BACKGROUND: Acellular tubular artery scaffolds offer structural support for vascular regeneration but are inherently limited by poor anticoagulant properties, which increases the risk of thrombus formation following implantation. This thrombogenicity remains a major obstacle to their clinical application, particularly in small-diameter vascular grafts. METHODS: To address this challenge, the present study investigates the use of the Layer-by-Layer (LbL) assembly technique for heparin immobilization under low-speed rotation. Utilizing a roller tube system, heparin was immobilized onto decellularized scaffolds through electrostatic interactions facilitated by a DHI-based linker. This low-speed rotation LbL approach enhanced the uniformity and stability of heparin deposition compared to traditional static methods. One, 4, 7, 10, 13 deposition cycles were performed to achieve optimal heparin loading, resulting in scaffolds capable of sustained heparin release over 28 days. RESULTS: The heparinized scaffolds exhibited an initial burst release (approximately 80%), followed by a sustained phase with 18.24% ± 0.242 remaining to support prolonged anticoagulant activity. Importantly, the modified scaffolds significantly reduced thrombus formation and exhibited minimal hemolytic activity, indicating improved hemocompatibility. In addition to their antithrombotic properties, the scaffolds also promoted endothelial cell adhesion, which is critical for restoring vascular integrity, regulating vascular tone, and maintaining long-term patency. CONCLUSION These findings highlight the efficacy of roller-assisted LbL heparinization as a practical and scalable strategy to enhance the blood compatibility of acellular vascular grafts. This method holds considerable promise for addressing thrombogenicity in vascular tissue engineering and advancing the clinical translation of bioengineered vascular constructs.

Objective: Unilateral biportal endoscopic (UBE) treatment for lumbar disc herniation (LDH) is an advanced surgical procedure that has recently gained popularity. Numerous reports from developed countries have demonstrated the effectiveness of this minimally invasive technique. We evaluated the initial outcomes of UBE at a healthcare facility with limited resources. Methods: Clinical and radiographic data of 82 patients with LDH treated between July 2022 and June 2023 using UBE discectomy techniques, including the ipsilateral interlaminar approach, contralateral sublaminar approach, and paraspinal approach, were reviewed. Outcomes were analyzed in terms of the modified MacNab criteria, Japanese Orthopaedic Association (JOA) score, and visual analogue scale (VAS), with a mean follow-up of 3.1 months. Results: At the final follow-up, the mean VAS for low back pain improved from 4.5±1.0 to 1.2±0.4 and the VAS for leg pain improved from 7.8±0.9 to 1.6±0.5. The mean JOA score improved from 13.5±2.4 to 24.2±2.1. The modified MacNab criteria were excellent in 56 patients (68.3%), good in 22 (26.9%), and fair in 4 (4.8%). In total, 106 levels of LDH were treated. L4–5 disc herniation was performed in 55 patients (51.9%), L5–S1 in 36 (34.0%), L3–4 in 8 (7.5%), L2–3 in 6 (5.7%), and L1–2 in 1 (0.9%). The ipsilateral interlaminar approach was performed in 93 patients (87.7%), the contralateral sublaminar approach in 7 (6.6%), and the paraspinal approach in 6 (5.7%). Operative time significantly improved after performing 20 cases. In the early stage (1–20 cases), the operation time per level was 102.0±28.2 min, while in the next stage (21–82 cases) it was 78.1±20.4 minutes. No serious complications, including cauda equine syndrome or root palsy, were observed. Three patients had dural tears (2.8%), and 1 had epidural hematoma (0.9%). Conclusion UBE discectomy may be performed safely and effectively for the treatment of LDH in limited-resource settings.

Background: Dengue virus infection is a major public health problem. A hypothesis put forward for severe dengue is the cytokine storm, a sudden increase in cytokines that induces vascular permeability. Previous studies and our recent meta-analysis showed that IL-6, IL-8, IFNγ, TNFα, VEGF-A and VCAM-1 are associated with dengue shock syndrome. Therefore, in this study we aim to validate the association of these cytokines with severe dengue. Methods & Findings: In a hospital based case control study in Vietnam, children with dengue fever, other febrile illness and healthy controls were recruited. Dengue virus infection was confirmed by several diagnostic tests. Multiplex Immunoassay using Luminex technology was used to measure cytokines simultaneously. A positive association with dengue shock syndrome was found for VCAM-1, whereas a negative association was found for IFNγ. Furthermore, the multivariate logistic analysis also showed that VCAM-1 and IFNγ were independently correlated with dengue shock syndrome. Conclusion: IFNγ and VCAM-1 were associated with dengue shock syndrome, although their role in the severe dengue pathogenesis remains unclear. Additional studies are required to further investigate the function of these cytokines in severe dengue.

Background: Dengue virus infection is a major public health problem. A hypothesis put forward for severe dengue is the cytokine storm, a sudden increase in cytokines that induces vascular permeability. Previous studies and our recent meta-analysis showed that IL-6, IL-8, IFNγ, TNFα, VEGF-A and VCAM-1 are associated with dengue shock syndrome. Therefore, in this study we aim to validate the association of these cytokines with severe dengue. Methods & Findings: In a hospital based-case control study in Vietnam, children with dengue fever, other febrile illness and healthy controls were recruited. Dengue virus infection was confirmed by several diagnostic tests. Multiplex immunoassay using Luminex technology was used to measure cytokines simultaneously. A positive association with dengue shock syndrome was found for VCAM-1, whereas a negative association was found for IFNγ. Furthermore, multivariate logistic analysis also showed that VCAM-1 and IFNγ were independently correlated with dengue shock syndrome. Conclusion: IFNγ and VCAM-1 were associated with dengue shock syndrome, although their role in the severe dengue pathogenesis remains unclear. Additional studies are required to shed further light on the function of these cytokines in severe dengue.