Vertebrate Type Research Articles

Концепция лечения взрывных переломов и переломов тел позвонков с дистракцией и ротацией грудного и поясничного отделов позвоночника по принципу остаточной фиксированности

Актуальность. Для решения задачи создания концепции и алгоритма лечения прежде всего необходимо разработать рабочую классификацию, на основе которой будет построена концепция. Предложенная классификация должна обеспечить выбор наиболее эффективных методов лечения у каждого больного, одновременно максимально безопасных и малотравматичных. Классификационное распределение основано на диагностических признаках переломов тел позвонков, а именно определении морфологических факторов, приводящих к патологическим изменениям. Именно выявление характера и тяжести повреждения позвоночного сегмента позволяет предвидеть дальнейшее развитие деформации и оценивать эффективность использования определенного метода лечения в конкретной клинической ситуации. Материалы и методы. Общее число больных с травматическими повреждениями грудного и поясничного отделов позвоночника составило 113. Средний возраст пациентов — 34,3 года. Мужчин было 67,9 %, женщин — 32,1 %. Проведено ретроспективное исследование историй болезни, данных клинического обследования, рентгенологических, КТ, МРТ до и после лечения. Критерии включения: неосложненные и осложненные взрывные переломы и переломы тел позвонков с дистракцией и ротацией грудного и поясничного отделов позвоночника. Согласно универсальной классификации повреждений грудного и поясничного отделов позвоночника Magerl et al., которая является классификацией AOSpine Thoracolumbar Spine Injury Classification System, различают: неполный взрывной перелом типа А 3.1 и неполный взрывной перелом с раскалыванием типа А 3.2, полный взрывной перелом типа А 3.3, перелом тела позвонка типа А с дистракцией типа АВ (тип В 1.2, В 2.3) и перелом тела позвонка типа А с ротацией типа АС (тип С 1.3). В зависимости от наличия неврологической симптоматики пациентов распределили на тех, кто имел несложные (74 человека; 65,4 %) и осложненные (39; 34,5 %) повреждения. Результаты. Разработка классификации предполагает анализ диагностических критериев, а разработка концепции лечения — анализ эффективности определенного метода лечения. Предложенная рабочая хирургическая классификация создана на основе классификаций Magerl et al., TLIСS и распределения внутренних напряжений McCormack, а также результатов собственных экспериментальных и клинических исследований. В результате собственных клинико­экспериментальных исследований доказано, что с увеличением степени разрушения тела позвонка растет величина кифотической деформации на уровне повреждения. Таким образом, величина первичной кифотической деформации позвоночника напрямую зависит от степени разрушения тела позвонка (степень фрагментации). Выводы. Разработана концепция лечения пациентов с взрывными переломами и переломами тел позвонков с дистракцией и ротацией, которая позволяет выбрать оптимальный метод лечения на основании трех признаков: степени фрагментации тела позвонка, деформирования позвоночника по принципу остаточной фиксированности и деформирования позвоночного канала.

Use of Cervid Serosurveys to Monitor Eastern Equine Encephalitis Virus Activity in Northern New England, United States, 2009-2017.

Vertebrate surveillance for eastern equine encephalitis virus (EEEV) activity usually focuses on three types of vertebrates: horses, passerine birds, and sentinel chicken flocks. However, there is a variety of wild vertebrates that are exposed to EEEV infections and can be used to track EEEV activity. In 2009, we initiated a pilot study in northern New England, United States, to evaluate the effectiveness of using wild cervids (free-ranging white-tailed deer and moose) as spatial sentinels for EEEV activity. In Maine, New Hampshire, and Vermont during 2009-2017, we collected blood samples from hunter-harvested cervids at tagging stations and obtained harvest location information from hunters. U.S. Centers for Disease Control and Prevention processed the samples for EEEV antibodies using plaque reduction neutralization tests (PRNTs). We detected EEEV antibodies in 6 to 17% of cervid samples in the different states and mapped cervid EEEV seropositivity in northern New England. EEEV antibody-positive cervids were the first detections of EEEV activity in the state of Vermont, in northern Maine, and northern New Hampshire. Our key result was the detection of the antibodies in areas far outside the extent of documented wild bird, mosquito, human case, or veterinary case reports of EEEV activity in Maine, New Hampshire, and Vermont. These findings showed that cervid (deer and moose) serosurveys can be used to characterize the geographic extent of EEEV activity, especially in areas with low EEEV activity or with little or no EEEV surveillance. Cervid EEEV serosurveys can be a useful tool for mapping EEEV activity in areas of North America in addition to northern New England.

Kyphosis types of the spine cervical-thoracic junction

Introduction. The strengthening of thoracic kyphosis and forward head posture is one of the urgent problems of modern man. Such changes are most often detected for elderly and senile people. However, today these features are also detected for young people. Digital radiography can objectively assess the position of the cervical and thoracic vertebrae. However, the criteria for reliably registering the position of the vertebrae of the cervicalthoracic junction have not yet been developed.The aim of the study — to develop a method for assessing the position of the vertebrae of the cervical-thoracic junction according to digital radiographs; to develop a typology of the vertebra positions of the cervical-thoracic junction; to study the frequency of vertebral position types for the cervical-thoracic junction for different age groups.Materials and methods. Spine X-ray images in the sagittal plane for 141 adult patients with dorsopathies were studied. The selection of patients was random and there were four age groups: 32 persons aged 21 to 45, 32 persons aged 46 to 59, 50 persons aged 60 to 74 and 21 persons aged 75 to 88 year-old. The study was conducted on PC screen, without the patient′s presence. A single digital X-ray image of the spine for each patient in the sagittal plane was obtained. On the combined digital radiograph, the occipital vertical was drawn along all parts of the spine, starting from the external hillock of the occipital bone downwards, and the anteroposterior CV–TV axes of the vertebrae (r axes) were applied. At the points of intersection of the axes with the occipital vertical, the perpendiculars to the axis were restored, and the angles between the perpendiculars and the vertical — the angles of the anteroposterior axes of the vertebrae (r angles) — were measured. Statistical analysis was performed using the MS Offi ce Excel 2007 and Statistica 12 software packages.Results. It was found that the values of the anteroposterior axe angles r of CVII–TIII vertebrae can serve as criteria for determining the spatial position of the cervical-thoracic junction vertebrae. There are 4 types of the shape of the cervical-thoracic junction. Type I is a straightened kyphosis («giraffe neck»); type II is physiological («harmonious»); type III — enhanced kyphosis («bear withers»); type IV–hyperkyphosis («buffalo hump»). Types III and IV are accompanied by a forward displacement of the head. Straightened cervical-thoracic junction kyphosis — type I — was diagnosed in 21 (15 %) people, 52 (37 %) patients were assigned to type II, another 48 (34 %) patients had type III, and 20 (14 %) patients had type IV cervical-thoracic junction kyphosis. In young patients aged 21 to 45, as well as in middle-aged patients aged 46 to 59, the most common type was the harmonious type II of cervical-thoracic junction, in elderly patients aged 60 to 74 — type III and close to it in frequency was type III. In elderly patients aged 75 to 88, the IV type of the position of the vertebrae of the cervical-thoracic junction prevailed in frequency.Conclusion. The proposed diagnostic method allows to register the type of the vertebra positions in cervicalthoracic junction for each patient. Four position types of the cervical-thoracic junction vertebrae were determined: straightened kyphosis «giraffe neck», physiological kyphosis «harmonious», enhanced kyphosis «bear withers» and hyperkyphosis «buffalo hump». Increased kyphosis and hyperkyphosis are accompanied by a forward head posture.

Sécurité et utilité de l’ablation du matériel après ostéosynthèse percutanée des fractures de type A du rachis thoraco-lombaire et lombaire

IntroductionImplant removal represents almost one third of all elective surgeries in orthopedics. There is no consensus regarding the time and need to remove the implants after vertebral fractures consolidation. The aim of this study was to assess the clinical and radiological effects of implant removal in patients with vertebral type A fracture who underwent a percutaneous intervention. Material and methodsWe evaluated 31 patients (mean age of 38.2±7.5 years) with thoracolumbar vertebral fracture (T11-L5) who underwent implant removal surgery after 24 months of fracture first surgery by a percutaneous approach. Inclusion criteria focused on patients’ preferences. The radiological parameters included fracture angle, initial sagittal index, compression percentage, degree displacement, deformation angle. The clinical variables included Visual Analog Scale and Oswestry Disability index. ResultsThere was no significant correction loss after removal surgery (before surgery and after 24 months): fracture angle (16.8±0.5 vs. 17.1±0.5; p˃0.05), initial sagittal index (12.5±0.5 vs. 12.7±0.5; p˃0.05), kyphotic deformity (17.5±0.6 vs. 17.8±0.7; p˃0.05), compression percentage (35.6±0.8 vs. 36.0±0.7; p˃0.05), degree displacement (4.4±0.4 vs. 4.5±0.3; p˃0.05) and deformation angle (23.0±0.7 vs. 23.1±0.7; p˃0.05). Patients who presented symptoms before the surgery showed better Visual Analog Scale (1.2±0.6 pre vs. 0.6±0.3 post, p˂0.05) and Oswestry Disability Index (20.1±6.8 pre vs. 15.7±0.5, p˂0.05). No complications were reported. DiscussionRoutine implant removal in patients undergoing a percutaneous approach to vertebral type A fracture is a safe technique and is associated with good clinical results without loss of radiological correction. In addition, this procedure could be indicated to patients who manifest symptoms since there is a clinical-radiological benefit. Level of proofII; A multicenter prospective cohort study.

Interferon functional analog activates antiviral Jak/Stat signaling through integrin in an arthropod.

Drosophila Vago is a small antiviral peptide. Its ortholog in Culex mosquito was found to be an interferon-like cytokine that limits virus replication through activating Jak/Stat signaling. However, this activation is independent of Domeless, the sole homolog of vertebrate type I cytokine receptor. How Vago activates the Jak/Stat pathway remains unknown. Herein, we report this process is dependent on integrin in kuruma shrimp (Marsupenaeus japonicus). Shrimp Vago-like (MjVago-L) plays an antiviral role by activating the Jak/Stat pathway and inducing Stat-regulated Ficolin. Blocking integrin abrogates the role of MjVago-L. The interaction between MjVago-L and integrin β3 is confirmed. An Asp residue in MjVago-L is found criticalfor the interaction and MjVago-L's antiviral role. Moreover, Fak, a key adaptor of integrin signaling, mediatesMjVago-L-induced Jak/Stat activation. Therefore, this study reveals that integrin, as the receptor of MjVago-L, mediates Jak/Stat activation. The establishment of the MjVago-L/integrin/Fak/Jak/Stat/Ficolin axis provides insights into antiviral cytokine signaling in invertebrates.

The Role of Digital X-Ray in Curative Effect and Nursing Evaluation of Cervical Spondylotic Radiculopathy.

The present study attempted to analyze the features of atlanto-occipital radiograph in patients with cervical spondylotic radiculopathy or vertebral artery type. In order to reduce the interference of human factors and the measurement error as much as possible, this experiment adopts the blind design and analyzes the digital format X-ray films by using the computer software ImageJ. Because the tangent line between the outer plates of the anterior and posterior margin of the foramen magnum was not accurately located on the X-ray film, the angle formed by the line between the saddle dorsal slope and the center point of the anterior and posterior nodule with a clear display was selected as the measurement method of the angle between the atlanto-occipital joints. The results showed that the lateral cervical curvature of the VCS group was 0.43 ± 0.51, and the lateral cervical curvature of the CSR group was 0.46 ± 0.49, both of which were significantly lower than the normal value (1.2 ± 0.5 cm). Patients in both groups had the characteristic of cervical curvature straightening. The changes of cervical curvature in overflexion and overextension positions can indirectly reflect the state of cervical motion. The anterior flexion neck curve of the VCS group was less than that of the CSR group (P < 0.05). Compared with the CSR group, VCS showed limited cervical anterior flexion movement. In this study, X-ray films of both CSR and VCS showed occipitocervical flexion and extension disorders, cervical curvature straightening, and lower cervical instability. In VCS, occipitocervical flexion and extension disorders were mainly manifested in atlantoaxial flexion disorders, while in CSR, atlanto-occipitocervical flexion and extension disorders were mainly manifested in atlantoaxial flexion disorders.

Vertebral pneumaticity of the paravian theropod Unenlagia comahuensis, from the Upper Cretaceous of Patagonia, Argentina

Postcranial skeletal pneumaticity (PSP) characterizes extant birds. This feature is related to a series of air sacs connected to the lungs and prolonged in diverticula that invade bones internally. Previous works revealed that PSP was present along the line to birds, being distinctive of pterosaurs and saurischian dinosaurs. PSP is profuse in the vertebral column of sauropods and theropods and was very studied in sauropods, although scarcely in non-avian theropods. Here we analyze the vertebral pneumaticity of the unenlagiine theropod Unenlagia comahuensis, including the observation through CT scans. Unenlagiinae is a clade of southern dromaeosaurid theropods that is closely related to birds. The vertebral centra have lateral pneumatic foramina (lpf) within fossae (commonly termed ‘pleurocoels’) in middle and posterior dorsals, an unusual feature among extant birds and many non-avian theropods. Another possibly pneumatic fossa stands out at both sides of the neural spine base, which is not present in dorsals of other non-avian theropods, except the unenlagiine Unenlagia paynemili. CT scans revealed camellate tissue in the centra, consisting of small chambers separated by thin trabeculae. Camellae are also observed in the unenlagiines U. paynemili and Austroraptor cabazai, other dromaeosaurids, other coelurosaurs, and some non-coelurosaurian tetanurans. Instead, more primitive groups generally have camerae (larger chambers separated by scarce thick septa). Thus, a possible trend of the vertebral inner pneumaticity types is observed throughout non-avian theropod evolution, as indicated by previous authors. This study provides valuable information that helps to clarify this trend, not only in dromaeosaurids but also throughout theropod evolution.

Cross-sectional analysis and trend of vertebral and associated anomalies in Chinese congenital scoliosis population: a retrospective study of one thousand, two hundred and eighty nine surgical cases from 2010 to 2019.

The objective of this article is to report associated anomaly incidences of a large CS cohort and analyze interrelationships among vertebral anomaly types and associated abnormalities. We retrospectively searched and extracted medical records of 1289 CS inpatients surgically treated in our institute from January 2010 to December 2019. All patients have taken spine X-ray, CT, MRI, echocardiogram, urogenital ultrasound, and systemic physical examination. We analyzed information on demographics, CS types, and associated anomalies. CS type was found to be 49.1% for failure of formation (FF), 19.5% for failure of segmentation (FS), and 31.4% for mixed defects (MD). Intraspinal defects were found in 29.4% patients (16.0% for FF, 45.4% for FS, 40.5% for MD), cardiac in 13.7% (12.3% for FF, 14.3% for FS, 15.6% for MD), genitourinary in 5.8% (4.1% for FF, 6.0% for FS, 8.4% for MD), gastrointestinal in 3.6% (4.7% for FF, 1.6% for FS, 3.0% for MD), and musculoskeletal in 16.4% (10.3% for FF, 19.9% for FS, 23.7% for MD). The intraspinal and musculoskeletal defect incidences were significantly higher in patients with failure of segmentation and mixed defects. We also observed a decreasing trend for intraspinal and musculoskeletal defect incidences as well as a tendency for more failure of formation and less failure of segmentation from 2010 to 2019. The intraspinal and musculoskeletal defect incidences were higher in patients with failure of segmentation and mixed defects. Strong interrelationships were found between intraspinal and musculoskeletal defects and among cardiovascular, genitourinary, and gastrointestinal defects. From 2010 to 2019, the proportion of patients with failure of formation increased significantly, causing a decrease in the intraspinal and musculoskeletal defect incidences over time. Female sex, failure of segmentation, and mixed defects could be considered risk factors for more associated anomalies in CS individuals, which would help surgeons in medical management and prenatal consultation.

Late onset recurrence of clinical signs after surgery for intervertebral disc extrusion in French bulldogs.

To identify the prevalence of recurrence of clinical signs after initial successful decompressive surgery for intervertebral disc extrusion in French bulldogs. A medical record search was performed to identify French bulldogs that experienced an initial successful outcome after surgery for thoracolumbar or cervical intervertebral disc extrusion. Collected information included signalment, neurological examination findings, intervertebral disc extrusion location, presence of vertebral malformations, kyphosis, type and extent of surgery. Decompressive surgery was not followed by extensive prophylactic fenestrations. Follow-up information was retrieved from medical records and telephone interviews with referring veterinary surgeons. Eighty-four French bulldogs with thoracolumbar (n=55) or cervical (n=29) intervertebral disc extrusion were included. Forty-three (51%) dogs that had decompressive surgery for thoracolumbar (n=29) or cervical (n=14) intervertebral disc extrusion suffered recurrence of signs. The median time between decompressive surgery and recurrence of clinical signs was 9 months and 21 days. Of the 29 dogs suffering recurrence of clinical signs following surgery for thoracolumbar intervertebral disc extrusion, 24 returned for recurrence of clinical signs localised to the thoracolumbar segments, while five returned for recurrence of signs localised to the cervical region. Of the 14 dogs who suffered recurrence of signs following surgery for cervical intervertebral disc extrusion, nine returned for signs localised to the cervical region, while five returned for clinical signs localised to the thoracolumbar region. This study suggests a high rate of late onset recurrence of clinical signs after decompressive surgery for intervertebral disc extrusion in French bulldogs. This information can aid in the management of owner expectations.

Vertebral Formulae and Congenital Vertebral Anomalies in Guinea Pigs: A Retrospective Radiographic Study.

Simple SummaryGuinea pigs are popular pets, but there is still a lack of information about their morphology. Variable morphology of the vertebral column can lead to incorrect localization of spinal diseases or the site of surgical intervention. This study aimed to determine the numerical variants of vertebral column and prevalence, localization, and type of congenital anomalies of the vertebral column. Vertebral column radiographs were reviewed in 240 guinea pigs, and nine numerical variants of the vertebral column were noticed. The most common vertebral formula, seven cervical, 13 thoracic, six lumbar, four sacral, and five to seven caudal vertebrae, was found in 75% of guinea pigs. Congenital anomalies were also found as incidental findings in 12.5% of guinea pigs, mostly in the thoracolumbar and lumbosacral regions. The most common congenital anomalies were a variable morphology of the last pair of ribs in the thoracolumbar region and transitional vertebra with a mixed morphological characteristic of lumbar and sacral vertebrae in the lumbosacral region. The cervical region was the least common region for congenital anomalies of the vertebral column. Our results contribute to the knowledge of clinical morphology in guinea pigs applicable in both, research and clinical practice.The objectives of this retrospective study of 240 guinea pigs (148 females and 92 males) were to determine the prevalence of different vertebral formulae and the type and anatomical localization of congenital vertebral anomalies (CVA). Radiographs of the cervical (C), thoracic (Th), lumbar (L), sacral (S), and caudal (Cd) part of the vertebral column were reviewed. Morphology and number of vertebrae in each segment of the vertebral column and type and localization of CVA were recorded. In 210/240 guinea pigs (87.50%) with normal vertebral morphology, nine vertebral formulae were found with constant number of C but variable number of Th, L, and S vertebrae: C7/Th13/L6/S4/Cd5-7 (75%), C7/Th13/L6/S3/Cd6-7 (4.17%), C7/Th13/L5/S4/Cd6-7 (2.50%), C7/Th13/L6/S5/Cd5-6 (1.67%), C7/Th12/L6/S4/Cd6 (1.25%), C7/Th13/L7/S4/Cd6 (1.25%), C7/Th13/L7/S3/Cd6-7 (0.83%), C7/Th12/L7/S4/Cd5 (0.42%), C7/Th13/L5/S5/Cd7 (0.42%). CVA were found in 30/240 (12.5%) of guinea pigs, mostly as a transitional vertebra (28/30), which represents 100% of single CVA localised in cervicothoracic (n = 1), thoracolumbar (n = 22) and lumbosacral segments (n = 5). Five morphological variants of thoracolumbar transitional vertebrae (TTV) were identified. Two (2/30) guinea pigs had a combination of CVA: cervical block vertebra and TTV (n = 1) and TTV and lumbosacral transitional vertebra (LTV) (n = 1). These findings suggest that guinea pigs’ vertebral column displays more morphological variants with occasional CVA predominantly transitional vertebrae.

An unusual thioredoxin system in the facultative parasite Acanthamoeba castellanii

The free-living amoeba Acanthamoeba castellanii occurs worldwide in soil and water and feeds on bacteria and other microorganisms. It is, however, also a facultative parasite and can cause serious infections in humans. The annotated genome of A. castellanii (strain Neff) suggests the presence of two different thioredoxin reductases (TrxR), of which one is of the small bacterial type and the other of the large vertebrate type. This combination is highly unusual. Similar to vertebrate TrxRases, the gene coding for the large TrxR in A. castellanii contains a UGA stop codon at the C-terminal active site, suggesting the presence of selenocysteine. We characterized the thioredoxin system in A. castellanii in conjunction with glutathione reductase (GR), to obtain a more complete understanding of the redox system in A. castellanii and the roles of its components in the response to oxidative stress. Both TrxRases localize to the cytoplasm, whereas GR localizes to the cytoplasm and the large organelle fraction. We could only identify one thioredoxin (Trx-1) to be indeed reduced by one of the TrxRases, i.e., by the small TrxR. This thioredoxin, in turn, could reduce one of the two peroxiredoxins tested and also methionine sulfoxide reductase A (MsrA). Upon exposure to hydrogen peroxide and diamide, only the small TrxR was upregulated in expression at the mRNA and protein levels, but not the large TrxR. Our results show that the small TrxR is involved in the A. castellanii’s response to oxidative stress. The role of the large TrxR, however, remains elusive.

Observation on clinical effect of Scalp cluster acupuncture treatment of cervical spondylosis of vertebral artery type

To observe the difference in clinical effect of Scalp cluster acupuncture on cervical spondylosis of vertebral artery type. Using a randomized control design, 96 patients with vertebral artery cervical spondylopathy were randomly divided into two groups: conventional acupuncture point combined with Scalp cluster acupuncture group (treatment group) 48 cases, conventional acupoint group (control group) 48 cases. After 2 courses of treatment, it was judged by observing clinical efficacy evaluation, DARS evaluation, and VAS pain scale. The total effective rate was 93.8% in the treatment group and 79.2% in the control group; the difference between the two groups was statistically significant (P &lt; 0.05). Before treatment, the difference in DARS between the two groups was not statistically significant (P&gt; 0.05); after treatment, the difference between the two groups was statistically significant (P &lt; 0.01) ; After treatment, the difference between the two groups was statistically significant (P &lt; 0.05). The VAS scores of the two groups of patients before treatment were comparable (P&gt; 0.05), and there were significant differences between the two groups after treatment (P &lt;0.05);The difference of VAS score between the two groups was statistically significant (P &lt; 0.01). Scalp cluster acupuncture therapy is more effective than traditional acupuncture therapy alone in treating vertebral artery type cervical spondylosis.

Hemodynamics Change and Clinical Efficacy on Cervical Spondylosis of Vertebral Artery Type Treated by Hot Compress Therapy with Medicinal Salt Pillow

Objective:To investigate the effect of hot compress therapy with medicinal salt pillow on cervical spondylosis of vertebral artery type,and to observe the effects on symptoms,cervical function and clinical effect of patients.Methods:A total of 80 patients with cervical spondylosis of vertebral artery type were randomly divided into observation group and control group according to the proportion of 1∶1 used by SPSS 17.0 software random sequence generation module,with 40 cases in each group.The patients in observation group were treated by hot compress therapy with medicinal salt pillow filled with Daqing salt as a heat conductor,and the patients in control group were treated by wax therapy and cervical traction.After 4 weeks of treatment,transcranial doppler ultrasound(TCD)was used to compare the blood flow velocity and asymmetry,and pulsatile index(PI)of the bilateral vertebro-basilar artery before and after treatment in the two groups.The cervical vertigo symptom and function assessment scale(ESCV)was used to evaluate the degree of symptoms and function of patients,and the clinical efficacy was evaluated according to the therapeutic standard of traditional Chinese medicine.Results:1)There were no statistical differences between the two groups before treatment for the indicators of blood flow velocity and asymmetry,PI of the bilateral vertebro-basilar artery and the score of ESCV(P>0.05).2)After four weeks treatment,the mean of peak systolic blood flow velocity[(LVA+RVA)VP/2]and the mean of end diastolic blood flow velocity[(LVA+RVA)Vd/2]of the bilateral vertebro-basilar artery in both groups with slow blood flow velocity were significantly higher than those before treatment(P<0.05).For the patients in both groups with rapid blood flow velocity,the(LVA+RVA)Vp/2 was obviously lower than that before treatment(P<0.05),and the decrease of(LVA+RVA)Vd/2 was not as significant as that of(LVA+RVA)Vp/2.Compared with the control group,the improvement of(LVA+RVA)Vp/2 in the observation group with slow blood flow velocity after treatment was more significant(P<0.05).3)The PI was reduced after treatment in the two groups,and the reduction in observation group with slow blood flow velocity was superior to that in the control group after treatment(P<0.05).4)The asymmetry of blood flow velocity showed that the difference of peak systolic blood flow velocity of bilateral vertebro-basilar artery[|LVA-RVA|Vp]in the observation group was dropped significantly after treatment(P<0.05).The ESCV scores were both improved after treatment for the two groups(P<0.05),with the scores of observation group(23.13±3.15)higher than the control group(21.73±3.39),however,the difference was not statistically significant(P>0.05).There was no statistically significant difference of clinical efficacy between the two groups(P>0.05),and no adverse reactions were observed in either groups.Conclusion:The effect of hot compress therapy with medicinal pillow filled with salt can significantly improve the blood flow of bilateral vertebro-basilar artery,effectively relieve the symptoms of cervical spondylosis of vertebral artery type and improve the function of cervical vertebra.

Application of Musculoskeletal Ultrasound in Real-Time Dynamic Detection of Luschka Joint Hyperplasia of Cervical Vertebrae

In order to explore the application of musculoskeletal ultrasound (MSKUS) in real-time dynamic detection of Luschka joint hyperplasia of cervical vertebrae, a total of 80 patients who were diagnosed as cervical spondylosis of vertebral artery type and underwent musculoskeletal ultrasound and three-dimensional computed tomography angiograph (3D-CTA) examination at a designated hospital by this study from December 2016 to December 2018 were selected as study subjects. Taking 3D-CTA as gold standard, the results of MSKUS and 3D-CTA were compared and their correlation and consistency analysis were performed; the sensitivity, specificity, false positive rate, false negative rate and diagnostic compliance rate of MSKUS were calculated for evaluating the lateral hyperplasia of Luschka joint; the Kappa values were used to compare the test results' consistency, which were divided into three categories of high consistency, general consistency, and poor consistency to evaluate the lateral hyperplasia of Luschka joint. The results show that the sensitivity, specificity, false positive rate, false negative rate, positive predictive value, negative predictive value and diagnostic coincidence rate of MSKUS in evaluating the lateral hyperplasia of Luschka joint were 87.34%, 95.78%, 2.49%, 12.45%, 93.02%, 92.18%, and 94.67%, respectively; there was no significantly statistical difference between the MSKUS and 3D-CTA evaluation results (χ2 = 0.34, P &gt; 0.05) and they have higher correlation (K = 0.82) and excellent consistency (K = 0.769). Therefore, it is concluded that the MSKUS has a good validity in evaluating the lateral hyperplasia of cervical vertebrae joints. The study results of this paper provide a reference for further research on the application of MSKUS in real-time dynamic detection of Luschka joint hyperplasia of cervical vertebrae.

Long-term direct and indirect economic burden associated with osteoporotic fracture in US postmenopausal women

SummaryThe study examined long-term direct and indirect economic burden of osteoporotic fractures among postmenopausal women. Healthcare costs among fracture patients were substantial in first year after fracture and remained higher than fracture-free controls for 5 years which highlight needs for early detection of high-risk patients and continued management for osteoporosis.IntroductionThis study compared direct and indirect healthcare costs between postmenopausal women and demographically matched controls in the 5 years after incident non-traumatic fracture, and by fracture type in commercially insured and Medicare populations.MethodsTwo hundred twenty-six thousand one hundred ninety women (91,925 aged 50–64 years; 134,265 aged ≥ 65 years) with incident non-traumatic fracture (hip, vertebral, and non-hip non-vertebral (NHNV)) from 2008 to 2017 were identified. Patients with fracture were directly matched (1:1) to non-fracture controls based on demographic characteristics. Direct healthcare costs were assessed using general linear models, adjusting for baseline costs, comorbidities, osteoporosis diagnosis, and treatment. Indirect costs associated with work loss due to absenteeism and short-term disability (STD) were assessed among commercially insured patients. Costs were standardized to 2018 US dollars.ResultsOsteoporosis diagnosis and treatment rates prior to fracture were low. Patients with fracture incurred higher direct costs across 5-year post-index compared with non-fracture controls, regardless of fracture type or insurance. For commercially insured hip fracture patients, the mean adjusted incremental direct healthcare costs in years 1, 3, and 5 were $59,327, $6885, and $3241, respectively. Incremental costs were lower, but trends were similar for vertebral and NHNV fracture types and Medicare-insured patients. Commercially insured patients with fracture had higher unadjusted indirect costs due to absenteeism and STD in year 1 and higher adjusted indirect costs due to STD at year 1 (incremental cost $5848, $2748, and $2596 for hip, vertebral, and NHNV fracture).ConclusionsA considerable and sustained economic burden after a non-traumatic fracture underscores the need for early patient identification and continued management.

An Anomaly in Vertebrates’ Evolution as Limit of Human Evolution

During several years we have studied the so-called “intracranial system”, that is the system constituted by a container, rigid and not expandable (skull and dura mater), and by non-compressible contents, represented by the brain parenchyma, cerebrospinal fluid, and blood. We studied this system in different animal models, <i>in vitro</i> in a physical model, and in patients. While the circulatory system is different in the various types of vertebrates, less complex in fishes and more complex in birds and in mammalians, the intracranial system is always the same, constituted by the same things, skull, dura mater, subarachnoid spaces, ventricles, parenchyma, blood, and cerebrospinal fluid. All these things follow the same rule, that is the Monro-Kellie doctrine. In other words, there is an exact balance between the blood flow inlet and the blood flow outlet for each cardiac cycle. This constitutes, for each instant considered, the constancy of the intracranial blood volume. This phenomenon is always the same in all the species examined: this fact forced us to ask what the real significance of this system in the evolutive field was. Why the circulatory system follows the laws of the evolution, from less to more complexity, and the intracranial system seems to escape from these same laws? The question has two answers: the first relates to the function of this system. Being to be enclosed in a rigid box permits to minimize the necessity of more space to compensate the spontaneous increase in blood volume due to the dilation of the arteries during the systolic period of the cardiac cycle. The second one is relative to the human birth: the birth of a human being is not possible without the protection furnished by a rigid skull.

Acupuncture-based treatments on cervical spondylosis of vertebral artery type

Acupuncture-based treatments on cervical spondylosis of vertebral artery type

On some features of the structure of the dorsal and sympathetic nodes in birds

The question of the finest structure of nerve cells over the past years has attracted the attention of many histologists and neuropathologists. In this direction, very interesting studies have already been carried out in various types of invertebrates and vertebrates, and only regarding birds, as far as I know, there has not yet been more or less detailed research on this topic. True, in the works of some authors there are brief references on this issue, but there are very few such references and these works relate almost exclusively to the period preceding the last studies by Nissl and other authors, who shed new light on the structure of nerve cells.

Safety and utility of implant removal after percutaneous osteosynthesis of type A thoracolumbar and lumbar fracture

IntroductionImplant removal represents almost one third of all elective surgeries in orthopedics. There is no consensus regarding the time and need to remove the implants after vertebral fractures consolidation. The aim of this study was to assess the clinical and radiological effects of implant removal in patients with vertebral type A fracture who underwent a percutaneous intervention. Material and MethodsWe evaluated 31 patients (mean age of 38.2±7.5 years) with thoracolumbar vertebral fracture (T11-L5) who underwent implant removal surgery after 24 months of fracture first surgery by a percutaneous approach. Inclusion criteria focused on patients’ preferences. The radiological parameters included fracture angle, initial sagittal index, compression percentage, degree displacement and deformation angle. The clinical variables included Visual Analog Scale and Oswestry Disability index. ResultsThere was no significant correction loss after removal surgery (before surgery and after 24 months): Fracture angle (16.8±0.5 vs 17.1±0.5; p˃0.05), initial sagittal index (12.5±0.5 vs 12.7±0.5; p˃0.05), kyphotic deformity (17.5±0.6 vs 17.8±0.7; p˃0.05), compression percentage (35.6±0.8 vs 36.0±0.7; p˃0.05), degree displacement (4.4±0.4 vs 4.5±0.3; p˃0.05) and deformation angle (23.0±0.7 vs 23.1±0.7; p˃0.05). Patients who presented symptoms before the surgery showed better Visual Analog Scale (1.2±0.6 pre vs 0.6±0.3 post, p˂0.05) and Oswestry Disability Index (20.1±6.8 pre vs 15.7±0.5, p˂0.05). No complications were reported. DiscussionRoutine implant removal in patients undergoing a percutaneous approach to vertebral type A fracture is a safe technique and is associated with good clinical results without loss of radiological correction. In addition, this procedure could be indicated to patients who manifest symptoms since there is a clinical-radiological benefit. Level of proofII; A multicenter prospective cohort study.

Fish complement C4 gene evolution and gene/protein regulatory network analyses and simulated stereo conformation of C4–MASP–2 protein complex

Complement C4 is a central protein by acting as pivotal molecule in the activation of the complement system. More than a decade ago, C4 gene duplication had been found in several species including fish, revealing the evolutionary origin of C4 gene. However, the evolutionary pattern and systematic function of C4 are still limited. In this study, C4 D and H types in different species groups were completely diverged. The codon usage of C4 H type in higher vertebrates were much closer to their own genome environment, in contrast to lower vertebrates, suggesting that the evolution may provide the dynamic for homogeneous codon usage between specific gene and genome. Multiple C4 sequence alignment showed that the sequences were conserved among different species. However, sequence similarity was obviously different between species C4 D and H type. Negative selection pressure was found on C4 gene evolution and it may be one of the possible reasons for the sequence broad similarity and conservation among interspecies. Proteins from C4 protein–protein interaction (PPI) network were enriched in more hematopoiesis, infections, diseases and immune–related pathways in human than zebrafish. The result suggested that the functional complexities of C4 isotypes are distinct in species from different evolutionary positions. The simulated C4 protein structures between human and grass carp shared structural similarity and the stereo structures of grass carp C4–MASP–2 protein complexes were further simulated according to a study of human. These results suggested that the interaction between C4 and MASP–2 proteins may also exist in grass carp. Our results can provide an insight for the evolutionary process of C4 and better understanding to the potential mechanism of interaction between C4 and MASP–2 in fish species.