1.Unveiling and Validating a Modified Method to Assess Cervical Sagittal Alignment as an Effective Substitute for Conventional C2-7 Cobb Angle
Wenpeng LI ; Qiwei WANG ; Qiancheng ZHAO ; Ziliang ZENG ; Xumin HU ; Xin LV ; Liangbin GAO
Clinics in Orthopedic Surgery 2025;17(1):130-137
Background:
Developing and validating a modified parameter, the SYS-G angle (the angle between the lower endplate of the C2 and the upper endplate of C7 vertebrae), as a feasible substitute for the C2–C7 Cobb method in assessing cervical sagittal alignment and exploring its reference range through a large-scale retrospective study.
Methods:
The visibility of the C6, C7 upper, and C7 lower endplates was graded and compared. Baseline data such as height, weight, body mass index (BMI), age, and sex were analyzed for their impact on the visibility of the C7 lower endplate. Values of C2-6 Cobb angle, SYS-G angle, and C2-7 Cobb angle were measured. The intra- and interobserver reliability, differences, and efficacy of evaluation on cervical lordosis of the parameters were compared, and the correlations among the parameters were analyzed. Furthermore, reference ranges for the SYS-G angle were established based on lateral cervical spine x-rays of 825 asymptomatic Chinese adults across different age groups and sexes.
Results:
The visibility of the C7 lower endplates was significantly reduced compared to the C6 lower and C7 upper endplates.Age, weight, BMI, and male sex were identified as factors negatively influencing the visibility of the C7 lower endplate. Both intraobserver and interobserver reliability demonstrated excellence for all tested parameters. The linear regression model unveiled a stronger association of the SYS-G angle with the C2-7 Cobb angle compared to the C2-6 Cobb angle. Furthermore, the SYS-G angle exhibited excellent efficacy in evaluating cervical lordosis. Age displayed a positive correlation with the SYS-G angle, and across every age bracket from 20 to 69 years, men exhibited a higher mean SYS-G angle compared to women.
Conclusions
The visibility of the C7 lower endplate diminishes with increasing age, weight, BMI, and male sex. In cases where the C7 lower endplate is unclear, the SYS-G angle emerges as a reliable method for estimating cervical sagittal morphology. Reference ranges for the SYS-G angle were established across various age groups and sexes among asymptomatic Chinese adults, offering a valuable resource to guide therapeutic interventions for cervical spine disorders and deformities.
2.Unveiling and Validating a Modified Method to Assess Cervical Sagittal Alignment as an Effective Substitute for Conventional C2-7 Cobb Angle
Wenpeng LI ; Qiwei WANG ; Qiancheng ZHAO ; Ziliang ZENG ; Xumin HU ; Xin LV ; Liangbin GAO
Clinics in Orthopedic Surgery 2025;17(1):130-137
Background:
Developing and validating a modified parameter, the SYS-G angle (the angle between the lower endplate of the C2 and the upper endplate of C7 vertebrae), as a feasible substitute for the C2–C7 Cobb method in assessing cervical sagittal alignment and exploring its reference range through a large-scale retrospective study.
Methods:
The visibility of the C6, C7 upper, and C7 lower endplates was graded and compared. Baseline data such as height, weight, body mass index (BMI), age, and sex were analyzed for their impact on the visibility of the C7 lower endplate. Values of C2-6 Cobb angle, SYS-G angle, and C2-7 Cobb angle were measured. The intra- and interobserver reliability, differences, and efficacy of evaluation on cervical lordosis of the parameters were compared, and the correlations among the parameters were analyzed. Furthermore, reference ranges for the SYS-G angle were established based on lateral cervical spine x-rays of 825 asymptomatic Chinese adults across different age groups and sexes.
Results:
The visibility of the C7 lower endplates was significantly reduced compared to the C6 lower and C7 upper endplates.Age, weight, BMI, and male sex were identified as factors negatively influencing the visibility of the C7 lower endplate. Both intraobserver and interobserver reliability demonstrated excellence for all tested parameters. The linear regression model unveiled a stronger association of the SYS-G angle with the C2-7 Cobb angle compared to the C2-6 Cobb angle. Furthermore, the SYS-G angle exhibited excellent efficacy in evaluating cervical lordosis. Age displayed a positive correlation with the SYS-G angle, and across every age bracket from 20 to 69 years, men exhibited a higher mean SYS-G angle compared to women.
Conclusions
The visibility of the C7 lower endplate diminishes with increasing age, weight, BMI, and male sex. In cases where the C7 lower endplate is unclear, the SYS-G angle emerges as a reliable method for estimating cervical sagittal morphology. Reference ranges for the SYS-G angle were established across various age groups and sexes among asymptomatic Chinese adults, offering a valuable resource to guide therapeutic interventions for cervical spine disorders and deformities.
3.Unveiling and Validating a Modified Method to Assess Cervical Sagittal Alignment as an Effective Substitute for Conventional C2-7 Cobb Angle
Wenpeng LI ; Qiwei WANG ; Qiancheng ZHAO ; Ziliang ZENG ; Xumin HU ; Xin LV ; Liangbin GAO
Clinics in Orthopedic Surgery 2025;17(1):130-137
Background:
Developing and validating a modified parameter, the SYS-G angle (the angle between the lower endplate of the C2 and the upper endplate of C7 vertebrae), as a feasible substitute for the C2–C7 Cobb method in assessing cervical sagittal alignment and exploring its reference range through a large-scale retrospective study.
Methods:
The visibility of the C6, C7 upper, and C7 lower endplates was graded and compared. Baseline data such as height, weight, body mass index (BMI), age, and sex were analyzed for their impact on the visibility of the C7 lower endplate. Values of C2-6 Cobb angle, SYS-G angle, and C2-7 Cobb angle were measured. The intra- and interobserver reliability, differences, and efficacy of evaluation on cervical lordosis of the parameters were compared, and the correlations among the parameters were analyzed. Furthermore, reference ranges for the SYS-G angle were established based on lateral cervical spine x-rays of 825 asymptomatic Chinese adults across different age groups and sexes.
Results:
The visibility of the C7 lower endplates was significantly reduced compared to the C6 lower and C7 upper endplates.Age, weight, BMI, and male sex were identified as factors negatively influencing the visibility of the C7 lower endplate. Both intraobserver and interobserver reliability demonstrated excellence for all tested parameters. The linear regression model unveiled a stronger association of the SYS-G angle with the C2-7 Cobb angle compared to the C2-6 Cobb angle. Furthermore, the SYS-G angle exhibited excellent efficacy in evaluating cervical lordosis. Age displayed a positive correlation with the SYS-G angle, and across every age bracket from 20 to 69 years, men exhibited a higher mean SYS-G angle compared to women.
Conclusions
The visibility of the C7 lower endplate diminishes with increasing age, weight, BMI, and male sex. In cases where the C7 lower endplate is unclear, the SYS-G angle emerges as a reliable method for estimating cervical sagittal morphology. Reference ranges for the SYS-G angle were established across various age groups and sexes among asymptomatic Chinese adults, offering a valuable resource to guide therapeutic interventions for cervical spine disorders and deformities.
4.Unveiling and Validating a Modified Method to Assess Cervical Sagittal Alignment as an Effective Substitute for Conventional C2-7 Cobb Angle
Wenpeng LI ; Qiwei WANG ; Qiancheng ZHAO ; Ziliang ZENG ; Xumin HU ; Xin LV ; Liangbin GAO
Clinics in Orthopedic Surgery 2025;17(1):130-137
Background:
Developing and validating a modified parameter, the SYS-G angle (the angle between the lower endplate of the C2 and the upper endplate of C7 vertebrae), as a feasible substitute for the C2–C7 Cobb method in assessing cervical sagittal alignment and exploring its reference range through a large-scale retrospective study.
Methods:
The visibility of the C6, C7 upper, and C7 lower endplates was graded and compared. Baseline data such as height, weight, body mass index (BMI), age, and sex were analyzed for their impact on the visibility of the C7 lower endplate. Values of C2-6 Cobb angle, SYS-G angle, and C2-7 Cobb angle were measured. The intra- and interobserver reliability, differences, and efficacy of evaluation on cervical lordosis of the parameters were compared, and the correlations among the parameters were analyzed. Furthermore, reference ranges for the SYS-G angle were established based on lateral cervical spine x-rays of 825 asymptomatic Chinese adults across different age groups and sexes.
Results:
The visibility of the C7 lower endplates was significantly reduced compared to the C6 lower and C7 upper endplates.Age, weight, BMI, and male sex were identified as factors negatively influencing the visibility of the C7 lower endplate. Both intraobserver and interobserver reliability demonstrated excellence for all tested parameters. The linear regression model unveiled a stronger association of the SYS-G angle with the C2-7 Cobb angle compared to the C2-6 Cobb angle. Furthermore, the SYS-G angle exhibited excellent efficacy in evaluating cervical lordosis. Age displayed a positive correlation with the SYS-G angle, and across every age bracket from 20 to 69 years, men exhibited a higher mean SYS-G angle compared to women.
Conclusions
The visibility of the C7 lower endplate diminishes with increasing age, weight, BMI, and male sex. In cases where the C7 lower endplate is unclear, the SYS-G angle emerges as a reliable method for estimating cervical sagittal morphology. Reference ranges for the SYS-G angle were established across various age groups and sexes among asymptomatic Chinese adults, offering a valuable resource to guide therapeutic interventions for cervical spine disorders and deformities.
5.Clinical efficacy of multi-technique combination in the treatment of ischemic diabetic foot.
Hui-Yan LIU ; Yi YOU ; Wen-Gao WU ; Sheng RONG ; Qing-Hua ZHOU ; Na-Xin ZENG
China Journal of Orthopaedics and Traumatology 2025;38(9):917-923
OBJECTIVE:
To explore clinical efficacy of different technical combinations in treating ischemic diabetic foot (DF).
METHODS:
A retrospective analysis was conducted on 35 patients with DF who were treated with vascular interventional opening technique, periosteal distraction technique and bone cement coverage technique from January 2024 to November 2024. They were divided into comprehensive group and periosteal distraction group according to whether the vascular interventional opening technique was used in combination or not. There were 5 patients in comprehensive group, including 4 males and 1 female, aged from 59 to 73 years old with an average of (64.40±5.46) years old;the duration of diabetes ranged from 0.17 to 30.00 years with an average of (14.63±12.02) years;the courses of DF ranged from 30 to 150 days with an average of (84.00±61.48) days;2 patients were grade 2, 2 patients were grade 3, and 1 patient was grade 4 according to Wagner classification;combined vascular interventional opening, periosteal distraction and bone cement coverage surgery for treatment. There were 30 patients in periosteal stretch group, including 22 males and 8 females, aged from 58 to 86 years old with an average of (72.63±7.84) years old;the duration of diabetes was 10.00 (6.75, 16.75) years;the courses of DF was 30.00 (15.00, 37.50) days;14 patients were grade 2, 11 patients were grade 3, and 5 patients were grade 4 according to Wagner classification; combined periosteal distraction and bone cement coverage surgery for treatment. Changes of C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT), toe skin temperature, peripheral capillary oxygen saturation (SpO2), and visual analogue scale (VAS) for pain were compared between two groups before operation and 1 week after operation. The number of operations, healing period, healing number, toe amputation number, preoperative fever situation and the number of complications were compared between two groups.
RESULTS:
Both groups were followed up for at least 6 months. There were no statistically significant differences in the number of operations, healing period, toe amputation rate, wound healing rate and complications between two groups (P>0.05). Before operation, the toe skin temperature of comprehensive group (26.98±0.88) ℃ was lower than that of periosteal distraction group (28.17±1.45) ℃, and the difference was statistically significant (P<0.05);while there were no statistically significant difference in CRP, IL-6, PCT, toe SpO2 and VAS between two groups (P>0.05). At 1 week after operation, IL-6, toe skin temperature, toe SpO2 and VAS in comprehensive group were 12.29(7.92, 22.15) pg·ml-1, (36.02±0.23) ℃, (95.80±0.84) % and(1.40±0.55) respectively, while those in periosteal distraction group were 5.49(4.36, 7.45) pg·ml-1, (31.36±1.57) ℃, (84.53±6.38) %, (2.20±0.81);and there were statistically significant differences between two groups(P<0.05). CRP, IL-6 and VAS at 1 week after operation in both groups were decreased compared with those before operation, and the differences were statistically significant(P<0.05). The toe skin temperature and SpO2 were increased compared with those before operation, and the differences were statistically significant(P<0.001).
CONCLUSION
The multi-technique combination therapy, including vascular interventional opening technique, periostealdistraction technique and bone cement covering technique, could protect each other, enhance efficacy, effectively promote the wound healing of ischemic diabetic foot ulcer, and reduce the toe amputation rate. For moderate to severe ischemic DF, the combined use of periosteal distraction and bone cement coverage techniques has a satisfactory effect. For extremely severe ischemic DF with inflow tract lesions, vascular interventional opening techniques need to be added.
Humans
;
Male
;
Female
;
Middle Aged
;
Aged
;
Diabetic Foot/surgery*
;
Retrospective Studies
;
Aged, 80 and over
;
Ischemia/surgery*
;
Interleukin-6/metabolism*
6.The protein arginine methyltransferase PRMT1 ameliorates cerebral ischemia-reperfusion injury by suppressing RIPK1-mediated necroptosis and apoptosis.
Tengfei LIU ; Gan HUANG ; Xin GUO ; Qiuran JI ; Lu YU ; Runzhe ZONG ; Yiquan LI ; Xiaomeng SONG ; Qingyi FU ; Qidi XUE ; Yi ZHENG ; Fanshuo ZENG ; Ru SUN ; Lin CHEN ; Chengjiang GAO ; Huiqing LIU
Acta Pharmaceutica Sinica B 2025;15(8):4014-4029
Receptor-interacting protein kinase 1 (RIPK1) plays an essential role in regulating the necroptosis and apoptosis in cerebral ischemia-reperfusion (I/R) injury. However, the regulation of RIPK1 kinase activity after cerebral I/R injury remains largely unknown. In this study, we found the downregulation of protein arginine methyltransferase 1 (PRMT1) was induced by cerebral I/R injury, which negatively correlated with the activation of RIPK1. Mechanistically, we proved that PRMT1 directly interacted with RIPK1 and catalyzed its asymmetric dimethylarginine, which then blocked RIPK1 homodimerization and suppressed its kinase activity. Moreover, pharmacological inhibition or genetic ablation of PRMT1 aggravated I/R injury by promoting RIPK1-mediated necroptosis and apoptosis, while PRMT1 overexpression protected against I/R injury by suppressing RIPK1 activation. Our findings revealed the molecular regulation of RIPK1 activation and demonstrated PRMT1 would be a potential therapeutic target for the treatment of ischemic stroke.
7.Analysis of factors affecting health status and abnormal lung function of workers exposed to welding fumes in Tianjin from 2020 to 2022
Moaga QUMU ; Yu BAI ; Pei LI ; Ya GAO ; Qiang ZENG ; Xin WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(10):757-762
Objective:To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases.Methods:In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function.Results:From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ 2=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ 2trend=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ 2=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ 2trend=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function ( OR=0.369, 0.568, 0.546; 95% CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion:Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.
8.Logic-gated tumor-microenvironment nanoamplifier enables targeted delivery of CRISPR/Cas9 for multimodal cancer therapy.
Yongchun PAN ; Xiaowei LUAN ; Fei ZENG ; Xuyuan WANG ; Shurong QIN ; Qianglan LU ; Guanzhong HE ; Yanfeng GAO ; Xiaolian SUN ; Xin HAN ; Bangshun HE ; Yujun SONG
Acta Pharmaceutica Sinica B 2024;14(2):795-807
Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H2O2-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H+ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H2O2-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.
9.Analysis of factors affecting health status and abnormal lung function of workers exposed to welding fumes in Tianjin from 2020 to 2022
Moaga QUMU ; Yu BAI ; Pei LI ; Ya GAO ; Qiang ZENG ; Xin WANG
Chinese Journal of Industrial Hygiene and Occupational Diseases 2024;42(10):757-762
Objective:To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases.Methods:In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function.Results:From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ 2=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ 2trend=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ 2=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ 2trend=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function ( OR=0.369, 0.568, 0.546; 95% CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion:Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.
10.Tianjin's occupational poisoning incidence: A comprehensive analysis, 2006—2020
Ya GAO ; Xin WANG ; Qiang ZENG ; Baofeng LIU ; Yu BAI
Journal of Environmental and Occupational Medicine 2024;41(6):668-672
Background At present, occupational poisoning has become one of the most serious occupational diseases that jeopardize the health of workers in China, in addition to pneumoconiosis, with a wide range of impacts and heavy social and economic losses. Objective To analyze the characteristics and patterns of the incidence of occupational poisoning in Tianjin from 2006 to 2020, and to provide a scientific basis for the development of effective intervention measures and prevention strategies. Methods The Occupational Diseases and Health Hazards Monitoring Information System, a module of the China Disease Prevention and Control Information System, was the primary data source of the study. The case files of acute and chronic occupational poisoning diagnosed by occupational disease diagnostic institutions in Tianjin from January 1, 2006 to December 31, 2020 were retrieved from the system. The data included basic information, occupational history, disease characteristics, and employer information. Excel 2016 was used to establish database, and frequencies and composition ratios were reported. Results From 2006 to 2020, a total of 234 cases of occupational chemical poisoning were reported in Tianjin, including 49 cases of acute occupational poisoning (20.94%) and 185 cases of chronic occupational poisoning (79.06%). The number of acute occupational poisoning cases showed a rising and then falling trend, and the number of chronic occupational poisoning cases showed an overall decreasing trend. Acute occupational poisoning mainly occurred in the four districts around the city (22 cases, 44.90%), and chronic occupational poisoning mainly occurred in Binhai New Area (90 cases, 48.65%). More male cases were reported than female cases. The age of onset was concentrated at 45-55 years old. The acute occupational poisoning cases were concentrated in the group with less than 5 years of service (22 cases, 44.90%), mainly asphyxiating gas poisoning, and the highest incidence was reported in chemical raw materials and chemical products manufacturing industry. The chronic occupational poisoning cases were concentrated in the groups with a working age of 5-14 years (70 cases, 37.84%), mainly organic solvent poisoning, and the highest incidence was also reported in chemical raw materials and chemical products manufacturing industry. Conclusion The prevention and control of occupational poisoning as well as health surveillance and management in Tianjin shall be carried out in a hierarchical and focused manner in accordance with types of acute and chronic occupational poisoning chemicals in the city, regional economic differences, types of industries, and distribution of workers.

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