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Endoscopic transforaminal decompression and interbody fusion (ETDIF) has been widely discussed due to its advantages of less trauma, less bleeding, quick recovery, high safety, and relatively fewer complications, as well as adverse factors such as incomplete decompression, steep learning curve, low fusion rate, and high radiation risk. Furthermore, this technique requires the use of supplemental posterior pedicle-screw. Decompression, interbody fusion and percutaneous pedicle screw implantation are not completed in a single channel. Percutaneous endoscopic transforaminal oblique fixation from posterior corner in lumbar spine (PETOFPC) overcomes the above limitations. The purpose of this study is to confirm the anatomical feasibility for PETOFPC in the posterolateral transforaminal approach and to provide anatomic data for the design of new integrated fixable and fused interbody cage.

Sixty volunteers (22 men and 38 women) who underwent lumbar CT scans were collected and sent to the GEAW4.4 workstation. As a cohort study, the distances and angles of each path in the sagittal and axial planes were measured and analyzed statistically.

The lengths of each path are not less than 40mm, and the longest can be up to 46mm. The paths in full-length group are about 5mm longer than that in medium group. PE (from point P to target E) path was the optimal path. The angles of each path were significantly different (P≤0.001), namely, a1 > a2 > a3, b1 > b2 > b3, and c1 < c2 < c3.

This study confirms anatomic feasibility for PETOFPC and provides anatomic data for the design of new integrated fixable and fused interbody cage. PETOFPC may be a very promising technology and have great clinical significance.

This study confirms anatomic feasibility for PETOFPC and provides anatomic data for the design of new integrated fixable and fused interbody cage. PETOFPC may be a very promising technology and have great clinical significance.

The upstream pressure for venous return (VR) is considered to be a combined conceptual blood pressure of the systemic vessels the mean systemic filling pressure (MSFP). The relevance of estimating the MSFP during dynamic changes of the circulation at the bedside is controversial. Herein, we studied the effect of high ventilatory pressures on the relationship between VR and central venous pressure (CVP).

In 9 healthy pigs under anaesthesia and mechanically ventilated, MSFP was estimated from extrapolated VR versus CVP relationships during inspiratory hold maneuvers (IHMs) with different levels of ventilatory pressure (Pvent). MSFP was measure 3 times per animal during euvolemia and hypovolemia. Hypovolemia was induced by bleeding with 10 mL/kg. The estimated MSFP values were compared to the blood pressure recording after induced ventricle fibrillation (i.e., mean circulatory filling pressure).

Our results revealed a strong linear correlation between VR and CVP [R2 of 0.92 (range, 0.67-0.99)], during IHMs with different levels of Pvent. Volume status significantly alters the resulting MSFP, 20±1 and 16±2 mmHg for euvolemia and hypovolemia respectively. This estimation of the MSFP was strongly correlated-but not interchangeable-to the blood pressure recording after induced ventricle fibrillation (R2=0.8 and P=0.045).

In conclusion, we showed a strong linear correlation between VR and CVP-when applying IHMs with high levels of Pvent-however the clinical applicability of this method to guide volume therapy in its current form is improbable.

In conclusion, we showed a strong linear correlation between VR and CVP-when applying IHMs with high levels of Pvent-however the clinical applicability of this method to guide volume therapy in its current form is improbable.

Papillary renal cell carcinoma type 2 (PRCC2) is refractory to systemic treatment and has a dismal prognosis. Previous studies showed that genetic alterations in PRCC2 were heterogeneous regardless of germline or somatic mutations. In this study, we aimed to perform precision treatment of PRCC2 based on genetic information.

We performed exome and genome sequencing of tumor tissues and matched normal samples. Based on sequencing data, we treated patients with metastatic PRCC2 using precision oncology.

Four patients underwent curative surgery of PRCC2 and three patients had metastatic PRCC2. Salubrinal in vivo All PRCC2 heterogeneously harbored own driver mutations. Two out of the three patients with metastatic disease had fumarate hydratase (

) germline mutations. One patient with a germline

mutation was diagnosed with hereditary leiomyomatosis RCC. He was treated with bevacizumab and erlotinib combination and showed a durable response. The other metastatic PRCC2 patient harboring a germline

mutation had an additional somatic

mutation and was durably controlled with pazopanib. Other metastatic PRCC2 patient with somatic

and

mutations had over 5 years of overall survival with axitinib treatment.

We performed precision systemic treatment based on genetic information. Genome sequencing could help identify candidates for targeted therapy in PRCC2, a genetically heterogeneous disease.

We performed precision systemic treatment based on genetic information. Genome sequencing could help identify candidates for targeted therapy in PRCC2, a genetically heterogeneous disease.

The objective of this study was to investigate the effects of glycaemic variability (GV) on intimal hyperplasia and plaque stability after coronary stenting via autophagy-mediated G3BP1/NLRP3 inflammasome signalling.

In the clinical study, between July 2017 and December 2017, 95 patients with acute myocardial infarction (AMI) and diabetes mellitus (DM) comorbidity received stent implantation. The patients were followed up for 2 years after discharge. The patients were divided into a low-GV (n=61) and high-GV (n=34) group, and the incidence of recurrent AMI was measured. In the animal study, thirteen pigs were divided into a sham (n=3), low-GV DM (n=5) and high-GV DM group (n=5). Intima samples were analysed by optical coherence tomography 22 weeks after coronary stenting. Becn1, LC3B, p62, G3BP1 and NLRP3 protein levels in the intima were examined by western blot.

experiments with THP-1 cells were also conducted.

In the high-GV group, patients exhibited a higher recurrent AMI, greater neointimal thickness, increased p62 and NLRP3 expression, and decreased Becn1, LC3B and G3BP1 expression compared with the low-GV group (P<0.

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