Objective Compare and analyze the clinical efficacy and imaging differences of zero-profile interbody fusion cage and interbody fusion cage combined with titanium plate in anterior cervical discectomy and fusion(ACDF).Methods The clinical data of 40 patients who underwent ACDF in our hospital from February 2017 to November 2021 were retrospectively analyzed.Among them,22 patients were treated with zero-profile interbody fusion cage(zero-profile group),and 18 patients were treated with interbody fusion cage combined with titanium plate(titanium plate group).Record the operation time and intraoperative blood loss of the two groups.Japa-nese Orthopaedic Association(JOA)score,neck disability index(NDI)score and postoperative dysphagia were used to evaluate the clinical efficacy.Measure the cervical Cobb angle(C2-C7),fusion segment Cobb angle,aver-age intervertebral space height,and fusion segment height.Evaluate the fusion and subsidence of the cage by observ-ing the internal and external bone bridging of the cage through postoperative CT.Results There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).The JOA score,NDI score,average intervertebral space height,and fusion segment height of the two groups after operation were signifi-cantly improved compared with those before operation(P<0.05).The incidence of postoperative dysphagia in the zero-profile group was significantly lower than that in the titanium plate group(P<0.05).The Cobb angle of the fusion segment in the zero-profile group at 3 months after operation was significantly improved compared with that before operation(P<0.05).There was no significant difference in the other radiographic parameters between the two groups at each follow-up time point(P>0.05),except for the Cobb angle of the fusion segment at 3 months after operation and at the last follow-up(P<0.05)and the difference in the extra-fusion bone bridge(ExGBB)between the two groups at the last follow-up(P<0.05).Conclusions In ACDF,the clinical efficacy of zero-profile interbody fusion cage and interbody fusion cage combined with titanium plate is similar,both of which can significantly improve cervical function and postoperative imaging indicators.However,the zero-profile interbody fusion cage sig-nificantly reduced the incidence of dysphagia compared with the interbody fusion cage combined with titanium plate.In the end-stage follow-up,the former is better than the latter in improving the Cobb angle of the fusion segment and ExGBB,which is more conducive to promoting bone graft fusion.Both fuses have the risk of sinking.

Objective To construct a new biomechanical testing system of in vitro spine based on LabVIEW and six-axis robot arm and conduct preliminary reliability studies, so as to make preparation for further studies on coupled motion testing. Methods By programming on LabVIEW platform, using Ethernet and Profibus to communicate the data of the robot arm with PC in real time, the displacement control and load control were realized, and the end position and rotation angle of the robot arm were read in real time. Through the force/torque sensor and data acquisition (DAQ), board DAQ, processing, storage and other functions were acquired. Using the digital micrometer and special stationary fixture, the 6-direction translation accuracy test was completed, and the data were analyzed. The flexion, extension, lateral flexion and rotation were applied on sheep spine specimen to draw the load-displacement curve, analyze and compare the experimental result, and verify the effectiveness of the biomechanical platform. Results A biomechanical test system with high precision for spine in vitro based on LabVIEW and 6-axis robot arm was developed and established, of which the average translational precision was 8.1 μm and the average translational accuracy was 56.7 μm. The program of control, data acquisition, data processing and storage were written, and the biomechanical test of the sheep spine was completed effectively. Conclusions This biomechanical test system based on Labview and 6-axis robot arm could complete the conventional three-dimensional spinal motion test with high precision and be used to conduct coupled motion test research in the next step.

The importance of follower loads in maintaining spine biomechanics was described, and the various methods and means of follower load simulations of human spine specimens in vitro in recent years were summarized. By comparison with the real data of range of motion (ROM) and intervertebral disc pressure of human vertebral body, the feasibility of various simulation methods was analyzed from the perspectives of mechanics, and the optimal loading load and torque of human cervical, thoracic and lumbar vertebrae biomechanical experiments were summarized. The effects of conventional spinal internal fixation on biomechanical properties of the spine were also discussed.

The description for load-displacement characteristics of in vitro spinal specimens in three-dimensional (3D) motion is the foundation of spinal biomechanical research. How to simulate the load and movement of spine in vivo as accurately as possible is the difficulty of in vitro spinal biomechanical research. Domestic and foreign scholars have carried out extensive research on theories and equipments of spinal biomechanical test. Currently, the spinal 3D motion test is mainly divided into load control, displacement control and hybrid control according to the control method. Based on different control method, the test equipments are also developing and perfecting constantly. The operation principle for current in vitro spinal loading devices are summarized, and their advantages and disadvantages are also analyzed, so as to provide references for the research on in vitro spinal biomechanical loading devices.

Objective To investigate the efficacy and value of intra-operative neuromonitoring (IONM) in preventing,identifying and repairing recurrent laryngeal nerve injury (RLNI) during thyroidectomy and parathyroidectomy.Methods Data were collected from a series (n =351) of patients operated in our department between Jan 2015 and Dec 2017.Results With IONM navigation a total of 460 recurrent laryngeal nerves were identified during surgery.Anatomic variations were found in 6 cases,3 were non-recurrent laryngeal nerve.Others were morphological branching variation.There were 4 cases of temporary RLNI,all were unilateral.Total temporary RLNI rate was 1.1％.All 4 cases recovered completely in 3 months after surgery.Complete transection injury of RLN were found in 2 cases,one underwent immediate nerve anastomosis,with the voice significantly improved in 6 months.The total permanent RLNI rate was 0.5％.There was no hoarseness after operation in patients with normal IONM signal.The incidence of vocal cord paralysis was 57.14％ in patients with loss of IONM signal but normal appearance of RLN.Use of IONM did not increase operation time.Conclusions IONM had significant advantages in recognition of RLN,repair of intraoperative RLNI and prediction of postoperative voice condition,which could improve the safety of surgery.

Objective To evaluate the efficacy of the sleeve type guide growth rod sliding automatically with the growth of piglet spine.Methods Fourteen 4-month-old piglets were randomly divided into growth rod group (n=8) and control group (n=6).Animals in growth rod group were implanted with the sleeve type guide growth rod system through the small incision of the tho racodorsal.Whereas ones in control group were just expose the bilateral lamina.On the day of surgery,6 and 12 weeks of postoperation,all piglets accepted the spinal X-ray examination.Measured the mean height of T8,T9 vertebral bodies,the average height of T7-8,T8-9,Tg-10 discs and the mean length of the rods through X-ray film.Spinal MRI was measured 3 months after the operation.The morphological changes of the plate were observed after HE staining.The morphological changes of the nucleus pulposus cells were observed and the thickness of the growth plate and the length of the growth bar were measured.Results Two piglets of growth rod group did not complete the experiment,1 piglet died of aspiration due to anesthesia resuscitation,and 1 piglet had infection after operation.The average height of T8,T9 vertebral bodies of the piglets in the growth rod group on the day after surgery and 3 months after operation was 18.26±3.26 mm and 27.15±4.18 mm,respectively,and the difference was statistically significant (F=16.868,P=0.002).Similarly,the mean height of T7-8,T8-9,Tg-10 discs of the piglets in growth rod group on the day after surgery and 3 months of postoperation was 1.79±0.24 mm and 2.14±0.23 mm,respectively,and the difference was statistically significant (F=6.455,P=0.029).The average height of T8,T9 vertebral bodies in the control group on the day after surgery and 3 months after operation was 17.86±3.50 mm and 28.63±4.45 mm,respectively,and the difference was statistically significant (F=21.654,P=0.001).Similarly,the mean height of T7-8,Ts-9,Tg-10 discs in control group at the day after surgery and 3 months of postoperation was 1.78±0.27 mm and 2.17±0.30 mm,respectively,the difference was statistically significant (F=5.928,P=0.035).There was no statistically significant difference in average height between T8 and T9 vertebral bodies in growth rod group and the control group at 3 months after operation (F=0.352,P=0.566).Similarly,There was no statistically significant difference in average height of T7-8、Ts-9、Tg-10 discs in growth rod group and the control group at 3 months after operation (F=0.053,P=0.823).The average sliding length of the growth rod in growth rod was 65.74 mm.Furthermore,growth plate chondrocytes and nucleus pulposus cells in EG and SG,all showed that the cells were arranged in order,the cell volume was large,the shape was round and the cytoplasm was rich.Simultaneously,there was no significant difference between the two groups in growth plate chondrocytes (P ＞ 0.05).Conclusion The sleeve type guiding growing rod can automatically slip to extend due to the driving force of young pig's spine growth,without obvious effects on the normal growth of piglet's spine.

Objective To regard the implication of viruses particularly herpes in pemphigus vulgaris,and assess and compare the level of immunoglobulin G (IgG) antibodies against herpes simplex virus types 1 and 2 (HSV1 and HSV2),cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with pemphigus vulgarisand healthy people.Methods In this study,23 patients with pemphigus vulgaris and 26 healthy individuals comprised the experimental and control groups,respectively.Serum samples were taken from both groups;the levels of IgG antibodies against HSV1,HSV2,CMV and EBV were measured using ELISA.Results Immunoglobulin G titer was higher for all four viruses in the patient group in comparison to the control group.This difference was significant for anti-EBV,anti-CMV and anti-HSV2 (t=2.16,P＜0.05;t =4.76,P＜ 0.01;t=3.75,P＜0.01),respectively,but not significant for anti-HSV1 (t=0.52,P＞0.05).Conclusion Viruses including EBV,CMV,and HSV2 probably play a role in the pathogenesis of pemphigus in addition to the effects of genetics,toxins and other predisposing factors.In this study,no statistically significant relationship was observed between HSV1 and pemphigus vulgaris.More studies must be done in this regard.

Objective This study was performed to investigate the levels of HSP70 in tissue in pemphigus as a possible new theoretical basis for further elucidate the pathogenesis of pemphigus.Methods The expression of HSP70 in 62 patients with pemphigus was determined by immunohistochemistry,and the normal skin was taken as control.Results The results showed that the positive cells of HSP70＞75 ％ in the blisters of pemphigus vulgaris and the positive cells of HSP70＞50％ in the inflammatory cells near the blisters,and the expression of HSP70 was significantly higher than that in normal skin,which was statistically significant(Z=5.42,4.73,P＜0.01).Conclusion The abnormal expression of HSP70 in inflammatory cells and psoriasis of pemphigus patients showed that HSP70 is involved in the pemphigus.

Intervertebral disc degeneration (IDD) is one of major causes for intervertebral disc degenerative diseases, and patients with IDD usually suffer from serious low back pain. The current treatments for patients with IDD only relieve the clinical symptom rather than restore biological balance of IDD, leading to inadequate and unsatisfactory results. MicroRNAs (miRNAs) are endogenous, non-coding, single-stranded RNA molecules, which regulate the gene expression at the post-transcription levels. Research evidences support the involvement of miRNAs in many biological processes, such as lipid metabolism, apoptosis, differentiation and organ development. Accumulating evidences indicate that the expressions of miRNAs change significantly in degenerative tissues. In addition, dysregulated miRNAs contribute to multiple pathological process of IDD, including proliferation and apoptosis of nucleus pulposus and extracellular matrix components, inflammatory response and cartilage endplates degeneration. In this review article, we summarize the expression profiles and roles of miRNAs in IDD, which may provide a novel strategy of biological therapy for the disease.
Apoptosis ; Extracellular Matrix ; pathology ; Gene Expression ; Gene Expression Profiling ; Humans ; Intervertebral Disc Degeneration ; genetics ; pathology ; MicroRNAs ; genetics

Objective To evaluate the feasibility and efficacy of atlantoaxial fusion by flipping periosteum pedicle occipital outer plate.Methods Between March 2010 and June 2013,27 patients with atlantoaxial instability were treated by atlantoaxial fusion with flipping periosteum pedicle occipital outer plate and combining pedicle screws fixation.There were 16 males and 11 females with the age ranging from 23 to 56 years (with an average of 45.6 years) at time of surgery.There were 12 cases of fresh odontoid fracture with atlantoaxial instability,7 cases of old odontoid fracture combined with uneducable atlantoaxial dislocation,7 cases of congenital loose of odontoid process,and 1 case of rheumatoid arthritis.The visual analog scale (VAS) scores and Frankel grades were respectively used to evaluate the axial neck pain and the neurological deficit,and the results were compared before and after the operation.Bony fusion was observed by the midline sagittal CT scan images.Results All the patients were successfully operated.The operation time was 90 to 140 mins (with an average of 100 mins),and the blood loss was 100 to 600 ml (with an average of 160 ml).All patients were followed up for 18 to 39 months,with an average of 32.6 months.19 cases got solid fusion 3 months after surgery,and 7 cases got solid fusion 6 months after surgery,while 1 case got solid fusion 9 months after surgery.The average VAS score at final follow-up was 2.87± 1.03,which was significantly lower than that preoperatively 7.23± 1.65.Before the operation,nine cases presented spinal nerve function damage.At the final follow up time,7 cases returned to complete normal and 2 cases improved from grade C to grade D according to the Frankel classification.1 case was complicated with veiniplex injury with no heavy blood loss,due to successful hemostasia.Two screws were placed close to the vertebral artery canal,without clinical consequences.Conclusion The flipping periosteum pedicle occipital outer plate as a bone graft is one effective method for atlantoaxial fusion,which got great feasibility and safety.