Gamma-delta (gd) T cells are a subset of T cells that promote the inflammatory responses of lymphoid and myeloid lineages, and are especially vital to the initial inflammatory and immune responses. Given the capability to connect crux inflammations of adaptive and innate immunity, gd T cells are responsive to multiple molecular cues and can acquire the capacity to induce various cytokines, such as GM-CSF, IL-4, IL-17, IL-21, IL-22, and IFN-g. Nevertheless, the exact mechanisms responsible for gd T cell proinflammatory functions remain poorly understood, particularly in the context of the central nervous system (CNS) diseases. CNS disease, usually leading to irreversible cognitive and physical disability, is becoming a worldwide public health problem. Here, we offer a review of the neuroinflammatory and immune functions of gd T cells, intending to understand their roles in CNS diseases, which may be crucial for the development of novel clinical applications.
Background: Anterior cervical discectomy and fusion (ACDF) sacrifices segmental mobility, which can lead to the acceleration of adjacent segment degeneration. The challenge has promoted cervical artificial disc replacement (CADR) as a substitute for ACDF. However, CADR has revealed a series of new issues that are not found in ACDF, such as hypermobility, subsidence, and wear phenomenon. This study designed a cervical subtotal discectomy prosthesis (CSDP) consisting of a cervical disc prosthesis structure (CDP structure), cervical vertebra fixation structure (CVF structure), link structure, and locking screw, aiming to facilitate motion control and reduce subsidence. The aim of this study was to assess the biomechanics of the CSDP using finite element (FE) analysis, friction-wear test, and non-human primates implantation study.Study Design: For the FE analysis, based on an intact FE C2-C7 spinal model, a CSDP was implanted at C5-C6 to establish the CSDP FE model and compare it with the Prestige LP prosthesis (Medtronic Sofamor Danek, Minneapolis, MN, United States). The range of motion (ROM), bone-implant interface stress, and facet joint force were calculated under flexion extension, lateral bending, and axial rotation. In addition, CSDP was elevated 1 mm to mimic an improper implantation technique to analyze the biomechanics of CSDP errors in the FE model. Moreover, the friction-wear test was conducted in vitro to research CSDP durability and observe surface wear morphology and total wear volume. Finally, the CSDP was implanted into non-human primates, and its properties were evaluated and verified by radiology.Results: In the FE analysis, the ROM of the CSDP FE model was close to that of the intact FE model in the operative and adjacent segments. In the operative segment, the CSDP error FE model increased ROM in flexion extension, lateral bending, and axial rotation. The maximum stress in the CSDP FE model was similar to that of the intact FE model and was located in the peripheral cortical bone region. The facet joint force changes were minimal in extension, lateral bending, and axial rotation loads in CSDP. In the friction-wear test, after the 150-W movement simulation, both the CVF-link-junction and the CDP-link-junction had slight wear. In the CSDP non-human primate implantation study, no subsidence, dislocation, or loosening was observed.Conclusion: In the FE analysis, the biomechanical parameters of the CSDP FE model were relatively close to those of the intact FE model when compared with the Prestige LP FE model. In terms of CSDP error FE models, we demonstrated that the implantation position influences CSDP performance, such as ROM, bone-implant interface stress, and facet joint force. In addition, we performed a friction-wear test on the CSDP to prove its durability. Finally, CSDP studies with non-human primates have shown that the CSDP is effective.
BackgroundMultilevel cervical spondylotic myelopathy (CSM) and ossification of the posterior longitudinal ligament (OPLL) are debilitating degenerative diseases. If conservative treatment is ineffective, surgical options for multilevel CSM and OPLL include laminoplasty (LP) and laminectomy with fusion (LF). In this updated meta-analysis, we aimed to compare the clinical outcomes and complications of both approaches.MethodsWe searched PubMed, the Cochrane Library and Embase datasets from their inception to 31 March 2020, to identify all eligible studies comparing LP versus LF for multilevel CSM and OPLL. Data were extracted according to predefined endpoints. We summarised data by the random-effects or fixed-effect models, as necessary.ResultsOf 533 eligible studies, 16 were identified, which included 638 patients who underwent LP and 671 patients who underwent LF. No significant differences were observed between preoperative and postoperative scores of the Japanese Orthopaedic Association (p=1.0 and 0.20, respectively); Visual Analogue Scale (p=0.24 and 0.89, respectively); sagittal vertical axis ((p=0.16 and 0.87, respectively); Nurick Scale (p=0.59 and 0.17, respectively); and range of motion (p=0.67 and 0.63, respectively). However, total complications were higher for LF compared with LP (p=0.006). A significantly higher incidence of C5 palsy was observed in the LF group (p=0.004). The postoperative Neck Disability Index (NDI) was also higher in the LF group (p<0.001).ConclusionsAlthough LP and LF shared similar clinical improvement, LP had fewer complications, a lower incidence of C5 palsy, and better NDI scores and recovery outcomes than LF. Randomised studies are warranted to validate these findings.
Purpose: In this study, pore size and porosity distribution of porous Ti-6Al-4V scaffolds (pTi) were controlled by 3D printing. The effects of pore size distribution at a constant porosity, or porosity distribution at a constant pore size pertaining to functions of adhesion, proliferation, and differentiation of the mouse embryonic osteoblast precursor (MC3T3-E1) cells were researched separately. Methods: 3D printing was used to design five groups of pTi, designated as PS300/HP, PS300/LP, PS500/HP, PS500/LP, and PS800/HP based on pore size and porosity distribution. MC3T3-E1 cells were cultured on pTi, and non-porous Ti-6Al-4V samples (npTi) were prepared as control. The pTi was characterized with the scanning electron microscopy (SEM). MC3T3-E1 cells were stained via AlamarBlue assay and viability and proliferation analyzed. The mRNA levels of alkaline phosphatase (ALP), osteocalcin (OCN), collagentype-1 (Col-1), and runt-related transcription factor 2 (Runx2) in MC3T3-E1 cells were analyzed by real-time PCR analysis. Results: The average pore size and porosity of pTi were recorded as (301 ± 9 μm, 58.8 ± 1.8%), (300 ± 9 μm, 43.4 ± 1.3%), (501 ± 11 μm, 58.3 ± 1.2%), (499 ± 12 μm, 42.7 ± 1.1%), and (804 ± 10 μm, 58.9 ± 1.3%), respectively. SEM images confirmed active attachment of cells and oriented with the direction of metal rod after pTi/MC3T3-E1 co-culture for 3 and 7 days. In addition, MC3T3-E1 cells grown on the PS800/HP displayed significantly higher proliferation compared with each group after 3 days incubation ( p < 0.05). Moreover, cells showed some degree of proliferation in all groups, with the highest value recorded for PS800/HP after culture for 7 days ( p < 0.05). The gene expression pattern of ALP, OCN, Col-1, and Runx2 confirmed that these were down-regulated when pore size increased or porosity decreased of pTi ( p < 0.05). Conclusion: The pTi facilitated the adhesion and differentiation of osteoblast when pore size decreased or porosity increased. The scaffold model resembles physical modification with porous structures, which has potential application in the surface modifications of Ti implant.
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