Osteoporosis is a prevalent skeletal condition characterized by reduced bone mass and strength, leading to increased fragility. Buqi-Tongluo (BQTL) decoction, a traditional Chinese medicine (TCM) prescription, has yet to be fully evaluated for its potential in treating bone diseases such as osteoporosis. To investigate the mechanism by which BQTL decoction inhibits osteoclast differentiation in vitro and validate these findings through in vivo experiments. We employed MTS assays to assess the potential proliferative or toxic effects of BQTL on bone marrow macrophages (BMMs) at various concentrations. TRAcP experiments were conducted to examine BQTL's impact on osteoclast differentiation. RT-PCR and Western blot analyses were utilized to evaluate the relative expression levels of osteoclast-specific genes and proteins under BQTL stimulation. Finally, in vivo experiments were performed using an osteoporosis model to further validate the in vitro findings. This study revealed that BQTL suppressed receptor activator of NF-κB ligand (RANKL)-induced osteoclastogenesis and osteoclast resorption activity in vitro in a dose-dependent manner without observable cytotoxicity. The inhibitory effects of BQTL on osteoclast formation and function were attributed to the downregulation of NFATc1 and c-fos activity, primarily through attenuation of the MAPK, NF-κB, and Calcineurin signaling pathways. BQTL's inhibitory capacity was further examined in vivo using an ovariectomized (OVX) rat model, demonstrating a strong protective effect against bone loss. BQTL may serve as an effective therapeutic TCM for the treatment of postmenopausal osteoporosis and the alleviation of bone loss induced by estrogen deficiency and related conditions.
Animals ; NFATC Transcription Factors/genetics* ; Drugs, Chinese Herbal/pharmacology* ; Ovariectomy ; Osteoclasts/metabolism* ; Female ; Osteogenesis/drug effects* ; Rats, Sprague-Dawley ; Rats ; NF-kappa B/genetics* ; Osteoporosis/genetics* ; Signal Transduction/drug effects* ; Bone Resorption/genetics* ; Cell Differentiation/drug effects* ; Humans ; RANK Ligand/metabolism* ; Mitogen-Activated Protein Kinases/genetics* ; Transcription Factors

BACKGROUND:Lumbar decompression and fusion is the most effective surgical method to treat lumbar degenerative spondylolisthesis.In recent years,the sagittal balance of the spine has been widely considered the key factor to adjust the outcome of spinal surgery,and factors that can affect the sagittal balance of the spine indirectly affect the surgical effect and prognosis. OBJECTIVE:To summarize the risk factors that can affect the sagittal balance of the spine during decompression and fusion due to lumbar spondylolisthesis,and play a certain reference role in the surgical treatment of lumbar spondylolisthesis. METHODS:With"lumbar spondylolisthesis,the sagittal plane balance of the spine,surgical treatment,risk factors"as the Chinese search terms,and"lumbar spondylolisthesis,sagittal balance,risk factor"as the English search terms,PubMed,Springer,ScienceDirect,Wanfang,VIP and CNKI were searched respectively.The focus of the search was from January 2010 to January 2023,and a few classic long-term articles were included.Preliminary screening was conducted by reading the title and abstract.After excluding repetitive research in Chinese and English literature,low-quality journals and irrelevant literature,67 articles were finally included for review. RESULTS AND CONCLUSION:(1)Degenerative lumbar spondylolisthesis is an important factor causing spinal canal stenosis and lumbar instability,and is the main cause of low back pain and intermittent claudication.Lumbar decompression,fusion and internal fixation is an effective way to treat degenerative lumbar spondylolisthesis.(2)In the past,the treatment of degenerative lumbar spondylolisthesis with decompression,fusion and fixation focused on thorough exploration and release of nerve roots,reduction of spondylolisthesis and solid internal fixation,but less attention was paid to the balance of sagittal plane of the spine.(3)With the popularization of lumbar decompression,fusion and internal fixation,complications caused by the sagittal imbalance of the spine gradually increased,resulting in poor prognosis of patients and even increased risk of secondary surgery.(4)Previous studies have only discussed the correlation between lumbar sagittal plane parameters and spinal sagittal plane balance,but have not in-depth studied the relevant factors causing spinal sagittal plane imbalance.(5)Our results show that open lumbar fixation and fusion,complete reduction of spondylolisthesis,selection of thicker pedicle screws,selection of larger fusion cages,and autologous bone transplantation are beneficial factors for maintaining sagittal balance.The higher the number of fusion segments,the higher the level of fusion segments is,which is a risk factor for sagittal plane imbalance.

BACKGROUND:Percutaneous vertebroplasty is the most widely used method for the treatment of osteoporotic vertebral compression fractures,and most studies have concluded that percutaneous vertebroplasty increases the probability of adjacent vertebral secondary compression fractures in patients with osteoporotic vertebral compression fractures.However,controversy remains regarding the risk factors associated with adjacent vertebral re-fracture caused after percutaneous vertebroplasty. OBJECTIVE:To summarize the influencing factors of adjacent vertebral compression fractures after percutaneous vertebroplasty in patients with osteoporotic vertebral compression fractures,in order to provide a certain reference for reducing the risk of its occurrence as well as formulating the corresponding treatment plan. METHODS:Using"osteoporosis,fracture,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as the Chinese search terms,"osteoporosis,osteoporotic vertebral compression fractures,percutaneous vertebroplasty,adjacent vertebral compression fractures,risk factors"as English search terms,computerized searches were conducted on CNKI,Wanfang Medical Network,VIP,PubMed,Springer,ScienceDirect,and Elsevier databases.The search timeframe focuses on January 2018 through September 2023,with the inclusion of a few classic forward literature.The literature was screened by reading the titles and abstracts,and 83 papers were finally included in the review. RESULTS AND CONCLUSION:(1)Osteoporotic vertebral compression fractures are one of the most common complications of osteoporosis,placing elderly patients at a significant risk of disability and death.Percutaneous vertebroplasty is a practical and effective treatment for osteoporotic vertebral compression fractures.(2)With the popularity of percutaneous vertebroplasty,its secondary vertebral compression fractures have gradually increased,with adjacent vertebral compression fractures being the most common.(3)Previous studies have only discussed the effects of factors such as bone mineral density,multiple vertebral fractures,body mass index,age,sex,amount of bone cement,cement leakage,and anti-osteoporosis treatment on secondary compression fractures of adjacent vertebrae after percutaneous vertebroplasty,and summarized the number of vertebral fractures,timing of the operation,surgical approach,cement material,diffuse distribution of bone cement,recovery height of the injured vertebrae,and wearing of a support after surgery,which is not yet comprehensive.The analysis of the specific mechanisms of risk factor-induced adjacent vertebral fractures is relatively rare.(4)The results of the article showed that low bone mineral density,advanced age,perimenopausal women,multiple vertebral fractures,excessive recovery of the height of the injured vertebrae,cement leakage,comorbid underlying diseases,and poor lifestyle habits were the risk factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty,and that maintaining a normal body mass index,early surgery,bilateral percutaneous vertebroplasty,use of a new type of cement material,an appropriate volume of bone cement injection and uniform cement dispersion,regular anti-osteoporosis treatment,and postoperative brace wearing are protective factors for secondary adjacent vertebral compression fractures after percutaneous vertebroplasty.

Posterior lumbar interbody fusion (PLIF) is currently well accepted and considered as safe and effective spinal surgical technique for the treatment of degenerative lumbar spondylolisthesis, and is widely used in clinical practice. But there are still some cases with poor overall postoperative efficacy. In order to discuss the relevant factors and mechanisms affecting the clinical outcomes of PLIF surgery, many scholars have conducted a large number of clinical studies over the years. However, due to the different methods and the factors among included studies, the conclusions reached were also different or even completely opposed. This article reviews the research results of various influencing factors of the postoperative efficacy of PLIF in recent years, and analyzes age, gender, body mass index, bone mineral density, duration of preoperative symptoms, whether the sliding vertebral body is reduced, spine-pelvic sagittal parameters (including lumbar lordosis, sacral slope, pelvic tilt, pelvic incidence, pelvic incidence-lumbar lordosis and Roussouly classification) and other factors (underlying diseases and poor lifestyle habits) on the clinical effects of PLIF, in order to provide a reference for further improving the postoperative quality of life and functional recovery of patients with degenerative lumbar spondylolisthesis.

The orbitofrontal cortex (ORB), a region crucial for stimulus-reward association, decision-making, and flexible behaviors, extensively connects with other brain areas. However, brain-wide inputs to projection-defined ORB neurons and the distribution of inhibitory neurons postsynaptic to neurons in specific ORB subregions remain poorly characterized. Here we mapped the inputs of five types of projection-specific ORB neurons and ORB outputs to two types of inhibitory neurons. We found that different projection-defined ORB neurons received inputs from similar cortical and thalamic regions, albeit with quantitative variations, particularly in somatomotor areas and medial groups of the dorsal thalamus. By counting parvalbumin (PV) or somatostatin (SST) interneurons innervated by neurons in specific ORB subregions, we found a higher fraction of PV neurons in sensory cortices and a higher fraction of SST neurons in subcortical regions targeted by medial ORB neurons. These results provide insights into understanding and investigating the function of specific ORB neurons.
Animals ; Neurons/physiology* ; Mice ; Prefrontal Cortex/cytology* ; Parvalbumins/metabolism* ; Brain Mapping/methods* ; Neural Pathways/physiology* ; Somatostatin/metabolism* ; Male ; Interneurons/physiology* ; Mice, Inbred C57BL ; Thalamus/physiology* ; Mice, Transgenic

Interval timing is involved in a variety of cognitive behaviors such as associative learning and decision-making. While it has been shown that time estimation is adaptive to the temporal context, it remains unclear how interval timing behavior is influenced by recent trial history. Here we found that, in mice trained to perform a licking-based interval timing task, a decrease of inter-reinforcement interval in the previous trial rapidly shifted the time of anticipatory licking earlier. Optogenetic inactivation of the anterior lateral motor cortex (ALM), but not the medial prefrontal cortex, for a short time before reward delivery caused a decrease in the peak time of anticipatory licking in the next trial. Electrophysiological recordings from the ALM showed that the response profiles preceded by short and long inter-reinforcement intervals exhibited task-engagement-dependent temporal scaling. Thus, interval timing is adaptive to recent experience of the temporal interval, and ALM activity during time estimation reflects recent experience of interval.
Animals ; Mice ; Reward ; Time Factors ; Cognition ; Learning ; Decision Making ; Reinforcement, Psychology

Objective:To investigate the safety and outcome of a new method to repair the morphological defects after epicanthic fold surgery.Methods:Retrospective analysis was commenced for patients from September 2020 to January 2022 at Chengdu Qingyang Yayuan Medical Beauty Clinic who received new methods to repair postoperative dysplasia of epicanthus. This method was improved on the basis of V-Y advancing skin flap. A flipped skin flap was made from the normal skin of the lower eyelid as the "posterior flap", which was diagonally crossed and covers the front of the inner canthus angle. Then, a skin muscle sliding flap was made from the upper eyelid as the "anterior flap", covering the surface of the posterior flap to form a new "epicanthus". Follow up were focused on the incidence of postoperative complications, patient satisfaction, and improvement in indicators such as eye spacing, inner canthus scars, lacrimal caruncle exposure, and inner canthus symmetry. Patient satisfaction was divided into three levels: satisfaction, average effect, and dissatisfaction. The evaluation of epicanthus scars was referred to the observer scar assessment scale (OSAS), which evaluates scar width, color, protrusion, and surface roughness in four aspects. The scores of the last three are all 1-10 points. Higher the score, the more severe the scar was. If the exposure of the lacrimal caruncle was less than 70%, it was considered undercorrected, 70%-80% is considered appropriate, and >80% is considered overcorrected. The symmetry of the inner canthus can be divided into three levels: symmetrical, basic symmetrical, and asymmetrical. Normally distributed econometric data were expressed as Mean±SD and analyzed by paired t-test. Results:A total of 34 patients (68 eyes) were included, including 4 males and 30 females, aged 20-38 years, with an average age of 27.4 years. Among them, there were 8 cases of inner canthal scars, 4 cases of excessive exposure of lacrimal caruncle, and 22 cases of inner canthal scars combined with excessive exposure of lacrimal caruncle. Postoperative follow-up was 6-12 months, with an average of 9.3 months. 28 cases (82.4%) were satisfied with the surgical results, 4 cases (11.7%) reported average results, and 2 cases (5.9%) were dissatisfied. After surgery, the distance between the eyes significantly increased compared to before surgery [(36.9±1.5) mm vs. (33.2±1.1) mm, P<0.05], the width of the inner canthus scar [(2.3±0.3) mm vs. (4.6±0.4) mm, P<0.05], and the surface roughness [(1.8±0.3) points vs. (3.3±0.5) points, P<0.05] were all significantly improved. Postoperative exposure of lacrimal caruncle: 5 eyes (7.4%) were undercorrected, 60 eyes (88.2%) were appropriate, and 3 eyes (4.4%) were overcorrected. Postoperative symmetry of inner canthus: 33 cases (97.1%) had symmetrical or almost symmetrical inner canthus, and 1 case (2.9%) had asymmetric inner canthus. All patients did not experience infection, delayed healing, or flap necrosis. Conclusion:This method of repair the defects after epicanthic fold correction is safe and effective, with high postoperative satisfaction, and can be widely used in clinical practice.

Objective:To investigate the safety and outcome of a new method to repair the morphological defects after epicanthic fold surgery.Methods:Retrospective analysis was commenced for patients from September 2020 to January 2022 at Chengdu Qingyang Yayuan Medical Beauty Clinic who received new methods to repair postoperative dysplasia of epicanthus. This method was improved on the basis of V-Y advancing skin flap. A flipped skin flap was made from the normal skin of the lower eyelid as the "posterior flap", which was diagonally crossed and covers the front of the inner canthus angle. Then, a skin muscle sliding flap was made from the upper eyelid as the "anterior flap", covering the surface of the posterior flap to form a new "epicanthus". Follow up were focused on the incidence of postoperative complications, patient satisfaction, and improvement in indicators such as eye spacing, inner canthus scars, lacrimal caruncle exposure, and inner canthus symmetry. Patient satisfaction was divided into three levels: satisfaction, average effect, and dissatisfaction. The evaluation of epicanthus scars was referred to the observer scar assessment scale (OSAS), which evaluates scar width, color, protrusion, and surface roughness in four aspects. The scores of the last three are all 1-10 points. Higher the score, the more severe the scar was. If the exposure of the lacrimal caruncle was less than 70%, it was considered undercorrected, 70%-80% is considered appropriate, and >80% is considered overcorrected. The symmetry of the inner canthus can be divided into three levels: symmetrical, basic symmetrical, and asymmetrical. Normally distributed econometric data were expressed as Mean±SD and analyzed by paired t-test. Results:A total of 34 patients (68 eyes) were included, including 4 males and 30 females, aged 20-38 years, with an average age of 27.4 years. Among them, there were 8 cases of inner canthal scars, 4 cases of excessive exposure of lacrimal caruncle, and 22 cases of inner canthal scars combined with excessive exposure of lacrimal caruncle. Postoperative follow-up was 6-12 months, with an average of 9.3 months. 28 cases (82.4%) were satisfied with the surgical results, 4 cases (11.7%) reported average results, and 2 cases (5.9%) were dissatisfied. After surgery, the distance between the eyes significantly increased compared to before surgery [(36.9±1.5) mm vs. (33.2±1.1) mm, P<0.05], the width of the inner canthus scar [(2.3±0.3) mm vs. (4.6±0.4) mm, P<0.05], and the surface roughness [(1.8±0.3) points vs. (3.3±0.5) points, P<0.05] were all significantly improved. Postoperative exposure of lacrimal caruncle: 5 eyes (7.4%) were undercorrected, 60 eyes (88.2%) were appropriate, and 3 eyes (4.4%) were overcorrected. Postoperative symmetry of inner canthus: 33 cases (97.1%) had symmetrical or almost symmetrical inner canthus, and 1 case (2.9%) had asymmetric inner canthus. All patients did not experience infection, delayed healing, or flap necrosis. Conclusion:This method of repair the defects after epicanthic fold correction is safe and effective, with high postoperative satisfaction, and can be widely used in clinical practice.

OBJECTIVE: To evaluate the application of surgical strategies for the treatment of cervical ossification of the posterior longitudinal ligament (OPLL) involving the C ₂ segment. METHODS: The literature about the surgery for cervical OPLL involving C ₂ segment was reviewed, and the indications, advantages, and disadvantages of surgery were summarized. RESULTS: For cervical OPLL involving the C ₂ segments, laminectomy is suitable for patients with OPLL involving multiple segments, often combined with screw fixation, and has the advantages of adequate decompression and restoration of cervical curvature, with the disadvantages of loss of cervical fixed segmental mobility. Canal-expansive laminoplasty is suitable for patients with positive K-line and has the advantages of simple operation and preservation of cervical segmental mobility, and the disadvantages include progression of ossification, axial symptoms, and fracture of the portal axis. Dome-like laminoplasty is suitable for patients without kyphosis/cervical instability and with negative R-line, and can reduce the occurrence of axial symptoms, with the disadvantage of limited decompression. The Shelter technique is suitable for patients with single/double segments and canal encroachment >50% and allows for direct decompression, but is technically demanding and involves risk of dural tear and nerve injury. Double-dome laminoplasty is suitable for patients without kyphosis/cervical instability. Its advantages are the reduction of damage to the cervical semispinal muscles and attachment points and maintenance of cervical curvature, but there is progress in postoperative ossification. CONCLUSION OPLL involving the C ₂ segment is a complex subtype of cervical OPLL, which is mainly treated through posterior surgery. However, the degree of spinal cord floatation is limited, and with the progress of ossification, the long-term effectiveness is poor. More research is needed to address the etiology of OPLL and to establish a systematic treatment strategy for cervical OPLL involving the C ₂ segment.
Humans ; Longitudinal Ligaments/surgery* ; Ossification of Posterior Longitudinal Ligament/surgery* ; Treatment Outcome ; Osteogenesis ; Decompression, Surgical/methods* ; Cervical Vertebrae/surgery* ; Laminoplasty/methods* ; Kyphosis/surgery* ; Retrospective Studies

Objective:To assess the ultrasonographic features and potential diseases of fetal abnormal sylvian fissure(SF), and to explore the value of whole-genome sequencing (WGS) in prenatal detection.Methods:A total of 28 fetuses with a sonographic diagnosis of abnormal SF in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University between October 2018 and October 2020 were prospectively included. The fetal brain was evaluated by neuroultrasound and intrauterine MRI in detail. Amniotic fluid/cord blood obtained by amniocentesis or tissue samples from umbilical cord after birth were collected for WGS. Pregnancy outcomes and postnatal MRI were recorded, and neurodevelopment of live-born infants was followed up for more than 24 months after delivery.Results:During the study period, 28 fetuses with abnormal SF were identified, with a gestational age of 21.3-30.0 (24.8±2.0) weeks. Abnormal SF presented in MCD ( n=15, 53.6%), chromosomal anomalies ( n=3, 10.7%) or single-gene genetic syndromes ( n=3, 10.7%) with the affected fetuses showing developmental delay, hydrocephalus or leukomalacia ( n=4, 14.2%), corpus callosal agenesis with large interhemispheric cysts ( n=1, 3.6%), benign subarachnoid space enlargement with arachnoid cysts ( n=1, 3.6%), and multiple malformations ( n=1, 3.6%). Among the 15 cases with MCD, the most common pathology was lissencephaly/pachygyria, followed by schizencephaly, severe microcephaly, hemimegalencephaly with paraventricular heterotopia, and polymicrogyria. Abnormal SF presented bilaterally in 23 fetuses and unilaterally in 5. All cases were categorized into six types depending on SF morphology in the transthalamic section: no plateau-like or a small insula, linear type, irregular corrugated SF, Z-shaped, and cyst occupying type. In addition to abnormal SF, associated anomalies or mild variations were identified in all fetuses. There were 17 cases underwent intrauterine MRI, and 13 cases underwent postnatal MRI examination.And 25 pregnancies were terminated; 3 were born alive, and 2 had typical syndromic changes with poor neurodevelopmental prognosis. A related pathogenic genetic variant was detected in 57.1% (16/28) fetus, and the incidence of single nucleotide variants(SNVs) was 42.9% (12/28), among which de novo SNVs accounted for 91.7% (11/12). Conclusions:Fetal abnormal SF could be classified based on the ultrasonographic features of transthalamic section. Fetal abnormal SF may indicate MCD, some chromosomal abnormalities or single-gene genetic syndromes that may lead to poor neurodevelopmental outcomes, and may be affected by extra-cortical factors. It is suggested to carry out targeted prenatal genetic diagnosis for fetuses with abnormal SF.