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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent for coronavirus 2019 (COVID-19) pneumonia. Little is known about the kinetics, tissue distribution, cross-reactivity, and neutralization antibody response in patients with COVID-19. Two groups of patients with RT-PCR-confirmed COVID-19 were enrolled in this study: 12 severely ill patients in intensive care units who needed mechanical ventilation and 11 mildly ill patients in isolation wards. Serial clinical samples were collected for laboratory detection. Results showed that most of the severely ill patients had viral shedding in a variety of tissues for 20-40 days after onset of disease (8/12, 66.7%), while the majority of mildly ill patients had viral shedding restricted to the respiratory tract and had no detectable virus RNA 10 days after onset (9/11, 81.8%). Mildly ill patients showed significantly lower IgM response compared with that of the severe group. IgG responses were detected in most patients in both the severe and mild groups at 9 days after onset, and remained at a high level throughout the study. Antibodies cross-reactive to SARS-CoV and SARS-CoV-2 were detected in patients with COVID-19 but not in patients with MERS. High levels of neutralizing antibodies were induced after about 10 days after onset in both severely and mildly ill patients which were higher in the severe group. SARS-CoV-2 pseudotype neutralization test and focus reduction neutralization test with authentic virus showed consistent results. Sera from patients with COVID-19 inhibited SARS-CoV-2 entry. Sera from convalescent patients with SARS or Middle East respiratory syndrome (MERS) did not. Anti-SARS-CoV-2 S and N IgG levels exhibited a moderate correlation with neutralization titers in patients' plasma. This study improves our understanding of immune response in humans after SARS-CoV-2 infection., Introduction Before November 2019, 6 coronaviruses (CoVs) were known to infect humans and cause respiratory disease: OC43, 229E, HKU1, and NL63, 4 community-acquired CoVs that are endemic in humans (1-4), [...]

This study aimed to determine the effect of topically applied Laminaria polysaccharide (LP) on skin aging. We applied ointment containing LP (10, 25, and 50 μg/g) or vitamin E (10 μg/g) to the dorsal skin of aging mice for 12 months and young control mice for 4 weeks. Electron microscopy analysis of skin samples revealed that LP increased dermal thickness and skin collagen content. Tissue inhibitor of metalloprotease- (TIMP-) 1 expression was upregulated while that of matrix metalloproteinase- (MMP-) 1 was downregulated in skin tissue of LP-treated as compared to untreated aging mice. Additionally, phosphorylation of c-Jun N-terminal kinase (JNK) and p38 was higher in aging skin than in young skin, while LP treatment suppressed phospho-JNK expression. LP application also enhanced the expression of antioxidative enzymes in skin tissue, causing a decrease in malondialdehyde levels and increases in superoxide dismutase, catalase, and glutathione peroxidase levels relative to those in untreated aging mice. These results indicate that LP inhibits MMP-1 expression by preventing oxidative stress and JNK phosphorylation, thereby delaying skin collagen breakdown during aging. [ABSTRACT FROM AUTHOR]

Purpose: Statins may have a protective effect against osteoarthritis (including knee osteoarthritis and hip osteoarthritis); however, the link between statins and osteoarthritis risk is incompletely established. The aim of this study was to explore the relationship between statins and osteoarthritis risk through Mendelian randomization analysis using pooled information from a large population-wide genome-wide association study (GWAS)., Methods: Statin-related single-nucleotide polymorphisms (SNPs) were obtained from FinnGen's latest 9th edition database, and data on osteoarthritis, knee osteoarthritis, and hip osteoarthritis were acquired from the IEU OpenGWAS, the UK Biobank, and Arthritis Research UK Osteoarthritis Genetics (ArcOGEN) database, respectively. The inverse-variance weighting method is an important analysis method to estimate the causal effect. Weighted median method, simple median method, weighted median estimator method, and MR-Egger regression were employed to supplement the explanation. Odds ratio and 95%CI were used to evaluate the causal relationship among statins and the osteoarthritis risk, osteoarthritis in the knee, and osteoarthritis in the hip. Second, sensitivity analysis was carried out to validate the reliability of the results. Cochran's Q test was employed to test heterogeneity, MR-Egger intercept was employed to test whether horizontal pleiotropy existed, and single-nucleotide polymorphisms with potential influence were determined by the one-method analysis., Results: (1) The results of the inverse variance weighting method showed Gene prediction indicated that statins were associated with osteoarthritis (OR = 0.998, 95% CI: 0.996-0.999, P = 0.01) and knee osteoarthritis (OR = 0.964, 95% CI: knee (0.940-0.989, P = 0.005) and hip osteoarthritis risk were associated (OR = 0.928, 95% CI: 0.901-0.955, P = 4.28 × 10 -7 ). (2) MR-Egger intercept analysis did not detect potential horizontal pleiotropy (osteoarthritis: P = 0.658; knee osteoarthritis: P = 0.600; and hip osteoarthritis: P = 0.141). (3) The findings provide evidence that statins reduce osteoarthritis risk, osteoarthritis in the knee, and osteoarthritis in the hip, as described in observational studies, and the specific mechanisms by which statins treat osteoarthritis require further investigation., Conclusion: The results of this study, at the genetic level, reveal a negative causal relationship between statins and osteoarthritis, and this causal relationship is also present in knee and hip osteoarthritis. This study provides evidence against the potential of statins in the treatment of osteoarthritis, prompting the clinical treatment of osteoarthritis to consider improving the start and compliance of statins in the future., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Sun, Xiong, Tan, Hu, Liu and Chen.)

Objective: To investigate the short-term effectiveness of three-dimensional (3D) printing personalized prosthesis in the treatment of giant cell tumor of bone around knee joint., Methods: A clinical data of 9 patients with giant cell tumor of bone around knee joints and met the inclusive criteria between May 2014 and August 2017 was retrospectively analysed. There were 4 males and 5 females, with an average age of 35.8 years (range, 24-50 years). The lesion located at the distal femur in 4 cases and at the proximal tibia in 5 cases. The disease duration was 5-25 months (mean, 12.9 months). According to Campanacci grading, there were 2 patients of grade Ⅰ and 7 of grade Ⅱ. The 3D printing personalized prosthesis was designed based on the CT scanning and 3D reconstruction prepared before operation. All patients were treated with the tumor resection and 3D printing personalized prosthesis reconstruction. The radiological examination was taken to observe the tumor recurrence and the Musculoskeletal Tumor Society 1993 (MSTS93) score was used to evaluate the knee function., Results: All operations were successful and all incisions healed by first intention without early complications. All patients were followed up 24-40 months (mean, 31.2 months). At last follow-up, no complication such as pain, pathological fracture, prosthesis loosening, or tumor recurrence occurred. The MSTS93 score was 20-29 (mean, 24.7). The knee function was rated as excellent in 6 cases and good in 3 cases, with the excellent and good rate of 100%., Conclusion: For giant cell tumor of bone around knee joint, 3D printing personalized prosthesis has the advantages of bio-fusion with host bone, mechanical stability, good joint function, and ideal short-term effectiveness. But the middle- and long-term effectiveness still need to be further observed.

Background: Neoplastic, traumatic, infectious, and degenerative pathologies affecting the thoracolumbar junction pose a unique challenge to spine surgeons. Posterior or anterior approaches have traditionally been utilized to treat these lesions. Although minimally invasive surgeries through a lateral approach to the thoracic or lumbar spine have gained popularity, lateral access to the thoracolumbar junction remains technically challenging due to the overlying diaphragm positioned at the interface of the peritoneum and pleura., Objective: To describe a mini-open lateral retropleural retroperitoneal approach for pathologies with spinal cord/cauda equina compression at the thoracolumbar junction., Methods: A mini-open lateral corpectomy is described in detail in a patient with an L1 metastatic tumor., Results: Satisfactory decompression and spinal column reconstruction were achieved. The patient obtained neural function recovery following the procedure with no intra- or postoperative complications., Conclusion: The morbidities associated with traditional posterior or anterior approaches to thoracolumbar junction pathologies have led to a growing interest in minimally invasive alternatives. The mini-open lateral approach allows for a safe and efficacious corpectomy and reconstruction for thoracolumbar junction pathologies. Thorough understanding of the anatomy, particularly of the diaphragm, is critical. This approach will have expanded roles in the management of patients with thoracolumbar neoplasms, fractures, infections, deformities, or degenerative diseases., (Copyright © 2019 by the Congress of Neurological Surgeons.)

Objective: To investigate the effectiveness of direct lateral interbody fusion (DLIF) for lumbar degenerative diseases., Methods: A retrospective study was done on 25 cases of lumbar degenerative diseases treated with DLIF between May 2013 and May 2014. There were 15 males and 10 females with an average age of 61.4 years (range, 36-78 years), including 14 cases of lumbar disc herniation, 2 cases of degenerative lumbar scoliosis, 3 cases of lumbar spondylolisthesis, and 6 cases of lumbar instability with spinal stenosis. The disease duration was 8 months to 20 years (mean, 5.7 years). The involved segments included L4, 5 in 10 cases, L3, 4 in 6 cases, L2, 3 in 2 cases, L2-4 in 2 cases, L3-5 in 3 cases, and L2-5 in 2 cases. The operation time, intraoperative bleeding volume, postoperative hospitalization time, and complications were recorded. The visual analogue scale (VAS) and Oswestry disability index (ODI) criteria were used to assess the effectiveness; X-ray film and CT were used to evaluate the bone fusion., Results: The mean operation time was 105?minutes (range, 85-155 minutes), and mean intraoperative bleeding volume was 158 mL (range, 80-300?mL). The postoperative hospitalization time was 2-5 days (mean, 3.2 days). All incisions healed by first intension. There was no complication of wound infection, vascular injuries, or intraoperative visceral injuries. All cases were followed up 24.6 months on average (range, 18-30 months). Four cases had iliopsoas weakness, 5 cases had iliopsoas weakness and anterior thigh hypoesthesia, which disappeared within 6 months after operation. No retrograde ejaculation, Cage displacement, or loosening was found after operation. Full bony fusion was observed in 20 segments and partial bony fusion in 12 segments. The mean bony fusion time was 10.8 months (mean, 6-18 months). The height of intervertebral space was significantly increased to (11.98±1.20)?mm at 2 days after operation and to (11.80±1.33) mm at last follow-up from preoperative (6.20±0.88) mm ( P < 0.05), but no significant difference was found between at 2 days and last follow-up (P > 0.05). At last follow-up, VAS score was significantly decreased to 3.43±0.53 from preoperative 8.26±0.49 ( t =26.275, P =0.000), and ODI was significantly decreased to 15.41%±3.91% from preoperative 40.80%±3.10% ( t =22.902, P =0.000)., Conclusions: DLIF is a safe and effective treatment for lumbar degenerative diseases, which has the advantages of less tissue damage, less blood loss, and fast rehabilitation.

Background: To introduce our experience of using the free neurovascular flap from great and second toe., Methods: Thirteen patients (fifteen fingers) sought surgical treatment for soft tissue defects of the hand at our medical institution between March 2006 and September 2009. In two patients, fibular side skin-nail flaps of great toe were applied to cover the dorsal defect of distal thumb. In twelve, the treatment was carried out for the pulp defect of finger with fibular side flap of great toe or tibial side flap of second toe. In one, the treatment was carried out for the defect of distal middle with composite flap with distal digital bone of second toe., Results: All flaps survived. The average subjective satisfaction score was 8.08 (range 4-10). Nine patients (69%) experienced cold intolerance, and 2 patients (15%) dysesthesia. The Semmes-Weinstein sensitivity score was between 3.47and 4.72 on the flap, and 0-4.18 on the donor site. The mean two-point discrimination was 6.8 mm (range 4-12). Grip strength was 10% less than in the unaffected hand. The proximal interphalangeal mobility loss was less than 15 degrees., Conclusions: Our results indicated that these free flaps from toe are useful for patients with a small soft-tissue defect in hand.