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1.
Insect Mol Biol ; 2024 May 27.
Article in English | MEDLINE | ID: mdl-38801334

ABSTRACT

Ribosomal protein L13 (RPL13) is highly conserved in evolution. At present, the properties and functions of RPL13 have not been characterised in insects. In this study, Bombyx mori RPL13 (BmRPL13) was first found to be specifically recruited to the sites of ultraviolet (UV)-induced DNA damage and contributed to UV damage repair. Escherichia coli expressing BmRPL13 showed better resistance to UV radiation. After knocking down the expression of BmRPL13 in BmN cells, the repair speed of UV-damaged DNA slowed down. The further results showed that BmRPL13 interacted with B. mori nucleopolyhedrovirus (BmNPV) ORF65 (Bm65) protein to locate at the UV-induced DNA damage sites of BmNPV and helped repair UV-damaged viral DNA.

2.
J Appl Microbiol ; 135(3)2024 Mar 01.
Article in English | MEDLINE | ID: mdl-38471668

ABSTRACT

AIMS: Enteroviruses are significant human pathogens associated with a range of mild to severe diseases. This study aims to understand the diversity and genetic characterization of enteroviruses circulated in southwest China's border cities by using environmental surveillance. METHODS AND RESULTS: A total of 96 sewage samples were collected in three border cities and a port located in Yunnan Province, China from July 2020 to June 2022. After cell culture and VP1 sequencing, a total of 590 enterovirus isolates were identified, belonging to 21 types. All PV strains were Sabin-like with ≤6 nucleotide mutations in the VP1 coding region. Echovirus 6, echovirus 21 (a rare serotype in previous studies), and coxsackievirus B5 were the predominant serotypes, which accounted for 21.19%, 18.31%, and 13.39% of the total isolates, respectively. The prevalence of the common serotypes varied across different border cities and periods. Phylogenetic analysis revealed the presence of multiple evolutionary lineages for E21, E6, and E30, some of which formed distinct branches. CONCLUSIONS: High diversity of enteroviruses and distinct lineages of predominant serotypes circulated in southwest China's border cities.


Subject(s)
Enterovirus Infections , Enterovirus , Humans , Cities , Phylogeny , China/epidemiology , Enterovirus Infections/epidemiology , Enterovirus B, Human/genetics , Antigens, Viral/genetics , Environmental Monitoring/methods
3.
Acta Trop ; 254: 107191, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38554994

ABSTRACT

Malaria remains one of the most perilous vector-borne infectious diseases for humans globally. Sexual gametocyte represents the exclusive stage at which malaria parasites are transmitted from the vertebrate to the Anopheles host. The feasible and effective approach to prevent malaria transmission is by addressing the sexual developmental processes, that is, gametocytogenesis and gametogenesis. Thus, this review will comprehensively cover advances in the regulation of gene expression surrounding the transmissible stages, including epigenetic, transcriptional, and post-transcriptional control.


Subject(s)
Anopheles , Plasmodium , Animals , Anopheles/parasitology , Anopheles/genetics , Plasmodium/genetics , Plasmodium/growth & development , Mosquito Vectors/genetics , Mosquito Vectors/parasitology , Mosquito Vectors/growth & development , Gametogenesis/genetics , Humans , Malaria/transmission , Malaria/parasitology , Gene Expression Regulation , Gene Expression Regulation, Developmental , Epigenesis, Genetic , Sexual Development/genetics
4.
Small ; 20(24): e2308304, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38308419

ABSTRACT

Lithium-ion batteries (LIBs) has been developed over the last three decades. Increased amount of silicon (Si) is added into graphite anode to increase the energy density of LIBs. However, the amount of Si is limited, due to its structural instability and poor electronic conductivity so a novel approach is needed to overcome these issues. In this work, the synthesized chromium silicide (CrSi2) doped Si nanoparticle anode material achieves an initial capacity of 1729.3 mAh g-1 at 0.2C and retains 1085 mAh g-1 after 500 cycles. The new anode also shows fast charge capability due to the enhanced electronic conductivity provided by CrSi2 dopant, delivering a capacity of 815.9 mAh g-1 at 1C after 1000 cycles with a capacity degradation rate of <0.05% per cycle. An in situ transmission electron microscopy is used to study the structural stability of the CrSi2-doped Si, indicating that the high control of CrSi2 dopant prevents the fracture of Si during lithiation and results in long cycle life. Molecular dynamics simulation shows that CrSi2 doping optimizes the crack propagation path and dissipates the fracture energy. In this work a comprehensive information is provided to study the function of metal ion doping in electrode materials.

5.
Radiol Case Rep ; 19(5): 1702-1707, 2024 May.
Article in English | MEDLINE | ID: mdl-38384704

ABSTRACT

Nasopharyngeal tuberculosis is a rare extrapulmonary tuberculosis caused by Mycobacterium tuberculosis invading the nasopharynx. Early clinical symptoms are atypical, making the condition easy to overlook and misdiagnosed. We retrospectively reviewed the case of a 37-year-old man who visited the clinic in March 2023, presenting with enlarged cervical lymph nodes persisting for over a year. Computed tomography and magnetic resonance imaging showed the nasopharynx wall was thickened, and cervical multiple enlarged lymph nodes were visible, presenting bead-like appearance. The enhanced scan revealed the lesion uneven enhancement. He was diagnosed with nasopharyngeal carcinoma with lymph node metastasis based on the images. However, the histopathological examination finally confirmed that the nasopharyngeal and neck mass were tuberculous granulomas. Nasopharyngeal tuberculosis is easily misdiagnosed and mistreated, and it is especially difficult to differentiate from nasopharyngeal carcinoma. When diagnosing and treating neck masses, clinicians should consider the possibility of nasopharyngeal tuberculosis in patients with chronic nasopharyngeal symptoms. Nasopharyngoscope biopsy and histopathological examination have great value in the diagnosis of nasopharyngeal tuberculosis.

6.
Org Lett ; 26(3): 664-669, 2024 Jan 26.
Article in English | MEDLINE | ID: mdl-38226908

ABSTRACT

A visible-light-driven iron-catalyzed C(sp3)-H amination of diphenylmethane derivatives with 1,2,3,4-tetrazoles under mild conditions has been developed. The reaction proceeds with photosensitizer-free conditions and features satisfactory to good yields. Mechanistic studies revealed that the reaction proceeded via an iron-nitrene intermediate, and H atom abstraction was the rate-determining step. Computational studies showed that the denitrogenation of 1,2,3,4-tetrazole depends on the conversion of the sextet ground state of 1,2,3,4-tetrazole-bounding iron species to the quartet spin state under visible-light irradiation.

7.
Nat Commun ; 15(1): 917, 2024 Jan 31.
Article in English | MEDLINE | ID: mdl-38296948

ABSTRACT

Heterogeneous Fenton reaction represents one of the most reliable technologies to ensure water safety, but is currently challenged by the sluggish Fe(III) reduction, excessive input of chemicals for organic mineralization, and undesirable carbon emission. Current endeavors to improve the catalytic performance of Fenton reaction are mostly focused on how to accelerate Fe(III) reduction, while the pollutant degradation step is habitually overlooked. Here, we report a nanoconfinement strategy by using graphene aerogel (GA) to support UiO-66-NH2-(Zr) binding atomic Fe(III), which alters the carbon transfer route during phenol removal from kinetically favored ring-opening route to thermodynamically favored oligomerization route. GA nanoconfinement favors the Fe(III) reduction by enriching the reductive intermediates and allows much faster phenol removal than the unconfined analog (by 208 times in terms of first-order rate constant) and highly efficient removal of total organic carbon, i.e., 92.2 ± 3.7% versus 3.6 ± 0.3% in 60 min. Moreover, this oligomerization route reduces the oxidant consumption for phenol removal by more than 95% and carbon emission by 77.9%, compared to the mineralization route in homogeneous Fe2++H2O2 system. Our findings may upgrade the regulatory toolkit for Fenton reactions and provide an alternative carbon transfer route for the removal of aqueous pollutants.

8.
Orthop Surg ; 16(2): 420-428, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38191985

ABSTRACT

OBJECTIVE: Foraminoplasty is an important step in transforaminal endoscopic lumbar discectomy (TELD). A trephine is widely used in foraminoplasty. However, foraminoplasty using a trephine alone sometimes fails to remove the resected bone, resulting in the bone remaining in the foramen or spinal canal, which can potentially cause neurological irritation or injury. The objective of this study is to introduce a self-designed tool, referred to as an anchoring drill, for use with a trephine in foraminoplasty in TELD and to evaluate its advantages. METHODS: A retrospective review was performed to identify patients who underwent L4-5 TELD between January 2019 to January 2022. Foraminoplasty was performed in all patients. Depending on whether the anchoring drill was used or not, patients were divided into two groups. Surgery-related parameters and complications were reviewed. Visual analog scale (VAS) and Japanese Orthopaedic Association (JOA) scores were also assessed for all patients. SPSS statistical software was used for statistical calculation. RESULTS: A total of 100 patients were included (55 in the anchoring drill group and 45 in the trephine group). The incidence of residual bone fragments after foraminoplasty of the anchoring drill group was 9.09%, which was lower than that of the trephine group, at 33.33% (p < 0.05). The mean endoscopic operation time of the anchoring drill group was shorter than that of the trephine group (p < 0.05). The mean fluoroscopy time and duration of foraminoplasty showed no significant differences between the two cohorts. The total perioperative complication incidence was lower in the anchoring drill group, in which the neural irritation incidence showed a significant difference (anchoring drill group: 3.64%, trephine group: 17.78%, p < 0.05). VAS and JOA scores were significantly improved after the operation for all patients (p < 0.001), however, no statistical differences were found between the two groups at each follow-up visit. CONCLUSION: The combination of a trephine with an anchor drill was demonstrated to be safe and effective in foraminoplasty in TELD, improving the success rate of foraminoplasty and reducing neurological complications compared to using trephine alone.


Subject(s)
Diskectomy, Percutaneous , Intervertebral Disc Displacement , Humans , Retrospective Studies , Intervertebral Disc Displacement/surgery , Treatment Outcome , Lumbar Vertebrae/surgery , Endoscopy/methods , Diskectomy/methods , Diskectomy, Percutaneous/methods
9.
Int Immunopharmacol ; 127: 111326, 2024 Jan 25.
Article in English | MEDLINE | ID: mdl-38091828

ABSTRACT

Cuproptosis is a new manner of mitochondrial cell death induced by copper. There is evidence that serum copper has a crucial impact on ankylosing spondylitis (AS) by copper-induced inflammatory response. However, the molecular mechanisms of cuproptosis modulators in AS remain unknown. We aimed to use a bioinformatics-based method to comprehensively investigate cuproptosis-related subtype identification and immune microenvironment infiltration of AS. Additionally, we further verified the results by in vitro experiments, in which peripheral blood and fibroblast cells from AS patients were used to evaluate the functions of significant cuproptosis modulators on AS. Finally, eight significant cuproptosis modulators were identified by analysis of differences between controls and AS cases from GSE73754 dataset. Eight prognostic cuproptosis modulators (LIPT1, DLD, PDHA1, PDHB, SLC31A1, ATP7A, MTF1, CDKN2A) were identified using a random forest model for prediction of AS risk. A nomogram model of the 8 prognostic cuproptosis modulators was then constructed; the model could be beneficial in clinical settings, as indicated by decision curve analysis. Consensus clustering analysis was used to divide AS patients into two cuproptosis subtypes (clusterA & B) according to significant cuproptosis modulators. The cuproptosis score of each sample was calculated by principal component analysis to quantify cuproptosis subtypes. The cuproptosis scores were higher in clusterB than in clusterA. Additionally, cases in clusterA were closely associated with the immunity of activated B cells, Activated CD4 T cell, Type17 T helper cell and Type2 T helper cell, while cases in clusterB were linked to Mast cell, Neutrophil, Plasmacytoid dendritic cell immunity, indicating that clusterB may be more correlated with AS. Notably, key cuproptosis genes including ATP7A, MTF1, SLC31A1 detected by RT-qPCR with peripheral blood exhibited significantly higher expression levels in AS cases than controls; LIPT1 showed the opposite results; High MTF1 expression is correlated with increased osteogenic capacity. In general, this study of cuproptosis patterns may provide promising biomarkers and immunotherapeutic strategies for future AS treatment.


Subject(s)
Copper , Spondylitis, Ankylosing , Humans , B-Lymphocytes , CD4-Positive T-Lymphocytes , Cluster Analysis , Apoptosis
10.
Small ; 20(8): e2305991, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37858930

ABSTRACT

The application of Si anodes is hindered by some critical issues such as large volume changes of bare Si and fragile solid-electrolyte interface (SEI), resulting in low coulombic efficiency and rapid capacity decay. Herein, a multifunctional SEI film with high content of LiF is in situ constructed via the surface grafting of carbon-fluorine functionalized groups on silicon nanoparticles (SiNPs) during cycling. Mechanical study demonstrates that the incorporation of LiF with high modulus and unbroken carbon-fluorine groups with highly elastic guarantee the rigid-soft coupling SEI film on Si electrode. Furthermore, it is demonstrated that the rigid-soft coupling SEI film can effectively accommodate the volume expansion of Si nanoparticles during lithiation process, with the electrode expanding rate of only 114.16% after 100 cycles (263.87% for bare Si without surface modification). Afterward, with the aid of well-designed rigid-soft coupling SEI, the initial Coulomb efficiency of 89.8% is achieved, showing a reversible capacity of 1477 mAh g-1 after 200 cycles at 1.2 A g-1 . This work provides a simple and efficient solution that can potentially facilitate the practical application of Si anodes.

11.
Waste Manag ; 174: 44-52, 2024 Feb 15.
Article in English | MEDLINE | ID: mdl-38006757

ABSTRACT

With the increasing demand for lithium resources, the efficient recovery of lithium from spent lithium-ion batteries (LIBs) has become the focus of social attention. Herein, a combined process of reduction roasting of herb-medicine residue (HMR) and oxalic acid (OA) leaching is proposed to improve the recovery efficiency of lithium. Due to the large amount of reducing gas produced by the pyrolysis of herb-medicine residue, the layered structure of LiNixCoyMnzO2 cathode powder can be destroyed at 650℃ for 10 min, and the cathode powder is converted into Li2CO3, Ni, Co, MnO. Moreover, about 99.6 % of Li in the roasting residue can be selectively extracted by 0.5 mol L-1 oxalic acid for 20 min. Under the combined action of HMR and OA, the extraction efficiency and kinetics of lithium are improved simultaneously. This work achieves synergistic treatment of two types of waste from the perspective of waste management for waste. Meanwhile, it provides an alternative and innovative approach for the difficult problem of low efficiency of lithium recovery from spent LIBs.


Subject(s)
Lithium , Waste Management , Oxalic Acid , Powders , Recycling , Electric Power Supplies
12.
Neural Netw ; 171: 200-214, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38096649

ABSTRACT

Loss function is a critical component of machine learning. Some robust loss functions are proposed to mitigate the adverse effects caused by noise. However, they still face many challenges. Firstly, there is currently a lack of unified frameworks for building robust loss functions in machine learning. Secondly, most of them only care about the occurring noise and pay little attention to those normal points. Thirdly, the resulting performance gain is limited. To this end, we put forward a general framework of robust loss functions for machine learning (RML) with rigorous theoretical analyses, which can smoothly and adaptively flatten any unbounded loss function and apply to various machine learning problems. In RML, an unbounded loss function serves as the target, with the aim of being flattened. A scale parameter is utilized to limit the maximum value of noise points, while a shape parameter is introduced to control both the compactness and the growth rate of the flattened loss function. Later, this framework is employed to flatten the Hinge loss function and the Square loss function. Based on this, we build two robust kernel classifiers called FHSVM and FLSSVM, which can distinguish different types of data. The stochastic variance reduced gradient (SVRG) approach is used to optimize FHSVM and FLSSVM. Extensive experiments demonstrate their superiority, with both consistently occupying the top two positions among all evaluated methods, achieving an average accuracy of 81.07% (accompanied by an F-score of 73.25%) for FHSVM and 81.54% (with an F-score of 75.71%) for FLSSVM.


Subject(s)
Algorithms , Machine Learning
13.
Sci Total Environ ; 912: 169541, 2024 Feb 20.
Article in English | MEDLINE | ID: mdl-38141997

ABSTRACT

With the annual increase in lithium-ion batteries (LIBs) disposal, valuable resources are being generated with worrying waste, so it is strategically important to recover the critical metals from them. Individual high temperature or leaching processes do not apparently achieve very satisfactory results. In the present work, the reduction with zinc powder was able to convert the lithium in LiNixCoyMnzO2 (NCM) to soluble LiOH, while the reduction and ammonia complexation environment generated by the decomposition of cysteine (Cys) achieved an efficient leaching of transition metals without additional additives. The leaching efficiency of Li can reach more than 92 %, while that of Ni/Co/Mn reaches more than 97 % through the regulation of the parameters of each process. In particular, an in-situ redox mechanism is proposed to explain the efficient leaching of transition metals, which further enriches the theory of spent LIBs recycling and provides a promising idea for various hydrometallurgical extraction systems.

14.
Vet Microbiol ; 289: 109970, 2024 Feb.
Article in English | MEDLINE | ID: mdl-38154394

ABSTRACT

As a gram-negative intracellular bacterial pathogen, Salmonella enterica serovar Typhimurium (S. Typhimurium) invades different cell types including macrophages. Its infection in macrophages induces robust innate immune responses that are featured by proinflammatory and type I interferon (IFN) responses. The type III secretion systems (T3SSs) of S. Typhimurium play a crucial role in activating host inflammasome pathways. It has been recognized that the inflammasome pathways inhibit the type I IFN cascade. However, the potential role of T3SS in regulating the type I IFN response and the underlying mechanisms are largely unknown. In this study, we showed that S. Typhimurium infection activated strong proinflammatory, type I IFN and IFN-stimulated genes (ISGs) expression in macrophages. Furthermore, we showed that T3SS-defective S. Typhimurium mutant ΔinvC elicited attenuated inflammatory response but enhanced type I IFN and ISGs expression. Additionally, the inhibition of caspase-1 by a specific inhibitor VX-765 resulted in increased type I IFN response. Moreover, cell-permeable pan-caspase inhibitor Z-VAD-FMK also enhanced the type I IFN response upon S. Typhimurium infection. Intriguingly, compared with exponential phase S. Typhimurium infection, stationary phase bacteria triggered higher levels of type I IFN responses. Finally, the inhibition of caspase-1 by VX-765 substantially increased the intracellular S. Typhimurium burden. In conclusion, we demonstrated that the proinflammatory response induced by S. Typhimurium T3SS can inhibit the type I IFN response, which provides insight into the role of T3SS in orchestrating innate immunity during S. Typhimurium infection.


Subject(s)
Inflammasomes , Interferon Type I , Animals , Immunity, Innate , Macrophages/microbiology , Salmonella typhimurium/genetics , Caspases
15.
BMC Endocr Disord ; 23(1): 213, 2023 Oct 05.
Article in English | MEDLINE | ID: mdl-37798680

ABSTRACT

BACKGROUND: Idiopathic hypogonadotropic hypogonadism (IHH) is a rare congenital or acquired genetic disorder caused by gonadotropin-releasing hormone (GnRH) deficiency. IHH patients are divided into two major groups, hyposmic or anosmic IHH (Kallmann syndrome) and normosmic IHH (nIHH), according to whether their sense of smell is intact. Here we report a case of novel compound heterozygous mutations in the GNRH1 gene in a 15-year-old male with nIHH. CASE PRESENTATION: The patient presented typical clinical symptoms of delayed testicular development, with testosterone < 3.5 mmol/L and reduced gonadotropin (follicle-stimulating hormone, luteinizing hormone) levels. Two heterozygous variants of the GNRH1 gene were detected, nonsense variant 1: c.85G > T:p.G29* and variant 2: c.1A > G:p.M1V, which disrupted the start codon. CONCLUSIONS: Two GNRH1 mutations responsible for nIHH are identified in this study. Our findings extend the mutational spectrum of GNRH1 by revealing novel causative mutations of nIHH.


Subject(s)
Gonadotropin-Releasing Hormone , Hypogonadism , Adolescent , Humans , Male , Gonadotropin-Releasing Hormone/genetics , Hypogonadism/genetics , Hypogonadism/diagnosis , Kallmann Syndrome/genetics , Mutation , Testosterone/analysis
16.
Hepatol Commun ; 7(11)2023 11 01.
Article in English | MEDLINE | ID: mdl-37820278

ABSTRACT

BACKGROUND: Pathogenetic mechanisms of the progression of NAFL to advanced NASH coupled with potential noninvasive biomarkers and novel therapeutic targets are active areas of investigation. The recent finding that increased plasma levels of a protein shed by myeloid cells -soluble Triggering Receptor Expressed on Myeloid cells 2 (sTREM2) -may be a biomarker for NASH has received much interest. We aimed to test sTREM2 as a biomarker for human NASH and investigate the role of sTREM2 in the pathogenesis of NASH. METHODS: We conducted studies in both humans (comparing patients with NASH vs. NAFL) and in mice (comparing different mouse models of NASH) involving measurements of TREM2 gene and protein expression levels in the liver as well as circulating sTREM2 levels in plasma. We investigated the pathogenetic role of sTREM2 in hepatic steatosis using primary hepatocytes and bone marrow derived macrophages. RESULTS: RNA sequencing analysis of livers from patients with NASH or NAFL as well as livers from 2 mouse models of NASH revealed elevated TREM2 expression in patients/mice with NASH as compared with NAFL. Plasma levels of sTREM2 were significantly higher in a well-characterized cohort of patients with biopsy-proven NASH versus NAFL (area under receiver-operating curve 0.807). Mechanistic studies revealed that cocultures of primary hepatocytes and macrophages with an impaired ability to shed sTREM2 resulted in reduced hepatocyte lipid droplet formation on palmitate stimulation, an effect that was counteracted by the addition of exogenous sTREM2 chimeric protein. Conversely, exogenous sTREM2 chimeric protein increased lipid droplet formation, triglyceride content, and expression of the lipid transporter CD36 in hepatocytes. Furthermore, inhibition of CD36 markedly attenuated sTREM2-induced lipid droplet formation in mouse primary hepatocytes. CONCLUSIONS: Elevated levels of sTREM2 due to TREM2 shedding may directly contribute to the pathogenesis of NAFLD by promoting hepatocyte lipid accumulation, as well as serving as a biomarker for distinguishing patients with NASH versus NAFL. Further investigation of sTREM2 as a clinically useful diagnostic biomarker and of the therapeutic effects of targeting sTREM2 in NASH is warranted.


Subject(s)
Non-alcoholic Fatty Liver Disease , Humans , Animals , Mice , Non-alcoholic Fatty Liver Disease/pathology , Hepatocytes/metabolism , Biomarkers , Macrophages/metabolism , Lipids , Recombinant Fusion Proteins/metabolism
17.
J Phys Chem Lett ; 14(36): 8213-8220, 2023 Sep 14.
Article in English | MEDLINE | ID: mdl-37672646

ABSTRACT

Synergistic therapy combining photothermal therapy and photodynamic therapy is considered to be a promising approach to treat cancer, but the precise temperature control of deep tissue remains a great challenge in achieving effective treatment. Herein, a two-dimensional Bi2WO6:Nd3+/Yb3+/Er3+@MoS2 nanoplatform with photothermal and photodynamic functions was constructed, where semiconductor MoS2 serves as both a photothermal agent and a photosensitizer. The photothermal conversion performance and the reactive oxygen species generation capacity of the nanoplatform were validated under the irradiation of 808 nm laser; meanwhile, the two sets of luminescence intensity ratios (IYb3+/INd3+ and IEr3+/INd3+) in the biological window region were selected as near-infrared temperature probes to monitor the heat generated during the photosynergistic process in real time. The feasibility of nanoplatform as an intratissue temperature probe and antibacterial agent was further assessed by vitro experiments, which provides an idea for designing multifunctional photosynergistic therapy nanoplatform.


Subject(s)
Molybdenum , Photochemotherapy , Anti-Bacterial Agents/pharmacology , Hot Temperature , Luminescence
18.
PLoS One ; 18(8): e0289749, 2023.
Article in English | MEDLINE | ID: mdl-37552706

ABSTRACT

In recent years, the prevalence of T2DM has been increasing annually, in particular, the personal and socioeconomic burden caused by multiple complications has become increasingly serious. This study aimed to screen out the high-risk complication combination of T2DM through various data mining methods, establish and evaluate a risk prediction model of the complication combination in patients with T2DM. Questionnaire surveys, physical examinations, and biochemical tests were conducted on 4,937 patients with T2DM, and 810 cases of sample data with complications were retained. The high-risk complication combination was screened by association rules based on the Apriori algorithm. Risk factors were screened using the LASSO regression model, random forest model, and support vector machine. A risk prediction model was established using logistic regression analysis, and a dynamic nomogram was constructed. Receiver operating characteristic (ROC) curves, harrell's concordance index (C-Index), calibration curves, decision curve analysis (DCA), and internal validation were used to evaluate the differentiation, calibration, and clinical applicability of the models. This study found that patients with T2DM had a high-risk combination of lower extremity vasculopathy, diabetic foot, and diabetic retinopathy. Based on this, body mass index, diastolic blood pressure, total cholesterol, triglyceride, 2-hour postprandial blood glucose and blood urea nitrogen levels were screened and used for the modeling analysis. The area under the ROC curves of the internal and external validations were 0.768 (95% CI, 0.744-0.792) and 0.745 (95% CI, 0.669-0.820), respectively, and the C-index and AUC value were consistent. The calibration plots showed good calibration, and the risk threshold for DCA was 30-54%. In this study, we developed and evaluated a predictive model for the development of a high-risk complication combination while uncovering the pattern of complications in patients with T2DM. This model has a practical guiding effect on the health management of patients with T2DM in community settings.


Subject(s)
Diabetes Mellitus, Type 2 , Humans , Diabetes Mellitus, Type 2/complications , Risk Factors , Algorithms , Blood Urea Nitrogen , Data Mining , Nomograms , Retrospective Studies
19.
Orthop Surg ; 15(10): 2730-2735, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37435856

ABSTRACT

BACKGROUND: Lateral displacement of cage is a rarely seen complication of oblique lumbar interbody fusion (OLIF). To the best of our knowledge, this complication has always been revised with posterior open surgery. However, open surgery often associates with large trauma and long period of recovery. CASE PRESENTATION: In the case presented, a 64-year-old male patient with lateral displacement of cage which consequently caused neurological symptoms after OLIF, was reported and surgically revised with an endoscopic resection and decompression technique. The surgery was performed through a posterolateral approach which was similar to transforaminal approach, with estimated blood loss of 45mL and whole operation time of 70 min. Neurological symptoms were disappeared after operation immediately and the patient was discharged 2 days later. He reported no symptoms other than mild weakness of the lower back at the last follow-up of 12 months. CONCLUSION: Endoscopic decompression technique may be an effective alternative to surgically treat lateral displacement of cage after OLIF with advantages of minimal invasion and quick recovery.

20.
Orthop Surg ; 15(9): 2274-2282, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37403557

ABSTRACT

OBJECTS: Oblique lumbar interbody fusion (OLIF) has gained increasing popularity recently. However, complications resulting from intraoperative retraction of psoas major (PM) sometimes occur. The aim of this study is to evaluate the degree of PM swelling by developing a scoring system called the Psoas Major Swelling Grade (PMSG), and to investigate the correlation between the PMSG and clinical outcomes after OLIF. METHODS: Patients who underwent L4-5 OLIF at our hospital from May 2019 to May 2021 were reviewed and all data were recorded. The extent of postoperative PM swelling was determined by calculating the percentage of change in the PM area before and after surgery on MRI and divided into three grades subsequently. Swelling within the range of 0% to 25% was defined as grade I, 25%-50% was grade II, and more than 50% was grade III. All patients were grouped into the new grade system and followed up for at least 1 year, during which the visual analog scale (VAS) and Oswestry disability index (ODI) scores were recorded. Categorical data were analyzed using chi-square and Fisher's exact tests, while continuous variables were assessed with one-way ANOVA and paired t-tests. RESULTS: Eighty-nine consecutive patients were enrolled in this study, with a mean follow-up duration of 16.9 months. The proportion of female patients in the PMSG I, II, and III groups was 57.1%, 58.3%, and 84.1%, respectively (p = 0.024).  Furthermore, the total complication rate was 43.2% in the PMSG III group, significantly higher than 9.5% and 20.8% in the PMSG I and II groups (p = 0.012). The incidence of thigh paraesthesia was also considerably higher in the PMSG III group at 34.1% (p = 0.015), compared to 9.5% and 8.3% in the PMSG I and II groups. Among the patients, 12.4% exhibited a teardrop-shaped PM, with the majority (90.9%) belonging to the PMSG III group (p = 0.012). Additionally, the PMSG III group demonstrated a higher estimated blood loss (p = 0.007) and significantly worse clinical scores at the 1-week follow-up assessment (p < 0.001). CONCLUSION: PM swelling adversely affects the OLIF prognosis. Female patients with teardrop-shaped PM are more likely to develop swelling after OLIF. A higher PMSG is associated with a higher complication rate of thigh pain or numbness and worse short-term clinical outcomes.


Subject(s)
Lumbar Vertebrae , Spinal Fusion , Humans , Female , Retrospective Studies , Lumbar Vertebrae/surgery , Spinal Fusion/methods , Lumbosacral Region/surgery , Pain , Treatment Outcome
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