BACKGROUND: Abnormal curvature of the cervical spine reflects in large measure the degenerative changes of the cervical vertebrae. OBJECTIVE: The effect of manipulative therapy has been recognized in restoring normal cervical curvature, and aimed to further probe into the effect of this therapy on blood flow velocity in the vertebrobasilar arteries of patients with cervical spondylosis. DESIGN: A non-randomized and controlled concomitant study. SETTING: Departments of Spinal Orthopaedics and General Sugery of a University hospital, and the Outpatient Department of Orthopaedic Institute of a college of Traditional Chinese Medicine. PARTICI PANTS: From January 1999 to December 2001, 60 patients with cervical spondylosis were treated in the Department of Spinal Orthopaedics in Ruikang Hospital, Third Department of Surgery, First Affiliated Hospital of Guangxi College of Traditional Chinese Medicine, and Outpatient Clinic of Institute of Orthopaedics, Guangxi College of Traditional Chinese Medicine. The patients were divided into spondylosis group with abnormal curvature(30 cases) and spondylosis group without normal curvature(30 cases) . Thirty healthy subjects were also included to serve as the control group.METHODS: Manipulation was applied in these patients and the cervical curvature and blood flow velocity in the left vertebral artery (LVA) and right vertebral artery(RVA) as well as in the basilar artery(BA) were measured before and after the treatment for comparison. The correlation coefficients between them were also calculated.MAIN OUTCOME MEASURES: ① The cervical curvature before and after manipulation in spondylosis group and control group; ② The blood flow velocity in maximal systolic phase and end-diastolic phase in the specified arteries.RESULTS: The blood flow velocity in maximal systolic phase and end-diastolic phase decreased in LVA, RVA and BA in patients with abnormal cervical curvature, whose blood velocities in maximal systolic phase in these arteries was less than those in control subjects and patients with normal curvature ( P ＜ 0.05). After manipulation, the velocity in these arteries in creased apparently in patients with abnormal curvature. The changes in systolic velocity in LVA and systolic in BA were correlated to the curvature before manipulation, and after that, the maximal systolic velocity in LVA,maximal systolic velocity in RVA and BA were all related to the changes of the cervical curvature. CONCLUSION: Abnormal cervical curvature is the anatomical basis for abnormalities of the vertebrobasilar arteries. Manipulative therapy can restore the cervical curve and blood flow velocity in these arteries.

BACKGROUND: Mechanic pressure could cause neurocyte death. Both direct mechanic injury and complex pathophysiological mechanism can induce the pathological changes of axon and neuronal soma. OBJECTIVE: To observe the relationship between ultrastructural changes and pressure degree of neurocyte and neurocyte damage. DESIGN: A randomized controlled observational study using experimental animals as study subjects.MATERIALS:The study was conducted in the Central Laboratory of Ruikang Hospital affiliated to Guangxi Traditional Chinese Medical University from December 2002 to August 2003.SUBJECTS:Fourty-eight male New Zealand rabbits with a bodymass of (2.45 ± 0. 28) kg were randomly divided into control group, mild pressure group and severe pressure group with 16 rabbits in each group.METHODS:Animal models with mild and severe cervical spinal cord chronic pressure were established in rabbits. Control group was pseudo-operation group. Spinal cord observation under optical microscope and electron microscope, neurocyte apoptosis analysis (TUNEL method), neuron counting, and the section size of the neuron were analyzed respectively.MAIN OUTCOME MEASURES: Main results: observational results under optical microscope of each group. Subordinate results: ① observational results under electron microscope of each group; ② neurocyte apoptosis analysis RESULTS: After chronic pressure in the spinal cord of rabbits, phenomena like neuron atrophy,loss,reduced section size,and neuron and neurocyte apoptosis appeared. The morphology of neurons in control group was normal and the quantity was quite a lot, which was (40 ± 2), and the neuron section size was(41.24 ± 15.61) μm2.The number of neuron of mild pressurc group was(27 ± 2), and the neuron section size was(20. 82 ± 6.57) μm2. The number of neurons of severe pressure group was (22± 2), and the neuron section size was( 17. 96 ± 9.03 ) μm2. The difference between mild, severe pressure group and control group was significant( P ＜ 0.01),while the difference between mild and severe pressure groups was insignificant(P ＞ 0. 05 ). The ultrastructural changes of neurons after chronic pressure were reduced volume of soma, unclear nucleolus and reduced rough endoplasmic reticulum. The lamellar structure of spinal sheath was loose with vacuole, and the cell organs in axial plasma were reduced or lost.CONCLUSION: The ultrastructure of neurocyte changes after chronic pressure in spinal cord. The more serious the pressure is, the more serious the neurocyte damages are. Cell apoptosis exists after chronic pressure in spinal cord.

OBJECTIVE: To observe the influence of the change of cervical curvature on the nerve root and the vertebral artery of the patients with cervical spondylosis and the curative effect of therapeutic manipulations. METHODS: Sixty cases of cervical spondylosis with the change of cervical curvature, 60 cases of cervical spondylosis without the change of cervical curvature and 60 normal people were chosen. They were clinically observed and the cervical spondylosis was treated by manipulations and the data was processed according to the principle of statistics. RESULTS: The change of cervical curvature affected the nerve root and the vertebral artery and therapeutic manipulations produced a satisfactory curative effect. CONCLUSION: Cervical spondylosis with change of cervical curvature has special characteristics in the etiology, course and state of the disease. The change of cervical curvature produces an effect on the nerve root and the vertebral artery. Selected therapeutic manipulations produce a better curative effect.

BACKGROUND:The correlation between blood stasis syndrome and non-blood stasis syndrome of lumbar intervertebral disc protrusion remains unclear.
OBJECTIVE:To construct serum protein pattern model for diagnosing blood stasis syndrome of lumbar intervertebral disc protrusion.
METHODS:A total of 180 cases were included in this study and divided into treatment group (120 patients with lumbar intervertebral disc protrusion) and control group (60 healthy cases from physical examination). Furthermore treatment group was equal y assigned into blood stasis syndrome subgroup and non-blood stasis syndrome subgroup, with 60 cases in each subgroup. The involved cases were wel matched in nations, genders and ages. Serum samples of peripheral blood from the 180 cases were col ected. Surface-enhanced laser desorption/inionation time of flight mass spectrometry and ProteinChip technology were employed to detect and plot protein mass spectrum. The protein peak values were identified using Biomarker Wizard software. Then serum diagnosis model of blood stasis syndrome of lumbar intervertebral disc protrusion was established. The obtained models were verified through double blind method. The differential proteins were searched by ExPASy data.
RESULTS AND CONCLUSION:We detected that peak values of eleven proteins had statistical significance (P<0.05) from the involved 180 cases. Among them, two proteins were highly expressed while the other nine proteins were lowly expressed. Serum protein pattern model for diagnosing blood stasis syndrome of lumbar intervertebral disc protrusion was established through Biomarker Patterns software, and the sensibility was 86.667%, the specificity was 94.167%, the positive predictive value was 88.136%. There are a variety of abnormal y expressed proteins in the serum of the patients with blood stasis syndrome of lumbar intervertebral disc protrusion. The serum protein pattern model involved eleven different proteins can be used to diagnose blood stasis syndrome of lumbar intervertebral disc protrusion.

Objective:To evaluate the efficacy of Wechsler's bone setting manipulation in the treatment of lumbar disc herniation.Methods:A randomized controlled trial was carried out. 50 LDH patients from the Spinal Surgery Department of Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine and the Ruikang Hospital Traditional Chinese Medicine Master Hall Affiliated to Guangxi University of Chinese Medicine were selected as observation subjects from January to November 2021. They were divided into two groups using a random number table method, with 25 patients in each group. The control group was treated with traditional bone setting techniques, while the observation group was treated with Wechsler's bone setting correction techniques. Both groups were treated for 3 weeks. VAS scale was used to evaluate the degree of lower back and leg pain, and the Japanese Orthopedic Association was used to evaluate treatment (JOA score) to evaluate lumbar function; the sacral tilt angle (SS), lumbar lordosis angle (LL), and coronal pelvic tilt angle values were measured on the lateral X-ray film of the entire spine; adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate of the observation group was 92.0% (23/25), and the control group was 68.0% (17/25), with statistical significance between the two groups ( χ2=4.50, P=0.034). The VAS score of the observation group after treatment was lower than that of the control group ( t=16.25, P<0.01); the JOA score was higher than that of the control group ( t=-29.39, P<0.01). The SS [(36.00 ± 1.87) ° vs. (34.16 ± 1.57) °, t=-10.64] and LL [(38.08 ± 2.60) ° vs. (34.96 ± 1.90) °, t=-10.04] in the observation group were higher than those in the control group ( P<0.01); the coronal pelvic tilt angle value [(0.47 ± 0.14) ° vs. (0.69 ± 0.14) °, t=42.57] was lower in the control group ( P<0.01). No adverse reactions occurred during the treatment period in both groups. Conclusion:Wechsler's bone setting manipulation can improve the pain symptoms of patients with LDH, and restore the spine pelvis biomechanical balance to a certain extent.

BACKGROUND:Adolescent idiopathic scoliosis is the most common scoliosis deformity,accounting for about 80%of all scoliosis.Its pathogenesis is unknown.In recent years,the incidence rate has shown an obvious upward trend,which seriously threatens the physical and mental health of adolescents. OBJECTIVE:To perform the visualization analysis of the relevant literature on adolescent idiopathic scoliosis in recent 20 years through the Bibliometrics method,and explore the research hotspots and trends in this field to provide references for further research. METHODS:The relevant articles included in the Web of Science core collection database from January 1,2002 to December 31,2021 were searched by computer.The scientific knowledge map was drawn by CiteSpace 5.8.R3 software.The cooperation network,co-citation network,keyword co-occurrence,burst,clustering and timeline map were visually analyzed. RESULTS AND CONCLUSION:A total of 5245 papers were included.In the past 20 years,the annual publication volume has shown a fluctuating upward trend.The analysis of the cooperation network shows that the author with the most publications is Qiu Yong;the institution is Nanjing University;the country is USA.The author with the highest intermediary centrality is Lowe TG;the institution is Childrens Hosp Philadelphia,and the country is Switzerland.The co-citation network analysis exhibits that the author with the highest frequency of citations is Lenke LG;the document is Weinstein SL,2013,N Engl J Med;the journal is Spine,and the author with the highest intermediary centrality is Suk SI,and the cited document is Danielsson AJ,2001,Eur Spine J;the cited journal is Spine.Keyword analysis displays that the research hotspots mainly focus on conservative treatment,imaging parameters,pathogenesis,and genome-wide associations.Through the visualization analysis of the literature in this research field,this study clarifies the context of the research in this field,reveals the research hotspots and trends in this field,and provides research ideas and methods for many scholars.