OBJECTIVESTo evaluate the relationship between Modic change and disc height together with lumbar hyperosteogeny and study the role of Modic change in lumbar degeneration.

METHODSThe imaging data of 150 elderly patients with chronic low back pain were analysed retrospectively. All patients underwent MRI and lumbar lateral X-ray examination. The lumbar disc from L1-L2 to L5-S1 were selected for this study, including 750 discs, vertebral and endplate close to disc in 150 patients. The incidence rate of lumbar endplate Modic change, disc height and the degree of vertebral bone hyperplasia were recorded. The ratio of disc height/lumbar intervertebral disc height < 50% was defined as disc collapse. The patients were divided into 4 groups in the basis of imaging changes. Group A1:disc collapse without severe lumbar hyperosteogeny; Group A2: disc collapse with severe lumbar hyperosteogeny; Group B1: Neither disc collapse nor severe lumbar hyperosteogeny; Group B2: severe lumbar hyperosteogeny without disc collapse. The incidence rates of Modic change were compared between the 4 groups by χ(2) test. Finally, the influence of disc height and vertebral bone hyperplasia on the incidence rate of Modic change was analysed.

RESULTSFour groups of patients observed a total of 750 discs. The number of intervertebral discs in the group A1 was 208, the incidence rate was 54.3%. The number of intervertebral discs in the group A2 was 135, the incidence rate of group A2 was 34.8%. The number of intervertebral discs in the B1 group was 225, the incidence rate of group B1 was 16.9%. The number of intervertebral discs in the B2 group was 182, the incidence rate of group B2 was 29.7%. There was significant difference of lumbar endplate Modic change incidence rate among the 4 groups(χ(2) = 69.565, P < 0.05). The results of post hoc test showed that the incidence rate of Modic change in group A1 was higher than group A2, B1 and B2 (χ(2) = 12.524, 66.701 and 24.102, P < 0.00714). There was significant difference of Modic change incidence rate between group A2 and B1(χ(2) = 15.032, P < 0.00714), but there was no significant difference of Modic change incidence rate between group A2 and B2 (χ(2) = 0.945, P > 0.00714) . There was significant difference of Modic change incidence rate between group B2 and group B1 (χ(2) = 9.395, P < 0.00714).

CONCLUSIONSThe incidence rate of Modic change with disc collapse but without severe lumbar hyperosteogeny is high in elderly patients with chronic low back pain. There is no significant difference of Modic change incidence between patients with both disc collapse and severe lumbar hyperosteogeny and patients with severe lumbar hyperosteogeny but without disc collapse.

Aged ; Aged, 80 and over ; Female ; Humans ; Intervertebral Disc ; pathology ; Intervertebral Disc Degeneration ; pathology ; Low Back Pain ; pathology ; Lumbar Vertebrae ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo study the clinical features, treatment methods and outcome of solitary plasmacytoma of cervical spine.

METHODSFrom January 1995 to December 2007, the data of 23 cases with solitary plasmacytoma of cervical spine was analyzed. There were 16 males and 7 females (mean age 56 years, range: 32 - 76 years). Two cases underwent radiotherapy alone and 21 patients received surgery. According to WBB staging system, surgical procedures were defined as total or subtotal resection (6 cases), appendix resection (4 cases), sagittal resection (3 cases) and total spondylectomy (8 cases). All surgical cases were managed using an anterior approach, posterior approach or combined anterior and posterior approach. The cervical spinal reconstruction was achieved through anterior cervical titanium plate and titanium mesh cage filled with auto iliac graft or bone cement, or anterior and posterior combined instrumented fusion. All patients received radiotherapy as adjunctive therapy.

RESULTSFollow-up of the 23 cases lasted 24.0 - 143.0 months (mean: 64.7 months). Neck pains obviously improved, and nerve compression symptoms disappeared or improved after surgery. Neurological function improved by 1 - 2 grades based on Frankel grading system. All the internal fixations were fused well and stability of the cervical spine was fine and no spine instability could be seen in our series. The bone graft fusion rate was 100%. During the follow-up period, 6 surgical cases had local recurrence and finally progressed to multiple myeloma (MM) and 3 died. Two cases without surgical treatment progressed to MM in 1 year and 1.5 years after confirmed diagnosis. They were given systemic chemotherapy. The other 15 patients had disease-free survival and after surgery and adjunctive radiotherapy. Obvious abnormity were not found in such examinations as M protein, bone marrow aspiration and emission computed tomography or PET-CT examinations.

CONCLUSIONSSolitary plasmacytoma of cervical spine is rarely seen clinically. Surgery is recommended as the primary management for patients with overt bone destruction and spinal instability or neurological dysfunction. Tumor excision with adjunctive radiotherapy can obviously reduce local recurrences and lower the possibility of progression to MM. The patients with progression to MM should receive chemotherapy according to chemotherapy protocol while the prognosis is comparatively worse.

Adult ; Aged ; Cervical Vertebrae ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Plasmacytoma ; surgery ; Retrospective Studies ; Spinal Neoplasms ; surgery ; Treatment Outcome

BACKGROUNDDegenerative lumbar scoliosis is common in older patients. Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis. A means of quantifying the relative signal intensity for degenerative disc disease has not been previously discussed. The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study.

METHODSFrom January 2001 to August 2010, 96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls. Cobb angle, height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group. The height of L2/L3, L3/L4, L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group. The grade of intervertebral disc degeneration was evaluated using T2WI sagittal images in both groups. The bone density of lumbar vertebrae was measured with dual-energy X-ray.

RESULTSIn scoliosis group, the intervertebral disc height on the convex side was greater than the height on the concave side (P < 0.001). The vertebral body height on the convex side was greater than the height on the concave side (P = 0.016). There was a significant difference between the scoliosis group and the control group (P = 0.003), and between T-value and the rate of osteoporosis between the two groups (both P < 0.001).

RESULTSwere verified using multiple linear regression analysis.

CONCLUSIONSDegenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces. There is a positive correlation between the angle of scoliosis and the disc index, the degree of degeneration of the intervertebral disc, and a negative correlation between the angle of scoliosis and bone density.

Aged ; Bone Density ; physiology ; Female ; Humans ; Intervertebral Disc ; pathology ; Intervertebral Disc Degeneration ; pathology ; physiopathology ; Linear Models ; Male ; Middle Aged ; Retrospective Studies ; Scoliosis ; pathology ; Spinal Stenosis ; pathology

OBJECTIVESTo investigate the radiological change of bilateral paravertebral muscles in degenerative lumbar scoliosis (DLS) and analyze its clinical significance.

METHODSAs a retrospective study, 66 patients with DLS and 66 patients with lumbar spinal stenosis were retrospectively enrolled from April 2004 to August 2011 as scoliosis group and lumbar spinal stenosis group, meanwhile 66 health persons with no lumbar spinal stenosis were selected as control group. No significant differences were found in the gender, age and body mass index among the three groups. The cross-sectional area (CSA) and percentage of fat infiltration area (FIA) of the bilateral paravertebral muscles at the L(1)-S(1) levels were measured using T2-weighted axial MRI and Image J software. The measured data were analyzed with a paired t-test.

RESULTSIn the DLS with bilateral symptom group, the mean percentage of FIA of the multifidus muscle on the convex side were 18% ± 4%, 21% ± 4%, 27% ± 4%, 34% ± 6%, 42% ± 10% and on the concave side were 25% ± 8%, 30% ± 7%, 35% ± 7%, 40% ± 10%, 44% ± 8% at L(1-2), L(2-3), L(3-4), L(4-5) and L(5)-S(1) levels, which showed significant differences between the convex side and the concave side (t = 7.95, 9.30, 5.35, 2.78, 2.38, P < 0.05); the mean percentage of FIA of the longissimus muscle on the convex side were 25% ± 9%, 28% ± 8% and on the concave side were 27% ± 9%, 31% ± 9% at L(3-4), L(4-5) levels, which showed significant differences between the convex side and the concave side (t = 2.52, 3.48, P < 0.05). There were no significant differences in the CSA of both muscles between the concave and convex sides (P > 0.05). In the DLS with unilateral symptom group, the mean percentage of FIA of the multifidus muscle on the convex side were 18% ± 5%, 23% ± 5%, 29% ± 5%, 34% ± 6%, 42% ± 9% and on the concave side were 23% ± 6%, 30% ± 7%, 36% ± 7%, 41% ± 10%, 45% ± 8% at L(1-2), L(2-3), L(3-4), L(4-5) and L(5)-S(1) levels, which showed significant differences between the convex side and the concave side (t = 6.67, 7.96, 6.43, 3.86, 2.15, P < 0.05). There were on significant differences in the CSA of both muscles, and in the percentage of FIA of the longissimus between the concave and convex sides (P > 0.05).

CONCLUSIONSThere exist asymmetric degeneration in paravertebral muscle in DLS, which have potential clinical importance on the evaluation of curve progression, and muscle degeneration is more often seen in the concave side. Spinal deformity and radiculopathy may contribute to the paravertebral muscle degeneration.

Aged ; Case-Control Studies ; Female ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Muscle, Skeletal ; diagnostic imaging ; pathology ; Muscular Atrophy ; pathology ; Radiography ; Retrospective Studies ; Scoliosis ; diagnostic imaging ; pathology

OBJECTIVETo study the etiology and clinical significance of axial symptoms after posterior operative procedures for ossification of the posterior longitudinal ligament (OPLL).

METHODSFrom February 2005 to February 2010, 76 patients with OPLL treated were retrospectively experienced. There were 34 male and 42 female with average of 52.1 years (range from 37 to 74 years), the average duration of the disease was 32.1 months (range from 11 to 56 months). Nineteen patients underwent traditional laminectomy in group A, 33 patients received open-door laminoplasty in group B and 24 patients underwent lateral mass screw fixation in group C. All patients underwent X-ray examination pre- and post operative, computed tomography were used for diagnosis of OPLL, the recovery rate was calculated using pre- and postoperative Japanese Orthopedic Association (JOA) scores for each patient. Pre- and postoperative cervical curvature index and axial symptoms were measured and compared. χ(2) test and SNK test were used as statistical methods.

RESULTSAll patients were followed up for 14 - 35 months, average (21 ± 5) months. Loss of cervical curvature index was 4.2% ± 1.7% in group A, 2.9% ± 2.2% in group B and 2.3% ± 1.9% in group C. The difference was significant in loss of cervical curvature indice between group A and B (q = 2.94, P < 0.01), group A and C (q = 4.23, P < 0.01). The average JOA recovery rate was 58.3% for group A, 64.3% for group B and 66.7% for group C. There was no significant difference in JOA recovery rate among the three groups (P > 0.05). The rate of early evident axial symptoms was 7/19 in group A, 30.3% in group B and 33.3% in group C and the difference was not statistically significant (P > 0.05). The incidence of late evident axial symptoms was 5/19 in group A, 12.1% in group B and 8.3% in group C, the difference was not significant between group B and C (χ(2) = 13.762, P < 0.01), but of statistical difference between group A and B(χ(2) = 6.368, P < 0.01), group A and C (χ(2) = 11.481, P < 0.01). No kyphotic deformity in the group A, no "Close Door" phenomenon in group B and no internal failure in group C.

CONCLUSIONThe incidence of early axial symptoms are of no significant difference among the three groups, but late axial symptoms are higher in the laminectomy than other groups, which may be associated with loss of cervical lordosis.

Adult ; Decompression, Surgical ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; adverse effects ; methods ; Male ; Middle Aged ; Ossification of Posterior Longitudinal Ligament ; surgery ; Postoperative Complications ; Retrospective Studies

The contents of 2011 Tokyo Declaration on Japanese Acupuncture and Moxibustion (Declaration for short) and its effect on development situation, current status, features, opportunities and challenges of Japanese acupuncture and moxibustion are introduced, some proposals brought up in the Declaration are analyzed as well. The Declaration summarizes six characteristics of Japanese acupuncture and moxibustion, including paying great attention to palpation techniques such as pulse and abdominal diagnosis, always selecting response point in the meridian during acupuncture treatment, etc. Also six proposals have been brought up to promote the development of Japanese acupuncture and moxibustion, such as being devoted to spread the latest knowledge of acupuncture and moxibustion to medical professionals and the public in order to get correct understanding and proper evaluation, etc. What's more, the Declaration makes a prospection of improving international academic exchange and promoting the globalization of acupuncture and moxibustion and so on. The Declaration is served as a link between past and future in the history and developing process of Japanese acupuncture and moxibustion, which has a great meaning to the development of Japanese acupuncture and moxibustion. We should have a clear understanding of weakness and strength in the development of acupuncture and moxibustion, seize the opportunity and develop science of acupuncture and moxibustion with our own characteristics, which makes more contribution to development of international acupuncture and moxibustion.
Acupuncture Therapy ; trends ; Humans ; Japan ; Moxibustion ; trends ; Tokyo

OBJECTIVETo investigate the effect of microRNA on the gene expression profile of human leukemia K562 cells using microarray technique.

METHODSmiR-181a RNA duplexes were designed and synthesized according to the mature sequence of miR-181a. Forty-eight hours after transfection of in vitro cultured K562 cells using Oligofectamine, gene expression profiles of the cells were studied and analyzed using Agilent Human 1A Oligo microarray.

RESULTSTotalling 228 differentially expressed genes were identified from the 20,173 screened genes, including 59 up-regulated ones (consisting of metabolism-associated genes, tumor suppressor genes, signal transduction-associated genes, immunity and defense-associated genes etc), and 169 down-regulated ones (consisting of oncogenes, DNA-binding and transcription genes, metabolism-associated genes, signal transduction-associated genes, cell cycle and development-associated genes etc.) in the transfected K562 cells as compared with the control K562 cells. Changes in expressions of CTCF, ZAP70, SEMA4C and RALA were confirmed by semi-quantitative reverse transcription-polymerase chain reaction.

CONCLUSIONSmiR-181a transfection for 48 h induces gene expression profile changes in K562 cells, indicating the functionality of the miR-181a. These differentially expressed genes are related to the functions of the microRNA, and may also be the basis of the regulation model of posttranscriptional gene silencing. These findings provide an evidence for further study of the machineries and functions of the microRNA in mammalian cells.

Gene Expression Profiling ; Humans ; K562 Cells ; MicroRNAs ; genetics ; Oligonucleotide Array Sequence Analysis ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo investigate the effect of long-term power frequency electromagnetic field (50 Hz) exposure on the proliferation and apoptosis of human lens epithelial cells (SRA01/04 cells).

METHODSSRA01/04 cells in the exponential growth phase were exposed or sham-exposed to power frequency electromagnetic field (50 Hz, 2.3 mT) for 2 hours per day, 5 days every week. After 11 weeks of exposure, the cells were collected; the cell morphology was observed under a microscope, the cell viability was measured by MTT assay, the cell cycle and apoptosis were examined by flow cytometry, and the protein expression levels of cyclin D and proliferating cell nuclear antigen (PCNA) were determined by western blot.

RESULTSCompared with the sham-exposed SRA01/04 cells, most exposed cells became rounded and more stereoscopic, and heterochromatin gathered near the nuclear membrane in some exposed cells. The MTT assay showed that the viability of exposed cells was significantly increased compared with that of the sham-exposed cells (P < 0.05). Long-term power frequency electromagnetic field exposure led to significantly increased number of cells in S phase (P < 0.05), and the proliferation index was significantly higher in the exposed cells than in the sham-exposed cells (P < 0.05). There was no significant difference in apoptotic rate between the exposed cells and sham-exposed cells (P > 0.05). The exposed cells had significantly higher protein expression levels of cyclin D and PCNA than the sham-exposed cells (P < 0.05).

CONCLUSIONLong-term power frequency electromagnetic field exposure can promote cellular proliferation and change cell cycle in SRA01/04 cells, but it has no marked effect on the apoptosis of SRA01/04 cells.

Apoptosis ; Cell Line ; Cell Proliferation ; Cyclin D1 ; metabolism ; Electromagnetic Fields ; adverse effects ; Environmental Exposure ; adverse effects ; Epithelial Cells ; cytology ; Humans ; Lens, Crystalline ; cytology ; Proliferating Cell Nuclear Antigen ; metabolism

In recent years, foreign countries are gradually implementing broad consent to improve the utilization of medical data and biological samples, but broad consent may face ethical issues such as imperfect notification and affecting the rights of subjects. There are already relevant regulations and practices on broad consent in foreign countries. The concept of broad consent is not clearly defined in China′s laws. At present, the treatment of biological samples can be roughly divided into four categories in practice, and there is potential application space for broad consent. The specific scope of broad consent should be clarified, distinguished from donation behavior, and the implementation of broad consent should be explored on the basis of protecting the rights of subjects.

OBJECTIVETo understand the clinical features of death from hand, foot and mouth disease (HFMD) and to explore the early warning index of HFMD death.

METHODSA total of 41 HFMD death cases were collected as case group in Shandong province between 2009 and 2011, and another 123 serious HFMD cases were selected as control group according to the similar gender, place of origin and hospital level, with the ratio at 1:3. We investigated the general situation, clinical treatment, past medical history, clinical symptoms and signs of the ill children, and applied the conditional logistic regression to explore early warning index of HFMD death.

RESULTSThe rate of patients who had symptoms in nervous system, digestive system, circulatory system and respiratory system were separately 90.2% (37/41), 58.5% (24/41), 53.7% (22/41) and 90.2% (37/41) in case group; and the proportions were 44.7% (55/123), 13.8% (17/123), 10.6% (13/123) and 12.2% (15/123) respectively in control group. The difference between the two groups showed statistical significance (χ(2) = 25.881, 32.791, 34.011, 86.505, P < 0.05). In case group, 37 patients had neurogenic pulmonary edema, 26 patients got encephalitis, 15 patients had respiratory and circulatory failure, 7 patients got pulmonary hemorrhage, 4 patients had multiple organ failure, 4 patients got myocarditis and 1 patient had cerebral hernia. According to multi-factor logistic regression analysis, the early warning indicators of HFMD death included neck resistance (case group: 34.1% (14/41), control group: 4.1% (5/123); OR = 7.145, 95%CI: 1.748 - 29.204), vomiting (case group: 58.5% (24/41), control group: 13.8% (17/123); OR = 5.632, 95%CI: 1.793 - 17.685) and increase of heart rate (case group: 53.7% (22/41), control group: 10.6% (14/123), OR = 6.370, 95%CI: 1.517 - 26.743).

CONCLUSIONIn the process of clinical treatment and care, we should interfere the serious HFMD patients with neck resistance, vomiting and increase of heart rate, and thereby reduce the death from HFMD.

China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; diagnosis ; epidemiology ; mortality ; Humans ; Infant ; Infant, Newborn ; Logistic Models ; Male ; Risk Factors ; Survival Rate