Does intraoperative reduction result in better outcomes in low-grade lumbar spondylolisthesis after transforaminal lumbar interbody fusion? A systematic review and meta-analysis.

Objective: This study aimed to compare the clinical efficacy and safety of reduction vs. arthrodesis in situ with transforaminal lumbar interbody fusion (TLIF) for low-grade lumbar spondylolisthesis. Study design: Systematic review and meta-analysis. Methods: A comprehensive literature search was implemented in PubMed, Embase, and Cochrane Library databases. Randomized or non-randomized controlled trials that were published until July 2023 that compared reduction vs. arthrodesis in situ techniques with minimally invasive or open-TLIF for low-grade spondylolisthesis were selected. The quality of the included studies was evaluated by the Newcastle-Ottawa Scale (NOS). Data were extracted according to the predefined outcome measures, including operation time and intraoperative blood loss; short- and long-time follow-up of visual analog scale (VAS) back pain (VAS-BP) and Oswestry Disability Index (ODI); slippage and segmental lordosis; and the complication and fusion rate. Results: Five studies (n = 495 patients) were finally included. All of them were retrospective cohort studies with Evidence Level II. The pooled data revealed that both techniques had similar patient-reported outcomes (VAS, ODI, and good and excellent rate) during short- and long-term follow-up. In addition, no significant differences were observed in the fusion and complication rates. However, although the reduction group did achieve better slippage correction, it was associated with increased operation time and intraoperative blood loss compared with the in situ arthrodesis group. Conclusions: Based on the available evidence, intraoperative reduction does not result in better clinical outcomes in low-grade spondylolisthesis after minimally invasive or open-TLIF, and the in situ arthrodesis technique could be an alternative.

RuO2 Catalysts for Electrocatalytic Oxygen Evolution in Acidic Media: Mechanism, Activity Promotion Strategy and Research Progress.

Proton Exchange Membrane Water Electrolysis (PEMWE) under acidic conditions outperforms alkaline water electrolysis in terms of less resistance loss, higher current density, and higher produced hydrogen purity, which make it more economical in long-term applications. However, the efficiency of PEMWE is severely limited by the slow kinetics of anodic oxygen evolution reaction (OER), poor catalyst stability, and high cost. Therefore, researchers in the past decade have made great efforts to explore cheap, efficient, and stable electrode materials. Among them, the RuO2 electrocatalyst has been proved to be a major promising alternative to Ir-based catalysts and the most promising OER catalyst owing to its excellent electrocatalytic activity and high pH adaptability. In this review, we elaborate two reaction mechanisms of OER (lattice oxygen mechanism and adsorbate evolution mechanism), comprehensively summarize and discuss the recently reported RuO2-based OER electrocatalysts under acidic conditions, and propose many advanced modification strategies to further improve the activity and stability of RuO2-based electrocatalytic OER. Finally, we provide suggestions for overcoming the challenges faced by RuO2 electrocatalysts in practical applications and make prospects for future research. This review provides perspectives and guidance for the rational design of highly active and stable acidic OER electrocatalysts based on PEMWE.

Construction of NiFe(CN)5NO/Ni3S2 hierarchical submicro-rods on nickel foam as advanced oxygen evolution electrocatalysts.

The development of cheap, abundant, and highly efficient electrocatalysts for the oxygen evolution reaction (OER) is urgently needed for hydrogen production from water splitting. Herein, we demonstrate a novel OER electrocatalyst (NiFe(CN)5NO/Ni3S2) prepared by coupling Ni3S2 and a bimetallic metal-organic framework (MOF) of NiFe(CN)5NO on nickel foam (NF) via a simple two-step route. The NiFe(CN)5NO/Ni3S2 electrocatalyst displays an interesting rod-like hierarchical architecture assembled by ultrathin nanosheets. The combination of NiFe(CN)5NO and Ni3S2 optimizes the electronic structure of the metal active sites and increases the electron transfer capability. Benefitting from the synergistic effect between Ni3S2 and the NiFe-MOF as well as the unique hierarchical architecture, the NiFe(CN)5NO/Ni3S2/NF electrode exhibits excellent electrocatalytic OER activity with ultralow overpotentials of 162/197 mV at 10/100 mA cm-2 and an ultrasmall Tafel slope of 26 mV dec-1 in 1.0 M KOH, which are far superior to those of the individual NiFe(CN)5NO, Ni3S2 and commercial IrO2 catalysts. In particular, unlike common metal sulfide-based electrocatalysts, the composition, morphology and microstructure of the NiFe-MOF/Ni3S2 composite electrocatalyst can be well retained after the OER, which endows it with fantastic long-term durability. This work offers a new strategy for the construction of novel and high-efficiency MOF-based composite electrocatalysts for energy applications.

Rational targeting of autophagy in colorectal cancer therapy: From molecular interactions to pharmacological compounds.

The abnormal progression of tumors has been a problem for treatment of cancer and therapeutic should be directed towards targeting main mechanisms involved in tumorigenesis in tumors. The genomic mutations can result in changes in biological mechanisms in human cancers. Colorectal cancer is one of the most malignant tumors of gastrointestinal tract and its treatment has been faced some difficulties due to development of resistance in tumor cells and also, their malignant behavior. Hence, new therapeutic modalities for colorectal cancer are being investigated. Autophagy is a "self-digestion" mechanism that is responsible for homeostasis preserving in cells and its aberrant activation/inhibition can lead to tumorigenesis. The current review focuses on the role of autophagy mechanism in colorectal cancer. Autophagy may be associated with increase/decrease in progression of colorectal cancer due to mutual function of this molecular mechanism. Pro-survival autophagy inhibits apoptosis to increase proliferation and survival rate of colorectal tumor cells and it is also involved in cancer metastasis maybe due to EMT induction. In contrast, pro-death autophagy decreases growth and invasion of colorectal tumor cells. The status of autophagy (upregulation and down-regulation) is a determining factor for therapy response in colorectal tumor cells. Therefore, targeting autophagy can increase sensitivity of colorectal tumor cells to chemotherapy and radiotherapy. Interestingly, nanoparticles can be employed for targeting autophagy in cancer therapy and they can both induce/suppress autophagy in tumor cells. Furthermore, autophagy modulators can be embedded in nanostructures in improving tumor suppression and providing cancer immunotherapy.

Carbon emission reduction policy with privatization in an oligopoly model.

This study constructs a mixed oligopoly model that includes a public enterprise and two private enterprises. Game theory was adopted to explore the effects of carbon emission reduction policies. In addition, this study analyzes the optimal carbon emission trading prices and privatization decisions. The results show that the proportion of state-owned shares and the equity efficiency gap affect the equilibrium results for different carbon emission policies. Privatization increases the profits of public firms but does not necessarily increase social welfare. Different carbon emission reduction policies have different effects on the equilibrium results. Moreover, the emission reduction target is not completely consistent with the maximum social welfare target and should be comprehensively considered. The government can intervene by setting carbon emission trading prices and making privatization decisions. Full and partial privatization may be optimal decisions.

Construction of bismuth-based porous carbon models by 3D printing technology for light-enhanced removal of chloride ions in wastewater.

The bismuth oxide (Bi2O3) based chloride (Cl-) removal method is one of the chemical precipitation methods possessing good selectivity and high removal efficiency of Cl- ions, but Bi2O3 often appears in the powder form, which is difficult to be recovered for regeneration. In this work, the combination of 3D printing technology and the Bi2O3 method was explored to construct the resin model including the Bi-precursors. In the optimum carbonization process at 400 °C for 30 min, the Bi3+ ions of the Bi-precursor were reduced into the metallic Bi0 nanoparticles, whose surfaces were covered by the thin Bi2O3 layers to form the heterostructured Bi0/Bi2O3 core/shell nanoparticles with an average size of 43 nm. These Bi0/Bi2O3 nanoparticles were tightly adhered to the internal and external surfaces of the hierarchical porous carbon model (Bi-PCM), which greatly facilitated their regeneration and ensured the stable Cl- removal performance. After five cycles of Cl- removal, the chloride removal efficiency over the multiple Bi-PCMs in the dark and pH 1 conditions maintained at about 26%, which then largely increased to 63.6% with UV light irradiation. The light-enhanced mechanism was related to the improved release rate of Bi3+ ions caused by photocorrosion and the Cl• radicals produced from the holes and the •OH and O2•- radicals, which quickly reacted with Bi2O3 to form BiOCl. The construction of Bi-PCMs by using 3D printing technology provides a very promising strategy for the removal of Cl- ions from wastewater.

Divergent Conceptualization of Embodied Emotions in the English and Chinese Languages.

Traditional cognitive linguistic theories acknowledge that human emotions are embodied, yet they fail to distinguish the dimensions that reflect the direction of neural signaling between the brain and body. Differences exist across languages and cultures in whether embodied emotions are conceptualized as afferent (feelings from the body) or efferent (enacted through the body). This important distinction has been neglected in academic discourse, arguably as a consequence of the 'lexical approach', and the dominance within the affective psychology of the cognitive and semantic models that overlook the role of interoception as an essential component of affective experience. Empirical and theoretical advances in human neuroscience are driving a reappraisal of the relationships between the mind, brain and body, with particular relevance to emotions. Allostatic (predictive) control of the internal bodily states is considered fundamental to the experience of emotions enacted through interoceptive sensory feelings and through the evoked physiological and physical actions mediated through efferent neural pathways. Embodied emotion concepts encompass these categorized outcomes of bidirectional brain-body interactions yet can be differentiated further into afferent or interoceptive and efferent or autonomic processes. Between languages, a comparison of emotion words indicates the dominance of afferent or interoceptive processes in how embodied emotions are conceptualized in Chinese, while efferent or autonomic processes feature more commonly in English. Correspondingly, in linguistic expressions of emotion, Chinese-speaking people are biased toward being more receptive, reflective, and adaptive, whereas native English speakers may tend to be more reactive, proactive, and interactive. Arguably, these distinct conceptual models of emotions may shape the perceived divergent values and 'national character' of Chinese- and English-speaking cultures.

Synergies of Atomically Dispersed Mn/Fe Single Atoms and Fe Nanoparticles on N-Doped Carbon toward High-Activity Eletrocatalysis for Oxygen Reduction.

PGM-free (platinum group metal) electrocatalysts are intensively investigated and used as low-cost catalysts for the oxygen reduction reaction (ORR) in the field of fuel cells, but further studying their performance improvement methods and actual reaction mechanism is still a big a challenge. In this work, a novel eletrocatalyst containing atomically dispersed Mn/Fe single atoms (SAs) and Fe nanoparticles (NPs) on N-doped carbonaceous (nanosheet/nanotube hybrids) is fabricated via a simple pyrolysis method. This high-activity ORR electrocatalyst has higher half-wave potential (E1/2 = 0.91 V) and superior long-term durability in alkaline solutions and outperforms Pt/C catalysts, which can be ascribed to the synergetic interaction between Mn/Fe SAs and Fe-NPs. FeNPs/MnFeSAs-NC-25 has stronger reactant adsorption ability and a lower dissociation energy barrier than FeNPs/FeSAs-NC, which is conducive to breaking the O-O bond and accelerating ORR kinetics. This work presents a method to synthesize carbon-based electrocatalysts with high ORR activity and stability and shows that a variety of active sites encapsulated in N-doped carbonaceous materials can be a class of competitive candidates for PGM-free electrocatalysts.

Insight into the Enhanced Removal of Water from Coal Slime via Solar Drying Technology: Dewatering Performance, Solar Thermal Efficiency, and Economic Analysis.

In this work, solar drying technology was applied for the deep dewatering of coal slime to save thermal energy and reduce the dust produced during the hot drying process of coal slime. Solar drying technology is used to dry coal slime to realize its resource utilization. The influence of solar radiation intensity and slime thickness is investigated on the drying process. The greater the solar radiation intensity (SRI) is, the faster the drying indoor air and coal slime are heated, and the faster the drying efficiency is. As the slime becomes thinner, the internal water diffusion resistance becomes smaller and the drying efficiency correspondingly becomes faster. In addition, to facilitate the application of coal slime drying in the actual project, the Page model is fitted and found to have a good fit for solar drying coal slime. Meanwhile, the optimal drying conditions are determined by analyzing the energy utilization under different conditions. It is found that the target moisture content of 10% is optimal for coal slime drying with the highest energy utilization. The laying thickness (L) of 1 cm has the highest solar thermal efficiency of 54.1%. More importantly, economic calculation and analysis are conducted in detail on solar drying. It is found that the cost of solar drying (¥38.59/ton) is lower than that of hot air drying (¥ 65.09/ton). Therefore, solar drying is a promising method for the drying of coal slime.

Precise constructed atomically dispersed Fe/Ni sites on porous nitrogen-doped carbon for oxygen reduction.

Exploring highly-efficient noble-metal-free electrocatalysts for oxygen reduction reaction (ORR) is crucial for preparation of rechargeable metal-air batteries. Herein, FeNi-mIm (guest) was loaded on the surface of ZIF-8 (host) via a novel host-guest strategy, and the resulting ZIF-8@FeNi(mIm)X precursors can be converted to FeNi SAs/NC catalysts with controllable structures. Robust metal-organic framework (MOF)-derived atomically dispersed Fe/Ni dual single atom electrocatalysts for ORR were developed, followed by pyrolysis of the precursors. Characterizations showed that the atomically-dispersed Fe/Ni active sites were uniformly embedded in the N-doped carbon framework. As a result, the ORR performance was obviously improved with lower half-wave potential (E1/2 = 0.91 V) in alkaline media. Such improvement is mainly attributed to the synergy of fully-exposed bimetallic single atom active sites caused by the interaction of Fe/Ni 3d orbitals. The lower adsorption energy of intermediate hydroxyl groups on the active sites and the smaller ORR energy barrier were calculated by the density functional theory. The novelty FeNi SAs/NC catalysts showed faster ORR dynamics in the rate-determining step of four-electron transfer. The synthesis strategy reported here provides an efficient approach to construct high performance dual single-atom catalysts with fully-exposed active sites on the surface.

Protective Effects of Bariatric Surgery on Kidney Functions by Inhibiting Oxidative Stress Responses Through Activating PPARα in Rats With Diabetes.

OBJECTIVE: The aim of this study was to explore the protective effects and the regulatory mechanisms of bariatric surgery on kidney injury in diabetic rats. METHODS: We established a useful type 2 diabetic rat model using high-fat and high-sugar diet feeding following low-dose streptozotocin (STZ) treatment. Sprague-Dawley (SD) rats were randomly divided into the following groups: control (Con) group, diabetic nephropathy (DN) group, and duodenal-jejunal bypass (DJB) surgery group. The food intake and body weight of rats were monitored and the glucose tolerance test (OGTT) test was performed every 2 weeks. The glomerular filtration rate (GFR) and urinary albumin excretion rate (UAFR) were measured to assess renal function. Hematoxylin-eosin (H&E), periodic acid-Schiff (PAS), and Masson staining were used to evaluate renal histopathological changes. TUNEL assay was performed to detect cell apoptosis. The expressions of oxidative stress factors and inflammatory factors in the renal tissues of rats were detected by ELISA. The expressions of PPARα, reactive oxygen species (ROS), and NF-κB were detected by immunofluorescence. For in vitro experiment, HK2 cells cultured with high glucose were treated with PPARα agonist, PPARα antagonist, and adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) agonist. The expressions of AMPK/PPARα/NF-κB signaling pathway-related proteins were detected by Western blot. RESULTS: Bariatric surgery improved the glucose tolerance of DN rats. The GFR was decreased, the promotion of urinary albumin excretion rate (UAER) was inhibited, and the renal injury was alleviated. The extracellular matrix fraction was decreased and the renal function was improved. Meanwhile, bariatric surgery activates PPARα, inhibits ROS release, reduces oxidative stress injury, and reduces renal cell apoptosis. In vitro experiment results showed that the AMPK activator could activate PPARα, downregulate NF-κB, and inhibit inflammatory response. The phosphorylation of AMPK was inhibited by PPARα antagonism. CONCLUSION: Bariatric surgery can activate PPARα, inhibit oxidative stress injury, and improve glucose metabolism and renal function in DN rats.

Ultrasound is Effective to Treat Temporomandibular Joint Disorder.

BACKGROUND: Temporomandibular joint disorder (TMD) affects millions of people. It is unclear if low intensity ultrasound (US) is effective to treat TMD. METHODS: A total of 160 patients with TMD were enrolled in this study. The subjects were randomized into two groups to receive US therapy or no therapy. Patients in the US group were given US therapy once a day for 5 days per week for 2 consecutive weeks. Before and 4 weeks and 6 months after the treatments, the patients were assessed for pain using visual analog scale (VAS) and the maximum pain-free inter-incisal distance (IID). In addition, mandibular movement (MM), jaw noise (JN), disability index (DI) and craniomandibular index (CMI) were also assessed. RESULTS: Compared with the patients before the therapy, VAS, IID, MM, JN, DI and CMI in the US group were significantly improved 4 weeks and 6 months after therapy. However, 6 months after the therapy, US group had a recurrence rate of 2.63%. CONCLUSION: US therapy can significantly reduce the pain, and improve the functionality of the temporomandibular joint and mouth opening limit for TMD patients, and is therefore recommended for TMD patients.

The conceptualization of emotions across cultures: a model based on interoceptive neuroscience.

Mental processes are recognized to be embodied, hence dependent upon functions of the body. Interoception (i.e., the sense of the internal bodily physiology) underpinning motivational states and emotional feelings, however, are mostly ignored within present sensory-motor accounts of embodiment. The inclusion of interoception within models of embodiment is important both for health psychology and for theories of cognition. Here, we deduce that reference to visceral organs, in language describing emotion concepts, should be viewed as metonymy (i.e., the mental mapping wherein a component is used to describe the whole), rather than metaphor (i.e., one familiar and concrete concept used to describe another unfamiliar and/or abstract concept that shares some similarities). This view contrasts with a dominant assumption within cognitive linguistics. We further argue that conceptual differences in the assumption about the body-mind-emotion relationship or emotional somatization, evident when comparing Chinese to standard English, is culturally and cognitively determined (e.g., by divergent Western and Chinese philosophical, medical traditions and meaning systems). We propose a new model in which two contending variables, bodily transparency and cognitive granularity, define cultural differences in emotion conceptualization, capturing the dynamic multidimensional interaction between body, mind, brain, language, and society.

Minimally invasive versus traditional open transforaminal lumbar interbody fusion for the treatment of low-grade degenerative spondylolisthesis: a retrospective study.

This was a retrospective study. We aimed to compare the clinical efficacy and safety between minimally invasive and traditional open transforaminal lumbar interbody fusion in the treatment of low-grade lumbar degenerative spondylolisthesis (LDS). 81 patients with LDS grades 1 and 2 treated in our spinal department from January 2014 to July 2016 were retrospectively analyzed. The MIS-TLIF group included 23 males and 11 females, while the TO-TLIF group included 29 males and 18 females. Follow-up points were set at 7 days, 3 months, 6 months, 12 months postoperatively and the last follow-up. Various clinical and radiological indicators were used to evaluate and compare the efficacy and safety between the two procedures. 8 cases (3 in the MIS-TLIF group and 5 in the TO-TLIF group) were loss of follow-up after discharge. And the remaining 73 patients were followed up for at least 2 years. No statistically significant difference was observed in the terms of age, sex, BMI, slippage grade, and surgical segments. The MIS-TLIF group had a longer operation and fluoroscopy time compared with the TO-TLIF group. But the MIS-TLIF group was associated with less blood loss, ambulation time, hospital stay, and time of return to work. In each group, significant improvement were observed in BP-VAS, ODI and vertebral slip ratio at any time-point of follow-up when compared with the preoperative condition. When the time-point of follow-up was less than 1 year, the MIS-TLIF group had significant advantages in the BP-VAS and ODI compared with TO-TLIF group. But no significant difference was observed in the BP-VAS and ODI at either 12 month follow-up or the last follow-up. Besides, no statistical difference was detected in vertebral slip ratio at any time-point of follow-up between the two groups. Successful intervertebral bone fusion was found in all patients and no significant difference was found in the incidence of total complications. Thus, we considered that MIS-TLIF and TO-TLIF both achieve satisfactory clinical efficacy in the treatment of low-grade single-segment LDS. But MIS-TLIF appears to be a more efficacious and safe technique with reduced tissue damage, less blood loss and quicker recovery.

Application of Anchoring Technique in Unilateral Percutaneous Vertebroplasty for Neurologically Intact Kümmell's Disease.

Purpose: We aimed to present our experience in anchoring technique and evaluate the efficacy and safety of unilateral percutaneous vertebroplasty in patients with neurologically intact Kümmell's disease. Methods: From January 2014 to December 2017, 29 patients (17 males and 12 females) with neurologically intact Kümmell's disease were operated on using anchoring technique in unilateral percutaneous vertebroplasty (PVP). Ages of the enrolled patients ranged from 67 to 81 years (mean 73.8 years). Clinical efficacy was evaluated by back pain visual analogue scale (BP-VAS) score, Oswestry disability index (ODI) score, as well as the height of anterior border and the kyphotic angle of the involved vertebral body on a standing lateral radiograph. The safety of PVP was assessed by surgical-related complications, including bone cement leakage and neurological deficit. Results: All 29 patients underwent the PVP procedure successfully. The mean operation time was 35 ± 12 min. And all patients were able to walk/ambulate with a thoracolumbar brace after 12 to 24 hours, staying in bed postoperatively. Significantly statistical differences were observed in both BP-VAS and ODI scores at each time point of follow-up when compared with the preoperative condition (P < 0.05). Besides, statistically significant improvement in radiographic measurements such as kyphotic angle and the height of the anterior border of the involved vertebral body between the preoperative and postoperative assessments was also observed (P < 0.05) and asymptomatic leakage of cement occurred in 7 of 29 cases (24.1%). Conclusions: We considered that the anchoring technique in unilateral PVP could provide an effective and safe alternative for neurologically intact Kümmell's disease.

A study of the desulfurization selectivity of a reductive and extractive desulfurization process with sodium borohydride in polyethylene glycol.

The selectivity of a facile reductive and extractive desulfurization process was studied. In this desulfurization method, polyethylene glycol was used as the extractant, and sodium borohydride was used as the reductant. Several different simulated fuels were prepared by dissolving thiophenic sulfides, methylbenzene and hexylene in octane. The results showed that methylbenzene and olefins had different effects on different sulfur compounds during this desulfurization process. The extraction and reduction mechanisms were also explained. Four factors could affect the desulfurization performance: (1) intermolecular hydrogen bonding: (a) active O bonding with aromatic H or (b) S bonding with H atoms in hydroxide radicals, (2) "like-dissolves-like" interactions between polyethylene glycol and thiophenic sulfides, (3) the methyl steric hindrance effect and the electron density of sulfur atoms, and (4) the combination of S atoms with produced nickel boride to form active desulfurization centres. The desulfurization reaction path was also deduced according to the GC/MS results.

Danshen Attenuates Intervertebral Disc Degeneration via Antioxidation in SD Rats.

OBJECTIVE: To investigate the effects of Danshen on the imaging and histological parameters, expression levels of ECM-associated proteins and inflammatory factors, and antioxidative activity in the degenerated intervertebral disc (IVD) of SD rats. METHODS: Sixty male rats were randomly divided into three groups (control, IDD, and Danshen IDD). Percutaneous needle puncture in Co8-9 intervertebral disc was conducted in all rats of the IDD and Danshen IDD groups to induce intervertebral disc degeneration (IDD). After operation, animals of the Danshen IDD group were administrated with Danshen granules (3 g/kg body weight ) by gavage once a day. Four weeks later, the coccygeal vertebrae were harvested and used for imaging (disc height and MR signal), histological, immunohistochemical, and biochemical [water content, glycosaminoglycans (GAG), superoxide dismutase (SOD2), glutathione (GSH), and malondialdehyde (MDA)] analyses. RESULTS: The puncture induced significant decreased IVD space and MR T2 signal at both 2 and 4 weeks, which were attenuated by Danshen treatment. The disc degeneration in the IDD group (HE and Safranin O-Fast Green histological staining was markedly more serious compared with that in the control group. Four weeks of Danshen treatment significantly alleviated this degeneration compared with the IDD group. Needle puncture resulted in the upregulation of IL-1ß and TNF-α, MMP-3, and downregulation of COL2 and aggrecan in the IDD group. However, this change was significantly weakened by Danshen treatment. Significantly lower water and GAG content, as well as the SOD2 and GSH levels, in the IDD group were found compared with those in the control group. However, the above parameters of the Danshen IDD group were significantly higher than those of the IDD group. Danshen treatment significantly decreased the content of MDA which was increased by needle puncture in the IDD group. CONCLUSION: Danshen can attenuate intervertebral disc degeneration in SD rats by suppressing the oxidation reaction.

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

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

Anterior Cervical Corpectomy and Fusion Versus Posterior Laminoplasty for Cervical Oppressive Myelopathy Secondary to Ossification of the Posterior Longitudinal Ligament: A Meta-analysis.

The purpose of this study was to compare the clinical effect of anterior cervical corpectomy with fusion vs laminoplasty for cervical ossification of the posterior longitudinal ligament. The outcome measures included the Japanese Orthopaedic Association score, neurological recovery rate, and complication rate. Subgroup A represented studies with the mean preoperative canal occupying ratio being less than 50%, whereas subgroup B represented studies with the mean canal occupying ratio being 50% or greater. In subgroup A, no difference was found between the 2 groups in the postoperative Japanese Orthopaedic Association score and neurological recovery rate. In subgroup B, the anterior cervical corpectomy with fusion group had a higher postoperative Japanese Orthopaedic Association score and neurological recovery rate. The authors recommend anterior cervical corpectomy with fusion for cervical ossification of the posterior longitudinal ligament when the canal occupying ratio is 50% or greater, and they prefer laminoplasty when the canal occupying ratio is less than 50%. [Orthopedics. 2019; 42(3):e309-e316.].

Temporal Summation of Painful Heat Stimulation Is Facilitated in Trigeminal and Extratrigeminal Regions in Painful Myofascial Temporomandibular Disorders: Evidence from a Case-Control Study.

AIMS: To determine whether patients with painful myofascial temporomandibular disorders (TMD) demonstrate facilitated temporal summation (TS) responses to painful heat stimuli applied to the painful trigeminal and extratrigeminal regions and whether there is a side difference in the trigeminal region for myofascial TMD pain patients compared to healthy controls. METHODS: Twenty female Chinese myofascial TMD pain patients and 20 age-matched female volunteers participated in this case-control study. Thermal detection thresholds, thermal pain thresholds, and TS of 20 repetitive noxious thermal stimuli were measured on the skin above the masseter muscle on both sides and the thenar eminence of the less painful side/dominant hand. Numeric rating scale (NRS) scores of pain were provided after the 1st, 5th, 10th, 15th, and 20th stimuli, and TS was calculated as the highest NRS score minus the first NRS score in each test. RESULTS: Evidence of TS was found in the trigeminal and extratrigeminal regions for both groups, but with facilitated TS responses in myofascial TMD pain patients (P < .001). Within the myofascial TMD group and control group, there were no side-to-side differences (P > .289). Interestingly, the repetition of the TS test was associated with facilitated responses in myofascial TMD pain patients (P < .001). CONCLUSION: The current findings suggest TS of painful heat stimulation is facilitated in myofascial TMD pain patients with no side difference in the trigeminal region.