Spin Group Research Articles

Clinical effect of the warm acupuncture of Mongolian medicine on insomnia in the elderly and its brain-gut peptide mechanism: a randomized controlled trial

To observe the clinical effect and safety of the warm acupuncture of Mongolian medicine in treatment of insomnia in the elderly, and to explore its underlying brain-gut peptide mechanism. Sixty elderly patients with insomnia were randomly divided into a warm acupuncture group and a western medication group, 30 cases in each group. In the warm acupuncture group, the warm acupuncture of Mongolian medicine was operated at Dinghuixue (at the center of the vertex, the crossing site of the anterior midline and the line connected the upper edges of two ear apexes), Heyixue (at the depression of the spinous process of the 7th cervical vertebra) or Xinxue (at the depression of the spinous process of the 6th thoracic vertebra) in each treatment. Only one of the above points was selected and stimulated for 20 min one treatment and the three points were used alternatively. The treatment was given once every day or every other day, 3 times a week, and for a total of 3 weeks. In the western medication group, estazolam tablets were administered orally, once a day, 1 mg before bedtime, consecutively for 3 weeks. Before and after treatment, as well as in 1-month follow-up visit after the treatment completion, the scores of the Pittsburgh sleep quality index (PSQI) and the insomnia severity index (ISI) were observed in the two groups. The serum brain-related peptide markers (substance P [SP], neuropeptide Y [NPY], 5-hydroxytryptamine 1A [5-HT1A] and 5-hydroxytryptamine 2A [5-HT2A]) were measured before and after treatment, and the clinical efficacy and safety was evaluated in the two groups. After treatment and in follow-up, the scores of sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance and daytime dysfunction, as well as the total scores of PSQI, and ISI scores were all reduced in the two groups (P<0.05, P<0.01); and the scores in the warm acupuncture group were lower than those of the western medication group (P<0.05, P<0.01). After treatment, the levels of serum SP and 5-HT2A were decreased (P<0.01) and the levels of serum NPY and 5-HT1A were increased (P<0.01) when compared with those before treatment in the two groups. The levels of serum SP and 5-HT2A in the warm acupuncture group were lower than those of the western medication group (P<0.05), and the levels of serum NPY and 5-HT1A were higher than those of the western medication group (P<0.05). After treatment, the total effective rate was 93.3% (28/30) in the warm acupuncture group, which was higher than 83.3% (25/30) of the western medication group (P<0.05). No serious adverse reactions were found in the two groups. Warm acupuncture of Mongolian medicine can effectively improve the sleep quality of the elderly patients with insomnia, and its mechanism may be related to the regulation of the levels of serum SP, NPY, 5-HT1A and 5-HT2A.

Optimal Intermittent Administration Interval of Abaloparatide for Bone Morphogenetic Protein-Induced Bone Formation in a Rat Spinal Fusion Model.

Both bone morphogenetic protein 2 (BMP-2) and abaloparatide are used to promote bone formation. However, there is no consensus about their optimal administration. We investigated the optimal administration theory for the pairing of BMP-2 and abaloparatide in a rat spinal fusion model. Group I was only implanted in carriers and saline. Carriers with 3 µg of recombinant human BMP-2 (rhBMP-2) were implanted in other groups. Abaloparatide injections were administered three times a week for group III (for a total amount of 120 µg/kg in a week) and six times a week for group IV (for a total amount of 120 µg/kg in a week) after surgery. They were euthanized 8 weeks after the surgery, and we explanted their spines at that time. We assessed them using manual palpation tests, radiography, high-resolution micro-computed tomography (micro-CT), and histological analysis. We also analyzed serum bone metabolism markers. The fusion rate in Groups III and IV was higher than in Group I, referring to the manual palpation tests. Groups III and IV recorded greater radiographic scores than those in Groups I and II, too. Micro-CT analysis showed that Tbs. Sp in Groups III and IV was significantly lower than in Group I. Tb. N in Group IV was significantly higher than in Group I. Serum marker analysis showed that bone formation markers were higher in Groups III and IV than in Group I. On the other hand, bone resorption markers were lower in Group IV than in Group I. A histological analysis showed enhanced trabecular bone osteogenesis in Group IV. Frequent administration of abaloparatide may be suitable for the thickening of trabecular bone structure and the enhancement of osteogenesis in a rat spinal fusion model using BMP-2 in insufficient doses.

Training of Pelvic Floor Muscle Training Improves the Severity and Quality of Urine Incontinence and Increases Social Participation of Older Women in Southern Iran.

Aging and gender are risk factors for urine incontinence, which can lead to psychological, physical, and social complications. This community-based study investigates the effectiveness of pelvic floor muscle training on the severity and quality of urine incontinence and social participation of older women. This quasi-experimental community-based study was performed with the participation of 60 older women referring to the Public Health Center in Kerman City, southern Iran. The experiment group was trained with pelvic floor muscle training in 7 training sessions with distance health education in the second half of 2021. Before and after the intervention, data were collected based on: demographic, severity and quality of urine incontinence, and social participation inventories. Data were analyzed using a t-test and ANOVA (P ≤ 0.05). The mean scores of severity and quality of urine incontinence and social participation in the experiment and control groups before receiving the intervention were not statistically significant (P ≥ 0.05). But after that, a statistically significant difference was observed between the groups (P <0.05), which showed an improvement in the severity and quality of urine incontinence scores as well as SP in the experiment group. Tele-training of the Kegel exercise, even during the pandemic, can play an important role in improving incontinence and social participation in older women. Therefore, this training can be used to prevent and improve urine incontinence in public health centers in the community.</p>.

A sustained-release phospholipid-based phase separation gel loaded with berberine for treating rheumatoid arthritis.

Berberine (BBR) has a long history of use in the treatment of Rheumatoid arthritis (RA) and is considered one of the most promising natural product for the treatment of RA. However, oral administration of berberine has low bioavailability and requires frequent administration, resulting in poor patient compliance. In this study, we developed a BBR-loaded phospholipid-based phase separation gel (BBR-PPSG) to achieve sustained drug release and long-term therapeutic effect. The stability of BBR-PPSG was verified and it was found that it can be stored for a long time. The pharmacokinetic study on rats and rabbits showed that BBR-PPSG not only achieved 1-month of sustained release, but also significantly increased the area under the curve (AUC) by nearly 9-fold and prolonged the half-life (t1/2) by 10-fold. By constructing rat and rabbit models of RA, we also proved that BBR-PPSG administration once a month effectively alleviated joint swelling, and significantly reduce TNF-α levels in AIA rats and OIA rabbits. Histopathological analysis of rabbit joint sections revealed that after intra-articular injection of BBR-PPSG, the synovial cell layer remained intact, while in the model group, the synovial cells were significantly reduced and exhibited necrosis. MicroCT data analysis showed that the values of Tb.N and Tb. Sp in the BBR-PPSG group were significantly better than those in the model group (p < 0.05). This study addressed the limitations of frequent administration of BBR by developing a phospholipid-based phase separation gel system for berberine delivery, achieving long-term sustained release. The BBR-PPSG demonstrated good biocompatibility, simple preparation and excellent stability, thus holding potential as a novel pharmaceutical formulation for RA treatment.

Comparisons of nonpharmaceutical analgesia and pharmaceutical analgesia on the labor analgesia effect of parturient women.

We aimed to compare the labor analgesia effects of nonpharmaceutical analgesia and pharmaceutical analgesia on parturient women. One hundred and four parturient women with spontaneous births were selected and randomly divided into pharmaceutical and nonpharmaceutical analgesia groups. Before and after analgesia, the Visual Analogue Scale (VAS), parturient satisfaction with analgesia, serum pain stress factors (substance P [SP], neuropeptide Y [NPY], nerve growth factor [NGF], and prostaglandin E2 [PGE2]), duration of labor, vaginal bleeding at 2 h postpartum, postpartum urinary retention and dysuria incidence, Apgar score of 1 min and 5 min after birth, and neonatal cord blood gas analysis (pH, partial pressure of oxygen [PO2 ], partial pressure of carbon dioxide [PCO2 ], and lactate [Lac]) were compared in the two groups. VAS scores were lower and the analgesia satisfaction was higher in the pharmaceutical analgesia group than in the nonpharmaceutical analgesia group (all p < .05). Serum levels of SP, NPY, NGF, and PGE2 in the pharmaceutical analgesia group were lower than those in the nonpharmaceutical analgesia group (all p < .05). The first and second stages of labor were longer and the bleeding volume at 2 h postpartum was greater in the pharmaceutical analgesia group than those in the nonpharmaceutical analgesia group (all p < .05). Reduced Lac and PCO2 levels and increased PO2 level were found in the pharmaceutical analgesia group in comparison to the nonpharmaceutical analgesia group (all p < .05). This study demonstrates that the analgesic effect and neonatal condition of the pharmaceutical analgesia are better than the nonpharmaceutical analgesia, but the labor duration and postpartum bleeding volume of the pharmaceutical analgesia are greater than those of the nonpharmaceutical analgesia.

$S$-arithmetic spinor groups with the same finite quotients and distinct $\ell^2$-cohomology

In this note we refine examples by Aka from arithmetic to S -arithmetic groups to show that the vanishing of the i -th \ell^2 -Betti number is not a profinite invariant for all i \geq 2 .

Pertussis-like syndrome often not associated with Bordetella pertussis: 5-year study in a large children’s hospital

Background: Recently, a resurgence of pertussis has been observed worldwide despite broad vaccination coverage. The purpose of this study was to identify the clinical characteristics and the aetiological agent of pertussis-like syndrome (PLS) in Eastern China.Methods: 1168 patients who were diagnosed with a suspected Bordetella pertussis in Shanghai Children’s Hospital from 2013 to 2017 were included in the study. Clinical features and aetiologies were analysed. Aetiological analyses in sub-cohorts of age, seasons and years were also investigated.Results: 96.0% (1121) of the patients were less than 12 months old. 59.0% (689) of the patients were male. The Top 5 pathogens were respiratory syncytial virus (RSV; n = 125; 10.7%), Streptococcus pneumonia (SP; n = 109; 9.3%), Haemophilus influenzae type b (HIB; n = 86; 7.4%), Bordetella pertussis (B. pertussis; n = 84; 7.2%), and Mycoplasma pneumonia (MP; n = 80; 6.9%), respectively. The percentage of SP in the age group of 0–3 months was significantly lower than that in other age groups. The percentage of B. pertussis in the age group of 3–6 months was significantly lower than that in the group of 6-12 months. The percentage of MP in 0-3 months’ group was significantly lower than that in >12 months group. RSV peaked in winter (n = 52), while HIB peaked in spring (n = 38).Conclusion: PLS occurred most often in infants. RSV, SP, HIB, B. pertussis, and MP were the most prevalent pathogens. Since patients with B. pertussis and other pathogens have similar clinical manifestations, diagnosis of pertussis should be based on both clinical symptoms and laboratory confirmation.

A counter-example by Yagita

According to a 2018 preprint by Nobuaki Yagita, the conjecture on a relationship between [Formula: see text]- and Chow theories for a generically twisted flag variety of a split semisimple algebraic group [Formula: see text], due to the author, fails for [Formula: see text] the spinor group [Formula: see text]. Yagita’s tools include a Brown–Peterson version of algebraic cobordism, ordinary and connective Morava [Formula: see text]-theories, as well as Grothendieck motives related to various cohomology theories over fields of characteristic [Formula: see text]. We provide a proof using only the [Formula: see text]- and Chow theories themselves and extend the (slightly modified) example to arbitrary characteristic.

The Noether Problem for spinor groups of small rank

Building on prior work of Bogomolov, Garibaldi, Guralnick, Igusa, Kordonskiĭ, Merkurjev and others, we show that the Noether Problem for Spinn has a positive solution for every n≤14 over an arbitrary field of characteristic ≠2.

Rationality Problem for Classifying Spaces of Spinor Groups

We study stable rationality and retract rationality properties of the classifying spaces of split spinor groups Spinn over a field F of characteristic different from 2.

1609P - Is there a difference of palliative care problems and needs between cancer and non-cancer hospitalized elderly patients?

BackgroundThe elderly (above 65 years) have become the leading population of our society. Their multitude of healthcare chronic problems demands palliative care and therefore Palliative Care problems and needs (PCPN) assessment. MethodsA quantitative study using structured questionnaires [PNPC, Mini – Mental State Examination (MMSE), demographic and clinical characteristics] was conducted through December 2018 – February 2019, at internal medicine wards of a public general hospital. Patients with MMSE<24, at the end of life and with recent surgery were excluded. A translated in Hellenic language short-form version of PCPN used assessing Palliative Care Problems and Need for Professional Care. The PCPN is a 33 items 3-point Likert type scale that covers 8 domains: Activities of daily living (ADL/IADL), Physical symptoms (PS), Autonomy (A), Social (SI), Psychological (PI), Spiritual issues (Sp), Financial problems (FP) and Need for information (NI). The level of statistical significance was set at 0.05. ResultsSample consisted of 150 patients (51% men) with mean age 75.6 years old (SD=10.1). The cancer diagnosis was 40% mostly colon cancer (38%) and for non-cancer patients hypertension (62.2%). No statistical differences were found between cancer and non cancer patients for the demographic and clinical characteristics (p>0.05). The mean MMSE scare was 27.2 (SD=2) in patients with cancer and 27.6 (SD=1.9) in patients with no cancer (p=0.313). Significantly greater scores were found on the ADL/IADL (p=.012 - p=.001), A (p=.050 - p=.002), SI (p=.007 - p=.004) and Sp (p=.014 - p=.001) in the cancer group for both problems and needs for care. Additionally, the cancer patients reported statistically significant higher need for professional care for FP (p=.022). No statistically significant differences were found for PS, PI and NI (p>.050). ConclusionsElderly hospitalized cancer patients have more palliative care problems and needs for care at daily living, social, spiritual and financial issues than those with no cancer. Hence, nurses should focus on meeting these needs, based on the principles of PC. Legal entity responsible for the studyThe authors. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Spinor groups with good reduction

Let $K$ be a two-dimensional global field of characteristic $\neq 2$ and let $V$ be a divisorial set of places of $K$. We show that for a given $n\geqslant 5$, the set of $K$-isomorphism classes of spinor groups $G=\operatorname{Spin}_{n}(q)$ of nondegenerate $n$-dimensional quadratic forms over $K$ that have good reduction at all $v\in V$ is finite. This result yields some other finiteness properties, such as the finiteness of the genus $\mathbf{gen}_{K}(G)$ and the properness of the global-to-local map in Galois cohomology. The proof relies on the finiteness of the unramified cohomology groups $H^{i}(K,\unicode[STIX]{x1D707}_{2})_{V}$ for $i\geqslant 1$ established in the paper. The results for spinor groups are then extended to some unitary groups and to groups of type $\mathsf{G}_{2}$.

Micro-CT analysis of chronic apical periodontitis induced by several specific pathogens.

To conduct three-dimensional micro-CT analysis of bone destruction, periapical sclerotic changes and inflammatory root resorption (IRR) to compare the differences between Enterococcus faecalis (Ef)- and Porphyromonas gingivalis (Pg)-induced chronic apical periodontitis (CAP). Mono-species bacteria-induced CAP was established in the first and second molars of the right maxilla and mandible of male Sprague-Dawley rats. Fifteen animals were divided into three groups with five rats in each group: control group, Ef-CAP group and Pg-CAP group. The maxilla and mandible were harvested and then scanned by micro-CT. Alveolar bone destruction was evaluated by measuring the volume of alveolar bone resorption, bone volume fraction (BV/TV), trabecular thickness (Tb. Th), trabecular number (Tb. N) and trabecular spacing (Tb. Sp). The results were analysed using one-way analysis of variance and Fisher's least significant difference methods (LSD). The sclerotic changes in the periapical bone were graded and the IRR indexes were scored. The data were analysed using the chi-square test. The alveolar bone resorption volume of the Pg-CAP group was significantly larger than that of the Ef-CAP group (P<0.01). In the maxilla, both Pg-CAP and Ef-CAP groups had a significant decrease in BV/TV and increase in Tb. Sp (P<0.01) with the more significant changes of trabecular bone in the Pg-CAP group. A significant reduction of Tb. N was only found in the Pg-CAP group (P<0.05). There was no significant change in Tb. Th in either group (P>0.05). In the mandible, except for an increase in Tb. Sp in the Pg-CAP group (P<0.05), there was no significant change in BV/TV, Tb. Th or Tb. N (P>0.05). No obvious sclerotic change was observed. IRR was detected in significantly more root surfaces in the Pg-CAP group (240 surfaces, 60%) than those in the Ef-CAP group (178 surfaces, 44.5%) (P<0.001). The IRR extension was also significantly more advanced in the Pg-CAP group (P<0.05). Pg-CAP caused more substantial alveolar bone destruction and IRR than Ef-CAP. The maxilla was more susceptible to CAP in terms of microstructural changes of trabecular bone than the mandible. Tb. Sp was the most sensitive index for evaluating the residual alveolar bone of CAP.

Exploration of Chlorella sp. as antibacterial to Aggregatibacter actinomycetemcomitans biofilm

Aggregatibacter actinomycetemcomitans is a facultative anaerobic gram-negative, which is major pathogenic bacteria cause of aggressive periodontitis that has the ability to form biofilm. The therapy of aggressive periodontitis has been done with tetracycline antibiotics, meanwhile it may cause resistance problem. Chlorella sp. has antimicrobial activity against the anaerobic gram-negative bacteria as an adjunctive therapy of aggressive periodontitis. Purpose: This study aimed to determine the antibacterial potency of various concentrations of Chlorella sp. to A actinomycetemcomitans biofilm. Method: The antibacterial potency of Chlorella sp. to A actinomycetemcomitans were examined by biofilm test, divided into 5 groups, each group consisted of 4 samples. The control groups were: K− (aquadest), K+ (tetracycline), and treatment groups were given Chlorella sp. in various concentrations: P1 (0.625%), P2 (1.25%), and P3 (2.5%). The inhibition of biofilm formation were examined on microtiter plate by measure its Optical Density (OD) value on ELISA Reader. Data were analyzed using One Way ANOVA followed by LSD test. Result: Treatment with Chlorella sp in all treatment groups decreased the OD value, as well with tetracycline (p<0.05). The decrease in OD values indicated that more biofilms were inhibited due to its antibacterial potency. Treatment with 2.5% of Chlorella sp. showed the greatest biofilm inhibition among the treatment groups (p<0.05). Conclusion: Chlorella sp. extract has antibacterial potency against A actinomycetemcomitans biofilm

Human Plasma Levels of VEGF-A, VEGF-C, VEGF-D, their Soluble Receptor - VEGFR-2 and Applicability of these Parameters as Tumor Markers in the Diagnostics of Breast Cancer

VEGF family members are important factors in promoting angio- and lymphangiogenesis. The aim of this study was to investigate concentrations, diagnostic utility and power of VEGF-A, VEGF-C, VEGF-D and VEGFR-2 in comparison to CA15–3 in breast cancer (BC) patients. The study included 120 BC patients and 60 control patients (28 with benign breast tumors and 32 healthy women). Plasma levels of tested parameters were determined by ELISA, CA15–3 by CMIA. Concentrations of all parameters showed statistical significance when compared BC patients to controls. VEGF-D showed the highest SE (82.50%) in total BC group. Highest SP and PPV in total BC group showed VEGF-A(76.67%;84.78%,respectively), but lower than CA15–3. Highest NPV showed VEGF-C(52.33%), but it was lower than CA15–3. VEGF-C was also the best parameter which had statistically significant AUC in total cancer group (0.7672), but also stages I(0.7684) and II(0.7772). In the total group of BC almost all tested parameters showed statistically significant AUC, but a maximum range was obtained for the combination of VEGF-C + CA15–3(0.8476). The combined analysis of tested parameters and CA15–3 resulted in increase in SE and AUC values, which provides hope for developing a new panel of biomarkers that may be used in the diagnosis of BC in the future.

Individualized Left Anterior Oblique Projection

Classical fluoroscopic criteria for the documentation of septal right ventricular (RV) lead positioning have poor accuracy. We sought to evaluate the individualized left anterior oblique (LAO) projection as a novel fluoroscopy criterion. Consecutive patients undergoing pacemaker or defibrillator implantation were prospectively included. RV lead positioning was assessed by fluoroscopy using posteroanterior, right anterior oblique 30° to rule out coronary sinus positioning, and LAO 40° in the classical group or individualized LAO in the individualized group. Individualized LAO was defined by the degree of LAO that allowed the perfect superposition of the RV apex (using the tip of the RV lead temporarily placed at the apex) and of the superior vena cava-inferior vena cava axis (materialized by a guidewire), hence providing a true profile view of the interventricular septum. Accuracy of fluoroscopy for RV lead positioning was then assessed by comparison with true RV lead positioning using transthoracic echocardiography. We included 100 patients, 50 in each study group. Agreement between RV lead septal/free wall positioning in transthoracic echocardiography and fluoroscopy was excellent in the individualized group (k=0.91), whereas it was poor in the classical group (k=0.35). Septal/free wall RV lead positioning was correctly identified in 48/50 (96%) patients in the individualized group versus 38/50 (76%) in the classical group (P=0.004). For septal lead positioning, fluoroscopy had 100% Se and 89.5% Sp in the individualized group versus 91.4% Se and 40% Sp in the classical group. Complications and procedural data were comparable in both groups. Individualized LAO is a quick and highly reliable patient-tailored fluoroscopy projection for RV lead positioning.

P2-3-8. Change of cross frequency coupling by symptom provocation in Obsessive Compulsive Disorder (OCD) based on sLORETA

We investigated the changes in directional cross frequency interactions between theta and alpha oscillations, across six cortical regions, induced by a symptom provocation procedure, in patients with OCD, and in normal controls. Nine OCD outpatients and nine controls participated in this study. Eyes closed EEG was recorded before and under the instruction to imagine that the towel placed on their hands is contaminated (symptom provocation, SP). Cortical electric neuronal activity were calculated with sLORETA at medial-prefrontal, precuneus, inferior-parietal, and dorsolateral-prefrontal cortices. Instantaneous amplitudes for the theta and alpha bands were obtained and used for computing Granger causal directional cross-frequency, cross-cortical interactions. In controls, SP is characterized by a significant increase in mPFC theta due to right fronto-parietal alpha. In contrast, SP in the OCD group mainly displayed alpha-alpha RIPL alpha decrease due to RDLPFC. A direct comparison of OCD and normal controls showed significant frontal decreases of theta-alpha interactions before SP. The symptom provocation procedure induced functional changes of cross-frequency connections in both groups involving core right hemisphere network nodes. Functional cross-frequency interactions involving all frontal nodes were decreased in OCD compared to controls during SP. These results support the use of cross-frequency interactions a possible trait marker of OCD.

Ameliorative Effect of &lt;I&gt;Spirulina platensis&lt;/I&gt; and &lt;I&gt;Erythrina variegata&lt;/I&gt; on Oxidative Stress in Imidacloprid Intoxicated White Leghorn Cockerels

The present experiment was conducted to evaluate the ameliorative efficacy of Erythrina variegata leaf powder (EVLP) and Spirulina platensis (SP, Blue green algae) as feed additives on antioxidant parameters following simultaneous administration of imidacloprid for 60 days in white leghorn cockerels. Forty two white leghorn cockerels weighing 250-275 g of 4-6 months age were selected for this study. Cockerels were divided equally and randomly into six groups T1 to T6 and fed on as control (T1), Spirulina platensis @ 0.2% (T2); imidacloprid @ 50 ppm (T3); Spirulina platensis @ 0.2% plus imidacloprid @ 50 ppm (T4); Erythrina variegata leaf powder (1%) (T5); and Erythrina variegata leaf powder (1%) plus imidacloprid @ 50 ppm (T6) for 60 days. Blood samples were collected at 0, 30 and 60 days interval, tissue samples were collected at the end of the study. A significant (P<0.05) decline in RBC catalase and SOD, and an increase in LPO in RBC, liver, kidney and testes was observed in imidacloprid treated group which returned to normalcy following simultaneous medication with SP and EVLP in T4 and T6 groups after 60 days. Findings of this study indicated that administration of imidacloprid @ 50 ppm in feed for 60 days produced oxidative stress which was ameliorated following simultaneous dietary supplementation of Spirulina platensis and Erythrina variegate @ 0.2% and 1%, respectively. Further, Spirulina platensis was more potent in reversing the oxidative stress induced toxic effects in cockerels.

Indication for hypertrophy posterior longitudinal ligament removal in anterior decompression for cervical spondylotic myelopathy.

The retrospective study aimed to investigate the indication for hypertrophy posterior longitudinal ligament (HPLL) removal in anterior decompression for cervical spondylotic myelopathy (CSM). A total of 138 consecutive patients with CSM were divided into 2 groups with developmental cervical stenosis (DCS) (group S) and non-DCS (group N), according to the Pavlov ratio. These 2 groups were subdivided into 2 further subgroups, according to whether HPLL was removed or preserved: group SR (49 patients) and group SP (32 patients) in group S, group NR (21 patients) and group NP (36 patients) in group N. The modified Japanese Orthopedic Association score (mJOA), the modified recovery rate (mRR), quality of life (QoL), and relevant clinical data were used for clinical and radiological evaluation. The mJOA scores improved from 7.3 ± 2.2 to 15.0 ± 1.8 in the SR group and from 7.9 ± 2.3 to 14.2 ± 1.5 in the SP group (P = .036), with postoperative QoL significantly higher in the SR group than the SP group. A reduction in the diameter of enlarged spinal canals occurred at a significantly faster rate in the SP group compared with the SR group (P = .002). Multivariate regression analyses showed removal of HPLL correlated with mJOA scores (coefficient = 7.337, P = .002), mRR (%) (coefficient = 9.117, P = .005), PCS (coefficient = 12.129, P < .001), and MCS (coefficient = 14.31, P < .001) in the S group at 24 months postoperatively, while removal of HPLL did not correlate with clinical outcomes in the N group. The HPLL should, therefore, be removed when mobility was reduced and the spinal cord remained compressed after anterior decompression procedures in the patients with DCS. However, in non-DCS patients, it remains unclear as to whether removal of HPLL provides any clinical benefit, thus, HPLL removal may not be necessary.

Rapoport–Zink spaces for spinor groups

After the work of Kisin, there is a good theory of canonical integral models of Shimura varieties of Hodge type at primes of good reduction. The first part of this paper develops a theory of Hodge type Rapoport–Zink formal schemes, which uniformize certain formal completions of such integral models. In the second part, the general theory is applied to the special case of Shimura varieties associated with groups of spinor similitudes, and the reduced scheme underlying the Rapoport–Zink space is determined explicitly.