ABSTRACT
Lumbosacral nerve root anomalies (LNRA) refers to the abnormality of lumbosacral nerve root in morphology, course and initial position, which may be related to the abnormal migration of nerve root in embryo. Imaging examination is a commonly used method for localization and qualitative diagnosis of LNRA. Clinically, many classification systems have been established based on imaging results, autopsy reports and Book observations. However, the lack of evaluation on the advantages and disadvantages of each classification is not conducive to the development of clinical work. In this paper, the classification and characteristics of LNRA at home and abroad were reviewed, and the advantages and limitations of each classification were evaluated. Through the literature retrieval and summary, it is not reliable to design the corresponding classification based on the imaging results. Not only is the detection rate of MRI as the preferred examination method far lower than that of autopsy, but also it is not an intuitive study of the lesions, and its authenticity is questionable. Based on the classification of autopsy results, the spinal cord is directly stripped in the study, excluding the surrounding soft tissue and bone marrow. The interference of spinal bone structure is more conducive to the comprehensive observation of variation, which has a certain guiding significance for clinical; based on the classification of intraoperative observation results, the number of research samples is large, easy to obtain, and there are matching imaging data to do the follow-up comparative study, among which the Neidre classification is themost widely used classification, which provides considerable convenience for clinical work. LNRA may not be treated as a common disease due to the limitation of technology and lack of understanding. The lack of specific symptoms and the characteristics of combined compression will affect the detection rate. In terms of treatment, traditional discectomy and spinal canal decompression cannot meet the clinical needs. More new surgical methods need to be proposed to improve the prognosis and quality of life of patients.
ABSTRACT
Objective Using dynamic glucose monitoring system to investigate the influence of dynamic glucose excursion onthe serum cystatin C (Cys-C) in patients with type 2 diabetes mellitus (T2DM).Methods A total of 164 hospitalized patients with T2DM were selected in this study.All the patients underwent continuous 72 hours dynamic glucose monitoring.The parameters of glucose excursion were calculated,including blood glucose standard deviation (SD),and average blood glucose level (MBG).According to the monitoring results,the patients were divided into two groups:high blood glucose excursion groupand low blood glucose excursion group.Cys-C level and other biochemical parameters were detected.Then the correlation of SD and Cys-C was analyzedin the two groups.Results There were significant difference in age,urea nitrogen (BUN),serum uric acid (SUA),glomerular filtration rate (eGFR),and Cys-C levels between the two groups (P＜ 0.05).The mean value of Cys-C and the percentage of high Cys-C level were higher in high blood glucose excursion group than in low blood glucose excursion group.There was a positive correlation between SD and Cys-C (r=0.344,P＜0.01) in the whole group as well as in high blood glucose excursion group and low blood glucose excursion group (r=0.604,0.331,P＜0.01).The incidence of diabetic peripheral arterial disease(PAD),diabetic peripheral neuropathy(DPN),diabetic retinopathy(DR),DKD were higher in high blood glucose excursion groupthan in the low blood glucose excursion group.Multivariate stepwise regression analysis showed that WC,GA,FPG,FIns,SUA,eGFR,and SD were in dependent risk factors for Cys-C,and among them,SD had the greatest contribution(β=0.112,SE=O.025,P=0.000).Conclusion The dynamic glucose excursion is positively correlated with Cys-C in patients with T2DM.The greater the blood glucose excursion,the higher the Cys-C level.