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Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc degeneration remains a controversial subject. To resolve this we have undertaken a meta-analysis comparing the outcomes from HS with ACDF in this condition.Seven databases were searched for studies of HS and ACDF from inception of the study to 1 September 2019. Both random-effects and fixed-effects models were used to evaluate the overall effect of the C2-C7 range of motion (ROM), ROM of superior/inferior adjacent levels, adjacent segment degeneration (ASD), heterotopic ossification (HO), complications, neck disability index (NDI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Odom's criteria, blood loss, and operating and hospitalization time. To obtain more credible results contour-enhanced funnel plots, Egger's and Begg's tests, meta-regression, and sensitivity analyses were performed.In total, 17 studies involving 861 patients were included in the analysis. HS was found to be superior to ACDF in maintaining C2-C7 ROM and ROM of superior/inferior adjacent levels, but HS did not reduce the incidence of associated level ASD. Also, HS did not cause a higher rate of HO than ACDF. The frequency of complications was similar between the two techniques. HS failed to achieve more favourable outcomes than ACDF using the NDI, VAS, JOA, and Odom's scores. HS did not show any more advantages in operating or hospitalization time but did show reduction in blood loss.Although HS maintained cervical kinetics, it failed to reduce the incidence of ASD. This finding differs from previous reports. Moreover, patients did not show more benefits from HS with respect to symptom improvement, prevention of complications, and clinical outcomes. Cite this article

Aim: Recently, several studies have reported that thrombocytosis may be associated with the poor prognosis of colorectal cancer (CRC). Nevertheless, their conclusions were still controversial. Results & methodology: We searched PubMed, Embase, Cochrane Library and Web of Science up to April 2016. A total of 30 studies including 9129 patients were included in this meta-analysis. Thrombocytosis had a close relationship with the poor overall survival of CRC compared with normal platelet counts, with the pooled hazard ratios being 1.89 (95% CI: 1.45–2.47; p < 0.00001) and 1.83 (95% CI: 1.33–2.53; p = 0.0002), with univariate and multivariate analyses, respectively. Discussion & conclusion: This meta-analysis indicated that thrombocytosis may be a cost-effective and noninvasive indicator for poor prognosis of patients with CRC, especially for overall survival.

To observe the early clinical effect of perfusion bone cement screw for lumbar degenerative diseases with osteoporosis.The clinical data of 28 patients with lumbar degenerative diseases combined with moderate to severe osteoporosis treated by posterior lateral graft fusion with perfusion of bone cement screws from June 2015 to June 2017 were retrospectively analyzed. There were 9 males and 19 females, aged from 55 to 86 years old with an average of 76 years. Anteroposterior, oblique, and dynamic radiography were performed before operation, and the diagnosis was confirmed by CT, MRI and dual energy X-ray absorptionmetry(DXA). All the patients had moderate to severe lumbar spinal stenosis, including 16 cases with degenerative scoliosis, 12 cases with degenerative lumbar spondylolisthesis, and 16 cases with lumbar disc herniation. According to Jikei grade of osteoporosis, 9 cases were grade II and 19 cases were grade III. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were used to assess the improvement of lumbar leg pain, and neurological function. Imaging data were used to observe the circumstance of pedicle loosening, prolapse, breakage and bone cement leakage, and comprehensively evaluate the fusion.The hospital stay was from 10 to 14 days with an average of 12 days; the operative time was 100 to 150 min with an average of 120 min;the blood loss was 200 to 600 ml with an average of 350 ml (for operations more than 3 vertebral segments, blood filtration recovery was intraoperatively used);the postoperative drainage volume was 150 to 600 ml with an average of 300 ml, no allogeneic blood was used in all the patients. Bone cement of 2 to 3 ml were injected into each vertebral body, and bone cement leakage occurred in 2 cases during injection, both of which were paravertebral vessel leakage, and there was no evidence of intravertebral leakage. The injection of bone cement was terminated in a timely manner without serious complications such as nerve injury, bone cement toxicity, and vascular embolization and pulmonary embolism. According to the fusion criteria by X-ray, 18 cases achieved strong bone fusion, and 10 cases were inaccurate fusion, but no pseudarthrosis occurred in the fusion segment. No screw loosening, prolapse or fracture were found, and postoperative VAS, JOA scores were significantly improved.Perfusion bone cement screw technique can obtain satisfactory effect in treating lumbar degenerative diseases with osteoporosis.

The inflammatory cytokines of IL-1β and TNF-α participate in the process of intervertebral disc degeneration is focused by the spine surgeons. Inflammatory cytokines represented by IL-1β and TNF-α act as the key factors in the process of intervertebral disc degeneration resulting in low back pain and radicular symptoms. Annulus fibrosus and nucleus pulposus can secrete TNF-α and IL-1β under the stimulation of mechanical injury, overstressed, genetic susceptibility and infection. The mechanism of inflammatory cytokines in intervertebral disc degeneration needs further investigation. The emphasis of researches will be on the inflammatory cytokines in the regulation of mechanism in the intervertebral disc degeneration, molecular targeted therapy, cell signaling pathways and the best time of anti-inflammatory therapy providing more evidence in the clinical application.

Rhizoma coptidis, a broadly used medicinal plant, originates from the dried rhizomes of three species in Chinese pharmacopoeia, namely, Coptis chinensis Franch, Coptis deltoidea C. Y. Cheng et Hsiao, and Coptis teeta Wall. In this study, a novel approach using (1)H NMR spectroscopy combined with multivariate analysis was introduced to differentiate the three species and identify potential metabolic markers for better controlling the quality of rhizoma coptidis. A broad range of metabolites including alkaloids, sugars, organic acids, amino acids, and fatty acids present in rhizoma coptidis were detected by means of (1)H NMR spectroscopy. Principal component analysis (PCA) of the (1)H NMR data set showed a clear separation between all samples by PC1 and PC3, and some metabolites that could be responsible for the discrimination of the three species were identified. An analysis of variance (ANOVA) was performed to statistically verify the significance of differences in metabolite levels between species. By combining PCA and ANOVA, significantly higher contents of palmatine, coptisine, epiberberine, columbamine, and fatty acids together with lower contents of jateorrhizine were found in Coptis chinensis, whereas Coptis deltoidea and Coptis teetA showed the highest levels of sucrose and chlorogenic acid, respectively. This study indicates that metabolites of rhizoma coptidis vary with the species and the proposed method is suitable for metabolic fingerprinting analysis to check the genuine origin of rhizoma coptidis.

Objective To investigate the learning and memory impairments at acute phase after mild traumatic brain injury (TBI) in Sprague-Dawley rats and its relationship with the expression of Arp2. Methods Hundred adult male Sprague-Dawley rats were randomly assigned into a TBI group or a control group. TBI was produced by using an impact acceleration model. Learning and memory function was assessed using Morris Water Maze test after different injury intervals, and synaptic function was investigated after TBI treatment by using field excitatory postsynaptic and long-term potentials. Western blot, immunochemistry, and polymerase chain reaction (PCR) were used to detect the mRNA and protein expression of actin-related protein 2 (Arp2) after injury, whereas Nissl staining and DNA ladder assays were performed to detect neuron apoptosis. Results Using water maze measurement, the authors found escape latency to be significantly higher in the TBI group compared with the control group, and at 7 days postinjury, the difference almost reached up to 30 seconds. Field excitatory postsynaptic potential measurement further found that the long-term potential decreased by nearly 20% in the TBI group compared with the control group, which meant the synaptic excitatory function was downregulated in the TBI group. Further, no significant neuron apoptosis could be detected in the TBI group by Nissl staining, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining, and DNA ladder assays. At last, we found that after TBI treatment, the Arp2 mRNA and protein levels were decreased in a time-dependent manner and reached 29.3% and 45.7% of control at 7 days postinjury, separately, and the decrease of mRNA of Arp2 was correlated with delayed escape latency. Conclusions This study demonstrated that impairments of learning and memory function in the acute phase after mild TBI may be induced by a reduction in Arp2 expression.