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Effect of surgical factors on the augmentation of cement-injectable cannulated pedicle screw fixation by a novel calcium phosphate-based nanocomposite

Haolin Sun, Chun Liu, Shunlun Chen, Yanjie Bai, Huilin Yang, Chunde Li, Lei Yang

《医学前沿（英文）》 2019年 第13卷 第5期   页码 590-601 doi: 10.1007/s11684-019-0710-z

摘要： Bone cement-augmented pedicle screw system demonstrates great efficacy in spinal disease treatments. However, the intrinsic drawbacks associated with clinically used polymethylmethacrylate (PMMA) cement demands for new bone cement formulations. On the basis of our previous studies, a novel injectable and biodegradable calcium phosphate-based nanocomposite (CPN) for the augmentation of pedicle screw fixation was systematically evaluated for its surgical feasibility and biomechanical performance by simulated and animal osteoporotic bone models, and the results were compared with those of clinical PMMA cement. ASTM-standard solid foam and open-cell foam models and decalcified sheep vertebra models were employed to evaluate the augmentation effects of CPN on bone tissue and on the cement-injected cannulated pedicle screws (CICPs) placed in osteoporotic bone. Surgical factors in CICPs application, such as injection force, tapping technique, screw diameter, and pedicle screw loosening scenarios, were studied in comparison with those in PMMA. When directly injected to the solid foam model, CPN revealed an identical augmentation effect to that of PMMA, as shown by the similar compressive strengths (0.73±0.04 MPa for CPN group vs. 0.79±0.02 MPa for PMMA group). The average injection force of CPN at approximately 40–50 N was higher than that of PMMA at approximately 20 N. Although both values are acceptable to surgeons, CPN revealed a more consistent injection force pattern than did PMMA. The dispersing and anti-pullout ability of CPN were not affected by the surgical factors of tapping technique and screw diameter. The axial pullout strength of CPN evaluated by the decalcified sheep vertebra model revealed a similar augmentation level as that of PMMA (1351.6±324.2 N for CPN vs. 1459.7±304.4 N for PMMA). The promising results of CPN clearly suggest its potential for replacing PMMA in CICPs augmentation application and the benefits of further study and development for clinical uses.

关键词： bone cement     pedicle screw     degenerative spinal diseases     calcium phosphate     injectable    

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Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

《医学前沿（英文）》 2021年 第15卷 第4期   页码 575-584 doi: 10.1007/s11684-020-0816-3

摘要： Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.

关键词： spinal surgery     tissue state recognition     image     force sensing     bioelectrical impedance    

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Primary spinal epidural non-Hodgkin’s lymphoma presented with spinal cord compression syndrome

Chunquan CAI MD, PhD, Qingjiang ZHANG BM, Changhong SHEN MD, PhD,

《医学前沿（英文）》 2009年 第3卷 第4期   页码 499-502 doi: 10.1007/s11684-009-0075-9

摘要： The spinal epidural space is an uncommon presenting site in primary non-Hodgkin’s lymphomas, especially for children. A boy suffered spinal cord compression syndrome caused by primary spinal epidural non-Hodgkin’s lymphoma. Thoracolumbar magnetic resonance imaging (MRI) demonstrated an intraspinal mass. An operation was performed with gross total tumor removal. Histological examination revealed a non-Hodgkin’s B-cell lymphoma. Bone marrow aspiration was negative for lymphoma involvement. No other therapies (chemotherapy and/or radiotherapy) were performed according to the parents’ opinion. The patient died approximately one year after the operation due to brain metastases. The clinical course and imaging features were discussed with a review of literatures.

关键词： non-Hodgkin’     s lymphoma     primary     spinal cord compression syndrome     epidural space    

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transplantation and genetic enhancement of intrinsic growth capacities to promote CNS axon regeneration after spinal

Bin Yu, Xiaosong Gu

《医学前沿（英文）》 2019年 第13卷 第2期   页码 131-137 doi: 10.1007/s11684-018-0642-z

摘要： The inhibitory environment that surrounds the lesion site and the lack of intrinsic regenerative capacity of the adult mammalian central nervous system (CNS) impede the regrowth of injured axons and thereby the reestablishment of neural circuits required for functional recovery after spinal cord injuries (SCI). To circumvent these barriers, biomaterial scaffolds are applied to bridge the lesion gaps for the regrowing axons to follow, and, often by combining stem cell transplantation, to enable the local environment in the growth-supportive direction. Manipulations, such as the modulation of PTEN/mTOR pathways, can also enhance intrinsic CNS axon regrowth after injury. Given the complex pathophysiology of SCI, combining biomaterial scaffolds and genetic manipulation may provide synergistic effects and promote maximal axonal regrowth. Future directions will primarily focus on the translatability of these approaches and promote therapeutic avenues toward the functional rehabilitation of patients with SCIs.

关键词： spinal cord injury     biomaterial     extrinsic barrier     intrinsic regeneration capacity    

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Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

Chengwei JING, Qin FU, Xiaojun XU

《医学前沿（英文）》 2009年 第3卷 第1期   页码 45-48 doi: 10.1007/s11684-009-0019-4

摘要： This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, = 2.800, <0.05; improved scores of cases with iliac bone grafting, = 3.270, <0.05), and reliable reconstruction of cervical spine. The two groups obtained the same curative effect ( = 0.470, >0.05) Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

关键词： central cord syndrome     decompression     surgical     titanium mesh    

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Developmental expression of CAPON and Dexras1 in spinal cord of rats

LI Xin, CHENG Chun, CHEN Mengling, GAO Shangfeng, ZHAO Jian, NIU Shuqiong, SHEN Aiguo

《医学前沿（英文）》 2008年 第2卷 第1期   页码 75-81 doi: 10.1007/s11684-008-0014-1

摘要： To study the expression of the carboxy-terminal PSD-95/DLG/ZO-1 ligand of nNOS (CAPON) and Dexras1 mRNA during development in the spinal cord of rats, real-time polymerase chain reaction (Real-time PCR), as a quantitative method, was used to study the developmental expression of CAPON and Dexras1 mRNA level in the spinal cord. The spatial expression of CAPON and Dexras1 mRNA was examined by a combination of hybridization (ISH) and immunofluorescence. During the development of the spinal cord, CAPON mRNA was expressed in low levels from embryo day 14 to day 18. At postnatal day 1, it reached the peak and was expressed in the part which will become the dorsal horn when mature. It then decreased gradually until postnatal week 12, when it presented in the ventral horn. At embryo day 14, Dexras1 mRNA was expressed at low levels, increased during embryo day 16 to day 18 and peaked at postnatal day 1. Spatiotemporal expression of Dexras1 mRNA was similar to CAPON as confirmed by correlation analysis and colocalization. CAPON and neuronal nitric oxide synthase (nNOS) was expressed within the same cells of the dorsal horn at postnatal day 1 but had different subcellular localizations. Co-expression of CAPON and Dexras1 mRNA in myeloid tissue during development process of rat indicates that the adaptor protein, CAPON may play a probable role in differentiation of neurons, synaptic plasticity and synaptogenesis by regulating nNOS to activate Dexras1.

关键词： CAPON     ISH     differentiation     postnatal     different subcellular    

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Laparoscopic treatment of liver diseases in children

Jia Wei, Jiexiong Feng

《医学前沿（英文）》 2011年 第5卷 第4期   页码 388-394 doi: 10.1007/s11684-011-0165-3

摘要： Laparoscopic liver surgery has been increasingly used for the treatment of pediatric liver diseases over the past decade due to the development of special laparoscopic instruments and improvements in the technique. A number of factors are considered when electing to undergo the surgical process, including age, type of liver disease, and so on. Especially in children with liver masses, the number of trocars used and the position of their placement must be carefully designed to achieve successful outcomes. In the current review, the application of various laparoscopic instruments and the methods used for the laparoscopic treatment of liver diseases in children over the past decade are summarized.

关键词： laparoscopic surgery     liver mass     pediatric    

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Prevalence of cardiovascular diseases in China

Jun-Jie XIAO MD, Yi-Han CHEN MD, PhD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 16-20 doi: 10.1007/s11684-010-0007-8

摘要： Cardiovascular diseases (CVD) cause one third of all deaths in China, and the number is anticipated to double by 2020. They also greatly result in disability and adjusted life year loss. The prevalence of CVD has become a new burden for China, due to an aging population, smoking, and changes in dietary habits and lifestyles. As the largest developing country, China needs to tailor her own national policies for managing CVD with full consideration of epidemiology, local needs, and affordability. Smoking cessation, increased physical activity, control of hypertension and hypercholesterolemia, and maintenance of a “traditional Chinese” diet should be important strategies for reducing the burden of CVD in China. Health officials in China should take their responsibilities to implement educational and preventive measures seriously.

关键词： cardiovascular diseases     prevalence     China     risk factors     prevention    

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Cultural differences define diagnosis and genomic medicine practice: implications for undiagnosed diseases

null

《医学前沿（英文）》 2013年 第7卷 第3期   页码 389-394 doi: 10.1007/s11684-013-0281-3

摘要：

Despite the current acceleration and increasing leadership of Chinese genetics research, genetics and its clinical application have largely been imported to China from the Occident. Neither genetics nor the scientific reductionism underpinning its clinical application is integral to the traditional Chinese worldview. Given that disease concepts and their incumbent diagnoses are historically derived and culturally meaningful, we hypothesize that the cultural expectations of genetic diagnoses and medical genetics practice differ between the Occident and China. Specifically, we suggest that an undiagnosed diseases program in China will differ from the recently established Undiagnosed Diseases Program at the United States National Institutes of Health; a culturally sensitive concept will integrate traditional Chinese understanding of disease with the scientific reductionism of Occidental medicine.

关键词： genetics     cultural differences     undiagnosed diseases program    

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Diagnosis and therapy of lacrimal system diseases by micro lacrimal endoscope

Nan XIANG, Weikun HU, Jing YUAN, Guigang LI, Haixia LIU

《医学前沿（英文）》 2009年 第3卷 第1期   页码 113-117 doi: 10.1007/s11684-009-0001-1

摘要： The lacrimal endoscope is applied to the diagnosis and therapy of the disorders of the lacrimal system in combination with laser or micro drills under orthophoria. The changes of mucous membranes, the characteristics of pathological changes and the predilection sites of lacrimal system diseases were initially approached. One hundred and forty six pairs of eyes of 128 patients with lacrimal system disease were observed by the lacrimal endoscope in the Ophthalmology Department of Tongji Hospital from June 2006 to March 2007. The dynamic changes in mucous membranes, lesion sites, secreted substances and formation of membrane could be observed under orthophoria. Combined with laser or micro drill, the endoscope was applied to the therapy of lacrimal system disorders and the difference before and after the treatment was observed. Results are as follows: (1) The examination and therapy using the lacrimal endoscope were completed under topical anesthesia in 122 patients, and 6 patients of neonatorum dacryocystitis were examined and treated under general anaesthesia. All patients reported painless. (2) Sharp images of the lacrimal system were obtained by the endoscope. Normal lacrimal mucosal membrane was smooth and light pink, expanded and unobstructed during irrigation. In chronic dacryocystitis patients, the inhomogeneous colour of mucosal membranes was red and white, with different degrees of fibrotic membranes at the superior, middle and inferior parts of the nasolacrimal canals and secreted substances at sac could be observed. The lacrimal ducts could not be expanded and obstructed during irrigation. The patients with lacrimal system obstruction had different extents of membrane formation, and stenosis or complete obstruction of the lacrimal duct could be observed, and the corresponding mucosal membrane was not smooth which could not be expanded and obstructed during irrigation. (3) After the treatment by the endoscope combined with laser or micro drill, the major proliferation of the membrane disappeared and the lacrimal duct was unobstructed during irrigation. The cure rate and effective rate were 80.1% and 93.1%, respectively. The lacrimal endoscope is a new method in the diagnosis of lacrimal system diseases. Through a combination with laser or micro drill to carry out the therapy under orthophoria, it will bring a great change to the diagnosis and therapy of lacrimal system diseases.

关键词： lacrimal apparatus diseases     endoscopes    

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Responses to emerging and re-emerging infectious diseases: One world, One health

null

《医学前沿（英文）》 2018年 第12卷 第1期   页码 1-2 doi: 10.1007/s11684-018-0619-y

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国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

《中国工程科学》 2017年 第19卷 第2期   页码 112-116 doi: 10.15302/J-SSCAE-2017.02.019

摘要：

重大慢性非传染性疾病包括心脑血管疾病、癌症、呼吸系统疾病、糖尿病等，其流行给全球居民健康造成了重大威胁。为进一步对慢性病进行有效预防控制，促进健康、推动经济和社会发展，2014年中国工程院立项并开展了“重大慢性非传染性疾病防治的国际对比研究”项目，对国内外慢性病预防控制情况以及可供我们借鉴的经验进行了详细分析。本文从慢性病发病概况入手，分析了各种疾病的预防控制措施，并对不同国家的慢性病预防控制体系进行比较，凝练有益经验和方法，提出了增强我国慢性病预防控制的措施和建议。

关键词： 慢性病     心脑血管疾病     癌症     呼吸系统疾病     糖尿病     疾病预防控制体系    

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New spinal robotic technologies

Bowen Jiang, Tej D. Azad, Ethan Cottrill, Corinna C. Zygourakis, Alex M. Zhu, Neil Crawford, Nicholas Theodore

《医学前沿（英文）》 2019年 第13卷 第6期   页码 723-729 doi: 10.1007/s11684-019-0716-6

摘要： Robotic systems in surgery have developed rapidly. Installations of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA, USA), widely used in urological and gynecological procedures, have nearly doubled in the United States from 2010 to 2017. Robotics systems in spine surgery have been adopted more slowly; however, users are enthusiastic about their applications in this subspecialty. Spinal surgery often requires fine manipulation of vital structures that must be accessed via limited surgical corridors and can require repetitive tasks over lengthy periods of time — issues for which robotic assistance is well-positioned to complement human ability. To date, the United States Food and Drug Administration (FDA) has approved 7 robotic systems across 4 companies for use in spinal surgery. The available clinical data evaluating their efficacy have generally demonstrated these systems to be accurate and safe. A critical next step in the broader adoption of surgical robotics in spine surgery is the design and implementation of rigorous comparative studies to interrogate the utility of robotic assistance. Here we discuss current applications of robotics in spine surgery, review robotic systems FDA-approved for use in spine surgery, summarize randomized controlled trials involving robotics in spine surgery, and comment on prospects of robotic-assisted spine surgery.

关键词： robotics     spine surgery     Mazor     ExcelsiusGPS     ROSA     pedicle screw    

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Analysis of spinal lumbar interbody fusion cage subsidence using Taguchi method, finite element analysis

Christopher John NASSAU, N. Scott LITOFSKY, Yuyi LIN

《机械工程前沿（英文）》 2012年 第7卷 第3期   页码 247-255 doi: 10.1007/s11465-012-0335-2

摘要：

Subsidence, when implant penetration induces failure of the vertebral body, occurs commonly after spinal reconstruction. Anterior lumbar interbody fusion (ALIF) cages may subside into the vertebral body and lead to kyphotic deformity. No previous studies have utilized an artificial neural network (ANN) for the design of a spinal interbody fusion cage. In this study, the neural network was applied after initiation from a Taguchi L18 orthogonal design array. Three-dimensional finite element analysis (FEA) was performed to address the resistance to subsidence based on the design changes of the material and cage contact region, including design of the ridges and size of the graft area. The calculated subsidence is derived from the ANN objective function which is defined as the resulting maximum von Mises stress (VMS) on the surface of a simulated bone body after axial compressive loading. The ANN was found to have minimized the bone surface VMS, thereby optimizing the ALIF cage given the design space. Therefore, the Taguchi-FEA-ANN approach can serve as an effective procedure for designing a spinal fusion cage and improving the biomechanical properties.

关键词： anterior lumbar interbody fusion (ALIF)     artificial neural network (ANN)     finite element     interbody cage     lumbar interbody fusion     subsidence     taguchi method    

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Circulating microRNAs in cardiovascular diseases: from biomarkers to therapeutic targets

null

《医学前沿（英文）》 2014年 第8卷 第4期   页码 404-418 doi: 10.1007/s11684-014-0379-2

摘要：

microRNAs (miRNAs) are a class of conserved, short, non-coding RNAs that have important and potent capacities to regulate gene expression at the posttranscriptional level. In the past several years, the aberrant expressions of miRNAs in the cardiovascular system have been widely reported, and the crucial roles of some special miRNAs in heart development and pathophysiology of various cardiovascular diseases have been gradually recognized. Recently, it was discovered that miRNAs are presented in peripheral circulation abundantly and stably. This has raised the possibility of using circulating miRNAs as biomarkers for diseases. Furthermore, some studies demonstrated that circulating miRNAs may serve as novel extracellular communicators of cell-cell communication. These discoveries not only reveal the functions of circulating miRNAs in cardiovascular system but also inform the development of miRNAs therapeutic strategies. In this review, we discuss the potential roles of circulating miRNAs in a variety of cardiovascular diseases from biomarkers to therapeutic targets to clearly understand the roles of circulating miRNAs in cardiovascular system.

关键词： microRNA     cardiovascular disease     biomarkers     therapeutic target    

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标题 作者 时间 类型 操作

Effect of surgical factors on the augmentation of cement-injectable cannulated pedicle screw fixation by a novel calcium phosphate-based nanocomposite

Haolin Sun, Chun Liu, Shunlun Chen, Yanjie Bai, Huilin Yang, Chunde Li, Lei Yang

期刊论文

Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

期刊论文

Primary spinal epidural non-Hodgkin’s lymphoma presented with spinal cord compression syndrome

Chunquan CAI MD, PhD, Qingjiang ZHANG BM, Changhong SHEN MD, PhD,

期刊论文

transplantation and genetic enhancement of intrinsic growth capacities to promote CNS axon regeneration after spinal

Bin Yu, Xiaosong Gu

期刊论文

Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

Chengwei JING, Qin FU, Xiaojun XU

期刊论文

Developmental expression of CAPON and Dexras1 in spinal cord of rats

LI Xin, CHENG Chun, CHEN Mengling, GAO Shangfeng, ZHAO Jian, NIU Shuqiong, SHEN Aiguo

期刊论文

Laparoscopic treatment of liver diseases in children

Jia Wei, Jiexiong Feng

期刊论文

Prevalence of cardiovascular diseases in China

Jun-Jie XIAO MD, Yi-Han CHEN MD, PhD,

期刊论文

Cultural differences define diagnosis and genomic medicine practice: implications for undiagnosed diseases

null

期刊论文

Diagnosis and therapy of lacrimal system diseases by micro lacrimal endoscope

Nan XIANG, Weikun HU, Jing YUAN, Guigang LI, Haixia LIU

期刊论文

Responses to emerging and re-emerging infectious diseases: One world, One health

null

期刊论文

国外重大慢性非传染性疾病防治对策研究

张祝琴,刘德培

期刊论文

New spinal robotic technologies

Bowen Jiang, Tej D. Azad, Ethan Cottrill, Corinna C. Zygourakis, Alex M. Zhu, Neil Crawford, Nicholas Theodore

期刊论文

Analysis of spinal lumbar interbody fusion cage subsidence using Taguchi method, finite element analysis

Christopher John NASSAU, N. Scott LITOFSKY, Yuyi LIN

期刊论文

Circulating microRNAs in cardiovascular diseases: from biomarkers to therapeutic targets

null

期刊论文