[Efficacy comparison of zero-profile intervertebral fusion and stand-alone interbody cage combined with cage-titanium plate construct in treatment of two-segment skip cervical spondylosis].

Objective: To investigate the difference in clinical efficacy between zero-profile interbody fusion (ROI-C) and stand-alone interbody cage combined with cage-titanium plate construct for patient with two-segment skipped cervical spondylosis who received the anterior cervical discectomy and fusion (ACDF) surgical strategies. Methods: The clinical data of 62 patients with two-segment skipped cervical spondylosis who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University from June 2017 to June 2020 were retrospectively analyzed, included 38 males and 24 females, aged (53.3±8.5) years. Thirty-three cases were treated with ROI-C (ROI-C group), and 29 cases with stand-alone interbody cage combined with cage-titanium plate construct (cage+titanium plate group). The following parameters, including operation time, intraoperative blood loss, dysphagia Bazaz grade, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) of pain, neck disability index (NDI), average intervertebral height of operated segments, C2-7 Cobb angle, and related complications, were compared between the two groups. Results: The patients were followed up for (28±5) months (16-34 months). The operation time of ROI-C group was (127.6±34.2) min, which was shorter than that in cage+titanium plate group [(157.1±43.9) min, P=0.004]. The scores of JOA and VAS in both ROI-C group and cage+titanium plate group were significantly improved 3 months after operation when compared with those before operation, and there was no significant difference between the two groups (all P>0.05). The average intervertebral space height of fusion segment in ROI-C group was (6.02±1.03) mm before operation, it was improved to (8.38±1.47) mm at 3 months after operation, (8.16±1.40) mm at 12 months after operation, and it was (6.24±1.05) mm, (8.58±1.18) mm and (7.87±0.73) mm in cage+titanium plate group, respectively, and there was no significant difference between the two groups at each time point (all P>0.05). The Cobb angle of cervical vertebrae in ROI-C group was 10.5°±6.8° before operation, improved to 19.2°±9.0° at 3 months after operation, 18.2°±5.8° at 12 months after operation, and it was 10.9°±4.6°, 18.5°±7.8°, 17.1°±5.2° in cage+titanium plate group, respectively, and there was no significant difference between the two groups at each time point (all P>0.05). The incidence of postoperative dysphagia was 9.1%(3/33) in the ROI-C group and 37.9%(11/29) in the cage+titanium plate group, and the difference was statistically significant (P=0.007). Conclusions: Both ROI-C and stand-alone interbody cage combined with cage-titanium plate construct can achieve good results for two-segment skipped cervical spondylosis. However, ROI-C is more advantageous in shortening the operation time and reducing early postoperative dysphagia.

[Meta-analysis of efficacy of pressure therapy in treating patients with hypertrophic scars].

Objective: To systematically evaluate the efficacy of pressure therapy in treating patients with hypertrophic scars by meta-analysis. Methods: Databases including PubMed, Embase, Web of Science, and Cochrane Library were retrieved with the search terms"hypertrophic scar, hyperplastic scar, HTS, pressure therapy, pressure treatment, and the Chinese Journals Full-text Database was retrieved with the search terms in Chinese version",,,,"to obtain the publicly published randomized controlled trials about pressure therapy in the treatment of patients with hypertrophic scar from the establishment of each database to July 2017. The measurement indexes included the effective ratio, Vancouver Scar Scale (VSS) score, scar vascularity, scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow). RevMan 5.3 and Stata 12.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 667 hypertrophic scar patients were enrolled in 11 articles, including 362 patients in pressure therapy group who received pressure treatment and 305 patients in untreated group who received no treatment. The bias risks of the 11 studies included were uncertain. Compared with those of untreated group, the effective ratio of patients in pressure therapy group was significantly increased, with the relative risk of 5.98 (95% confidence interval=1.83-19.46, P<0.01); the VSS score and scar vascularity of patients in pressure therapy group were obviously decreased, with weighted mean differences of -2.24 and -0.66 respectively (95% confidence interval=-4.16--0.33, -1.21--0.12, P<0.05); the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow) of patients in pressure therapy group were not changed obviously (P≥0.05). Significant heterogeneity existed in the included studies of the effective ratio, VSS score, scar vascularity, scar hardness, scar pigment, and scar thickness, P<0.01, I(2)=90%, 87%, 80%, 93%, 86%, 94%. Pressure range might be the heterogeneity source of effective ratio, and pressure clothing combined with pressure pad therapy might be a heterogeneous source of VSS score. Sensitivity analysis showed that the combined effect size results were stable in the effective ratio and scar pigment, but not stable in the VSS score, scar thickness, scar hardness, and scar vascularity. There was no publication bias in the effective ratio, VSS score, scar hardness, scar pigment, and scar vascularity (P>0.1), while there was publication bias in the scar thickness (95% confidence interval=-19.77--3.30, P<0.1). Conclusions: Compared with patients without treatment, in the treatment of hypertrophic scars, pressure therapy can obviously increase the effective ratio, reduce the VSS score and scar vascularity, but can not obviously improve the scar hardness, scar pigment, scar thickness, and value of scar color (brightness, red, and yellow).

Microglia M1/M2 polarization contributes to electromagnetic pulse-induced brain injury.

The development of electronic technology has attracted attention on the biological effects of electromagnetic fields (EMFs) and electromagnetic pulse (EMP). It remains controversial whether EMP irradiation is neurotoxic or beneficial for recovery from injuryies such as cerebral ischemia. Microglia is innate immune cells in the brain, exhibiting either neurotoxicity or neuroprotection effect during various central nervous system diseases, depending on their activation into a classical (M1) or alternative (M2) phenotype, respectively. The Toll-like receptor-4 (TLR4), myeloid differentiation factor 88 (MyD88) and nuclear factor kappa B (NFκB) pathway is important for microglia activation. In this study, we investigated the effect of EMP on neuronal apoptosis and microglia polarization in vivo and in vitro, using an EMP of 400 kV/m and 1 hertz for 200 pulses. Short EMP irradiation (≤24 h) resulted in microglial conversion from the resting to the M1-type state, activation of the TLR4/MyD88/NFκB pathway, higher levels of inflammatory cytokines including interleukin (IL)-6, IL-1ß and tumor necrosis factor-α, as well as neuronal apoptosis induction. In contrast, long EMP irradiation (3 days) resulted in microglial activation into the M2-type, decreased apoptosis and inflammatory mediator production, and increased levels of the neuroprotective effectors IL-10, transforming growth factor beta, and brain-derived neurotrophic factor. EMP induces both neuronal damage and neuronal recovery by influencing the switch of M1/M2 polarization and the TLR4/MyD88/NFκB pathway.

Red mud (RM)-Induced enhancement of iron plaque formation reduces arsenic and metal accumulation in two wetland plant species.

Human activities have resulted in arsenic (As) and heavy metals accumulation in paddy soils in China. Phytoremediation has been suggested as an effective and low-cost method to clean up contaminated soils. A combined soil-sand pot experiment was conducted to investigate the influence of red mud (RM) supply on iron plaque formation and As and heavy metal accumulation in two wetland plant species (Cyperus alternifolius Rottb., Echinodorus amazonicus Rataj), using As and heavy metals polluted paddy soil combined with three rates of RM application (0, 2%, 5%). The results showed that RM supply significantly decreased As and heavy metals accumulation in shoots of the two plants due to the decrease of As and heavy metal availability and the enhancement of the formation of iron plaque on the root surface and in the rhizosphere. Both wetland plants supplied with RM tended to have more Fe plaque, higher As and heavy metals on roots and in their rhizospheres, and were more tolerant of As and heavy metal toxicity. The results suggest that RM-induced enhancement of the formation of iron plaque on the root surface and in the rhizosphere of wetland plants may be significant for remediation of soils contaminated with As and heavy metals.

Anti-diabetic effect of methylswertianin and bellidifolin from Swertia punicea Hemsl. and its potential mechanism.

In this study, we continued to investigate the hypoglycemic activity of Swertia punicea Helmsl., the hypoglycemic and hypolipidemic effects of methylswertianin and bellidifolin from the active ethyl acetate (EtOAc) fraction, and the potential mechanism(s) underlying the improvement of insulin resistance. Streptozotocin (STZ)-induced type 2 diabetic male BABL/c mice treated with methylswertianin and bellidifolin at different doses (orally, 200 and 100mg/kg body wt./day) for 4 weeks were analyzed in comparison to untreated mice. The results proved that methylswertianin and bellidifolin significantly reduced fasting blood glucose (FBG). The administration of both compounds also improved the oral glucose tolerance and lowered fasting serum insulin (FINS). Moreover, post-administration evaluation revealed lower serum total cholesterol (TC), low density lipoprotein cholesterol (LDL) and triglyceride (TG) levels and increased relative high density lipoprotein cholesterol (HDL) concentrations (HDL/TC). Methylswertianin and bellidifolin appeared to improve insulin resistance by enhancing insulin signaling. The expression levels of insulin-receptor alpha subunit (InsR-alpha), insulin-receptor substrate-1 (IRS-1), and phosphatidylinositol 3-kinase (PI3K) were also increased after administration. Meanwhile, methylswertianin and bellidifolin increased hepatic glycogen content, decreased glucokinase (GK) activities and increased glucose-6-phosphatase (G6Pase) activities. In conclusion, these result indicated that methylswertianin and bellidifolin could be useful for treating type-2 diabetes, likely via the improvement of insulin resistance (IR).

Visual spatial memory is enhanced in female rats (but inhibited in males) by dietary soy phytoestrogens.

BACKGROUND: In learning and memory tasks, requiring visual spatial memory (VSM), males exhibit superior performance to females (a difference attributed to the hormonal influence of estrogen). This study examined the influence of phytoestrogens (estrogen-like plant compounds) on VSM, utilizing radial arm-maze methods to examine varying aspects of memory. Additionally, brain phytoestrogen, calbindin (CALB), and cyclooxygenase-2 (COX-2) levels were determined. RESULTS: Female rats receiving lifelong exposure to a high-phytoestrogen containing diet (Phyto-600) acquired the maze faster than females fed a phytoestrogen-free diet (Phyto-free); in males the opposite diet effect was identified. In a separate experiment, at 80 days-of-age, animals fed the Phyto-600 diet lifelong either remained on the Phyto-600 or were changed to the Phyto-free diet until 120 days-of-age. Following the diet change Phyto-600 females outperformed females switched to the Phyto-free diet, while in males the opposite diet effect was identified.Furthermore, males fed the Phyto-600 diet had significantly higher phytoestrogen concentrations in a number of brain regions (frontal cortex, amygdala & cerebellum); in frontal cortex, expression of CALB (a neuroprotective calcium-binding protein) decreased while COX-2 (an inducible inflammatory factor prevalent in Alzheimer's disease) increased. CONCLUSIONS: Results suggest that dietary phytoestrogens significantly sex-reversed the normal sexually dimorphic expression of VSM. Specifically, in tasks requiring the use of reference, but not working, memory, VSM was enhanced in females fed the Phyto-600 diet, whereas, in males VSM was inhibited by the same diet. These findings suggest that dietary soy derived phytoestrogens can influence learning and memory and alter the expression of proteins involved in neural protection and inflammation in rats.