Predicting the risk of non-specific low back pain in the young population: development and assessment of a new predictive nomogram.

OBJECTIVE: Non-specific low back pain is a common disorder that affects more than 80% of the world's population. But the potential risk factors remain unclear. The aim of this study is to develop a nomogram for the risk prediction of low back pain in young population. PATIENTS AND METHODS: A total of 264 young participants (18-45 years old) were recruited and randomly divided into a training set (n=188) and a validation set (n=76) by a ratio of 7:3. The nomogram was developed based on the training set. The independent predictors of low back pain were identified by LASSO and logistic regression analysis. A nomogram was developed according to the predictors. To assess the reliability of the nomogram, the area under the curve (AUC), calibration curve, and decision curve analysis (DCA) were applied. The validation set was used to validate the results. RESULTS: Sixteen factors were included in the characteristics of the eligible subjects. LASSO showed that five independent predictors including working posture, exercising hours per week, Tuffier's line, six lumbar vertebrae anomaly, and lumbar lordosis angle were the independent risk factors of low back pain in young population, which were identified by multivariate logistic regression analysis and were used to establish the nomogram. The AUC values of the nomogram were 0.867 (95% CI: 0.809-0.924) and 0.868 (95% CI: 0.775-0.961) in the training and validation set, respectively. The calibration curve revealed that the prediction model of the nomogram was greatly consistent with the actual observation. In addition, the DCA indicated that the nomogram was clinically useful. CONCLUSIONS: Working posture, exercising hours per week, Tuffier's line, six lumbar vertebrae anomaly, and lumbar lordosis angle are identified as independent predictors of non-specific low back pain in young population. And the nomogram based on the above five predictors can accurately predict the risk of low back pain in young people.

[Analysis of correlation between spinal nerve high tension and disc degeneration in 100 cases].

Objective: To explore the correlation between the spinal nerve high tension and lumbar disc degeneration, the pathogenesis of hanging intervertebral disc degeneration. Methods: From June 2016 to June , a retrospective analysis 2017 of 100 cases of lumbar spinal stenosis were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University. They were divided into experimental group (50 cases, nerve high tension group) and control group (50 cases, nervous tension in the normal group) according to preoperative lumbar MRI of cauda equina syndrome and settlement of intraoperative detecting nerve tension. The Pfirrmann grade was used to evaluate degree of lumbar (L3/4-L5/S1) disc degeneration.The correlation between spinal nerve tension and lumbar disc degeneration was analyzed, and the severity of experimental group and control group on lumbar disc degeneration was compared. Results: There was no significant difference in the age and sex ratio between the two groups (P>0.05). The Pfirrmann score of the experimental group was L3/4 (4.74±1.6) grade, L4/5 (5.32±1.33) grade, L5/S1 (5.54±1.13) grade; the control group Pfirrmann score was L3/4 (3.5±1.16) grade, L4/5 (4.12±0.9) grade, and L5/S1 (4.1±0.97) grade.The severity of intervertebral disc degeneration in experimental group was higher than that in control group, with statistical significance (P<0.05). There was a correlation between lumbar disc degeneration and nerve tension in L3/4, L4/5 and L5/S1, and the correlation trend was L5/S1> L4/5> L3/4. Conclusion: There is a correlation between lumbar disc degeneration and spinal nerve high tension.A new pathogenesis of hanging intervertebral disc degeneration that the degeneration of lumbar disc is a compensatory mechanism in order to alleviate the axial stretch injury is put forward.

[Lumbosacral nerve bowstring disease].

Objective: To define a novel disease-lumbosacral nerve bowstring disease, and propose the diagnostic criteria, while capsule surgery was performed and evaluated in the preliminary study. Methods: From June 2016 to December 2016, a total of 30 patients (22 male and 8 female; mean age of 55.1±9.7 years) with lumbosacral nerve bowstring disease were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University.Lumbosacral nerve bowstring disease was defined as axial hypertension of nerve root and spinal cord caused by congenital anomalies, which could be accompanied by other lesions as lumbar disc herniation, spinal cord stenosis or spondylolisthesis, or aggravated by iatrogenic lesions, resulting in neurological symptoms.This phenomenon is similar to a stretched string, the higher tension on each end the louder sound.Meanwhile, the shape of lumbosacral spine looks like a bow, thus, the disease is nominated as lumbosacral nerve bowstring disease.All the patients underwent capsule surgery and filled out Owestry disability index (ODI) and Tempa scale for kinesiophobia (TSK) before and after surgery. Results: The mean surgery time was (155±36) min, (4.3±0.4) segments were performed surgery.The pre-operative VAS, TSK and ODI scores were (7.6±0.8), (52.0±10.3) and (68.4±12.7), respectively.The post-operative VAS, TSK and ODI scores were (3.3±0.4), ( 24.6±5.2) and (32.1±7.4)(P<0.05, respectively), respectively. Conclusion: The definition and diagnostic criteria of lumbosacral nerve bowstring disease was proposed.Capsule surgery was an effective strategy with most patients acquired excellent outcomes as symptoms relieved and quality of life improved.

Identification of isomers of resveratrol dimer and their analogues from wine grapes by HPLC/MS(n) and HPLC/DAD-UV.

A facile method based on HPLC/(-)ESI-MS(n) is established for the analysis of seven isomers of resveratrol dimers and three of their analogues in Xinjiang wine grapes. The structures of these compounds are positively or tentatively determined. Among them, three are tentatively identified as new compounds. MS(n) experiments on the [M-H](-) ions provide abundant structural information, especially regarding the relative abundance of the key product ions, m/z 333 and 369 (385 in compound 3), which can be utilised to distinguish whether or not the compound identified contains the scaffold of the isomer of a resveratrol dimer. The relative abundance of key product ions remains unchanged as collision energy varies from 0.60 to 0.95V. All the trans-, and cis-isomers could be identified by HPLC/DAD-UV spectra. The UV spectra of compounds 2 and 9 tentatively show cis and trans- configurations, respectively.