Changzhi Medical College Peace Hospital

ObjectiveTo evaluate the incidence of L5 radiculitis in patients undergoing posterior lumbar interbody fusion (PLIF) using a force-limited distance-measurable nerve root retractor (FLDM-NRR) combined with intraoperative neurophysiological monitoring (IONM), compared with conventional nerve root retraction.MethodsThis retrospective cohort study examined 234 patients with L4-L5 lumbar spinal stenosis (LSS) undergoing single-level PLIF from January 2022 to March 2024. Patients were categorized into the FLDM-NRR plus IONM group (n = 96) with force limitation ≤ 3.5 N, and the conventional nerve root retraction group (n = 138). The primary outcome was 3-month L5 radiculitis; Secondary outcomes included 1-year persistent neurological impairment, Japanese Orthopedic Association (JOA) scores, Oswestry Disability Index (ODI), Visual Analog Scale (VAS) pain scores, and achievement of minimal clinically important difference (MCID). Multivariable logistic regression, mixed-effects models, and hierarchical testing were applied.ResultsFLDM-NRR with IONM reduced the 3-month L5 radiculitis incidence (7.29% vs 18.12%, adjusted OR = 0.31, 95% CI 0.11–0.78; P = 0.017; absolute risk reduction (ARR) = 10.83%; number needed to treat (NNT) = 9), with greatest protection in the first postoperative week (3.13% vs 13.04%, P = 0.020). No significant difference was observed in 1-year persistent neurological impairment (3.13% vs 7.25% P = 0.200). The FLDM-NRR group showed superior ODI (18.43 ± 7.85% vs 21.17 ± 8.42%, P = 0.018) and higher MCID rates in VAS leg pain (95.8% vs 93.5%, P = 0.028). IONM demonstrated 85.71% sensitivity and 96.63% specificity in predicting postoperative complications. The FLDM-NRR system consistently upheld the predetermined force threshold in all instances without any device-related problems.ConclusionFLDM-NRR combined with IONM significantly reduces early L5 radiculitis after PLIF and provides short-term functional benefits. Long-term neuroprotection remains unproven and requires validation in prospective randomized trials.Supplementary InformationThe online version contains supplementary material available at 10.1186/s13018-025-06429-0.

IntroductionWe aimed to comprehensively evaluate the association between four important dietary patterns and micronutrients with sarcopenia and osteopenia. Data were obtained from the National Health and Nutrition Examination Survey 2005-2018.MethodsThe association between dietary patterns and micronutrients with sarcopenia and osteopenia was evaluated by logistic regression models. 6709 and 7161 participants were included in the final analyses.ResultsHigher adherence to HEI-2020, aMed, and DASH dietary patterns was inversely associated with sarcopenia risk, with each standard deviation (SD) increment linked to 18%, 16%, and 14% reductions in odds, respectively. However, DII increased the prevalence of sarcopenia and osteopenia by 44% and 8% per SD increase. Dietary intake of vitamins A, B2, B9, C, calcium, phosphorus, magnesium, copper, and potassium were negatively associated with sarcopenia, whereas vitamins D and K were negatively associated with osteopenia. SIRI and NLR partially mediated the associations among them.DiscussionAdherence to healthy dietary patterns especially anti-inflammatory diet and supplementary micronutrients reduce bone and muscle loss.

Tension viscerothorax is a severe condition characterized by significant increases in thoracic pressure due to the herniation of abdominal organs into the thoracic cavity. It is commonly observed in children with congenital diaphragmatic hernias or as a postoperative complication, while tension viscerothorax resulting from blunt trauma is rare. A 48-year-old male was urgently admitted to the emergency department with dyspnea following a fall from a height of 15 m. The patient, presenting in shock and based on clinical signs, was initially diagnosed with a tension pneumothorax (TPT). Bedside point-of-care ultrasound (POCUS) revealed substantial parenchymal echo abnormalities in the left thoracic cavity and cardiac displacement to the right, suggesting a left-sided tension viscerothorax. Thoracic and abdominal computed tomography confirmed the diagnosis of a rare left-sided tension viscerothorax. Due to the delayed diagnosis, the patient experienced a cardiac arrest. Following cardiopulmonary resuscitation and advanced life support, the patient regained spontaneous circulation and underwent an emergency laparotomy to reduce abdominal organs and repair a diaphragmatic hernia. Postoperatively, the patient received comprehensive medical care. The patient recovered well postsurgery and was discharged after an 18-day hospital stay. Follow-up over 2 years revealed no significant complications. Blunt trauma-induced tension viscerothorax is rare and can easily be confused with TPT, leading to misdiagnosis. Early use of bedside POCUS is recommended for suspected cases to expedite identification and management, thereby improving survival rates.

BackgroundCurrent research lacks comprehensive investigation into the biomechanical changes in the spinal cord and nerve roots during scoliosis correction. This study employs finite element analysis to extensively explore these biomechanical variations across different Cobb angles, providing valuable insights for clinical treatment.MethodsA personalized finite element model, incorporating vertebrae, ligaments, spinal cord, and nerve roots, was constructed using engineering software. Forces and displacements were applied to achieve Cobb angle improvements, designating T1/2-T4/5 as the upper segment, T5/6-T8/9 as the middle segment, and T9/10-L1/2 as the lower segment. Simulations under traction, pushing, and traction + torsion conditions were conducted, and biomechanical changes in each spinal cord segment and nerve roots were analyzed.ResultsThroughout the scoliosis correction process, the middle spinal cord segment consistently exhibited a risk of injury under various conditions and displacements. The lower spinal cord segment showed no significant injury changes under traction + torsion conditions. In the early correction phase, the upper spinal cord segment demonstrated a risk of injury under all conditions, and the lower spinal cord segment presented a risk of injury under pushing conditions. Traction conditions posed a risk of nerve injury on both sides in the middle and lower segments. Under pushing conditions, there was a risk of nerve injury on both sides in all segments. Traction + torsion conditions implicated a risk of injury to the right nerves in the upper segment, both sides in the middle segment, and the left side in the lower segment. In the later correction stage, there was a risk of injury to the upper spinal cord segment under traction + torsion conditions, the left nerves in the middle segment under traction conditions, and the right nerves in the upper segment under pushing conditions.ConclusionWhen the correction rate reaches 61–68%, particular attention should be given to the upper-mid spinal cord. Pushing conditions also warrant attention to the lower spinal cord and the nerve roots on both sides of the main thoracic curve. Traction conditions require attention to nerve roots bilaterally in the middle and lower segments, while traction combined with torsion conditions necessitate focus on the right-side nerve roots in the upper segment, both sides in the middle segment, and the left-side nerve roots in the lower segment.

The online version contains supplementary material available at 10.1007/s10616-024-00642-1.

This study aimed to explore the prognostic value of Anoikis-related genes (ANRGs) in colon cancer using bioinformatics and construct a prognostic model based on ANRGs. ANRGs integrated from GeneCard and Harmonizome were used to identify CRC subtypes and construct a prognostic model for CRC patients. The immune microenvironment (TME) between different subtypes was also investigated. Finally, a line chart based on ANRGs was provided for clinical use, and decision curve analysis (DCA) was performed to determine the potential benefits of the model for clinical strategies. We identified 14 differential expression genes (DEGs) related to survival in CRC Anoikis, and selected 7 genes to construct the prognostic model. The prognostic risk score was determined as independent prognostic factor. Functional analysis showed that high-risk and low-risk groups had different immune infiltration status. Combined with CRC clinical pathological characteristics, a line chart was constructed, and DCA analysis showed that this model could benefit from clinical treatment strategies. This study explored 7 prognostic-associated risk genes related to CRC and constructed a line chart, which can provide important reference value for clinical doctors to choose personalized treatment for CRC patients.

Abstract Background: Esophageal cancer occupies the sixth leading cause of cancer death worldwide. Colorectal metastases are less likely to occur in squamous esophageal cancer. We report a case of metastatic squamous cell carcinoma of colon from esophageal cancer. Case presentation: A 66-year-old Chinese female with diabetes presented with left neck mass for 1 month. CT scan demonstrated uneven thickening wall of the mid-thoracic esophagus. A lymph node aspiration biopsy of the neck showed metastases in the lymph nodes of the left cervical region 4, which were supported by immunohistochemistry as squamous cell carcinoma. Stage ⅣA (T4N2M0) middle thoracic esophageal carcinoma was diagnosed. The patient had been treated with neoadjuvant concurrent radiotherapy and chemotherapy for 1 cycle. Then she had undergone thoracoscopic radical esophageal cancer surgery in September 2020. Pathology from esophagus and nodes showed no residual tumor and pathological stage was ypT0N0M0. In August 2021, the patient developed hematochezia, and the colonoscopy showed a nodular neoplasm with a brittle texture. Fine needle aspiration biopsy of the colon neoplasm showed squamous cell carcinoma with poorly differentiation. She subsequently received chemotherapy with oxaliplatin and irinotecan for 1 cycle. Two months later, the patient underwent a palliative resection operation and the patient died 3 months after the operation. Conclusion: We report the first case of metastatic squamous cell carcinoma of colon from esophageal cancer with ypT0N0M0 underwent surgery after neoadjuvant chemoradiotherapy. This case raises clinical awareness regarding colorectal metastases from esophageal cancer with pT0N0M0 underwent surgery after neoadjuvant chemoradiotherapy.

Abstract BackgroundBisphenol A (BPA) is an environmental chemical substance, and the widespread use of plastic products, its hazards can be said to be ubiquitous. We aimed to evaluate the relationship between serum bisphenol A (BPA), biomarkers and recent mortality in pats with young interacerebral hemorrhage (YICH) and different thyroid functions,and the cumulative consumption of plastic products.MethodsUsing a multi-center longitudinal prospective study, the research team recruited 600 YICH patients and divided them into two subgroups according to their thyroid function, of which 320 (53.3%) were in the low T3.Sub-clinical hypothyroidism(SCH) was 280 (46.6%) and control group (n = 600).All patients received serum BPA, and biomarker blood draws.ResultsEach log unit of BPA increased by 0.204 standard deviation unit (P<0.003).BPA(0.91±0.14)vs(0.765±0.13)vs(0.535±0.11)pg/ml,thrombin(1.35±0.18) vs (0.66±0.15) vs (0.66 ±0.15) ng/ml, MMP-9 (104±10 vs (53±8.1)vs(53±8.1) pg/ml,both P＜0.01. Serum BPA is positively correlated with biomarker, 24hDBPCV, and was negatively correlated LT3 and niR-451. Multiple linear regression showed that BPA was an independent risk factor affecting the percentage increase of nDBP (β = 0.286), P <0.01.Mortality rate showed 2 ,15 and 30 days of patients in the LT3 and the SCH of 4.7%vs 2.5%,6.25% vs 3.75%,4.68%vs 2.5%,P<0.01.ConclusionThus, Long-term exposure to BPA levels may be related to the occurrence of YICH, High BPA exposure strongly predicts the risk of ICH in young patients. Activation of NF-κB signaling pathway, secondary thyroid function and ABP changes, together to construct an inflammatory response program, is related to the risk of short-term death. There is a significant difference in recent mortality compared to LT3 vs SCH. Trial registrationThe trial is registered at clinical .gov (www.medresman.Chi CTR1900023626)

Two groups of Ecuadorian women were included, indigenous from rural region and urban women, both from Canar province. A descriptive cross-sectional study was conducted from July 2017 to September 2018. Two hundred endocervical cytological samples were collected from both women populations between 15 and 55 years of age, residing in this province. Samples were analyzed by Papanicolaou test and mucosal cells were submitted to DNA extraction and subsequently HPV detection and genotyping using a commercial kit CLART® HPV 2 (Genomic, Spain).

This study aimed to investigate the characteristics and mechanisms responsible for heteroresistance to colistin in Acinetobactor baumannii clinical isolates from a Chinese teaching hospital. Five hundred and seventy-six nonduplicate A. baumannii clinical isolates isolated from 2014 to 2015 were tested. Colistin heteroresistance was determined using population analysis profiles (PAPs). Susceptibility testing was conducted using the broth microdilution method (BMD). The ability to form biofilm formation was determined using 96-well flat bottom microtiter plates. Time-kill assays were also conducted. PCR and sequencing were used to detect the presence of resistant genes. Expression levels of efflux pump genes were determined by qRT-PCR. LPS analysis was conducted by SDS-PAGE. Lipid A characteristic were determined via MALDI-TOF MS. Nine colistin heteroresistant A. baumannii clinical isolates which were selected by PAPs, exhibited multidrug-resistant phenotypes. The microplate biofilm assay revealed that colistin heteroresistant A. baumannii clinical isolates had weaker biofilm formation capacity than A. baumannii ATCC19606. Colistin-heteroresistant A. baumannii isolates exhibited regrowth after 12 h at 0.5 × MIC, 1 × MIC, and 2 × MIC. The results of PCR and sequencing revealed mutations of lpxACD in some colistin heteroresistant A. baumannii isolates. qRT-PCR also showed that the expressions of efflux pump genes were upregulated in some of the heteroresistant isolates. Our study was the first report of colistin heteroresistant A. baumannii clinical isolates in China. The transition of colistin heteroresistance to resistance should be of concern in future clinical surveillance.