The intricate pathophysiological cascades following spinal cord injury (SCI), encompassing cellular demise, axonal degeneration, and the formation of glial scars, pose formidable barriers to neural regeneration and restoration. Notably, neuroinflammation and glial scars emerge as pivotal barrier to post-SCI repair. Formyl peptide receptors (FPRs) emerge as critical regulators of immune responses, exerting significant influence over inflammatory modulation and nerve regeneration subsequent to SCI. Beyond their classical expression in myeloid cells, FPRs demonstrate a pronounced presence within the central nervous system (CNS) with roles in the progression of neurodegenerative disorders and neurological malignancies. Post-SCI, the equilibrium of the inflammatory microenvironment is recalibrated through the strategic modulation of FPRs, including facilitating a balance in microglial polarization, stimulating neural stem cells (NSCs) migration, and promoting neural axon elongation. These observations enlighten the potential of FPRs as innovative targets for neuronal regenerations bolstering SCI repair. This review endeavors to delineate the distribution and function of FPRs in the aftermath of SCI, with a special attention to their roles in inflammatory regulation, NSCs mobilization, and synaptic growth. By elucidating these mechanisms, we aspire to contribute novel insights and strategies for SCI therapy.

Skeletal disorders pose significant challenges to health and quality of life, underscoring the critical need for innovative bone repair methods. Recent studies have spotlighted the promising role of extracellular vesicles (EVs) derived from bone marrow mesenchymal stem cells (BMSCs) in conjunction with biomimetic peptide (BP) WKYMVm (WK) for bone repair. This research leveraged a self-healing hydrogel as a carrier, effectively loading EVs and WK to enhance treatment efficacy. Through the regulation of vascular formation and osteoblast differentiation, notable advancements were achieved in mending femoral defect bone injuries, offering new possibilities for addressing bone metabolic disorders. The detailed methodology encompassed hydrogel preparation, EVs and WK loading, in vitro cell studies, and rat model experiments. Results unveiled that graphene oxide gelatin hydrogel loaded with wkymvm and extracellular vesicles (GOG@WK-EVs) notably bolstered osteogenic differentiation of bone cells and angiogenesis, while impeding osteoclast differentiation, culminating in potent bone regeneration within femoral defects.

The failure mode of cement-augmented pedicle screw (CAPS) was different from common pedicle screw. No biomechanical study of this failure mode named as “reversed windshield-wiper effect” was reported. To investigate the mechanisms underlying this failure mode, a series of finite element models of CAPS and PS were modified on L4 osseous model. Nine models were created according to the cement volume at 0.5 mL interval (range: 1–5 mL). Pullout load and cranio-caudal loads were applied on the screws. Stress and instantaneous rotation center (IRC) of the vertebra were observed. Under cranio-caudal load, the stress concentrated on the screw tip and pedicle region. The maximal stress (MS) at the screw tip region was +2.143 MPa higher than pedicle region. With cement volume increasing, the maximal stress (MS) at the screw tip region decreased dramatically, while MS at pedicle region was not obviously affected. As dose increased to 1.5 mL, the MS at pedicle region became higher than screw tip region and the maximal stress difference was observed at 3.5 mL. IRC of the vertebra located at the facet joint region in PS model. While IRC in CAPS models shifted anteriorly closer to the vertebral body with the increasing of cement volume. Under axial pull-out load, the maximal stress (MS) of cancellous bone in CAPS models was 29.53–50.04% lower than that 2.228 MPa in PS model. MS in the screw-bone interface did not change significantly with cement volume increasing. Therefore, the possible mechanism is that anterior shift of IRC and the negative difference value of MS between screw tip and pedicle region due to cement augmentation, leading to the screw rotate around the cement-screw complex as the fulcrum point.

Abstract Objective To investigate the role and mechanism of BAHD1 in the proliferation and migration of osteosarcoma cells escaping from senescence. Methods Osteosarcoma cell lines U2OS and MG63 were cultured in vitro. Doxorubicin (DOX) and cisplatin induced U2OS and MG63 into a senescent state. The medium without DOX and CIS was replaced for continuous culture. Some cells were observed to proliferate again, which were defined as senescence-escaped OS cells (SEOS). The DOX group and CIS group were divided respectively. The DOX and CIS groups are divided into: the parent U2OS group, the U2OS SEOS cells at the 9th passage group, the parent MG63 group, and the MG63 SEOS cells at the 9th passage group. The expression of BAHD1 was detected by qRT PCR, Western blot and immunofluorescence. Cell count, CCK-8 test, agarose clone formation test, flow cytometry, etc. were used to detect cell proliferation. Cell Migration Assay was used to detect cell migration. Tumor Xenografts was used to detect the ability of cells to form tumors. The effect of BAHD1 was detected by RNA interference assay. Results The expression of BAHD1, cell cycle related proteins YWHAZ, CCND1 and stem cell factor KLF4 were significantly increased in SEOS cells at the 9th passage group compared with the parent group. Cell cycle enters S phase more quickly. After knockdown of BAHD1 expression, the above results were significantly recalled, and the ability of migration, cloning and tumor formation was significantly reduced. Conclusion The increased expression of BAHD1 is crucial in the progression of osteosarcoma, which may be achieved by up regulating the cell cycle related proteins YWHAZ, CCND1 and stem cell factor KLF4.

Previous studies have revealed cellular heterogeneity in intervertebral discs (IVDs). However, the cellular and molecular alteration patterns of cell populations during degenerative progression remain to be fully elucidated. To illustrate the cellular and molecular alteration of cell populations in intervertebral disc degeneration (IDD), we perform single cell RNA sequencing on cells from four anatomic sites of healthy and degenerative goat IVDs. EGLN3(+) StressCs, TGFBR3(+) HomCs and GPRC5A(+) RegCs exhibit the characteristics associated with resistance to stress, maintaining homeostasis and repairing, respectively. The frequencies and signatures of these cell clusters fluctuate with IDD. Notably, the chondrogenic differentiation programme of PROCR+ progenitor cells is altered by IDD, while notochord cells turn to stemness exhaustion. In addition, we characterise CAV1(+) endothelial cells that communicate with chondrocytes through multiple signalling pathways in degenerative IVDs. Our comprehensive analysis identifies the variability of key cell clusters and critical regulatory networks responding to IDD, which will facilitate in-depth investigation of therapeutic strategies for IDD.

Mechanical overload on the spine is a critical factor in the onset of intervertebral disc (IVD) degeneration. However, the lack of a precise and reliable animal model impedes a comprehensive understanding of the pathogenesis associated with IVD degeneration. In this study, we identified the high prevalence of spontaneous fibrotic alterations in IVDs predominantly located in the tail base, spanning from Co3/4 to Co5/6 levels, as early as 28 days in mice. These fibrotic IVDs manifested characteristics including extracellular matrix fibrosis and a decline in cell density. We leveraged a finite element model of computational biomechanics to generate fully predictive, three-dimensional simulations of flexion motion in the mouse tail. Our simulations revealed that the caudal discs in the mouse tail base underwent various mechanical overloads. Hence, we propose that the caudal IVDs in mice can serve as a novel mechanical model for investigating the mechanisms underlying the pathogenesis of IVD degeneration.### Competing Interest StatementThe authors have declared no competing interest.

目的 探讨新型冠状病毒肺炎疫情对低流行地区的急性ST段抬高型心肌梗死(STEMI)患者急诊机械再灌注特征的影响.方法 纳入重庆市新型冠状病毒肺炎疫情期间(2020年1月23日-3月29日)及2019年同期至陆军军医大学第二附属医院胸痛中心接受直接经皮冠状动脉介入治疗(PPCI)的STEMI患者,并排除新型冠状病毒感染患者.比较2020年疫情期间及2019年同期两组患者间的临床特征和再灌注参数.结果 共纳入接受PPCI术的STEMI患者64例,分别为疫情期间的13例以及2019年同期的51例.两组患者在临床体征、GRACE评分、就诊时间区间、就诊方式及首次医疗接触至双联抗血小板治疗时间等方面差异无统计学意义(P＞0.05).疫情使接受PPCI治疗的STEMI患者例数明显减少;并使起病至首次医疗接触时间(10 h比3.0 h,P＜0.001)、急诊入门至心电图完成时间(6 min比3 min,P＜0.001)、急诊入门至完成肌钙蛋白检测时间(15 min比12 min,P=0.048)、急诊入门至导丝通过时间(76 min比62 min,P=0.017)、导管室激活时间(15 min比5 min,P＜0.001)和患者进入导管室至导丝通过时间(52 min比41 min,P=0.033)等机械再灌注参数显著延长.结论 在低流行地区,新型冠状病毒肺炎疫情仍显著延迟了机械再灌注.

Study Design: A radiological study and workshop. Objective: To propose a novel technique for subaxial cervical pedicle screw (CPS) insertion via the nonanatomic axis (nAA) and identify a new entry point (EP) and trajectory based on a radiological study. Methods: The new EP was determined to be the center of the upper half of the lateral mass, and the nAA was defined as the line connecting the EP and center of the pedicle. CT images of 493 subaxial cervical pedicles from 51 adults were utilized. The pedicle axis length (PAL/nPAL), pedicle transverse angle (PTA/nPTA), sagittal and transverse pedicle screw depth ratio (S-DO, T-DO), and sagittal and transverse angles (S-angle, T-angle) were measured in the anatomical axis (AA) and nAA. nAA-CPS insertions were conducted on dry specimens, and the positions of the screws were graded. Results: The nPTA (22.35° ± 1.57°), nPAL (23.75 ± 2.07 mm), T-DO (45.61% ± 3.10%), and S-DO (70.46% ± 4.44%) of the nAA-CPS were significantly different from the PTA (41.86° ± 2.77°), PAL (31.98 ± 2.40 mm), T-DO and S-DO of the AA-CPS (both 100% in ideal conditions), respectively ( P < .05). The T-angle and S-angle were 92.78° ± 3.07° and 92.18° ± 3.78°, respectively. A constant EP and consistent trajectory of the nAA-CPS identified by 2 perpendicular angles were summarized and utilized as the manipulation protocols of the workshop, and a perfect position was achieved in 80.00% (24/30) of screws. Conclusion: The nAA-CPS is a novel alternative to the classic CPS technique. A constant entry point and 2 perpendicular angles in the sagittal and transverse planes for identifying the trajectory of the nAA-CPS should be taken into account in the establishment of a manipulation protocol.

原发性髓外硬膜下黑色素瘤在临床上极为罕见,发生率约为中枢神经系统原发性黑色素瘤的1/2[1],主要以脊髓压迫症状为首发临床表现,常被误诊为脊膜瘤、神经鞘瘤等[2],最终确诊需结合病理.目前,对于该病的治疗尚无统一标准[3-4],相关文献多为病例报告,治疗方法主张以手术完全切除为主,不能完全切除者结合术后放、化疗,可在一定程度上改善预后.本研究收集陆军军医大学大坪医院2010年1月—2018年12月采用椎管内肿瘤切除术治疗的原发性髓外硬膜下黑色素瘤患者3例,分析其临床资料,并以"原发性黑色素瘤""melanocytoma"为关键词对PubMed、中国知网、维普网近10年相关文献进行检索,挑选出原发性髓外硬膜下黑色素瘤相关文献,结合文献内容分析讨论该病的诊断和治疗.

Study Design: Retrospective study. Objective: To report the technical details of subaxial cervical pedicular screw insertion via the nonanatomic axis (nAA-CPS) and evaluate its clinical safety and accuracy. Methods: The nAA-CPS technique was performed in 21 patients. Preoperative and intraoperative management-related details are described, and a manipulation protocol is presented. Clinical outcomes were used to assess the safety and accuracy of screws was evaluated using postoperative computed tomography (CT) according to the pedicle perforation grading system, and the nonanatomic pedicle transverse angle (nPTA) and nonanatomic pedicle axis length (nPAL) were assessed based on pre- and postoperative CT images. Results: According to “one constant entry point (EP) and two perpendicular trajectory angles” protocol, nAA-CPS was performed without much interference from the muscles. No intraoperative or postoperative neurovascular complications related to the technique were observed. Of the 112 inserted screws, 78 (69.64%) were assessed as grade 0, 24 (21.43%) as grade 1, 4 (3.57%) as grade 2 and 6 (5.36%) as grade 3. The overall rate of correct position (grades 0 and 1) was 91.07% (102/112), and the rate of malposition was 8.93% (10/112), including five screws implanted medially and the other five laterally. The nPTA was highly consistent on pre- and postoperative CT ( P < .05), while postoperative nPAL was significantly shorter than preoperative nPAL ( P > .05). Conclusions: Clinically, the accuracy and safety of nAA-CPS was similar to the traditional CPS technique. The protocol, derived from previous radiological studies and workshops, greatly helped standardize clinical manipulation; thus, nAA-CPS is a promising alternative to the traditional CPS.

目的 探讨腰椎退行性疾病行后路内固定融合术后早期感染清创的危险因素.方法 回顾性分析行后路内固定融合术治疗腰椎退行性疾病的患者资料,将发生手术部位感染(SSI)且需行清创治疗的60例患者纳入清创组,于同期未发生SSI的患者中按照1:4比例随机抽取240例纳入无感染组.对患者一般资料、手术相关资料、影像和实验室相关资料进行组间单因素分析,筛选出具有统计学差异的指标纳入二元Logistic回归,分析与感染清创相关的危险因素,并选取属于计量资料的因素进行受试者工作特征(ROC)曲线分析.结果 单因素分析结果 显示,2组患者美国麻醉医师协会(ASA)评分、合并糖尿病、总住院时间、住院花费、脊柱侵袭性指数(SII)、手术时间、手术椎体数、失血量、术中输血、皮下脂肪厚度、术前血红蛋白、术前白细胞、淋巴细胞、C反应蛋白(CRP)、血清白蛋白和术前血糖比较,差异具有统计学意义(P<0.05).Logistic回归分析结果 表明,SII、皮下脂肪厚度、血清白蛋白和术前血糖是腰椎退行性疾病行后路内固定融合术后早期感染清创的危险因素(P<0.05);ROC曲线分析显示SII的临界值为9.5,皮下脂肪厚度的临界值为23.5 mm,血清白蛋白的临界值为35.8 g/L,术前血糖的临界值为6.18 mmol/L.结论 更高的SII、更厚的皮下脂肪、更低的血清白蛋白和术前更高的血糖会增加腰椎退行性疾病行后路内固定融合术后发生早期感染清创的风险.

镁离子是自然界中广泛存在且人体必需的重要无机离子,作为体内300 多个酶促反应中的辅助因子,参与了ATP生成、核苷酸合成、葡萄糖代谢和脂质氧化等重要生理过程[1].它也是体内仅次于钾的第二重要阳离子,是保证肌肉收缩、神经传导、骨骼强度、血压控制、心电稳定的重要基础[1].成人每公斤体重约含400 mg镁,其中50％ ～60％储存于骨骼,其余则分布于心肌、骨骼肌和软组织中;血清镁所占比例很小,约为体内镁含量的1％,且与骨骼进行交换以保证血清镁浓度的稳定[2].人体可以从不同类型的食物中获取镁,绿叶蔬菜、豆类、谷物和坚果的镁含量较高,猪肉、家禽及鱼的含量则较为适中.此外,饮用水也是人体日常镁摄入的重要来源,镁含量30～50 mg/L[3].

目的 探讨通过双线中点法行经皮椎体后凸成形术(PKP)治疗重度骨质疏松性椎体压缩骨折(OVCF)的安全性及临床疗效.方法 回顾性分析2015年1月—2020年1月陆军军医大学大坪医院脊柱外科收治重度OVCF患者32例,男性7例,女性25例;年龄60～86岁,平均73.1岁,患者椎体压缩＞75％.摔伤21例,扭伤3例,负重7例,无明显诱因1例.实施双线中点法PKP(术中调整正位C型臂X线机透视使椎体下缘保持重合,椎体上终板最低点连线与椎弓根外缘交点平行线为第一条线,椎弓根下缘平行线为第二条线,两者中点向外延伸至椎弓根外缘的交点为伤椎穿刺点).记录手术时间、手术前后受伤椎体高度、视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)变化、骨水泥弥散情况及有无严重并发症.结果 手术时间25～59min,平均37.1min.术前椎体高度(6.03±1.03)mm,术后3d恢复至(14.96±1.28)mm,术后3个月(14.46±1.29)mm.出现骨水泥渗漏5例,均未向椎管内渗漏,包括椎体前方渗漏1例、沿椎旁静脉渗漏1例、上下椎间隙渗漏3例.术中推注骨水泥出现心率下降1例,出现术中血压明显升高2例,给予处理后均恢复术前水平,无心脑血管意外发生.所有患者未出现脊髓、神经及血管并发症.患者术后3d及3个月ODI(31.06±3.51)％、(30.50±3.37)％及VAS(2.43±0.55)分、(2.44±0.49)分均显著优于术前(72.91±5.20)％、(7.18±0.63)分(P＜0.05).结论 双线中点法在严重塌陷的椎体均有较高的穿刺成功率及安全性,球囊复位技术可明显恢复急性重度压缩骨折患者的椎体高度,改善患者的症状和生活质量,具有较好的临床疗效.

Ankylosing spondylitis cervical spine fractures (ASCFs) are particularly unstable and need special consideration when selecting appropriate internal fixation technology. However, there is a lack of related biomechanical studies. This study aimed to investigate the biomechanical influence of the pattern, length, and density of instrumentation for the treatment of ASCF. Posterior, anterior, and various combined fixation approaches were constructed using the finite element model (FEM) to mimic the surgical treatment of ASCFs at C5/6. The rate of motion change (RMC) at the fractured level and the internal stress distribution (ISD) were observed. The results showed that longer segments of fixation and combined fixation approaches provided better stability and lowered the maximal stress. The RMC decreased more significantly when the length increased from 1 to 3 levels (302% decrease under flexion, 134% decrease under extension) than from 3 to 5 levels (22% decrease under flexion, 23% decrease under extension). Longer fixation seems to be more stable with the anterior/posterior approach alone, but 3-level posterior fixation may be the most cost-effective option. It is recommended to perform surgery with combined approaches, which provide the best stability. Long skipped-screwing posterior fixation is an alternative technique for use in ASCF patients.

目的 探讨经椎弓根内侧入路减压复位在治疗胸腰段椎体爆裂骨折合并脊髓神经损伤中的临床疗效.方法 回顾性分析2012年8月—2018年12月陆军军医大学大坪医院脊柱外科收治的胸腰段椎体爆裂骨折合并脊髓神经损伤患者76例,男性47例,女性29例;年龄17～61岁,平均35.6岁.骨折AO分型:A1.3型43例,A2.1型19例,A2.2型7例,A3.1型5例,A3.2型2例.按脊髓损伤程度分为完全性脊髓损伤组5例、不完全性脊髓损伤组71例;根据美国脊髓损伤学会(ASIA)感觉评分和运动评分进行评估,所有患者行后路切开经椎弓根内侧入路减压复位、椎弓根钉棒系统内固定及后外侧植骨融合治疗,均于术前、术后末次随访12个月摄脊柱正侧位X线片和CT片,通过术前、末次随访伤椎椎体前缘高度恢复率、Cobb角、椎管侵占率、ASIA评分4个主要指标评估临床疗效.结果 所有患者随访12个月,未发生内固定物断裂及椎体前缘高度丢失等并发症;椎体前缘高度恢复率:术前(47.3％ ±9.8％),术后12个月(87.1％±4.7％),差异有统计学意义(P<0.05);Cobb角:术前(29.3° ±5.8°),术后12个月(6.3° ±2.8°),差异有统计学意义(P<0.05);椎管侵占率:术前(29.5％ ±6.7％),术后12个月(11.3％ ±5.8％),差异有统计学意义(P<0.05);完全性脊髓损伤组感觉评分:术前(150±17)分,术后12个月(175±16)分;运动评分:术前(47±14)分,术后12个月(79±11)分,差异均有统计学意义(P<0.05);不完全性脊髓损伤组感觉评分:术前(167±21)分,术后12个月(186±13)分;运动评分:术前(71±15)分,术后12个月(82±14)分,差异均有统计学意义(P<0.05).结论 经椎弓根内侧入路减压复位、椎弓根钉棒系统内固定治疗胸腰段椎体爆裂骨折能有效减压、恢复椎体高度、促进脊髓神经功能恢复,临床疗效良好.

目的 分析PVP治疗骨质疏松性椎体压缩性骨折的临床疗效.方法 我院门诊接受药物保守治疗效果不理想的骨质疏松性压缩性骨折患者150例为研究对象,所有患者给予PVP治疗.结果 患者术后下床活动时间(3.0±0.1)d,VAS评分为(2.0±0.1)分.结论 PVP手术治疗骨质疏松性椎体压缩性骨折临床疗效明显.

BACKGROUND:Cannulated pedicle screw (CPS) augmented by polymethylmethacrylate (PMMA) can achieve satisfactory clinical efficacy in the treatment of lumbar spondylolisthesis with osteoporosis. However, accurate application of CPSs will help to avoid the difficulty of screw revision and reduce the incidence of PMMA-related complications. This study aimed to investigate the mid-term efficacy of CPS compared to unilateral and bilateral applications in this common lumbar degenerative disease. METHODS:May 2011 and May 2018, 50 patients with lumbar spondylolisthesis with osteoporosis who underwent posterior fixation and fusion using traditional pedicle screws or CPSs were included in the study. Patients were divided into two groups based on the application: the unilateral PMMA-augmented CPS group (UC, n = 29) and the bilateral PMMA-augmented CPS group (BC, n = 21). Operation time, blood loss, average hospitalization time, PMMA leakage, and other complications were recorded. The visual analog scale (VAS) and Oswestry disability index (ODI) scores were used to evaluate symptom recovery. Radiographic results were compared for intervertebral fusion and screw loosening. RESULTS:There were no significant differences in the baseline data of the two groups. The VAS and ODI scores improved significantly after surgery (P < 0.05), with no significant differences between the groups (P > 0.05). The operation time and blood loss in the UC group were significantly lower than those in the BC group (P < 0.05). However, the loss of intervertebral disk height and Taillard index did not differ significantly between the groups. The rates of PMMA leakage in the UC and BC groups were 7.0% and 11.9%, respectively (P < 0.05). Bony fusion was achieved in all groups without screw loosening at the last follow-up. Only one patient experienced superficial infection in both groups, while cerebrospinal fluid leakage was observed in two patients in the BC group. CONCLUSIONS:Unilateral application of PMMA-augmented CPS may provide adequate clinical safety and effectiveness in the surgical treatment of lumbar spondylolisthesis with osteoporosis.

Many clinical studies have shown a satisfactory clinical efficacy using bone cement-augmented pedicle screw in osteoporotic spine, however, few studies have involved the application of this type of screw in lumbar spondylolisthesis. This study aims to investigate the mid-term clinical outcome of bone cement-injectable cannulated pedicle screw (CICPS) in lumbar spondylolisthesis with osteoporosis. From 2011 to 2015, twenty-three patients with transforminal lumbar interbody fusion (TLIF) using CICPS for lumbar spondylolisthesis were enrolled in the study. Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) were used to evaluate faunctional recovery and physical pain; and operation time, blood loss and hospitalization time were recorded, respectively. Radiograph and computed tomography of lumbar spine was performed to assess loss of the intervertebral disc space height, fixation loosening, and the rate of bony fusion. The average follow-up time of 23 patients was 22.5 ± 10.2 months (range, 6–36 months). According to VAS and ODI scores, postoperative pain sensation and activity function were significantly improved (p < 0.05). The height of the intervertebral disc space was reduced by 0.4 ± 1.1 mm, and the bone graft fusion rate was 100%. No cases of internal fixation loosening or screw pullout was observed. CICPS using cement augmentation may suggest as a feasible surgical technique in osteoporotic patients with lumbar spondylolisthesis.

Spinal cord injury (SCI) is a devastating disorder that often results in temporary and/or permanent functional impairment below the injured level. To date, few satisfactory therapeutic strategies are available to treat SCI. Hence, exploring novel strategies for SCI is an essential public health concern. Cell transplantation therapy, which is associated with neuroprotection, immunomodulation, axon regeneration, neuronal relay formation and myelin regeneration, provides a promising therapeutic strategy for SCI. The neuronal stem cell (NSC) preconditioning method is an emerging approach, which facilitates NSC survival and neuronal differentiation after implantation. The aim of the present study was to develop a feasible candidate for cell-based therapy following SCI in rats and to investigate the role of high mobility group box-1 (HMGB1) in NSC activation. The results of the present study showed that transplantation of NSCs, preconditioned with 1 ng/ml HMGB1, facilitated functional improvement of injured spinal cords, as indicated by Basso, Beattie and Bresnahan mean scores, mechanical hypersensitivity and cold stimulation. Meanwhile, the histological examination of hematoxylin and eosin staining indicated that engraftment of HMGB1-preconditioned NSCs resulted in decreased atrophy of the injured spinal cord. Meanwhile, the transplantation of HMGB1-preconditioned NSCs resulted in an increased number of functional Nissl bodies in neurons, as detected by Nissl staining, and an increase in the number of beta III-tubulin(+) cells in the epicenter of injured spinal cords in rats with SCI. In addition, the results also demonstrated that 1 ng/ml HMGB1 promoted the differentiation of NSCs into neurons, and that the ERK signaling pathway played an important role in this process. In conclusion, the present data indicated that the preconditioning strategy with 1 ng/ml HMGB1 may present a feasible candidate for cell-based therapy following SCI in rats, which may enlarge the scope of HMGB1 in NSC activation.

Background: For back pain patients with spine dysfunction, clinical profiles are crucial for clinicians to establish the diagnostic and therapeutic decision-making. The objectives of this study were (1) to outline the incident clinical findings and familiarize physicians with the clinical profiles of osteoporotic vertebral fractures (OVFs) and (2) to characterize patients with radiating pain (RP), spinal palpation tenderness (SPT), or axial spinal percussion pain (ASPP). Methods: This is a secondary data analysis of 358 patients from a prospective clinical study (November 1, 2016, to September 30, 2018) with particular focus on the incident RP, SPT, and ASPP. Predictive analyses for the incident RP, SPT and ASPP were done along the clinical profiles in 358 patients (284 females). Results: The cohort patients who complained of spinal movement-related pain performed a limited amplitude of movements with the purpose of avoiding the onset of back pain in daily life. Of the patients who had OVFs, 76 (21.2%) patients had RP, 197 (55.0%) patients had SPT, and 83 (23.2%) patients had ASPP. On multiple regression analysis, only patients with VFs located in T1–T9 or those who had a -2.5 ≤ T-score < -3.5 showed significantly higher incidences of RP, SPT, and ASPP (p < 0.05). Conclusion: Dynamic back pain and backache avoidance behavior are the typical clinical presentations of patients with OVFs. RP, SPT, and ASPP are nondeterministic incidents, indicating that avoidance is necessary with respect to cognitive bias in clinical practice.