A multifunctional two-dimensional nanocoating consists of graphene oxide nanosheets, polydopamine nanofilm, and oligopeptide constructed on porous sulfonated polyetheretherketone for the purpose of bone infection treatment.

Hidden blood loss (HBL) plays an important role in perioperative rehabilitation of patients underwent posterior lumbar fusion surgery. This study was to calculate the volume of HBL and evaluate the risk factors among patients after posterior lumbar fusion surgery. A retrospective analysis was made on the clinical data of 143 patients underwent posterior lumbar fusion surgery from March 2017 to December 2017. Recording preoperative and postoperative hematocrit to calculate HBL according to Gross formula and analyzing its related factors including age, sex, height, weight, body mass index (BMI), surgery levels, surgical time, surgery types, duration of symptoms, disorder type, specific gravity of urine (SGU), plasma albumin (ALB), glomerular filtration rate (GFR), glucose (GLU), drainage volume, hypertension. Risk factors were further analyzed by multivariate linear regression analysis and t test. Eighty-six males and 57 females, mean age 52.7 ± 11.4 years, mean height 162 ± 7.0, mean weight 61.5 ± 9.4, were included in this study. The HBL was 449 ± 191 mL, with a percentage of 44.2% ± 16.6% in the total perioperative blood loss. Multivariate linear regression analysis revealed that patients with higher BMI ( P = .026), PLIF procedures ( P = .040), and more surgical time ( P = .018) had a greater amount of HBL. Whereas age ( P = 0.713), sex ( P = .276), surgery levels ( P = .921), duration of symptoms ( P = .801), disorder type ( P = .511), SGU ( P = .183), ALB ( P = .478), GFR ( P = .139), GLU ( P = .423), hypertension ( P = .337) were not statistically significant differences with HBL. HBL is a large proportion of total blood loss in patients after posterior lumbar fusion surgery. BMI >24 kg/m 2 , PLIF procedures, and more surgical time are risk factors of HBL. Whereas age, sex, surgery levels, duration of symptoms, disorder type, SGU, ALB, GFR, GLU, hypertension were not associated with HBL.

N/A.

The reparative process following spinal cord injury (SCI) is extremely complicated. Cells in the microenvironment express multiple inhibitory factors that affect axonal regeneration over a prolonged period of time. The axon growth inhibitory factor glycogen synthase kinase-3 (GSK-3) is an important factor during these processes. TDZD-8 (4-benzyl-2-methyl-1,2,4-thiadiazolidine-3,5-dione) is the most effective and specific non-ATP-competitive inhibitor of GSK-3. Here, we show that administering TDZD-8 after SCI was associated with significantly inhibited neuronal apoptosis, upregulated GAP-43 expression, increased density of cortical spinal tract fibers around areas of injury, and increased Basso, Beattie, and Bresnahan (BBB) scores in the lower limbs. These findings support the notion that GSK-3 inhibitors promote neuronal cell regeneration and lower limb functional recovery.

SCE could promote the proliferation of NSCs. It is demonstrated that the microenvironment of SCI may promote the proliferation of NSCs. Besides, SCE could increase the expression of Notch1 and Hes1 mRNA of NSC. It can be concluded that the Notch signaling pathway activation is one of the mechanisms that locally injured microenvironment contributes to the proliferation of ENSC after SCIs. This process may be performed by up-regulating the expressions of Notch1 and Hes1 gene.

Objective: Long-segment spinal fusion surgery was associated with substantial perioperative blood loss which may increase hospitalization expenses and mortality rates. Substantial studies have reported that tranexamic acid (TXA) could reduce blood products and cost after joint arthroplasty surgery. However, there still exists controversy regarding the efficacy of TXA in long-segment spinal fusion surgery. We performed this protocol to design a randomized controlled study to evaluate the efficacy of TXA in decreasing transfusion rate of allogeneic blood products and transfusion cost in degenerative lumbar scoliosis patients. Methods: This study was carried out as a double-blinded, randomized clinical trial on patients with degenerative lumbar scoliosis who prepared for long-segment spinal fusion surgery from December 2018 to December 2019. It was authorized via the Institutional Review Committee in Southwest Medical University (ky2019225). Eighty patients were divided randomly into 2 groups (Experimental group = 40, control group = 40). The patients in the experimental group received 1000 mg of TXA mixed in 100 mL normal saline as a single dose intravenously over 20 minutes before the skin incision was made. Control group received equivalent normal saline without TXA. Primary outcomes included total blood loss, estimated intraoperative blood loss, hematocrit and hemoglobin decline, postoperative drain amount, intra-/postoperative allogeneic transfusion amount and rate, and total transfusion cost. Secondary outcomes included surgical time, thrombotic complications including deep vein thrombosis and pulmonary embolism. All the needed analyses were implemented through utilizing SPSS for Windows Version 20.0. Results: Table showed the relevant clinical outcomes between experimental group and control group. Conclusion: We hypothesized that TXA was effective and safe in reducing blood transfusion and cost in long-segment spinal fusion surgery. Trial registration: This study protocol was registered in Research Registry (researchregistry5854).

The purpose of this study was to calculate and compare the volume of hidden blood loss (HBL) and perioperative blood loss between open posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) by Wiltse approach. We retrospectively analyzed 143 patients between March 2017 and December 2017, they were randomly divided into PLIF group and TLIF group. The following information were collected on admission: patient's age, gender, height, weight, body mass index (BMI), surgery levels, surgical time, duration time, disorder type, intraoperative bleeding, wound drainage, visual analog scale (VAS) scores, neurological complications, transfusion rate. Preoperative and postoperative hematocrit (Hct) were recorded in order to calculate total blood loss (TBL) according to Gross's formula. To calculate each patient's HBL, chi-square test and Student's t test were used to analyze data. Patients in PLIF had a mean TBL of 1144 ± 356 mL, and the mean HBL was 486 ± 203 mL, 43.9 ± 16.2% of the TBL. While patients in TLIF, the mean TBL was 952 ± 303 mL, and the mean HBL was 421 ± 178 mL, 44.7 ± 17.0% of the TBL. Hence, there was significant difference in TBL and HBL between 2 groups, respectively (P = .000, P = .044). However, there was no difference in the ratio of the HBL between 2 groups (P = .797). The volume of HBL is lower in open TLIF by Wiltse approach than that in PLIF, which may be a large proportion of TBL in posterior lumbar fusion surgery. Comprehensive understanding of HBL can contribute to keep patient safety and better to rehabilitation in perioperative.

this paper describes a minimally invasive technique of percutaneous intervertebral bridging cementoplasty (piBc) to augment the fractured vertebrae and immobilize the intervertebral space with endplate-disc complex injury simultaneously. thirty-two patients with adjacent multilevel osteoporotic thoracolumbar fractures (AMotLfs) and vertebral endplate-disc complex injury (eDci) treated by piBc were retrospectively reviewed. the piBc technique was a combination of puncture, balloon expansion and bridging cementoplasty. the clinical and radiological assessments were reviewed. The operation time was 82.8 ± 32.5 min, and blood loss was 76.9 ± 31.7 mL. A cement bridge was connected between the two fractured vertebrae across the injured intervertebral space. VAS at three time points including pre-operation, post-operation 1 day and final follow-up was 6.9 ± 0.9, 2.9 ± 0.8 and 1.7 ± 0.8, respectively; ODI at three time points was (71.1 ± 7.8)%, (18.4 ± 5.7)%, and (10.3 ± 5.7)%, respectively; Cobb angle at three time points was 46.0° ± 10.4°, 25.9° ± 8.5°, and 27.5° ± 7.1°, respectively. Compared with pre-operation, VAS, ODI and Cobb angle were significantly improved at post-operation 1 day and final follow-up (P < 0.05). Clinical asymptomatic cement leakage was observed in thirteen patients. no vessel or neurological injury was observed. piBc may be an alternative way of treatment for AMotLfs with eDci. the technique is a minimally invasive surgery to augment the fractured vertebrae and immobilize the injured intervertebral space simultaneously. Osteoporotic vertebral fracture is an increasing common spinal disorder among the elderly patients. Thoracolumbar vertebrae are frequently involved segments and they can cause disabling pain and kyphotic deformity 1. Although conservative pain management is recommended for some patients, minimally invasive vertebral augmentation is generally advocated for symptomatic osteoporotic vertebral fracture 2,3. Patients with symptomatic acute or subacute osteoporotic vertebral compression fracture (OVCF) are often considered potential candidates for treatment with vertebral augmentation. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are the preferred augmentation techniques which provided rapid pain relief and sustained improvement of physical function 3,4. Furthermore, PKP has advantages of correcting the kyphotic deformity and restoring the height of the fractured vertebrae. However, some OVCFs are characterized not only by vertebral compression fractures, but also by vertebral endplate-disc complex injury (EDCI) 5. Current treatment strategies, such as vertebroplasty and kyphoplasty, are aimed only at stabilizing these painful vertebral fractures. EDCI cannot be treated by traditional augmentation techniques. Consequently, EDCI may account for cement leakage into the disc and persistent back pain after vertebral augmentation. In addition, EDCI may be labeled as new adjacent levels fracture or instability 6 .