Efficacy and Safety of Cortical Bone Trajectory Screws versus Pedicle Screws in Lumbar Fusion: A Systematic Review and Meta-Analysis.

OBJECTIVE: A systematic review and meta-analysis was conducted to compare the efficacy and safety of cortical bone trajectory (CBT) screws and traditional pedicle screws in lumbar fusion. METHODS: Randomized controlled studies and cohort studies on CBT versus pedicle screws in lumbar fusion were searched in China Biology Medicine, China National Knowledge Infrastructure, Wanfang, VIP Database for Chinese Technical and Science Periodicals, PubMed, Cochrane Library, and Web of Science databases. The search period spanned from the establishment of the databases to December 2023. The Cochrane bias risk assessment tool and Newcastle-Ottawa scale were applied to assess the quality of the literature included. Clinical and imaging data as well as surgical outcomes, recovery, and postoperative complications were extracted from the relevant literature. RESULTS: A total of 6 randomized controlled trials and 26 cohort studies were included after screening by inclusion and exclusion criteria with a total of 2478 patients. The meta-analysis demonstrated significant discrepancies between the CBT and TPS groups in Japanese Orthopaedic Association score at 3 and 6 months and final follow-up. Moreover, the TPS group exhibited a higher Oswestry disability index at final follow-up, a greater VAS for low back pain at both 1 week and final follow-up, as well as a higher VAS for leg pain at 1 month. Differences were also noted in surgical and recovery outcomes. However, there was no significant difference between the 2 groups in postoperative complications. CONCLUSIONS: CBT and TPS have analogous safety profiles when applied to lumbar fusion, but the clinical efficacy of CBT is superior to that of TPS to some extent, and the procedure is less invasive with faster recovery.

Proinflammatory follicular helper T cells promote immunoglobulin G secretion, suppress regulatory B cell development, and correlate with worse clinical outcomes in gastric cancer.

Gastric cancer is one of the most common and aggressive malignancies. Both bacterial virulence factors and host chronic inflammation are thought to promote gastric cancer development. In this study, we investigated the potential involvement of follicular helper T cells in gastric cancer. Functions of follicular helper T subsets were examined in Helicobacter pylori-infected gastric cancer patients and H. pylori-infected but asymptomatic individuals. We found that the follicular helper T cells in gastric cancer individuals were skewed toward the Th1 and Th17 subsets compared to those in H. pylori-infected but asymptomatic individuals. In a naive B cell-follicular helper T cell coculture, the Th1-follicular helper T cells by themselves were ineffective at stimulating a robust antibody response, unlike the Th2-follicular helper T and Th17-follicular helper T cells. However, Th1-follicular helper T cells significantly promoted the immunoglobulin G response in collaboration with other follicular helper T subsets, through the secretion of interferon gamma. We also found that Th1-follicular helper T cells suppressed the development of interleukin-10+ regulatory B cells, a cell type previously thought to protect H. pylori-infected individuals from tissue damage. In addition, the frequency of Th1-follicular helper T cells in gastric cancer patients was negatively correlated with the disease-free survival of gastric cancer patients after tumor resection. These results suggested that dysregulation of follicular helper T subsets in gastric cancer patients, characterized by increased Th1-follicular helper T cells, contributed to inflammation and tumor development.

A contrast study of Dermacyn on enterocoely irrigate to control intraoperative infection.

BACKGROUND: To evaluate antimicrobial properties of Dermacyn in abdominal infections, and to develop a new method for peritoneal lavage without using antibiotics. METHODS: One hundred and ten patients suffering from intestinal perforation (abdominal closed injury), who had been treated with opened surgical repair or partial intestinal resection, were enrolled in this study. In the study group, Dermacyn was used for peritoneal lavage. During the same period, 102 patients with intestinal perforation of abdominal closed injury and opened repair or partial intestinal resection were enrolled as a control group. For the control group, metronidazole physiological saline was used for peritoneal lavage. Patients from both groups had a postoperative indwelling peritoneal drainage tube. Five objective indicators were studied and compared at 24, 48, and 72 hours: volume of drainage, drainage fluid culture, blood routine test, C-reactive protein, calcitonin and antibiotics dose. RESULTS: There were no significant differences between the drainage volumes in two groups three days after the operation. There were significant differences in the nature of the drainage fluid, bacterial culture results, blood routine, C-reactive protein and procalcitonin between the two groups. In the experimental group, after the Dermacyn flushing, the average volume of peritoneal drainage fluid was reduced (from 30 to 5 mL) from 24 to 72 hours postoperatively. CONCLUSIONS: The use of Dermacyn as an antibiotic agent for intraoperative peritoneal lavage was effective in reducing the risk of infection, due to its broad-spectrum bactericidal effect. Dermacyn could be used safely to perform peritoneal flushing to clean the operation site.

Preferential Tim-3 expression on Treg and CD8(+) T cells, supported by tumor-associated macrophages, is associated with worse prognosis in gastric cancer.

While infection with H. pylori is a strong risk factor for gastric cancer, most H. pylori-colonized individuals, even those with the high-risk CagA(+)VacA(+) strain, remain asymptomatic over their lifetime. We hypothesized that the discordant outcomes were due to differences in the host immune responses. Previously, Tim-3-mediated immune modulation was observed in H. pylori-challenged mice. In this study, we compared Tim-3-related responses in CagA(+)VacA(+) H. pylori-infected asymptomatic individuals and H. pylori-associated gastric adenocarcinoma patients. We showed that compared to H. pylori-uninfected individuals, both H. pylori-infected asymptomatic and gastric cancer patients upregulated Tim-3 overall. However, the Tim-3 upregulation was enriched on Th1 cells in asymptomatic patients and on Treg and CD8(+) T cells in gastric cancer patients, with respective differences in T cell subset functions. In gastric cancer patients, high Tim-3 expression on Treg and CD8(+) T cells, but not on Th1 cells, was associated with worse prognosis. H. pylori-antigen presentation by tumor-associated macrophages upregulated Tim-3 expression more effectively than by blood monocyte-derived macrophages in vitro. The upregulation of Tim-3 in vitro depended on the concentration of H. pylori antigen but not on whether the cells were from asymptomatic or cancer patients. These data suggest that the discrepancy in Tim-3 upregulation in asymptomatic and cancer subjects is induced by cancer but not the other way around. Once gastric cancer is developed, Tim-3 expression is associated with worse prognosis.

Design and Discovery of Some Novel Chalcones as Antioxidant and Anti-Inflammatory Agents via Attenuating NF-κB.

Concerning the role of antioxidant and anti-inflammatory agents for hepatic fibrosis patients, the current study deals with the development of novel chalcone derivatives 5a-i via efficient synthetic methodology in a two-step reaction involving Claisen-Schmidt condensation. The obtained target analogs were screened for in vitro antioxidant activity by various methods (H2 O2 , DPPH, ferrous reducing power, and nitric oxide), where they exhibit considerable radical scavenging activity. These compounds were also evaluated for inhibitory potency against NF-κB activation induced by LPS for the determination of their anti-inflammatory activity. The inhibition values indicate that the entire set of compounds efficiently inhibits the NF-κB activation provoked by LPS. Among the series, compound 5i was identified as the most potent inhibitor of NF-κB, with a relative NF-κB activity of 1.12 ± 0.53. It also inhibits various inflammatory mediators, such as TNF-α, IL-1ß, IL-6, and PGE2 .

Elevated expression of immunity-related GTPase family M in gastric cancer.

Recent researches have suggested that autophagy may play critical roles in tumorigenesis. Immunity-related GTPase family M (IRGM) is a human protein highlighted for its contribution to autophagy upon inflammation and infections. Studies have shown that IRGM is involved in the development of several cancers. In the current study, we investigated expression of IRGM and gastric cancer. Levels of messenger RNA (mRNA) and protein were examined by real-time reverse transcription PCR (RT-PCR) and Western blot, respectively. Data showed that mRNA level of IRGM was significantly increased in peripheral blood mononuclear cells (PBMCs) of gastric cancer patients than in PBMCs from healthy controls (p > 0.05). Moreover, both mRNA and protein levels were significantly higher in cancer tissues compared to adjacent noncancerous stomach tissues (1.28-fold, p < 0.001; 1.19-fold, p < 0.01, respectively). However, the level of IRGM seemed not to be affected by Helicobacter pylori infection. In addition, we investigated the correlation between IRGM expression and cancer stages and identified that stage IV patients had upregulated mRNA level and protein level of IRGM in cancer tissues than those stage I patients. Our findings suggest that expression of IRGM is dysregulated in gastric cancer and that the molecule may affect progression of the disease.

Development and characterization of a novel nanoemulsion drug-delivery system for potential application in oral delivery of protein drugs.

BACKGROUND: The stability of protein drugs remains one of the key hurdles to their success in the market. The aim of the present study was to design a novel nanoemulsion drug-delivery system (NEDDS) that would encapsulate a standard-model protein drug--bovine serum albumin (BSA)--to improve drug stability. METHODS: The BSA NEDDS was prepared using a phase-inversion method and pseudoternary phase diagrams. The following characteristics were studied: morphology, size, zeta potential, drug loading, and encapsulation efficiency. We also investigated the stability of the BSA NEDDS, bioactivity of BSA encapsulated within the NEDDS, the integrity of the primary, secondary, and tertiary structures, and specificity. RESULTS: The BSA NEDDS consisted of Cremophor EL-35, propylene glycol, isopropyl myristate, and normal saline. The average particle diameter of the BSA NEDDS was about 21.8 nm, and the system showed a high encapsulation efficiency (>90%) and an adequate drug-loading capacity (45 mg/mL). The thermodynamic stability of the system was investigated at different temperatures and pH levels and in room-temperature conditions for 180 days. BSA NEDDS showed good structural integrity and specificity for the primary, secondary, and tertiary structures, and good bioactivity of the loaded BSA. CONCLUSIONS: BSA NEDDS showed the properties of a good nanoemulsion-delivery system. NEDDS can greatly enhance the stability of the protein drug BSA while maintaining high levels of drug bioactivity, good specificity, and integrity of the primary, secondary, and tertiary protein structures. These findings indicate that the nanoemulsion is a potential formulation for oral administration of protein drugs.

Genome of Helicobacter pylori strain XZ274, an isolate from a tibetan patient with gastric cancer in China.

The infection rate of Helicobacter pylori is high all over the world, especially in the Chinese Tibetan Plateau. Here, we report the genome sequence of Helicobacter pylori strain XZ274 isolated from a Tibetan patient with gastric cancer. The strain contains 1,634,138 bp with 1,654 coding sequences and a pXZ274 plasmid of 22,406 bp with 26 coding sequences. This is the first complete genome sequence of Helicobacter pylori from the Tibetan Plateau in China.

Genotyping analysis of Helicobacter pylori using multiple-locus variable-number tandem-repeats analysis in five regions of China and Japan.

BACKGROUND: H. pylori (Helicobacter pylori) is the major causative agent of chronic active gastritis. The population of H. pylori shows a high genomic variability among isolates. And the polymorphism of repeat-units of genomics had participated the important process of evolution. Its long term colonization of the stomach caused different clinical outcomes, which may relate to the high degree of genetic variation of H. pylori. A variety of molecular typing tools have been developed to access genetic relatedness in H. pylori isolates. However, there is still no standard genotyping system of this bacterium. The MLVA (Multi-locus of variable number of tandem repeat analysis) method is useful for performing phylogenetic analysis and is widely used in bacteria genotyping; however, there's little application in H. pylori analysis. This article is the first application of the MLVA method to investigate H. pylori from different districts and ethnic groups of China. RESULTS: MLVA of 12 VNTR loci with high discrimination power based on 30 candidates were performed on a collection of 202 strains of H. pylori which originated from five regions of China and Japan. Phylogenetic tree was constructed using MLVA profiles. 12 VNTR loci presented with high various polymorphisms, and the results demonstrated very close relationships between genotypes and ethnic groups. CONCLUSIONS: This study used MLVA methodology providing a new perspective on the ethnic groups and distribution characteristics of H. pylori.

Magnetization influence on the performance of ferrosoferric oxide: polyacrylonitrile membranes in ultrafiltration of pig blood solution.

Three kinds of membranes were prepared from suspensions containing polyacrylonitrile, dimethyl sulfoxide, polyethylene glycol and different amount of Fe3O4 by the phase inversion process. The rejection rate and the flux of membrane were investigated in the filtration of pig blood solution. SEM also studied the morphologies of fouled membranes. The permeate flux and the rejection rate decline fast in the initial several minutes and then change slowly. The magnetized membrane has a higher flux and a relative flux than the corresponding non-magnetized membrane. And the magnetized membrane containing about 3 wt% Fe3O4 has a prominent anti-fouling performance with above 52% relative flux. The results indicate that the magnetized ferrosoferric oxide-polyacrylonitrile membranes are promising in the recovery of blood proteins in the slaughterhouse effluents. In addition, the hydraulic resistance model explained results and the fouling mechanism was also given.