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The incidence and proportion of traumatic spinal cord injury in the elderly are increasing year by year, and it has become the main affected population of spinal cord injury in developed countries. Fall is the main cause of injury. The increase of spinal stenosis, the biomechanical changes of the spine and the hyperextension injuries may be the mechanism of spinal cord injury caused by minor trauma in this population. Traumatic spinal cord injury in the elderly usually requires early surgical treatment. When there are complicated comorbidities, unstable vital signs or mild spinal cord injury without major fracture or dislocation, non-surgical treatment and active rehabilitation can be considered. However, the specific indications and timing of surgery are still controversial. Compared with young people, most elderly patients present with incomplete cervical spinal cord injury and are expected to restore better limb function, following poor recovery of self-care ability. It is important to monitor the functional change throughout rehabilitation and adjust the hours and intensity of training accordingly.
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Objective:To investigate the relation between aquaporins (AQPs) and fecal water content in rats with spinal cord injury. Methods:A total of 48 female Sprague-Dawley rats were divided into control group (n= 24) and spinal cord injury group (SCI group,n = 24). SCI group underwent transection at T8, while the control group was only subjected to laminectomy. Posterior limb function was assessed by Basso-Beattie-Bresnahan (BBB) score before modeling and on the 1st, 3rd, 7th, 14th and 28th day after SCI. Fecal water content was measured before modeling and on the 3rd, 14th and 28th day after SCI. Colon specimens were collected to detect the expression of AQP1, AQP3 and AQP4 by immunohistochemistry on the 3rd, 14th and 28th day after SCI. Results:The BBB score was significantly lower in SCI group than in the control group (t > 69.230,P< 0.001) after SCI, as well as the fecal water content (t > 5.814,P< 0.001). The expression of AQP1, AQP3, and AQP4 in the colon was higher in SCI group than in the control group (|t|> 5.165,P < 0.01) on the 3rd, 14th, and 28th day after SCI. The expression of AQPs negatively correlated with fecal water content (r = -0791~-0.730,P< 0.001). Conclusion:The expression of AQPs in the colon of rats after SCI was up-regulated, which was correlated with excessive water absorption after SCI.
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Objective:To analyze the characteristics of athletes' sports injuries during the Winter Olympic and Winter Youth Olympic Games. Methods:The information of registered athletes during the 2010, 2014 Winter Olympics and 2012 Winter Youth Olympic Games, including the injury numbers of each sport, damage sites, types and severity of injuries were collected, and the epidemiological characteristics were analyzed. Results:A total of 6370 person-time registered athletes were collected and 789 sports injuries were recorded. The injury rate per 1000 registered athletes was 123.9. An average of 11% of athletes was injured at least once. There was a significant difference in the injury rate among these events (χ2 = 12.301, P = 0.002). Women were more likely to be injured than men (χ2 = 5.220, P = 0.022). The top three sports with the highest injury rate were snowboarding (23.9%), freestyle skiing (23.2%) and Bobsleigh (18.0%); the top three sports with the largest number of injuries were ice hockey (160 person-time, 20.3%), alpine skiing (128 person-time, 16.2%) and snowboarding (113 person-time, 14.3%). The top three most injured sites were knee (54 person-time, 13.6%), head (41 person-time, 10.3%) and lumbar spine/lower back (27 person-time, 6.8%); the top three types of injury were contusion/haematoma/bruise (123 person-time, 30.9%), sprain (dislocation/subluxation or ligamentous rupture) (71 person-time, 17.8%) and strain (muscle rupture/tear or tendon rupture) (47 person-time,11.8%). A total of 251 injuries (31.8%) were expected to result in time loss for the athlete, 81 out of whom were severe injuries (32.3%). Conclusion:There is a mass of sport injuries in winter sports events with different types and severities. The incidence of injury varies with sports, and it is focused on snowboarding, freestyle skiing and Bobsleigh, ice hockey and alpine skiing. It is needed to research the technical characteristics of specific sports, damage risk factors and mechanism to reduce the sports injuries, and to construct green channels for sports injuries, to promote the recovery of function.
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Spinal injuries caused by competitive sports are common. Spinal diseases are important issues that needs to be solved urgently in the fields of sports injury. Return to play recommendations are complicated due to a mix of medical factors, social pressures, and limited outcome data. This article reviewed the current situation of athletes return to play after spine and spinal cord injury based on disease classification, including cervical spine (cervical soft tissue injuries, cervical fracture and dislocation, cervical stenosis, cervical disk herniation, stingers and burners), thoracic spine (thoracic fracture), lumbar spine (lumbar strain, lumbar stenosis spondylolysis and spondylolisthesis, lumbar disk herniation), and spinal cord concussion and spinal cord injury. This article also analyzed the criteria for athletes to return to play after spine and spinal cord injuries. It may provide references for future clinical management and consensus/guidelines.
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Objective:To study the regularity of clinical symptoms of sympathetic cervical spondylosis. Methods:A retrospective study was conducted on 110 patients with sympathetic cervical spondylosis admitted to the outpatient department from 2017 to 2019. The regularity of clinical symptoms of the patients was analyzed, including the sympathetic symptoms of different systems, the property of dizziness, the sequence, time interval and correlation of the symptoms, and whether the numbness of the limbs was accompanied by the symptoms and signs of cervical spondylotic radiculopathy and cervical spondylotic myelopathy. Results:The sympathetic symptoms were complex, involved in digestive system (71.82%), cardiovascular system (83.64%), respiratory system (63.64%), sweat gland (48.18%), eyes (81.82%), ears (60.91%), brain (68.18%) and limbs (70%), mainly sympathetic excitatory. The dizziness of the patients was mainly manifested as muddled brain (66.36%), a few patients were accompanied by external objects or their own rotation and sloshing (23.64%), and a very few patients showed external objects or their own rotation and sloshing (8.18%). Most patients complained chronic neck pain before dizziness and other sympathetic symptoms, accounting for 58.18%. The mean time for progression from neck pain to dizziness was (68.98±64.42) months. There were 77 patients complaining limb numbness, but none of them was found symptoms or signs of cervical spondylotic radiculopathy or cervical spondylotic myelopathy. It seemed to be a part of sympathetic symptoms in the limbs. The severity of dizziness was positively correlated with the course of disease (r = 0.610, P < 0.001), and was also positively correlated with the score of sympathetic symptom (r = 0.301, P = 0.004). Conclusion:The symptoms of sympathetic cervical spondylosis are complex. Muddled brain is the main symptom of dizziness, not vertigo. As the disease progresses, dizziness and sympathetic symptoms gradually worsen. Most sympathetic cervical spondylosis develops from cervical spondylosis. Cervical spondylotic radiculopathy or cervical spondylotic myelopathy may be the more severe forms of cervical spondylosis that develop on this basis。
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Objective:To Compare and analyze the gut microbiota and biochemical indexes between patients with acute traumatic complete spinal cord injury and healthy subjects. Methods:From May, 2017 to May, 2018, a total of 44 patients with acute traumatic complete spinal cord injury (patient group) and 33 healthy controls (control group) were included. The clinical data and fresh blood, urine and fecal samples of the two groups were collected. The V3-V4 region of 16S rRNA gene was sequenced and analyzed. Results:The abundance of gut microbiota was higher in the patient group than in the control group, and the structural composition was different. Compared with the control group, the expression of Bacteroidetes decreased (P < 0.05), and the expression of Actinobacteria, Proteobacteria, Synergistetes, Saccharibacteria and Cyanobacteria increased in the patient group (P < 0.05). The serum glucose, low density lipoprotein, triglyceride and total cholesterol were significantly higher in the patient group than in the control group (P < 0 05). There was a significant correlation between these elevated markers and intestinal microbial community structure (P < 0.05). Conclusion:There is gut microbiota dysbiosis in patients with acute traumatic complete spinal cord injury, and the changes of the microbiota are related to the elevation of some serum biomarkers.
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Objective:To explore the related factors affecting the functional outcome of adult spinal cord injury and to establish a predictive model. Methods:A retrospective analysis was made on the medical records of 110 adult spinal cord injured patients with paraplegia from September, 2016 to December, 2018. Quantitative indicators that affected functional outcome were systematically collected, including age, length of stay, number of other diagnostic, number of complications, number of comorbidities, number of operations, days from onset to rehabilitation intervention, and the total scores of Lower Extremity Motor Subscore (LEMS), light touch (LT), pin prick (PP) and modified Barthel Index (MBI) at admission (MBIa) and discharge (MBId), the change values and change rates of MBI were calculated. The correlation coefficients among variables were analyzed. Multivariate linear regression models were established for the MBI total score at discharge and change of MBI score from admission to discharge (MBIc). Results:MBId was significantly correlated with MBIa, the total score of LEMS at admission (LEMSa), the total score of PP at admission, the total score of LT at admission, the number of days from onset to rehabilitation intervention, the number of operations and the number of comorbidities. The fitted regression equation was: MBId = 28.24 + 0.52 × MBIa + 0.24 × LEMSa - 1.23 × number of comorbidities (R2 = 0.64, P < 0.001). The MBIc was significantly correlated with MBIa, the days from onset to rehabilitation intervention and the length of stay. The fitted regression equation was: MBIc = 18.44 - 0.29 × MBIa + 0.06 × length of stay (R2 = 0.29, P < 0.001). Conclusion:The spinal cord injured patients with better functional status, higher motor score and less comorbidity at admission, and longer hospitalization have better functional recovery.
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Objective To study the dynamic changes of the intestinal function of neurogenic bowel dysfunction rats caused by spi-nal cord injury using X-ray radiography. Methods Twenty-four female Sprague-Dawley rats were divided into control group (n=12) and spinal cord injury group (n=12). The T10spinal cord injury model was established using aneurysm clip (70 grams calibration force) for 60 seconds. The control group exposed the dura only. X-ray Barium was used to observe the dynamic changes of in-testinal function, and HE staining was used to observe the pathology of the colon before and four weeks after modeling. Results Compared with the control group, gastric emptying and intestinal transit function significantly reduced in the spinal cord injury group (P<0.05). Conclusion The spinal cord injury model can be successfully duplicated with aneurysm clip in rats; neurogenic bowel dysfunction occurs after spinal cord injury, gastric emptying and intestinal transit function are weakened.
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Neurogenic bowel dysfunction is one of the most common complications of spinal cord injury.It can cause abdominal distension,constipation,fecal incontinence,difficult defecation,prolonged defecation and other symptoms.At present, neurogenic bowel dysfunction is mainly evaluated through general condition,physical examination,experimental exami-nation,professional scales and intestinal microbiota,etc.
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<p><b>OBJECTIVE</b>To investigate the clinical outcomes of semicircular decompression in treating old thoracolumbar fractures and intractable neuropathic pain.</p><p><b>METHODS</b>From September 2009 to September 2013, 21 patients with old thoracolumbar fracture and intractable neuropathic pain were treated with semicircular decompression. Among initial surgery, posterior pedicle screw fixation was used in these patients, with or without laminectomy. All patients were male, range in age from 20 to 28 years old with an average of (25.00±2.38) years. Vertebral body residual bone block resulted in intra-spinal placeholder more than 50%. All patients were complete spinal cord injury (ASIA grade) or cauda equina injury. VAS scores was from 6 to 10 points with the mean of 7.14±0.91. In these patients, MRI, CT, X-rays were performed; denomination and dosage of analgesics were recorded; nerve function and pain status were respectively evaluated by ASIA grade and VAS score before and after operation.</p><p><b>RESULTS</b>All patients were followed up from 8 to 32 months with an average of (17.29±6.02) months. All bone fragments of spinal canal were removed and spinal cord decompressions were achieved. At final follow-up, VAS scores were from 0 to 8 points with an average of (2.43±2.46) points, and were obviously reduced than peroperative data (P<0.05). Eleven cases of them stopped analgesic intake and 7 cases reduced using. Three patients' symptoms and VAS scores were not improved.</p><p><b>CONCLUSION</b>Old thoracolumbar fractures and intractable neuropathic pain need receive imaging examination as soon as possible and consider semicircular decompression therapy if bone fragments were in vertebral canal and spinal canal stenosis existed. This therapy can effectively relieve pain and profit nerve functional recovery.</p>
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Adult , Humans , Male , Young Adult , Decompression, Surgical , Methods , Lumbar Vertebrae , Wounds and Injuries , General Surgery , Neuralgia , General Surgery , Pain, Intractable , General Surgery , Spinal Fractures , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General Surgery , Visual Analog ScaleABSTRACT
<p><b>OBJECTIVE</b>To summarize the experiences in the treatment of complicated orbital fractures.</p><p><b>METHODS</b>A total of 89 patients with complicated orbital fractures treated in Department of Oral and Maxillofacial Surgery, China Medical University from January 2005 to January 2010 were retrospectively reviewed. The classification of these cases included naso-orbital-ethmoid fracture, frontal orbital fracture and orbitozygomatic fracture. All patients were followed up for 6 - 36 months.</p><p><b>RESULTS</b>The orbital frame was repaired or reconstructed in these patients. The function of lacrimal pathways was improved. All the patients and the physicians were satisfied with the surgical effects. However, recurrence of deformity after endophthalmas correction was found in several cases.</p><p><b>CONCLUSIONS</b>The experiences, comprehensive management of complicated orbital fractures by team approaches, concluded from this study could be expanded. There are still challenges in the treatment of complicated orbital fractures, such as severe endophthalmas deformity, recurrence of endophthalmas deformity and malunion of complicated orbital fracture.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Enophthalmos , General Surgery , Ethmoid Bone , Wounds and Injuries , General Surgery , Follow-Up Studies , Nasal Bone , Wounds and Injuries , General Surgery , Orbital Fractures , General Surgery , Plastic Surgery Procedures , Retrospective Studies , Skull Fractures , General Surgery , Zygomatic Fractures , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the classification of alar base depression, so as to provide the reference for the surgical management of secondary nasal deformity of unilateral cleft lip.</p><p><b>METHODS</b>From Jul. 2008 to Feb. 2009, 26 cases with secondary deformity of unilateral cleft lip were treated. All the patients underwent 3-dimensional CT for maxillary measurement. The nasal soft tissue measurement was performed pre- and post-operatively. The relationship between the maxillary and soft tissue at alar base was analyzed. The nasal deformity was classified.</p><p><b>RESULTS</b>The location of alar base was not related to the form of piriform aperture, but the bony defect at the alar base was correlated to the patient satisfactory. The nasal deformity was graded as I when the depression at alar base was less than 4.5 mm in depth, as II when it was 4.5-5.0 mm in depth, and as III when it was more than 5 mm in depth. The deformity could be corrected with only soft tissue plasty for grade I, with soft tissue plasty or artificial implants for grade II, with combined bone autograft or alveolar cleft repair for grade III.</p><p><b>CONCLUSIONS</b>The depression at maxillary does not necessarily result in alar base depression. The alar base can be adjust to proper position through operation. The operation should be designed based on the preoperative nasal measurement.</p>
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Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Cleft Lip , General Surgery , Nose , Congenital Abnormalities , General Surgery , Postoperative Complications , General Surgery , Rhinoplasty , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the influence of LY294002 on protein kinase B expression in salivary adenoid cystic carcinoma cells (SACC).</p><p><b>METHODS</b>Using Western-blot and RT-PCR detected the protein and mRNA level of protein kinase B (PKB) both in cell line, absent and present LY294002. The data were analysed by t-test.</p><p><b>RESULTS</b>The expression and transcription level of PKB (Ser(473)) in SACC-83 was lower than in SACC-LM (P < 0.05). The expression of PKB (Ser(473)) in SACC cell lines with LY294002 was lower than in SACC cell lines without LY294002 (P < 0.01). The transcription level of PKB showed no difference in SACC cell lines with and without LY294002 (P > 0.05).</p><p><b>CONCLUSIONS</b>In vitro, the protein expression and transcription level of PKB (Ser(473)) is higher in SACC-LM cell line than in SACC-83 cell line. In vitro, LY294002 can inhibit protein expression of PKB (Ser(473)) in SACC-83 cells and SACC-LM cells.</p>
Subject(s)
Humans , Carcinoma, Adenoid Cystic , Drug Therapy , Chromones , Pharmacology , Enzyme Inhibitors , Pharmacology , Morpholines , Pharmacology , Proto-Oncogene Proteins c-akt , Metabolism , Salivary Gland Neoplasms , Drug Therapy , Tumor Cells, CulturedABSTRACT
<p><b>OBJECTIVE</b>To introduce the therapy of malformation caused by naso-orbito-ethmoidal (NOE) complex and adjacent craniomaxillofacial fracture.</p><p><b>METHODS</b>Seventy-six cases with NOE complex and adjacent craniomaxillofacial fracture underwent surgical replacement and internal fixation, using several cosmetically favorable incisions. At the same time, nasal reconstruction was performed to correct nasal deformities and defect through the coronal access during the exposure for the treatment of the NOE fracture. If larger nasal fragments were present, they were reduced and fixed by microplates or wires. If there was lack of septal support, dorsal nasal bone grafting was used to reestablish the height and anterior projection of the nose. Synthetic material (Medpor) was chosen for restoration of the orbital defects. Transnasal reduction was used for canthopexy.</p><p><b>RESULTS</b>After 3 - 6 months follow-up, the outcomes of these patients were satisfactory functionally and esthetically. Posttraumatic nasal malformation and enophthalmos were corrected in most cases, and residual enophthalmos occurred in 3 cases, diplopia in 2 cases, insufficient prominence in 5 cases which underwent secondary correction with good results. Transnasal reduction of canthal realignment in the type III fracture was also satisfactory. There was no complication in this group.</p><p><b>CONCLUSIONS</b>Comprehensive pre-operative evaluation of the patient and careful examinations should be taken to workout an appropriate operation plan. Simultaneous restoration for this type of complicated fracture is critical to obtain good results.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Ethmoid Bone , Wounds and Injuries , General Surgery , Follow-Up Studies , Fracture Fixation, Internal , Nasal Bone , Wounds and Injuries , General Surgery , Orbital Fractures , General Surgery , Plastic Surgery Procedures , MethodsABSTRACT
<p><b>OBJECTIVE</b>The aim of this study was to observe the expression of mTOR (mammalian target of rapamycin) and its substrates in oral squamous cell carcinoma.</p><p><b>METHODS</b>mTOR and its substrates alpha1, alpha2, beta1, beta2 isoforms of p70 S6 kinase (p70S6k) and 4EBP1 were examined by means of RT-PCR, Western-blot test.</p><p><b>RESULTS</b>The result of RT-PCR showed that in poorly differentiated tissue, the expression level of mTOR and its substrates alpha1, alpha2, beta1, beta2 isoforms of p70S6k increased obviously, while that of 4EBP1 decreased, while that in well differentiated tissue was second to it, the normal oral tissue was the last. The expression of Western-blot was the same as the RT-PCR.</p><p><b>CONCLUSION</b>The expression of mTOR and its substrates differs in different types of oral squamous cell carcinoma. The result suggests that mTOR, p70S6K and 4EBP1 might play important roles in oral squamous cell carcinoma. It may be an important target protein to treat tumor in the future.</p>
Subject(s)
Humans , Adaptor Proteins, Signal Transducing , Metabolism , Carcinoma, Squamous Cell , Metabolism , Mouth Neoplasms , Metabolism , Phosphoproteins , Metabolism , Ribosomal Protein S6 Kinases, 70-kDa , Metabolism , TOR Serine-Threonine Kinases , MetabolismABSTRACT
<p><b>OBJECTIVE</b>In order to improve the diagnosis and treatment of the complex fracture of the orbit region and adjacent cranio-maxillofacial fracture.</p><p><b>METHODS</b>73 cases with blowout fracture of the orbit and adjacent cranio-maxillofacial fracture in recent years were retrospectively analyzed and comparied with different methods of treatment. All cases had undertaken CT examinations.</p><p><b>RESULTS</b>The positive rate of the CT examinations with blowout fracture of the orbit and adjacent cranio-maxillofacial region were 100%. Operating repositioning, rigid fixation and artificial material placement were used to treat this kind of deformities.</p><p><b>CONCLUSIONS</b>With the progress of modern photographic methods, blowout fracture of the orbit and adjacent cranio-maxillofacial fracture can be diagnosed clearly and help the operation procedure. Operations with reduction, rigid fixation and filling materials can be used to restore this kind of fracture and appearance.</p>