Correlation between degeneration of cervical intervertebral disc and degeneration of paravertebral muscle.

Objective: To investigate the relationship between degeneration of cervical intervertebral disc and degeneration of paravertebral muscles[multifidus (MF), cervical semispinalis (SCer), semispinalis capitis (SCap) and splenius capitis (SPL)]. Methods: 82 patients with chronic neck pain were randomly selected, including 43 males and 39 females, with 50.73 0.7.51 years old. All patients were scanned by 3.0T MRI Philips Ingenia performed conventional MRI sequence scanning and fat measurement sequence mDIXON-Quant scanning of cervical. Fat infiltration (FI) and cross-sectional area (CSA) of cervical paravertebral muscle (MF, SCer, SCap and SPL) at central level of C5-6 disc were measured by Philips 3.0T MRI image post-processing workstation. According to Pfirrmann grading system, there was no grade I in the included cases. The number of grade IIr IV cases were n=16, 40, 19 and 7 respectively. CSA and FI of cervical paravertebral muscles were compared with t test or one-way ANOVA, Spearman correlation analysis was used to evaluate the correlation between age, disc degeneration, and CSA, FI of cervical paravertebral muscles, and multiple linear regression analysis was used to analyze the independent influencing factors of CSA and FI. Results: CSA of cervical paravertebral muscles in male patients was significantly higher than that in female patients (all P<0.001), but there was no significant difference in FI (all P>0.05). Age was weakly correlated with CSA of MF+SCer, moderately correlated with CSA of SCap and SPL (r=-0.256, -0.355 and -0.361, P<0.05), weakly correlated with FI of SCap and SPL (r= 0.182 and 0.264, P<0.001), moderately correlated with FI of MF+SCer (r=0.408, P<0.001). There were significant differences in FI with disc degeneration (P<0.001, P=0.028 and P=0.005). Further correlation analysis showed that disc degeneration was strongly correlated with FI of MF+SCer (r=0.629, P<0.001), and moderately correlated with FI of SCap and SPL (r=0.363, P=0.001; r=0.345, P=0.002). Multiple linear regression analysis showed that sex and age were the influencing factors of CSA of SCap and SPL, sex was the independent influencing factor of CSA of MF+SCer, and disc degeneration was the independent influencing factor of FI. Conclusions: Age is negatively correlated with CSA and positively correlated with FI. Disc degeneration was correlated with FI of paravertebral muscles, especially with FI of MF and SCer. Sex and age were the influencing factors of CSA, while disc degeneration was the independent influencing factor of FI.

Prevalence and risk factors for cage subsidence after lumbar interbody fusion: A protocol for systematic review and meta-analysis.

INTRODUCTION: Lumbar interbody fusion (LIF) is an effective treatment for lumbar degenerative diseases. Cage subsidence (CS) contitutes one of the most common postoperative complications. Many risk factors for CS after LIF have been reported in some studies. However, controversies still exist. The objective of this study will be to summarize data on the prevalence and risk factors of CS after LIF. METHODS AND ANALYSIS: Our study present a protocol that conducted a systematic review and meta-analysis of prevalence and risk factors for CS after LIF. Two reviewers retrieved the relevant articles using the 5 databases (PubMed, Scopus, EMBASE, Cochrane Library, and Web of Science) from inception to May 31st, 2021. Primary outcome will be the prevalence of CS after LIF. Second outcomes include the risk factors associated with postoperative CS and clinical outcomes associated with postoperative CS. Three reviewers will screen citation titles and abstracts and evaluated full-text of each potentially relevant citation, and then extracted the data using a data extraction form. Any discrepancies in decisions between reviewers will be resolved through discussion. We assessed the methodological quality and risk of bias of the included studies based on the Newcastle-Ottawa Quality Assessment Scale (NOS). The aim of the extra analysis is to explore the explanations of the heterogeneity (age, gender, race, year of publication, type of study and surgical procedure). Publication bias will be assessed by Begg test, Egger test and funnel plots. ETHICS AND DISSEMINATION: No primary data will be collected and individual patient information and endangering participant rights, thus ethics approval is not required. Findings will be reported through publication and media. PROTOCOL REGISTRATION NUMBER: PROSPERO CRD42021257981 (https://www.crd.york.ac.uk/PROSPERO/#joinuppage).

Development and validation of a nomogram for predicting the probability of new vertebral compression fractures after vertebral augmentation of osteoporotic vertebral compression fractures.

INTRODUCTION: New vertebral compression fractures (NVCFs) are adverse events after vertebral augmentation of osteoporotic vertebral compression fractures (OVCFs). Predicting the risk of vertebral compression fractures (VCFs) accurately after surgery is still a significant challenge for spinal surgeons. The aim of our study was to identify risk factors of NCVFs after vertebral augmentation of OVCFs and develop a nomogram. METHODS: We retrospectively reviewed the medical records of patients with OVCFs who underwent percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). Patients were divided into the NVCFs group and control group, base on the patients with or without NVCFs within 2 years follow-up period after surgery. A training cohort of 403 patients diagnosed in our hospital from June 2014 to December 2016 was used for model development. The independent predictive factors of postoperative VCFs were determined by least absolute shrinkage and selection operator (LASSO) logistic regression, univariate analysis and multivariate logistic regression analysis. We provided a nomogram for predicting the risk of NVCFs based on independent predictive factors and used the receiver operating characteristic curve (ROC), calibration curve, and decision curve analyses (DCA) to evaluated the prognostic performance. After internal validation, the nomogram was further evaluated in a validation cohort of 159 patients included between January 2017 and June 2018. RESULTS: Of the 403 patients in the training cohort, 49(12.16%) were NVCFs at an average of 16.7 (1 to 23) months within the 2 years follow-up period. Of the 159 patients in the validation cohort, 17(10.69%) were NVCFs at an average of 8.7 (1 to 15) months within the 2 years follow-up period. In the training cohort, the proportions of elderly patients older than 80 years were 32.65 and 13.56% in the NVCFs and control group, respectively (p = 0.003). The percentages of patients with previous fracture history were 26.53 and 12.71% in the NVCFs and control group, respectively (p = 0.010). The volume of bone cement were 4.43 ± 0.88 mL and 4.02 ± 1.13 mL in the NVCFs and Control group, respectively (p = 0.014). The differences have statistical significance in the bone cement leakage, bone cement dispersion, contact with endplate, anti-osteoporotic treatment, post-op Cobb angle and Cobb angle restoration characteristics between the two groups. The model was established by multivariate logistic regression analysis to obtain independent predictors. In the training and validation cohort, the AUC of the nomogram were 0.882 (95% confidence interval (CI), 0.824-0.940) and 0.869 (95% CI: 0.811-0.927), respectively. The C index of the nomogram was 0.886 in the training cohort and 0.893 in the validation cohort, demonstrating good discrimination. In the training and validation cohort, the optimal calibration curves demonstrated the coincidence between prediction and actual status, and the decision curve analysis demonstrated that the full model had the highest clinical net benefit across the entire range of threshold probabilities. CONCLUSION: A nomogram for predicting NVCFs after vertebral augmentation was established and validated. For patients evaluated by this model with predictive high risk of developing postoperative VCFs, postoperative management strategies such as enhance osteoporosis-related health education and management should be considered.

Clinical observation of two bone cement distribution modes after percutaneous vertebroplasty for osteoporotic vertebral compression fractures.

BACKGROUND: Current findings suggest that percutaneous vertebroplasty(PVP) is a suitable therapeutic approach for osteoporotic vertebral compression fractures (OVCFs). The present retrospective study aimed to investigate the differences in clinical efficacy and related complications between the two bone cement distribution modes. METHODS: We retrospectively reviewed the medical records of the patients with single-segment OVCFs who underwent bilateral percutaneous vertebroplasty. Patients were divided into blocky and spongy group according to the type of postoperative bone cement distribution. Clinical efficacy and related complications was compared between the two bone cement distribution modes on 24 h after the operation and last follow-up. RESULTS: A total of 329 patients with an average follow up time of 17.54 months were included. The blocky group included 131 patients, 109 females(83.2 %) and 22 males(16.8 %) with a median age of 72.69 ± 7.76 years, while the Spongy group was made up of 198 patients, 38 females(19.2 %) and 160 males(80.8 %) with a median age of 71.11 ± 7.36 years. The VAS and ODI after operation improved significantly in both two groups. The VAS and ODI in the spongy group was significantly lower than that in the blocky group, 24 h postoperatively, and at the last follow-up. There were 42 cases (12.8 %) of adjacent vertebral fractures, 26 cases (19.8 %) in the blocky group and 16 cases (8.1 %) in the spongy group. There were 57 cases (17.3 %) of bone cement leakage, 18 cases (13.7 %) in blocky group and 39 cases (19.7 %) in the spongy group. At 24 h postoperatively and at the last follow-up, local kyphosis and anterior vertebral height were significantly corrected in both groups, but gradually decreased over time, and the degree of correction was significantly higher in the spongy group than in the block group. The change of local kyphosis and loss of vertebral body height were also less severe in the spongy group at the last follow-up. CONCLUSIONS: Compared with blocky group, spongy group can better maintain the height of the vertebral body, correct local kyphosis, reduce the risk of the vertebral body recompression, long-term pain and restore functions.

Expression and clinical significance of galectin 3 in bladder cancer tissues and its effect on malignant biological behavior of T24 cells / 中国肿瘤生物治疗杂志

@#[Abstract] Objective: To investigate the expression of galectin-3 in bladder cancer tissues and its correlation with clinicopathological characteristics of bladder cancer patients, as well as to explore its effect on the proliferation, invasion and apoptosis of bladder cancer T24 cells. Methods:Atotal of 104 cases of pathologically confirmed bladder cancer tissues and the corresponding adjacent tissues were collected from the patients treated at the Affiliated Hospital of North Sichuan Medical College from May 2014 to June 2016. Immunohistochemistry staining was used to determine the galectin-3 protein expression in both cancer and adjacent tissues, and the correlations between galectin-3 expression and clinical pathological features were analyzed. siRNA-Gal3 and siRNA-Control were transfected into T24 cell, respectively. The expression of galectin-3 protein was detected by Western blotting, the proliferation of cells was detected by MTT assay; the invasion of cells was detected by Transwell assay; and the cell apoptosis was determined by Flow cytometry. Results: The positive rate of galectin-3 in bladder cancer tissues was significantly higher than that in adjacent tissues (73.1% vs 9.6%, P<0.05). The expression of galectin-3 in bladder cancer was correlated with histological grade, depth of invasion, lymph node metastasis and TNM stage (all P <0.05), but not with sex and age (P>0.05). The expression of galectin-3 was down-regulated significantly by siRNAGal3 (P<0.05). After interference with galectin-3, the proliferation and invasion of T24 cells was significantly decreased (all P<0.05) but the apoptosis was significantly increased (P<0.05). Conclusion: Galectin-3 is over-expressed in bladder cancer and is closely related to the clinicopathological features of bladder cancer patients. Interference of galectin-3 protein expression can inhibit proliferation and invasion and promote cell apoptosis of bladder cancer T24 cells. ··