As an emerging non-invasive brain stimulation technique, transcranial direct current stimulation (tDCS) has received increasing attention in the field of stroke disease rehabilitation. However, its efficacy needs to be further studied. The tDCS has three stimulation modes: bipolar-stimulation mode, anode-stimulation mode and cathode-stimulation mode. Nineteen stroke patients were included in this research (10 with left-hemisphere lesion and 9 with right). Resting electroencephalogram (EEG) signals were collected from subjects before and after bipolar-stimulation, anodal-stimulation, cathodal-stimulation, and pseudo-stimulation, with pseudo-stimulation serving as the control group. The changes of multi-scale intrinsic fuzzy entropy (MIFE) of EEG signals before and after stimulation were compared. The results revealed that MIFE was significantly greater in the frontal and central regions after bipolar-stimulation ( P< 0.05), in the left central region after anodal-stimulation ( P< 0.05), and in the frontal and right central regions after cathodal-stimulation ( P< 0.05) in patients with left-hemisphere lesions. MIFE was significantly greater in the frontal, central and parieto-occipital joint regions after bipolar-stimulation ( P< 0.05), in the left frontal and right central regions after anodal- stimulation ( P< 0.05), and in the central and right occipital regions after cathodal-stimulation ( P< 0.05) in patients with right-hemisphere lesions. However, the difference before and after pseudo-stimulation was not statistically significant ( P> 0.05). The results of this paper showed that the bipolar stimulation pattern affected the largest range of brain areas, and it might provide a reference for the clinical study of rehabilitation after stroke.
Humans ; Transcranial Direct Current Stimulation/methods* ; Electroencephalography ; Stroke Rehabilitation ; Stroke/therapy* ; Electrodes

Objective:To explore the difference and clinical significance of paraspinal muscle degeneration between single-segment degenerative lumbar spondylolisthesis and degenerative lumbar spinal stenosis.Methods:From January 2014 to October 2020, a retrospective analysis of 30 patientswere diagnosed with L 4,5 degenerative lumbar spondylolisthesis, aged 61.63±8.42 years old (range 44 to 82 years old), body mass index 24.07±3.17 kg/m 2 and 30 patientswere diagnosed with L 4,5 degenerative lumbar spinal stenosis, aged 59.67±12.89 years old (range 31 to 80 years old), body mass index 25.29±3.48kg/m 2, both of them went on surgery in department of spine surgery, shengjing hospital, China Medical University.30 healthy people were selected from outpatient physical examination in the control group, aged 58.33±7.36 years old (range 52 to 83 years old), body mass index 25.72±2.58 kg/m 2. These three groups were all male. Select all patients with L 3,4, L 4,5 and L 5S 1 disc level axial MRI images, and use the deep learning automatic segmentation measurement system developed by our hospital and Shenyang Institute of Automation Chinese Academy of Sciences to measure multifidus muscle cross sectional area (MMCSA), erector spinae cross sectional area (ESCSA), multifidus muscle fatty infiltration rate (MMFIR) and erector spinae fatty infiltration rate (ESFIR). One-way ANOVA was used to test the imaging parameters of multifidus and erector spinae of the three groups, and LSD- t test was used to compare the imaging parameters in each segment of paraspinal muscles. Results:The gender of three groups were male, there was no significant difference in age ( H=5.303, P>0.05), and there was no significant difference in body mass index ( F=2.267, P>0.05). Multifidus muscle cross-sectional area in L 3,4: degenerative lumbar spondylolisthesis groupincreased 189.11 mm 2 compared with degenerative lumbar spinal stenosis group ( P=0.010). Multifidus muscle cross-sectional area in L 4,5: compared with healthy people group, degenerative lumbar spondylolisthesis group decreased 205.52 mm 2 ( P=0.002), while degenerative lumbar spinal stenosis group decreased 184.14 mm 2 ( P=0.006). Multifidus muscle cross-sectional area in L 5S 1: compared with degenerative lumbar spinal stenosis group, degenerative lumbar spondylolisthesis group decreased 174.93 mm 2 ( P=0.018); compared with healthy people group, degenerative lumbar spondylolisthesis group decreased 406.06 mm 2 ( P<0.001), while degenerative lumbar spinal stenosis group decreased 231.13 mm 2 ( P=0.002). Erector spinae cross sectional area in L 4,5: compared with healthy people group, degenerative lumbar spinal stenosis group decreased 398.70 mm 2 ( P=0.006). Erector spinae cross sectional area in L 5S 1: compared with degenerative lumbar spinal stenosis group, degenerative lumbar spondylolisthesis group decreased 500.02 mm 2 ( P<0.001); compared with healthy people group, degenerative lumbar spinal stenosis group decreased 455.37 mm 2 ( P<0.001). Compared with healthy group, the multifidus muscle fatty infiltration rate of degenerative lumbar spondylolisthesis group in L 3,4 increased 4.96% ( P=0.001). Compared with degenerative lumbar spinal stenosis group, the erector spinae fatty infiltration rate of degenerative lumbar spondylolisthesis group in L 5S 1 decreased 5.41% ( P=0.004). Compared with healthy group, the erector spinae fatty infiltration rate of degenerative lumbarspinal stenosis group in L 5S 1 increased 5.02% ( P=0.008) . Conclusion:Paraspinal muscle cross sectional area of each segment in degenerative lumbar spondylolisthesis group and degenerative lumbar spinal stenosis group decreased in different degrees. In degenerative lumbar spondylolisthesis group, the degree of multifidus muscle fat infiltration was more significant, while indegenerative lumbar spinal stenosis group,the degree of erector spinal fat infiltration was higher.

Objective:To investigate the safety and effectiveness of anterior-curved rod and precompressive reduction and fixation from posterior approach for unstable burst fractures in thoracolumbar junction.Methods:From July 2017 to December 2019, according to the classification standard of AO Spine-Spine Trauma Classification System of 2019, 33 patients with type A3 thoracolumbar junction fractures with kyphosis angle > 20° and Asia Grade E were treated with anterior-curved rod and precompressive reduction and fixation from posterior approach. All the patients had single vertebral fractures. Three groups of screws were used to fix the injured vertebrae and the upper and lower vertebrae adjacent to the injured vertebrae, and the injured vertebrae were reduced. No bone graftor fusion was performed during the operation. The main outcome measures were the height of middle column of the injured vertebrae, the invaded cross-area of the injured vertebral canal, the encroachment rate of the injured vertebral canal, the Cobb angle of kyphosis, and visual analogue scale (VAS) and Oswestry disability index (ODI) before and after operation and at the last follow-up. All these data were analyzed statistically by t-test. Results:The operation was successfully performed in all 33 patients. 198 pedicle screws were implanted. The accuracy ofthe screws by CT evaluation was 98.8%. The average operation time was 89.8±20.4 min, and the average intraoperative blood loss was 170±53.7 ml. The height of the middle column was improved from 17.32±2.02 mm preoperatively to 21.41±3.68 mm postoperatively, and the invaded cross-area of the injured vertebral canal was improved from 101.3 ± 21.67mm2 before operation to 68.5±18.2 mm 2 after operation. The encroachment rate of the injured vertebral canal was improved from 47.66% ± 19.83% before operation to 19.61%±5.75% after operation; Cobb angle of kyphosis was improved from 26.33°±5.68° before operation to 3.13°±1.25° after operation; VAS score was improved from 6.42±1.25 before operation to 1.85±0.71 after operation, and 1.69±1.21 at the last follow-up; ODI was improved from 43.03%±3.46% before operation to 21.88%±4.22% after operation and 6.33%±2.31% at the last follow-up. There were statistically significant differences in the observative indexes after operation and at the last follow-up compared with those before the operation (P < 0.05). Conclusion:The technique of anterior-curved rod and precompressive reduction and fixation from posterior approach can safely and effectively reduce both the invading bone mass within the injured vertebral canal and the kyphosis angle.

Objective To compare the feasibility and efficacy of intervertebral wedge osteotomy and pedicle subtraction osteotomy (PSO),vertebral column resection (VCR),Smith-Petersen osteotomy (SPO) for the treatment of severe kyphosis and scoliosis.Methods The data of 38 cases of severe kyphosis and kyphoscoliosis were retrospectively analyzed from January 2010 to February 2016,including 22 males and 16 females.According to the osteotomy mode,PSO,SPO,VCR and intervertebral disc wedge osteotomy were used to collect the average number of fixed phases,volume of bleeding,length of stay,length of hospital stay,improvement of main cobb angle,improvement of ODI score,and Frankel classification to evaluate the efficacy.Results There were no significant differences in the overall operative time between the four groups.The average number of fixation in 18 patients with SPO was (9.4±3.9) segments,the blood loss was (3 000±410) ml,the average Cobb angle was improved by 55.3％± 9.5％,the average postoperative hospitalization was (14.6±4.9) days,the improvement rate of ODI was 42.1％±7.4％,all the patients were improved to Frankel E;The average number of fixation in 5 patients with PSO was (7.6± 1.5) segments,the blood loss was (4 360± 1 161) ml,the average Cobb angle was improved by 58.9％ ± 15.1％,the average postoperative hospitalization was (18.2±7.0) days,the improvement rate of ODI was 41.3％±9.6％.One Frankel C patient was improved to Frankel D,others remained to be Frankel E as the same as pre-operation;The average number of fixation in 4 patients with VCR was (6.2±2.6) segments,the blood loss was (3 750+ 1 848) ml,the average Cobb angle was improved by 83.9％± 10.9％,the average postoperative hospitalization was (21±7.2) days,the improvement rate of ODI was 39.6％± 18.1％.Three Frankel D patients were improved to Frankel E and one Frankel C patient was improved to Frankel D;The average number of fixation in 11 patients with IWO was (7.1 ± 2.7) segments,the blood loss was (2855±1046) ml,the average Cobb angle was improved by 59.6％±22.05％,the average postoperative hospitalization was (13.5±2.7) days,the improvement rate of ODI was 51.3％±8.3％.One Frankel C patient was improved to Frankel D,eight Frankel D patients were improved to Frankel E,other patients remained to be Frankel E;The mean follow-up time was 25.2 months in 11 patients underwent intervertebral wedge osteotomy.All the patients had successful spinal fusion and no failure of internal fixation.Conclusion Intervertebral wedge osteotomy for the treatment of scoliosis and kyphosis could reduce surgical injury to obtain good biomechanics and surgical result.

Objective To study the effect of different rod curvature on the postoperative stability and stress of thoracolumbar junction fracture using the finite element simulation.Methods (1) Thoracolumbar finite element model of T11 to L1 from three-dimensional CT data of a 30-year-old healthy male volunteer was established,including the assignment of cortical bone,cancellous bone,disc,ligaments and facet joints.On this basis,the T12fracture model was also established.T11 to L1 bilateral pedicle screw fixation was loaded,and the rod connection was divided into straight rod group and pre-bended rod group (lordotic 15°-25°) according to angle of the rod.A 400 N stress was loaded on the top of the upper endplate of T11 to simulate the upper part body gravity,while applying a 10 N · m torque to generate flexion and extension,lateral flexion and rotation.Stress distribution of different methods of pre-bending for thoracolumbar fractures after reduction was compared.(2) A retrospective cohort analysis was made on 56 cases of thoracolumbar fractures surgically treated from July 2012 to July 2016,including 31 cases in straight rod group and 25 cases in pre-bended rod group.Two groups were compared in angle between adjacent level before operation,after operation and at final follow-up.Results (1) In flexion,extension,lateral bending and rotation,both rod bending methods effectively controlled the thoracolumbar junction displacement.The peak stress of connecting rod (151,315,369,377 MPa respectively) in pre-bended rod group was lower than that in straight rod group (110,239,281,189 MPa respectively) (P ＜ 0.05),and straight rod group appeared relatively obvious stress concentration.(2) Mean follow-up time was 21.4 months (range,4-33 months).Preoperative kyphosis angle was (21.7 ± 7.4)°in straight rod group and (20.3 ± 6.8)° in pre-bended rod group (P ＞ 0.05).Postoperative lordosis angle in straight rod group was (3.3 ± 1.2) °versus (8.3 ± 2.8) ° in pre-bended rod group (P ＜ 0.05).At the final follow-up,the lordosis angle in straight rod group was reduced by (8.7 ± 2.3) ° versus (3.9 ± 1.7)°in pre-bended rod group (P ＜0.05).Implant failure was seen in 3 cases in straight rod group,but there was no implant failure in pre-bended rod group.Conclusion Pre-bended (lordotic 15°-25°) and pre-loaded rods used in internal fixation of thoracolumbar fractures may reduce the stress of rods,decrease the incidence of implant failure and facilitate the recovery of spine stability.

Objective To study the radiosensitizing effect of 2'-hydroxyflavanone (2'-HF) on prostate cancer cells,and to preliminarily investigate its mechanism.Methods Colony formation assay,tert-butylhydroperoxide (TBHP) oxidative stress assay,Hoechst staining,and apoptosis flow cytometry using Annexin V-FITC and propidium iodide (PI) were performed to measure the impact of 2'-HF on the radiosensitivity of VCaP prostate cancer cells.Western blot was used to determine the effects of 2'-HF on expression of AKT,phosphorylated AKT (p-AKT),and aldo-keto reductase 1 C3 (AKR1 C3) in VCaP cells and preliminarily investigate the mechanism.Data were analyzed by t test and factorial analysis of variance.Results The results of colony formation assay indicated that after exposure to radiation,VCaP cells treated with 2'-HF had a significantly lower proliferation level than cells in the control group (P=0.010),yielding a sensitization enhancement ratio of 1.19.The resuhs of TBHP oxidative stress assay suggested that VCaP cells treated with 2'-HF had significantly weaker anti-oxidative capacity than cells in the control group (P=0.015).Hoechst staining and apoptosis flow cytometry with Annexin V-FITC and PI indicated that 2'-HF treatment plus irradiation significantly enhanced apoptosis in VCaP cells (P=0.001.The results of Western blot suggested that 2'-HF treatment significantly inhibited the protein expression of p-AKT and AKR1C3 in VCaP cells (P=0.013 and P=0.016).Conclusions 2'-HF can enhance the radiosensitivity of prostate cancer cells,which is probably associated with its inhibitory effects on AKT pathway and AKR1C3 expression in prostate cancer cells.

ObjectiveTo observe the effect of early-stage intervention with acupuncture on gastrointestinal dysfunction in critically ill patients.MethodTotally 112 critically ill patients were randomized into two groups. Based on the treatment for primary disease, the conventional group additionally received Lived Combined B. Subtilis and E. Faecium Enteric-coated Capsules, plus Alanyl Glutamine injection when parenteral alimentation was required; in addition to the treatments given to the conventional group, the acupuncture group received electroacupuncture, once a day. Before treatment, and on treatment day 7 and day14, the gastrointestinal function and nutritional state (hemoglobin, albumin), nutrition type, APACHEⅡscore, incidence rate of gastrointestinal function failure, and mortality rate were evaluated and compared.ResultAfter 7-day treatment, the gastrointestinal function scores were significantly improved in both groups (P<0.05), and there was a significant difference between the acupuncture group and conventional group (P<0.05); after 14-day treatment, the gastrointestinal function scores were significantly improved in both groups compared to that before treatment (P<0.01), and there was a significant difference between the acupuncture group and conventional group (P<0.05). Respectively after 7-day and 14-day treatment, the APACHEⅡscores were significantly improved in both groups (P<0.01), and there was a significant difference between the acupuncture group and conventional group (P<0.05); after 14-day treatment, there was a significant difference between the two groups (P<0.05). After 7-day treatment, the hemoglobin levels were insignificantly changed in the two groups (P>0.05), and the difference was insignificant between the two groups (P>0.05); after 14-day treatment, the hemoglobin levels were significantly changed in both groups compared to that before treatment (P<0.05), and there was a significant difference between the two groups (P<0.05). After 7-day treatment, the albumin levels were insignificantly changed in the two groups (P>0.05), and the between-group difference was statistically insignificant (P>0.05); after 14-day treatment, the albumin levels were significantly changed in both groups compared to that before treatment (P<0.05), and there was a significant difference between the two groups (P<0.05). In the acupuncture group, 10 patients were dead, and there were 13 dead in the conventional group, and the between-group difference in death rate was statistically insignificant (P>0.05), though the death rate was comparatively lower in the acupuncture group; in the acupuncture group, 3 patients turned from complete parenteral nutrition to mixed nutrition, while 4 patients turned to mixednutrition because of intolerance to enteral nutrition and 2 cases turned to complete parenteral nutrition in the conventional group.Conclusion The two groups of treatments both can effectively improve the gastrointestinal function, decrease the incidence rate of gastrointestinal function failure, and the efficacy in the acupuncture group was more significant than that in the conventional group;the two groups of treatments both can sustain the gastrointestinal function and nutrition supply, and improve the nutrition state of the patients, and the acupuncture group was superior to the conventional group; the two methods both can effectively reduce APACHEⅡ score and improve the prognosis, while the acupuncture group was superior to the conventional group. Regardingthe death rate and enteral nutrition, the acupuncture group produced a higher comprehensive efficacy than the conventional group.

Objective: To discuss the effect of volatile organic compounds to the potential of embryonic development. From the angle of the laminar flow process, we found ways to control VOCs to ensure that the potential of embryonic development. Methods:To collect the air from the outdoor, laboratory hundred and thousand grade level central corridor three VOCs for testing;we used raw, medium effect filter to replace the original filter and got different results. Results:The indoor VOCs were higher than outdoor;Changes in concentrations of VOCs can affect embryonic development potential. The effect of replaced filter is bigger. After a period of time in a laminar flow system, it gradually getting better and finally change more than before. Conclusion:The embryo laboratory has volatile organic compounds VOCs. VOCs have larger influence on embryonic development potential and can be effectively controlled.

ObjectiveTo identify the anatomical feasibility of cross screw fixation in the atlas via posterior arch,provide a reference for clinical applications.MethodsA total of 10 dry atlas specimens were used to measure anatomic data and three dimension(3D) CT data.The data included height of the posterior tubercle,width of the posterior arch,distance from the ideal point to the interior of the vertebral artery sulcus,from nail point to central line,and the ideal direction of the screws.Statistical analysis was done to compare the two methods.Then 100 3D CT data were measured.The parameters included height of the posterior tubercle (mid-sagittal plane),width of the posterior arch (the inner side where arch transformed to the vertebral artery sulcus),distance from the ideal point to the interior of the vertebral artery sulcus (where screws completely located in the medullary cavity),distance between the nail point to central line,and angle of the ideal screws (between screws and horizontal line).The anatomy of the atlas was analyzed for whether height of the posterior tubercle is more than 7 mm,width of the posterior arch is more than 3.5 mm,and whether or not cross screws can be planted.ResultsThere was no statistical difference between anatomic and 3D-CT measures.Thickness of the C1 laminar was (4.7±0.9) mm in the left side,(4.6±0.8) mm in the right side,and 93.5％ of specimens were thicker than 3.5 mm.Distance of the ideal screw was(15.9±3.0) mm in the left side,(15.9±3.0) mm in the right side.Height of the C1 posterior tuber was (7.8±1.2) mm,with 91％ of the data higher than 7.0 mm.Angle between the axial of C1 laminar and frontal plane was 26.8°±6.8° (8°-44°) in the left side,26.8°±6.3°(13°-44°) in the right side,and about 11％ of them can not cross plant.ConclusionIt is feasible and safe to place cross screws in the posterior arch of the C1 in anatomy.