） and nine retrospective comparative studies met the inclusion criteria.These studies included a total of 732 patients in whom 4,953 screws were inserted.In conclusion,accuracy of the position of grade I,II,III and IV screws and complication rate related to pedicle screw placement were significantly increased when navigation techniques were used in comparison to conventional techniques.Future research in this area should include RCTs with well-planned methodology to limit bias and report on validated,patient-based outcome measures.

Mitomycin C induces apoptosis in human epidural scar fibroblasts after surgical decompression for spinal cord injury

Numerous studies have shown that topical application of mitomycin C after surgical decompression effectively reduces scar adhesion. However, the underlying mechanisms remain unclear. In this study, we investigated the effect of mitomycin C on the proliferation and apoptosis of human epidural scar fibroblasts. Human epidural scar fibroblasts were treated with various concentrations of mitomycin C （1, 5, 10, 20, 40 μg/mL） for 12, 24 and 48 hours. Mitomycin C suppressed the growth of these cells in a dose- and time-dependent manner. Mitomycin C upregulated the expression levels of Fas, DR4, DR5, cleaved caspase-8/9, Bax, Bim and cleaved caspase-3 proteins, and it downregulated Bcl-2 and Bcl-xL expression. In addition, inhibitors of caspase-8 and caspase-9 （Z-IETD-FMK and Z-LEHD-FMK, respectively） did not fully inhibit mitomycin C-induced apoptosis. Furthermore, mitomycin C induced endoplasmic reticulum stress by increasing the expression of glucose-regulated protein 78, CAAT/enhancer-binding protein homologous protein （CHOP） and caspase 4 in a dose-dependent manner. Salubrinal significantly inhibited the mitomycin C-induced cell viability loss and apoptosis, and these effects were accompanied by a reduction in CHOP expression. Our results support the hypothesis that mitomycin C induces human epidural scar fibroblast apoptosis, at least in part, via the endoplasmic reticulum stress pathway.

Comparison of the modified Wiltse’s approach with spinal minimally invasive system and traditional approach for the therapy of thoracolumbar fracture

Thoracolumbar fractures are usually treated by open posterior pedicle screw fixation.However,this procedure involves massive paraspinal muscle stripping,inflicting surgical trauma,and prolonged X-ray exposure.In this study,we observed 127 patients with single-segment injury thoracolumbar fractures.Thirty-six patients were treated by the modified Wiltse’s paraspinal approach with minimally invasive channel system,while 91 patients were treated via traditional posterior approach.Operation time,intraoperative blood loss,intraoperative fluoroscopy frequency,screw placement accuracy,visual analogue scale score,and Cobb’s angle of two groups were compared.The X-ray exposure times were notably reduced(4.2±1.6) in the new approach group(P<0.05).The pedicle screw placement accuracy and Cobb’s angle after surgery were similar in the two groups.We conclude that modified Wiltse’s paraspinal approach w ith spinal minimally invasive channel system surgery can significantly reduce the X-ray exposure times and is an alternative therapy for the thoracolumbar fracture.

Neuroanatomy and clinical analysis of the cervical sympathetic trunk and longus colli

Anterior cervical surgery is commonly used for cervical vertebral body lesions. However, the structure of blood vessels and nerve tissues along the route of anterior cervical surgery is complex. We aimed to measure the data of the longus colli, the sympathetic trunk and the cervical sympathetic trunk （CST） ganglia in Chinese cadaver speci- mens. A total of 32 adult cadavers were studied. We delineated the surgical anatomy of the CST. The superior and inferior/cervicothoracic ganglia of the sympathetic trunk consistently appeared. The middle ganglion was observed in 28.1% of the specimens and there were 2 cases of unilateral double middle cervical ganglia. The inferior ganglion was observed in 25.0% of the specimens and the cervicothoracic ganglion was observed in the remaining speci- mens. The distance between the CST gradually decreased from the top to the bottom, and the distance between the medial edges of the longus colli gradually broadened from the top down. The average angle between the bilat- eral CST and the midline of the vertebra was 11.2°± 1.8° on the left side and 10.3°± 1.4° on the right side. The average angle between the medial margins of longus colli of both sides was 11.1°± 1.9°. The CST is at high risk when LC muscle is cut transversely or is dragged heavily, especially at the levels of C6 and C7. Awareness of the regional anatomy of the CST could help surgeons to identify and preserve it during anterior cervical surgeries.

A comparison of robot-assisted and fluoroscopy-assisted kyphoplasty in the treatment of multi-segmental osteoporotic vertebral compression fractures

Osteoporotic vertebral compression fracture(OVCF)has become a major public health issue that becomes more pressing with increasing global aging.Percutaneous kyphoplasty(PKP)is an effective treatment for OVCF.Robot-assisted PKP has been utilized in recent years to improve accuracy and reduce complications.However,the effectiveness of robot-assisted PKP in the treatment of multi-segmental OVCF has yet to be proved.This study was designed to compare the efficacy of robot-assisted and conventional fluoroscopy-assisted multi-segmental PKP.A total of 30 cases with multi-segmental OVCF between April 2019 and April 2021 were included in this study.Fifteen cases were assigned to the robot-assisted PKP group(robot group)and 15 cases to the conventional fluoroscopy-assisted PKP group(conventional fluoroscopy group).The number of fluoroscopic exposures,fluoroscopic dose,operation time,cement leakage rate,visual analog scale(VAS)score,vertebral kyphosis angle(VKA),and height of fractured vertebral body(HFV)were compared between the 2 groups.The number of fluoroscopic exposures,fluoroscopic doses,and cement leakage rates in the robot group were lower than in the conventional fluoroscopy group(P<0.05)while the operative time in the robot group was longer than in the conventional fluoroscopy group(P<0.05).VAS score and VKA were decreased and HFV was increased after surgery in both groups(P<0.05).Therefore,robot-assisted PKP for the treatment of multi-segmental OVCF can reduce the number of fluoroscopic exposures,fluoroscopic doses,and cement leakage compared to conventional treatment.As such,robot-assisted PKP has good application prospects and is potentially more effective in the treatment of multi-segmental OVCF.

Tacrolimus reduces scar formation and promotes sciatic nerve regeneration

A sciatic nerve transection and repair model was established in Sprague-Dawley rats by transecting the tendon of obturator internus muscle in the greater sciatic foramen and suturing with nylon sutures. The models were treated with tacrolimus gavage （4 mg/kg per day） for 0, 2, 4 and 6 weeks. Specimens were harvested at 6 weeks of intragastric administration. Masson staining revealed that the collagen fiber content and scar area in the nerve anastomosis of the sciatic nerve injury rats were significantly reduced after tacrolimus administration. Hematoxylin-eosin staining showed that tacrolimus significantly increased myelinated nerve fiber density, average axon diameter and myelin sheath thickness. Intragastric administration of tacrolimus also led to a significant increase in the recovery rate of gastrocnemius muscle wet weight and the sciatic functional index after sciatic nerve injury. The above indices were most significantly improved at 6 weeks after of tacrolimus gavage. The myelinated nerve fiber density in the nerve anastomosis and the sciatic nerve functions had a significant negative correlation with the scar area, as detected by Spearman＇s rank correlation analysis. These findings indicate that tacrolimus can promote peripheral nerve regeneration and accelerate the recovery of neurological function through the reduction of scar formation.

腔内激光与泡沫硬化剂闭合术在轻中度下肢静脉曲张治疗中的应用价值对比

目的对比腔内激光和泡沫硬化剂闭合术治疗轻中度下肢静脉曲张的疗效及安全性。方法收集2019年1月至2020年12月运城市中心医院收治的120例轻中度下肢静脉曲张患者临床资料,根据治疗方法不同将患者分为对照组(实施腔内激光闭合术)和观察组(实施泡沫硬化剂闭合术),每组60例。比较两组患者的围手术期指标,包括手术时间、术中出血量、穿刺点数量、治疗费用及住院时间。比较两组患者术前及术后1周凝血功能指标[纤溶酶原激活物抑制物(PAI-1)、纤维蛋白原(Fib)、纤溶酶原激活物(t-PA)]和炎性反应指标[白细胞介素-10(IL-10)、白细胞介素-2(IL-2)]。比较两组患者术后1周、6个月的疗效及术后1周的并发症发生情况。结果观察组患者的手术时间明显短于对照组患者,穿刺点数量明显少于对照组患者,差异均有统计学意义(P<0.01)。与对照组患者相比,观察组患者术后1周的PAI-1、Fib、IL-2水平明显降低,t-PA、IL-10水平明显升高,差异均有统计学意义(P<0.01)。术后1周、6个月,两组患者的治疗总有效率比较,差异均无统计学意义(P>0.05)。术后1周,对照组患者的并发症总发生率明显高于观察组患者,差异有统计学意义(P<0.05)。结论腔内激光闭合术和泡沫硬化剂闭合术均是治疗轻中度下肢静脉曲张的有效手段,疗效相当,但泡沫硬化剂闭合术对患者凝血功能及炎性反应的改善更显著,术后并发症发生率更低。

Rapid identification of spinal ventral and dorsal roots using a quartz crystal microbalance

The fast and accurate identification of nerve tracts is critical for successful nerve anastomosis. Taking advantage of differences in acetylcholinesterase content between the spinal ventral and dorsal roots, we developed a novel quartz crystal microbalance method to distinguish between these nerves based on acetylcholinesterase antibody reactivity. The acetylcholinesterase antibody was immobilized on the electrode surface of a quartz crystal microbalance and reacted with the acetylcholinesterase in sample solution. The formed antigen and antibody complexes added to the mass of the electrode inducing a change in frequency of the electrode. The spinal ventral and dorsal roots were distinguished by the change in frequency. The ventral and dorsal roots were cut into 1 to 2-mm long segments and then soaked in 250 pL PBS. Acetylcholinesterase antibody was immobilized on the quartz crystal microbalance gold electrode surface. The results revealed that in 10 minutes, both spinal ventral and dorsal roots induced a frequency change; however, the frequency change induced by the ventral roots was notably higher than that induced by the dorsal roots. No change was induced by bovine serum albumin or PBS. These results clearly demonstrate that a quartz crystal microbalance sensor can be used as a rapid, highly sensitive and accurate detection tool for the quick identification of spinal nerve roots intraoperatively.

Potential risk of mitomycin C at high concentrations on peripheral nerve structure

Although the local application of mitomycin C may prevent epidural adhesion after laminectomy, mitomycin C can induce neurotoxicity in optic and acoustic nerves at high concentrations. To determine the safe concentration range for mitomycin C, cotton pads soaked with mitomycin C at different concentrations （0.1, 0.3, 0.5, and 0.7 mg/mL） were immediately applied for 5 minutes to the operation area of rats that had undergone laminectomy at L1. Rat sciatic nerves, instead of dorsal nerves, were used in this study. The results showed that mitomycin C at 0.1-0.5 mg/mL did not damage the structure and function of the sciatic nerve, while at 0.7 mg/mL, mitomycin C signiifcantly reduced the thickness of the sciatic nerve myelin sheath compared with lower concen-trations, though no functional change was found. These experimental ifndings indicate that the local application of mitomycin C at low concentrations is safe to prevent scar adhesion following laminectomy, but that mitomycin C at high concentrations （＆gt;0.7 mg/mL） has potential safety risks to peripheral nerve structures.

A novel entry point for pedicle screw placement in the thoracic spine

This study was aimed to introduce a novel entry point for pedicle screw fixation in the thoracic spine and compare it with the traditional entry point. A novel entry point was found with the aim of improving accuracy, safety and stability of pedicle screw technique based on anatomical structures of the spine. A total of 76 pieces of normal thoracic CT images at the transverse plane and the thoracic pedicle anatomy of 6 cadaveric specimens were recruited.Transverse pedicle angle（TPA）, screw length, screw placement accuracy rate and axial pullout strength of the two different entry point groups were compared. There were significant differences in the TPA, screw length, and the screw placement accuracy rate between the two groups（P〈0.05）. The maximum axial pullout strength of the novel entry point group was slightly larger than that of the traditional group. However, the difference was not significant（P 〉 0.05）. The novel entry point significantly improved the accuracy, stability and safety of pedicle screw placement.With reference to the advantages above, the new entry point can be used for spinal internal fixations in the thoracic spine.

A drone‑and feld‑based investigation of the land degradation and soil erosion at an opencast coal mine dump after 5 years’evolution of natural processes

Opencast coal mining has a large impact on the land surface,both at the mining pits themselves and at waste sites.After artifcial management is stopped,a reclaimed opencast coal mine dump is afected by wind and water erosion from natural processes,resulting in land degradation and even safety incidents.In this paper,the soil erosion and land degradation after 5 years of such natural processes,at the Xilinhot opencast coal mine dump in Inner Mongolia,were investigated.A multisource data acquisition method was applied:the vegetation fraction coverage(VFC)was extracted from GF-1 satellite imagery,high-precision terrain characteristics and the location and degree of soil erosion were obtained using a drone,and the physical properties of the topsoil were obtained by feld sampling.On this basis,the degree and spatial distribution of erosion cracks were identifed,and the causes of soil erosion and land degradation were analyzed using the geographical detector.The results show that(1)multi-source data acquisition method can provide efective basic data for the quantitative evaluation of the ecological environment at dumps,and(2)slope aspect and VFC are the main factors afecting the degree of degradation and soil erosion.Based on above analysis,several countermeasures are proposed to mitigate land degradation:(1)The windward slope be designed to imitate the natural landform.(2)Reasonable engineering measures should be applied at the slope to restrain soil erosion.(3)The Pioneer plants should be widely planted on the platform at the early stage of reclamation.

A novel extradural nerve transfer technique by coaptation of C4 to C5 and C7 to C6 for treating isolated upper trunk avulsion of the brachial plexus

The study aimed to demonstrate the feasibility of an extradural nerve anastomosis technique for the restoration of a C5 and C6 avulsion of the brachial plexus.Nine fresh frozen human cadavers were used.The diameters,sizes,and locations of the extradural spinal nerve roots were observed.The lengths of the extradural spinal nerve roots and the distance between the neighboring nerve root outlets were measured and compared in the cervical segments.In the spinal canal,the ventral and dorsal roots were separated by the dura and arachnoid.The ventral and dorsal roots of C7 had sufficient lengths to anastomose those of C6.The ventral and dorsal of C4 had enough length to be transferred to those of C5,respectively.The feasibility of this extradural nerve anastomosis technique for restoring C5 and C6 avulsion of the brachial plexus in human cadavers was demonstrated in our anatomical study.

DIC imaging for identification of motor and sensory nerves

Identification of motor and sensory nerves is important in applications such as nerve injury repair.Conventional practice relies on time consuming staining methods for this purpose.Here,we use laser scanning infrared diferential interference contrast(IR-DIC)microscopy for label-free observation of the two types of nerve.Ventral and dorsal nerve roots of adult beagle dogs were collected and sections of different thicknesses were imaged with an IR-DIC microscope.Different texture patterns of the IR-DIC images of the motor and sensory nerve can be distinguished when the section thickness increases to 40 pm.This suggests that nerve fibers in motor and sensory nerves have different distribution patterns.The result hints a potential new way for more rapid identification of nerve type in peripheral nerve repair surgery.

氨甲环酸对于不同体外循环预充液凝血功能的影响

目的观察氨甲环酸对于不同体外循环预充液用于成人体外循环预充对术后凝血功能的影响。方法采用双盲、随机对照研究方法,272例18岁以上于2019年6月至2019年12月于本院行体外循环下心脏手术患者,分为白蛋白预充组(1g/kg)(A组,n=68)、羟乙基淀粉130/0.4电解质注射液组(40ml/kg)(B组,n=68)、预充氨甲环酸(30mg/kg)且白蛋白预充组(1g/kg)(C组,n=68)、预充氨甲环酸(30mg/kg)且羟乙基淀粉130/0.4电解质注射液组(40ml/kg)(D组,n=68),应用血栓弹力图测定检测转前、鱼精蛋白中和后15min、转后4h及术后24h的凝血功能。结果四组患者年龄、身高、体重、性别、手术种类及术前心功能差异均无统计学意义(P>0.05),体外循环时间、主动脉阻断时间、术后呼吸机辅助通气时间、ICU监护时间、术后24h红细胞用量差异均无统计学意义(P>0.05);24h胸液引流量B组显著高于其余三组(P=0.009)。组间比较,Pt在T2时点B组与A组、C组、D组有显著性差异(P=0.005);MA值在T2时点A组与B组、C组、D组有显著性差异(P=0.023、0.016、0.033),B组与C组、D组有显著性差异(P=0.001、0.005);MA值在T3时点A组与C组、D组有显著性差异(P=0.022、0.026),B组与C组、D组有显著性差异(P=0.032、0.028);α角在T2时点A组与B组、C组、D组有显著性差异(P=0.035、0.026、0.019),B组与C组、D组有显著性差异(P=0.009、0.004),T3时点B组与C组、D组有显著性差异(P=0.032、0.043)。结论氨甲环酸能显著改善体外循环术中、术后凝血功能,有效减少手术后出血量,对于不同预充液引起的凝血功能障碍,可起到改善作用。

Surface enhanced Raman spectroscopy signals of mixed pesticides and their identification

A rapid and sensitive method to identify and analyze mixed pesticides of tricyclazole,paraquat and flusilazole by surface-enhanced Raman scattering has been reported.Aqueous samples can be detected by SERS in low concentrations of 0.01 mg/L, 0.1 mg/L and 2.85 mg/L for individual tricyclazole,paraquat and flusilazole respectively.When mixing the three pesticides in the low concentrations,their characteristic peaks can still be identified from the SERS spectrum of the mixture.

Rapid and sensitive detection of pesticides by surface-enhanced Raman spectroscopy technique based on glycidyl methacrylate-ethylene dimethacrylate(GMA-EDMA) porous material

A novel method of fast and sensitive SERS detection using GMA-EDMA porous material combined with a miniature device was reported in this study. A 100 μL solution containing sample, silver colloid and NaC1 was evenly mixed to ensure the sample molecules would adsorb onto silver nanoparticles. Then the mixture was added onto the porous material surface slowly, so that the aggregation of silver colloid would stay on the surface while the liquid components would flow away. This technology can improve the sensitivity of SERS detection. By this method, two pesticides tricyclazole and paraquat were successfully detected at concentrations of 5 × 10 3 mg/L and I × 10-3 mg/L, respectively.