Biodegradation of the methylenedioxyphenyl group in piperine and its derivatives: discovery of a novel methylenetransferase in an actinomycete.

IMPORTANCE: Pepper is a spice that has been used worldwide since the Age of Discovery. The substance that is responsible for the spiciness in pepper is piperine, a type of alkaloid. It has never been reported how piperine is degraded by microorganisms. In this study, we discovered a bacterium in the soil that is capable of catabolizing piperine as its sole nitrogen source. Furthermore, we discovered the enzyme involved in piperine metabolism. This enzyme decomposed the methylenedioxyphenyl group, which is the common structure in various plant-derived bioactive compounds such as sesamin, piperonal, safrole, and berberin. By utilizing this enzyme, piperine can be converted into a useful antioxidant compound. The findings about previously unknown metabolic pathways in nature can lead to the discovery of new enzymes and provide methods for the enzymatic synthesis of useful compounds.

Corrigendum: Effects of chlorantraniliprole on the life history traits of fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae).

[This corrects the article DOI: 10.3389/fphys.2023.1155455.].

Effects of chlorantraniliprole on the life history traits of fall armyworm Spodoptera frugiperda (Lepidoptera: Noctuidae).

Introduction: Spodoptera frugiperda is an important nomadic agricultural pest with a diverse host range and resistance against several insecticides. The current study investigated the life history traits of two strains of the field-collected population against chlorantraniliprole using an age-stage two-sex life table. Method: For this, we established the chlorantraniliprole-susceptible (Crp-SUS G12), and chlorantraniliprole-reduced susceptible (Crp-RES G12) strains derived from the sixth generation of the QJ-20 population having a resistance ratio (RR) of 10.39-fold, compared with the reported susceptible population. Results: The results showed that the chlorantraniliprole-reduced susceptible strain attained a 4.0-fold RR, while the chlorantraniliprole-susceptible strain attained an RR of 0.85-fold, having overlapped fiducial limits (FLs) with the referred susceptible baseline. Meanwhile, the present study revealed that the development time of the susceptible strain was significantly longer than that of the reduced susceptible strain. Similarly, the mean longevity, adult pre-oviposition period (APOP), and total pre-oviposition period (TPOP) of the female chlorantraniliprole-susceptible strain were considerably longer than those of the female chlorantraniliprole-reduced susceptible strain. Contrarily, the population parameters, including the intrinsic rate of increase (r), finite rate of increase (λ), and net reproductive rate (R), of the chlorantraniliprole-susceptible strain were considerably lower than those of the chlorantraniliprole-reduced susceptible strain, while the mean generation time (T) of the chlorantraniliprole-susceptible strain was substantially longer than the chlorantraniliprole-reduced susceptible strain. The age-stage characteristic survival rate (s xj ) and age-stage characteristic life expectancy (e xj ) of the chlorantraniliprole-susceptible strain were longer than those of the chlorantraniliprole-reduced susceptible strain, but the age-stage-specific reproductive value (v xj ) of the chlorantraniliprole-susceptible strain was shorter than that of the chlorantraniliprole-reduced susceptible strain. Moreover, the contents of vitellogenin (Vg) and VgR in the chlorantraniliprole-reduced susceptible strain were higher than those in the chlorantraniliprole-susceptible strain. Discussion: These findings showed that reducing susceptibility to chlorantraniliprole promoted population growth in S. frugiperda. Therefore, this study could provide conceptual support for the integrated pest management (IPM) approach to control S. frugiperda in the field.

An ABA-serotonin module regulates root suberization and salinity tolerance.

Suberin in roots acts as a physical barrier preventing water/mineral losses. In Arabidopsis, root suberization is regulated by abscisic acid (ABA) and ethylene in response to nutrient stresses. ABA also mediates coordination between microbiota and root endodermis in mineral nutrient homeostasis. However, it is not known whether this regulatory system is common to plants in general, and whether there are other key molecule(s) involved. We show that serotonin acts downstream of ABA in regulating suberization in rice and Arabidopsis and negatively regulates suberization in rice roots in response to salinity. We show that ABA represses transcription of the key gene (OsT5H) in serotonin biosynthesis, thus promoting root suberization in rice. Conversely, overexpression of OsT5H or supplementation with exogenous serotonin represses suberization and reduces tolerance to salt stress. These results identify an ABA-serotonin regulatory module controlling root suberization in rice and Arabidopsis, which is likely to represent a general mechanism as ABA and serotonin are ubiquitous in plants. These findings are of significant importance to breeding novel crop varieties that are resilient to abiotic stresses and developing strategies for production of suberin-rich roots to sequestrate more CO2 , helping to mitigate the effects of climate change.

Analysis of the frontier and hotspot of screening technology for early lung cancer based on bibliometrics / 中国胸心血管外科临床杂志

@#Objective    To reveal and demonstrate the hotspots and further research directions in screening technology for early lung cancer, and provide references for the future studies. Methods    Researches related to lung cancer screening from 2011 to 2021 in the Web of Science database were included. Biblioshiny, a bibliometrics program based on R language, was used to perform content analysis and visualization of the included literature information. Results    Researches related to lung cancer screening were increasing year by year. Six major cooperation groups were formed between countries. The current research hotspots in the field of early lung cancer screening technology mainly focused on the multi-directional fusion of radiographic imaging, liquid biopsy and artificial intelligence. Conclusion    Low-dose spiral CT screening is still the most important and mainstream method for the screening of early lung cancer at present. The combination and integration of artificial intelligence with various screening methods and the innovation of novel testing and diagnostic equipment are the current research hotspots and the future research trend in this field.

Suberin plasticity to developmental and exogenous cues is regulated by a set of MYB transcription factors.

Suberin is a hydrophobic biopolymer that can be deposited at the periphery of cells, forming protective barriers against biotic and abiotic stress. In roots, suberin forms lamellae at the periphery of endodermal cells where it plays crucial roles in the control of water and mineral transport. Suberin formation is highly regulated by developmental and environmental cues. However, the mechanisms controlling its spatiotemporal regulation are poorly understood. Here, we show that endodermal suberin is regulated independently by developmental and exogenous signals to fine-tune suberin deposition in roots. We found a set of four MYB transcription factors (MYB41, MYB53, MYB92, and MYB93), each of which is individually regulated by these two signals and is sufficient to promote endodermal suberin. Mutation of these four transcription factors simultaneously through genome editing leads to a dramatic reduction in suberin formation in response to both developmental and environmental signals. Most suberin mutants analyzed at physiological levels are also affected in another endodermal barrier made of lignin (Casparian strips) through a compensatory mechanism. Through the functional analysis of these four MYBs, we generated plants allowing unbiased investigation of endodermal suberin function, without accounting for confounding effects due to Casparian strip defects, and were able to unravel specific roles of suberin in nutrient homeostasis.

Rotational Doppler shift from a rotating rod.

This Letter reports on a rotational Doppler effect obtained from a rotating rod illuminated by a fundamental Gaussian laser beam. More specifically, we decompose the transmitted light behind the rotating rod into Laguerre-Gaussian modes and investigate the associated frequency shifts. The main contributing modes correspond to modes having the same rotational symmetry as the rotating object. Furthermore, their shifts equal the topological charge of the beam times the rotational frequency of the object. Potential applications in pattern recognition and rotation identification are then considered.

A potassium-sensing niche in Arabidopsis roots orchestrates signaling and adaptation responses to maintain nutrient homeostasis.

Organismal homeostasis of the essential ion K+ requires sensing of its availability, efficient uptake, and defined distribution. Understanding plant K+ nutrition is essential to advance sustainable agriculture, but the mechanisms underlying K+ sensing and the orchestration of downstream responses have remained largely elusive. Here, we report where plants sense K+ deprivation and how this translates into spatially defined ROS signals to govern specific downstream responses. We define the organ-scale K+ pattern of roots and identify a postmeristematic K+-sensing niche (KSN) where rapid K+ decline and Ca2+ signals coincide. Moreover, we outline a bifurcating low-K+-signaling axis of CIF peptide-activated SGN3-LKS4/SGN1 receptor complexes that convey low-K+-triggered phosphorylation of the NADPH oxidases RBOHC, RBOHD, and RBOHF. The resulting ROS signals simultaneously convey HAK5 K+ uptake-transporter induction and accelerated Casparian strip maturation. Collectively, these mechanisms synchronize developmental differentiation and transcriptome reprogramming for maintaining K+ homeostasis and optimizing nutrient foraging by roots.

Treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position: an experience on 18 patients / 中华肝胆外科杂志

Objective:To study the feasibility and safety in treatment of trauma to right posterior liver using laparoscopic surgery with patients in the left semiprone position.Methods:The clinical data of consecutive patients who were diagnosed to have trauma to the right posterior liver and were treated with laparoscopic surgery with patients in the left semiprone position at the Department of Hepatobiliary Surgery, the Affiliated Hospital of Youjiang Medical University for Nationalities between February 2016 and August 2020 were retrospectively analysed. The patients’ gender, age, mechanisms of injury, operative methods, operative time, amounts of abdominal effusion, degrees of liver injury, extents of intraoperative bleeding, amounts of postoperative drainage, lengths of postoperative hospital stay, and major postoperative complications were recorded and analyzed.Results:Among the 18 patients, there were 16 males and 2 females, aged (41.6±14.4) years. The mechanisms of liver trauma were caused by fall injury ( n=10), traffic accidents ( n=4), blunt injury ( n=2) and penetrating injury ( n=2). The levels of injuries were level Ⅲ in 16 patients and level Ⅳ in 2 patients. Laparoscopic suture repair was performed in 8 patients, partial hepatectomy in 4 patients, electrocoagulation hemostasis in 4 patients and ligation of bleeding vessels in 2 patients. All were successful in hemostasis. Abdominal effusion was (1 528.8±373.2) ml, intraoperative blood loss (80.6±16.7) ml, operation time (88.5±9.1) min, postoperative hospital stay 7 days and postoperative total drainage (93.8±13.6) ml. Ten patients were complicated with right pleural effusion, and they recovered with conservative treatment. There were no bile leakage, infection and other complications. Conclusion:Trauma to right posterior liver treated with laparoscopic with surgery patients in the left semiprone position had the advantages of adequate exposure which facilitated surgical hemostasis, resulting in minimal collateral damages and short hospital stay. The treatment was feasibility and safe.

Study on Anti-inflammatory Effect and Mechanism of Jingulian Capsule on Inflammatory Model Rats / 中国药房

OBJECTIVE：To study the anti- inflammatory effect and mechanism of Jingulian capsule on inflammatory model rats. METHODS ：Totally 48 rats were randomly divided into blank control group ，model group ，Jingulian capsule low-dose ， medium-dose and high-dose groups （0.66，1.32，2.64 g/kg），dexamethasone group （positive control ，0.945 mg/kg），with 8 rats in each group. Blank control group and model group were given constant volume of water intragastrically ，and other groups were given relevant medicine intragastrocally ，twice a day ，for consecutive 3 days. Thirty minutes after last administration ，model group and administration groups were given lipopolysaccharide （10 mg/kg）intraperitoneally to induce inflammatory model. Six hours after intraperitoneal injection ，the contents of TNF-α，IL-1β，IL-6，PGE2 in serum were detected by ELISA. The wet to dry weight （W/D）ratio of lung tissue were determined. HE staining was used to observe the pathological changes of lung tissue . RT-PCR was used to detect the mRNA expression of TNF-α，IL-6，PGE2 and IL- 1β in lung tissue. Western blot assay was used to detect the phosphorylation of NF-κB p65 protein and the expression of IκBα protein in lung tissue. RESULTS：Compared with blank ； control group ，the contents of TNF-α，IL-1β，IL-6 and PGE 2 in serum ，the W/D ratio of lung tissue ，the expression of TNF-α，IL-1β，IL-6 and PGE 2 mRNA and the phosphorylation level of NF-κB p65 protein in lung tissue of model group weresignificantly increased ，and the expression of IκBα proteinwas significantly decreased （P＜0.05 or P＜0.01）；a large number of alveolar atrophy and collapse ，alveolar wall thickening ，lung consolidation ，and a large number of inflammatory cell infiltration could be seen in lung tissue. Compared with model group ，the contents of TNF-α，IL-1β（except for low-dose group ）， IL-6 and PGE 2 in serum ，as well as the expression of TNF-α（except for high-dose group ），IL-1β，IL-6（except for low-dose ， high-dose groups ）and PGE 2 mRNA in lung tissue were decreased significantly in Jingulian capsule groups （P＜0.05 or P＜0.01）； the W/D ratio of lung tissue was decreased significantly in Jingulian high-dose group （P＜0.05 or P＜0.01）；the expression of phosphorylation level of NF-κB p65 protein in lung tissue of Jingulian medium-dose group were decreased significantly （P＜0.05 or P＜0.01），while the expression of IκBα protein was increased significantly（P＜0.05）；the alveolar structure was clear ，the alveolar wall was slightly thickened ， and a small amount of inflammatory cell infiltration was seen in lung tissue. CONCLUSIONS：Jingulian capsule has good anti-inflammatory effect on inflammatory model rats ，the mechanism of which may be related to the inhibition of NF-κB signal pathway.

YY1 directly interacts with myocardin to repress the triad myocardin/SRF/CArG box-mediated smooth muscle gene transcription during smooth muscle phenotypic modulation.

Yin Yang 1 (YY1) regulates gene transcription in a variety of biological processes. In this study, we aim to determine the role of YY1 in vascular smooth muscle cell (VSMC) phenotypic modulation both in vivo and in vitro. Here we show that vascular injury in rodent carotid arteries induces YY1 expression along with reduced expression of smooth muscle differentiation markers in the carotids. Consistent with this finding, YY1 expression is induced in differentiated VSMCs in response to serum stimulation. To determine the underlying molecular mechanisms, we found that YY1 suppresses the transcription of CArG box-dependent SMC-specific genes including SM22α, SMα-actin and SMMHC. Interestingly, YY1 suppresses the transcriptional activity of the SM22α promoter by hindering the binding of serum response factor (SRF) to the proximal CArG box. YY1 also suppresses the transcription and the transactivation of myocardin (MYOCD), a master regulator for SMC-specific gene transcription by binding to SRF to form the MYOCD/SRF/CArG box triad (known as the ternary complex). Mechanistically, YY1 directly interacts with MYOCD to competitively displace MYOCD from SRF. This is the first evidence showing that YY1 inhibits SMC differentiation by directly targeting MYOCD. These findings provide new mechanistic insights into the regulatory mechanisms that govern SMC phenotypic modulation in the pathogenesis of vascular diseases.

Difference Analysis of Volatile Components in Roots ，Stems and Leaves of Gaultheria yunnane nsis by GC-MS / 中国药房

OBJECTIVE：To compare the volatile components extracted from the roots ，stems and leaves of Gaultheria yunnanensis. METHODS ：Steam distillation method was used to extract the volatile oils from roots ，stems and leaves of G. yunnanensis. Chemical constituents were analyzed by GC-MS. NIST 2011 standard mass spectral library was adopted to select the chromatographic peak with a matching degree higher than 80，and combined with relevant literatures for identification. Relative percentages of chemical constituents were calculated by peak area normalization. RESULTS ：Totally 95 chromatographic peaks were detected in valatile oil from the roots of G. yunnanensis and 54 chemical constituents were identified ，accounting for 82.35％ of the total content of root volatile components. The constituents with relatively high content were methyl salicylate （20.30％）， n-hexadecanoic acid （19.86％），（Z，Z）-9，12-octadecadienoic acid （9.26％），phenanthrene（4.37％）and so on. Totally 69 chromatographic peaks were detected in volatile oil from the stems and leaves of G. yunnanensis and 46 chemical constituents were identified，accounting for 97.10％ of the total content of volatile components in stems and leaves. The constituents with relatively high content were methyl salicylate （86.72％），n-hexadecanoic acid （2.60％），（Z，Z，Z）-9，12，15-octadecatrienoic acid （1.25％） and so on. Both of them contained 16 common constituents such as alkenes esters ，acids and so on. CONCLUSIONS：The chemical constituents of volatile oils extracted from the roots ， stems and leaves of G. yunnanensis are mainly esters and acids. The components are similar to each other ，but the contents of acids in the roots and esters in the leaves and stems are higher.

An analysis of global research on SARS-CoV-2 / 生物医学工程学杂志

The SARS-CoV-2 has been spread to 26 countries around the world since its outbreak. By February 16, 2020, more than 68 000 people had been diagnosed with COVID-19. Researchers from all over the world have carried out timely studies on this public health emergency and produced a number of scientific publications. This review aims to re-analyze and summarize the current research findings in a timely manner to guide scholars in relevant fields to further SARS-CoV-2 research and assist healthcare professionals in their work and decision-making. The SARS-CoV-2 related terms were selected in both English and Chinese and were searched in several major databases, including Pubmed, Web of Science, CNKI, Wanfang, and VIP databases. The reference list of each search result was screened for relevance, which was further supplemented to the search results. The included studies were categorized by topics with key characteristics extracted, re-analyzed, and summarized. A total of 301 articles were finally included with 136 in Chinese and 165 in English. The number of publications has rapidly increased since mid-January, 2020, and a peak day was 6th February on which 50 articles were published. The top three countries publishing articles were China, the United States and the United Kingdom. The and its specialty journals have published the most articles, with contribution also from journals such as ( ), ( ), and . All articles were categorized into epidemiology, clinical diagnosis and treatment, basic research, pregnant women and children, mental health, epidemic prevention & control, and others. The literatures related to SARS-CoV-2 are emerging rapidly. It is necessary to sort out and summarize the research topic in time, which has a good reference value for staff in different positions. At the same time, it is necessary to strengthen the judgment of the quality of literatures.

A comparative study of bibliometrics between Chinese and American research-oriented hospitals in the context of "Double First-Class" :Taking West China Hospital of Sichuan University and Mayo Clinic as an example / 中华医学科研管理杂志

Objective To conduct a comparative study on the papers between domestic research hospital and world-class hospital in order to find out the gap between them,and to provide countermeasures and reference basis for the discipline construction of research hospitals in China.Methods A comparative study of papers published from 2016 to 2018 in Web of Science core database between West China Hospital and Mayo Clinic was conducted by bibliometric methods.Chi-square tests and non-parametric tests were carried out to verify the consistency of paper distribution between these two institutions.Results The results showed that there was a big gap between West China Hospital and Mayo Clinic in quality of papers.The proportion of papers participating in other institutions and the proportion of papers in clinical medical category of West China Hospital are much lower than those of Mayo.Conclusions It is suggested that domestic research hospitals should focus on improving the quality of scientific research achievements by strengthening substantive scientific research cooperation,vigorously developing clinical research,establishing full-time scientific research teams,and improving the supporting system of clinical translation services.

Global research hotspots on oncology-bibliometric analysis based on the ESI hot papers / 生物医学工程学杂志

With the increasing global burden of various cancer, an abundance of papers emerged every year in the research hotspots of oncology, covering a wide range of research types and topics. In order to facilitate interested readers to quickly grasp the frontier and hotspots of cancer research, it would be helpful to sort out and summarize the research topic in a timely manner. According to the classification of disciplines, we screened the Essential Science Indicators (ESI) hot papers released in 2019 for the ones in the oncology field, utilized methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation to further reveal the context and characteristics of research in the field of oncology, summarized the latest progresses and future directions in the field, and provided information and hints for the trajectory of future research. A total of 549 papers were included, which were mainly from the field of clinical medicine; the country with the most publications was the United States, while China ranked the fourth in terms of contribution; the research institution with the highest number of published papers was University of Texas system;

Global research hot points on cardiovascular disease--bibliometric analysis based on the ESI hot papers / 生物医学工程学杂志

With the heavier burden of cardiovascular disease, an abundance of papers emerge every year in the research hotspots, which cover a wide range of types and content. In order to let readers interested in the cardiovascular field quickly understand the research hotspots and research frontier, it is necessary to sort out and summarize the research topic in time. According to the discipline classification, we screened papers in cardiovascular field from the Essential Science Indicators (ESI) hot papers published in 2019. Methods such as bibliometrics, statistical description, hierarchical induction, analysis and interpretation were used a step further to reveal the context and characteristics of research in the field of cardiovascular diseases, summarize the latest progress and development direction in this field, and provide information and hints for the expansion of future research directions. A total of 297 papers were finally included, which were mainly in the field of clinical medicine; The country with the most publications was the United States, while China ranked the fifth in terms of contribution; the research institution with the highest number of published papers was Harvard University;

Fine-tuning of RBOHF activity is achieved by differential phosphorylation and Ca2+ binding.

RBOHF from Arabidopsis thaliana represents a multifunctional NADPH oxidase regulating biotic and abiotic stress tolerance, developmental processes and guard cell aperture. The molecular components and mechanisms determining RBOHF activity remain to be elucidated. Here we combined protein interaction studies, biochemical and genetic approaches, and pathway reconstitution analyses to identify and characterize proteins that confer RBOHF regulation and elucidated mechanisms that adjust RBOHF activity. While the Ca2+ sensor-activated kinases CIPK11 and CIPK26 constitute alternative paths for RBOHF activation, the combined activity of CIPKs and the kinase open stomata 1 (OST1) triggers complementary activation of this NADPH oxidase, which is efficiently counteracted through dephosphorylation by the phosphatase ABI1. Within RBOHF, several distinct phosphorylation sites (p-sites) in the N-terminus of RBOHF appear to contribute individually to activity regulation. These findings identify RBOHF as a convergence point targeted by a complex regulatory network of kinases and phosphatases. We propose that this allows for fine-tuning of plant reactive oxygen species (ROS) production by RBOHF in response to different stimuli and in diverse physiological processes.

Laparoscopic resection of hemangiomas in the right posterior hepatic section without any blood flow occlusion: a study on 28 patients / 中华肝胆外科杂志

Objective To study the safety and efficacy of laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion.Methods Patients with hemangiomas in the right posterior section of liver operated from January 2016 to June 2018 in the Affiliated Hospital of Youjiang Medical College for Nationalities were studied retrospectively.There were 19 females and 9 males.The average age was (37.9 ± 6.1).The operation methods,perioperative factors,hospitalization cost and follow-up outcomes were recorded and analyzed.Results 28 patients with hemangiomas were treated with laparoscopic resection of right posterior hepatic section without any blood flow occlusion.An ultrasound scalpel was applied to split the liver in 27 patients,and ultrasound scalpel combined with Ligasure to split the liver in 1 patient.The mean diameter of the hepatic hemangiomas was (6.7 ± 1.3) cm.The intraoperative blood loss was (330.4 ± 139.0) ml and the operation time was (87.4 ±27.9) min.One patient required conversion to open surgery due to rupture and bleeding of the hemangioma.The conversion rate was 3.6％ (1/28).The postoperative drainage time was (45.4 ± 18.9) h.The postoperative hospitalization time was (7.5 ± 1.3) d,and the hospitalization cost was (3.1 ± 0.5) ten thousand yuan.No death or serious complications occurred.No reoperation was needed.The follow-up period ranged from 1 to 30 months,and all the patients were well on follow-up.Conclusions Laparoscopic resection of hemangioma in the right posterior hepatic section without any blood flow occlusion was safe and efficacious.This method can be used for hemangiomas in the right posterior section of liver.

Percutaneous Full-Endoscopic Anterior Transcorporeal Procedure for Cervical Disc Herniation: A Novel Procedure and Early Follow-Up Study.

OBJECTIVE: To describe the surgical technique of percutaneous full-endoscopic anterior transcorporeal cervical discectomy (PEATCD) in detail and report the clinical outcomes and radiologic changes in patients with cervical intervertebral disc herniation (CIVDH). METHODS: A novel procedure, PEATCD, was performed on 36 patients with CIVDH between June 2015 and June 2016. A retrospective study of these patients was carried out over a follow-up period of 12-24 months. The visual analog scale scores, Japanese Orthopedic Association (JOA) scores, and improvement rates (IRs) of the JOA scores were used to evaluate neurologic symptoms. Radiologic follow-up included magnetic resonance imaging, computed tomography scan, and standard radiographs. RESULTS: All patients reported immediate postoperative relief of neck and arm pain compared with the recorded preoperative levels of discomfort, and the JOA scores improved gradually during the follow-up period. The IRs of the neurologic evaluations ranged from 60% to 100%, the average being 85.47% ± 9.32%. The decrease in the intervertebral disc height was statistically significant (P < 0.0001), and there were no adverse clinically related symptoms. No collapse of the drilled vertebrae was recorded, and the bone defects showed significant decreases within 3 months after the operation. There were no surgery-related complications. CONCLUSIONS: PEATCD combines the benefits of an anterior transcorporeal approach with endoscopy, preserves the cervical motion segment and causes less damage to the disc, and significantly decreases surgical trauma. Therefore, PEATCD is a safe, effective, minimally invasive, alternative procedure for patients with CIVDH.