Search

OBJECTIVE: Non-specific low back pain is a common disorder that affects more than 80% of the world’s population. But the potential risk factors remain unclear. The aim of this study is to develop a nomogram for the risk prediction of low back pain in young population. PATIENTS AND METHODS: A total of 264 young participants (18-45 years old) were recruited and randomly divided into a training set (n=188) and a validation set (n=76) by a ratio of 7:3. The nomogram was developed based on the training set. The independent predictors of low back pain were identified by LASSO and logistic regression analysis. A nomogram was developed according to the predictors. To assess the reliability of the nomogram, the area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were applied. The validation set was used to validate the results. RESULTS: Sixteen factors were included in the characteristics of the eligible subjects. LASSO showed that five independent predictors including working posture, exercising hours per week, Tuffier’s line, six lumbar vertebrae anomaly, and lumbar lordosis angle were the independent risk factors of low back pain in young population, which were identified by multivariate logistic regression analysis and were used to establish the nomogram. The AUC values of the nomogram were 0.867 (95% CI: 0.809-0.924) and 0.868 (95% CI: 0.775-0.961) in the training and validation set, respectively. The calibration curve revealed that the prediction model of the nomogram was greatly consistent with the actual observation. In addition, the DCA indicated that the nomogram was clinically useful. CONCLUSIONS: Working posture, exercising hours per week, Tuffier’s line, six lumbar vertebrae anomaly, and lumbar lordosis angle are identified as independent predictors of non-specific low back pain in young population. And the nomogram based on the above five predictors can accurately predict the risk of low back pain in young people. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the effect of miR-543-3p on the recovery of locomotor function after spinal cord injury (SCI) by regulating tumor necrosis factor superfamily member 15 (TNFSF15) mediated inflammation and apoptosis. MATERIALS AND METHODS: Macrophages were isolated from the abdominal cavity of 2-3 months old Sprague-Dawley (SD) rats and cultured. The levels of miR-543-3p, tumor necrosis factor superfamily member 15 (TNFSF15), TNF-like molecule 1A (TL1A) and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) after transfection of miR-92b-5p into activated macrophages were detected by quantitative Real-time polymerase chain reaction (qRT-PCR). Moreover, the mRNA expressions of miR-543-3p, TNFSF15, TL1A and NF-κB after SCI in rats were detected by qRT-PCR. Meanwhile, the protein expressions of tumor necrosis factor (TNF-α), interleukin-1 β (IL-1β) and Caspase8 were detected by Western blot. After intrathecal injection of miR-543-3p mimics, the mRNA expressions of miR-543-3p, TNFSF15, TL1A and NF- κ B and the protein expressions of TNF-α, IL-1β and Caspase8 in spinal cord injured area of mice were measured by qRT-PCR and Western blot, respectively. Basso Beattie Bresnahan (BBB) locomotor rating scale was used to determine the recovery of locomotor function after spinal cord injury and injection of miR-543-3p mimics. RESULTS: Compared with inactivated cells, the expression of miR-543-3p in activated macrophages was significantly declined. However, the levels of TNFSF15, TL1A and NF-κB were significantly elevated. The expressions of TNFSF15, TL1A and NF-κB were remarkably downregulated after transfection of miR-543-3p. In addition, the level of miR-543-3p was significantly downregulated, accompanied by an increase in TNFSF15, TL1A and NF-κB in SCI rats. Accordingly, the protein levels of TNF-α and IL-1β and Caspase8 were also significantly increased. However, the expressions of TNFSF15, TL1A and NF-κB were significantly down-regulated in rats injected with miR-543-3p mimics, whereas the protein levels of TNF-α and IL-1β and Caspase8 were significantly suppressed. Finally, compared with SCI group, the recovery of locomotor function in miR-543-3p mimics administration group was significantly improved. CONCLUSIONS: After SCI, miR-543-3p can inhibit the activity of NF-κB by suppressing the inflammatory aggravation of TNFSF15 and decreasing its product TL1A. MiR-543-3p leads to the improvement of neuron protection and locomotor function via attenuating inflammatory reaction and cell apoptosis. [ABSTRACT FROM AUTHOR]

Superabsorbent polymer (SAP) efficiency in water absorption and release depends on soil properties and SAP type and concentration. Our objective was to examine the effects of soil texture, SAP concentration and properties on water absorption and release from soil-SAP mixtures during 10 h of drying. Four SAP types, five SAP concentrations and five soils were used. Initial water quantity absorbed by SAPs (53-171 g g-1 of SAP) was more than two orders of magnitude greater than that absorbed by soils (0.35-0.53 g g-1 of soil). Water absorption by soil-SAP mixtures (i) significantly improved water holding capacity relative to the soil and (ii) increased with an increase in SAP concentration and soil clay content. The ability of soil-SAP mixtures to retain water after 5 h of drying relative to the initial water content was greater than that of the soils alone, especially in coarse-textured soils. After 5 h of drying, the specific amount of water retained by a unit weight of SAP in the soil-SAP mixture was higher than that at 0 h. This observation suggests a continued absorption of water by SAPs from soils during the first 5 h of drying. The fraction of water loss from SAP with large-size beads (BJ-2101M) was smallest in all the mixtures among the four SAPs after 10 h drying. Our results showed that addition of SAPs to soils not only decreases water loss to evaporation from soils but also from the SAPs, especially for a SAP with large size beads. [ABSTRACT FROM AUTHOR]

Lung cancer is the leading cause of cancer death worldwide. Furthermore, more than 50% of lung cancer patients are found affected by distant metastases at the time of diagnosis. On the other hand, 20% of these patients are without regional spread and are good candidates for surgical operation. The remaining 30% represent an intermediate group whose tumors have metastasized up to regional lymph nodes. These remain 30% are the most appropriate candidates for radiation therapy. These patients are also called as "locally advanced lung cancer" or stage III lung cancer patients. In these patients strategy of combination therapy viz. radiation therapy in combination with chemotherapy is also tried by various groups in the recent past for this better management. However, long-term survival is still poor with a 5-year survival in 5-25% of patients. During the last decades, there has been a development in radiation strategies. The present review article focuses on different approaches to optimize radiotherapy for these patients. [ABSTRACT FROM AUTHOR]

Superabsorbent Polymers (SAPs) are capable of swelling and retain large amounts of water. Knowledge of the ability of SAPs to retain the absorbed water under evaporative conditions is less understood. We saturated four SAPs, seven soils from the semiarid areas in Northwest China (control treatments), and mixtures of 100 g of soil with 0.5 g of SAP, with tap water (electrical conductivity [EC] = 0.5 dS m-1, sodium adsorption ratio [SAR] =2 [mmolc L-1] 0-5) for 15 min. The water-saturated SAPs, soils and soil-SAP mixtures were then placed in an oven at 60°C, and loss of water to evaporation from each treatment was measured every hour for 7 h. Water content of the soils at saturation ranged between 0.306 and 0.522 g g-1 of soil, while after drying it dropped to <0.08 g g-1 of soil. Water content of the SAPs ranged between 30 and 199 g g-1 of SAP at saturation, and decreased to 17 and 108 g g-1 of SAP after 7 h of drying. The soil-SAP mixtures absorbed between 78.59 and 47.94 g of water and retained between 34.51 and 12.75 g of water after 7 h of drying. Generally, evaporative water loss from soil-SAP mixtures was slower than for SAPs alone. When the SAP particle size was larger (3-4 mm) the opposite trend was noted. Furthermore, the 3 to 4 mm sized SAP differed from its <1.5 mm counter parts, that is, the water content retained by the soil-SAP (3-4 mm) mixture exceeded the sum of that retained by each component material alone. This suggests a synergy between this SAP and the soils with respect to the mixtures' ability to retain water during the 7 h of drying. Our results suggest that when use of SAPs in cultivated soils to mitigate water stress is being considered, the characteristics of water loss from the soil-SAP mixture should be taken into account and not just the amount of water that the SAPs can absorb when mixed with the soils. INSET: 767. [ABSTRACT FROM AUTHOR]

Mixing cross-linked polyacrylamides with semiarid soils may increase water availability to crops. The effects of soils, sand, and superabsorbent properties on water absorption by four superabsorbent polymers (SAPs) were studied. The amount of water absorbed by the SAPs in tap water increased with increasing polymer cation exchange capacity. Less water was absorbed by SAPs mixed with soil or sand than by the control. In the sand and soil mixtures with a large-grain (3-4 mm) SAP, water absorption increased with time (up to 40-50 min) to a steady-state value in the range of 90 to 160 kg kg-1 in the sand-SAP mixture and 33-55 kg kg-1 in the soil-SAP mixture. Conversely, in the other three sod-SAP mixtures, water absorption reached a maximum value after 10 to 20 rain, followed by a decrease with time to values ranging between 20 and 60 kg kg-1 At the initial stage of water absorption, confinement of the SAP grains by the soil particles was the dominant factor limiting water absorption by these SAPs; the confinement increased as soil texture became finer. The subsequent observed reduction was ascribed to the gradual replacement of Na or K cations that were adsorbed on the SAPs with Ca and Mg cations released from the soil. The results suggest that addition of a small amount of SAP to soils (5 g kg-1 soil) is more effective at increasing water holding capacity in soils with low clay content than in soils with high clay content. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety and efficacy of the combined use of ultrasonic bone curette with the high-speed drill in posterior laminectomy and decompression procedure for severe thoracic spinal stenosis, and propose the optimal cutting position for ultrasonic bone curette during the laminectomy. Methods: By observing and measuring the parameters of thoracic pedicle, lamina, inner wall of the vertebral canal and their relation with the surrounding structures on cadavers, we provided a morphological marker for laminectomy by an ultrasonic bone curette. Data of 19 patients with severe thoracic spinal stenosis treated by posterior laminectomy and decompression were collected from June 2017 to June 2018 in Shanghai Changzheng Hospital. There were 11 males and 8 females, aged (50±6) years. The patients received laminectomy with the combined use of ultrasonic bone curette and the high-speed drill (Group A, n= 10) or the use of ultrasonic bone curette alone (Group B, n= 9). Operational time of decompressive laminectomy, blood loss, as well as perioperative complications such as durotomy, cerebrospinal fluid leak, injury of the nerve root and spinal cord were recorded in these two groups. The improvement of symptoms and the decompression width of the spinal canal were evaluated after operation. Two independent samples t -test was used for the comparison of two sets of continuous normal distribution data. Results: We had done the measurement in 6 cadavers. The mean distance between the boundary of cancellous-cortical bone of lamina and the inner wall of spinal canal was (0.9±0.4) mm, and the distance between the boundary of cancellous-cortical bone of pedicle and the inner wall of the spinal canal was (1.2±0.6) mm. For the surgeries in groups A, the mean laminectomy time for each segment was (4.4±0.5) min, the mean width of posterior laminectomy was (21.8±0.5) mm; and for the surgeries in group B, the mean laminectomy time for each segment was (5.0±0.5) min, the mean width of posterior laminectomy was (19.9±1.0) mm; there were significant differences in laminectomy time for each segment and the width of posterior laminectomy between the two groups ( t= -2.391, 3.491, both P< 0.05). There was one case of dura injury and one case of thoracic nerve root injury during the operation in group B. Conclusions: It is safer and more reliable for the combined use of ultrasonic bone curette with the high-speed drill in posterior laminectomy and decompression procedure for the severe thoracic spinal stenosis. The interface between the cortical bone and the medial edge of cancellous bone of the pedicle could be identified as the cutting mark for ultrasonic bone curette in this procedure.

Objective: To explore the correlation between the spinal nerve high tension and lumbar disc degeneration, the pathogenesis of hanging intervertebral disc degeneration. Methods: From June 2016 to June , a retrospective analysis 2017 of 100 cases of lumbar spinal stenosis were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University. They were divided into experimental group (50 cases, nerve high tension group) and control group (50 cases, nervous tension in the normal group) according to preoperative lumbar MRI of cauda equina syndrome and settlement of intraoperative detecting nerve tension. The Pfirrmann grade was used to evaluate degree of lumbar (L3/4-L5/S1) disc degeneration.The correlation between spinal nerve tension and lumbar disc degeneration was analyzed, and the severity of experimental group and control group on lumbar disc degeneration was compared. Results: There was no significant difference in the age and sex ratio between the two groups ( P >0.05). The Pfirrmann score of the experimental group was L3/4 (4.74±1.6) grade, L4/5 (5.32±1.33) grade, L5/S1 (5.54±1.13) grade; the control group Pfirrmann score was L3/4 (3.5±1.16) grade, L4/5 (4.12±0.9) grade, and L5/S1 (4.1±0.97) grade.The severity of intervertebral disc degeneration in experimental group was higher than that in control group, with statistical significance ( P <0.05). There was a correlation between lumbar disc degeneration and nerve tension in L3/4, L4/5 and L5/S1, and the correlation trend was L5/S1> L4/5> L3/4. Conclusion: There is a correlation between lumbar disc degeneration and spinal nerve high tension.A new pathogenesis of hanging intervertebral disc degeneration that the degeneration of lumbar disc is a compensatory mechanism in order to alleviate the axial stretch injury is put forward.

Introduction: The laminoplasty has been the most widely used surgical method for OPLL. In recent years, increasing attention has been drawn to the anterior operative approaches for surgical treatment of cervical OPLL. However, which method is the optimum selection for therapy of cervical OPLL is still obscure. Therefore, we performed this prospective nonrandomized clinical study in patients with multilevel cervical myelopathy due to OPLL and compare the therapeutic efficiency of laminoplasty and anterior approach (cervical discectomy and/or cervical corpectomy) in the management of multilevel cervical OPLL., Hypothesis: There is no difference in clinical effects between anterior cervical spine surgery and laminoplasty in the treatment of multilevel cervical OPLL., Material and Methods: A total of 150 consecutive patients with multilevels of cervical OPLL underwent anterior approaches (ACDF, ACCF and HDF) from July 2010 to June 2014, which were enrolled in this study. During the same period, one hundred and two patients receiving the laminoplasty were enrolled in the study. The clinical effects, alignment and range of motion (ROM) of cervical spine in patients of the anterior group and posterior group were assessed, respectively. The effects of high signals in T2 weighed MRI scans and percentage of spinal canal stenosis in these patients were also evaluated. Finally, postoperative complications regarding each group were analyzed., Results: Although significant differences in types of OPLL and preoperative sagittal alignment of cervical spine occurred in the two groups (P<0.05), clinical effects of the two groups were similar (P>0.05). The cervical curvature in laminoplasty group showed significant decrease at final follow-up (P<0.05). For ROM of cervical spine, no significant alteration was observed in both groups. The high T2 weighed signals and rate of spinal canal stenosis can influence clinical effects of both anterior group and laminoplasty group. In addition, significantly higher complication rate was observed in laminoplasty group compared with anterior group (P<0.05)., Discussion: Both anterior and laminoplasty approaches can be considered effective and safe procedures in the treatment of the multilevel OPLL. However, the anterior approach with relatively lower incidence of postoperative complications is a better choice for cases with poor cervical curvature and serious spinal canal stenosis., Type of Study and Level of Proof: Level 3 nonrandomized, controlled clinical trials., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: To investigate the clinical characteristics and surgical treatment of cervical spondylotic amyotrophy. Methods: Thirteen patients(13 man) with proximal (10) and distal(3) cervical spondylotic amyotrophy between November 2014 and September 2016 were included in this study. The average age of the patients was 55 (range, 47-66) years. The sex, age, clinical course, type of amyotrophy, lesion segment and postdecompression improvement in muscle power were reviewed. Results: Of 13 cervical spondylotic amyotrophy patients, 9 were performed on with cervical disectomy, 2 were performed on with cervical posterior operation, 2 remainding patients received nonoperative treatment. Cervical spondylotic amyotrophy patients were followed up 6-22 (average 10.6) months, muscle power of 4 patients (all proximal-type)were improved completely (the average recovery time were 4.4 months), muscle power of 6 patients were improved uncompletely, 1 patients failed to improve, the 2 remainding patients received nonoperative treatment had no change. Conclusion: Cervical spondylotic amyotrophy as a rare type of cervical spondylotic disorder, It should distinguish cervical spondylotic amyotrophy from amyotrophic lateral sclerosis, especially in the early stage of amyotrophic lateral sclerosis. A surgical treatment is recommended as the first line of proximal-type CSA, especially those with serious compression. It is important that clinicians should be aware that distal-type CSA had a poor results, resulting in a lower lower satisfaction, especially those with no, or insignificant, sensory disturbance.

Objective: To define a novel disease-lumbosacral nerve bowstring disease, and propose the diagnostic criteria, while capsule surgery was performed and evaluated in the preliminary study. Methods: From June 2016 to December 2016, a total of 30 patients (22 male and 8 female; mean age of 55.1±9.7 years) with lumbosacral nerve bowstring disease were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University.Lumbosacral nerve bowstring disease was defined as axial hypertension of nerve root and spinal cord caused by congenital anomalies, which could be accompanied by other lesions as lumbar disc herniation, spinal cord stenosis or spondylolisthesis, or aggravated by iatrogenic lesions, resulting in neurological symptoms.This phenomenon is similar to a stretched string, the higher tension on each end the louder sound.Meanwhile, the shape of lumbosacral spine looks like a bow, thus, the disease is nominated as lumbosacral nerve bowstring disease.All the patients underwent capsule surgery and filled out Owestry disability index (ODI) and Tempa scale for kinesiophobia (TSK) before and after surgery. Results: The mean surgery time was (155±36) min, (4.3±0.4) segments were performed surgery.The pre-operative VAS, TSK and ODI scores were (7.6±0.8), (52.0±10.3) and (68.4±12.7), respectively.The post-operative VAS, TSK and ODI scores were (3.3±0.4), ( 24.6±5.2) and (32.1±7.4)( P <0.05, respectively), respectively. Conclusion: The definition and diagnostic criteria of lumbosacral nerve bowstring disease was proposed.Capsule surgery was an effective strategy with most patients acquired excellent outcomes as symptoms relieved and quality of life improved.