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Incidence and risk factors analysis of heterotopic ossification after cervical disc replacement

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Chinese Medical Journal 2014年第22期127卷 3871-3875页

作者： Qi Min Chen Huajiang Cao Peng Tian Ye Yuan Wen Department of spine Surgery Changzheng Orthopedics HospitalSecond Military Medical University Shanghai 200003 China

Background Cervical disc replacement （CDR） as a substitute for traditional fusion surgery has been widely used in treating degenerative cervical disc *** objectives of this study were to assess the clinical and radiological findings for patients with heterotopic ossification （HO） following CDR and to detect the risk factors of HO after *** A total of 125 patients with symptomatic cervical single-or double-level disc diseases,who underwent CDR procedure with Discover prosthesis in Department of spine Surgery,Changzheng Orthopedics Hospital from March 2009 to March 2011,were enrolled in this retrospective *** of HO was defined by the McAfee classification on cervical lateral X-rays in this *** vertebral ratio （PVR） was used to determine the matching degree between the cervical disc prosthesis and cervical *** regression analyses were performed to determine the risk factors of *** evaluated for their association with HO occurrence included age,gender,high-intensity signal in spinal cord,preoperative range of motion （ROM）,postoperative ROM,operation level number,and *** Mean follow-up time was （26.4±5.8） *** the patients had significant symptoms and neurological function improvements during the follow-up *** ROM of the operated segment from the preoperative period to the last follow-up was relatively well *** rate of HO in this cohort of patients,who underwent Discover disc,was 27.92％ per surgical level and 24.8％ per patient by the last *** were 19 patients （19.79％） with HO in the single-level group while 12 patients （41.38％） in the double-level *** We identified preoperative high-intensity signal in spinal cord,postoperative ROM of surgical level,number of operation level,and PVR as significant risk factors for postoperative HO occurrence.

关键词： cervical disc replacement heterotopic ossification risk factors

Intervertebral disc degeneration and bone density in degenerative lumbar scoliosis： a comparative study between patients with degenerative lumbar scoliosis and patients with lumbar stenosis

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Chinese Medical Journal 2011年第23期124卷 3875-3878页

作者： DING Wen-yuan YANG Da-long CAO Lai-zhen SUN Ya-peng ZHANG Wei XU Jia-xin ZHANG Ying-ze SHEN Yong Department of spine Surgery Third Hospital of Hebei Medical University Shiiiazhuang. Hebei 050051China

Degenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the retative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study. Methods From January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2Wl sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray. Results In scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side （P 〈0.001）. The vertebral body height on the convex side was greater than the height on the concave side （P=0.016） There was a significant difference between the scoliosis group and the control group （P=0.003）, and between T-value and the rate of osteoporosis between the two groups （both P 〈0.001）. Results were verified using multiple linear regression analysis. Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis a

关键词： degenerative scoliosis osteoporosis intervertebral disc lumbar degeneration

Shen(Kidney)-Tonifying Principle for Primary Osteoporosis:to Treat Both the disease and the Chinese Medicine Syndrome

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Chinese Journal of Integrative Medicine 2015年第9期21卷 656-661页

作者：舒冰施杞王拥军 Longhua Hospital Shanghai University of Traditional Chinese Medicine spine Research Institute Shanghai University of Traditional Chinese Medicine

Primary osteoporosis （POP） is one of the most common diseases in the elderly people resulting in high risk of fracture and poor quality of life. In addition to the pathological changes in bone mass, most of the POP patients also suffer from Chinese medicine （CM） syndromes of Shen （Kidney） essence deficiency. Shen essences are highly related to bone. Shen essence deficiency plays an important part in the development of POP and a better diagnosis of POP could be made by combining CM syndromes with Western medicine risk factors. Treatments of POP should aim at both increasing the bone mass and relieving the syndromes of Shen essence deficiency. Clinical study confirmed that treating POP patients with Shen-tonifying herbs could increase the bone mass and relieve the CM syndromes of POP patients. Basic researches clarified the mechanism by which Shen-tonifying herbs increased bone mass in animal models. The mechanisms by which Shentonifying herbs relieve the CM syndromes are still in investigation.

关键词： primary osteoporosis Chinese medicine syndrome Shen (Kidney) essence deficiency Shen (Kidney)-tonifying herbs

Sustained release of hydrogen sulfide from anisotropic ferrofluid hydrogel for the repair of spinal cord injury

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Bioactive Materials 2023年第5期23卷 118-128页

作者： Ruofei Wang Xia-Xiao Wu Zhenming Tian Tian Hu Chaoyang Cai Guan-Ping Wu Gang-Biao Jiang Bin Liu Department of spine Surgery The Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhou510630China Guangdong Provincial Center for Quality Control of Minimally Invasive spine Surgery Guangzhou510630China Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive spine Surgery Guangzhou510630China Key Laboratory for Biobased Materials and Energy of Ministry of Education College of Materials and EnergySouth China Agricultural UniversityGuangzhou510642China

Spinal cord injury(SCI)results in massive neuronal death,axonal disruption,and cascading inflammatory response,which causes further damage to impaired *** survived neurons with damaged function fail to form effective neuronal *** is mainly caused by the neuroinflammatory microenvironment at injury sites and regenerated axons without *** address this challenge,a ferrofluid hydrogel(FFH)was prepared with Ferric tetrasulfide(Fe3S4),carboxymethyl chitosan,and *** internal structural particles can be oriented in a magnetic field to acquire ***,Fe3S4 can release hydrogen sulfide(H2S)with anti-inflammatory effects under acidic *** in vitro experiments,0.01g/ml Fe3S4 FFH significantly reduced the inflammatory factors produced by LPS-induced BV2 *** and longer axons of the induced neural stem cells loaded on anisotropic FFH were *** vivo experiments showed that FFH reduced the activated microglia/macrophage and the expression of pro-inflammatory factors in SCI rats through the NF-κB ***,it significantly promoted directional axonal regrowth and functional recovery after *** the critical role of inhibition of neuroinflammation and directional axonal growth,anisotropic Fe3S4 FFH is a promising alternative for the treatment of SCI.

关键词： Spinal cord injury Anisotropic Ferrofluid Hydrogen sulfide

Factors affecting directional migration of bone marrow mesenchymal stem cells to the injured spinal cord

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Neural Regeneration Research 2014年第18期9卷 1688-1695页

作者： Peng Xia Su Pan Jieping Cheng Maoguang Yang Zhiping Qi Tingting Hou Xiaoyu Yang Department of spine Surgery Orthopedics HospitalSecond HosptalJilin University Department of Endocrinology Second HosptalJilin University

Microtubule-associated protein 1B plays an important role in axon guidance and neuronal migration. In the present study, we sought to discover the mechanisms underlying microtu- bule-associated protein 1B mediation of axon guidance and neuronal migration. We exposed bone marrow mesenchymal stem cells to okadaic acid or N-acetyl-D-erythro-sphingosine （an inhibitor and stimulator, respectively, of protein phosphatase 2A） for 24 hours. The expression of the phosphorylated form of type I microtubule-associated protein 1B in the cells was greater after exposure to okadaic acid and lower after N-acetyl-D-erythro-sphingosine. We then injected the bone marrow mesenchymal stem cells through the ear vein into rabbit models of spinal cord contusion. The migration of bone marrow mesenchymal stem cells towards the injured spinal cord was poorer in cells exposed to okadaic acid- and N-acetyl-D-erythro-sphingosine than in non-treated bone marrow mesenchymal stem cells. Finally, we blocked phosphatidylinosi- tol 3-kinase （PI3K） and extracellular signal-regulated kinase 1/2 （ERK1/2） pathways in rabbit bone marrow mesenchymal stem cells using the inhibitors LY294002 and U0126, respectively. LY294002 resulted in an elevated expression of phosphorylated type I microtubule-associated protein 1B, whereas U0126 caused a reduction in expression. The present data indicate that PI3K and ERKI/2 in bone marrow mesenchymal stem cells modulate the phosphorylation of micro- tubule-associated protein 1B via a cross-signaling network, and affect the migratory efficiency of bone marrow mesenchymal stem cells towards injured spinal cord.

关键词： nerve regeneration bone marrow mesenchymal stem cells spinal cord injury microtubule-associated protein 1 B protein phosphatase 2A cell transplantation phosphorylation signal transduction NSFC grant neural regeneration

Human umbilical cord mesenchymal stem cells to treat spinal cord injury in the early chronic phase: study protocol for a prospective, multicenter, randomized, placebo-controlled, single-blinded clinical trial

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Neural Regeneration Research 2020年第8期15卷 1532-1538页

作者： Yang Yang Mao Pang Yu-Yong Chen Liang-Ming Zhang Hao Liu Jun Tan Bin Liu Li-Min Rong Department of spine Surgery the Third Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Center for Quality Control of Minimally Invasive Spine SurgeryGuangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine SurgeryGuangzhouGuangdong ProvinceChina Department of Orthopedics West China Hospital of Sichuan UniversityChengduSichuan ProvinceChina Department of Orthopedics Shanghai East HospitalTongji University School of MedicineShanghaiChina

Human umbilical cord mesenchymal stem cells(hUC-MSCs)support revascularization,inhibition of inflammation,regulation of apoptosis,and promotion of the release of beneficial ***,they are regarded as a promising candidate for the treatment of intractable spinal cord injury(SCI).Clinical studies on patients with early chronic SCI(from 2 months to 1 year post-injury),which is clinically common,are rare;therefore,we will conduct a prospective,multicenter,randomized,placebo-controlled,single-blinded clinical trial at the Third Affiliated Hospital of Sun Yat-sen University,West China Hospital of Sichuan University,and Shanghai East Hospital,Tongji University School of Medicine,*** trial plans to recruit 66 early chronic SCI *** patients will undergo randomization at a 2:1 ratio to two arms:the observation group and the control *** in the observation group will receive four intrathecal transplantations of stem cells,with a dosage of 1×106/kg,at one calendar month *** in the control group will receive intrathecal administrations of 10 mL sterile normal saline in place of the stem cell *** safety will be assessed by the analysis of adverse events and laboratory *** American Spinal Injury Association(ASIA)total score will be the primary efficacy endpoint,and the secondary efficacy outcomes will be the following:ASIA impairment scale,International Association of Neural Restoration-Spinal Cord Injury Functional Rating Scale,muscle tension,electromyogram,cortical motor and cortical sensory evoked potentials,residual urine volume,magnetic resonance imaging–diffusion tensor imaging,T cell subtypes in serum,neurotrophic factors and inflammatory factors in both serum and cerebrospinal *** evaluations will be performed at 1,3,6,and 12 months following the final intrathecal *** the entire study procedure,all adverse events will be reported as soon as they are *** trial is d

关键词： clinical study early chronic phase efficacy human umbilical cord mesenchymal stem cell multicenter trial prospective study randomized controlled trial safety spinal cord injury study protocol

Microglia lactylation in relation to central nervous system diseases

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Neural Regeneration Research 2025年第1期20卷 29-40页

作者： Hui Yang Nan Mo Le Tong Jianhong Dong Ziwei Fan Mengxian Jia Juanqing Yue Ying Wang School of Pharmacy Hangzhou Normal UniversityHangzhouZhejiang ProvinceChina Department of Clinical Laboratory The Fourth Clinical Medical College of Zhejiang University of Traditional Chinese Medicine(Hangzhou First People’s Hospital)HangzhouZhejiang ProvinceChina College of Medical Veterinary and Life SciencesUniversity of GlasgowGlasgowUK Department of Orthopedics(spine Surgery) the First Affiliated Hospital of Wenzhou Medical UniversityWenzhouZhejiang ProvinceChina Department of Pathology Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhouZhejiang ProvinceChina Department of Clinical Research Center Affiliated Hangzhou First People’s HospitalWestlake University School of MedicineHangzhouZhejiang ProvinceChina

The development of neurodegenerative diseases is closely related to the disruption of central nervous system ***,as innate immune cells,play important roles in the maintenance of central nervous system homeostasis,injury response,and neurodegenerative *** has been considered a metabolic waste product,but recent studies are revealing ever more of the physiological functions of *** is an important pathway in lactate function and is involved in glycolysis-related functions,macrophage polarization,neuromodulation,and angiogenesis and has also been implicated in the development of various *** review provides an overview of the lactate metabolic and homeostatic regulatory processes involved in microglia lactylation,histone versus non-histone lactylation,and therapeutic approaches targeting ***,we summarize the current research on microglia lactylation in central nervous system diseases.A deeper understanding of the metabolic regulatory mechanisms of microglia lactylation will provide more options for the treatment of central nervous system diseases.

关键词： brain central nervous system glycolysis immune response inflammation lactate metabolism lactate lactylation microglia neurodegenerative diseases

Effects of decompression joint Governor Vessel electro-acupuncture on rats with acute upper cervical spinal cord injury

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Neural Regeneration Research 2018年第7期13卷 1241-1246页

作者： Yan-Lei Wang Ying-Na Qi Wei Wang Chun-Ke Dong Ping Yi Feng Yang Xiang-Sheng Tang Ming-Sheng Tan Beijing University of Chinese Medicine Beijing China Department of spine Surgery China-Japan Friendship Hospital Beijing China

Decompression is the major therapeutic strategy for acute spinal cord injury,but there is some debate about the time window for decompression following spinal cord *** important goal and challenge in the treatment of spinal cord injury is inhibiting or reversing secondary *** Vessel electroacupuncture can improve symptoms of spinal cord injury by inhibiting cell apoptosis and improving the microenvironment of the injured spinal *** this study,Governor Vessel electroacupuncture combined with decompression at different time points was used to treat acute spinal cord *** rat models were established by inserting a balloon catheter into the atlanto-occipital *** upper cervical spinal cord was compressed for 12 or 48 hours prior to *** was conducted at the acupoints Dazhui（GV14） and Baihui（GV 20）（2 Hz,15 minutes） once a day for 14 consecutive *** with decompression alone,hind limb motor function recovery was superior after decompression for 12 and 48 hours combined with ***,the recovery of motor function was not significantly different at 14 days after treatment in rats receiving decompression for 12 ***-activating factor levels and caspase-9 protein expression were significantly reduced in rats receiving electroacupuncture compared with decompression *** findings indicate that compared with decompression alone,Governor Vessel electroacupuncture combined with delayed decompression（48 hours） is more effective in the treatment of upper cervical spinal cord *** Vessel electroacupuncture combined with early decompression（12 hours） can accelerate the recovery of nerve movement in rats with upper cervical spinal cord ***,further studies are necessary to confirm whether it is possible to obtain additional benefit compared with early decompression alone.

关键词： nerve regeneration acute spinal cord injury decompression Governor Vessel electroacupuncture platelet-activating factor apoptosis methylprednisolone caspase family upper cervical spine animal model Basso,Beattie and Bresnahan locomotor scale neural regeneration

Occult Andersson lesions in patients with ankylosing spondylitis: undetectable destructive lesions on plain radiographs

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Chinese Medical Journal 2021年第12期134卷 1441-1449页

作者： Ji-Chen Huang Bang-Ping Qian Yong Qiu Bin Wang Yang Yu Shi-Zhou Zhao Department of spine Surgery Affiliated Drum Tower HospitalMedical School of Nanjing UniversityNanjingJiangsu 210008China

Background:Andersson lesions(ALs)are not uncommon in ankylosing spondylitis(AS).Plain radiography(PR)is widely used for the diagnosis of ***,in our practice,there were some ALs in AS patients that could not be detected on plain *** study aimed to propose the concept of occult ALs and evaluate the prevalence and radiographic characteristics of the occult ALs in AS ***:A total of 496 consecutive AS patients were admitted in the Affiliated Drum Tower Hospital,Medical School of Nanjing University between April 2003 and November 2019 and they were retrospectively *** AS patients with ALs who met the following criteria were included for the investigation of occult ALs:(1)with pre-operative plain radiographs of the whole-spine and(2)availability of pre-operative computed tomography(CT)and/or magnetic resonance imaging(MRI)of the *** occult ALs were defined as the ALs which were undetectable on plain radiographs but could be detected by CT and/or *** extensive ALs involved the whole discovertebral junction or manifested as destructive lesions throughout the vertebral ***-samples t test was used to compare the age between the patients with only occult ALs and those with only detectable ***-square or Fisher exact test was applied to compare the types,distribution,and radiographic characteristics between detectable and occult ALs as ***:Ninety-two AS patients with a mean age of 44.4±10.1 years were included for the investigation of occult ***-three patients had occult ALs and the incidence was 25%(23/92).Fifteen extensive ALs were occult,and the proportion of extensive ALs was significantly higher in detectable ALs(97%vs.44%,χ^(2)=43.66,P<0.001).As assessed by PR,the proportions of osteolytic destruction with reactive sclerosis(0 vs.100%,χ^(2)=111.00,P<0.001),angular kyphosis of the affected discovertebral units or vertebral body(0 vs.22%,χ^(2)=8.86,P=0.003),formation of an osseo

关键词： Ankylosing spondylitis Andersson lesions Occult Radiographic characteristics