BACKGROUND:Recently, non-fusion technology representing as artificial cervical disc replacement continues to improve. On the basis of reconstruction of disc structure and function of involved segments, cervical spine structure of surgery area segment is significantly close to dynamic and static load stress distribution required by natural physiological systems. It effects are apparent in protecting intervertebral facet joints of degenerated segment and structure and function of the cervical spine of adjacent segments and in maintaining cervical dynamic stability, which presented obvious methodological strengths compared with segmental fusion technology.
OBJECTIVE:To evaluate the clinical outcomes of anterior cervical discectomy and fusion and Bryan artificial cervical disc replacement in the treatment of single-level cervical spondylotic myelopathy or radiculopathy.
METHODS:A total of 43 middle and old age patients with single-level cervical spondylotic myelopathy or radiculopathy, who were treated from March 2010 to March 2012, were enrol ed in this study. They were randomly assigned to anterior cervical discectomy and fusion group (fusion group) and Bryan artificial cervical disc replacement group. Range-of-motion of cervical overal and adjacent intervertebral area near the intervertebral space was observed with radiography. During fol ow-up, postoperative recovery of neurological function was evaluated using Japanese Orthopaedic Association scale, visual analog scale and neck disability index.
RESULTS AND CONCLUSION:None patients experienced complications of neurovascular injury during and after the surgery. Range-of-motion of postoperative overal cervical vertebra and adjacent joint was improved in the Bryan artificial cervical disc replacement group compared with the fusion group. Neurological function was apparently improved after surgery in each group. At 3 months after surgery, scores of Japanese Orthopaedic Association, visual analog scale and neck disability index were significantly improved in the Bryan artificial cervical disc replacement group compared with the fusion group (P<0.05). During final fol ow-up, there were significant differences in visual analog scale scores between the two groups. Japanese Orthopaedic Association scale score and neck disability index score were similar between the two groups. During fol ow-up, no prosthesis sinking, displacement or heterotopic ossification were detected. These data indicated that artificial cervical disc replacement could effectively keep the range of motion of cervical segments and protect disc degeneration of adjacent segment. Mid-term fol ow up obtained similar improvement of neurological function of fusion surgery. The moderate-term and short-term efficacies of non-fusion technology were better than fusion technology in the treatment of single-level cervical spondylopathy.

Objective : To identify spatio-temporal distribution patterns of mumps in Zhejiang Province from 2008 to 2019, so as to provide insights into precise control of mumps. Methods : The epidemiological data pertaining to mumps in Zhejiang Province from 2008 to 2019 were collected from the China Information System for Disease Control and Prevention. The time- and region-specific incidence of mumps was descriptively analyzed, and the spatio-temporal clustering characteristics of mumps incidence were identified using global and local spatial autocorrelation analyses and spatio-temporal scan analysis. Results : A total of 167 196 cases of mumps were reported in Zhejiang Province from 2008 to 2019, and the incidence of mumps reduced from 56.08/105 in 2008 to 11.35/105 in 2019, with a reduction of 79.76%. There was no remarkable mumps seasonality since 2017; however, spatial autocorrelation was seen in mumps incidence in 2008, 2011 and 2012, respectively ( Moran's I coefficient=0.16, 0.18, 0.16; all P<0.05 ). Spatio-temporal scan analysis identified five spatio-temporal clusters of mumps incidence in 2008, 2011 and 2012, and the most likely spatio-temporal cluster was mainly concentrated in Cangnan County of Wenzhou City, covering 17 counties clustered in the time frame from 15 January 2008 to 28 February 2009, while the other four clusters were concentrated in Pinghu City of Jiaxing City, Kaihua County of Quzhou City, Fuyang District of Hangzhou City and Zhuji City of Shaoxing City, clustered in the time frame from 15 January 2008 to 30 June 2012. Conclusion The incidence of mumps appeared a tendency towards a reduction in Zhejiang Province from 2008 to 2019, and rebounded in some regions. No remarkable mumps seasonality was seen since 2017. The spatio-temporal clusters of mumps incidence were concentrated in Wenzhou and Jiaxing cities of Zhejiang Province in 2008, 2011 and 2012; however, no spatial cluster was identified since 2012.

Objective:To evaluate the diagnosis, surgical treatment, and neurological function recovery after surgery of patients with intraspinal tumors. Methods:The clinical data of 69 patients who suffered from intraspinal tumors and underwent surgery from Janu-ary 2008 to December 2012 were retrospectively analyzed. Neuroimaging and ASIA scoring were performed to examine the pathologi-cal characteristics of tumors and the neurological function of these patients before and after treatment. The major factors affecting prognosis were also probed, and the average follow-up period was 12.2 months. Results:Of the total cases, 62.3%showed intradural extramedullary intraspinal tumors located in the thoracic vertebra. Neurilemoma (Schwannoma) and meningioma were the most com-mon pathological types (53.5%). Posterior approaches with hemi-and complete-laminectomy were conducted to expose the intraspi-nal tumors, and the separation and removal of the tumors located at the cervical and thoracic levels were aided with surgical microsco-py. The main clinical symptoms, including back pain, radicular neuralgia, sensory disturbance, and motor dysfunction, were significant-ly improved after surgery, and this observation was supported by the follow-up ASIA scores before and after treatment. Of the in-volved cases, 91%were successfully treated, and their tumors were totally resected. Conclusion:Total or subtotal intraspinal tumor re-section enhanced with surgical microscopy could achieve satisfactory clinical results through posterior hemi-or complete-laminectomy.

Objective In vitro model with three dimensional cell culture provides the appealing biomimetic platform to probe the biological characteristics of multiple stem cells,which serves as an important in vitro tools to investigate regulating factors controlling the proliferation and differentiation of neural stem cells (NSCs).The present study aims to reconstruct an integrated poly-peptide hydrogel made extracellular matrix (ECM) enhanced with cyclo-RGD molecular [c(RGDfK)] for the exploration of NSCs bio-characteristics.Methods Spinal cords from one-d-old SD rats were collected and spinal-derived NSCs were induced in the complete medium; immunofluorescence staining was employed to observe the NSCs morphology and identify NSCs.Three hydrogel including type Ⅰ collagen,self-assembly poly-peptide nanofiber hydrogel (SAPNH) of RADA16 and RADA16-c(RGDfK) were employed to serve as culturing ECM of spinal-derived NSCs to mimic the ex vivo 3-D culturing.With the theological analysis,cyto-morphological observation was performed,NSCs proliferation was observed by MTT assay,and cell immunochemistty and confocal microscopy were employed to detect the NSCs differentiation.Results SAPNH born appropriate elastic module conducive to the cellular adhesion and proliferation of neural cells (RADA16 and RADA16-c (RGDfK)=(0.42±0.07) kPa and (0.47 ±0.09) kPa,without significant difference (P＞0.05); however,the elastic module in the type Ⅰ collagen group was (0.87±0.12) kPa,which was significantly stronger than the two groups (P＜0.05).Uniform distribution of neuron-shape cells was noted in the extracellular matrix ofRADA16-c (RGDfK) cells,with almost the diameter of cell sphere (200-300 μm); cells in the RADA16 and RADA16-c (RGDfK) had better growth characteristics than the other two groups; RADA16-c(RGDfK) had significantly better cellular adhesion and proliferation of neural cells as compared with RADA16 and collagen groups (P＜0.05).A large number of neural precursor cells differentiated into neurogliocytes was noted in the RADA16 group and RADA16-c (RGDfK) group,with low proportion of neuronal differentiation (17.6％ ±3.1％ and 19.0％±3.6％,respectively); this proportion of neuronal differentiation was significantly higher than that in the type Ⅰ collagen group (10.6％±2.3％,P＜0.05).Conclusions The functionalized SAPNH enhanced with c(RGDfK) presents the excellent biocompatibility and promotes the adhesion and proliferation of spinal NSCs.Serving as the engineered cellular vector,functionalized SAPNH has laid a solid foundation for the studies of neural regeneration and repair with novel neuro-engineering techniques in the subsequent researches.