BACKGROUND: Cervical intervertebral foramen stenosis induced by cervical spondylosis of nerve root type usual y requires surgical treatment. The ways mainly include anterior cervical discectomy and fusion and cervical posterior intervertebral foramen decompression. Which is the best way is stil inconclusive. With innovation, anterior cervical discectomy and fusion for cervical spondylosis of nerve root type has become the mainstream in the current treatment. OBJECTIVE: To study the relationship between curative effects and intervertebral foramen-associated parameter changes in patients with cervical spondylosis of nerve root type after anterior cervical discectomy and fusion. METHODS: From March 2011 to April 2013, 132 patients with cervical spondylosis of nerve root type were treated with anterior cervical discectomy and fusion in the Changzheng Hospital Affiliated to the Second Military Medical University. Neck pain and arm pain visual analogue score, neck disability index score and imaging changes were evaluated before and after treatment. RESULTS AND CONCLUSION: 132 patients were fol owed up for 25(4-28) months. Significant differences in neck pain visual analogue scale, anterior intervertebral disc height, posterior intervertebral disc height, intervertebral foramen height, anterior and posterior diameters of the intervertebral foramen, the area of the intervertebral foramen, and the Cobb angle of the fused segment were detected in al patients before and after treatment (P < 0.05). Posterior intervertebral disc height was positively correlated with intervertebral foramen area (r=0.427, P=0.000). The increased Cobb angle of the fused segment was negatively associated with the size of intervertebral foramen (r=-0.273, P=0.003). Intervertebral foramen area was negatively associated with arm pain visual analogue score (r=-0.502, P=0.000). These results indicated that anterior cervical discectomy and fusion with an interbody fusion cage can obviously enlarge intervertebral foramen in patients with cervical spondylosis of nerve root type, and obtain good curative effect. The size of the intervertebral foramen is negatively related to the axial pain. The reconstruction of the intervertebral disc height is necessary to expand the intervertebral foramen. However, the increase of the curvature fusion segments is not helping to expand the intervertebral foramen.

BACKGROUND:Intervertebral disc degeneration is one of the ancient and common clinical diseases. Its complex pathogenesis affected by various factors, such as environment and genes, is stil in debate. Because of the technical limitations, there is stil no deep understanding on the molecular mechanism of intervertebral disc degeneration. However, its molecular mechanism in recent years has made considerable development. OBJECTIVE: To summarize and discuss the molecular mechanism of intervertebral disc degeneration, thereby providing the basis for the effective treatment. METHODS: CNKI and Medline databases were retrieved by the first author using computer to search relevant articles published from 2005 to 2015. The key words were “intervertebral disc degeneration, molecular mechanism, environmental factors, genes, matrix, degradation enzyme,inflammatory factor, biological environment, treatment” in Chinese and English, respectively. Mechanisms of intervertebral disc degeneration, involving genes, cel senescence and apoptosis, degradation enzyme and substrate, inflammatory cytokines, were summarized to explore the pathogenesis and possible effective treatment of intervertebral disc degeneration. RESULTS AND CONCLUSION:Totaly 153 articles were initialy retrieved and finaly 52 articles were included in result analysis according to inclusive and exclusive criteria. Unique structure and biochemical properties of the intervertebral disc are easy to cause intervertebral disc degeneration. Traditionaly, environmental factors, such as occupation and smoking, are considered as the main factors inducing intervertebral disc degeneration; however, more and more studies have shown that genes have the most important influence on intervertebral disc degeneration. Declined extracelular matrix, increased degradation enzymes, and overexpression of inflammatory factors can al destroy the entire structure of intervertebral disc, and accelerate the process of intervertebral disc degeneration. Effective treatment for intervertebral disc degeneration can be formulated depending on the deep understanding on its molecular mechanisms. Although there is a further understanding on the molecular medium of intervertebral disc degeneration, the complex biochemical environment within the intervertebral disc is stil a great chalenge to the treatment of intervertebral disc degeneration.

Objective To determine the application value of quantitative detection of DNA in cervical lesion screening.Methods Retrospective analysis of 82 518 cases of cervical lesions was carried out.The sensitivity,specificity,positive predictive value (PPV),and negative predictive value (NPV) of DNA quantification and ThinPrep cytology test (TCT) for the diagnosis of cervical lesions were compared with the results of biopsy.The accuracy of the two methods was evaluated by applying the receiver operating characteristic curve.Results The sensitivity of DNA quantification,TCT,and combined diagnosis was 77.37％,70.97％,and 90.24％,respectively,and the specificity was 65.59％,70.42％,and 45.06％,respectively.The sensitivity of cell DNA quantitative analysis was higher but the specificity was lower than that of TCT,while the sensitivity of combined diagnosis was the highest.In DNA quantitative analysis of patients with and without atypical squamous cells of undetermined significance (ASCUS),the positive rates of pathology were 42.71％ and 12.5％,respectively.The misdiagnosis rate of cell DNA quantitative analysis for screening cervical adenocarcinoma (39.13％) was higher than that for screening cervical squamous cell carcinoma (15.11％).In a cytologic smear,the misdiagnosis rate of cells ＜ 5 000 (57.83％) was much higher than that of cells ＞ 5 000 (22.63％).However,a combined diagnosis with TCT could reduce the misdiagnosis rate from 20.19％ to 13.38％.Conclusion Cell DNA quantification is more sensitive than TCT,but the specificity of cell DNA analysis is lower than that of TCT,and the screening rate for cervical adenocarcinoma is high.Quantitative DNA analysis combined with TCT can significantly improve the screening sensitivity.

OBJECTIVE: To determine the expression of vascular endothelial growth factor (VEGF) and their receptor in nasal inverted papillomas (NIP) and to clarify the function of VEGF in the occurrence of NIPs and the correlation with malignant phenotype. METHOD: VEGF and its receptor (flk-1), expression were examined by immunohistochemistry using LSAB method in sections of NIP from 48 patients and squamous carcinoma from 8 patients. RESULT: All the epithelium together with the adjacent vascular and stroma,expressed increased positive staining of VEGF and flk-1 with the degree of atypical hyperplasia in epithelium. The VEGF/flk-1 expression in epithelium was significantly stronger in severe atypical hyperplasia than that in mild atypical hyperplasia, and same in mild atypical hyperplasia than in NIPs (P<0.01). CONCLUSION VEGF/flk-1 participate in the growth of NIPs. The enhanced VEGF/flk-1 in the epithelium may be identified as one of the parameters in judging malignant transformation of NIPs.
Aged ; Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; genetics ; metabolism ; pathology ; Papilloma, Inverted ; genetics ; metabolism ; pathology ; Prognosis ; Vascular Endothelial Growth Factor A ; genetics ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; genetics ; metabolism

Objective To investigate the clinical effect of anterior controllable antedisplacement and fusion (ACAF) for the treatment of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine.Methods The data of 45 cases with cervical posterior longitudinal ligament ossification treated by ACAF from March 2017 to October 2017 were retrospectively analyzed,including 25 males and 20 females,age 45-68 years,average 57.5 years.There were 18 cases involving C3 vertebral body,30 cases involving C4 vertebral body,40 cases involving C5 vertebral body,34 cases involving C6 vertebral body,and 7 cases involving C7 vertebral body.The function of the neural function was evaluated by the Japanese Orthopaedic Association (JOA) scoring system at preoperation and latest follow-up.The curvature of the cervical spine was measured on the lateral X-ray film of the cervical spine,the maximum occupying ratio of the spinal canal was measured on the cross section of the CT scan,and compression of the cervical spinal cord was evaluated by the cervical MRI.Results Patients were followed up for 3 to 6 months (average,3.9 months).The improvement of neurological function was obtained in all the patients.The JOA score improvement rate at the latest follow-up was 71.3％±9.6％.The cervical lordosis was improved from preoperative 4.5°±3.8° to 10.3°±4.8° at the latest follow-up.The canal stenosis ratio was decreased from preoperative 54.3％±8.2％ to 12.5％±5.3％ at the latest follow-up.MRI showed that the cervical spinal cord was adequately decompressed in situ.No specific complications were identified that were associated with this technique.Conclusion The present study elaborates the surgical tips and demonstrates the satisfactory outcome of ACAF for the treatment of OPLL.This novel technique has the potential to serve as an alternative surgical technique for the treatment of cervical OPLL.