The human cytomegalovirus (HCMV), whose genome is 235 ± 1.9 kbp long, is a common herpesvirus. However, the functions of many of its genes are still unknown. HCMV is closely associated with various human diseases and infects 60-90% of the global population. It can infect various human cells, including fibroblasts, epithelial cells, endothelial cells, smooth muscle cells, and monocytes. Although HCMV infection is generally asymptomatic and causes subtle clinical symptoms, it can generate a robust immune response and establish a latent infection in immunocompromised individuals, including those with AIDS, transplant recipients, and developing fetuses. Currently available antivirals approved for the treatment of HCMV-associated diseases are limited by dose-limiting toxicity and the emergence of resistance; however, vaccines and immunoglobulins are unavailable. In this review, we have summarized the recent literature on 43 newly identified HCMV genes. We have described their novel functions on the viral replication cycle, latency, and host immune evasion. Further, we have discussed HCMV-associated diseases and current therapeutic targets. Our review may provide a foundational basis for studies aiming to prevent and develop targeted therapies for HCMV-associated diseases.
Study design: Retrospective cohort analysis. Objective: Our study aimed to investigate the effect of preoperative lumbar muscle quality (including muscle cross-sectional area (CSA) and muscle fatty infiltration rate (FIR) on L5-S1 foraminal stenosis degeneration after L4-5 TLIF. Summary of Background Data: Adjacent segment degeneration (ASD) was a major spinal fusion complication. The paraspinal muscle had been proven to be an essential factor influencing the happening of ASD. However, few studies had investigated the association between paraspinal muscle and adjacent segment foraminal stenosis degeneration (ASD-FS). Methods: One hundred-thirteen patients diagnosed with lumbar spinal stenosis at L4-5 were involved. Paraspinal muscle measurements were obtained preoperatively and bilaterally from axial T2-weighted MR images. The parameters included the, psoas cross-sectional area (p-CSA), erector spinae cross-sectional area (es-CSA), multifidus cross-sectional area (m-CSA), psoas fatty infiltration rate (p-FIR), erector spinae fatty infiltration rate (es-FIR), and multifidus fatty infiltration rate(m-FIR). The foraminal parameters were obtained in the Computed Tomography system bilaterally, including posterior disc height (PDH), disc-to-facet distance (D-F), foraminal height (FH), and foraminal area (FA). The association between muscle quality and ASD-FS had also been studied. Results: At the last follow-up, the DF, FH, and FA were significantly decreased compared to pre-operation, and the decrease in FA was significantly positively related to es-FIR and m-FIR. Conclusion: FIR for lumbar muscles preoperative was a predictor for L5-S1 ASD-FS after TLIF surgery, and patients who had higher es-FIR and higher m-FIR were more inclined to develop L5-S1 ASD-FS.
Study design: Retrospective study. Objectives: Adjacent segment degeneration (ASD) is a major complication associated with spinal fusion. The lumbar paraspinal muscle is an essential factor influencing the occurrence of ASD. This study aimed to investigate the effect of preoperative lumbar paraspinal muscle quality on L5-S1 adjacent lumbar foraminal stenosis degeneration (ASLFSD) after L4-5 transforaminal lumbar interbody fusion (TLIF). Methods: 113 patients diagnosed with lumbar spinal stenosis at L4-5 were treated with TLIF. Lumbar paraspinal muscle measurements were obtained preoperatively and bilaterally from axial T2-weighted MR images. The measurementsincluded the total cross-sectional area of psoas (PS-tCSA), of erector spinae (ES-tCSA), and of multifidus (MF-tCSA); and fatty infiltration of psoas (PS-FI), of erector spinae (ES-FI) and of multifidus (MF-FI). Foraminal measurements, including posterior disc height (PDH), disc-to-facet distance (D-F), foraminal height (FH), and foraminal area (FA), were obtained bilaterally using a computed tomography system. The association between lumbar paraspinal muscle quality and changes in foraminal measurements was also studied. Results: We observed that the FH and FA significantly reduced at 1 year postoperatively at the mean follow-up period of 41.56 ± 8.38 months (range. 43–50 months), and PDH, D-F, FH, and FA all significantly reduced at final follow-up. These changes in foraminal measurements were significantly and negatively correlated with PS-FI, ES-FI, and MF-FI. Conclusion: During the clinical follow-up, we found that patients with a higher degree of paraspinal muscle FI were more likely to develop L5-S1 ASLFSD after L4-5 TLIF.
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