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Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

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Neural Regeneration Research 2024年第5期19卷 1126-1132页

作者： Hengxing Zhou Yongfu Lou Lingxiao Chen Yi Kang Lu Liu Zhiwei Cai David BAnderson Wei Wang Chi Zhang Jinghua Wang Guangzhi Ning Yanzheng Gao Baorong He Wenyuan Ding Yisheng Wang Wei Mei yueming song Yue Zhou Maosheng Xia Huan Wang Jie Zhao Guoyong Yin Tao Zhang Feng Jing Rusen Zhu Bin Meng Li Duan Zhongmin Zhang Desheng Wu Zhengdong Cai Lin Huang Zhanhai Yin Kainan Li Shibao Lu Shiqing Feng Department of Orthopedics The Second HospitalCheeloo College of MedicineShandong UniversityShandongChina Department of Orthopedics Shandong University Center for OrthopedicsQilu HospitalCheeloo College of MedicineShandong UniversityShandongChina Department of Orthopedics Tianjin Medical University General HospitalInternational Science and Technology Cooperation Base of Spinal Cord InjuryTianjin Key Laboratory of Spine and Spinal CordTianjinChina Faculty of Medicine and Health The Back Pain Research TeamSydney Musculoskeletal HealthThe Kolling InstituteUniversity of SydneySydneyNSWAustralia Department of Spine Surgery Honghui HospitalXi’an Jiaotong UniversityXi’anShaanxi ProvinceChina Department of Burns and Plastic Surgery The Fourth Medical Center of Chinese PLA General HospitalBeijingChina Faculty of Medicine and Health School of Health SciencesUniversity of SydneyNSWAustralia Sydney Spine Institute BurwoodSydneyNSWAustralia Laboratory of Epidemiology Tianjin Neurological InstituteDepartment of NeurologyTianjin Medical University General Hospital&Tianjin Neurological InstituteKey Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous SystemMinistry of Education and Tianjin CityTianjinChina Department of Orthopedics Henan Provincial People’s HospitalZhengzhouHenan ProvinceChina Department of Spinal Surgery The Third Hospital of Hebei Medical UniversityShijiazhuangHebei ProvinceChina Department of Orthopedics The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan ProvinceChina Department of Spine Surgery Zhengzhou Orthopedics HospitalZhengzhouHenan ProvinceChina Department of Orthopedic Surgery and Orthopedic Research Institute West China HospitalSichuan UniversityChengduSichuan ProvinceChina Department of Orthopedics Xinqiao HospitalArmy Medical UniversityChongqingChina Department of Orthopedics The First Affiliated Hospital of China Medical UniversityShenyangLiaoning ProvinceChina Department of Spinal Surgery Shengj

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even *** has the largest population of patients with traumatic spinal cord *** studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been *** the best of our knowledge,no national-level study of treatment status and economic burden has been *** retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national *** included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of *** epidemiological and clinical features,treatment status,and total and daily costs were *** in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression *** percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent *** 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 *** total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 ho

关键词： China clinical features costs epidemiology methylprednisolone sodium succinate methylprednisolone retrospective study traumatic spinal cord injury treatment

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腰椎退行性疾病外科治疗的发展与趋势

西部医学 2024年第8期36卷 1093-1096页

作者：宋跃明丰干钧四川大学华西医院四川成都610041

随着人口老龄化的发展,腰椎退行性疾病的患病率持续增加,腰椎外科治疗技术也逐渐向微创化发展。传统开放手术虽然疗效稳定,但可能导致脊柱后方结构的破坏和瘢痕化。目前微创腰椎手术的焦点包括单纯减压、镜下融合和斜外侧腰椎椎间融合术... 详细信息

随着人口老龄化的发展,腰椎退行性疾病的患病率持续增加,腰椎外科治疗技术也逐渐向微创化发展。传统开放手术虽然疗效稳定,但可能导致脊柱后方结构的破坏和瘢痕化。目前微创腰椎手术的焦点包括单纯减压、镜下融合和斜外侧腰椎椎间融合术(OLIF)三个方面。对于单纯减压,腰椎间盘摘除术可以通过显微镜、显微内镜椎间盘摘除术(MED)、单侧双通道内镜(UBE)及全内镜(FE)等方式实施。其中FE创伤最小,经椎间孔入路腰椎间盘摘除术(PETD)和经椎板间入路腰椎间盘摘除术(PEID)各有优势,UBE技术则因其灵活性和清晰视野成为近年来的优势技术。对于镜下融合,其主要用于治疗腰椎滑脱症,恢复正常腰椎序列。其中FE-TLIF和UBE-TLIF手术创伤小、恢复快、融合率高。相比腰椎前路椎间融合术(ALIF)和极外侧腰椎椎间融合术(XLIF),OLIF具有创伤小、植骨面大、矫正脊柱畸形等优点,能有效减少腹腔血管损伤及神经损伤等并发症。总体来看,腰椎微创技术发展迅速,结合机器人和导航技术将提高手术精准性和微创程度,有望推动腰椎退行性疾病向精准化、个体化治疗发展,并降低医疗成本。

关键词：腰椎退行性疾病外科治疗腰椎微创手术

基于MRI或CT预测退变性脊柱侧凸术后近端交界性后凸

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中华骨科杂志 2024年第11期44卷 748-755页

作者：王哲陈骞黄勇吴锐邦赵一泽刘立岷宋跃明丰干钧四川大学华西医院骨科(四川大学华西医院骨科研究所) 成都610041

目的探讨基于MRI和CT评估患者椎体骨密度进而预测成人退变性脊柱侧凸术后近端交界性后凸的诊断效能。方法回顾性收集2010年1月至2020年12月于四川大学华西医院骨科行长节段固定融合手术且具有完整术前全脊柱X线片、CT、MRI等影像学资料... 详细信息

目的探讨基于MRI和CT评估患者椎体骨密度进而预测成人退变性脊柱侧凸术后近端交界性后凸的诊断效能。方法回顾性收集2010年1月至2020年12月于四川大学华西医院骨科行长节段固定融合手术且具有完整术前全脊柱X线片、CT、MRI等影像学资料的成人退变性脊柱侧凸患者68例,男16例、女52例,年龄(66.87±6.65)岁(范围54~80岁)。采用术前腰椎MRI T1WI进行骨质量评分(vertebral bone quality score,VBQ)、采用CT测量L_(1)椎体亨氏单位(Hounsfield unit,HU),并根据术后影像学评估是否发生近端交界性后凸(proximal junctional kyphosis,PJK)分为PJK组和非PJK组。比较两组年龄、性别、体质指数、合并症、腰椎VBQ值、L_(1)HU值,对比两组手术前后的影像学参数(包括骨盆入射角、腰椎前凸角、矢状面轴向距离、骨盆倾斜角、骶骨倾斜角、骨盆入射角-腰椎前凸角、T1骨盆角、上端固定椎螺钉朝向),分别绘制受试者工作特征曲线(receiver operating characteristic curve,ROC)以分析腰椎VBQ值、L_(1)HU值及二者联合指标的诊断效能、灵敏度和特异度。结果PJK组17例、非PJK组51例。术前PJK组的VBQ值、L_(1)HU值分别为3.10±0.43、99.76±16.34,非PJK组分别为2.62±0.37、115.27±13.46,差异均有统计学意义(t=3.896,P<0.001;t=4.482,P<0.001)。VBQ值和L_(1)HU值的ROC曲线下面积(area under curve,AUC)分别为0.773[95%CI(0.633,0.914)]和0.814[95%CI(0.680,0.949)]、灵敏度分别为82.4%和76.5%、特异度分别为70.6%和76.5%、最大约登指数和临界值分别为0.530、2.895和0.530,111.0,二者联合指标AUC为0.895[95%CI(0.795,0.995)],灵敏度、特异度分别为94.1%、82.4%,最大约登指数和临界值为0.765,0.734。结论VBQ值和L_(1)HU值均可有效预测退变性脊柱侧凸术后近端交界性后凸,L_(1)HU值准确率略高于VBQ值,二者联合诊断准确率最高。

关键词：脊柱侧凸骨密度磁共振成像体层摄影术近端交界性后凸

A combination of chondroitinase ABC,glial cell line-derived neurotrophic factor,and Nogo A antibody delayed-release microspheres for the treatment of spinal cord injury

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Neural Regeneration Research 2011年第10期6卷 772-777页

作者： Yu Zhang yueming song Department of Orthopedics West China Hospital Sichuan University Chengdu 610041 Sichuan Province China

The purpose of this study was to evaluate the effect of poly（lactide-co-glycolic acid） delayed-release microspheres,which were prepared using glial cell line-derived neurotrophic factor（GDNF）,on the delayed-release,controllability,and protection of GDNF *** present study is the first to combine chondroitinase ABC,GDNF,and Nogo A antibody delayed-release microspheres for the treatment of spinal cord *** show that the combined therapy of chondroitinase ABC,GDNF,and Nogo A antibody microspheres can increase the immunoreaction of neurofilament 200 in the injured spinal cord,and this therapeutic effect was better than chondroitinase ABC,GDNF,or Nogo A antibody microspheres administered singularly.

关键词： glial cell line-derived neurotrophic factor microspheres poly(lactide-co-glycolic acid) spinal cord injury neural regeneration

Effects of poly lactic-co-glycolic acid-Nogo A antibody delayed-release microspheres on regeneration of injured spinal cord in rats

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Neural Regeneration Research 2009年第5期4卷 358-364页

作者： Hai Lan yueming song Department of Orthopedic Surgery West China Hospital Sichuan University Chengdu 610041 Sichuan Province China Department of Orthopedic Surgery Chengdu Railway Center Hospital Chengdu 610081 Sichuan Province China

BACKGROUND： Nogo A antigen is the major inhibiting factor blocking regeneration of the injured spinal cord. Neutralizing Nogo A antigens using Nogo A antibodies may help promote neurite regeneration and nervous function recovery. For successful regeneration, sustained release of the antibody from a biodegradable material loaded with Nogo A antibodies to the injury site is required. OBJECTIVE： To compare the therapeutic effects of poly lactic-co-glycolic acid （PLGA）-Nogo A antibody delayed-release microspheres and Nogo A antibody alone on spinal regeneration in Sprague-Dawley rats with complete transverse injury to the spinal cord. DESIGN, TIME AND SETTING： A randomized, controlled animal trial was performed at the Pharmacological Laboratory of West China Center of Medical Sciences, Sichuan University, between October 2007 and January 2008. MATERIALS： Goat anti-rat Nogo A monoclonal antibody was purchased from Santa, American; goat anti-rat neurofilament 200 monoclonal antibody was from Zhongshan Goldenbridge, Beijing, China; PLGA-Nogo A antibody delayed-release microspheres were provided by the College of Pharmacy, Sichuan University. METHODS： A total of 36 adult female Sprague Dawley rats were used to establish models of completely transected spinal cord injury, at T10. Animals were randomly divided into three groups （n=12）： model, Nogo A antibody alone, and Nogo A antibody delayed-release microsphere groups. After transverse injury of the spinal cord, 50 μ L normal saline solution, 50 μL normal saline solution containing 50μL g Nogo A antibody, and 50 μL normal saline solution containing 50 μg Nogo A antibody microspheres were administered to the respective groups at the injury site. MAIN OUTCOME MEASURES： The expression of Nogo A and neurofilament 200 in injured spinal cord was tested immunohistochemically, and motor function of rats was assessed by Basso-Beattie-Bresnahan （BBB） locomotor rating scale. RESULTS： Four weeks after injury, expression of Nogo A in mic

关键词： Nogo A antibody microspheres poly lactic-co-glycolic acid spinal cord injury neural regeneration

Unplanned surgery of congenital scoliosis

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Chinese Medical Journal 2022年第3期135卷 374-376页

作者： Huiliang Yang Gihye Im Ce Zhu Camilo Osorio Umar Masood Chunguang Zhou Xi Yang Limin Liu yueming song Department of Orthopedics Orthopedic Research InstituteWest China HospitalSichuan UniversityChengduSichuan 610041China Department of Emergency Medicine Rhode Island HospitalWarren Alpert Medical School of Brown UniversityProvidenceRI 02903USA Department of Orthopedics Rhode Island HospitalWarren Alpert Medical School of Brown UniversityProvidenceRI 02903USA

To the Editor:There is a high probability of requiring unplanned surgery for congenital scoliosis(CS),but very few publications have reported the proportion of unplanned surgeries,the causes of those unplanned surgeries,and the prevalence of each *** study aimed to provide more information regarding the *** reviewed the electronic medical records of patients with CS that underwent unplanned surgeries at our hospital from 2009 to *** searching the database of West China Hospital,we found 317 CS *** these,33 cases underwent unplanned surgeries,of which five had their primary surgeries at outside *** unplanned surgery rate in our case series was 9.0%(28/312).In our case series,the most common cause of unplanned surgery for patients with CS was progressive deformity(49%,16/33),followed by implant-related complications(36%,12/33),wound-related complications(12%,4/33),and surgical error-related complications(cerebrospinal fluid[CSF]leak,3%,1/33).The most common reason for unplanned surgery in CS was progressive spinal deformity or imbalance,which accounted for 49%(16/33)of the unplanned surgeries.

关键词： surgery congenital wound

局部注射负载姜黄素的介孔二氧化硅纳米粒延缓大鼠尾椎间盘退变的研究

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华西医学 2024年第4期39卷 604-612页

作者：李建华吴锐邦刘铮黄勇丰干钧张利刘立岷宋跃明四川大学华西医院骨科/骨科研究所成都610041 四川大学分析测试中心成都610064

目的探讨局部注射负载姜黄素的介孔二氧化硅纳米粒(curcumin-loaded mesoporous silica nanoparticles,Cur@MSN)对大鼠退变椎间盘组织的修复和治疗作用,为椎间盘退变的治疗提供新策略。方法按文献报道方法制备介孔二氧化硅纳米粒(mesopo... 详细信息

目的探讨局部注射负载姜黄素的介孔二氧化硅纳米粒(curcumin-loaded mesoporous silica nanoparticles,Cur@MSN)对大鼠退变椎间盘组织的修复和治疗作用,为椎间盘退变的治疗提供新策略。方法按文献报道方法制备介孔二氧化硅纳米粒(mesoporous silica nanoparticles,MSN),并进一步制备Cur@MSN。将大鼠髓核细胞分别与姜黄素及Cur@MSN共培养,分别观察正常环境和炎症环境(加入脂多糖)细胞的生长状态及其活性。将12只8周龄SD大鼠随机分为4组,包括正常组、退变组、姜黄素组、Cur@MSN组,每组3只,于大鼠尾椎第7~8和8~9节段椎间盘建立针刺退变模型,并注射相应干预药物,分别于4周后行影像学、大体病理及组织学检查,观察椎间盘组织结构及病理变化。结果扫描电镜下Cur@MSN呈现圆球形状,表面有沟回状孔隙。粒径分析显示,MSN的粒径集中在120~160 nm,Cur@MSN的粒径分布于130~170 nm。Zeta电位分析表明,MSN、姜黄素、Cur@MSN的平均Zeta电位分别为-12.5、-22.5、-13.5 mV。Cur@MSN的包封率为20.4%,载药率为0.2%,12 h Cur@MSN释放姜黄素约占总药物量的60%,28 h释放姜黄素约占70%。细胞实验结果中,正常环境下各组间细胞增殖吸光度值差异无统计学意义(P>0.05),炎症环境下第3天和第5天Cur@MSN组的细胞增殖吸光度值均明显高于对照组和姜黄素组(P<0.01)。影像学结果中,Cur@MSN组的椎间盘高度指数百分比和Pfirrmann分级均优于退变组和姜黄素组(P<0.01)。组织学结果中,Cur@MSN组的组织学评分低于退变组和姜黄素组(P<0.01)。结论Cur@MSN可延缓大鼠尾椎间盘的退变过程,对其退变椎间盘有一定的修复和治疗作用。其中姜黄素能通过抑制炎症来延缓椎间盘退变,MSN的搭载有助于姜黄素发挥生物学效应。

关键词：椎间盘退变姜黄素介孔二氧化硅纳米粒

Enhanced bone regenerative properties of calcium phosphate ceramic granules in rabbit posterolateral spinal fusion through a reduction of grain size

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Bioactive Materials 2022年第5期7卷 90-106页

作者： Xiangfeng Li Quan Zhou Yonghao Wu Cong Feng Xi Yang Linnan Wang Yumei Xiao Kai Zhang Xiangdong Zhu Limin Liu yueming song Xingdong Zhang National Engineering Research Center for Biomaterials College of Biomedical EngineeringSichuan UniversityChengdu610064China Department of Orthopaedic Surgery West China Hospital of Sichuan UniversityChengdu610041China

Osteoinductivity is a crucial factor to determine the success and efficiency of posterolateral spinal fusion(PLF)by employing calcium phosphate(Ca-P)*** this study,three kinds of Ca-P ceramics with microscale to nanoscale gain size(BCP-control,BCP-micro and BCP-nano)were prepared and their physicochemical properties were ***-nano had the spherical shape and nanoscale gain size,BCP-micro had the spherical shape and microscale gain size,and BCP-control(BAM®)had the irregular shape and microscale gain *** obtained BCP-nano with specific nanotopography could well regulate in vitro protein adsorption and osteogenic differentiation of MC3T3 *** vivo rabbit PLF procedures further confirmed that nanotopography of BCP-nano might be responsible for the stronger bone regenerative ability comparing with BCP-micro and ***,due to nanocrystal similarity with natural bone apatite,BCP-nano has excellent efficacy in guiding bone regeneration of PLF,and holds great potentials to become an alternative to standard bone grafts for future clinical applications.

关键词： Calcium phosphate ceramics Nanotopography Osteogenic differentiation Osteoinductivity Posterolateral spinal fusion

Structural insight into the dual-antagonistic mechanism of AB928 on adenosine A_(2)receptors

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Science China(Life Sciences) 2024年第5期67卷 986-995页

作者： Yuan Weng Xinyu Yang Qiansen Zhang Ying Chen yueming Xu Chenyu Zhu Qiong Xie Yonghui Wang Huaiyu Yang Mingyao Liu Weiqiang Lu Gaojie song Shanghai Key Laboratory of Regulatory Biology Institute of Biomedical Sciences and School of Life SciencesEast China Normal UniversityShanghai 200241China Department of Medicinal Chemistry School of PharmacyFudan UniversityShanghai 201203China

The adenosine subfamily G protein-coupled receptors A_(2A)R and A_(2B)R have been identified as promising cancer immunotherapy *** of the A_(2A)R/A_(2B)R dual antagonists,AB928,has progressed to a phaseⅡclinical trial to treat rectal ***,the precise mechanism underlying its dual-antagonistic properties remains ***,we report crystal structures of the A_(2A)R complexed with AB928 and a selective A_(2A)R antagonist *** structures revealed a common binding mode on A_(2A)R,wherein the ligands established extensive interactions with residues from the orthosteric and secondary *** contrast,the cAMP assay and A_(2A)R and A_(2B)R molecular dynamics simulations indicated that the ligands adopted distinct binding modes on A_(2B)*** analysis of their chemical structures suggested that AB928 readily adapted to the A_(2B)R pocket,while 2-118 did not due to intrinsic *** disparity potentially accounted for the difference in inhibitory efficacy between A_(2B)R and A_(2A)*** study serves as a valuable structural template for the future development of selective or dual inhibitors targeting A_(2A)R/A_(2B)R for cancer therapy.

关键词： adenosine receptor A2AR A2BR inhibitor dual-antagonism drug discovery