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Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

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Neural Regeneration Research 2024年第12期19卷 2773-2784页

作者： Hui Zhu James D.Guest Sarah Dunlop Jia-Xin Xie Sujuan Gao zhuojing luo Joe E.Springer Wutian Wu Wise Young Wai Sang Poon Song Liu Hongkun Gao Tao Yu Dianchun Wang Libing Zhou Shengping Wu Lei Zhong Fang Niu Xiaomei Wang Yansheng Liu Kwok-Fai So Xiao-Ming Xu Kunming Tongren Hospital KunmingYunnan ProvinceChina Neurological Surgery and the Miami Project to Cure ParalysisMiller School of MedicineUniversity of MiamiMiamiFLUSA School of Biological Sciences The University of Western AustraliaPerthWAAustralia Minderoo Foundation PerthWAAustralia Clinical Center for Spinal Cord Injury Kunming General Hospital of Chengdu Military CommandKunmingYunnan ProvinceChina Department of Biostatistics and Health Data Science Indiana University School of MedicineIndianapolisINUSA Department of Orthopedic Spinal Surgery Xijing HospitalFourth Military Medical UniversityXi’anShaanxi ProvinceChina Spinal Cord and Brain Injury Research Center Department of Physical Medicine and RehabilitationUniversity of Kentucky College of MedicineLexingtonKYUSA Guangdong-HongKong-Macao Institute of CNS Regeneration Jinan UniversityGuangzhouGuangdong ProvinceChina W.M.Keck Center for Collaborative Neuroscience Rutgers UniversityPiscatawayNJUSA Neurosurgery Department Chinese University of Hong KongPrince of Wales HospitalHong Kong Special Administration RegionChina Spinal Cord and Brain Injury Research Group Stark Neurosciences Research InstituteDepartment of Neurological SurgeryIndiana University School of MedicineIndianapolisINUSA

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein *** is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury *** of effective therapies fo r chronic spinal co rd injury patients is *** conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive *** clinical trial was registered at ***(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord *** found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training ***,the surgical procedures and intensive rehabilitation were *** Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 *** combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

关键词： chronic spinal cord injury intensive rehabilitation locomotor training neurological recovery surgical intervention weightbearing walking training

影响Lenke 1型青少年特发性脊柱侧凸术后满意度的肩平衡影像学指标

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中华骨科杂志 2024年第8期44卷 525-531页

作者：解放耿丹王飞党靖刚夏莉玉罗卓荆胡学昱空军军医大学西京医院骨科西安710032 空军军医大学西京医院颈腰伤病医学中心西安710032

目的分析影响Lenke 1型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)术后满意度的肩平衡影像学指标。方法回顾性分析2017年8月至2020年7月于空军军医大学西京医院接受后路全椎弓根螺钉矫形融合术的AIS患者98例,男26例、... 详细信息

目的分析影响Lenke 1型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)术后满意度的肩平衡影像学指标。方法回顾性分析2017年8月至2020年7月于空军军医大学西京医院接受后路全椎弓根螺钉矫形融合术的AIS患者98例,男26例、女72例,年龄(15.2±5.3)岁(范围10~24岁)。上端固定椎分布:T258例(59%)、T325例(26%)、T415例(15%);下端固定椎分布:T1263例(64%)、L128例(29%)、L24例(4%)、L33例(3%)。比较手术前后锁骨角(clavicle angle,CA)、影像学肩高(radiographic shoulder height,RSH)、喙突高度差(coracoid height difference,CHD)、锁骨肋骨交点高度差(clavicle-rib cage intersection difference,CRID)、T1倾斜角、第1肋倾斜角、锁骨胸廓角度差(clavicle chest angle difference,CCAD)及脊柱侧凸研究学会22项量表(Scoliosis Research Society-22,SRS-22)结果。采用二分类logistic回归分析影响Lenke 1型AIS术后满意度的肩平衡影像学指标。绘制受试者工作特征(receiver operating characteristic,ROC)曲线,确定该影像学指标的阈值。结果所有患者均顺利完成手术,手术时间为(260±80)min(范围220~320 min),术中出血量为(360±110)ml(范围300~700 ml),术中无一例出现神经、硬膜及血管损伤。末次随访时RSH、CHD、CRID、T1倾斜角、第1肋倾斜角、CCAD分别为4.0(0,13.9)mm、7.0(0,12.9)mm、4.0(0,10.0)mm、4.8°(3.3°,8.2°)、5.3°±3.9°、5.5°(3.0°,8.9°),小于术前的10.6(2.0,20.3)mm、10.3(2.5,15.9)mm、8.0(1.0,15.2)mm、7.6°(3.5°,12.2°)、7.5°±6.9°、8.5°(3.6°,18.3°),差异有统计学意义(P<0.05)。末次随访时SRS-22功能、疼痛、外观、心理评分分别为4.6(4.0,4.9)分、(4.1±0.5)分、(4.1±0.7)分、4.2(3.9,4.8)分,均大于术前的4.2(3.8,4.6)分、(4.0±0.7)分、(3.5±0.7)分、4.0(3.5,4.4)分,差异有统计学意义(P<0.05)。二分类logistic回归结果显示,CCAD是影响AIS矫形术后满意度的独立肩平衡影像学指标(OR=0.826,P=0.040)。ROC曲线示曲线下面积及95%CI为0.726(0.572,0.865),阈值为6.6°。结论CCAD是影响AIS矫形术后满意度的独立肩平衡影像学指标,术后CCAD≤6.6°时患者更容易达到疗效满意,可作为评估脊柱矫形手术疗效的影像学指标应用于临床。

关键词：青少年脊柱侧凸矫形外科手术病人满意度放射学

胸腰段骨折术后伤椎内骨缺损的临床特征及防治进展

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脊柱外科杂志 2024年第1期22卷 65-69页

作者：赵士贤罗卓荆胡学昱空军军医大学西京医院骨科西安710032

胸腰段骨折是脊柱骨折最常见类型,手术治疗的目的是提供坚固固定以保持脊柱的稳定性,恢复损伤节段的高度,维持脊柱的生理曲度,促进脊柱脊髓的功能恢复[1]。目前,临床上常用的手术方式为后路椎弓根螺钉内固定伴/不伴融合术,以跨伤椎短节... 详细信息

胸腰段骨折是脊柱骨折最常见类型,手术治疗的目的是提供坚固固定以保持脊柱的稳定性,恢复损伤节段的高度,维持脊柱的生理曲度,促进脊柱脊髓的功能恢复[1]。目前,临床上常用的手术方式为后路椎弓根螺钉内固定伴/不伴融合术,以跨伤椎短节段内固定多见。术中通常采用撑开复位的方式,依靠前后纵韧带及椎间盘纤维环的牵拉力量,间接恢复伤椎的外形和高度。

关键词：胸椎腰椎脊柱骨折综述文献

Acute penetrating injury of the spinal cord by a wooden spike with delayed surgery:a case report

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Neural Regeneration Research 2023年第12期18卷 2781-2784页

作者： James D.Guest zhuojing luo Yansheng Liu Hongkun Gao Dianchun Wang Xiao-Ming Xu Hui Zhu Neurological Surgery and the Miami Project to Cure ParalysisMiller School of MedicineUniversity of MiamiMiamiFLUSA Kunming International Spine and Spinal Cord Injury Treatment CenterKunming Tongren HospitalKunmingYunnan ProvinceChina Department of Orthopedic Spinal Surgery Xijing HospitalThe Fourth Military Medical UniversityXi’anShaanxi ProvinceChina Department of Neurosurgery Kunming Tongren HospitalKunmingYunnan ProvinceChina Indiana University School of Medicine Stark Neurosciences Research InstituteIndianapolisINUSA

Rarely,penetrating injuries to the spinal cord result from wooden objects,creating unique challenges to mitigate neurological injury and high rates of infection and foreign body *** report a man who sustained a penetrating cervical spinal cord injury from a sharpened *** initially tetraparetic,he rapidly recovered *** risks of neurological deterioration during surgical removal made the patient reluctant to consent to surgery despite the impalement of the spinal cord.A repeat MRI on day 3 showed an extension of edema indicating progressive *** the 7~(th)day after injury,fever and paresthesias occurred with a large increase in serum inflammatory indicators,and the patient agreed to undergo surgical removal of the wooden *** discuss the management nuances related to wood,the longitudinal evolution of MRI findings,infection risk,surgical risk mitigation and technique,an inflammatory marker profile,long-term recovery,and the surprisingly minimal neurological deficits associated with low-velocity midline spinal cord *** patient had an excellent clinical *** main lessons are that a wooden penetrating central nervous system injury has a high risk for infection,and that surgical removal from the spinal cord should be performed soon after injury and under direct visualization.

关键词： case report interleukin-6 magnetic resonance imaging penetrating spinal cord injury wood

Decoding the annulus fibrosus cell atlas by scRNA-seq to develop an inducible composite hydrogel:A novel strategy for disc reconstruction

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Bioactive Materials 2022年第8期7卷 350-363页

作者： Han Wang Di Wang Beier luo Dong Wang Haoruo Jia Pandi Peng Qiliang Shang Jianxin Mao Chu Gao Ye Peng Lu Gan Junjie Du zhuojing luo Liu Yang Department of Orthopedics Xijing HospitalFourth Military Medical UniversityXi’an710032China Department of Orthopedics Air Force Medical Center100142BeijingChina Department of Spinal Surgery Changhai HospitalNaval Medical UniversityShanghai200433China Medical Research Institute Northwestern Polytechnical UniversityXi’an710072China

Low back pain is one of the most serious public health problems worldwide and the major clinical manifestation of intervertebral disc degeneration(IVDD).The key pathological change during IVDD is dysfunction of the annulus fibrosus(AF).However,due to the lack of an in-depth understanding of AF biology,the methods to reconstruct the AF are very *** this study,the mice AF cell atlas were decoded by single-cell RNA sequencing to provide a guide for AF *** results first identify a new population of AF cells,fibrochondrocyte-like AF cells,which synthesize both collagen Ⅰ and collagen Ⅱ and are potential functional cells for AF *** to the dual features of the AF extracellular matrix,a composite hydrogel based on the acylation of methacrylated silk fibroin with methacrylated hyaluronic acid was *** obtain the ability to stimulate differentiation,the composite hydrogels were combined with a fibrochondrocyte-inducing ***,reconstruction of the AF defects,by the novel AF stem cell-loaded composite hydrogel,could be observed,its amount of chondroid matrices recovered to 31.7% of AF aera which is significantly higher than that in other control *** summary,this study decodes the AF cell atlas,based on which a novel strategy for AF reconstruction is proposed.

关键词： Single cell RNA-Seq Annulus fibrosus-derived stem cells Lineage tracing Composite hydrogel Annulus fibrosus reconstruction

Upregulation of β-catenin signaling represents a single common pathway leading to the various phenotypes of spinal degeneration and pain

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Bone Research 2023年第2期11卷 316-327页

作者： Ke Lu Qingyun Wang Hua Jiang Jun Li Zhou Yao Yongcan Huang Jianquan Chen Yejia Zhang Guozhi Xiao Xueyu Hu zhuojing luo Liu Yang Liping Tong Di Chen Research Center for Computer-aided Drug Discovery Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenChina Faculty of Pharmaceutical Sciences Shenzhen Institute of Advanced TechnologyChinese Academy of SciencesShenzhenChina Division of Spine Surgery the First Affiliated Hospital of Guangxi Medical UniversityNanningGuangxiChina Department of Orthopedic Surgery Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA Institute of Orthopedics Xijing Hospitalthe Fourth Military Medical UniversityXi’anChina Department of Spine Surgery Peking University Shenzhen HospitalShenzhenChina Department of Clinical Medicine School of MedicineZhejiang University City CollegeHangzhouZhejiangChina Departments of Physical Medicine&Rehabilitation Perelman School of MedicineUniversity of PennsylvaniaPAUSA School of Medicine Southern University of Science and TechnologyShenzhenChina

Spine degeneration is an aging-related disease,but its molecular mechanisms remain unknown,although elevatedβ-catenin signaling has been reported to be involved in intervertebral disc ***,we determined the role ofβ-catenin signaling in spinal degeneration and in the homeostasis of the functional spinal unit(FSU),which includes the intervertebral disc,vertebra and facet joint and is the smallest physiological motion unit of the *** showed that pain sensitivity in patients with spinal degeneration is highly correlated withβ-catenin protein *** then generated a mouse model of spinal degeneration by transgenic expression of constitutively activeβ-catenin in Col2^(+) *** found thatβ-catenin-TCF7 activated the transcription of CCL2,a known critical factor in osteoarthritic *** a lumbar spine instability model,we showed that aβ-catenin inhibitor relieved low back *** study indicates thatβ-catenin plays a critical role in maintaining spine tissue homeostasis,its abnormal upregulation leads to severe spinal degeneration,and its targeting could be an avenue to treat this condition.

关键词： degeneration smallest homeostasis

广场舞对不同年龄段绝经后妇女腰椎骨密度影响的队列研究

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空军军医大学学报 2024年第4期45卷 430-435页

作者：魏彬黄景辉程智涛聂善化夏冰高雪郑毅魏毅涛罗卓荆空军军医大学西京医院骨科陕西西安710032 武警湖北省总队医院骨科湖北武汉430061 武警湖北省总队医院湖北武汉430061

目的探索广场舞对不同年龄段绝经后妇女腰椎骨密度(LBMD)的影响,为指导广场舞预防绝经后妇女骨质疏松问题提供参考依据。方法本研究设计为前瞻性队列研究,招募250名西安市绝经后中老年妇女,其中广场舞组170例,非运动组80例。广场舞组人... 详细信息

目的探索广场舞对不同年龄段绝经后妇女腰椎骨密度(LBMD)的影响,为指导广场舞预防绝经后妇女骨质疏松问题提供参考依据。方法本研究设计为前瞻性队列研究,招募250名西安市绝经后中老年妇女,其中广场舞组170例,非运动组80例。广场舞组人群维持广场舞运动习惯,非运动组保持不运动的习惯,6个月后对两组人群进行LBMD检测。以似然比检验分析广场舞与年龄分级(45~65岁及>65岁)对LBMD的交互作用后按年龄分级进行亚组分析,并通过倾向性评分匹配校正年龄亚组内广场舞组与非运动组的组间混杂因素,最后通过校正匹配后的数据分析广场舞对不同年龄亚组内绝经后妇女LBMD的影响。结果在45~65岁绝经后妇女中,6个月后广场舞组测量LBMD均值高于非运动组,组间差异均有统计学意义(P=0.006);在>65岁的绝经后妇女中,6个月后广场舞组与非运动组的LBMD均值差异无统计学意义(P=0.149)。结论在45~65岁的人群中,广场舞能有效改善中年绝经后妇女的LBMD,在>65岁的老年绝经后妇女中,广场舞对参与者LBMD的改善效果不明显。

关键词：广场舞绝经后妇女腰椎骨密度年龄分级

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骨损伤的异种组织修复现状与展望

中华创伤骨科杂志 2023年第6期25卷 461-466页

作者：罗卓荆毕龙空军军医大学附属西京医院骨科西安710032

严重骨创伤及其并发症,如骨感染、骨不愈合、骨坏死及骨缺损等,常需应用结构和功能相似的组织或材料来移植、修复。骨组织移植是仅次于输血的第2常见组织移植类型,国外研究资料显示全世界每年约完成200多万次骨移植手术[1]。

关键词：骨不愈合骨损伤骨坏死骨感染组织修复骨缺损骨组织移植手术

Expression of HERG in musculoskeletal tumors with different degrees of malignancy

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Oncology and Translational Medicine 2019年第5期5卷 242-248页

作者： Lu Gan Mo Li Tongtao Yang Jin Wu Junjie Du zhuojing luo Yong Zhou Department of Orthopedics Air Force Medical University

Objective The expression of HERG in common bone tumors is scarcely reported and there is a lack of dedicated *** study aimed to investigated the expression of HERG in several common musculoskeletal *** Immunohistochemical staining,RT-PCR,and Western blotting were used to observe HERG expression differences in various tissues and cell *** HERG was differentially expressed in different malignant tumors,both at a differential protein level and localization within *** was not expressed in normal bone *** HERG inhibitor E-4031 markedly inhibited the proliferation of osteosarcoma cell *** HERG was highly expressed in malignant *** of HERG can effectively inhibit the proliferation of bone tumors.

关键词： HERG potassium ion channel musculoskiletal tumors expression