Analysis on optimal cut-off values for prediction of lumbar spinal stenosis using lumbar pedicle thickness / 中国基层医药

Objective:To investigate the optimal cut-off values for the prediction of lumbar spinal stenosis using lumbar pedicle thickness.Methods:The clinical data of 64 patients with lumbar spinal stenosis (patient group) admitted to Binzhou Center Hospital from November 2019 to April 2021 and 48 healthy volunteers (healthy control group) who concurrently received routine physical examination involving lumbar spine MRI examination in the same hospital were retrospectively analyzed. Lumbar pedicle thickness was measured on T 2 weighted images of the L 5 vertebral body in the axial projection. Lumbar pedicle thickness was compared between groups using the independent sample t-test. The relationship between lumbar pedicle thickness and age change was analyzed using a one-way analysis of variance. The efficacy of lumbar pedicle thickness in the diagnosis of lumbar spinal stenosis was evaluated using the receiver operating characteristic (ROC) curve, optimal cut-off values, sensitivity, specificity, and the area under the ROC curve. Results:There was no significant correlation between lumbar pedicle thickness and age change ( P > 0.05). Lumbar pedicle thickness of patients with lumbar spinal stenosis was significantly higher than that of healthy controls [(13.25 ± 1.73) mm vs. (8.54 ± 1.88) mm, t = 13.75, P < 0.05]. ROC curve results showed that the optimal cut-off value was 10.50 mm, with a sensitivity of 95.3% and a specificity of 85.4. The area under the ROC curve was 0.963 (95% CI 0.928-0.998). Conclusion:The increase in lumbar pedicle thickness is related to the increase in the incidence of lumbar spinal stenosis. Lumbar pedicle thickness is an accurate, objective, and clear morphological parameter for the prediction of lumbar spinal stenosis. Application of lumbar pedicle thickness to predict lumbar spinal stenosis is innovative and scientific.

The finite element analysis of polyetheretherketone/hydroxyapatite/carbon fiber cage / 生物医学工程学杂志

To compare the bio-mechanical characteristics of cages of two types, i. e., polyetheretherketone/ hydroxyapatite/carbon fiber (PEEK/HA/CF) and titanium combined with internal pedicle screw fixation in lumbar model, and to provide experimental evidences for clinical application, we constructed a three-dimensional finite element model of an intact L2-L4 segment by using computer tomography scans of a healthy male. The three-dimensional finite element models of an intact L2-L4 segment and single cage plus bilateral vertebral pedicle screw fixation were established. The angular motion of fused segment and stress distribution in the bone graft and cage and L3 inferior endplate under different loads were recorded. The result showed that the peak Von Mises stresses of the bone graft of PEEK/HA/CF group were at least 2.2 time as that of titanium group. The peak Von Mises stresses of L3 inferior endplate of the titanium group were at least 2. 3 times as that of PEEK/HA/CF group. These stresses were concentrated at places where the cage interfaced with the endplate. The angular variation of the titanium group showed similarity to PEEK/HA/CF group. The PEEK/HA/CF cage could provide stability similar to that of titanium cage in the presence of posterior instrumentation. It could increase the load transfer through the bone graft and promote the bone fusion. It could also reduce the stresses in endplates adjacent to the cage and reduce the subsidence of the cage.

Observation of the effect of multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy / 中国基层医药

Objective To explore the efficacy of multilevel anterior cervical discectomy and fusion for aged patients with cervical spondylotic myelopathy. Methods 25 aged patients with cervical spondylotic myelopathy were treated by multilevel anterior cervical discectomy and fusion. Japanese Orthopedic Association (JOA) scores were evaluated,clinical results were graded from excellent to poor using Odoms criteria,and the sagittal alignment of fusion segements were measured using Cobb method. Bone fusion and complications was evaluated. Results The final follow up score according to Odoms criteria was excellent in 8 patients ,good in 14 patients,and fair in 3 patients ,with excellent and good rate of 88%. The JOA score at final follow up(7.8) was significantly higher than preoperative(12. 8),with average improvement rate of 54%. At final follow up,bone fusion rate was 100%. Conclusion Multilevel anterior discectomy and fusion for aged patients with cervical spondylotic myelopathy was effective.

Expression and function of hepatocellular carcinoma-related gene pp1158 / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study in vitro and in vivo protein expression and biological function of gene pp1158, a hepatocellular carcinoma (HCC)-related gene.</p><p><b>METHODS</b>pp1158 was expressed with fusion expression vector pET-32a in E. Coli-BL21 (DE3), and rabbit anti-pp1158 fusion protein polyclonal antibody was prepared. The biological function and differential expressions of pp1158 were studied by in vitro colony formation assay nude mouse in vivo tumor formation assay of transfected BEL7402 cell line and immunohistochemistry and Western blot. Differential expression of pp1158 in human fetal tissues were examined by Northern blot.</p><p><b>RESULTS</b>In vitro experiment showed that pp1158 inhibited colony formation rate of transfected BEL 7402 cells, with an inhibition rate of 58.3% (P < 0.01). Tumor formation assay indicated that tumor formation of pCMV-Script-1158 transfected BEL 7402 cell line was significantly inhibited (P < 0.05) as compared with that of the control group. Immunohistochemical assay showed that pp1158 was expressed in human tissue in the following sequence: normal liver >/= noncancerous liver tissue > HCC. Western blot indicated that a 60kD protein (pp1158 protein) was expressed in BEL 7402 cells transfected with pCMV-Script-pp1158 DNA, while it was detected in BEL 7402 cells transfected with pCMV-Script vector DNA. Northern blot showed pp1158 was expressed in the placenta at a very high level, heart, liver, muscle, pancreas and lung but expressed poorly in the brain and kidney.</p><p><b>CONCLUSION</b>pp1158 is a new candidate tumor suppressor gene of HCC.</p>