Background: Many surgeons believe that the use of a 3D-printed drill guide template shortens operative time and reduces intraoperative blood loss compared with those of the free-hand technique. In this study, we investigated the effects of a drill guide template on the accuracy of pedicle screw placement (the screw placed completely in the pedicle), operative time, and intraoperative blood loss. Materials/Methods: We systematically searched the major databases, such as Medline via PubMed, EMBASE, Ovid, Cochrane Library, and Google Scholar, regarding the accuracy of pedicle screw placement, operative time, and intraoperative blood loss. The χ 2 test and I 2 statistic were used to examine heterogeneity. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the accuracy rate of pedicle screw placement, and weighted mean differences (WMDs) with 95% CIs were utilized to express operative time and intraoperative blood loss. Results: This meta-analysis included 13 studies (seven randomized controlled trials and six prospective cohort studies) involving 446 patients and 3375 screws. The risk of research bias was considered moderate. Operative time (WMD = − 20.75, 95% CI − 33.20~− 8.29, P = 0.001) and intraoperative blood loss (WMD = − 106.16, 95% CI − 185.35 − 26.97, P = 0.009) in the thoracolumbar vertebrae, evaluated by a subgroup analysis, were significantly different between groups. The 3D-printed drill guide template has advantages over the free-hand technique and improves the accuracy of pedicle screw placement (OR = 2.88; 95% CI, 2.39~3.47; P = 0.000). Conclusion: The 3D-printed drill guide template can improve the accuracy rate of pedicle screw placement, shorten operative time, and reduce intraoperative blood loss.

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BackgroundTo explore the related influencing factors of adjacent segment degeneration (ASD) after cervical discectomy and fusion (ACDF).Material/MethodsA retrospective analysis of 263 patients who underwent ACDF was carried out. Cervical x-ray and magnetic resonance imaging (MRI) were required before operation, after operation, and at the last follow-up. General information and some radiographic parameters of all patients were measured and recorded. According to the imaging data, patients were put into one of two groups: non-ASD group and ASD group. The differences between the two groups were compared by t-test and χ2-test, and the related influencing factors of ASD were analyzed by logistic regression.ResultsIn all, 138 patients had imaging ASD. Comparing the age, the postoperative cervical arc chord distance (po-CACD), and the plate to disc distance (PDD) of the two groups, differences were statistically significant (p<0.05). The gender, the fusion segment number, the pre-CACD, the pre-and-po CACD, the preoperative cervical spinal canal ratio, and the upper and lower disc height (DH) showed no statistical difference between the two groups (p>0.05). The results of logistic regression analysis showed that there were significant correlations in the following characteristics: age, postoperative po-CACD, and the PDD (p<0.05). Of all these characteristics, the correlation of age was the highest (R=1.820).ConclusionsAge, po-CACD, and PDD were risk factors for ASD after ACDF. The older the operation age, the worse the recovery was of postoperative physiological curvature of cervical spine, and a PDD < 5 mm was more likely to lead to ASD.

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Introduction: Studies have shown that long non-coding RNAs (lncRNA) are aberrantly expressed in polycystic ovarian syndrome (PCOS) ovaries and may have a role in PCOS development. In this study, the role and therapeutic implications of lncRNA H19 were investigated in PCOS ovaries and granulosa cells. Material and methods: qRT-PCR was used for expression analysis. Cell Counting Kit 8 (CCK-8) assay was used for cell viability and acridine orange/ ethidium bromide (AO/EB) and Annexin V/propidium iodide staining was used to detect apoptosis. All transfections were carried out with Lipofectamine 2000 reagent. Western blot analysis was used for protein expression analysis. Results: The expression of lncRNA H19 was remarkably upregulated in the PCOS ovarian tissues as well as the granulosa cells. Suppression of lncRNA H19 expression caused the inhibition of KGN granulosa cell proliferation due to the triggering of apoptosis. Bioinformatic analysis revealed the presence of the GAS binding site for STAT3 in the promoter of lncRNA H19. Silencing of STAT3 suppressed the expression of lncRNA H19 in KGN cells and also halted their growth by triggering apoptosis. Co-transfect experiments revealed that STAT3 and lncRNA H19 silencing cause inhibition of KGN growth synergistically. Conclusions: lncRNA H19 regulates the growth of ovarian granulosa cells and might prove to be a therapeutic target for management of PCOS.