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Objective To analyse the cement distribution after vertebroplasty and investigate the feasibility and clinical significance of its typing.Methods A retrospective case-series study examining the bone cement distribution on anteroposterior radiograph after vertebral augmentation was conducted on 1 324 patients (2 119 vertebrae) with osteoporotic vertebral compression fractures (OVCF) from May 2009 to May 2016.Among the patients,due to refracture,147 patients suffered two or more surgeries with a vertebral refracture rate of 11.1％.One or more adjacent vertebrae refracture occurred in 105 patients with the adjacent vertebrae refracture rate of 7.9％.The vertebral body was split into four regions on the basis of the central vertical and bilateral pedicle of vertical line.According to the bone cement distribution in the four regions,there were five distribution types:type Ⅰ:1-4 regions;type Ⅱ:2-3 regions;type Ⅲ:1 and 4 regions;type Ⅳ:3 and 4 or 1 and 2 regions;type Ⅴ:1 or 4 regions.The X-ray of 40 patients was randomly typed by three orthopedics physicians,and the complication rate and refracture rate of adjacent vertebrae in each type were calculated.Credibility and repeatability analysis were performed.Results The average credibility of the typing was 92.5％.The Kappa coefficient was 0.850 on average.The repeatability of two times of typing was on average 95％,and the Kappa coefficient was 0.900 on average.From type Ⅰ to Ⅴ,there were 26 cases (3.5％),16 cases (4.5％),29 cases (7.3％),40 cases (9.9％),and 41 cases (18.1％) of adjacent vertebral refracture.There were 10 cases of the same vertebral refracture and 5 cases of scoliosis deformity in the type Ⅴ,with incidence rates of 4.4％ and 2.2％,respectively.Conclusions Being reliable and repeatable,the typing for cement distribution after vertebral augmentation is simple and practicable.The type Ⅳ and Ⅴ cement distribution carries higher risk of refracture in adjacent or the same vertebral body and long-term scoliosis than others types.
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AIM:To explore the therapeutic effect of a novel Rho kinase inhibitor WAR 5 on the experimental autoimmune encephalomyelitis (EAE) and its possible mechanism.METHODS: Female C57BL/6 mice were randomly divided into EAE group and WAR5 group.EAE model was induced by the application of MOG 35-55 peptide.WAR5 was in-jected intraperitoneally every other day from post-immunization (PI) day 3 to PI day 27.The clinical score and body weight were recorded every other day .On PI day 28, the animals were sacrificed and spinal cords were obtained for HE and mye-lin staining .The splenocytes were isolated and the expression of CD 16/32 and CD206 were analyzed by flow cytometry . The protein extracts from the brains and spinal cords were collected for the measurement of inducible nitric oxide synthase ( iNOS) by Western blotting .RESULTS:The administration of WAR 5 delayed the onset of EAE and attenuated the clini-cal symptoms .The results of the pathological examination revealed that WAR 5 inhibited the infiltration of inflammatory cells and improved myelination in spinal cords , accompanied with the poralization of M 1 macrophages to M2 phenotype in the spleen.WAR5 inhibited the expression of iNOS in the central nervous system , especially in the spinal cords .CON-CLUSION:The therapeutic effect of WAR5 on EAE may be related to the shift of M1 macrophages to M2 phenotype and inhibition of inflammation in the central nerve system .
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Ossification of the posterior longitudinal ligament (OPLL) is common clinical spinal disorders often occurring in the cervical spine,with the main symptom being nerve compression.The specific mechanism of OPLL remains unclear,but genetic factors,single nucleotide polymorphisms (SNPs),mechanical stimulation,metabolism abnormality might be involved in the etiology of the disease.Multiple genetic and environmental factors may contribute to the development of OPLL.OPLL has prominent genetic characteristic,and it is associated with SNPs of several genes.Here we review the SNPs of several genes (COL11A2,BMP-2,TGF-?1,TGF-?3,NPPS,COL6A1 and Runx2) which contribute to the development of OPLL,hoping to lay a foundation for future study.
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Objective To evaluate the validity and reliability of simplified Chinese version Scoliosis Research Society-22 (SRS-22) questionnaire on assessment of life quality of adolescent idiopathic scoliosis (AIS) patients at different time points pre-and post-operation. Methods Translation and cross-cultural adaptation of the English version of SRS-22 questionnaire was done. 177 AIS patients were involved in present study and the life quality before and 6-and 12-months after operation was assessed by SRA-22 and Short Form-36 (SF-36) questionnaire, of them 145 cases (26 males and 119 females; 11.1-17.9 years old, averaged 15.8; Cobb angle 41?-109?, averaged 63?) completed all the 3 steps. To evaluate the reproducibility, 65 patients were assessed twice in an interval time of 4-6 days (averaged 4.6 days) before operation and 55 valid questionnaires were received, 65 patients were assessed twice in an interval time of 7-21 days (averaged 14.7 days) at 12 months following up and 57 valid questionnaires were received. The two measures of reliability as internal consistency and reproducibility were determined by Cronbach's ? coefficients and intraclass correlation coefficient (ICC), respectively. Concurrent validity was measured by comparing with SF-36 questionnaire. Measurement was made using the Pearson correlation coefficient (r). Results The Chinese version SRS-22 questionnaire had a satisfactory validity and reliability, with average Cronbach's ? coefficients of 0.79-0.85 and average ICC of 0.77-0.87. Considering concurrent validity, 2 domains had excellent correlation (r=0.75-1.00), while 12 had moderate correlation (r=0.50-0.75). The function/activity (SRS-22) and role-physical or physical functioning (SF-36), pain (SRS-22) and pain index (SF-36), mental health (SRS-22) and mental health (SF-36) had good correlation (r=0.70-1.00). For the 145 patients, there were some differences in 5 various domains between the three measurements (pre-operation and 6 and 12 months post-operation). The scores of all domains 12 months after operation increased significantly than those of pre-operation and 6 months post-operation (P