5.The Role of Spinal Cord Compression in Predicting Intraoperative Neurophysiological Monitoring Events in Patients With Kyphotic Deformity: A Magnetic Resonance Imaging-Based Study
Zhen JIN ; Jie LI ; Hui XU ; Zongshan HU ; Yanjie XU ; Ziyang TANG ; Yong QIU ; Zhen LIU ; Zezhang ZHU
Neurospine 2024;21(2):701-711
Objective:
To establish a novel classification system for predicting the risk of intraoperative neurophysiological monitoring (IONM) events in surgically-treated patients with kyphotic deformity.
Methods:
Patients with kyphotic deformity who underwent surgical correction of cervicothoracic, thoracic, or thoracolumbar kyphosis in our center from July 2005 to December 2020 were recruited. We proposed a classification system to describe the morphology of the spinal cord on T2-weighted sagittal magnetic resonance imaging: type A, circular/symmetric cord with visible cerebrospinal fluid (CSF) between the cord and vertebral body; type B, circular/oval/symmetric cord with no visible CSF between the cord and vertebral body; type C, spinal cord that is fattened/deformed by the vertebral body, with no visible CSF between the cord and vertebral body. Furthermore, based on type C, the spinal cord compression ratio (CR) < 50% was defined as the subtype C-, while the spinal cord CR ≥ 50% was defined as the subtype C+. IONM event was documented, and a comparative analysis was made to evaluate the prevalence of IONM events among patients with diverse spinal cord types.
Results:
A total of 294 patients were reviewed, including 73 in type A; 153 in type B; 53 in subtype C- and 15 in subtype C+. Lower extremity transcranial motor-evoked potentials and/or somatosensory evoked potentials were lost intraoperatively in 41 cases (13.9%), among which 4 patients with type C showed no return of spinal cord monitoring data. The 14 subtype C+ patients (93.3%) had IONM events. Univariate logistic regression analysis showed that patients with a type C spinal cord (subtype C-: odds ratio [OR], 10.390; 95% confidence interval [CI], 2.215–48.735; p = 0.003; subtype C+, OR, 497.000; 95% CI, 42.126– 5,863.611; p < 0.001) are at significantly higher risk of a positive IONM event during deformity correction compared to those with a type A. In further multiple logistic regression analysis, the spinal cord classification (OR, 5.371; 95% CI, 2.966–9.727; p < 0.001) was confirmed as an independent risk factor for IONM events.
Conclusion
We presented a new spinal cord classification system based on the relative position of the spinal cord and vertebrae to predict the risk of IONM events in patients with kyphotic deformity. In patients with type C spinal cord, especially those in C+ cases, it is essential to be aware of potential IONM events, and adopt standard operating procedures to facilitate neurological recovery.
6.The Role of Spinal Cord Compression in Predicting Intraoperative Neurophysiological Monitoring Events in Patients With Kyphotic Deformity: A Magnetic Resonance Imaging-Based Study
Zhen JIN ; Jie LI ; Hui XU ; Zongshan HU ; Yanjie XU ; Ziyang TANG ; Yong QIU ; Zhen LIU ; Zezhang ZHU
Neurospine 2024;21(2):701-711
Objective:
To establish a novel classification system for predicting the risk of intraoperative neurophysiological monitoring (IONM) events in surgically-treated patients with kyphotic deformity.
Methods:
Patients with kyphotic deformity who underwent surgical correction of cervicothoracic, thoracic, or thoracolumbar kyphosis in our center from July 2005 to December 2020 were recruited. We proposed a classification system to describe the morphology of the spinal cord on T2-weighted sagittal magnetic resonance imaging: type A, circular/symmetric cord with visible cerebrospinal fluid (CSF) between the cord and vertebral body; type B, circular/oval/symmetric cord with no visible CSF between the cord and vertebral body; type C, spinal cord that is fattened/deformed by the vertebral body, with no visible CSF between the cord and vertebral body. Furthermore, based on type C, the spinal cord compression ratio (CR) < 50% was defined as the subtype C-, while the spinal cord CR ≥ 50% was defined as the subtype C+. IONM event was documented, and a comparative analysis was made to evaluate the prevalence of IONM events among patients with diverse spinal cord types.
Results:
A total of 294 patients were reviewed, including 73 in type A; 153 in type B; 53 in subtype C- and 15 in subtype C+. Lower extremity transcranial motor-evoked potentials and/or somatosensory evoked potentials were lost intraoperatively in 41 cases (13.9%), among which 4 patients with type C showed no return of spinal cord monitoring data. The 14 subtype C+ patients (93.3%) had IONM events. Univariate logistic regression analysis showed that patients with a type C spinal cord (subtype C-: odds ratio [OR], 10.390; 95% confidence interval [CI], 2.215–48.735; p = 0.003; subtype C+, OR, 497.000; 95% CI, 42.126– 5,863.611; p < 0.001) are at significantly higher risk of a positive IONM event during deformity correction compared to those with a type A. In further multiple logistic regression analysis, the spinal cord classification (OR, 5.371; 95% CI, 2.966–9.727; p < 0.001) was confirmed as an independent risk factor for IONM events.
Conclusion
We presented a new spinal cord classification system based on the relative position of the spinal cord and vertebrae to predict the risk of IONM events in patients with kyphotic deformity. In patients with type C spinal cord, especially those in C+ cases, it is essential to be aware of potential IONM events, and adopt standard operating procedures to facilitate neurological recovery.
7.The Role of Spinal Cord Compression in Predicting Intraoperative Neurophysiological Monitoring Events in Patients With Kyphotic Deformity: A Magnetic Resonance Imaging-Based Study
Zhen JIN ; Jie LI ; Hui XU ; Zongshan HU ; Yanjie XU ; Ziyang TANG ; Yong QIU ; Zhen LIU ; Zezhang ZHU
Neurospine 2024;21(2):701-711
Objective:
To establish a novel classification system for predicting the risk of intraoperative neurophysiological monitoring (IONM) events in surgically-treated patients with kyphotic deformity.
Methods:
Patients with kyphotic deformity who underwent surgical correction of cervicothoracic, thoracic, or thoracolumbar kyphosis in our center from July 2005 to December 2020 were recruited. We proposed a classification system to describe the morphology of the spinal cord on T2-weighted sagittal magnetic resonance imaging: type A, circular/symmetric cord with visible cerebrospinal fluid (CSF) between the cord and vertebral body; type B, circular/oval/symmetric cord with no visible CSF between the cord and vertebral body; type C, spinal cord that is fattened/deformed by the vertebral body, with no visible CSF between the cord and vertebral body. Furthermore, based on type C, the spinal cord compression ratio (CR) < 50% was defined as the subtype C-, while the spinal cord CR ≥ 50% was defined as the subtype C+. IONM event was documented, and a comparative analysis was made to evaluate the prevalence of IONM events among patients with diverse spinal cord types.
Results:
A total of 294 patients were reviewed, including 73 in type A; 153 in type B; 53 in subtype C- and 15 in subtype C+. Lower extremity transcranial motor-evoked potentials and/or somatosensory evoked potentials were lost intraoperatively in 41 cases (13.9%), among which 4 patients with type C showed no return of spinal cord monitoring data. The 14 subtype C+ patients (93.3%) had IONM events. Univariate logistic regression analysis showed that patients with a type C spinal cord (subtype C-: odds ratio [OR], 10.390; 95% confidence interval [CI], 2.215–48.735; p = 0.003; subtype C+, OR, 497.000; 95% CI, 42.126– 5,863.611; p < 0.001) are at significantly higher risk of a positive IONM event during deformity correction compared to those with a type A. In further multiple logistic regression analysis, the spinal cord classification (OR, 5.371; 95% CI, 2.966–9.727; p < 0.001) was confirmed as an independent risk factor for IONM events.
Conclusion
We presented a new spinal cord classification system based on the relative position of the spinal cord and vertebrae to predict the risk of IONM events in patients with kyphotic deformity. In patients with type C spinal cord, especially those in C+ cases, it is essential to be aware of potential IONM events, and adopt standard operating procedures to facilitate neurological recovery.
8.Correlation between plasma Pannexin-1 and no reflow in STEMI patients after PCI
Guoqiang HUANG ; Ziyang HU ; Yong ZHAO ; Xueshan LI
Chinese Journal of Geriatric Heart Brain and Vessel Diseases 2024;26(2):142-146
Objective To analyze the correlation between plasma Pannexin-1(Panx-1)level and no-reflow after percutaneous coronary intervention(PCI)in patients with ST-segment elevation my-ocardial infarction(STEMI).Methods A prospective trial was performed on 218 STEMI patients who underwent PCI in our hospital from January 2019 to December 2021.According to the blood flow classification of myocardial infarction thrombolysis(TIMI)after PCI,they were divided into normal reflow group(110 cases),slow reflow group(69 cases)and no reflow group(39 cases).The plasma Panx-1 level was determined by ELISA,and the levels of P-selectin,activated glyco-protein Ⅱ b/Ⅲ a(aGP Ⅱ b/Ⅲ a)and platelet-leukocyte aggregates(PLA)were determined by flow cytometry.Results Older age,larger ratio of diabetes mellitus,longer time from symptom onset to PCI,higher platelet count and levels of LDL-C,D-dimer,P-selectin,GP Ⅱ b/Ⅲ a,PNA,PM A,PLyA and plasma Panx-1 were observed in the no-reflow group than the normal and slow reflow groups(P<0.05).The plasma Panx-1 level in STEMI patients was positively correlated with P-selectin,GP Ⅱ b/Ⅲ a,PNA,PM A and PLyA(P<0.05,P<0.01).LDL-C ≥3.20 mmol/L and plasma Panx-1>0.88 μg/mL were independent risk factors for no-reflow after PCI in STEMI pa-tients(OR=2.198,95%CI:1.252-3.858,P=0.006;OR=16.849,95%CI:4.481-63.357,P=0.000).The AUC value of Panx-1 was 0.826(95%CI:0.744-0.907,P<0.01)in predicting no re-flux in STEMI patients after PCI.Conclusion The increase of plasma Panx-1 level is closely asso-ciated with the occurrence of no reflow in STEMI patients after PCI,and the protein can be used as a predictive biomarker for the phenomenon.
9.Research status of premyopia
Yitong LIN ; Ziyang CHEN ; Zhaoda YE ; Sheng CHEN ; Yanhong HU
International Eye Science 2024;24(7):1102-1105
The visual impairment and blindness caused by myopia have become a global burden, and the World Health Organization has included the prevention and control of myopia in the global program for preventing blindness. In China, the development of myopia is showing a trend with higher incidence, younger age, and higher refractive errors. Moving forward the port of prevention and control myopia has become an important strategy to address the current predicament. Premyopia refers to the stage in children where the refractive power is ≤+0.75 D and >-0.50 D, and there are multiple risk factors during this stage that can potentially lead to myopia. Currently, the incidence of premyopia and its transformation into myopia is high, and the key prevention and control measures include building a predictive model for the transformation of premyopia into myopia, emphasizing the reduction of exposure to risk factors, using low-concentration atropine eye drops, red light therapy, and optical defocus intervention. This article provides a comprehensive review of the current situation regarding the incidence of premyopia and its transformation into myopia, as well as the research progress on existing prevention and control measures, with the aim of providing relevant references for the prevention and control of myopia during the premyopia stage.
10.Research Progress on the Role of HMGB1 in Regulating the Function of Osteoarthritis Chondrocytes
Xin QI ; Xiaogang ZHANG ; Haiyang YU ; Xin CHEN ; Wenbo AN ; Zhipeng WANG ; Duoxian WANG ; Pengfei LUO ; Yixin CHEN ; Jiaojiao MA ; Wei QI ; Ziyang HU ; Jianjun LIU
Medical Journal of Peking Union Medical College Hospital 2024;15(1):141-146
Osteoarthritis (OA) is a chronic degenerative joint disease whose main characteristic is the destruction of articular cartilage, causing pain and disability in patients and seriously affecting their quality of life. OA can be induced by a variety of causes, and pathological changes in articular cartilage are considered to be one of the key driving factors for the occurrence of OA. High mobility group box-1 protein (HMGB1), as a non-histone protein in eukaryotic cells, can participate in regulating the inflammation and apoptosis process of OA chondrocytes, thus leading to the occurrence of OA. This article reviews the research on the mechanism of HMGB1 in OA chondrocytes, with a view to providing new ideas for the clinical prevention and treatment of OA.

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