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Background: Peripheral nerve injury (PNI) has devastating consequences. Dorsal root ganglion as a pivotal locus participates in the process of neuropathic pain and nerve regeneration. In recent years, gene sequencing technology has seen rapid rise in the biomedicine field. So, we attempt to gain insight into in the mechanism of neuropathic pain and nerve regeneration in the transcriptional level and to explore novel genes through bioinformatics analysis. Methods: The gene expression profiles of GSE96051 were downloaded from GEO database. The gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes pathway (KEGG) enrichment analyses were performed, and protein–protein interaction (PPI) network of the differentially expressed genes (DEGs) was constructed by Cytoscape software. Results: Our results showed that both IL-6 and Jun genes and the signaling pathway of MAPK, apoptosis, P53 present their vital modulatory role in nerve regeneration and neuropathic pain. Noteworthy, 13 hub genes associated with neuropathic pain and nerve regeneration, including Ccl12, Ppp1r15a, Cdkn1a, Atf3, Nts, Dusp1, Ccl7, Csf, Gadd45a, Serpine1, Timp1 were rarely reported in PubMed database, these genes may provide us the new orientation in experimental research and clinical study. Conclusions: Our results may provide more deep insight into the mechanism and a promising therapeutic target. The next step is to put our emphasis on an experiment level and to verify the novel genes from 13 hub genes.

Abstract Background Decompressive laminectomy (DI) is a standard operation for lumbar spinal stenosis (LSS) patient with severe claudication symptoms for many years. However, patients whose symptom severity does not meet undergoing invasive surgery make therapeutic options into dilemma. Interspinous spacers (ISP) bridge the gap between surgical interventions and CC in management of LSS. In our study, we aim to systematically assess the two FDA-approved interspinous spacers for treatment of lumbar spinal stenosis: Superion versus X-STOP. Methods Electronic databases, including PubMed, Embase, MEDLINE, Cochrane Library were searched to retrieve clinical trials concerning the comparison between Superion and X-STOP in treatment for lumbar spinal stenosis before April 2017. The following outcome measures were extracted: (1) Zurich Claudication Questionnaire (ZCQ) patient satisfaction score, (2) axial pain severity, (3) extremity pain severity, (4) back-specific functional impairment, (5) reoperation, and (6) complication. The data analysis was conducted with Review Manager 5.3. Results Five randomized controlled trials (RCTs) with 1118 patients were included in this meta-analysis. The pooled analysis indicated that the Superion group is superior to X-STOP in axial pain severity (SMD: 0.03; 95% CI 0.15, 0.45; p

Decompression is the major therapeutic strategy for acute spinal cord injury, but there is some debate about the time window for decompression following spinal cord injury. An important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary injury. Governor Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal cord. In this study, Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord injury. The rat models were established by inserting a balloon catheter into the atlanto-occipital space. The upper cervical spinal cord was compressed for 12 or 48 hours prior to decompression. Electroacupuncture was conducted at the acupoints Dazhui (GV14) and Baihui (GV 20) (2 Hz, 15 minutes) once a day for 14 consecutive days. Compared with decompression alone, hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with electroacupuncture. However, the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 hours. Platelet-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression alone. These findings indicate that compared with decompression alone, Governor Vessel electroacupuncture combined with delayed decompression (48 hours) is more effective in the treatment of upper cervical spinal cord injury. Governor Vessel electroacupuncture combined with early decompression (12 hours) can accelerate the recovery of nerve movement in rats with upper cervical spinal cord injury. Nevertheless, further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.

Background: The footprint of most prostheses is designed according to Caucasian data. Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China. It is essential to analyze the match sizes of prostheses footprints and Chinese cervical anatomic dimensions in our study. Methods: The anatomic dimensions of the C4-C7 segments of 138 patients (age range 16-77 years) in a Chinese population were measured by computed tomography scans. We compared the footprints of the most commonly used cervical disc prostheses (Bryan: Medtronic, Minneapolis, MN, USA; Prestige LP: Medtronic, Fridley, Minnesota, USA; Discover: DePuy, Raynham, MA, USA; Prodisc-C: Synthes, West Chester, PA, USA) in China with Chinese cervical anatomic dimensions and assessed the match of their size. Results: The mismatch of available dimensions of prostheses and anatomic data of cervical endplates ranged from 17.03% (C4/C5, Prestige LP, Prodisc-C) to 57.61% (C6/C7, Discover) in the anterior-posterior (AP) diameter, and 35.51% (C4/C5, Prodisc-C, Prestige LP) to 94.93% (C6/C7, Bryan) in the center mediolateral (CML) diameter. About 21.01% of endplates were larger than the largest prostheses in the AP diameter and 57.25% in the CML diameter. All available footprints of prostheses expect the Bryan with an unfixed height, can accommodate the disc height (DH), however, 36.23% of the middle DH was less than the smallest height of the prostheses. The average disc sagittal angles (DSAs) of C4-C7 junctions were 5.04°, 5.15°, and 4.13° respectively. Only the Discover brand had a built-in 7° lordotic angle, roughly matching with the DSA. Conclusions: There is a large discrepancy between footprints of prostheses and Chinese cervical anatomic data. In recent years, possible complications of TDR related with mismatch sizes are increasing, such as subsidence, displacement, and heterotopic ossification. Manufacturers of prostheses should introduce or produce additional footprints of prostheses for Chinese TDR.

The Editor-in-Chief has retracted this article [1] because of an error in the meta analysis. Re-examination of the data has showed that there is only one published randomized controlled trial comparing Superion with XStop. Due to a misunderstanding of the published clinical data, the conclusions drawn in the article are incorrect. Author Xing Yu approved this retraction, none of the other authors replied to correspondence from the publisher about this retraction.

Objective: To determine the asymmetry in the paraspinal muscle before pregnancy and evaluate its association with pregnancy‐associated lumbopelvic pain (LPP). Methods: This was a prospective case–control study conducted from January 2017 and December 2018. A total of 171 subjects (mean age ± SD, 27.4 ± 5.8 years) were finally divided into the LBP group, PGP group, and no LPP group. Each subject was asked to follow a standardized clinical imaging protocol before the pregnancy. The area of muscles (multifidus, erector spinae, and psoas muscles) on the axial slice at mid‐disc of L4–L5 and L5–S1 were segmented and then the cross‐sectional area (CSA) of a particular muscle was measured by outlining the innermost fascial border surrounding each muscle. The mean value of F‐CSA's ratio to T‐CSA (F/T CSA) was used to determine whether the bilateral paraspinal muscle was asymmetrical. Total muscle CSA (T‐CSA) represents the sum of CSA of interested three muscles. The signal intensity can distinguish fat and muscle tissue in a different range. Based on this, functional CSA (F‐CSA), represented by fat‐free area, was evaluated quantitively by excluding the signal of the deposits of intramuscular fat. Total muscle CSA (T‐CSA), functional CSA (F‐CSA), and the ratio of F‐CSA to T‐CSA (F/T CSA) were measured unilaterally and compared between groups. Logistic regression was performed to determine the risk factors for pregnancy‐associated LPP. The Pearson correlation coefficient was performed to test the relationship between asymmetry in F/T‐CSA and pain rating. Results: A total of 124 subjects (72.5%) (28.5 ± 5.2 years) had LPP during pregnancy. Forty‐eight (38.7%) individuals had low back pain (LBP) and 76 (61.3%) had pelvic girdle pain (PGP). Seventy‐six women (44.4%) were determined to have asymmetry in paraspinal muscle according to the definition in this methods section. The duration of follow‐up was 24 months postpartum. A total of 39 (31.5%) women unrecovered from LPP. F/T‐CSA was significantly decreased for LBP in the PGP group than in the and control group (0.03 ± 0.02 vs 0.05 ± 0.03 vs 0.12 ± 0.05, P < 0.001). Meanwhile, significant differences were detected in both groups (all P < 0.001). In patients with LBP, the level of paraspinal asymmetry, represented by the difference in F/T‐CSA, was positively correlated with pain scores (r = 0.52, P < 0.01). However, no statistically significant correlation between pain scores and paraspinal asymmetry was found in PGP (r = 0.42, P > 0.05). Asymmetry in the paraspinal muscle (adjusted OR = 1.5), LBP (adjusted OR = 1.6), LPP in a previous pregnancy (adjusted OR = 1.4), sick leave ≥90 days (adjusted OR = 1.2), and heavy labor (adjusted OR = 1.2) were risk factors for the unrecovered LPP during pregnancy. Conclusions: Asymmetrical muscular compositions could lead to abnormal biomechanics for the segmental motions. Lateral‐directed physical training and stretching may help decrease the occurrence and severity of this condition. [ABSTRACT FROM AUTHOR]

Objective: To investigate the impact of different skin incisions on recovery from total knee arthroplasty (TKA). Methods: This is a retrospective study conducted in a tertiary hospital. A total of 1210 patients accepted primary and unilateral total knee arthroplasty (TKA) at the authors' affiliated institutions between January 2015 and January 2019. Patients who accepted primary and unilateral TKA due to OA under epidural anesthesia were included. Excluded cases included patients who had no completed follow‐up; preoperative flexion contracture greater than 15° and preoperative flexion less than 90°; paresthesia in lower limb; scar within the knee area; patella alta or baja. We recorded and analyzed the following data, including each patient's characteristics, incision stretching index (IS index), perioperative information, and follow‐up assessments. Patients were grouped by trisecting the range of IS index we observed in the present study. The primary outcome measure was the visual analog scale (VAS) pain score rated on a scale of 0–10 from no pain to severe pain. Secondary outcome measures include knee girth reflecting postoperative swelling, knee range of motion (ROM), sensory testing, and the strength of quadriceps. These measures were completed 2 weeks postoperatively. Results: A total of 1089 patients undergoing primary and unilateral TKA in our two institutions were screened for final analysis, and 121 ones were excluded. The patients were followed up for an average of 13.3 months postoperatively. The mean length of FL was 28.3 cm (range: 21.0–38.8 cm). The mean IS index was 2.7 cm (range: 0.4–5.1 cm). We found no significant difference in those data among groups (P > 0.05). VAS pain scores among group IS A, IS B, and IS C were significantly different (2.3 ± 0.6 vs 3.4 ± 1.6 vs 3.9 ± 1.5, P = 0.0001). Similar situations were seen in knee circumference, ROM, area of abnormal sensation, and quadriceps strength among groups (all P < 0.05). With the increase in the IS index, VAS pain score, knee circumference, area of abnormal sensation, and incision problems were significantly increased (P < 0.05). At the same time, ROM and the strength of quadriceps decreased (P < 0.05). With the increase in the IS index, the number of patients with incision problems was increased significantly (P < 0.05). Besides, no significant difference in PJI and DVT among groups was observed (P > 0.05). Conclusions: Proper incision stretching can improve postoperative pain relief, surgical swelling, ROM, sensory disturbance of the knee, and the strength of quadriceps with reduced risk of incision complications. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of different acupuncture treatments in the treatment of lumbar disc herniation. Methods: Searching PubMed, EMBASE, Cochrane Library, web of by computer Science, Chinese Journal Full-text Database, Wanfang database, VIP database and Chinese biomedical literature database, the retrieval time is from the establishment of the database to January 1, 2020. Two researchers conducted literature screening, quality evaluation and data extraction according to the nano platoon standard, and used stata16.0 for network meta-analysis. Results: a total of 69 RCTs were included, involving 6168 patients with lumbar disc herniation, 5 kinds of acupuncture therapy (warm acupuncture, fire acupuncture, electroacupuncture, acupuncture thread embedding, general acupuncture). The results of network meta-analysis showed that the effect of electroacupuncture was inferior to that of warm acupuncture, acupuncture thread embedding, and the effect of general acupuncture was inferior to that of warm acupuncture, fire acupuncture, electroacupuncture, acupuncture thread embedding, and the difference was statistically significant. In terms of efficiency, acupuncture and moxibustion embedding thread > warming acupuncture and moxibustion > fire acupuncture > electroacupuncture > ordinary acupuncture. Conclusion: in the treatment of lumbar disc herniation, the clinical effect of acupuncture thread embedding is better than the other four interventions. However, the quality and quantity of literature in this study are limited, and the conclusion of this study needs to be verified by high-quality RCT with multiple centers and large samples. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical effect of Duhuo Jisheng Decoction in the treatment of lumbar disc herniation. Methods: CNKI, VIP, Wan Fang Data, Pubmed, Cochrane Library, Medline Complete and Embase databases were searched by computer. The randomized controlled trial (RCT) of Duhuo Jisheng Decoction combined with western medicine in the treatment of lumbar intervertebral disc herniation was studied. The searching time was from the establishment of the database to July 20, 2019. Data were extracted and analyzed by Revman 5.3 software. Results: Twenty-four literatures involving 1980 patients were included. Meta-analysis showed that the total effective rate of Duhuo Jisheng Decoction group was significantly higher (OR = 5.26, 95% CI (4.13, 6.69), Z = 13.47, P < 0.00001) and the incidence of adverse reactions was significantly lower (OR = 0.45, 95% CI (0.23, 0.87), Z = 2.36, P = 0.00001) than that of Western medicine group. 02). Conclusion: Duhuo Jisheng Decoction is effective and safe in the treatment of lumbar intervertebral disc herniation. However, the literature included in this study is limited, and the quality of the literature is low. It is necessary to carry out in-depth verification of high-quality, large-sample RCT. [ABSTRACT FROM AUTHOR]

By consulting and collating the relevant literatures on the treatment of fluorosis in Traditional Chinese medicine, the research progress of TCM in the treatment of fluorosis was summarized. This paper summarizes the treatment of fluorosis in traditional Chinese medicine from the aspects of the traceability of TCM theory, etiology and pathogenesis, syndrome differentiation and cure, special disease specialty and foreign medicine, so as to guide clinical practice. TCM treatment of fluorosis more use of tonifying kidney and bone, activating blood circulation stasis, cold moisturizing, Tongluo pain relief and other methods, based on dispelling evil and tonifying kidney, combined with a variety of treatment methods, in relieving clinical symptoms and improving the quality of life of patients have an irreplaceable role, has been widely recognized, but most of the research reports are their own work experience summary, Lack of uniform diagnosis and treatment standards, and small sample size, data repeatability is weak, future research needs to further enhance the scientific and objective of the experiment, for TCM treatment of fluorosis to provide a scientific and reasonable diagnosis and treatment program, give full play to the advantages of TCM therapy. [ABSTRACT FROM AUTHOR]

Uranium precipitation involves the decomposition of uranyl complexes and the reduction of hexavalent uranium, which can occur sequentially or simultaneously within one redox reaction. The redox condition of hydrothermal fluid plays a vital role in controlling the migration and precipitation of uranium in hydrothermal uranium deposits. However, little attention has been paid to the role of uranyl complex decomposition in uranium precipitation. In this study, chlorite mineralogy and geochemistry were examined to clarify the process of uranium precipitation in the Shazhou deposit, Xiangshan uranium orefield, Southeast China. Based on comprehensive petrographic and mineral chemistry studies of chlorites obtained from altered granite porphyries and uranium ores, five types of chlorites were identified: (1) chlorite present in the form of pseudomorphous biotite, which was produced by the hydrothermal alteration of biotite in rocks that underwent hematitization and chloritization (Chl-I); (2) chlorite filling the cleavage cracks in biotite in rocks that underwent hematitization and chloritization (Chl-II); (3) chlorite occurring in pyrite veins (Chl-III); (4) chlorite intergrown with pitchblende in ore veins (Chl-IV); and (5) chlorite occurring in calcite veins (Chl-V). Chlorite geothermometry revealed that the formation temperatures of the five types of chlorites ranged from 219 °C to 254 °C. Mineral chemistry analyses revealed that the five types of chlorites formed in a reductive fluid environment, where the oxygen fugacity at different stages is similar, with log fO2 values ranging from -41.6 to -39.1. Uranium precipitation started only in stage Chl-IV. The examination of the mineral assemblage revealed that the ore-forming fluid was rich in F-, HPO32-, and CO32-. Comprehensive investigation of chemistry and physicochemical conditions of the ore-forming fluid revealed that oxidized uranium (UO22+) could be complexed with HPO42- and F-, and uranyl phosphate and the uranyl fluoride complexes were the main uranium species when uranium precipitation and the decomposition occurred at stage Chl- IV. However, the assessment of oxygen fugacity of the solution equilibria between the UO2(s) and the uranyl phosphate and uranyl fluoride complexes revealed that the reducibility of the fluid favoring the reduction of uranyl ions (UO22+) to U4+ was insufficient to reduce the uranyl phosphate and uranyl fluoride complexes. This indicates that the breakup of uranyl phosphate and the uranyl fluoride complexes to release uranyl ions should occur first at stage Chl-IV, reducing uranyl ions to U4+, and leading to uranium precipitation. Hence, the decomposition of uranyl complexes played an important role in uranium precipitation. With the increase in pH, uranyl phosphate and the uranyl fluoride complexes gradually decomposed and became reducible. Moreover, the decrease in ligand concentration was conducive to the decomposition of uranyl phosphate and the uranyl fluoride complexes. During the formation of the Shazhou deposit, the fluid boiling process induced the loss of volatiles, such as CO2, CH4, HF, and H2S, leading to an increase in pH and decrease in HPO42-, F-, and CO32- concentrations in the fluid. These factors also led to the decomposition of uranyl fluoride and the uranyl phosphate complexes and the precipitation of fluorapatite and calcite. Uranium was then reduced by the action of Fe2+ and S- (pyrite) from a hexavalent to a tetravalent, and finally, uranium was precipitated to form uranium ores. [ABSTRACT FROM AUTHOR]