Proper regulation of synapse formation and elimination is critical for establishing mature neuronal circuits and maintaining brain function.Synaptic abnormalities,such as defects in the density and morphology of posts...Proper regulation of synapse formation and elimination is critical for establishing mature neuronal circuits and maintaining brain function.Synaptic abnormalities,such as defects in the density and morphology of postsynaptic dendritic spines,underlie the pathology of various neuropsychiatric disorders.Protocadherin 17(PCDH17)is associated with major mood disorders,including bipolar disorder and depression.However,the molecular mechanisms by which PCDH17 regulates spine number,morphology,and behavior remain elusive.In this study,we found that PCDH17 functions at postsynaptic sites,restricting the number and size of dendritic spines in excitatory neurons.Selective overexpression of PCDH17 in the ventral hippocampal CA1 results in spine loss and anxiety-and depression-like behaviors in mice.Mechanistically,PCDH17 interacts with actin-relevant proteins and regulates actin filament(F-actin)organization.Specifically,PCDH17 binds to ROCK2,increasing its expression and subsequently enhancing the activity of downstream targets such as LIMK1 and the phosphorylation of cofilin serine-3(Ser3).Inhibition of ROCK2 activity with belumosudil(KD025)ameliorates the defective F-actin organization and spine structure induced by PCDH17 overexpression,suggesting that ROCK2 mediates the effects of PCDH17 on F-actin content and spine development.Hence,these findings reveal a novel mechanism by which PCDH17 regulates synapse development and behavior,providing pathological insights into the neurobiological basis of mood disorders.展开更多
Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been ...Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.展开更多
BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous syst...BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous system dysfunction,spinal instability and/or deformity,and cause a huge burden on society and families.Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients.At present,the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus,Streptococcus,Pneumococcus,Escherichia coli,and Klebsiella.There are no reports of spinal infection caused by Pseudomonas fluorescens.CASE SUMMARY We report a 32-year-old female patient with spinal infection.She presented with flank pain,initially thought to be bone metastases or bone tuberculosis,and had a family background of tumors.Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection.Histopathology of the lesion showed inflammation,tissue culture of the lesion was negative several times,and the possible pathogen-Pseudomonas fluorescens was found after gene sequencing of the lesion.The patient recovered completely after a full course of antibiotic treatment.CONCLUSION This report increases the range of pathogens involved in spinal infections,highlights the unique advantages of gene sequencing technology in difficult-todiagnose diseases,and validates conservative treatment with a full course of antibiotics for spinal infections without complications.展开更多
Adolescent binge drinking leads to long-lasting disorders of the adult central nervous system,particularly aberrant hippocampal neurogenesis.In this study,we applied in vivo fluorescent tracing using NestinCreERT2::Ro...Adolescent binge drinking leads to long-lasting disorders of the adult central nervous system,particularly aberrant hippocampal neurogenesis.In this study,we applied in vivo fluorescent tracing using NestinCreERT2::Rosa26-tdTomato mice and analyzed the endogenous neurogenesis lineage progression of neural stem cells(NSCs)and dendritic spine formation of newborn neurons in the subgranular zone of the dentate gyrus.We found abnormal orientation of tamoxifen-induced tdTomato+(tdTom^(+))NSCs in adult mice 2 months after treatment with EtOH(5.0 g/kg,i.p.)for 7 consecutive days.EtOH markedly inhibited tdTom^(+)NSCs activation and hippocampal neurogenesis in mouse dentate gyrus from adolescence to adulthood.EtOH(100 mM)also significantly inhibited the proliferation to 39.2%and differentiation of primary NSCs in vitro.Adult mice exposed to EtOH also exhibited marked inhibitions in dendritic spine growth and newborn neuron maturation in the dentate gyrus,which was partially reversed by voluntary running or inhibition of the mammalian target of rapamycinenhancer of zeste homolog 2 pathway.In vivo tracing revealed that EtOH induced abnormal orientation of tdTom+NSCs and spatial misposition defects of newborn neurons,thus causing the disturbance of hippocampal neurogenesis and dendritic spine remodeling in mice.展开更多
Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching...Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching methods. The use of technologies like virtual reality presents an opportunity to enhance their skills through simulations and training. The main objective of this study is to qualitatively assess the stress levels experienced by medical students and residents by integrating virtual reality into their current learning methods, aiming to improve their ability to manage stressors in their practice. Material and Methods: A questionnaire was conducted with 12 medical students and 12 Traumatology and orthopedics residents. The purpose of the questionnaire was to evaluate the levels of academic stress using the SISCO inventory. The stress levels were calculated by transforming average values into percentages, and the following criteria were assigned: 0 to 33% for Mild Stress, 34 to 66% for Moderate Stress, and 67 to 100% for Deep Stress. Then, a virtual reality class focused on spine surgery was provided. Both medical students and residents were trained using the Non Nocere SharpSurgeon software platform and Oculus Quest 2 virtual reality glasses. At the end of the session, a second questionnaire related to the practice with virtual reality was conducted with the same evaluation criteria and a comparative analysis was carried out. Results: 12 undergraduate students from Hospital Angeles Mexico, CDMX and 12 traumatology and orthopedics residents at Hospital Santa Fe, Bogota were evaluated. The students in CDMX reported an average qualitative stress of 28.50% during habitual practices, which decreased to an average of 14.67% after virtual reality practice. Residents in Bogotá experienced an average qualitative stress of 30.50% with their current learning methods but this reduced to an average of 13.92% after using virtual reality. These findings indicate that the use of virtual reality has a positive impact on reducing stress levels qualitatively. Conclusions: The use of virtual reality as a learning method for medical students and residents qualitatively improves stress levels. Further studies are required to define the potential uses of Virtual Reality to improve learning methods and emotional state in medical students and residents and for a quantitative assessment to validate the training as certified learning methods.展开更多
Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscop...Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscopic surgery of the appendicular skeleton has evolved dramatically and become an integral part of musculoskeletal surgery over the last several decades,allowing surgeons to achieve similar or better outcomes,while reducing cost and recovery time.However,to date,the axial skeleton,with its close proximity to critical neural and vascular structures,has not adopted endoscopic techniques at as rapid of a rate.Over the past decade,increased patient demand for less invasive spine surgery combined with surgeon desire to meet these demands has driven significant evolution and innovation in endoscopic spine surgery.In addition,there has been an enormous advancement in technologies that assist in navigation and automation that help surgeons circumvent limitations of direct visualization inherent to less invasive techniques.There are currently a multitude of endoscopic techniques and approaches that can be utilized in the treatment of spine disorders,many of which are evolving rapidly.Here we present a review of the field of endoscopic spine surgery,including the background,techniques,applications,current trends,and future directions,to help providers gain a better understanding of this growing modality in spine surgery.展开更多
Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension unde...Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension undergoing surgical procedures such as hemiarthroplasty present a high risk of fatal complications. Nonetheless, there are no widely accepted protocols explaining their perioperative care in great detail. Case presentation: We present a case with an 89-years-old patient, with comorbidities such as GOLD 4D chronic obstructive pulmonary disease (COPD) and, as a consequence of this, severe pulmonary hypertension with signs of right ventricular dysfunction, thus requiring of pulmonary vasodilator, that has suffered a subcapital hip fracture requiring urgent surgery. Surgery is carried out successfully, under regional lumbar-sacral plexus block and sedation assisted by non-invasive ventilation. Conclusion: Multidisciplinary specialized treatment, preoperative optimization, as well as the careful selection of both the surgical and anesthetic techniques to be used, are among the strategies that improve the perioperative outcome in patients with pulmonary hypertension with right ventricle systolic dysfunction. Regional lumbar-sacral plexus block plus sedation is a technique that maintains hemodynamic stability;however, these patients require advance measures and postoperative monitoring under intensive care.展开更多
Fruit spine is an important quality trait of cucumber.To better understand the molecular basis of cucumber spine development and function,RNA-Seq was performed to identify differentially expressed genes(DEGs)in fruit ...Fruit spine is an important quality trait of cucumber.To better understand the molecular basis of cucumber spine development and function,RNA-Seq was performed to identify differentially expressed genes(DEGs)in fruit spines of different development stages,namely,8 days before anthesis(SpBA8),anthesis(SpA)and 8 days after anthesis(SpAA8).Stage-wise comparisons obtained 2,259(SpBA8 vs.SpA),4,551(SpA vs.SpAA8),and 5,290(SpBA8 vs.SpAA8)DEGs.All the DEGs were classified into eight expression clusters by trend analysis.Among these DEGs,in addition to the Mict,Tril,CsTTG1,CsMYB6,NS,and Tu genes that have been reported to regulate fruit spine formation,we found that the CsHDG11,CsSCL8,CsSPL8,CsZFP6 and CsZFP8 may also be involved in spine development in cucumber.Our study provides a theoretical basis for further research on molecular mechanisms of spine development in cucumber.展开更多
Objective: To explore the feasibility and clinical significance of surgical approach selection for cervical spine injury guided by SLIC scoring system. Methods: The clinical data of 75 patients with lower cervical inj...Objective: To explore the feasibility and clinical significance of surgical approach selection for cervical spine injury guided by SLIC scoring system. Methods: The clinical data of 75 patients with lower cervical injury surgery from January 2020 to November 2022 were retrospectively analyzed, including 48 males and 27 females. Age: 28 - 65 years old. Causes of injury: 39 cases of traffic accidents, 15 cases of ice and snow sports, 12 cases of falling from high places, 9 cases of heavy objects. There were 12 cases of C3-4, 33 cases of C4-5, 21 cases of C5-6, and 9 cases of C6-7. Time from injury to medical treatment: 4 h - 2 d. Cervical spine X-ray, MRI, MDCT examination and preoperative SLIC score were performed on admission. Anterior approach was performed by subtotal cervical vertebrae resection or discectomy, titanium Cage or cage supported bone grafting and anterior titanium plate fixation. Posterior approach was performed with cervical laminoplasty, lateral mass or pedicle screw fixation and fusion. The combined anterior-posterior operation was performed by the anterior methods+ posterior methods. The time from injury to surgery is 12 h to 3 d. The function before and after operation was evaluated by JOA efficacy evaluation criteria. The correlation between the three surgical approaches and postoperative efficacy and SLIC score was compared. SPSS 22.0 software was used for statistical analysis of the data. Results: In this group of 75 patients, 32 cases of anterior operation, 22 cases of posterior operation and 21 cases of combined operation were followed up for no less than 12 months. There was no significant difference in age, gender, injury cause, injury segment, time from injury to treatment, and time from injury to operation among the three surgical approaches, which were comparable. The SLIC scores of mild, moderate and severe injuries of anterior surgery, posterior surgery and combined anterior and posterior surgery, They were (5.26 ± 1.24, 5.86 ± 1.67, 8.25 ± 0.21), (5.57 ± 1.43, 5.99 ± 1.85, 9.00 ± 0.25), (0, 5.98 ± 0.33, 9.44 ± 0.34), respectively. By comparing the SLIC scores and JOA scores of anterior surgery and posterior surgery, there was no difference in SLIC scores and JOA scores between the two groups for mild and moderate injuries (P > 0.05). However, the JOA scores at 3 months, 6 months and 12 months after surgery were different from those before surgery, and the postoperative efficacy and JOA scores were significantly improved (P & lt;0.05), indicating that the two surgical methods had the same therapeutic effect, that is, anterior or posterior surgery could be used to treat mild or moderate injuries (P > 0.05). There were differences in SLIC scores among the three surgical approaches for severe injury (P 0.05). The postoperative efficacy and JOA score of combined anterior-posterior approach were significantly improved compared with those before operation (P Conclusion: SLIC score not only provides accurate judgment for conservative treatment or surgical treatment of cervical spine injury, but also provides evidence-based medical basis and reference value for the selection of surgical approach and surgical method. According to the SLIC score, the surgical approach is safe and feasible. When the SLIC score is 4 - 7, anterior surgery is selected for type A injury, and posterior surgery is selected for type B injury. When the SLIC score is ≥8, combined anterior-posterior surgery should be selected. It is of great significance for clinical formulation of precision treatment strategy.展开更多
Introduction: Traumatic spinal cord injuries (TSCI) are a public health problem. Subaxial cervical spine trauma (SCST) is the most common. They are a source of neurological consequences that can affect the functional ...Introduction: Traumatic spinal cord injuries (TSCI) are a public health problem. Subaxial cervical spine trauma (SCST) is the most common. They are a source of neurological consequences that can affect the functional prognosis, but above all vital. The objective of this study was to describe the profile of patients with lower cervical spine trauma. Method: We carried out a cross-sectional and retrospective study over seven years, from January 1, 2015, to December 31, 2021, in the multipurpose surgery department of the University Hospital Center of Brazzaville. We included all patients hospitalized for SCST, having performed at least one radiological examination. We excluded all patients whose records were incomplete. Results: We recorded 90 cases of SCST, and 60 cases met our selection criteria. The median age was 37 years, with the extremes of 6 and 83, the sex ratio of 3.6. The level of education was secondary in 45 cases (75%), and university in 13 cases (21.7%). Road traffic accidents accounted for 68.3% of cases, followed by falls in 16.7%. Motorcyclists were the most frequent victims (46.3%). Among the 60 patients in the series, three (5%) had health insurance. Conclusion: The SCST concerns subjects in their thirties, of the male sex. Road traffic accidents are the first cause, and mainly concern motorcyclists.展开更多
In clinical practice,cervical spine surgery inevitably alters the original physiological structure of the cervical spine,thus causing changes in the original biomechanical properties of the cervical spine.The biomecha...In clinical practice,cervical spine surgery inevitably alters the original physiological structure of the cervical spine,thus causing changes in the original biomechanical properties of the cervical spine.The biomechanical properties of the cervical spine are particularly significant as it is an essential structure that supports the head and connects the trunk.Different cervical spine surgery options can have different effects on the biomechanics of the cervical spine.Therefore,this review will discuss recent research advances on the effects of cervical spine surgery on cervical spine biomechanics.We hope that this review will provide some theoretical basis for future studies on the biomechanical effects of cervical spine surgery on the cervical spine.展开更多
目的:探究中国腰椎研究对世界的贡献。方法:在Web of Science(WOS)核心合集数据库中,对腰椎相关研究的主题词进行文献检索,采用文献计量方法对收集到的文献进行统计和分析;利用数据库(https://www.geenmedical.com)对国家自然科学基金...目的:探究中国腰椎研究对世界的贡献。方法:在Web of Science(WOS)核心合集数据库中,对腰椎相关研究的主题词进行文献检索,采用文献计量方法对收集到的文献进行统计和分析;利用数据库(https://www.geenmedical.com)对国家自然科学基金资助的腰椎研究项目进行检索,在国家科学技术奖励工作办公室官网(https://www.nosta.gov.cn/web/index.aspx)下载2000~2020年国家科学技术进步奖资助的项目信息,检索与腰椎研究相关的项目;采用CiteSpace软件对近5年腰椎研究的文献进行可视化研究,分析腰椎研究的趋势。结果:在WOS数据库中,共检索到腰椎相关研究的论著44381篇。其中腰椎间盘退变4977篇,腰椎生物力学2977篇,腰椎间盘突出症5568篇,腰椎管狭窄症6509篇,腰椎滑脱症3861篇,退行性脊柱侧凸1155篇。TOP10国家/地区文章数量显示:美国14742篇,位居第一位;中国5432篇,仅次于美国,位居世界第二位,占比12.2%。文章发表数量方面:腰椎间盘突出症领域,中国为发文量最多的国家;其他相关的腰椎研究,中国的发文量均仅次于美国,位于全世界的第二位。2006~2019年中国国家自然科学基金资助的腰椎研究项目共91项,总资助金额4023万元,研究热点主要包括:腰椎退变、基因、生物力学。2000~2020年中国国家科学技术进步奖资助的腰椎研究项目共计9项,研究热点主要包括:脊柱畸形、骨质疏松、腰椎微创。近5年腰椎研究的趋势主要集中在腰椎退变、腰椎融合、腰椎稳定性、手术治疗原则、手术失败的危险因素、机器学习以及微创手术。结论:中国腰椎研究对世界的贡献巨大,主要表现为以下几个方面:中国多层次的基金资助机构大力资助腰椎相关的研究;中国多个高校及研究机构大力支持腰椎相关研究;众多中国腰椎领域专家高度重视腰椎研究,发表了多篇高水平的研究成果;多篇文章为高被引文献。展开更多
基金supported by the National Natural Science Foundation of China(82171506 and 31872778)Discipline Innovative Engineering Plan(111 Program)of China(B13036)+3 种基金Key Laboratory Grant from Hunan Province(2016TP1006)Department of Science and Technology of Hunan Province(2021DK2001,Innovative Team Program 2019RS1010)Innovation-Driven Team Project from Central South University(2020CX016)Hunan Hundred Talents Program for Young Outstanding Scientists。
文摘Proper regulation of synapse formation and elimination is critical for establishing mature neuronal circuits and maintaining brain function.Synaptic abnormalities,such as defects in the density and morphology of postsynaptic dendritic spines,underlie the pathology of various neuropsychiatric disorders.Protocadherin 17(PCDH17)is associated with major mood disorders,including bipolar disorder and depression.However,the molecular mechanisms by which PCDH17 regulates spine number,morphology,and behavior remain elusive.In this study,we found that PCDH17 functions at postsynaptic sites,restricting the number and size of dendritic spines in excitatory neurons.Selective overexpression of PCDH17 in the ventral hippocampal CA1 results in spine loss and anxiety-and depression-like behaviors in mice.Mechanistically,PCDH17 interacts with actin-relevant proteins and regulates actin filament(F-actin)organization.Specifically,PCDH17 binds to ROCK2,increasing its expression and subsequently enhancing the activity of downstream targets such as LIMK1 and the phosphorylation of cofilin serine-3(Ser3).Inhibition of ROCK2 activity with belumosudil(KD025)ameliorates the defective F-actin organization and spine structure induced by PCDH17 overexpression,suggesting that ROCK2 mediates the effects of PCDH17 on F-actin content and spine development.Hence,these findings reveal a novel mechanism by which PCDH17 regulates synapse development and behavior,providing pathological insights into the neurobiological basis of mood disorders.
文摘Introduction: While autograft bone is the gold standard for multilevel posterolateral lumbar fusion, bone substitutes and graft extenders such as allograft bone, ceramics and demineralized bone matrix (DBM) have been used to avoid the morbidity and insufficient quantity associated with harvesting autologous bone. The primary objective of this retrospective study was to determine whether, in patients with increased risk of operative nonunion related to multilevel fusion, adding DBM fibers to mineralized bone allograft resulted in better fusion than using allograft alone. The secondary objectives were to evaluate how adding DBM fibers affects functional disability, low back pain, intraoperative blood loss and the nonunion rate. Methods: This retrospective study involved a chart review of consecutive patients who underwent multilevel lumbar spinal fusion and were operated on by a single surgeon. The patients were divided into two groups: 14 patients received mineralized bone allograft (control group) and 14 patients received a combination of mineralized bone allograft and DBM (experimental group). Patients were reviewed at a mean of 16.4 ± 2.2 months after surgery at which point CT scans were analyzed to determine whether fusion had occurred;Oswestry disability index (ODI) and pain were also evaluated. Results: A mean of 5 levels [min 2, max 13] were fused in these patients. Posterolateral fusion as defined by the Lenke classification was not significantly different between groups. The experimental DBM group had a significantly better composite fusion score than the control group (P Discussion: Adding DBM fibers to allograft bone during multilevel posterolateral spinal fusion was safe and produced better composite fusion than using allograft only as an autograft extender.
文摘BACKGROUND The clinical incidence of spinal infection is gradually increasing,and its onset is insidious,easily leading to missed diagnosis and misdiagnosis,which may lead to serious complications such as nervous system dysfunction,spinal instability and/or deformity,and cause a huge burden on society and families.Early identification of the causative agent and precision medicine will greatly reduce the suffering of patients.At present,the main pathogenic bacteria that cause spinal infection are Staphylococcus aureus,Streptococcus,Pneumococcus,Escherichia coli,and Klebsiella.There are no reports of spinal infection caused by Pseudomonas fluorescens.CASE SUMMARY We report a 32-year-old female patient with spinal infection.She presented with flank pain,initially thought to be bone metastases or bone tuberculosis,and had a family background of tumors.Her clinical features and changes in imaging and laboratory tests led to the suspicion of thoracic spine infection.Histopathology of the lesion showed inflammation,tissue culture of the lesion was negative several times,and the possible pathogen-Pseudomonas fluorescens was found after gene sequencing of the lesion.The patient recovered completely after a full course of antibiotic treatment.CONCLUSION This report increases the range of pathogens involved in spinal infections,highlights the unique advantages of gene sequencing technology in difficult-todiagnose diseases,and validates conservative treatment with a full course of antibiotics for spinal infections without complications.
基金supported by the National Natural Science Foundation of China,Nos.31601175(to YL),81803508(to KZ),82074056(to JY)the Natural Science Foundation of Liaoning Province of China,No.20180550335(to YL)the Scientific Research Project of Educational Commission of Liaoning Province of China,No.201610163L22(to YL)。
文摘Adolescent binge drinking leads to long-lasting disorders of the adult central nervous system,particularly aberrant hippocampal neurogenesis.In this study,we applied in vivo fluorescent tracing using NestinCreERT2::Rosa26-tdTomato mice and analyzed the endogenous neurogenesis lineage progression of neural stem cells(NSCs)and dendritic spine formation of newborn neurons in the subgranular zone of the dentate gyrus.We found abnormal orientation of tamoxifen-induced tdTomato+(tdTom^(+))NSCs in adult mice 2 months after treatment with EtOH(5.0 g/kg,i.p.)for 7 consecutive days.EtOH markedly inhibited tdTom^(+)NSCs activation and hippocampal neurogenesis in mouse dentate gyrus from adolescence to adulthood.EtOH(100 mM)also significantly inhibited the proliferation to 39.2%and differentiation of primary NSCs in vitro.Adult mice exposed to EtOH also exhibited marked inhibitions in dendritic spine growth and newborn neuron maturation in the dentate gyrus,which was partially reversed by voluntary running or inhibition of the mammalian target of rapamycinenhancer of zeste homolog 2 pathway.In vivo tracing revealed that EtOH induced abnormal orientation of tdTom+NSCs and spatial misposition defects of newborn neurons,thus causing the disturbance of hippocampal neurogenesis and dendritic spine remodeling in mice.
文摘Introduction: The evaluation of academic stress in medical students and residents is a topic of significant interest, given the considerable challenges they face during their learning process with traditional teaching methods. The use of technologies like virtual reality presents an opportunity to enhance their skills through simulations and training. The main objective of this study is to qualitatively assess the stress levels experienced by medical students and residents by integrating virtual reality into their current learning methods, aiming to improve their ability to manage stressors in their practice. Material and Methods: A questionnaire was conducted with 12 medical students and 12 Traumatology and orthopedics residents. The purpose of the questionnaire was to evaluate the levels of academic stress using the SISCO inventory. The stress levels were calculated by transforming average values into percentages, and the following criteria were assigned: 0 to 33% for Mild Stress, 34 to 66% for Moderate Stress, and 67 to 100% for Deep Stress. Then, a virtual reality class focused on spine surgery was provided. Both medical students and residents were trained using the Non Nocere SharpSurgeon software platform and Oculus Quest 2 virtual reality glasses. At the end of the session, a second questionnaire related to the practice with virtual reality was conducted with the same evaluation criteria and a comparative analysis was carried out. Results: 12 undergraduate students from Hospital Angeles Mexico, CDMX and 12 traumatology and orthopedics residents at Hospital Santa Fe, Bogota were evaluated. The students in CDMX reported an average qualitative stress of 28.50% during habitual practices, which decreased to an average of 14.67% after virtual reality practice. Residents in Bogotá experienced an average qualitative stress of 30.50% with their current learning methods but this reduced to an average of 13.92% after using virtual reality. These findings indicate that the use of virtual reality has a positive impact on reducing stress levels qualitatively. Conclusions: The use of virtual reality as a learning method for medical students and residents qualitatively improves stress levels. Further studies are required to define the potential uses of Virtual Reality to improve learning methods and emotional state in medical students and residents and for a quantitative assessment to validate the training as certified learning methods.
文摘Across many of the surgical specialties,the use of minimally invasive techniques that utilize indirect visualization has been increasingly replacing traditional techniques which utilize direct visualization.Arthroscopic surgery of the appendicular skeleton has evolved dramatically and become an integral part of musculoskeletal surgery over the last several decades,allowing surgeons to achieve similar or better outcomes,while reducing cost and recovery time.However,to date,the axial skeleton,with its close proximity to critical neural and vascular structures,has not adopted endoscopic techniques at as rapid of a rate.Over the past decade,increased patient demand for less invasive spine surgery combined with surgeon desire to meet these demands has driven significant evolution and innovation in endoscopic spine surgery.In addition,there has been an enormous advancement in technologies that assist in navigation and automation that help surgeons circumvent limitations of direct visualization inherent to less invasive techniques.There are currently a multitude of endoscopic techniques and approaches that can be utilized in the treatment of spine disorders,many of which are evolving rapidly.Here we present a review of the field of endoscopic spine surgery,including the background,techniques,applications,current trends,and future directions,to help providers gain a better understanding of this growing modality in spine surgery.
文摘Background: Pulmonary hypertension is defined as a mean arterial pressure in the pulmonary artery exceeding 20 mm Hg at rest, measured by means of right heart catheterization. Patients with pulmonary hypertension undergoing surgical procedures such as hemiarthroplasty present a high risk of fatal complications. Nonetheless, there are no widely accepted protocols explaining their perioperative care in great detail. Case presentation: We present a case with an 89-years-old patient, with comorbidities such as GOLD 4D chronic obstructive pulmonary disease (COPD) and, as a consequence of this, severe pulmonary hypertension with signs of right ventricular dysfunction, thus requiring of pulmonary vasodilator, that has suffered a subcapital hip fracture requiring urgent surgery. Surgery is carried out successfully, under regional lumbar-sacral plexus block and sedation assisted by non-invasive ventilation. Conclusion: Multidisciplinary specialized treatment, preoperative optimization, as well as the careful selection of both the surgical and anesthetic techniques to be used, are among the strategies that improve the perioperative outcome in patients with pulmonary hypertension with right ventricle systolic dysfunction. Regional lumbar-sacral plexus block plus sedation is a technique that maintains hemodynamic stability;however, these patients require advance measures and postoperative monitoring under intensive care.
基金sponsored by the Natural Science Foundation of Shanghai(20ZR1439600,19ZR1436500)the Agricultural Field Project of Shanghai“Action Plan for Scientific and Technological Innovation”(20392001300)+1 种基金the Young and Middle-Aged Leading Talent Project of Shanghai Vocational College of Agriculture and Forestry(A2-0273-20-01-16)the Project of Shanghai Vocational College of Agriculture and Forestry(KY2-0000-20-01).
文摘Fruit spine is an important quality trait of cucumber.To better understand the molecular basis of cucumber spine development and function,RNA-Seq was performed to identify differentially expressed genes(DEGs)in fruit spines of different development stages,namely,8 days before anthesis(SpBA8),anthesis(SpA)and 8 days after anthesis(SpAA8).Stage-wise comparisons obtained 2,259(SpBA8 vs.SpA),4,551(SpA vs.SpAA8),and 5,290(SpBA8 vs.SpAA8)DEGs.All the DEGs were classified into eight expression clusters by trend analysis.Among these DEGs,in addition to the Mict,Tril,CsTTG1,CsMYB6,NS,and Tu genes that have been reported to regulate fruit spine formation,we found that the CsHDG11,CsSCL8,CsSPL8,CsZFP6 and CsZFP8 may also be involved in spine development in cucumber.Our study provides a theoretical basis for further research on molecular mechanisms of spine development in cucumber.
文摘Objective: To explore the feasibility and clinical significance of surgical approach selection for cervical spine injury guided by SLIC scoring system. Methods: The clinical data of 75 patients with lower cervical injury surgery from January 2020 to November 2022 were retrospectively analyzed, including 48 males and 27 females. Age: 28 - 65 years old. Causes of injury: 39 cases of traffic accidents, 15 cases of ice and snow sports, 12 cases of falling from high places, 9 cases of heavy objects. There were 12 cases of C3-4, 33 cases of C4-5, 21 cases of C5-6, and 9 cases of C6-7. Time from injury to medical treatment: 4 h - 2 d. Cervical spine X-ray, MRI, MDCT examination and preoperative SLIC score were performed on admission. Anterior approach was performed by subtotal cervical vertebrae resection or discectomy, titanium Cage or cage supported bone grafting and anterior titanium plate fixation. Posterior approach was performed with cervical laminoplasty, lateral mass or pedicle screw fixation and fusion. The combined anterior-posterior operation was performed by the anterior methods+ posterior methods. The time from injury to surgery is 12 h to 3 d. The function before and after operation was evaluated by JOA efficacy evaluation criteria. The correlation between the three surgical approaches and postoperative efficacy and SLIC score was compared. SPSS 22.0 software was used for statistical analysis of the data. Results: In this group of 75 patients, 32 cases of anterior operation, 22 cases of posterior operation and 21 cases of combined operation were followed up for no less than 12 months. There was no significant difference in age, gender, injury cause, injury segment, time from injury to treatment, and time from injury to operation among the three surgical approaches, which were comparable. The SLIC scores of mild, moderate and severe injuries of anterior surgery, posterior surgery and combined anterior and posterior surgery, They were (5.26 ± 1.24, 5.86 ± 1.67, 8.25 ± 0.21), (5.57 ± 1.43, 5.99 ± 1.85, 9.00 ± 0.25), (0, 5.98 ± 0.33, 9.44 ± 0.34), respectively. By comparing the SLIC scores and JOA scores of anterior surgery and posterior surgery, there was no difference in SLIC scores and JOA scores between the two groups for mild and moderate injuries (P > 0.05). However, the JOA scores at 3 months, 6 months and 12 months after surgery were different from those before surgery, and the postoperative efficacy and JOA scores were significantly improved (P & lt;0.05), indicating that the two surgical methods had the same therapeutic effect, that is, anterior or posterior surgery could be used to treat mild or moderate injuries (P > 0.05). There were differences in SLIC scores among the three surgical approaches for severe injury (P 0.05). The postoperative efficacy and JOA score of combined anterior-posterior approach were significantly improved compared with those before operation (P Conclusion: SLIC score not only provides accurate judgment for conservative treatment or surgical treatment of cervical spine injury, but also provides evidence-based medical basis and reference value for the selection of surgical approach and surgical method. According to the SLIC score, the surgical approach is safe and feasible. When the SLIC score is 4 - 7, anterior surgery is selected for type A injury, and posterior surgery is selected for type B injury. When the SLIC score is ≥8, combined anterior-posterior surgery should be selected. It is of great significance for clinical formulation of precision treatment strategy.
文摘Introduction: Traumatic spinal cord injuries (TSCI) are a public health problem. Subaxial cervical spine trauma (SCST) is the most common. They are a source of neurological consequences that can affect the functional prognosis, but above all vital. The objective of this study was to describe the profile of patients with lower cervical spine trauma. Method: We carried out a cross-sectional and retrospective study over seven years, from January 1, 2015, to December 31, 2021, in the multipurpose surgery department of the University Hospital Center of Brazzaville. We included all patients hospitalized for SCST, having performed at least one radiological examination. We excluded all patients whose records were incomplete. Results: We recorded 90 cases of SCST, and 60 cases met our selection criteria. The median age was 37 years, with the extremes of 6 and 83, the sex ratio of 3.6. The level of education was secondary in 45 cases (75%), and university in 13 cases (21.7%). Road traffic accidents accounted for 68.3% of cases, followed by falls in 16.7%. Motorcyclists were the most frequent victims (46.3%). Among the 60 patients in the series, three (5%) had health insurance. Conclusion: The SCST concerns subjects in their thirties, of the male sex. Road traffic accidents are the first cause, and mainly concern motorcyclists.
文摘In clinical practice,cervical spine surgery inevitably alters the original physiological structure of the cervical spine,thus causing changes in the original biomechanical properties of the cervical spine.The biomechanical properties of the cervical spine are particularly significant as it is an essential structure that supports the head and connects the trunk.Different cervical spine surgery options can have different effects on the biomechanics of the cervical spine.Therefore,this review will discuss recent research advances on the effects of cervical spine surgery on cervical spine biomechanics.We hope that this review will provide some theoretical basis for future studies on the biomechanical effects of cervical spine surgery on the cervical spine.
文摘目的:探究中国腰椎研究对世界的贡献。方法:在Web of Science(WOS)核心合集数据库中,对腰椎相关研究的主题词进行文献检索,采用文献计量方法对收集到的文献进行统计和分析;利用数据库(https://www.geenmedical.com)对国家自然科学基金资助的腰椎研究项目进行检索,在国家科学技术奖励工作办公室官网(https://www.nosta.gov.cn/web/index.aspx)下载2000~2020年国家科学技术进步奖资助的项目信息,检索与腰椎研究相关的项目;采用CiteSpace软件对近5年腰椎研究的文献进行可视化研究,分析腰椎研究的趋势。结果:在WOS数据库中,共检索到腰椎相关研究的论著44381篇。其中腰椎间盘退变4977篇,腰椎生物力学2977篇,腰椎间盘突出症5568篇,腰椎管狭窄症6509篇,腰椎滑脱症3861篇,退行性脊柱侧凸1155篇。TOP10国家/地区文章数量显示:美国14742篇,位居第一位;中国5432篇,仅次于美国,位居世界第二位,占比12.2%。文章发表数量方面:腰椎间盘突出症领域,中国为发文量最多的国家;其他相关的腰椎研究,中国的发文量均仅次于美国,位于全世界的第二位。2006~2019年中国国家自然科学基金资助的腰椎研究项目共91项,总资助金额4023万元,研究热点主要包括:腰椎退变、基因、生物力学。2000~2020年中国国家科学技术进步奖资助的腰椎研究项目共计9项,研究热点主要包括:脊柱畸形、骨质疏松、腰椎微创。近5年腰椎研究的趋势主要集中在腰椎退变、腰椎融合、腰椎稳定性、手术治疗原则、手术失败的危险因素、机器学习以及微创手术。结论:中国腰椎研究对世界的贡献巨大,主要表现为以下几个方面:中国多层次的基金资助机构大力资助腰椎相关的研究;中国多个高校及研究机构大力支持腰椎相关研究;众多中国腰椎领域专家高度重视腰椎研究,发表了多篇高水平的研究成果;多篇文章为高被引文献。
