Effect of T1 Slope on Disappearance of Cervical Lordosis after Posterior Cervical Double-Door Laminoplasty Based on Medical Informatics.

Cervical sagittal balance plays a pivotal role in spine surgeries as it has a significant impact on the clinical outcomes in cervical spine surgery. Image processing techniques have significantly improved the accuracy and precision of cervical surgical techniques. This study aims to investigate the effects of T1 slope (T1s) on the disappearance of cervical lordosis after posterior cervical double-door laminoplasty using medical informatics and radiographic measures. To do so, we determined and measured the loss of T1s and cervical lordosis during the postoperative follow-up period in patients with double-door posterior cervical laminoplasty. Patients (n = 40) who underwent posterior cervical double-door laminoplasty participated in this study. For all patients, the difference between the preoperative T1s (angle between the upper edge of T1 and the horizontal line) and preoperative and postoperative cervical lordosis (Cobb method) was estimated, and the linear relationship between the two was statistically analyzed to observe the influence of preoperative T1s on postoperative cervical lordosis disappearance. The average preoperative T1s was 23.54°, and the average preoperative cervical lordosis angle was 8.50°. After 1-20 months of follow-up (mean = 9.53 months), the average postoperative cervical lordosis was 8.50°, and the average loss of cervical lordosis was 0.22°. Twenty cases had different degrees of lordosis angle loss after the operation, with an average loss of 9.31°. All patients were divided into groups A and B, according to a mean value of T1s = 23.54°, of which T1S > 23.54° was group A and T1s < 23.54 was group B. Cervical lordosis was quantified by the C2-C7 Cobb angle. The Cobb angle difference of cervical lordosis was measured before and after the operation, and its correlation with preoperative T1s was assessed. The preoperative Cobb angle and cervical curvature changes in the two groups were statistically compared, and the difference between the two groups was statistically significant (p < 0.05). The group with a T1s > 23.54° had greater loss of preoperative Cobb angle and cervical curvature. In group A, the mean preoperative cervical disability index (NDI) was 32.4 ± 3.4, and the mean postoperative NDI score was 16.5 ± 2.1. The mean preoperative VAS scores of neck pain and neck pain were 5.41 ± 1.1 and 5.55 ± 0.3, respectively, and the improvement in neck pain was -0.2%. The mean preoperative NDI in group B was 30.1 ± 2.9, and the mean postoperative NDI score was 11.5 ± 3.1. The mean VAS score for preoperative neck pain was 5.11 ± 1.2, that for postoperative neck pain was 4.18 ± 0.7, and that for neck pain improved by 18%. There was a significant difference between the two groups (p < 0.05). The disappearance of cervical lordosis after posterior cervical double-door laminoplasty is an important cause of postoperative cervical spine pain. The T1s is meaningful for predicting the loss of postoperative curvature in patients undergoing posterior cervical double-door laminoplasty. This is especially true for patients with good preoperative cervical curvature without ankylosis and kyphosis but with a wide T1s.

Radiographic analysis of the sacral-2-alar screw trajectory.

PURPOSE: To explore the feasibility of sacral-2-alar (S2-alar) screw placement by measuring the length, diameter, and angle of the screw trajectory on computed tomography (CT). METHODS: This study selected 100 Han-nationality adults in northern China with a normal spine and pelvis. CT data were imported into PHILIPS software for reconstructing the 3D digital images. The optimal S2-alar screw trajectory was imitated on CT. Parameters including the length of the screw trajectory, sagittal angle, coronal angle, distance between the entry point and the spinous process, and minimum diameter of the screw trajectory were measured to evaluate the application of S2-alar screws. RESULTS: In total, 48 males and 52 females were included. The average length of the left screw trajectory was 47.18 ± 3.91 mm. The sagittal angle was 29.06 ± 4.00°. The coronal angle was 13.31 ± 6.95°. The distance between the entry point and the spinous process was 21.0 (3.7) mm. The minimum diameter of the screw trajectory was 17.1 (2.3) mm. The average length of the right screw trajectory was 45.46 ± 4.37 mm. The sagittal angle was 23.33 ± 4.26°. The coronal angle was 14.88 ± 6.84°. The distance between the entry point and the spinous process was 22.8 (2.9) mm. The minimum diameter of the screw trajectory was 16.9 (3.1) mm. In women, the average length of the left screw trajectory was 44.80 ± 3.66 mm. The sagittal angle was 32.14 ± 5.48°. The coronal angle was 16.04 ± 7.74°. The distance between the entry point and the spinous process was 21.8 (2.8) mm. The minimum diameter of the screw trajectory was 17.1 (5) mm. The average length of the right screw trajectory was 44.01 ± 3.72 mm. The sagittal angle was 25.12 ± 5.19. The coronal angle was 16.67 ± 8.34°. The distance between the entry point and the spinous process was 21.6 (2.7) mm. The minimum diameter of the screw trajectory was 17 (4.5) mm. As seen from the data, there were significant differences in the minimum diameter of the screw trajectory in both males and females. In females, there were also significant differences between the left and right sides in the coronal angle. Between males and females, there were statistically significant differences in the length of the screw trajectory. There were no statistically significant differences in the other parameters between males and females. CONCLUSION: The optimal screw trajectory of the S2-alar screw can be found on CT. The length and deflection angle of the screw meet the clinical requirements. This method is easy to perform and feasible for clinical application.

SLC19A1 May Serve as a Potential Biomarker for Diagnosis and Prognosis in Osteosarcoma.

BACKGROUND: Osteosarcoma is the most frequent primary malignant tumor of bone. SLC19A1 has been explored as a novel biomarker in some cancers. In this research, the diagnostic and prognostic value of SLC19A1 expression in osteosarcoma was evaluated by bioinformatics analysis. Data were sourced from the Gene Expression Omnibus (GEO) database. METHODS: Gene expression data and clinical materials of patients with osteosarcoma were collected from GSE42352 and GSE21257 datasets. The mRNA expression of SLC19A1 was compared between osteosarcoma cells and mesenchyme stem cells with the Wilcoxon rank-sum test. Moreover, receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic merit of SLC19A1 for osteosarcoma. The relationship between SLC19A1 and clinicopathological characteristics was analyzed using logistic regression. Besides, the correlation between SLC19A1 and survival rate was assessed using Kaplan-Meier and Cox regression. The biological functions of SLC19A1 were annotated and evaluated through gene set enrichment analysis (GSEA) and gene set variation analysis (GSVA). RESULTS: SLC19A1 was significantly highly expressed in osteosarcoma cells (p < 0.001). The ROC curve showed an area under the curve of 0.899, which indicated a high diagnostic value. High SLC19A1 expression showed a negative correlation with Huvos grade [odds ratio (OR) = 0.09 for III vs. I, p = 0.014]. Kaplan-Meier survival analysis showed that the overall survival (OS) of the patients with high SLC19A1 expression was significantly poorer than the low SLC19A1 expression group (p = 0.016). The univariate analysis revealed that high SLC19A1 expression was associated with poor OS [p = 0.013, hazard ratio (HR) = 6.74, 95% CI = 1.49 - 30.46]. The multivariate analysis revealed that SLC19A1 expression (p = 0.014, HR = 8.03, 95% CI = 1.52 - 42.51) was independently correlated with OS. GSEA showed that genes in high expression group of SLC19A1 were enriched in KEGG pathways, including "Glyoxylate and dicarboxylate metabolism", "Oxidative phosphorylation", "Aminoacyl tRNA biosynthesis", "Base excision repair", "Pyrimidine metabolism" and "Proteasome". GSVA further suggested their importance in the progression of osteosarcoma. CONCLUSIONS: SLC19A1 may be a potential biomarker for diagnosis and prognosis in osteosarcoma.

Association analysis between thrombospondin-2 gene polymorphisms and intervertebral disc degeneration in a Chinese Han population.

The aim of this study is to determine the contribution of 2 single nucleotide polymorphisms (SNPs) in thrombospondin 2 (THBS2) gene to the development of intervertebral disc degeneration (IDD) in a Chinese Han population.We studied 138 patients with radiographically proven IDD and 136 healthy volunteers with no history of back problems. Magnetic resonance images (MRIs) were obtained for all the patients and controls. Image evaluation for IDD was performed to evaluate the severity of IDD. All patients and controls were genotyped for rs6422747 and rs6422748. Associations between genotypes and development of IDD were analyzed.We found that 2 SNPs in the intron region of THBS2 gene (rs6422747 and rs6422748) were associated with susceptibility of IDD. However, they were not related with severity of IDD, including the total number of degenerative disc and level of IDD. G allele in both SNPs was associated with a higher risk of IDD.The 2 SNPs (rs6422747 and rs6422748) in the THBS2 gene were associated with susceptibility of IDD but not severity of IDD in a Chinese Han population. Our results indicated that THBS2 gene polymorphisms might be the risk factors for IDD. More studies with larger sample size need to be perfected to make sure the functions of THBS2 gene polymorphisms in IDD development.

Combined analysis of gene expression and genome binding profiles identified potential therapeutic targets of ciclopirox in Ewing sarcoma.

Ciclopirox (CPX) is a synthetic antifungal drug that is mainly used to treat dermatomycoses. The aim of the present study was to determine whether CPX could influence Ewing sarcoma progression. The present study suggested that CPX treatment may inhibit Ewing sarcoma (ES) progression through Ewing sarcoma breakpoint region 1­Friend leukemia integration 1 (EWS­FLI1), a common fusion transcript structure in patients with ES. To determine the underlying mechanisms of ES progression, cross analysis was conducted on three high­throughput genome or transcript me datasets from the Gene Expression Omnibus. The results indicated that CPX may inhibit ES growth by affecting vasculature development and DNA replication. A combination of genome­wide expression and binding profiles revealed several potential targets for CPX in ES, including collagen type I α2 chain, N­myc proto­oncogene and transforming growth factor ß1, which contained significantly enriched binding peaks of FLI1. In addition, network analysis, including a protein­protein interaction network and a transcription regulatory network, provided further detailed information about the roles of CPX in ES. This study may provide a novel solution for ES treatment and may also aid in improving its prognosis.