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The natural course of syringomyelia is unpredictable. Only a few cases of adults with spontaneous resolution of syringomyelia associated with Chiari malformation type I (CM-I) have been reported. The timing of surgical intervention for syringomyelia remains controversial. The present report has documented a case with the longest medical history of syringomyelia reported, the associated imaging findings over 16 years, the mild symptom progression after the spontaneous resolution of syringomyelia, and a review of the relevant reported data. The natural history of our patient provides a unique view regarding the factors that might lead to the development and spontaneous resolution of syringomyelia. We present the case of a 36-year-old woman who had been monitored for 16 years for mild symptomatic CM-I and syringomyelia. After regular follow-up examinations for the initial 10 years, magnetic resonance imaging revealed partial spontaneous resolution of the syringomyelia and unchanged symptoms. However, after 6 additional years of follow-up examinations, her symptoms had mildly progressed, and the size of the syringomyelia had obviously decreased. The findings from our patient suggest that the natural course of mild symptomatic CM-I in adult patients will be benign and nonprogressive. Patients will commonly present with very few or mild symptoms, despite the presence of a large syrinx. It would be reasonable to observe patients with similar mild symptoms and syringomyelia. Surgery will be indicated by the type, severity, and duration of symptoms at the first clinical visit. Periodic follow-up examinations are also essential after spontaneous resolution because the pathophysiology of syringomyelia is incompletely understood and recurrence possible. [ABSTRACT FROM AUTHOR]

Abstract: The continental slopes of the South China Sea (SCS), the largest marginal sea on the continental shelf of Southeast Asia, are among the most significant shelf‐margin basins in the world because of their abundant petroleum resources and a developmental history related to sea floor spreading since Late Oligocene time. Based on integrated analyses of seismic, well‐logging and core data, we systematically document the sequence architecture and depositional evolution of the northern continental slope of the SCS and reveal its responses to tectonism, sea‐level change and sediment supply. The infill of this shelf‐margin basin can be divided into seven composite sequences (CS1–CS7) that are bounded by regional unconformities. Composite sequences CS3 to CS7 have formed since Late Oligocene time, and each of them generally reflects a regional transgressive–regressive cycle. These large cycles can be further divided into 20 sequences that are defined by local unconformities or transgressive–regressive boundaries. Depositional–geomorphological systems represented on the continental slope mainly include shelf‐edge deltas, prodelta‐slope fans, clinoforms of the shelf‐margin slope, unidirectionally migrating slope channels, incised slope valleys, muddy slope fans, slope slump‐debris‐flow complexes and large‐scale soft‐sediment deformation of bedding. Changing sea levels, reflected by evidence from sequence architecture in the study area, are generally comparable with those of the Haq (1987) global sea level curve, whereas the regional transgressions and regressions were apparently controlled by tectonic uplift and subsidence. Composite sequences CS3 and CS4 formed from Late Oligocene to Middle Miocene time and represent continental‐slope deposition during a time of northwest‐northeast seafloor spreading and subsequent development of sub‐basins in the southwest‐central SCS. The development of composite sequences CS5 to CS7 after Middle Miocene time was obviously influenced by the Dongsha Movement during convergence between the SCS and Philippine Sea plates. Climatic variations and monsoon intensification may have enhanced sediment supply during Late Oligocene‒Early Miocene (25–21 Ma) and Late Pliocene‒Pleistocene (3–0.8 Ma) times. This study indicates that shelf‐edge delta and associated slope fan systems are the most important oil/gas‐bearing reservoirs in the SCS continental‐slope area. [ABSTRACT FROM AUTHOR]

Peripheral nerve stimulation is an effective neuromodulation method in patients with lower extremity movement disorders caused by stroke, spinal cord injury, or other diseases. However, most current studies on rehabilitation using sciatic nerve stimulation focus solely on ankle motor regulation through stimulation of common peroneal and tibial nerves. Using the electrical nerve stimulation method, we here achieved muscle control via different sciatic nerve branches to facilitate the regulation of lower limb movements during stepping and standing. A map of relationships between muscles and nerve segments was established to artificially activate specific nerve fibers with the biomimetic stimulation waveform. Then, characteristic curves depicting the relationship between neural electrical stimulation intensity and joint control were established. Finally, by testing the selected stimulation parameters in anesthetized rats, we confirmed that single-cathode extraneural electrical stimulation could activate combined movements to promote lower limb movements. Thus, this method is effective and reliable for use in treatment for improving and rehabilitating lower limb motor dysfunction., Competing Interests: Competing interests: The authors declare that they have no competing interests., (Copyright © 2024 Pengcheng Xi et al.)

Spinal cord stimulation (SCS) can effectively restore locomotor function after spinal cord injury (SCI). Because the motor neurons are the final unit to execute sensorimotor behaviors, directly studying the electrical responses of motor neurons with SCS can help us understand the underlying logic of spinal motor modulation. To simultaneously record diverse stimulus characteristics and cellular responses, a patch-clamp is a good method to study the electrophysiological characteristics at a single-cell scale. However, there are still some complex difficulties in achieving this goal, including maintaining cell viability, quickly separating the spinal cord from the bony structure, and using the SCS to successfully induce action potentials. Here, we present a detailed protocol using patch-clamp to study the electrical responses of motor neurons to SCS with high spatiotemporal resolution, which can help researcher improve their skills in separating the spinal cord and maintaining the cell viability at the same time to smoothly study the electrical mechanism of SCS on motor neuron and avoid unnecessary trial and mistake.

Background: Selective nerve root block has been widely used to treat degenerative disc disease (DDD), but no detailed research data is provided to compare the efficacy of epidural injection of anesthetics with or without steroids on the DDD treatment., Objectives: This study aimed to  provide the first comparison of steroids + local anesthetic (LA) or LA alone for the treatment of DDD., Study Design: We systematically searched PubMed, Medline, Embase, and Cochrane. A systemic review and meta-analysis were performed to assess the clinical efficacy of both the steroids + LA group and the LA alone group, and subgroup analysis was also adopted., Setting: A systematic review and meta-analysis using a random effects model on randomized controlled studies (RCTs)., Methods: After reviewing titles, abstracts, risk of bias, and full texts of 15,889 studies that were chosen following removal of duplicates after the initial database search, finally, 19 RCTs were included. Pain rating, functional score, follow-up period, and other-related data were extracted from these included works, and the effect size and statistical significance were calculated by the random effects model. The quality and level of the derived evidence were assessed by means of the  Grading of Recommendations Assessment, Development and Evaluation method., Results: In terms of the Numeric Rating Scale (NRS-11) and Oswestry Disability Index (ODI) at one year, the combination of steroids + LA was obviously superior to LA. Subgroup analysis suggested that the combination of steroids + LA was more effective than LA alone in regard to the ODI in the lumbar group within 2 years. The opioids intake of patients treated by LA alone was less than that of the steroids + LA group within 3 months, and LA alone was more effective in pain score reduction, with more than 50% within 6 months in the interlaminar injection group. However, the combination of steroids + LA was more effective when alleviating the NRS-11 within 18 months in the caudal injection group., Limitations: Firstly, this analysis was inconsistent in technique, dosage, injection frequency, and follow-up period of epidural injections. Such differences may compromise the reported efficacy. Secondly, adverse reactions arising out of the 2 groups were not examined in that the included RCTs did not provide the data. Thirdly, different injection methods would compromise the outcomes, and no subgroup analysis was performed on different injection methods. Finally, these included articles that were mainly sourced from Manchikanti's team, and thus biased to some extent., Conclusions: The addition of steroids to anesthetic injectates was associated with a better NRS-11 and ODI compared with LA alone within one year in patients with DDD. Furthermore, the improvement of the ODI was observed within 2 years in patients with lumbar DDD.

The leading causes of death in breast cancer patients are disease recurrence and metastasis. Growing evidence has suggested that metastasis possibly originates from cancer stem-like cells (CSCs). Previous studies indicated dopamine decreased CSC frequency through activating dopamine D 1 receptor pathway. Hence, this study explored the efficacy of two dopamine D 1 receptor agonists in lung metastasis of breast cancer and the preliminary mechanism. The two dopamine D 1 receptor agonists, fenoldopam (FEN) and l-stepholidine (l-SPD), performed well in decreasing lung metastasis in 4T1 breast cancer model. And the cGMP in the primary tumor was significantly elevated while cAMP mildly elevated in FEN and l-SPD dosing groups. CSC markers (CD44 + /CD24 - and ALDH + ) and MMP2 in 4T1 primary tumor were repressed after dopamine D 1 receptor agonist administration while E-cadherin up-regulated. FEN and l-SPD also inhibited cancer stemness and cell motility in vitro, and the inhibitory effects could be reversed by dopamine D 1 receptor antagonist SCH23390. Besides, FEN impacted the white blood cell increase caused by breast cancer disease showing decreased neutrophils but increased lymphocytes. Drug safety was verified in aspects of body weight, organ index and tissue section. In conclusion, dopamine D 1 receptor agonists FEN and l-SPD showed efficacy in inhibiting metastasis along with good safety in breast cancer, thus providing an alternative for anti-metastasis therapy in the future. Furthermore, this study also indicates that dopamine D 1 receptor may be a possible target for metastatic breast cancer treatment and even other cancers at a late stage., (Copyright © 2019 Elsevier B.V. All rights reserved.)