A retrospective study to evaluate the effectiveness of 3-dimensional rapid prototyping (3DRP) technology in corrective surgery for Lenke 1 adolescent idiopathic scoliosis (AIS) patients.3DRP technology has been widely used in medical field; however, no study has been performed on the effectiveness of 3DRP technology in corrective surgery for Lenke 1 AIS patients.Lenke 1 AIS patients who were preparing to undergo posterior corrective surgery from a single center between January 2010 and January 2012 were included in this analysis. Patients were divided into 2 groups. In group A, 3-dimensional (3D) printing technology was used to create subject-specific spine models in the preoperative planning process. Group B underwent posterior corrective surgery as usual (by free hand without image guidance). Perioperative and postoperative clinical outcomes were compared between 2 groups, including operation time, perioperative blood loss, transfusion volume, postoperative hemoglobin (Hb), postoperative complications, and length of hospital stay. Radiological outcomes were also compared, including the assessment of screw placement, postoperative Cobb angle, coronal balance, sagittal vertical axis, thoracic kyphosis, and lumbar lordosis. Subgroup was also performed according to the preoperative Cobb angle: mean Cobb angle <50° and mean Cobb angle >50°. Besides, economic evaluation was also compared between 2 groups.A total of 126 patients were included in this study (group A, 50 and group B, 76). Group A had significantly shorter operation time, significantly less blood loss and transfusion volume, and higher postoperative Hb (all, P < 0.001). However, no significant differences were observed in complication rate, length of hospital stay, and postoperative radiological outcomes between 2 groups (all, P>0.05). There was also no significant difference in misplacement of screws in total populations (16.90% vs 18.82%, P = 0.305), whereas a low misplacement rate of pedicle screws was observed in patients whose mean Cobb angle was >50° (9.15% vs 13.03%, P = 0.02). Besides, using 3DRP increased the economic burden of patients (157,000 ± 9948.85 Ren Min Bi (RMB) vs 152,500 ± 11,445.52 RMB, P = 0.03).Using the 3D printing technology before posterior corrective surgery might reduce the operation time, perioperative blood loss, and transfusion volume. There did not appear to be a benefit to using this technology with respect to complication rate and postoperative radiological outcomes; however, 3D technology could reduce the misplacement rate in patients whose preoperative mean Cobb angle was >50°. Besides, it also increased the patients’ hospital cost. Therefore, future prospective studies are needed to elucidate the efficacy of this emerging technology.

Adjacent segment discs with pre-existing degeneration had a higher likelihood of ASDeg progression compared with normal discs, especially for those classified as UCLA grade C.

Our findings demonstrate that CUEDC2 plays an important role in protection from colonic inflammation, primarily by inhibiting the NF-κB and STAT3 signaling pathways and preventing excessive proliferation of the inflammatory epithelial cell.

Multidrug-resistant (MDR) Klebsiella pneumoniae is a severe threat to public health worldwide. Worryingly, colistin resistance, one of the last-line antibiotics for the treatment of MDR K. pneumoniae infection, has been increasingly reported. This study aims to investigate the emergence of evolved colistin resistance in a carbapenem-resistant K. pneumoniae isolate during colistin treatment. In this study, a pair of sequential carbapenem-resistant K. pneumoniae isolates were recovered from the same patient before and after colistin treatment, named KP1-1 and KP1-2, respectively. Antibiotic susceptibility testing was performed by the microdilution broth method. Whole genome sequencing was performed, and putative gene variations were analyzed in comparison of the genome sequence of both isolates. The bacterial whole genome sequence typing and source tracking analysis were performed by BacWGSTdb 2.0 server. Validation of the role of these variations in colistin resistance was examined by complementation experiments. The association between colistin resistance and the expression level of PhoP/PhoQ signaling system and its regulated genes was evaluated by quantitative real-time PCR (qRT-PCR) assay. Our study indicated that KP1-1 displayed extensively antibiotic resistant trait, but only susceptible to colistin. KP1-2 showed additional resistance to colistin. Both isolates belonged to Sequence Type 11 (ST11). The whole genome sequence analysis uncovered multiple resistance genes and virulence genes in both isolates. No plasmid-mediated mcr genes were found, but genetic variations in five chromosomal genes, especially the Gln30∗ alteration in MgrB, were detected in colistin-resistant isolate KP1-2. Moreover, only complementation with wild-type mgrB gene restored colistin susceptibility, with colistin MIC decreased from 32 to 1 mg/L. Expression assays revealed an overexpression of the phoP, phoQ, and pmrD genes in the mgrB-mutated isolate KP1-2 compared to the wild-type isolate KP1-1, confirming the MgrB alterations was responsible for increased expression levels of those genes. This study provides direct in vivo evidence that Gln30∗ alteration of MgrB is a critical region responsible for colistin resistance in K. pneumoniae clinical strains.

Objective: To observe the immediate and mid-term effects of partial spleen embolization (PSE) in reducing hepatic venous pressure gradient (HVPG) in patients with cirrhotic esophagogastric varices. Methods: Patients diagnosed with cirrhosis and esophagogastric varices in our hospital between July 2016 and March 2018 were consecutively selected. Forty-three patients were selected based on the eligibility criteria to undergo PSE. The change in HVPG 5 minutes before and after embolization, was used to determine the immediate effect of PSE on HVPG reduction. HVPG was retested after 6 months to observe the change in the antihypertensive effect along with time. Results: Forty-three patients successfully underwent PSE and HVPG measurements. The HVPG was 17.7 ± 3.9 mmHg and 13.9 ± 3.1 mmHg before and after PSE, respectively, showing a significant decrease (21.5%, P < .05). Among them, 18 cases were retested for HVPG at 6 months after PSE, and the results showed significant differences in the HVPG levels before, immediately and 6 months after PSE. Compared with preoperative PSE, HVPG was decreased by 22.9% and 17.7% (P < 0.05) immediately and at 6 months after operation, respectively. There was no significant change at 6 months after PSE when compared with immediate postoperative PSE. No serious complications were observed in patients during their postoperative hospital stay. Conclusion: PSE immediately reduced the portal pressure, and HVPG remained stable at 6 months after surgery. PSE is considered as a safe and easy to implement method, and is expected to be one of the treatments for reducing the portal pressure.

Objective Endoscopic remission is the primary therapeutic target and associated with clinical outcome in Crohn’s disease (CD). Non-invasive and accurate biomarkers are important in monitoring endoscopic remission frequently. Our study aimed at investigating the predictive capacity of prealbumin and retinol-binding protein 4 (RBP4) for identifying endoscopic remission. Methods From June 2018 to December 2020, 515 endoscopy procedures (332 in the training cohort and 183 in the validation cohort) were enrolled in this multicentre retrospective cohort study. Blood samples were collected for prealbumin or RBP4 testing with 7 days before the endoscopy. A simple Endoscopic Score for CD (SES-CD) was performed to evaluate endoscopic activity and defined endoscopic remission. The area under receiver operating characteristic curve (AUROC), sensitivity, specificity, positive predictive value and negative predictive value were performed to assess the predictive capacity of the biomarkers. Results Serum concentration of prealbumin and RBP4 was demonstrated to be higher in patients with endoscopic remission and significantly negatively correlated with SES-CD in the training cohort. The AUROC of prealbumin and specificity of prealbumin and RBP4 were larger than that of C-reactive protein in the training cohort and the validation cohort. The model combining prealbumin and faecal calprotectin had the largest AUROC (0.842 [95% CI: 0.775–0.908]). Furthermore, in both cohorts, prealbumin had a larger AUROC than C-reactive protein for identifying endoscopic remission in patients with anti-tumour necrosis factor therapy. Conclusion Prealbumin and RBP4 were promising biomarkers for identifying endoscopic remission, especially in patients with anti-tumour necrosis factor therapy.

The aim of this paper was to investigate the change of serum leptin and its relationship with platelet membrane glycoprotein Ib (GP Ib) in patients with coronary heart disease (CHD). The enrolled included 50 patients with CHD (CHD group) and 30 patients without CHD (control group) who were diagnosed by coronary angiography. The positive percentage and the average fluorescence intensity of platelet membrane GP Ib were detected by full-blood flow cytometry. Serum leptin was detected by enzyme linked immunosorbent assay. The positive percentage and the average fluorescence intensity of platelet membrane GP Ib in the CHD group were significantly lower than those in the control group (P < 0.05). After correcting the differences of systolic blood pressure, body mass index (BMI), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting glucose, PPBS, fasting insulin and quantitative insulin sensitive index, serum leptin level in the CHD group was significantly higher than that in the control group (P < 0.05). Single factor correlative analysis revealed that serum leptin in CHD patients was negatively correlated with the average fluorescence intensity of platelet membrane GP Ib (P < 0.05). Multifactorial stepwise regression analysis showed that serum leptin in CHD patients was independently negatively correlated with the average fluorescence intensity of platelet membrane GP Ib (P < 0.05). Logistic analysis demonstrated that serum leptin was independently correlated with the risk of CHD (P < 0.05). Hyperleptinemia was verified in CHD patients. The increase of serum leptin could affect blood platelet activation. Hyperleptinemia may play an important role in the pathogenesis of CHD.

Background: Phthalates are non-persistent chemicals with endocrine-disrupting abilities widely used in a variety of consumer products. Evidence for the effects of phthalate exposure on liver function in adolescents is lacking. The aim of this study was to investigate the association between phthalate exposure and changes in liver function indicators.Methods: Data were analyzed from the combined 2007-2016 National Health and Nutrition Examination Survey (NHANES). Weighted linear regressions were used to explore the association between urinary phthalate metabolites and indicators of liver function. Bayesian kernel machine regressions (BKMR) were used to evaluate the joint effects of phthalate metabolite mixtures on indicators of liver function.Results: Weighted Linear regression models showed that MCOP and MiBP were negatively associated with TBIL (all P FDR < 0.05), MCPP was positively correlated with TBIL (P FDR < 0.05), ΣDEHP, MCOP, and MEP (all P FDR < 0.05) were negatively correlated with ALB, while MCPP was positively correlated with ALB (P FDR < 0.05), and MCOP was negatively correlated with TP (P FDR < 0.05). BKMR analysis showed phthalate metabolite mixtures had significant positive dose response relationships with ALT, AST, GGT, ALP and TBIL, and significant negative dose response relationships with ALB and TP.Conclusions: The implications of these results demonstrate that phthalate exposure may contribute to adverse effects on liver function indicators among U.S. adolescents.