Zero-profile implant system versus novel plate systems after ACDF for comparison of sagittal balance parameters and clinical efficacy analysis.

BACKGROUND: The zero-profile implant system (Zero-P) and conventional plates have been widely used in anterior cervical discectomy and fusion (ACDF) to treat cervical spondylosis. The purpose of this study was to compare the effects of the application of Zero-P and new conventional plates (ZEVO, Skyline) in ACDF on the sagittal imaging parameters of cervical spondylosis patients and to analyze their clinical efficacy. METHODS: We conducted a retrospective study on 119 cervical spondylosis patients from January 2018 to December 2021, comparing outcomes between those receiving the Zero-P device (n = 63) and those receiving a novel conventional plate (n = 56, including 46 ZEVO and 10 Skyline plates) through ACDF. Cervical sagittal alignment was assessed pre- and postoperatively via lateral radiographs. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and visual analog scale (VAS) scores were recorded at baseline, after surgery, and at the 2-year follow-up to evaluate patient recovery and intervention success. RESULTS: There were significant differences in the postoperative C0-C2 Cobb angle and postoperative sagittal segmental angle (SSA) between patients in the novel conventional plate group and those in the Zero-P group (P < 0.05). Postoperatively, there were significant changes in the C2‒C7 Cobb angle, C0‒C2 Cobb angle, SSA, and average surgical disc height (ASDH) compared to the preoperative values in both patient groups (P < 0.05). Dysphagia in the immediate postoperative period was lower in the Zero-P group than in the new conventional plate group (0% in the Zero-P group, 7.14% in the novel conventional plate group, P = 0.046), and the symptoms disappeared within 2 years in both groups. There was no statistically significant difference between the two groups in terms of complications of adjacent spondylolisthesis (ASD) at 2 years postoperatively (3.17% in the Zero-P group, 8.93% in the novel conventional plate group; P = 0.252). According to the subgroup analysis, there were significant differences in the postoperative C2‒C7 Cobb angle, C0‒C2 Cobb angle, T1 slope, and ASDH between the ZEVO group and the Skyline group (P < 0.05). Compared with the preoperative scores, the JOA, NDI, and VAS scores of all groups significantly improved at the 2-year follow-up (P < 0.01). According to the subgroup analysis, the immediate postoperative NDI and VAS scores of the ZEVO group were significantly better than those of the Skyline group (P < 0.05). CONCLUSION: In ACDF, both novel conventional plates and Zero-P can improve sagittal parameters and related scale scores. Compared to the Zero-P plate, the novel conventional plate has a greater advantage in correcting the curvature of the surgical segment, but the Zero-P plate is less likely to produce postoperative dysphagia.

Mean number of DNA breakpoints: illuminating sperm DNA integrity and in vitro fertilization outcomes.

OBJECTIVE: To verify the capacity of the mean number of DNA breakpoints (MDB) for evaluating sperm integrity and its relationship with in vitro fertilization (IVF) outcomes. DESIGN: Retrospective cohort study. SETTING: Reproductive center in a tertiary hospital. PATIENT(S): All men whose female partners underwent IVF from March to October 2022 in the reproductive center. INTERVENTION(S): The MDB and DNA fragmentation index (DFI) were used to assess sperm DNA integrity. The patients were stratified into two groups according to MDB and DFI cutoffs: sperm DNA-normal and sperm DNA-impaired. MAIN OUTCOME MEASURES: Semen parameters: concentration, progressive motility (PR), MDB, and the DFI; IVF outcome measures: two pronuclei (2-PN), fertilization rate, fertilization cleavage rate, high-quality embryo rate, biochemical pregnancy rate, clinical pregnancy rate, and implantation rate. RESULTS: Sperm MDB had a higher negative correlation with PR compared with the DFI (r = -0.43; r = -0.37, respectively). Sperm MDB did not have a statistical correlation with sperm concentration, whereas the DFI correlated significantly with concentration (r = -0.17; r = -0.27, respectively). Logistic regression analysis controlling for age and semen concentration demonstrated that an increase in MDB increased the risk of asthenospermia (odds ratio = 1.018, 95% confidence interval [CI] 1.003-1.034). An increasing DFI also increased the risk of asthenospermia (odds ratio = 1.044, 95% CI 1.002-1.087). The MDB showed a stronger clinical relevance with sperm PR than the DFI, as indicated using the area under the curve values (0.754, 95% CI 0.649-0.859 vs. 0.691, 95% CI 0.556-0.825). A threshold of the MDB >0.37 nM was calculated to define sperm DNA-impaired. Comparison of IVF results showed that the high-quality embryo rate (χ2 = 13.00) was significantly lower in the DNA-impaired group than in the DNA-normal group stratified using the MDB, although there were no significant differences in IVF outcomes in DFI-stratified groups. CONCLUSION: The MDB has been verified to correlate closely with semen PR and may serve as a predictive parameter for IVF outcomes. Rigorous prospective studies are required to explore MDB performance and to further validate and reinforce the potential application of MDB as a parameter for male infertility.

Potential molecular targets and drugs for basement membranes-related intervertebral disk degeneration through bioinformatics analysis and molecular docking.

BACKGROUND: Through bioinformatics analysis to identify the hub genes of Intervertebral disc degeneration (IVDD) associated with basement membranes (BMs) and find out the potential molecular targets and drugs for BMs-related annulus fibrosus (AF) degeneration based on bioinformatic analysis and molecular approach. METHODS: Intervertebral disc degeneration (IVDD) related targets were obtained from GeneCards, DisGenet and OMIM databases. BMs related genes were obtained from Basement membraneBASE database. The intersection targets were identified and subjected to protein-to-protein interaction (PPI) construction via STRING. Hub genes were identified and conducted Gene ontology (GO) and pathway enrichment analysis through MCODE and Clue GO in Cytospace respectively. DSigDB database was retrieved to predict therapeutic drugs and molecular docking was performed through PyMOL, AutoDock 1.5.6 to verify the binding energy between the drug and the different expressed hub genes. Finally, GSE70362 from GEO database was obtained to verify the different expression and correlation of each hub gene for AF degeneration. RESULTS: We identified 41 intersection genes between 3 disease targets databases and Basement membraneBASE database. PPI network revealed 25 hub genes and they were mainly enriched in GO terms relating to glycosaminoglycan catabolic process, the TGF-ß signaling pathway. 4 core targets were found to be significant via comparison of microarray samples and they showed strong correlation. The molecular docking results showed that the core targets have strong binding energy with predicting drugs including chitosamine and retinoic acid. CONCLUSIONS: In this study, we identified hub genes, pathways, potential targets, and drugs for treatment in BMs-related AF degeneration and IVDD.

Accumulative Rolling Mg/PLLA Composite Membrane with Lamellar Heterostructure for Enhanced Bacteria Inhibition and Rapid Bone Regeneration.

Developing composite materials with optimized mechanics, degradation, and bioactivity for bone regeneration has long been a crucial mission. Herein, a multifunctional Mg/Poly-l-lactic acid (Mg/PLLA) composite membrane based on the "materials plain" concept through the accumulative rolling (AR) method is proposed. Results show that at a rolling ratio of 75%, the comprehensive mechanical properties of the membrane in the rolling direction are self-reinforced significantly (elongation at break ≈53.2%, tensile strength ≈104.0 MPa, Young's modulus ≈2.13 GPa). This enhancement is attributed to the directional arrangement and increased crystallization of PLLA molecular chains, as demonstrated by SAXS and DSC results. Furthermore, the AR composite membrane presents a lamellar heterostructure, which not only avoids the accumulation of Mg microparticles (MgMPs) but also regulates the degradation rate. Through the contribution of bioactive MgMPs and their photothermal effect synergistically, the membrane effectively eliminates bacterial infection and accelerates vascularized bone regeneration both in vitro and in vivo. Notably, the membrane exhibits outstanding rat skull bone regeneration performance in only 4 weeks, surpassing most literature reports. In short, this work develops a composite membrane with a "one stone, four birds" effect, opening an efficient avenue toward high-performance orthopedic materials.

Clinical outcome analysis of sequential transplantation of frozen-thawed embryo transfer cycle: a retrospective study.

The sequential transplantation was a new mode of in vitro fertilization and embryo transfer. To compare the clinical outcomes of sequential transplantation, embryo transplantation and blastocyst transplantation during freeze-thaw embryo transfer cycle. The retrospective study was conducted on 767 patients who received freeze-thaw embryo transfer at Reproductive Medicine Center of Hangzhou Women Hospital from July 1, 2020 to June 30, 2021. According to the age of transplanted embryos, all patients were divided into sequential transplantation, embryo embryo transplantation group and blastocyst stage transplantation group. The clinical data, embryo status and pregnancy outcome of the 3 groups were compared, the number of transplanted embryos in the sequential group was significantly higher than that in the other 2 groups (P < .05). The implantation rate of blastocyst transplantation group was the highest, there was no statistical significance between the sequential transplantation group and the other 2 groups (39.13% vs 30.00%, 39.13 vs 43.50%). The multiple birth rate (30.77%) and spontaneous abortion rate (20.51%) were higher in the sequential transplantation group, and there was no significant difference among the 3 groups (P > .05). The sequential transplantation cycle can obtain a higher clinical pregnancy rate than the conventional single cycle transplantation, without causing the waste of transplanted embryos, and can be used as the choice mode of resuscitation transplantation cycle for some patients.

Effect of Cu and Mg addition on the mechanical and degradation properties of Zn alloy wires.

In this study, Zn-xCu (-0.1 Mg) wires with a diameter of 0.3 mm were obtained by hot extrusion and cold drawing. The microstructures, mechanical properties, and degradation behaviour were investigated to evaluate their feasibility as biodegradable metals. During the drawing process of the Zn-xCu alloys, many granular CuZn5 phases were dynamically precipitated, and the grains were significantly refined, along with a significant work softening with the tensile strength decreasing and the elongation increasing (from 161 MPa to 92 MPa and 22%-103% for Zn-0.2Cu). With the increase of Cu additions, the phenomenon of work softening was more intense and there was an opposite trend in the strength changes between the as-extruded rods (increase) and as-drawn wires (decrease). With 0.1 wt.% Mg added, the stable rod-like Mg2Zn11 phase was formed in as-extruded Zn-xCu-0.1 Mg rods, which obviously improved the strength, and inhibited the dynamic precipitation of granular CuZn5 phase and work softening phenomenon in the drawing process (from 332 MPa to 313 MPa and 11%-46% for Zn-0.2Cu-0.1 Mg). In addition, due to the micro-galvanic effect induced by the precipitates, alloying accelerated the degradation of Zn alloy wires, especially Zn-1Cu-0.1 Mg, which was related to the shape, distribution, and potential of the phases.

Preparation of 4D printed peripheral vascular stent and its degradation behavior under fluid shear stress after deployment.

Shape memory stents are mild intervention devices for vascular diseases as compared to balloon-dilated ones; however, their degradation behavior under blood shear stress after deployment also deserves further attention. To understand the degradation behavior, we first prepared 4D printed poly(lactic acid) (PLA) stents via 3D printing technology and studied their failure behavior in a dynamic condition after self-expandable deployment. Mechanical property tests showed that the 4D printed stents had a compression force of 0.06-0.39 N mm-1 and a recovery ratio of 85.3-93.4%, respectively, which was verified to be wall thickness dependent. The stents were then implanted in simulated blood vessels with minimal microstructural damage at 60 °C followed by 8-week degradation tests. The results showed the microstructure damage caused by deployment could accelerate the degradation of stents faster than fluid shear stress. Furthermore, we conducted microstructural analysis and numerical simulation on the stent by finite element analysis (FEA) to explain the relationship between stent injury, vascular injury, and stent deployment temperature. A physical model derived from micro-morphologies on the degradation mechanism of PLA was also proposed. These results may provide new insights for the examination of the degradation behavior of 4D printed stents and minimize medical risk.

Active Components of Traditional Chinese Medicinal Material for Multiple Myeloma: Current Evidence and Future Directions.

Multiple myeloma (MM) is a hematological malignancy characterized by clonal expansion of plasma cells in bone marrow, leading to the overproduction of monoclonal immunoglobulins. The clinical manifestations resulting from monoclonal proteins and malignant cells include signs of end-organ damage, such as hypercalcemia, renal failure, anemia, and bone lesions. Despite improvement in the survival of MM patients with use of myeloma-targeted and immunomodulatory therapies, MM remains an incurable disease. Moreover, patients with relapsed or refractory MM show poor survival outcomes. In recent years, there has been a growing interest in the use of traditional Chinese medicinal materials (TCMMs) for management of a wide spectrum of diseases. The bioactive ingredients derived from TCMMs hold great potential for the development of anticancer drugs. Here we summarize the evidence of the pharmacological effects of the active components in TCMMs on MM, including curcumin, resveratrol, baicalein, berberine, bufalin, cinobufagin, gambogic acid, ginsenoside, icariin, daidzin, formononetin, polysaccharides extracts from Hedyotis difus, and scutellarein. Available evidence indicates that the anti-MM effects of these bioactive ingredients are mediated via regulation of proliferation, apoptosis, autophagy, cell cycle, osteogenic differentiation, and drug resistance. In the future, the underlying mechanisms of the anti-MM effects of these components should be further investigated. Large-scale and well-designed clinical trials are also required to validate the efficacy of these bioactive constituents for MM.

Microchannelled alkylated chitosan sponge to treat noncompressible hemorrhages and facilitate wound healing.

Developing an anti-infective shape-memory hemostatic sponge able to guide in situ tissue regeneration for noncompressible hemorrhages in civilian and battlefield settings remains a challenge. Here we engineer hemostatic chitosan sponges with highly interconnective microchannels by combining 3D printed microfiber leaching, freeze-drying, and superficial active modification. We demonstrate that the microchannelled alkylated chitosan sponge (MACS) exhibits the capacity for water and blood absorption, as well as rapid shape recovery. We show that compared to clinically used gauze, gelatin sponge, CELOX™, and CELOX™-gauze, the MACS provides higher pro-coagulant and hemostatic capacities in lethally normal and heparinized rat and pig liver perforation wound models. We demonstrate its anti-infective activity against S. aureus and E. coli and its promotion of liver parenchymal cell infiltration, vascularization, and tissue integration in a rat liver defect model. Overall, the MACS demonstrates promising clinical translational potential in treating lethal noncompressible hemorrhage and facilitating wound healing.

Construction of chitosan scaffolds with controllable microchannel for tissue engineering and regenerative medicine.

Microchannels are effective means of enabling the functional performance of tissue engineering scaffolds. Chitosan, a partial deacetylation derivative of chitin, exhibiting excellent biocompatibility, has been widely used in clinical practice. However, development of chitosan scaffolds with controllable microchannels architecture remains an engineering challenge. Here, we generated chitosan scaffolds with adjustable microchannel by combining a 3D printing microfiber templates-leaching method and a freeze-drying method. We can precisely control the arrangement, diameter and density of microchannel within chitosan scaffolds. Moreover, the integrated bilayer scaffolds with the desired structural parameters in each layer were fabricated and exhibited no delamination. The flow rate and volume of the simulated fluid can be modulated by diverse channels architecture. Additionally, the microchannel structure promoted cell survival, proliferation and distribution in vitro, and improved cell and tissue ingrowth and vascular formation in vivo. This study opens a new road for constructing chitosan scaffolds, and can further extend their application scope across tissue engineering and regenerative medicine.

Screening and identification of endometrial proteins as novel potential biomarkers for repeated implantation failure.

Inadequate endometrial receptivity may be responsible for the low implantation rate of transferred embryos in in vitro fertilization (IVF) treatments. Patients with repeated implantation failure (RIF) impact the clinical pregnancy rate for IVF. We collected endometrial tissue during the implantation window of hysteroscopy biopsies from September 2016 to December 2019 and clinical data were collected simultaneously. Patients were divided into RIF and pregnant controls group according to pregnancy outcomes. A total of 82 differentially expressed endometrial proteins were identified, including 55 up-regulated proteins (>1.50-fold, P < 0.05) and 27 down-regulated proteins (<0.67-fold, P < 0.05) by iTRAQ labeling coupled with the 2D LC MS/MS technique in the RIF group. String analysis found interactions between these proteins which assembled in two bunches: ribosomal proteins and blood homeostasis proteins. The most significant enriched Gene Ontology terms were negative regulation of hydrolase activity, blood microparticle, and enzyme inhibitor activity. Our results emphasized the corticosteroid-binding globulin and fetuin-A as the specific proteins of endometrial receptivity by Western-blot. Our study provided experimental data to establish the objective indicator of endometrial receptivity, and also provided new insight into the pathogenesis of RIF.

Proteomic Analysis of the Alterations in Follicular Fluid Proteins During Oocyte Maturation in Humans.

Many components in ovarian follicles (follicular fluid, cumulus cells, granular cells, etc.) dynamically change during folliculogenesis and play a positive or negative role in oocyte maturation. Infertile women who underwent intracytoplasmic sperm injection (ICSI) treatment in the reproductive medicine centre of Hangzhou Women's Hospital between October 2018 and October 2021 were included. The ovarian follicular fluid and cumulus cells of diminished ovarian response (DOR) patients and control subjects with medical records of clinical data were collected. In total, 31 differentially expressed proteins, including 10 upregulated proteins (>1.50-fold, P<0.05) and 21 downregulated proteins (<0.67-fold, P<0.05), were identified in mature vs. immature oocytes by iTRAQ labelling coupled with 2D LC-MS/MS. GO analysis revealed that 'cell population proliferation' was the most diverse enrichment trend between up/downregulated proteins, while phagosome process and the PI3K-Akt signaling pathway were the two most significant pathways revealed by KEGG enrichment classification. Human prostatic acid phosphatase (PAP, ACPP) and CD5 antigen-like (CD5L) were two proteins verified by ELISA to be differentially expressed between MII and Gv oocytes (P<0.0001 and P<0.0001, respectively). Further measurement found significantly lower level of ACPP in follicular fluids and cumulus cells of DOR patients (P=0.028 and P=0.004, respectively), as an indicator of oocyte quality. Otherwise, CD5L level is upregulated in follicular fluid of DOR patients (P<0.0001). Our study provided experimental data to establish the objective indicator of oocyte maturation in the microenvironment of ovarian follicles, and also provided new insight into the measurement of oocyte quality.

Mechanical Properties and Degradation Behaviors of Zn-xMg Alloy Fine Wires for Biomedical Applications.

Zn and Zn-based alloys exhibit biosafety and biodegradation, considered as candidates for biomedical implants. Zn-0.02 wt.% Mg (Zn-0.02 Mg), Zn-0.05 wt.% Mg (Zn-0.05 Mg), and Zn-0.2 wt.% Mg (Zn-0.2 Mg) wires (Φ 0.3 mm) were prepared for precision biomedical devices in this work. With the addition of Mg in Zn-xMg alloys, the grain size decreased along with the occurrence of Mg2Zn11 at the grain boundaries. Hot extrusion, cold drawing, and annealing treatment were introduced to further refining the grain size. Besides, the hot extrusion and cold drawing improved the tensile strength of Zn-xMg alloys to 240-270 MPa while elongation also increased but remained under 10%. Annealing treatment could improve the elongation of Zn alloys to 12% -28%, but decrease the tensile strength. Furthermore, Zn-xMg wires displayed an increase in degradation rate with Mg addition. The findings might provide a potential possibility of Zn-xMg alloy wires for biomedical applications.

Correlation between C7 slope and cervical lordosis in patients after expansive open-door laminoplasty.

Purpose of the article: To investigate the correlation between C7 slope and cervical lordosis in patients after expansive open-door laminoplasty (EOLP).Material and methods: We retrospectively analyzed 57 patients who underwent EOLP between June 2013 and January 2017 in the Department of Spinal Surgery of our hospital. The operation time, intraoperative blood loss and follow-up time were recorded. The C7 slope, C2-7 sagittal vertical axis, and C2-7 Cobb angle were measured anteroposterior radiograph of the cervical spine preoperatively and postoperatively. All patients were divided into two groups according to the preoperative C7 slope (C7 slope ≤20° group and C7 slope >20° group).Results: The amount of intraoperative bleeding was 220.2 ± 180.9ml, and the operation time was 143.4 ± 51.2min. The average follow-up time was 24.9 ± 10.3months (range12-48 months). The C2-7 Cobb angle was 13.49 ± 10.46°at the final follow-up, which was significantly lower than that preoperatively (p = .026). But, The C7 slope and C2-7 sagittal vertical axis showed no significant difference between preoperatively and postoperatively. Preoperative and postoperative C7 slope and C2-7 Cobb angle were positively correlated to age and significant difference was observed. In the group of C7 slope >20°, significant difference was observed in term of the change of the C2-7 Cobb angle and C2-7SVA postoperatively (p = .009 and p= .020). However, there was no statistically significant difference detected in these two parameters in the group of C7 slope ≤20°.Conclusion: This study indicated that C7 slope could be used as an indicator of the change in the curvature of the cervical spine after EOLP. The loss of cervical curvature after surgery was prone to occur when C7 slope was greater than 20°, which should be noted in clinical practice.

[Correlation analysis between C 7 slope and cervical sagittal parameters in short segment anterior cervical discectomy with fusion].

OBJECTIVE: To elucidate the relationship between preoperative C 7 slope (C 7S) and sagittal parameters in anterior cervical discectomy with fusion (ACDF) by imaging. METHODS: A retrospective analysis of 54 patients (24 males and 30 females) with ACDF for cervical spondylosis between January 2012 and January 2017 was performed. The age ranged from 23 to 71 years (mean, 46.6 years). There were 29 cases of cervical spondylotic radiculopathy and 25 cases of cervical spondylotic myelopathy. The disease duration ranged from 3 to 48 months, with an average of 16.8 months. In the 55 patients, 44 were single-segment ACDF and 10 were double-segment ACDF. Sagittal parameters of cervical spine were measured on cervical X-ray films before operation and at last follow-up, including C 2-7 Cobb angle, C 2-7 sagittal vertical axis (C 2-7 SVA), C 7S, and segment Cobb angle (SCobb), and the changes of C 2-7 Cobb angle (the difference between the last follow-up and the preoperative angle) were calculated. Pearson correlation was used to analyze the correlation between the parameters before operation and at last follow-up. According to the preoperative median value of C 7S (15°), the patients were divided into group A (C 7S<15°) and group B (C 7S≥15°). The sagittal parameters before and after operation were compared between the two groups. RESULTS: All the 54 patients were followed up 6-45 months (mean, 15.5 months). At last follow-up, C 7S, C 2-7 Cobb angle, C 2-7 SVA, and SCobb angle were significantly improved when compared with preoperative values ( P<0.05). Correlation analysis showed that the preoperative C 7S and SCobb angles were significantly correlated with C 2-7 Cobb angle and C 2-7 SVA ( P<0.05), but there was no significant correlation between C 7S and SCobb angle ( r=0.049, P=0.724). There was a significant correlation between C 7S, C 2-7 Cobb angle, and SCobb angle at last follow-up ( P<0.05), but there was no significant correlation between C 7S and SCobb angles and C 2-7 SVA ( P>0.05). According to the median value of preoperative C 7S, 28 patients in group A had C 7S of (11.82±3.60)°, while 26 patients in group B had C 7S of (20.77±4.09)°. There was no significant difference in gender and age between the two groups ( P>0.05). The preoperative C 2-7 Cobb angle and C 2-7 SVA in group A were significantly lower than those in group B ( P<0.05). There was no significant difference between preoperative SCobb angle and group B ( t=0.234, P=0.816). There were no significant differences in C 2-7 Cobb angle, C 2-7 SVA, and SCobb angle between group A and group B at last follow-up ( P>0.05). However, the change of C 2-7 Cobb angle in group A was significantly higher than that in group B ( t=2.321, P=0.024). CONCLUSION: Preoperative C 7S≥15° group has more physiological lordosis before operation, but its postoperative cervical curvature changes less, while ACDF is more conducive to correct the preoperative C 7S<15 ° cervical curvature.

[Correlation analysis of preoperative T 1 slope in MRI and physiological curvature loss after expansive open-door laminoplasty].

Objective: To investigate whether preoperative T 1 slope (T 1S) in MRI can predict the changes of cervical curvature after expansive open-door laminoplasty (EOLP) in patients with cervical spondylotic myelopathy, so as to make up for the shortcomings of difficult measurement in X-ray film. Methods: The clinical data of 36 patients with cervical spondylotic myelopathy who underwent EOLP were retrospectively analysed. There were 21 males and 15 females with an average age of 55.8 years (range, 37-73 years) and an average follow-up time of 14.3 months (range, 12-24 months). The preoperative X-ray films at dynamic position, CT, and MRI of cervical spine before operation, and the anteroposterior and lateral X-ray films at last follow-up were taken out to measure the following sagittal parameters. The parameters included C 2-C 7 Cobb angle and C 2-C 7 sagittal vertical axis (C 2-C 7 SVA) in all patients before operation and at last follow-up; preoperative T 1S were measured in MRI, and the patients were divided into larger T 1S group (T 1S>19°, group A) and small T 1S group (T 1S≤19°, group B) according to the median of T 1S, and the preoperative T 1S, C 2-C 7 Cobb angle, C 2-C 7 SVA, and the C 2-C 7 Cobb angle and C 2-C 7 SVA at last follow-up, difference in axial distance (the difference of C 2-C 7 SVA before and after operation), postoperative curvature loss (the difference of C 2-C 7 Cobb angle before and after operation), the number of patients whose curvature loss was more than 5° after operation, and the number of patients whose kyphosis changed (C 2-C 7 Cobb angle was less than 0° after operation). Results: The C 2-C 7 Cobb angle at last follow-up was significantly decreased when compared with preoperative value ( t=8.000, P=0.000), but there was no significant difference in C 2-C 7 SVA between pre- and post-operation ( t=-1.842, P=0.074). The preoperative T 1S was (19.69±3.39)°; there were 17 cases in group A and 19 cases in group B with no significant difference in gender and age between 2 groups ( P>0.05). The preoperative C 2-C 7 Cobb angle in group B was significantly lower than that in group A ( t=-2.150, P=0.039), while there was no significant difference in preoperative C 2-C 7 SVA between 2 groups ( t=0.206, P=0.838). At last follow-up, except for the curvature loss after operation in group B was significantly lower than that in group A ( t=-2.723, P=0.010), there was no significant difference in the other indicators between 2 groups ( P>0.05). Conclusion: Preoperative larger T 1S (T 1S>19°) in MRI had a larger preoperative lordosis angle, but more postoperative physiological curvature was lost; preoperative T 1S in MRI can not predict postoperative curvature loss, but preoperative larger T 1S may be more prone to kyphosis.

[Analysis of cervical sagittal parameters on MRI in patients with cervical spondylotic myelopathy].

Objective: To analyse the correlation between cervical sagittal parameters of cervical spondylotic myelopathy in different sagittal curvature so as to find out representative cervical sagittal alignment parameters by measuring on MRI. Methods: A retrospective analysis was made on the clinical data of 88 patients with cervical spondylotic myelopathy between July 2015 and January 2016. The C 2-C 7 Cobb angle, T 1 slope (T 1S), and C 2-C 7 sagittal vertical axis (C 2-C 7 SVA) were measured on T2-weight MRI. According to C 2-C 7 Cobb angle, the patients were divided into lordosis group (≥10° Cobb angle, 48 cases) and straightened group (0-10° Cobb angle, 40 cases). Intraclass correlation coefficient (ICC) was used for the reliability of measured data, Pearson correlation analysis for correlation between cervical sagittal parameters. Results: ICC was 0.858-0.946, indicating good consistency of measurement parameters. The C 2-C 7 Cobb angle, T 1S, and C 2-C 7 SVA were (5.6±2.4)°, (22.2±6.7)°, and (10.2±5.4) mm in straightened group, and were (20.1±8.2)°, (23.4±8.9)°, and (8.2±4.6) mm in lordosis group respectively. There was no correlation between the 3 parameters in straighten group ( r=0.100, P=0.510 for T 1S and C 2-C 7 Cobb angle; r=-0.100, P=0.500 for T 1S and C 2-C 7 SVA; r=0.080, P=0.610 for C 2-C 7 Cobb angle and C 2-C 7 SVA). There was positive correlation between T 1S and C 2-C 7 Cobb angle ( r=0.540, P=0.000), negative correlation between T 1S and C 2-C 7 SVA ( r=-0.450, P=0.001), and no correlation between C 2-C 7 Cobb angle and C 2-C 7 SVA ( r=-0.003, P=0.980). Conclusion: For cervical spondylotic myelopathy in patients with cervical lordosis, only T 1S measurement on MRI can be used as the main parameter to judge the sagittal curvature, but in patients with straightened cervical Cobb angle, measurements of T 1S, C 2-C 7 Cobb angle, and C 2-C 7 SVA should be taken for the comprehensive evaluation of cervical sagittal curvature.

A novel dendritic-cell-targeting DNA vaccine for hepatitis B induces T cell and humoral immune responses and potentiates the antivirus activity in HBV transgenic mice.

Strategies for inducing an effective immune response following vaccination have focused on targeting antigens to dendritic cells (DCs) through the DC-specific surface molecule DEC-205. The immunogenicity and efficacy of DNA vaccination can also be enhanced by fusing the encoded antigen to single-chain antibodies directed against DEC-205. Here, we investigated this promising approach for its enhancement of hepatitis B virus (HBV)-specific cellular and humoral immune responses and its antiviral effects in HBV transgenic mice. A plasmid DNA vaccine encoding mouse DEC-205 single-chain fragment variable (mDEC-205-scFv) linked with the hepatitis B surface antigen (HBsAg) was constructed. Vaccination with this fusion DNA vaccine in HBV transgenic mice induced robust antiviral T cell and antibody immunity against HBsAg. The levels of serum-circulating HBsAg and the HBV DNA copy number were downregulated by the induction of a higher HBsAg-specific response. Thus, in this study, we demonstrated the therapeutic efficacy of the novel mDEC-205-scFv-fused DNA vaccine in a mouse model of immune-tolerant, chronic HBV infection.