BACKGROUND:Currently,spinal endoscopic technology has become the mainstream technology in minimally invasive spinal surgery.The specifications of the instruments for different operating systems are different,and the choice of specific surgical protocols needs to be combined with the actual situation of the patient and the choice of the clinical surgeon. OBJECTIVE:To compare the early efficacy of percutaneous endoscopic interlaminar discectomy for L5-S1 disc herniation under the iLESSYS Delta System and Endo-Surgi Plus System. METHODS:Totally 80 patients with L5-S1 disc herniation were treated with percutaneous endoscopic interlaminar discectomy.Patients were divided into two groups based on the endoscopic system used.Among them,37 cases received the iLESSYS Delta System(Delta group)and 43 cases received the Endo-Surgi Plus System(Plus group).Patient demographic characteristics,perioperative indicators,and complications were analyzed between the two groups.Clinical outcomes were quantified using back and leg visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores at 1 day,1,3,and 6 months after surgery.Patient satisfaction was assessed according to modified MacNab criteria at final follow-up. RESULTS AND CONCLUSION:(1)The operative time and number of arthroplasties in the Plus group were less than those in the Delta group,and the differences were statistically significant(P<0.05).(2)Compared with the preoperative period,the visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in both groups improved at all follow-up time points,and the difference was statistically significant(P<0.001).(3)There was no statistically significant difference in the comparison of pain visual analog scale scores,Oswestry Disability Index,and Japanese Orthopaedic Association scores of patients in the two groups(P>0.05).(4)At 6-month follow-up after surgery,the MacNab standard excellent and good rates in the Delta group and Plus group were 81%and 79%,respectively,with no significant difference(P=0.823).(5)The incidence of complications was 3%in the Delta group and 2%in the Plus group,but there was no significant difference between the two groups(P=0.914).(6)It is concluded that both iLESSYS Delta and Endo-Surgi Plus surgical systems achieved satisfactory early clinical results in the treatment of lumbar disc herniation,with Endo-Surgi Plus surgical moulding being more efficient and safer.

Objective: To analyze the correlation between ABO blood group compatibility and the risk of early complications after liver transplantation, and to identify risk factors for clinical intervention. Methods: Clinical data of 404 liver transplant recipients and donors were collected. Based on donor-recipient ABO matching, patients were divided into three groups: ABO-Identical (ABO-Id, n=313), ABO-compatible (ABO-c, n=68), ABO-incompatible (ABO-i, n=23). Clinical data, early complications, and associated risk factors were compared. Results: Compared with the ABO-Id, ABO-c and ABO-i recipients were younger, had a higher proportion of primary biliary atresia, and more frequently received living-donor transplantation from relatives (P<0.05). Overall complication rates were: ABO-c 47.1% (32/68), ABO-i 43.5% (10/23), ABO-Id 39.3% (123/313), with no significant intergroup difference (P>0.05). Infection was the most common complication [ABO-c 30.9% (21/68), ABO-i 21.7% (5/23), ABO-Id 17.9% (56/313)]. No significant differences were found in infection, vascular/biliary or acute kidney injury/renal failure among the three groups (P>0.05). However, ABO-c group had significantly higher rates of ascites/abscess (20.6% vs 8.9%, P<0.05) and pleural effusion (14.7% vs 7.0%, P<0.05) than ABO-Id group. There was no significant difference in the incidence of complications and ABO blood group between ABO non-Identical (ABO-c and ABO-i) and Identical groups. Logistic regression analysis showed that the risk of ascites/abscess in ABO non-Identical was higher than that in ABO-Id liver transplantation (P<0.05), and the risk of ascites/abscess after ABO-c liver transplantation was 2.246 times higher than that of ABO-Id liver transplantation. The primary biliary atresia were a risk factor for postoperative ascites/abscess. Conclusion: Enhanced postoperative management is critical for ABO-nonidentical (especially ABO-compatible) recipients, and those with biliary atresia to reduce complication risks.

[This corrects the article DOI: 10.1016/j.jpha.2023.08.006.].

To effectively exploit the tumor microenvironment (TME), TME-responsive nanocarriers based on cascade reactions have received much attention. In this study, we designed a novel nanoparticle PB@SiO₂@MnO₂@P-Arg (PMP) to construct a cascade reaction nanoplatform. While using biosafety Prussian blue (PB) for photothermal therapy (PTT), this nanoplatform uses silica (SiO₂) as an intermediate layer to assemble Prussian blue and manganese dioxide (MnO₂) into a core-shell structure, which effectively enhances the response of the nanoplatform to TME and promotes the effect of chemodynamic therapy (CDT) resulting from glutathione (GSH) depletion and Fenton-like reaction. The released Mn²⁺ can also be used for magnetic resonance imaging (MRI). Through the cascade reaction, poly-l-arginine (P-Arg) coated on the surface of the nanoparticles can react with hydroxyl radical (•OH) obtained from the Fenton-like reaction to release nitric oxide (NO), which further reacts with O₂•^- to produce the more toxic peroxynitrite anion (ONOO^-). The photothermal effect of PB further enhances the effect of the cascade reaction while reducing the amount of heat required for treatment. In vitro and in vivo studies confirmed the antitumor effects of cascade reaction-based nanoplatforms in combined photothermal/chemodynamic/gas cancer therapies, providing new strategies for the design and fabrication of multifunctional nanoplatforms that integrate diagnostic and therapeutic functions, as well as the application of cascade reactions in multimodal synergistic therapy.

Glioma is the most common primary malignant tumor of the central nervous system in adults. Despite the standard treatment of surgery combined with radiotherapy and chemotherapy, the prognosis for high-grade glioma patients remains poor, highlighting the urgent need to further explore its pathogenesis and develop new therapeutic strategies. This article reviews the research progress in the field of glioma in China in 2024, covering tumorigenesis mechanisms, tumor immune microenvironment composition, advances in imaging techniques and novel imaging agents, improvements in surgical approaches, mechanisms of radio- and chemoresistance, and explorations of new therapeutic modalities. These studies provide a solid theoretical foundation for advancing clinical diagnosis and treatment of gliomas and may offer new opportunities to improve patient outcomes.

Depression's high recurrence rate and severe consequences pose significant challenges to public health.To address this issue effectively,this review explores the innovative application of wearable devices in monitoring and intervening in depression,surpassing the limitations of traditional subjective assessments and patient self-reports.The paper systematically analyzes recent studies utilizing wearable devices to monitor physiological and behavioral indicators of depression,categorizing them by different technological types and evaluating their practical effectiveness in early diagnosis and intervention.The findings indicate that wearable devices can continuously monitor physiological indicators and behavioral patterns related to depression,potentially enabling early detection of depressive episodes and supporting timely interventions.Despite challenges such as data privacy and user acceptance,wearable technology holds immense potential in enhancing clinical outcomes in depression treatment.

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Using big data and artificial intelligence to establish a multi-point monitoring, early warning, and disposal system to achieve early warning and intervention of infectious disease outbreaks is an important means of controlling the spread of the epidemic. Taking Xiaoshan district as an example, this study analyzes the monitoring contents, warning methods, and application effectiveness of the infectious disease monitoring, early warning and disposal system. Based on Xiaoshan′s health big data resources, the system starts with syndrome, disease diagnosis and etiology. Through advanced technologies such as artificial intelligence and block chain, it realizes early identification of infectious disease outbreaks, data fusion, multi-cross collaboration, and closed-loop management. It has improved the sensitivity of clustered outbreaks monitoring and the effectiveness of epidemic disposal and provided a reference for grassroots disease prevention and control departments to establish an infectious disease monitoring and early warning system.

Bacterial outer membrane vesicles (OMVs) are diminutive vesicles naturally released by Gram-negative bacteria. These vesicles possess distinctive characteristics that attract attention for their potential use in drug administration and immunotherapy in cancer treatment. Therapeutic medicines may be delivered via OMVs directly to the tumor sites, thereby minimizing exposure to healthy cells and lowering the risk of systemic toxicity. Furthermore, the activation of the immune system by OMVs has been demonstrated to facilitate the recognition and elimination of cancer cells, which makes them a desirable tool for immunotherapy. They can also be genetically modified to carry specific antigens, immunomodulatory compounds, and small interfering RNAs, enhancing the immune response to cancerous cells and silencing genes associated with disease progression. Combining OMVs with other cancer treatments like chemotherapy and radiation has shown promising synergistic effects. This review highlights the crucial role of bacterial OMVs in cancer, emphasizing their potential as vectors for novel cancer targeted therapies. As researchers delve deeper into the complexities of these vesicles and their interactions with tumors, there is a growing sense of optimism that this avenue of study will bring positive outcomes and renewed hope to cancer patients in the foreseeable future.

BACKGROUND:In recent years,with the development of 3D printing,surgical surgery has become personalized and accurate.3D printed guide template technique can realize preoperative planning and intraoperative navigation,making surgery more accurate.In clinical orthopedic surgery for moderate and severe stiff scoliosis,there is still a problem that the accuracy of screw placement is not high,resulting in screw loosening and even nerve complications.There are few studies on 3D printed guide template technique to guide screw placement in surgery for severe stiff scoliosis. OBJECTIVE:To evaluate the clinical effect of the 3D printed guide template technique combined with multiple posterior derotation in the treatment of severe rigid scoliosis. METHODS:The clinical data of six patients with severe scoliosis undergoing 3D printed guide template technique of pedicle screw combined with multiple posterior derotation were retrospectively analyzed.There were 3 males and 3 females,with a mean age of(18.17±3.49)years(range,15-23 years).The changes of parameters related to lateral bending were analyzed at postoperative 2 weeks and 18 months,and the results were obtained by statistical analysis. RESULTS AND CONCLUSION:(1)The operation time was 280-540 minutes(mean 340.83±102.20 minutes).The intraoperative blood loss was 1 000-4 000 mL(mean 2 000.00±1 073.70 mL).The fixed segments were 9-14 vertebral bodies(mean 11.83±1.72),and no screw loosening occurred during the operation.(2)All patients were followed up.At postoperative 2 weeks,the anteroposterior and lateral radiography of the whole spine showed that the cobb angle,the distance between the vertical line of C7 on the coronal plane and the median line of S1,the distance between the vertical line of C7 in the sagittal plane and the posterior edge of S1,apical vertebral translation,thoracic kyphosis,and lumbar lordosis were significantly corrected.The average correction rate of the cobb angle in the main curve was 62.22%.After 18 months of follow-up,there was no significant change in all parameters compared with 2 weeks after operation;the orthopedic effect was satisfactory,and there was no infection or internal fixation fracture.(3)There was one case of delayed wound healing;scar healing appeared after dressing change treatment;no neurological complications occurred.(4)The results show that the 3D print-guide template combined with multiple posterior rod derotation technique is safe and effective in the treatment of severe rigid scoliosis,and the correction effect is satisfactory.