Spinal cord injury (SCI) is a debilitating condition of the central nervous system (CNS) that leads to severe impairments in sensory and motor functions. Previous studies have pointed out that patient age is a critical factor influencing SCI prognosis. However, the role of microglia in age-related differences in SCI outcomes remains unclear. The current study aims to identify specific microglial subtypes and investigate their responses and functional differences in SCI recovery across different age groups. Single-cell RNA sequencing (scRNA-seq) data were obtained from the Gene Expression Omnibus (GEO) database, integrating multiple datasets to identify microglial subtypes. We performed pseudotime trajectory analysis and cell-cell communication analysis to understand microglial differentiation and interactions. Finally, immunofluorescence staining of mouse model samples was conducted to validate our bioinformatics findings. Microglia were classified into four subtypes: Homeostatic, Proliferating, Inflammatory A, and Inflammatory B. The Young SCI group exhibited a higher proportion of Homeostatic microglia and Inflammatory microglia A, whereas the old SCI group had more Inflammatory Microglia B but lacked Homeostatic Microglia. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed that markers for homeostasis microglia were enriched in immune modulation pathways. While makers for Inflammatory Microglia were enriched in immune response pathways. Specifically, markers for Inflammatory microglia B were enriched in pathways associated with overactive immune response. Pseudotime analysis indicated that microglia in young mice predominantly differentiated into Inflammatory Microglia A and Homeostatic Microglia, whereas in old mice, they tended to only differentiate into Inflammatory Microglia B. CellChat analysis showed increased pro-inflammatory signaling generated by Inflammatory Microglia B, exclusively in the old group. Our study demonstrates significant differences in microglial subtypes and functions between different age groups following SCI. These findings provide novel insights into the development of age-related therapeutic strategies and microglia-targeted biological treatments for SCI.

Objectives:To establish a model of Mycobacterium tuberculosis infection of osteoclasts(OC)and explore the mechanism of Mycobacterium tuberculosis infection on OC.Methods:Peripheral blood mononuclear cells(peripheral blood mononuclear cells,PBMCs)were isolated from healthy volunteers.Receptor activator of nuclear factor-KB ligand(RANKL)and macrophage-colony stimulating factor(M-CSF)were used to make PBMCS into OC,and tartrate resistant acid phosphatase(TRAP)staining was performed on the cells.The constructed kanamycin resistant H37Rv pMV261-GFP green fluorescent strain was resuscitated and cultured with 10％oleic albumin dextrose catalase(OADC),7H9 and kanamycin containing Mycobacterium tuberculosis special liquid medium in an incubator at 37℃ until the optical density(OD)value was about 0.5 at 600nm.The OC cells cultured alone were set as the blank control group.And OC cells were also infected with Mycobacterium tuberculosis at different multiplicity of infection(MOI)for 24h,and MTT colorimetric method was used to detect cell survival rate.The MOI with the highest cell survival rate was selected as experimental MOI,and OC cells infected with H37Rv at experimental MOI were set as the experimental group.Fluorescence microscopy and Mycobacterium tuberculosis acid-fast staining were used to observe the transfection of Mycobacterium tuberculosis at the experimental MOI.Quantitative real-time PCR(qRT-PCR)was used to detect the expressions of non-receptor tyrosine kinase C-src,cathepsin K(CK),carbonic anhydrase 2(CA2),Integrin-β3 and matrix metalloproteinase-9(MMP-9).Immunohistochemistry was used to detect the expressions of P-src,CK,CA2,Integrin-β3 and MMP-9 on the cell surface.Western blot(WB)was used to detect the protein expression levels of P-src,CK,CA2,Integrin-β3,and MMP-9.Results:TRAP staining showed that more than 90％of the cells were OC after 15d of culture,which could be used for experiments.The results of MTT colorimetric assay showed that the cell survival rate was the highest when the MOI was 20:1(P＜0.05).This transfection multiplicity can be used as the concentration of experimental group.Fluorescence microscopy showed that when the transfection multiplicity ratio was 20:1,the green fluorescent Mycobacterium tuberculosis entered the OC and was successfully transfected into the OC.The results of acid-fast staining after infection of OC with Mycobacterium tuberculosis showed that when the MOI was 20:1,the acid-fast Mycobacterium tuberculosis stained red entered OC and was also successfully transfected into OC.The results of qRT-PCR,cell immunohistochemistry,and WB showed that the expressions of MMP-9,CK,C-src,CA2,and Integrin-β3 in the experimental group were higher than those in the blank control group(P＜0.05).Conclusions:Mycobacterium tuberculosis can transfect OC;Compared with the blank control group,the levels of five bone destruction factors in the experimental group transfected with OC by Mycobacterium tuberculosis were increased,suggesting that bone destruction of spinal tuberculosis may be related to this,which may provide a new exploration direction for the diagnosis and treatment of bone tuberculosis diseases.

Background Magnetic resonance imaging (MRI) is widely used for the evaluation of knee injuries, however, the accuracy of MRI in classifying multiple ligament knee injuries (MLKIs) remains unknown. This study aimed to investigate the accuracy of MRI in diagnosing and classifying acute traumatic MLKIs, we hypothesize that MRI had high accuracy in detecting and classifying MLKIs. Methods The clinical data of 97 patients who were diagnosed with acute traumatic MLKIs and managed by multi-ligament reconstruction between 2012 and 2020 were retrospectively reviewed. The MR images were read by two experienced radiologists and results were compared with intraoperative findings, which were considered as the reference for the identification of injured structures. The value of MRI in detecting injuries of anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), lateral collateral ligament (LCL), and meniscus was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and kappa coefficients analysis. The value of MRI in classifying MLKIs was evaluated by calculating the agreement between MRI and intraoperative findings. Results For detecting the specific injured structures in MLKIs, MRI had high sensitivity (90.7% for ACL, 90.4% for PCL, and moderate specificity (63.6% for ACL, 50% for PCL) in detecting cruciate ligament injuries, moderate sensitivity (79.1% for MCL, 55.6% for LCL) and specificity (46.7% for MCL, 68.4% for LCL) in detecting collateral ligament injuries, fair sensitivity (61.5%) and low specificity (39.4%) in the diagnosis of injuries to the meniscus. For classifying the MIKIs, MRI had a moderate agreement with intraoperative findings in classifying KD-V (kappa value = 0.57), poor agreement in the KD-I (kappa value = 0.39) and KD-IIIM (kappa value = 0.31), meaningless in the KD-II and KD-IIIL (kappa value < 0). The overall agreement between MRI and intraoperative findings in classifying MLKIs was poor (kappa value = 0.23). Conclusions MRI is valuable in early detection and diagnosis of acute MLKIs, however, the accuracy of MRI in classifying MLKIs is limited. The management of MLKIs should be based on intraoperative findings, physical examinations, and comprehensive imaging results.

Retrospective.Acute spinal cord injury (ASCI) is caused by direct or indirect strikes from external forces on the spinal cord. Here, we investigated the correlation between the miR-124, miR-544a, and TNF-α levels in patients with ASCI, aiming to evaluate the potential usage of miR-124 and miR-544a in ASCI diagnosis.University/hospital.A total of 90 (58 male/32 female) ASIA patients and 15 (9 male/6 female) control patients (with acute limb trauma) were involved in the presented study. The ASIA patients were further subclustered based on the International Standards for the Neurological Classification of SCI (ISNCSCI) exam. 30 (18 male/12 female)cases were determined to have complete spinal cord injury (CSCI) and classified as ASIA grade A (Complete); 30 (20 male/10 female) cases were determined to have incomplete spinal cord injury (ISCI) and classified as ASIA grade B (sensory incomplete), C (motor incomplete), or D (motor incomplete); 30 (20 male/10 female) cases were determined to have normal neurological function (NNF) and classified as ASIA grade E (Normal). Plasma miR-124, miRNA-544a, and tumor necrosis factor-alpha (TNF-α) levels were measured from the blood samples collected 24 h, 48 h, and 72 h after trauma.The levels of miR-124 and miR-544a in the CSCI and ISCI groups were significantly higher than those of the NNF and the control group 24 h after injury (P < 0.05). The increased levels gradually declined from 24 h to 72 h after injury. The area under the receiver operating characteristic curve (ROC) of miR-124, miR-544a and TNF-α 24 h after trauma in patients with acute spinal cord injury were 0.948 [95% CI (0.890, 1.000)], 0.815 [95% CI (0.638, 0.994)] and 0.770 [95% CI (0.641, 0.879)], respectively.The miRNA-124 and miRNA-544a levels increased significantly in ASCI patients compared with control patients 24 h after injury. These increased levels gradually reduced from 24 h to 72 h after injury. There is a strong positive correlation between miRNA-124, miRNA-544a, and acute spinal cord injury.The present study was supported by a University-level project of Ningxia Medical University (Project Number: XY2017147).

目的:比较经皮椎间孔镜椎间盘切除术(PTED)与开窗减压髓核摘除术(ODD)治疗腰椎间盘突出症(LDH)的临床治疗效果.方法:选取186例LDH患者,按不同手术方式分为PTED组(114例)和ODD组(75例).比较两组患者手术时间、术中出血量、术后下床时间、脊柱Oswestry功能障碍指数(ODI)评分、日本腰椎矫形外科学会脊柱功能(JOA)评分、视觉模拟量表(VAS)评分以及住院满意度评分.结果:PTED组手术时间长于ODD组,术中出血量及术后下床时间均端于ODD组,术后3、6个月ODI评分均低于ODD组,术后3、6个月JOA评分均高于ODD组,术后3个月VAS评分明显低于ODD组,住院满意度评分高于ODD组(均P<0.05).结论:相较于开窗减压髓核摘除术,经皮椎间孔镜椎间盘切除术在治疗腰椎间盘突出症中疗效更显著,创伤更小,患者术后恢复更快,腰椎功能改善更明显.

This study aims to evaluate the effect of peroxisome proliferator-activated receptor (PPAR) γ gene inhibition on the adipogenic differentiation of rabbit bone marrow mesenchymal stem cells (BMSCs). Primary BMSCs were isolated from rabbit bone marrow, cultured, and the markers of BMSCs on cell’s surface were analyzed using flow cytometry. The experiment involved five groups, namely, control: untreated BMSCs; model: BMSCs treated with ethanol; empty siRNA: BMSCs treated with ethanol + empty siRNA; PPARγ: BMSCs treated with ethanol + PPARγ siRNA; and PPARγ inhibitor: BMSCs treated with ethanol + T0070907. RT-PCR and Western blotting were used to detect changes in the expression level of PPARγ, PETALA2 (AP2), lipoprotein lipase (LPL), fatty acid transport protein (FATP) 1, and fatty acid transporter (FAT). Adipocyte count and triacylglycerol content of the model and the empty siRNA groups were considerably greater than the control group (P<0.01). After the inhibition with PPARγ or T0070907, adipocyte count and triacylglycerol content of the PPARγ and T0070907 groups were significantly reduced (P<0.01), with no statistically significantly difference than the control group (P>0.05). The expression levels of PPARγ gene and protein in the model and empty siRNA groups were ominously enhanced than the control group (P<0.01), and after inhibition with PPARγ or T0070907, the PPARγ gene or protein expression level of PPARγ and T0070907 groups significantly reduced (P<0.01), with no statistically significance difference compared to the control group (P>0.05). The expression levels of Ap2, LPL, FATP1, and FAT genes in the model and empty siRNA groups were considerably greater compared to the control group (P<0.01). Inhibition with PPARγ or T0070907 in the PPARγ and T0070907 groups, respectively, lead to significantly reduced expression levels of adipogenic genes (P<0.01), with no statistically significance difference compared to the control (P>0.05). Inhibition of PPARγ gene downregulates the differentiation of BMSCs into adipocytes, indicating its putative role in the expression of adipogenic genes.

Objective:To investigate the difference between simple posterior interbody fixation and fusion and posterior interbody fixation combined with focus debridement and bone graft fusion for the treatment of mono- and bi-segmental lumbar brucella spondylitis.Methods:A total of 63 patients (42 males and 21 females), aged 50.9±8.18 years (range from 38 to 69 years) with mono- and bi-segmental lumbar brucella spondylitis who received surgical treatment from June 2014 to Feb 2018 were retrospectively analyzed. There were 44 cases of mono-segmental and 19 cases of bi-segmental. Thirty-one cases were treated with single posterior interbody fixation and fusion (PIFF group), and 32 caseswere treated with posterior interbody fixation combined with focus debridement and bone graft fusion (debridement group). The main observation indicators include operation time, intraoperative blood loss, postoperative hospital stay, postoperative medication time, Visual Analogue Scale(VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Frankel score and clinical efficacy.Results:All of 63 patients were followed up for 27.16±6.07 months (range 15 to 38 months). The operation time of mono-segmental patients of PIFF group was 105.86±16.66 min,the intraoperative blood loss was 295.00±55.11 ml, and the postoperative hospitalization was 4.45±1.53 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was without significant difference between the two groups ( P>0.05). The opration time of bi-segmental patients of PIFF group was 150.33±26.29 min, the intraoperative blood loss was 242.05±50.56 ml, and the postoperative hospitalization was 4.56±1.50 days, which was significantly shorter than debridement group ( P<0.001), while the postoperative medication time was also without significant difference between the two groups. At the last follow-up time, the VAS scores and ODI values of mono- and bi-segments in PIFF group and debridement group were lower than those preoperation, but there was no significant difference between the two groups ( P>0.05). There was no significant difference in CRP between mono-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time ( P>0.05). The CRP in mono-segments of PIFF group and debridement group decreased at 3 months after the operation compared with that preoperation, and the difference was statistically significant ( P<0.001). There was no significant difference in CRP between bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was no significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at 3 months after operation and the last follow-up time ( P>0.05). There was significant difference in ESR between mono- and bi-segments of PIFF group and debridement group at the preoperation, 3 months after operation and the last follow-up time. There was no statistical difference in the proportion of excellent postoperative clinical efficacy between the two groups. Complications were observed in two patients in PIFF group (6.5%, 2/31) compared with 8 patients in debridement group (25%, 8/32, χ2=4.057, P=0.044). Conclusion:On the basis of standardized anti-brucella drug therapy, simple posterior interbody fixation and fusion for the treatment of brucella spondylitis has a satisfactory surgical effect, and has the advantages of less surgical trauma, shorter time, earlier postoperative movement time and fewer complications.

目的 探讨经皮球囊扩张椎体后凸成形术(Percutaneous kyphoplasty,PKP)治疗老年骨质疏松性胸腰椎压缩骨折的临床疗效.方法 回顾性分析自2017-01-2019-12采用PKP治疗的265例骨质疏松性胸腰椎压缩骨折,比较术前、术后1 d、术后3个月、术后6个月疼痛VAS评分、ODI指数、椎体前缘高度、伤椎后凸角.结果 265例均顺利完成手术并获得完整随访,随访时间6～8个月,平均7.1个月.术后1d疼痛VAS评分较术前明显改善,术后3个月疼痛VAS评分较术后1 d改善;术后1 d ODI指数较术前明显减小,术后3个月ODI指数较术后1 d减小;术后1d椎体前缘高度较术前明显增加,伤椎后凸角较术前减小,差异有统计学意义(P＜0.05).结论 PKP能短期内显著改善患者术后疼痛症状,并且能恢复椎体高度和改善椎体后凸畸形,是治疗老年骨质疏松性胸腰椎压缩骨折的有效方法.

Background. Anterior cervical discectomy and fusion with instrumentation (ACDFI) have been widely used in the treatment of the degenerative disease or traumatic instability of the cervical spine. This study aimed to investigate the clinical efficacy of the autologous vertebral-filled polyetheretherketone (PEEK) cage in anterior cervical discectomy and fusion with instrumentation (ACDFI). Material and Methods. The clinical data of 368 patients who received ACDFI from September 2015 to September 2020 were retrospectively analyzed. According to the material that filled PEEK cage during the surgery, the patients were divided into two groups, the autologous vertebrate group (n = 185) and the autologous iliac group (n = 183). The operative time, operative blood loss, postoperative complications in two groups were recorded and analyzed. The bone graft fusion and postoperative functional outcomes, including scores of modified Japanese Orthopedic Association score (mJOA), Neck Disability Index (NDI), and visual analog scale (VAS) were compared. Results. Patients were followed-up for 14.04 ± 0.98 months. At a 6-months follow-up, the rate of spinal fusion was 96.29% (178/185) in the vertebral group and 95.94% (176/183) in the iliac group, there was no statistically significant difference between the two groups ( P >0.05). The postoperative VAS, mJOA, and NDI scores were not significantly different between two groups during the follow-up ( P >0.05). The operative time and blood loss in the vertebral group were significantly less than that of the iliac group ( P <0.01). In the iliac group, all patients suffered pain in the iliac donor site, 65 patients suffered numbness, 12 patients had fat liquefaction in donor incision, while all patients in the vertebral group had no postoperative complications. Conclusion. The autologous vertebrae-filled PEEK cage can achieve the same clinical outcome as the autologous iliac, but the autologous vertebrae filled PEEK cage have the advantage of shorter operative time, less intraoperative blood loss, and postoperative complications.

Objective: To establish an animal model of adjacent intervertebral disc degeneration in New Zealand White rabbits undergoing lumbar fixation and fusion for intervertebral disc degeneration. Methods: Fifteen healthy, 10-month-old New Zealand rabbits were used in this study. The L3-4 intervertebral disc was located with an 18-G puncture needle under fluoroscopic guidance. Magnetic resonance imaging (MRI) of the spine was performed periodically. When L3-4 disc degeneration occurred, the L3-4 disc was excised, and interbody fusion with the transverse process graft and titanium plate fixation were performed. The changes in the adjacent intervertebral disc were observed periodically via MRI after interbody fusion. The animals were sacrificed 12 weeks after surgery, and the histopatholo& of the adjacent intervertebral disc was studied. Results: The animal response score was not statistically significant before or after intervertebral disc puncture (F = 1.563, P > 0.05), but it was significantly different before and after the intervertebral disc excision and interbody fusion (F = 6.178, P < 0.001). Compared with the response scores in the animals undergoing disc puncture, the response scores in the animals undergoing fusion and fixation were significantly lower at all studied time points (T = 7.952, 5.791 and 3.944, P < 0.001). The survival rate was 100%. Dynamic MRI revealed that the overall T2 signal intensity started to decrease beginning in the 4th week after disc puncture. Varying degrees of degeneration were present in the adjacent disc after fixation and interbody fusion. The adjacent disc degeneration was not significantly different between the puncture group and the fixation and fusion groups (P > 0.05) in the 4th week after intervention but was significantly different (P < 0.05) in the 8th and 12th weeks. The animals were sacrificed 12 weeks after fixation and interbody fusion, and we observed complete fusion of the fixated segments with surrounding callus formation. A gross pathological examination revealed darkgray nucleus pulposus with partial fat-like changes. The hematoxylin and eosin (HE)-stained sections showed vague borders of the nucleus pulposus. The nucleus pulposus tissue was replaced by cartilage tissue, and degenerative changes were present in the center. Conclusion: The animal model studied in this work is preliminary for studying adjacent intervertebral disc degeneration after intervertebral disc excision, fixation, and fusion.

目的 对比分析颈椎前路椎间盘切除椎体间植骨融合(ACDF)术中是否应用显微镜技术治疗单节段脊髓型颈椎病的疗效.方法 此研究为前瞻性随机对照研究,将76例单节段脊髓型颈椎病患者分为2组,显微镜组与非显微镜组38例.术后随访时间＞2年,比较2组手术时间、出血量、并发症、住院天数及神经功能恢复情况.结果 显微镜组与非显微镜组手术时间分别为(92.0±18.2)min和(78.0±14.3) min,术中出血量分别为(40.3±23.5)mL和(84.6±19.2)mL,2组比较差异有统计学意义(P＜0.05),显微镜组手术时间长、出血量少.显微镜组与非显微镜组患者并发症、神经功能恢复情况间差异无统计学意义(P＞0.05).末次随访时,显微镜组与非显微镜组患者脊髓神经功能评分(JOA评分)改善率差异无统计学意义(P＞0.05);2组并发症发生率差异无统计学意义(P＞0.05),2组均未发生定位错误、大血管损伤和术后感染.结论 ACDF术中应用显微镜治疗单节段脊髓型颈椎病并未获得更好的远期疗效,虽然手术时间延长,但显微镜下行ACDF操作更精细、损伤小、术中出血少.

目的 探讨在腰椎后路减压椎间植骨融合术(posterior lumber interbody fusion,PLIF)中应用超声骨刀的临床价值.方法 回顾性分析2014年1月至2015年12月宁夏医科大学总医院脊柱骨科应用超声骨刀行腰椎PLIF手术的35例患者(超声骨刀组)和同期使用传统器械手术的40例患者(传统器械组)的临床资料.分析并比较两组患者的手术时间、术中出血量、术后引流量、日本骨科学会(JOA)评分、JOA改善率等指标.结果 相比于传统器械组,超声骨刀组的手术时间短、术中出血量及术后引流量少(P均<0.05),两组患者术后1周JOA评分均高于术前(P均<0.05).两组患者术后JOA评分、JOA改善率以及JOA改善优良率差异均无统计学意义(P均>0.05).结论 超声骨刀进行PLIF手术可缩短手术时间,减少手术出血,并能避免硬膜损伤及脑脊液漏等,值得临床推广应用.

医源性脊柱骨折是指医务人员在诊疗活动中,由于各种原因造成患者脊柱骨折或原有脊柱骨折加重.是脊柱外科的一种少见且严重的并发症,由此导致的脊髓、马尾神经受压可造成患者瘫痪,甚至危及生命.目前,对于腰椎后路手术发生医源性脊柱骨折国内外报道并不多见.我院收治1例腰椎间盘突出症患者行腰椎后路椎板开窗髓核摘除术中并发腰5椎体骨折,报道如下.

Aim: Both Superion and X-Stop interspinous spacers have been approved by Food and Drug Administration (FDA) for the treatment of neurogenic claudication secondary to lumbar spinal stenosis (LSS). However, controversy remains as to the difference in the improvement of clinical outcomes in moderate LSS patients treated with the two interspinous spacers. Our purpose was to comprehensively appraise the difference. Methods: We searched multiple databases for literature retrieval. The difference in the improvement of Zurich Claudication Questionnaire (ZCQ) patient satisfaction, Visual Analog Scale (VAS) back pain, VAS leg pain and Oswestry Disability Index (ODI) was assessed between the two spacers after treatment. And the difference in the occurrence rate of adverse events between the two groups was also appraised. The Standardized Mean Difference (SMD)/risk ratio (RR) with corresponding 95% confidence interval (CI) for each parameter was estimated. Results: There was significant difference in the improvement of ZCQ patient satisfaction and VAS back pain between the two spacers (ZCQ: SMD = 0.242, P < 0.001; VAS back pain: SMD = 0.147, P = 0.012), whereas no significant difference was detected in the improvement of VAS leg pain and ODI, and the occurrence rate of adverse events between the two treatment. Conclusion: Our meta-analysis suggests that moderate LSS patients receiving X-Stop interspinous spacer have significantly higher patient satisfaction and larger reduction in the back pain severity than those implanted with Superion after surgery.

目的 探讨布氏杆菌性脊柱炎术前实验室及影像学检查特点,以提高对该病的诊断水平.方法 回顾性分析2013年12月至2015年12月在宁夏医科大学总医院脊柱骨科收治的40例布氏杆菌性脊柱炎患者的实验室与影像学检查资料,分析实验室检查中布氏杆菌凝集试验、C反应蛋白(CRP)、红细胞沉降率(ESR)与影像学检查中DR、CT、MRI对诊断布氏杆菌性脊柱炎的价值.结果 40例患者布氏杆菌凝集试验均为阳性,ESR升高36例(90%),CRP升高39例(97.5%).病变累及腰椎最为常见(80.7%),其余依次为胸椎(8.0%)、骶椎(6.8%)、颈椎(4.5%).DR发现骨质破坏16例,椎间隙变窄28例,骨质增生31例;CT发现骨质破坏33例,骨质硬化6例,椎间隙变窄31例,韧带钙化13例,骨质增生35例;MRI发现骨质破坏38例,椎旁脓肿形成22例,硬膜外脓肿形成12例,椎间盘破坏18例,椎间隙变窄31例.结论 布氏杆菌性脊柱炎患者术前的实验室检查可明确机体炎症感染及感染类型,脊柱影像学检查可明确感染部位及严重程度,对布氏杆菌性脊柱炎的诊断可以提供有力的辅助诊断依据.术前实验室及影像学检查优势可互补,临床上利于诊断布氏杆菌性脊柱炎.

Objective To investigate the blocking effect of AG490 at different dose on JAK2/STAT3 signal pathway of spinal nerve cells, and to explore its effect on apoptosis and function. Methods 60 healthy adult male SD rats weighing 220~250g were adopted. 48 rats were chosen to establish the acute spinal cord injury using "spinal beater special for rats". According to the dose of AG490 divide them into groups A,B,C,D (injection dose:0mg·kg-1 weight,5mg·kg-1 weight,10mg·kg-1 weight,15mg·kg-1 weight)while 12 rats of control group were named E group, only openning the vertebral plate and no hurting spine cord. BBB rating was recorded at preoperative and 24h after operation. The rats were put to death at 24h after the operation. 6 rats from each group were embedded in paraffin for the detection of HE staining and TUNEL apoptosis, and another 6 rats were taken fresh tissues to conduct Western blot assay for detecting the expression changes of P-JAK2 and P-STAT3. The relation scheme between the levels of P-JAK2 and P-STAT3 and the number of apoptosis were drawn. Results A stable ASCI model was successfully established and the satisfactory sample of spinal cord tissue was obtained. HE staining showed that the degree of spinal cord injury was no significant difference among the groups(P>0.05). TUNEL assay showed few apoptotic cells in the control groups and most apoptotic cells in the injury groups, as well as that the number of apoptotic cells in the injury group intervened by AG490 was increased along with the reduction of AG490 dose. Western blot detection showed that the levels of P-JAK2 and P-STAT3 in group A,B,C and D decreased with the increasing doses of AG490,with significant differences among the groups(P<0.05). Conclusion After the acute spinal cord injury of rats,the application of AG490 was of no impact on the observation of cord morphology. The levels of P-JAK2 and P-STAT3 and the number of apoptotic cells reduced with the increasing dose of AG490.

Objective To explore the effect of posterior debridement, grafting and internal fixation for treatment of non-specific lumbar intervertebral infection. Methods Clinical data of 20 patients with non-specific lumbar intervertebral infection treated in General Hospital of Ningxia Medical University from October 2013 to June 2013 were retrospectively analyzed. There were 15 males and 5 females with an average age of 41 years (range, 36-51 years). All patients suffered from single lumbar inter-vertebral infection, including 3 cases at L2/3,4 at L3/4,10 at L4/5 and 3 at L5/S1. All 20 cases underwent one-stage posterior debride-ment, autogenous bone grafting and internal fixation, tissue samples in focus were collected for bacterial culture and pathological examination. The disease controlling statues were evaluated based on laboratory results of ESR and CRP. Imaging examinations were taken to evaluate the fusion of vertebral body. Clinical effects were evaluated using the visual analog scale (VAS) and the Jap-anese Orthopaedic Association scores (JOA) score of lumbar fumction. Results All patients underwent the surgery successfully. The surgery duration time was 90-160 min, average 125 min, and the blood loss was 200-700 ml, average 360 ml. Cerebrospinal fluid leakage occurred in one case. Postoperatively, all patients experienced significant reliefof back pain, improving in the func-tion of movement, and no fever. The lower back VAS score: average (5.35 ± 1.15) points before operation , average (2.76 ± 0.34) points one week after operation, and an average score of (0.85±0.65) points by the last follow-up time. JOA lumbar function score:all patients were effective after operation, the improvement rate was excellent in 65%(13cases), good in 25%(5 cases), and pass-able in 10%(2cases). Comparing with preoperation, the excellent and good rate was 90%. All patients ESR and CRP returned to normal levels at the last follow-up. Ordinary bacterial culture was positive in 8 cases and negative in 12 cases. The pathogens iden-tified were staphylococcus aureus (6 cases), Escherichia coli (2 cases) and staphylococcus epidermidis (2cases). All incisions achieved primary healing. All patients were followed up from 6-18 months (average,12 months), and the symptom of pain relieved significantly. No recurrent infection had happened. A solid bony fusion was found in all patients at 6-14 months (average, 8.5 months) after the surgery. Conclusion Posterior debridement, grafting and internal fixation are effective treatments for non-spe-cific lumbar intervertebral infection, can reduce the time of staying in hospital, this operation is safe and reliable.

目的 检测人退变颈椎间盘髓核组织的细胞凋亡率以及相关蛋白Caspase-1及IL-1β的表达.方法 将30例颈椎间盘突出症患者(实验组)的间盘髓核组织和30例颈椎骨折患者(对照组)的间盘髓核组织,采用原位DNA片段末端标记(TUNEL)法和免疫组织化学方法,观察其细胞凋亡状态及Caspase-1及IL-1β的表达.结果 实验组TUNEL阳性细胞率为(10.21 ±1.13)％,高于对照组的(6.34±1.65)％(P＜0.01);实验组Caspase-1、IL-1β蛋白阳性细胞率分别为(42.31 ±8.08)％、(56.07±10.22)％,高于对照组的(22.06±1.28)％、(43.12±13.56)％ (P＜0.01).将实验组进行Pearson相关分析,发现间盘髓核组织TUNEL阳性细胞率和Caspase-1、IL-1β阳性细胞率呈正相关,相关系数r分别为0.828和0.780(P＜0.01).结论 在人退变颈椎间盘髓核中,高表达的Caspase-1、IL-1β与其细胞凋亡有关,是引起盘源性颈椎间盘退变的原因之一.

目的 比较Wiltse入路与传统后正中入路行胸腰椎骨折内固定取出术的疗效.方法 将52例胸腰椎骨折术后需行内固定取出的患者按数字随机表法分为2组,分别采用Wiltse入路与传统后正中入路进行手术治疗,比较2组手术时间、术中出血量、术后引流量、术后疼痛视觉模拟评分(VAS评分)的差异.结果 2组患者均顺利取出内植物,无椎弓根螺钉断裂发生.Wiltse入路组患者手术时间(35.80±2.833) min、术中出血量(17.20±1.568) mL、术后引流量(20.33±1.988) mL及术后VAS评分(1.90士0.738)分,均明显低于传统后正中入路组的(55.33±2.769) min、(45.40±2.473) mL、(50.20±4.799) mL、(3.00±0.667)分(P＜0.05),Wiltse入路组疗效优于传统后正中入路组.结论 Wiltse入路行胸腰椎骨折内固定取出术,在手术时间、术中出血量、术后引流量及术后VAS评分方面均明显优于传统后正中入路,手术创伤小、出血少、疼痛轻、恢复快,可作为胸腰椎骨折内固定取出的良好入路选择.