1.Research Progress in the Mechanism of TCM for Regulating JAK/STAT Signaling Pathway in Intervention of Myocardial Ischemia-reperfusion Injury
Xiaobin ZHAO ; Xinqiang WANG ; Hugang JIANG ; Jinyan HAN ; Xiaogang ZHANG ; Yingdong LI ; Xinke ZHAO
Chinese Journal of Information on Traditional Chinese Medicine 2024;31(1):191-196
Acute myocardial infarction(AMI)is a common cardiovascular emergency in clinic.Early reperfusion is a typical and effective method for the treatment of AMI.However,the recovery of blood supply after reperfusion therapy will accelerate the damage of ischemic myocardium and cause myocardial ischemia-reperfusion injury(MI/RI).In recent years,studies have found that TCM has the unique advantages of multi-component,multi-channel and multi-target in the intervention of MI/RI.Janus tyrosine kinase/signal transducer and activator of transcription(JAK/STAT)signaling pathway is closely related to MI/RI,which can reduce MI/RI process by regulating inflammation,oxidative stress,cell proliferation,differentiation and apoptosis.This article reviewed the mechanism of JAK/STAT signaling pathway in MI/RI and the research of TCM targeting this pathway,in order to provide references for the prevention and treatment of MI/RI and further drug development.
2.Renal eosinophilic vacuolated tumor: a clinicopathological analysis of seven cases
Yan WANG ; Jie ZHUANG ; Yujun LI ; Xiaobin JI ; Yunxia LI ; Yuejuan ZHANG ; Wenjuan YU ; Daochen ZHONG ; Wei ZHANG ; Yanxia JIANG
Chinese Journal of Pathology 2024;53(9):910-915
Objective:To investigate the clinicopathological features and differential diagnosis of eosinophilic vacuolated tumor (EVT).Methods:Seven cases of EVT with characteristic morphology and unequivocal diagnosis from the Affiliated Hospital of Qingdao University (6 cases), Qingdao, China and the 971 Hospital of PLA Navy (1 case), Qingdao, China between January 2010 and December 2021 were subject to morphological and immunohistochemical analyses. Additionally, whole exome sequencing (WES) was performed in two cases. Twenty-two cases of renal oncocytoma (RO) and 17 cases of eosinophilic chromophobe renal cell carcinoma (eChRCC) diagnosed at the same time were used as controls.Results:Four males and three females with a mean age of 42 years (range: 29-61 years) were included in the study. The tumors were nodular and well-circumscribed, with sizes ranging from 1.5 to 4.5 cm. On cross-section, they appeared gray-red or gray-white, solid, and soft. Tumor cells were arranged in nests, solid sheets, and acinar or small vesicular structures. These cells exhibited eosinophilic cytoplasm with large, prominent clear vacuoles and round nuclei with prominent nucleoli. Perinuclear halos were focally present in four cases, while small tumor cells with sparse cytoplasm and hyperchromatic nuclei were seen in one case. No necrosis or mitosis was noted. Edematous stroma was detected in three cases. All tumors were positive for CD117 and Cathepsin K, but negative for vimentin and CK7. CK20 was positive in scattered individual cells, and Ki-67 positivity ranged from 1% to 4%. Point mutations in MTOR were identified in both patients who were subject to the molecular analysis. Statistical differences in the expression of Cathepsin K, CD10, S-100A1, and Cyclin D1 between EVT and RO ( P<0.05) were significant, so were the differences in the expression of Cathepsin K, CD10, CK7 and claudin 7 between EVT and eChRCC ( P<0.001). Seven patients were followed up for 4 to 96 months (mean, 50 months), with no recurrences or metastases. Conclusions:EVT is a rare renal tumor that shares morphological and immunophenotypic features with RO and eChRCC, and it is closely linked to the TSC/MTOR pathway. The presence of large prominent transparent vacuoles in eosinophilic cytoplasm along with conspicuous nucleoli is its key morphological characteristics. The use of combined immunohistochemical stains greatly aids in its diagnosis. Typically, the tumor exhibits indolent biological behaviors with a favorable prognosis.
3.Evaluation of prophylactic use of metal clips after cold resection of 6-10 mm intestinal polyps
Zhongxin SUN ; Can WU ; Mei YANG ; Li LIU ; Liu LIU ; Zhengkui ZHOU ; Weidong XI ; Jing SHAN ; Lin JIANG ; Yu LEI ; Xiaobin SUN
Chinese Journal of Digestive Endoscopy 2024;41(7):550-554
Objective:To investigate whether prophylactic use of metal clips is necessary after cold snare polypectomy (CSP) of colorectal polyps of 6-10 mm.Methods:A total of 200 patients with 6-10 mm polyps that met the criteria of cold snare resection in Chengdu Third People's Hospital from 15 February 2022 to 30 May 2022 were randomly divided into two groups: a group that received preventive metal clip treatment and an observation group. Age, gender, body mass index (BMI), Boston score, endoscopy entry time, wound size, operation time, intraoperative bleeding time, postoperative delayed bleeding rate and cost between the two groups were compared and analyzed.Results:Ninety-eight patients in the metal clip group had 122 polyps removed, and 97 patients in the observation group had 119 polyps removed. There was no significant difference in the age, gender, BMI, Boston score, endoscopy entry time or wound size between the two groups. There were significant differences in the operation time (171.03±90.78 s VS 69.81±43.26 s, t=2.266, P=0.010), intraoperative bleeding time (19.98±17.37 s VS 29.16±17.56 s, t=-2.875, P=0.006) and surgery cost (571.63±110.92 yuan VS 366.32±13.2 yuan, t=18.102, P<0.001) between the metal clip group and the observation group. There was no significant difference in the delayed bleeding incidence[0.0%(0/98)VS 1.0%(1/97), P=0.497]between the two groups. Conclusion:For patients with continuous bleeding time <60 seconds after CSP of 6-10 mm colonic polyps, the prophylactic use of metal clips may reduce the bleeding time, but may increase the operation time and cost. Metal clips have little effect on preventing postoperative complications.
4.Delayed medical visit among tuberculosis patients and risk factors in Huaibei City, Anhui Province from 2017 to 2021
Yang HAN ; Xiaobin NIU ; Ailing PENG ; Xiaodong LI ; Yihong JIANG
Shanghai Journal of Preventive Medicine 2023;35(8):758-763
ObjectiveTo understand the situation about time interval between the onset and medical visit among tuberculosis patients in Huaibei City, Anhui Province from 2017 to 2021, and to determine the delayed medical visit and its risk factors, as to provide evidence for tuberculosis prevention and control. MethodsCase information of confirmed tuberculosis patients in Huaibei City in 2017‒2021 was collected from the tuberculosis management information system. Factors associated with time interval between the onset and medical visit were analyzed using rank sum test and multivariate linear regression. Furthermore, factors associated with the delayed medical visit were determined by Chi-square test, Chi-square Cocharan⁃Mantel⁃Haensze test and logistic regression. ResultsThe median time interval between the onset of tuberculosis and medical visit were 22 days among the tuberculosis patients in Huaibei City from 2017‒2021, and the proportion of delayed medical visit was 68.57%. There was an overall decreasing trend in the proportion of delayed medical visit over years (
5.Efficacy of O-arm combined with CT three-dimensional navigation system assisted versus manual screw placement in the treatment of lower cervical fracture and dislocation
Shuai LI ; Jinpeng DU ; Jiang WANG ; Yunfei HUANG ; Zhigang ZHAO ; Zhen CHANG ; Xuefang ZHANG ; Liang YAN ; Hua HUI ; Xiaobin YANG ; Zhongkai LIU ; Lingbo KONG ; Bolong ZHENG ; Baorong HE
Chinese Journal of Trauma 2023;39(8):712-720
Objective:To compare the clinical efficacies of O-arm combined with CT three-dimensional navigation system assisted screw placement versus manual screw placement in treating lower cervical fracture and dislocation.Methods:A retrospective cohort study was used to analyze the clinical data of 41 patients with lower cervical fracture and dislocation, who were treated in Honghui Hospital, Xi′an Jiaotong University from May 2021 to February 2022. The patients included 26 males and 15 females, aged 31.5-48.6 years [(41.5±15.0)years]. The injured segments were C 3 in 3 patients, C 4 in 12, C 5 in 13, C 6 in 10 and C 7 in 3. Nineteen patients were treated with cervical pedicle screws by O-shaped arm combined with CT three-dimensional navigation system (navigation group, 76 screws) and 22 by bare hands (traditional group, 88 screws). The total operation time, effective operation time, single nail placement time, single screw correction times, screw distance from anterior cortex, intraoperative blood loss, intraoperative fluoroscopic radiation dose, incision length and length of hospital stay were compared between the two groups, and the height of intervertebral space, Cobb angle, interbody slip distance and American Spinal injury Association (ASIA) grade were compared before operation and at 3 days after operation. Visual analogue score (VAS), Japanese Orthopedic Association (JOA) score, and neck dysfunction index (NDI) were evaluated before operation, at 3 days, 3 months after operation and at the last follow-up. Accuracy of screw placement and incidence of complications (adjacent facet joint invasion, infection, screw loosening) were detected as well. Results:All the patients were followed up for 11.1-13.9 months [(12.5±1.4)months]. The total operation time, intraoperative blood loss, intraoperative fluoroscopic radiation dose and incision length in the navigation group were more or longer than those in the traditional group (all P<0.05). The effective operation time, single nail placement time, single nail correction times and screw distance from anterior cortex in the navigation group were markedly less or smaller than those in the traditional group (all P<0.05). There was no significant difference in the length of hospital stay between the two groups ( P>0.05). There were significant improvements in the height of intervertebral space, Cobb angle and interbody slip distance between the two groups at 3 days after operation (all P<0.05). There was no significant difference in the height of intervertebral space, Cobb angle, interbody slip distance or ASIA grade between the two groups before operation or at 3 days after operation (all P>0.05). Compared with pre-operation, the VAS, JOA score and NDI were significantly improved in both groups at 3 days, 3 months after operation and at the last follow-up (all P<0.05), with further improvement with time. There was no significant difference in VAS between the two groups before operation or at 3 months after operation (all P>0.05), but it was markedly lower in the navigation group compared with the traditional group at 3 days after operation and at the last follow-up (all P<0.05). There were no significant differences in JOA score or NDI between the two groups before operation or at 3 days and 3 months after operation (all P>0.05), but both were lower in the navigation group compared with the traditional group at the last follow-up (all P<0.05). The accuracies of placement of grade 0 and grade 0+1 screws were 92.0% (70/76) and 96.6% (73/76) in the navigation group, respectively, which were markedly higher than 88.7% (78/88) and 93.5% (82/88) in the traditional group (all P<0.05). The rates of adjacent facet joint invasion of A, B, and C degrees were 71.2% (54/76), 28.8% (22/76) and 0% (0/76) in the navigation group, respectively, while the invasion rates were 60.5% (53/88), 32.3% (28/88) and 7.3% (7/88) in the traditional group ( P<0.05). No screw loosening was noted in the navigation group, but the screw loosening rate was 9.1% (8/88) in the traditional group ( P<0.01). Conclusion:Compared with manual screw placement, O-arm combined with CT three-dimensional navigation system assisted screw placement for lower cervical fracture and dislocation has the advantages of shorter effective operation time, quicker screw placement, stronger screw holding force, better cervical stability, slighter postoperative pain, higher screw placement accuracy, and lower facet joint invasion and screw loosening rates.
6.Role of Nrf2/HO-1 Signaling Pathway in Myocardial Infarction and Traditional Chinese Medicine Intervention: A Review
Xiaobin ZHAO ; Hugang JIANG ; Xinqiang WANG ; Jinyan HAN ; Kai LIU ; Yingdong LI ; Xinke ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(14):248-255
Myocardial infarction (MI) is a common cardiovascular disease in clinical practice and one of the main causes of cardiovascular mortality. Its pathogenesis is complex and associated with oxidative stress reactions. Nuclear factor E2-related factor 2 (Nrf2) is a key factor in regulating oxidative stress reactions. It can regulate the expression of heme oxygenase-1 (HO-1), playing a role in maintaining the oxidative-reductive homeostasis in the body. During the course of MI, the biological activity and levels of Nrf2 and HO-1 decrease, leading to weakened tissue antioxidant and anti-inflammatory capabilities, endothelial damage in myocardial blood vessels, release of vascular cell adhesion factors, and impaired endothelial function. In recent years, many basic research studies have explored the role and mechanisms of traditional Chinese medicine (TCM) in treating MI by modulating the Nrf2/HO-1 signaling pathway. The results have indicated that the Nrf2/HO-1 signaling pathway is an important potential target for TCM in the treatment of MI. This article reviewed the mechanism of the Nrf2/HO-1 signaling pathway in MI and the research progress of TCM in targeting and regulating this pathway, aiming to provide a theoretical basis for the prevention and treatment of MI and further drug development.
7.Establishment and evaluation of a mouse model of schistosomiasis liver disease induced by portal vein injection of worm eggs
LE Bin ; TANG Rui ; JIANG Pengyue ; HE Xing ; FAN Xiaobin
China Tropical Medicine 2023;23(10):1023-
Abstract: Objective To construct a mouse model of Schistosoma japonicum liver disease induced by direct injection of Schistosoma japonicum eggs through the portal vein and evaluate its effectiveness, in order to provide a new animal model for schistosomiasis liver disease research. Methods Fifteen 8-week-old C57BL/6 male mice were randomly divided into control group and egg injection group, with 5 in the control group and 10 in the egg injection group. On day -14, 5 000 live eggs were injected into the abdominal cavity of mice, and on day 0, the mice were anesthetized and the abdominal cavity was opened. 5 000 live eggs were injected through the portal vein, and the control group was injected with equal volume of phosphate buffer (PBS). 5 mice in the egg group were killed on day 10 and 30, respectively. The control group mice were killed on day 10, and their serum and liver tissue were collected. Hematoxylin eosin staining (HE) and Masson staining were performed, and alanine aminotransferase (ALT), aspartate aminotransferase (AST), and liver hydroxyproline (HYP) content were detected using a microplate spectrophotometer. Liver fibrosis-related genes, Th1 and Th2 type immune response-related genes were analyzed by real-time fluorescence quantitative PCR (qPCR). Liver injury, egg granuloma and fibrosis, and adaptive immune response were detected to evaluate the effect of portal vein injection of eggs while inducing mouse model of schistosomiasis liver disease. Results The results showed that significant egg granulomas appeared in the liver of mice after injection of eggs into the portal vein for 10 and 30 days. There was no statistically significant difference in the area of egg granulomas between the 10-day group and the 30-day group (t=0.975, P=0.332). Masson staining and liver hydroxyproline content detection showed significant fibrosis in the liver. The qPCR results showed that, compared with the control group, the expression levels of fibrosis marker genes, such as α⁃Sma (alpha smooth muscle actin), Col1a1 (collagen type Ⅰ alpha 1), and Tgfb1 (transforming growth factor beta 1), were significantly increased (t=6.380, 7.533, 5.314; P=0.002, 0.001, 0.007), and then decreased on the 30th day, with no statistical difference compared to the control group (t=0.940, 1.529, 1.746; P=0.778, 0.543, 0.457). At the same time, the expression levels of Th1 type immune response-related genes, such as tumor necrosis factor alpha (Tnf), interferon gamma (Ifng), and Th2 type immune response-related genes, such as interleukin-5 (Il5), interleukin-13 (Il13), significantly increased 10 days after eggs injection (t=6.163, 4.589, 5.651, 5.367; P=0.003, 0.018, 0.020, 0.009). In addition, there was no significant change in the levels of AST and ALT in the serum of each group of mice (t=0.982, 3.450; P=0.771, 0.074. t=1.164, 0.564; P=0.697, 0.917). Conclusions A mouse model of schistosomiasis liver disease induced by portal vein injection of worm eggs was constructed. The study provides a new modeling method for studying the mechanism of liver fibrosis in schistosomiasis..
8.Interventional Effect of Angelica Sinensis Ultrafiltrate on Radiation-Induced Myocardial Fibrosis by Inhibiting the Overexpression of Cardiac CILP1
Xiaobin ZHAO ; Hugang JIANG ; Xinqiang WANG ; Jinyan HAN ; Yulin CHEN ; Yingdong LI ; Xinke ZHAO
World Science and Technology-Modernization of Traditional Chinese Medicine 2023;25(7):2612-2620
Objective To clarify the intervention effect of Angelica Radix Astragali ultrafiltrate(RAS-RH)on radiation-induced myocardial fibrosis by inhibiting the overexpression of cardiac CILP1.Methods Forty SPF Wistar male rats were randomly divided into normal group,model group,Benazepril hydrochloride group,RAS-RH group and Benazepril hydrochloride +RAS-RH group.Cardiomyocytes were induced by X-ray.The rat model of myocardial fibrosis was prepared by injury.The benazepril hydrochloride group was given benazepril hydrochloride 1.0 mg·kg-1 by gavage;the RAS-RH group was given RAS-RH 0.6 g·kg-1 by gavage;benazepril hydrochloride was given by gavage Pril + RAS-RH group was given benazepril hydrochloride 1.0 mg·kg-1 and RAS-RH 0.6 g·kg-1 by gavage;model group and normal group were given equal volume of normal saline by gavage,once a day,After 4 weeks of drug intervention,the serum NT-ProBNP,CTnⅠ and CTnT contents of the rats in each group were detected by ELISA method;HE staining was used to evaluate the pathological changes of myocardial tissue of the rats in each group;Masson staining was used to evaluate the myocardial collagen deposition of the rats in each group and calculated Collagen volume fraction(CVF);immunohistochemistry to detect the expression levels of α-SMA,Col-Ⅰ,Col-Ⅲ protein in myocardial tissue of rats in each group;Western blot method to detect TGF-β1 and smad3 in myocardial tissue of rats in each group,CILP1 protein expression.Results Compared with the blank group,the serum levels of NT-ProBNP,CTnⅠ and CTnT in the model group were significantly increased(P<0.01).Blue-stained fibrous tissue increased significantly,myocardial CVF increased significantly,and myocardial tissue α-SMA,Col-Ⅰ,Col-Ⅲ,TGF-β1,Smad3,CILP1 protein expression increased(P<0.01);Serum contents of NT-ProBNP,cTnⅠ and CTnT in rats in napril group,RAS-RH group and benazepril hydrochloride + RAS-RH group were significantly decreased(P<0.01).Sexual cell infiltration was improved,myocardial CVF was significantly decreased(P<0.01),and the protein expressions of α-SMA,Col-Ⅰ,Col-Ⅲ,TGF-β 1,Smad3 and CILP1 in myocardial tissue were significantly decreased(P<0.05).Conclusion Angelica sinensis ultrafiltrate can alleviate X-ray radiation-induced myocardial fibrosis in rats by inhibiting the overexpression of CILP 1 in the heart.
9.Clinical efficacy of Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve
Xiaofeng DUAN ; Jie YUE ; Xiaobin SHANG ; Zhao MA ; Chuangui CHEN ; Chen ZHANG ; Zuoyu CHEN ; Hongjing JIANG
Chinese Journal of Digestive Surgery 2023;22(S1):1-6
Objective:To investigate the clinical efficacy of Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 404 patients with esophageal cancer who underwent Da Vinci robot-assisted esophagectomy in Tianjin Medical University Cancer Hospital and Institute from June 2017 to June 2022 were collected. There were 349 males and 55 females, aged (62±8)years. Observation indicators: (1) intraoperative conditions; (2) postoperative conditions; (3) comparison of clinical features in patients who were admitted in different time periods. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the one way ANOVA. Measurement data with skewed distribution were represented as M(IQR), and comparison among multiple groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers or percentages, and com-parison between groups was conducted using the chi-square test or Fisher exact probability. Results:(1) Intraoperative conditions. The operation time, volume of intraoperative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, left recurrent laryngeal nerve lymph node metastasis rate, right recurrent laryngeal nerve lymph node dissection rate, the number of right recurrent laryngeal nerve lymph node dissected, right recurrent laryngeal nerve lymph node metastasis rate were (306±56)minutes,200(100)mL, 29.9±13.1, 18.5±9.7, 78.47%(317/404), 4.0(3.0), 17.35%(55/317), 94.55%(382/404), 3.0(2.0), 21.20%(81/382). (2) Postoperative conditions. The tumor histopathological type (squamous cell carcinoma, neuroendocrine carcinoma, adenocarcinoma, carcinosarcoma, adenosquamous carcinoma, malignant melanoma), incidence rate of overall complications, cases with recurrent laryngeal nerve paralysis, cases with pulmonary complications, cases with anastomotic fistula, cases with incision infection, cases with chylothorax, cases with arrhythmia, cases with deep vein thrombosis, cases with other complications, incidence of re-admission to the intensive care unit, duration of postoperative hospital stay, 90-day mortality were 377, 11, 7, 5, 3, 1, 27.48%(111/404), 8.91%(36/404), 10.64%(43/404), 6.93%(28/404), 0.99%(4/404), 2.48%(10/404), 1.73%(7/404), 0.50%(2/404), 1.98%(8/404), 6.93%(28/404), 16(11)days, 0.50%(2/404). (3) Comparison of clinical features in patients who were admi-tted in different time periods. The number of patients who were admitted from June 2017 to May 2018, from June 2018 to May 2019, from June 2019 to May 2020, from June 2020 to May 2021, from June 2021 to June 2022 was 40, 56, 57, 116, 135, respectively. There were significant differences in age, tumor histopathological type, pT staging, neoadjuvant therapy, operation time, volume of intra-operative blood loss, the total number of lymph node dissected, the number of thoracic lymph node dissected, left recurrent laryngeal nerve lymph node dissection rate, the number of left recurrent laryngeal nerve lymph node dissected, the number of right recurrent laryngeal nerve lymph node dissected, incidence rate of overall complications among patients who were admitted in different time periods ( P<0.05). Conclusion:The Da Vinci robot-assisted superior mediastinum lymph node dissection around recurrent laryngeal nerve is safe and feasible, which can achieve good short-term efficacy.
10.Comparison of the efficacy of cervical decompression performed at different times in the treatment of incomplete cervical spinal cord injury
Shuai LI ; Yuan HE ; Yanzheng GAO ; Dianming JIANG ; Jun SHU ; Jian CHEN ; Jinpeng DU ; Lei ZHU ; Yunfei HUANG ; Zhen CHANG ; Liang YAN ; Hua HUI ; Xiaobin YANG ; Lingbo KONG ; Baorong HE
Chinese Journal of Trauma 2023;39(12):1070-1078
Objective:To compare the efficacy of cervical decompression performed at different times in the treatment of incomplete cervical spinal cord injury.Methods:A multicenter retrospective cohort study was conducted to analyze the clinical data of 96 patients with incomplete cervical spinal cord injury admitted to six hospitals including Honghui Hospital affiliated to Xi'an Jiaotong University, etc, from May 2018 to May 2021. There were 36 females and 60 males, aged 28-42 years [(35.2±6.7)years]. The injured segments were at C 3 in 7 patients, C 4 in 15, C 5 in 20, C 6 in 23 and C 7 in 31. According to the American Spinal Injury Association (ASIA) scale, there were 59 patients with grade B, 27 grade C, and 10 grade D. A total of 36 patients underwent cervical decompression within 24 hours after injury (early group), 33 patients within 24-72 hours after injury (late group), and 27 patients within 4-14 days after injury (delayed group). The operation time, intraoperative blood loss, postoperative drainage, length of hospital stay, Cobb angle, height of intervertebral space and space occupation of the spinal canal before surgery and at postoperative 3 days, and ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, visual analog scale (VAS) score, Japanese Orthopedic Association (JOA) score, neck dysfunction index (NDI) before surgery and at postoperative 3 months, 1 year and at the last follow-up and incidence of complications were compared among the three groups. Results:All the patients were followed up for 12-21 months [(16.4±4.2)months]. There was no significant difference in the operation time among the three groups (all P>0.05). The intraoperative blood loss and postoperative drainage volume in the early group were (312.5±5.2)ml and (165.3±45.8)ml, which were higher than those in the late group [(253.5±40.0)ml, (120.4±60.6)ml] and the delayed group [(267.3±36.8)ml and (130.4±38.6)ml] (all P<0.01). There was no significant difference between the late group and the delayed group (all P>0.05). The length of hospital stay in the early group was (5.2±1.6)days, which was shorter than that in the late group [(7.6±2.3)days] and the delayed group [(8.0±1.3)days] (all P<0.05), but there was no significant difference between the late group and the delayed group ( P>0.05). There was no significant difference in the Cobb angle, height of intervertebral space and space occupation of the spinal canal among the three groups before and at postoperative 3 days (all P>0.05). There was no significant difference in the ASIA score, ASIA motor score, ASIA light tactile score, ASIA acupuncture sensation score, VAS score, JOA score and NDI among the three groups before surgery (all P>0.05). At postoperative 3 months, 1 year and at the last follow-up, the ASIA grading of the early group was better than that of the late group and the delayed group ( P<0.05 or 0.01), but there was no statistically significant difference between the late group and the delayed group (all P>0.05). The ASIA motor scores of the early group were (56.4±4.5)points, (76.3±3.6)points and (85.4±6.5)points at postoperative 3 months, postoperative 1 year and the last follow-up, respectively, which were higher than those in the late group [(52.3±2.4)points, (60.3±8.6)points and (72.3±2.4)points] and the delayed group [(51.9±2.3)points, (62.8±4.6)points and (71.9±1.3)points]; the ASIA light tactile scores of the early group were (70.2±2.9)points, (72.6±4.3)points and (78.3±2.3)points, which were higher than those in the late group [(66.2±3.7)points, (68.3±1.6)points and (73.3±1.6)points] and the delayed group [(65.2±2.1)points, (67.8±1.9)points and (72.3±2.5)points]; acupuncture sensation scores of the early group were (71.9±3.1)points, (80.1±3.8)points and (89.1±7.6)points, which were higher than those in the late group [(67.4±2.7)points, (72.6±3.7)points and (77.9±1.8)points] and the delayed group [(68.3±2.2)points, (72.6±3.1)points and (77.2±1.9)points] (all P<0.05). VAS scores of the early group at postoperative 3 months, 1 year and at the last follow-up were (4.3±0.6)points, (2.4±0.3)points and (1.6±0.2)points, which were lower than those in the late group [(5.1±1.3)points, (4.1±0.6)points and (3.0±0.6)points] and the delayed group [(5.0±1.7)points, (4.0±0.8)points and (3.1±0.2)points]; JOA scores of the early group were (12.8±1.6)points, (14.4±2.6)points and (17.9±3.3)points, which were higher than those in the late group [(11.9±1.9)points, (13.3±1.6)points and (8.9±1.3)points] and the delayed group [(11.6±1.8)points, (13.2±1.4)points and (9.3±2.1)points]; NDI scores of the early group were 12.1±3.3, 10.1±2.1 and 7.3±1.4, which were lower than those in the late group (14.4±3.1, 12.3±1.6 and 8.9±1.3) and the delayed group (14.1±2.3, 12.9±1.9 and 9.5±2.1) (all P<0.05). There was no significant difference in all the above-mentioned scores at postoperative 3 months, 1 year and at the last follow-up between the late group and the delayed group (all P>0.05). The incidence of complications was 25.0% (9/36) in the early group, 27.3% (9/33) in the late group and 37.0% (10/27) in the delayed group (all P>0.05). Conclusion:Compared with within 24-72 hours and 4-14 days after injury, cervical decompression performed within 24 hours after injury for patients with incomplete cervical spinal cord injury can shorten the length of hospital stay, improve the function of the spinal cord nerves and relieve pain, with no increase of the incidence of complications.

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