Global 3-hourly wind-wave and swell data for wave climate and wave energy resource research from 1950 to 2100.

Ocean wave climate, including wind waves and swells, is essential to human marine activities and global or regional climate systems, and is highly related to harnessing wave energy resources. In this study, a global 3-hourly instantaneous wave dataset was established with the third-generation wave model MASNUM-WAM and wind forcings derived from the products of the First Institute of Oceanography-Earth System Model version 2.0, the climate model coupled with wave model, under the unified framework of the Coupled Model Intercomparison Project phase 6. This dataset contains 17 wave parameters, including the information associated with wave energy and spectral shape geometries, from one historical (1950-2014) simulation and three future (2015-2100) scenario experiments (ssp125, ssp245, and ssp585). Moreover, all the parameters can be accessed separately in the form of wind waves and swells. The historical results show that the simulated wave characteristics agree well with satellite observations and the ERA5 reanalysis products. This dataset can provide the community with a unique and informative data source for wave climate and wave energy resource research.

Ameliorative effects of miR-423-5p against polarization of microglial cells of the M1 phenotype by targeting a NLRP3 inflammasome signaling pathway.

Spinal cord injury (SCI) causes sensation and motion dysfunction. Activation of microglial cells (MCs) in the central nervous system (CNS) is heterogeneous. Heterogeneous types of MCs can produce cytotoxic or neuroprotective effects, secrete proinflammatory or anti-inflammatory factors. The cytotoxic effect of MCs is one of the reasons for secondary damage after SCI. The NLR family pyrin domain containing 3 (NLRP3) inflammasome is a protein that can recognize pathogen-related molecular patterns or host-derived danger signal molecules, responses to microbial infection, and sterile stressors. SCI triggers activation of the NLRP3 inflammasome in the CNS. We investigated the interaction between miR-423-5p and NLRP3 in MCs polarization after SCI. A rat model of SCI was established by a modified version of Allen's method. Spinal samples were adopted for preparation and sequencing of RNA. We screenedapromising microRNA (miR-423-5p) according to the results. Then, we found that NLRP3 was one of the prediction targets of miR-423-5p. By intervening in expression of miR-423-5p and NLRP3, we observed the different polarization of MCs. We employeda dual-luciferase reporter study, proteomics, and transcriptomicsto ascertain the direct targeting relationship between miR-423-5p and NLRP3. MiR-423-5p expression was decreased significantly after SCI in vivo and in vitro. Upregulation of miR-423-5p expression could prevent MCs from lipopolysaccharide-induced M1 polarization. Knockdown of NLRP3 expression could prevent MCs from lipopolysaccharide-induced M1 polarization. MiR-423-5p inhibited MCs polarization to the M1 phenotype by targeting NLRP3.

Percutaneous Endoscopic Transforaminal Decompression in the Treatment of Patients with Migrated Lumbar Disc Herniation: A Retrospective Study.

OBJECTIVE: We aimed to discuss the surgical strategies, safety and clinical efficacy of percutaneous endoscopic transforaminal decompression for the treatment of patients with migrated lumbar disc herniation. METHODS: This is a retrospective study. From May 2014 to April 2017, a total of 56 patients (32 men and 24 women) with migrated lumbar disc herniation were operated on by percutaneous endoscopic decompression via transforaminal approach. All enrolled patients had clinical symptoms with radiculopathy, and were identified as single-level, soft herniated disc by computed tomography and magnetic resonance imaging. Clinical efficacy were evaluated chiefly by leg pain visual analogue scale score, Oswestry disability index score, and modified MacNab criteria. RESULTS: Patients were all successfully treated by percutaneous endoscopic transforaminal decompression, with an mean operation time of 63 ± 12 minutes. The patients were followed up for a mean duration of 15 ± 2.7 months (range 12-18 months). The leg pain visual analogue scale score was dropped from 8.2 ± 1.9 preoperatively to 2.4 ± 1.5, 2.2 ± 1.3, and 1.8 ± 1.1 at 1, 6, and 12 months after the operation, respectively. Similarly, the Oswestry disability index score was also decreased from 62.4 ± 8.2 preoperatively to 18.4 ± 6.2, 12.6 ± 5.1, and 9.2 ± 3.4 at 1, 6, and 12 months postoperatively. There were 38 excellent cases, 13 good cases, and 5 fair cases by the assessment method of modified MacNab criteria at 12 months after the operation, with an excellent and good rate of 91.07%. Two cases were complicated with low extremity numbness, which were recovered by conservative treatment in 3 weeks. No persistent neurological deficit or infection occurred in this group postoperatively. CONCLUSIONS: We consider that percutaneous endoscopic decompression via transforaminal approach provided a safe, effective and minimally invasive alternative for the treatment of patients with migrated lumbar disc herniation.

Polarization of Helper T Lymphocytes Maybe Involved in the Pathogenesis of Lumbar Disc Herniation.

This study aimed to explore the expression of T helper type 1 (Th1)/T helper type 2 (Th2) in herniated nucleus pulposus (NP) and determine their association with sciatic pain. NP was collected from 12 patients with lumbar disc herniation (LDH) (extrusion group) and 6 patients with a vertebral fracture (control group). The expression of Th1/Th2 and related cytokines in the NP was examined by flow cytometry, Western blot, and immunofluorescent staining. Subsequently, an LDH model was established in male Sprague-Dawley rats, and behavioral testings were carried out. The expression of Th1/Th2 and related cytokines in rat NP and the expression of macrophages in the dorsal root ganglia (DRG) were also examined. The number of Th1 cells in rat NP dramatically increased on day 14 after the surgery, but significantly decreased on day 28. The number of Th2 cells increased on day 28. Chemokine ligand 3(CCL3) and CD86 proteins (M1-specific molecules) were expressed at a relatively low level in naive DRG, markedly increased on day 14 after the surgery, and decreased on day 28. Arg1 and CD206 protein (M2-specific molecules) were expressed at a relatively low level in naive DRG and markedly increased on day 28. The mechanical allodynia and heat hyperalgesia developed after NP application and finally partially alleviated. The results suggested that the polarization of Th cells might be involved in the pathogenesis of LDH, and this might be achieved via the phenotypic shift of macrophages.

Downregulation of USP4 Promotes Activation of Microglia and Subsequent Neuronal Inflammation in Rat Spinal Cord After Injury.

NF-κB is involved in the activation of microglia, which induces secondary spinal cord injury (SCI). This process involves the activation of NF-κB signaling pathway by TRAF6 through its polyubiquitination function. We know that deubiquitination of TRAF6 mediated by deubiquitinating enzyme (DUB) significantly inhibits activation of NF-κB pathway. The ubiquitin-specific protease 4 (USP4) belongs to the deubiquitinase family. Therefore, we hypothesize that USP4 is involved in the microglial activation and subsequent neuronal inflammation after SCI. In this study, we examined the expression and the role of USP4 after SCI. Western blot analysis showed that the expression of USP4 was downregulated and the expression of p-p65 was upregulated in the spinal cord after SCI. Immunohistochemical and immunofluorescence staining showed that USP4 was expressed in microglia but its expression decreased after SCI. In vitro LPS-induced activation of microglia showed decreased expression of USP4 and increased expression of p-p65 and TRAF6. USP4 silencing in LPS-induced activation of microglia promoted the expression of p-p65 and TRAF6 and the secretion of TNF-α and IL-1ß. In conclusion, our study provides the first evidence that in microglial cells expression of USP4 decreases after SCI in rats. The downregulation of USP4 expression may promote microglial activation and subsequent neuronal inflammation through NF-κB by attenuating the deubiquitination of TRAF6. This mechanism is of great significance in the pathophysiology of secondary SCI.

Surgical Treatment for Subaxial Cervical Facet Dislocations with Incomplete or without Neurological Deficit: A Prospective Study of 52 Cases.

BACKGROUND This study aimed to treat patients with subaxial cervical facet dislocations with incomplete or without neurological deficit by a prospectively designed surgical protocol and observe the short-term clinical outcomes. MATERIAL AND METHODS Fifty-two consecutive subaxial cervical dislocation patients with incomplete or without neurological deficit were enrolled. The surgical strategy was determined based on whether or not the initial anterior closed reduction was successful and whether or not the patients were simultaneously combined with traumatic disc herniation (TDH). Postoperative radiographs were used to assess the reduction and fusion, and kyphosis and lordosis of cervical spines were calculated. The neck pain was assessed by visual analog scale. Body function and neurologic status was evaluated according to the Neck Disability Index and classification of American Spinal Injury Association. Clinical and radiologic outcomes were compared before and after the surgery and during the follow-up. The average follow-up period was 23 months. RESULTS Five patients with TDH and 17 with non-TDH were successfully treated by a single anterior approach, 22 non-TDH patients by a posterior-anterior approach, and another eight TDH patients by an anterior-posterior-anterior approach. No neurologic deterioration or other severe adverse events occurred postoperatively. The kyphosis angle of the dislocated levels was well restored after surgery, and the neck pain was significantly relieved as well. The neurologic status was obviously improved, and bony fusion was obtained in all patients within one-year follow-up. CONCLUSIONS Our prospectively designed surgical strategy is effective for the treatment of patients with subaxial cervical dislocation with incomplete or without neurological deficit.

Role of miR-15a in intervertebral disc degeneration through targeting MAP3K9.

BACKGROUND: Accumulating evidence indicates that microRNAs are involved in various cellular processes, including cell proliferation, differentiation, apoptosis and metastasis. miR-15a is an important regulator of immune responses and angiogenesis, endogenous controls as well as potential targets and hallmarks of cancer. However, the role of miR-15a in intervertebral disc degeneration (IDD) has not been elucidated. METHODS: Total RNA was extracted from degenerative nucleus pulposus (NP) tissues of 20 patients with IDD and NP cells, respectively. The expression levels of miR-15a were examined by quantitative real-time PCR. The stable overexpress or silence miR-15a expression cell lines and control cell lines were constructed by lentivirus infection. Subsequently, 3-(4,5-dimethylthia zol-2-yl)-2,5-diphenylte trazolium bromide (MTT) assay, flow cytometry test, TdT-mediated dUTP Nick-End Labeling (TUNEL) experiment, colony formation assay and western blot analysis were performed to detect the biological functions of miR-15a. Moreover, a luciferase reporter assay was conducted to confirm its target associations. RESULTS: Herein, the results found that miR-15a was dramatically up-regulated in degenerative NP tissues and NP cells compared with the controls. Overexpression of miR-15a promoted NP cells proliferation and induced apoptosis. Moreover, apoptosis-related protein caspase-3 was significantly up-regulated and bcl-2 was observably down-regulated when NP cells were transfected with miR-15a mimics, while bax and caspase-3 were significantly down-regulated as well as bcl-2 was observably up-regulated when NP cells were transfected with miR-15a inhibitors. Further, luciferase reporter assay showed that MAP3K9, an upstream activator of MAPK kinase, was putative target of miR-15a. There was a negatively relationship between miR-15a and MAP3K9 expression in NP cells. In addition, knockdown MAP3K9 inhibited NP cells proliferation and promoted apoptosis, which further inhibited the activation of p38 and ERK MAPK pathway. CONCLUSION: This present study revealed that miR-15a might be considered as a novel therapeutic target for IDD treatment.

Surgical Management of Old Lower Cervical Dislocations With Locked Facet.

STUDY DESIGN: Prospective study. OBJECTIVE: To evaluate the role of the canal and vertebrae sagittal diameter (C/V) ratio in the treatment of old dislocations of the lower cervical spine. SUMMARY OF BACKGROUND DATA: Few studies have reported the management of old dislocations of the lower cervical spine. Conservative treatments including the use of a Halo vest, neck brace, and prolonged traction have been problematic. Operative treatment consisted of a primary or staged reduction and fusion using an anterior, posterior, or combined approach. METHODS: Fourteen consecutive patients with old dislocations of the lower cervical spine were included in this series. The preoperative C/V value was calculated based on the measurement on the neutral sagittal computed tomography at the most narrow place of the dislocated segments. Closed reduction was attempted in 9 patients with moderate stenosis (C/V>0.5). Five patients with severe stenosis (C/V≤0.5) were treated with a primary combined anterior and posterior operation. Patient's radiographic information, pain, and neurological function were assessed and recorded before and after surgery. RESULTS: Closed reduction followed by anterior cervical discectomy and fusion was performed in 3 of 9 patients with moderate stenosis. Eleven patients underwent circumferential release, posterior reduction, and fixation followed by anterior fusion. No severe complications were found. The average operative time was 138±43 minutes. The average blood loss was 239±140 mL. The postoperative C/V value was significantly increased. The neurological status improved at least one grade in all 13 neurologically impaired cases except for 2 who had complete spinal cord injuries. Bony fusion was obtained in all patients at 1-year follow-up. CONCLUSIONS: The C/V value plays an important role in determining surgical solutions for old lower cervical dislocations with locked facets. Favorable clinical outcomes can be achieved using closed reduction and surgical procedures with anterior or anterior plus posterior approaches.

[Comparison of clinical outcomes between unilateral fixation fusion and minimally invasive spine transforaminal lumbar interbody fusion in treating lumbar disc herniation].

OBJECTIVE: To compare the short-term clinical outcome between unilateral fixation fusion (ULF) and minimally invasive spine transforaminal lumbar interbody fusion (MIS-TLIF) in treating lumbar disc herniation (LDH). METHODS: The clinical data of 39 patients with LDH were retrospectively analyzed from June 2008 to March 2013. There was 22 males and 17 females, aged from 45 to 75 years old with an average of 56.9 years. Therer were 3 cases in L3,4, 15 cases in L4,5, 21 cases in L5S1. Among them, 21 patients underwent unilateral fixation fusion (ULF group) and 18 underwent minimally invasive spine transforaminal lumbar interbody fusion (MIS-TLIF group). Operation time, blood loss, the times of radiographic exposure and hospital stay were noted and compared between two groups. Radiograph informations were regularily accessed and VAS, ODI scores were recorded at 3 days and 3, 6, 12 months after operation, respectively. According to modified Macnab criteria, the clinical effects were evaluated at final follow-up. RESULTS: All operations were successful without severe complications. The averaged operative time and the times of radiographic exposure in ULF group [(95 ± 25) min and (4.2 ± 0.4) times] were less than that of MIS-TLIF group [(120 ± 35) min and (10.1 ± 3.9) times] (P < 0.05). But, the mean blood loss and hospital stay in MIS-TLIF group [(75 ± 45) ml and (7.2 ± 2.2)d ]were less than that of ULF group [(165 ± 60) ml and (11.0 ± 3.7) d] (P < 0.01). All patients were followed up from 12 to 45 months with an average of 29.5 months. The VAS and ODI score had significantly improved during the follow-up and no significant differences were found between two groups at the same time point (P > 0.05). The postoperative radiographs showed internal fixation position was good. And all patients obtained bone fusion by CT scan at 1 year after operation. There was no significant differences in modified Macnab criteria between two groups at the latest follow-up (P > 0.05). CONCLUSION: Favorable short-term clinical effects can be achieved in suitable LDH patients with ULF or MIS-TLIF surgical procedures.

Interleukin-21 Is Associated with the Pathogenesis of Lumbar Disc Herniation.

Inflammation is an important reaction underlying lumbar disc herniation (LDH). Th17 cells play a critical role in immune activation. Interleukin (IL)-21 controls the functional activity of effector T-helper cells and the differentiation of Th17 cells, and promotes B-cell differentiation. It plays important roles in chronic inflammation and autoimmune diseases. However, little is known about relationship between IL-21 and LDH. This study was aimed to determine the association between IL-21 levels and pain scores in LDH patients compared to healthy controls.We enrolled 34 LDH patients and 20 healthy controls in this study. The LDH patients underwent surgery. Pain intensity was recorded using visual analogue scale (VAS) scores preoperatively. Serum IL-21 and IL-17 levels in the peripheral blood were determined using enzyme-linked immunosorbent assay. Disc tissue was examined using western blot and quantitative reverse-transcription polymerase chain reaction to determine IL-21, IL-17, and cyclooxygenase (COX)-2 expression, and using immunohistochemistry to assess IL-21 expression.LDH patients exhibited significantly higher levels of serum IL-21 and IL-17 than healthy controls. Moreover, higher expression of IL-21, IL-17, and COX-2 was found in the protein and mRNA levels in disc tissues from LDH patients than in normal disc tissues. Different parameters like VAS pain scores, IL-17, and COX-2 were positively correlated with the IL-21 levels. Enhanced production of IL-21 in disc tissues of LDH patients was also confirmed using immunohistochemical analyses.We concluded that inflammation was responsible for the pain associated with LDH, and that increased IL-21 expression may be associated with the pathogenesis of LDH.

[Case-control study on treating severe tibial open fractures by amputation and limb salvage].

OBJECTIVE: To compare mid-term clinical outcomes between amputation and limb salvage in treating severe open tibial fractures with type Gustilo III B, III C. METHODS: From July 2007 to June 2010,68 patients with severe open tibial fractures with type Gustilo III B, III C treated by amputation and limb salvage were retrospectively analyzed. In amputation group, there were 26 males and 12 females with an average age of (44.9±16.3) years old; and 21 cases were type Gustilo (III B, 17 cases were Gustilo III C; amputation were performed in accordance with soft tissue injury degree of shank, fracture types and surgical exploration. In limb salvageg group, there were 21 males and 9 females with an average age of (43.5±14.7) years old; and 23 cases were type Gustilo III B, 7 cases were Gustilo III C; the method of internal fixation and and wound healing were performed in accordance with patients's specific condition. Operative time, blood loss, hospital stay and postoperative infection was compared between two groups; time of loading and rate of return to work was compared; VAS scoring was used to evaluate condition of pain; SF-36 health queationaire was used to assess postoperative life quality. RESULTS: Totally 60 patients were followed up (33 cases in amputation group and 27 cases in limb salvage group) with an average time of 49.1 months. Operative time, blood loss, hospital stay and postoperative infection in amputation and limb salvage group respectively was (109.0±25.7) min, (245.0±58.6) min; (168.0±49.0) ml, (311.0±137.0) ml; (13.8±2.7) d, (28.8±13.1) d; 7.9%, 36.7%. At the final following-up, there was no significance meaning between two groups in VAS scoring and rate of return to work, but time of loading in amputation group was shorter than that of in limb salvage group. Physiological function in amputation group was better than limb salvage group, while body pain was worse; and there was no signicance meaning in psychological health between two groups. CONCLUSION: Amputation and limb salvage both can treat severe open tibial fractures, and mid-term clinical outcomes between two groups has equivalent efficacy.

Biomechanical evaluation of vertebroplasty using calcium sulfate cement for thoracolumbar burst fractures.

OBJECTIVE: To evaluate the biomechanical performance of vertebroplasty using calcium sulfate cement for thoracolumbar burst fractures. METHODS: Sixteen bovine thoracolumbar spines (T11-L1) were divided into 4 groups (A,B,C and D). After burst-fracture model was created, 12 vertebral bodies in Groups A, B and C were augmented with calcium sulfate cement (CSC), calcium phosphate cement (CPC) and polymethylmethacrylate (PMMA) bone cement, respectively. Each anterior vertebral body height was measured with a caliper at 4 time points: intact conditions (HInt), post-fracture (HFr), post-reduction (HRe) and post-vertebroplasty (HVP). The filling volume of 3 different bone cements was also measured. Each vertebral body was compressed at 0.5 mm/s using a hinged plating system on a materials testing machine to 50% of the post-vertebroplasty height to determine strength and stiffness. Difference was checked using t test or One-way ANOVA. RESULTS: The average strike energy was 66.2 J. Vertebroplasty with different cements could sustain vertebral height. The average filling volume of bone cement in 3 groups was 4.35 ml (CSC), 3.72 ml (CPC) and 3.95 ml (PMMA), respectively, and there was no statistically significant difference among them (P larger than 0.05). Vertebroplasty with PMMA completely restored strength (116%) and stiffness (105%). CSC or CPC partly recovered vertebral strength and stiffness. However, greater strength restoration was got with CSC (1659 N) as compared with CPC (1011N, P less than 0.01). Regarding stiffness, differences between CSC (140 N/mm+/-40 N/mm)and the other two bone cements (CPC:148 N/mm+/-33 N/mm, PMMA:236 N/mm+/-97 N/mm) were not significant (P larger than 0.05). CONCLUSIONS: For a burst-fracture of calf spine, use of CSC for vertebroplasty yields similar vertebral stiffness as compared with PMMA or CPC. Although augmentation with CSC partly obtains the normal strength, this treatment still can be applied in thoracolumbar burst fractures with other instrumental devices in light of its bioactivation.