Objective To evaluate the efficacy and safety of transforaminal lumbar interbody fusion(TLIF)and oblique lateral interbody fusion(OLIF)combined with posterior pedicle screw fixation in treating degenerative lumbar spondylolisthesis.Methods This retrospective analysis included 65 patients with degenerative lumbar spondylolisthesis treated at the Second Affiliated Hospital of Xi'an Medical University's Department of Spine Surgery from January 2021 to February 2023.Patients were divided into two groups based on the surgical method:30 patients underwent OLIF combined with posterior pedicle screw fixation,and 35 patients underwent TLIF combined with posterior pedicle screw fixation.Perioperative outcomes(surgical time,intraoperative blood loss,etc.)were assessed,along with pre-and post-operative evaluations using the Visual Analog Scale(VAS)for back pain,the Oswestry Disability Index(ODI),the Japanese Orthopaedic Association(JOA)score,the modified Macnab criteria,and radiological parameters(intervertebral disc height,foraminal height,lumbar lordosis angle,fusion segment lordosis angle,and vertebral slip rate).Results Both groups of patients completed a 6-month follow-up.The intraoperative blood loss in the OLIF group was(57.79±11.54)ml,and the postoperative hospital stay was(5.85±0.94)days,while in the TLIF group,the values were(150.57±29.68)ml and(6.76±1.13)days,respectively.The differences between the two groups were statistically significant(P＜0.05).The VAS score,ODI index,and JOA score on the 3rd postoperative day in the OLIF group were(1.50±0.61)points,(17.06±2.92)％,and(12.06±2.90)points,respectively,while in the TLIF group,they were(2.05±0.72)points,(26.41±3.38)％,and(10.24±2.68)points.The differences between the two groups were statistically significant(P＜0.05).The intervertebral space height and foramen height on the 3rd postoperative day in the OLIF group were(14.43±1.50)mm and(23.87±1.41)mm,respectively,while in the TLIF group,they were(13.66±1.12)mm and(23.14±1.39)mm.The differences between the two groups were statistically significant(P＜0.05).At 3 months postoperatively,the intervertebral space height and foramen height in the OLIF group were(13.42±1.41)mm and(23.34±1.33)mm,while in the TLIF group,they were(12.63±1.33)mm and(22.42±1.40)mm.The differences between the two groups were statistically significant(P＜0.05).However,there were no statistically significant differences between the two groups in VAS score,ODI index,JOA score,modified Macnab criteria score,intervertebral space height,or foramen height at 6 months postoperatively(all P＞0.05).From the 3rd postoperative day to 6 months,there were no statistically significant differences between the two groups in lumbar lordosis angle,segmental lordosis angle,or vertebral slippage rate(all P＞0.05).Conclusion OLIF combined with posterior pedicle screw fixation may provide better short-term perioperative outcomes,particularly in terms of intraoperative blood loss and postoperative pain control,compared to TLIF.However,there were no significant differences in short-term outcomes between the two methods.

Objective To evaluate the efficacy and safety of transforaminal lumbar interbody fusion(TLIF)and oblique lateral interbody fusion(OLIF)combined with posterior pedicle screw fixation in treating degenerative lumbar spondylolisthesis.Methods This retrospective analysis included 65 patients with degenerative lumbar spondylolisthesis treated at the Second Affiliated Hospital of Xi'an Medical University's Department of Spine Surgery from January 2021 to February 2023.Patients were divided into two groups based on the surgical method:30 patients underwent OLIF combined with posterior pedicle screw fixation,and 35 patients underwent TLIF combined with posterior pedicle screw fixation.Perioperative outcomes(surgical time,intraoperative blood loss,etc.)were assessed,along with pre-and post-operative evaluations using the Visual Analog Scale(VAS)for back pain,the Oswestry Disability Index(ODI),the Japanese Orthopaedic Association(JOA)score,the modified Macnab criteria,and radiological parameters(intervertebral disc height,foraminal height,lumbar lordosis angle,fusion segment lordosis angle,and vertebral slip rate).Results Both groups of patients completed a 6-month follow-up.The intraoperative blood loss in the OLIF group was(57.79±11.54)ml,and the postoperative hospital stay was(5.85±0.94)days,while in the TLIF group,the values were(150.57±29.68)ml and(6.76±1.13)days,respectively.The differences between the two groups were statistically significant(P＜0.05).The VAS score,ODI index,and JOA score on the 3rd postoperative day in the OLIF group were(1.50±0.61)points,(17.06±2.92)％,and(12.06±2.90)points,respectively,while in the TLIF group,they were(2.05±0.72)points,(26.41±3.38)％,and(10.24±2.68)points.The differences between the two groups were statistically significant(P＜0.05).The intervertebral space height and foramen height on the 3rd postoperative day in the OLIF group were(14.43±1.50)mm and(23.87±1.41)mm,respectively,while in the TLIF group,they were(13.66±1.12)mm and(23.14±1.39)mm.The differences between the two groups were statistically significant(P＜0.05).At 3 months postoperatively,the intervertebral space height and foramen height in the OLIF group were(13.42±1.41)mm and(23.34±1.33)mm,while in the TLIF group,they were(12.63±1.33)mm and(22.42±1.40)mm.The differences between the two groups were statistically significant(P＜0.05).However,there were no statistically significant differences between the two groups in VAS score,ODI index,JOA score,modified Macnab criteria score,intervertebral space height,or foramen height at 6 months postoperatively(all P＞0.05).From the 3rd postoperative day to 6 months,there were no statistically significant differences between the two groups in lumbar lordosis angle,segmental lordosis angle,or vertebral slippage rate(all P＞0.05).Conclusion OLIF combined with posterior pedicle screw fixation may provide better short-term perioperative outcomes,particularly in terms of intraoperative blood loss and postoperative pain control,compared to TLIF.However,there were no significant differences in short-term outcomes between the two methods.

A 79-year male presenting with abdominal distension, diarrhea, edema and oliguria, which soon progressed to acute renal failure, was admitted in Xiamen Branch of Zhongshan Hospital. The diagnosis of atypical hemolytic uremic syndrome (aHUS) was confirmed after admission. The hematological parameters and renal function were improved after prompt hemodialysis, plasma exchange, plasma and immunoglobulin transfusion. The patient experienced multiple recurrences of aHUS within 1 year, but achieved long-term remission with regular use of eculizumab. The reported cases of aHUS were searched from Wanfang Data Knowledge Service Platform and CNKI Database from January 2000 to January 2024, and 64 non-pregnant adult aHUS cases were retrieved from literature. The analysis of 65 cases showed a male-to-female ratio was 1.2∶1 and an average age of 34.8 years ranging from 20 to 86 years. Common clinical manifestations included fever (24 cases, 36.9%), renal dysfunction (27 cases, 41.5%), and neurological symptoms (15 cases, 23.1%). Additionally, 40 cases (61.5%)had concomitant hypertension. Among the 65 patients, 36 (55.4%) received hemodialysis, 31 (47.7%) underwent plasma exchange or plasma transfusion, 29 (44.6%) were treated with glucocorticoids, and only 3 (4.6%) were treated with eculizumab. In terms of treatment outcomes, 29.2% (19 cases)of the patients achieved complete renal function recovery, 46.2% (30 cases)developed end-stage renal disease, and 4 patients died. aHUS presents with a variety of clinical manifestations involving multiple systems. Plasma exchange remains the primary treatment method at present. Early and accurate diagnosis, prompt and effective treatment can significantly improve patient prognosis.

Objective To investigate the transmission of blaNDM-1 gene in carbapenem-resistant Citrobacter freundii. Methods A total of 18 strains of NDM-1-producing C. freundii were collected from the First Affiliated Hospital of Kunming Medical University during the period from June 2012 to October 2014. The isolates were identified and subjected to antimicrobial susceptibility testing with VITEK 2 System. Conjugation experiments, pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to determine the transferability of plasmids. Results The antibiotic susceptibility results showed that all the NDM-1-producing C. freundii isolates were resistant to penicillins, cephalosporins and carbapenems. All isolates exhibited different level resistance to other antibiotics. Conjugation experiments revealed that the plasmids harboring blaNDM-1 in 13 strains were transformed into E. coli 600, and exhibited carbapenem resistance. PFGE and Southern blot hybridization found that blaNDM-1 was located on a 33.3 kb plasmid in 16 isolates and on 33.3-54.7 kb plasmid in 2 isolates. Conclusions Our findings suggest that plasmids contribute to the horizontal dissemination of blaNDM-1 gene in carbapenemresistant C. freundii.

Background It is essential to measure and assess the parameters of ocular anterior segment for refractive surgery in myopic eyes.Some different imaging devices can be used for biometric measurement of ocular anterior segment,but which is more accurate and convenient is still under investigation.Objective This study was to compare the anterior segment parameters in myopic eyes measured by anterior segment optical coherence tomography (AS-OCT),Orbscan topography and ultrasonic pachymetry (US).Methods One hundred and forty eyes of 70 myopic subjects with the diopter of-0.75 to-10.25 D,who intended to receive corneal refractive surgery in the Second Affiliated Hospital of Zhejiang University School of Medicine from November 2011 to May 2012,were retrospectively analyzed.Central corneal thickness (CCT) was measured using AS-OCT,Orbscan Ⅱ and US,respectively,and anterior chamber depth (ACD) was measured by AS-OCT and Orbscan Ⅱ,and the angle to angle (ATA) distance and corneal white-to-white corneal distance (WTW) were measured by AS-OCT and Orbscan Ⅱ,respectively.The parameters from different apparatuses were statistically compared.Results The mean CCT were (516.57±30.25) μm in AS-OCT,(523.68±31.87) μm in US and (514.69±38.40) μm in Orbscan Ⅱ,without significant difference among them (F =2.775,P =0.063).Then the patients were divided into three groups based on the US measurement of CCT (＜500 μm group,500-569 μm group,and ≥ 570 μm group).In the ＜500 μm group,there was a significant difference in the CCT among the three methods (F =22.236,P =0.000),significant differences were found between AS-OCT and Orbscan Ⅱ,or Orbscan Ⅱ and US(both at P＜0.05).In the 500-569 μm group,there was no significant difference in the CCT among the three methods (F =3.011,P =0.051).In the ≥ 570 μm group,there was a significant difference in the CCT among the three methods (F =4.133,P =0.021),a significant difference was found between AS-OCT and US(P＜0.05),but there was no significant difference between AS-OCT and Orbscan Ⅱ (P＞0.05).The ACD values measured by AS-OCT was (3.83±0.21) mm,which was higher than (3.75 ± 0.21) mm by Orbscan Ⅱ,with a significant difference between them (t =-8.520,P =0.000).In addition,the ATA value by AS-OCT (12.43 mm±0.74 mm) was higher than the WTW value (11.42 mm±0.33 mm) by OrbscanⅡ,with a significant difference between them(t=-18.088,P=0.000).Conclusions AS-OCT,US and Orbscan Ⅱ can offer accurate CCT value,and they can provide references to one another before refractive surgery.However,the ACD,ATA and WTW values by AS-OCT and Orbscan]Ⅱ have large differences.

Nanobodies are derived from the variable domain of the heavy-chain antibodies (HCAbs) that occur naturally in the serum of Camelidae. They are the smallest antibody fragments capable to bind antigens. With the characteristics of their increased solubility, increased domain stabilities, nanomolar affinities, easy crossing the blood-brain barrier, easy generation, engineering, optimization and tailoring, easy humanization, nanobodies have extensive application prospects in diagnosis and detection. Although nanobody has demonstrated tremendous success, a number of practical challenges limit its broader applications in disease diagnosis and detection, including construction of a phage library and selection of nanobody fragments with high affinity and immunogold labeling technique. Here, we review several recent findings on the use of nanobodies in molecular diagnostics and suggest some practical strategies in resolving the current challenges in this attractive research area, particularly to optimize the affinity, solubility, humanization of nanobodies.
Humans ; Immunoglobulin Heavy Chains ; chemistry ; Single-Domain Antibodies ; chemistry ; drug effects

Objective　To study the plasticity of hippocampal formation in epilepsy.Methods　The optical density (OD)of synaptophysin positive immunoreactive product was examined by image pattern analysis instrument in hippocampus of pentylenetetrazol induced kindling epileptic rats. The examined areas included CA1,CA3 and the dentate gyrus.Results　The OD of synaptophysin positive immunoreactive product in hippocampal formation of kindling group was higher than the controls,especially in the mossy fiber layer of the area CA3 and the inner molecular layer in the dentate gyrus. Conclusion　The change of synaptophysin resulted from kindling, it also could result in the molecular elements of kindling maintenance.