Prenatal stress increased Snk Polo-like kinase 2, SCF β-TrCP ubiquitin ligase and ubiquitination of SPAR in the hippocampus of the offspring at adulthood

Exposure to excessive glucocorticoids during fetal development period contributes to later life psychopathology. Prenatal stress decreases dendritic spine density and impair LTP in the hippocampus of rat pups, however, the mechanisms regulating these changes are still unclear.     

The role and safety of the sitting position in instrumented cervical surgery

Placing patients who are undergoing neurosurgical procedures to the cervical spine in the sitting position offers significant advantages. These must be counterbalanced against the risk of venous and paradoxical air embolism. This study addresses the role and safety of the sitting position for instrumented cervical surgery. Twenty-five consecutive patients who underwent instrumented cervical surgery in the sitting position were recruited via retrospective analysis. Complications arising from the surgical procedure – specifically venous air embolism – were recorded, as well as pre- and post-operative haemoglobin levels. The incidence of venous air embolism was 0% (97.5% one-sided confidence interval: 0–13.7%). However, five other complications occurred (incidence rate of 20% with a 95% confidence interval of 6.8–40.7%). With appropriate precautions, screening and specific indications, the sitting position can be safely used in more complex instrumented cervical surgery.     

Limitations of administrative databases in spine research: a study in obesity

Background contextThe use of national inpatient databases for spine surgery research has been increasing. Unfortunately, without firsthand knowledge of each specific database, it can be difficult to judge the validity of such studies. Large databases that rely on administrative data, such as International Classification of Diseases, Ninth Revision (ICD-9) codes, may misrepresent patient information and could thus affect the results of studies that use these data.PurposeThe present study uses obesity, an easily quantified and objective variable, as an example comorbidity to assess the accuracy of ICD-9 codes in the setting of their continued use in spine database studies.Study design/settingA cross-sectional study at a large academic medical center.Patient sampleAll patients spending at least one night in the hospital as an inpatient between April 1, 2013 and April 16, 2013. Obstetrics and gynecology, psychiatry, and pediatric patients were excluded.Outcome measuresProportion of patients for whom ICD-9 obesity diagnosis codes assigned at hospital discharge match chart-documented body mass index (BMI).MethodsThe medical record was reviewed for each patient, and obesity ICD-9 codes were directly compared with documented BMI.ResultsThe study included 2,075 patients. Of 573 “obese” patients (calculated BMI 30–39.9), only 109 received the correct code (278.00), giving this ICD-9 code a sensitivity of 0.19. Of 174 “morbidly obese” patients (calculated BMI >40), only 84 received the correct code (278.01), giving this ICD-9 code a sensitivity of 0.48.ConclusionsUsing obesity as an example, this study highlights the potential errors inherent to using ICD-9–coded databases for spine surgery research. Should a study based on such data use “obesity” as a variable in any analyses, the reader should interpret these results with caution. We further suggest that obesity is likely not the only comorbidity to which these results apply. As database research continues to represent an increasing proportion of publications in the field of spine surgery, it is important to realize that study outcomes can be skewed by data accuracy, and, thus, should not be blindly accepted simply by virtue of large sample sizes.     

Is there an association between external workload and lower-back injuries in cricket fast bowlers? A systematic review

ObjectiveTo examine the level of evidence for an association between external bowling workload and lower-back injuries in cricket fast bowlers.MethodsSix online databases were searched using four sets of keywords (relating to cricket, bowler, lumbar, workload). Risk of bias was assessed using the NIH quality assessment tool, while quality of evidence was assessed according to the Cochrane Back and Neck (CBN) group guidelines.ResultsEight articles were found to fit the inclusion/exclusion criteria. It was found that overall, there was a low quality of evidence amongst the included studies. A high risk of bias was present – both in the measurement of external workload and lower-back injuries.ConclusionThe association between external workload and lower-back injuries has minimal strength. Technological advancements that allow total workload to be measured accurately would potentially allow the association between workload and lower-back injury to be examined more precisely, possibly leading to effective injury prevention interventions in fast bowlers.     

生骨胶囊联合低分子肝素治疗脊柱术后下肢深静脉血栓48例疗效观察

目的 观察生骨胶囊联合低分子肝素对脊柱术后下肢深静脉血栓(DVT)疗效及安全性的影响。方法 选择2015年12月至2016年11月于石家庄市第一医院行脊柱外科手术病人96例作为研究对象,采用随机数字表法将其分为观察组(48例)与对照组(48例)。对照组给予低分子肝素治疗,每天4 100 IU,皮下注射。观察组则在对照组用药治疗基础上加以口服生骨胶囊,5粒/次,3次/天。观察两组临床疗效、DVT发生率、不良反应发生情况以及治疗前后血液流变学、腘静脉内径(POPV)、股浅静脉内径(FSV)等变化情况。结果 观察组总有效95.83%高于对照组77.08%,DVT发生率4.17%低于对照组20.83%,差异有统计学意义(P＜0.05)。治疗后观察组PT、FIB、D-D指标水平较高于治疗前,差异有统计学意义(P＜0.05)。治疗后观察组FIB(4.02±0.46) g/L、D-D(385.24±26.41) μg/L指标水平较低于对照组FIB(4.63±0.51) g/L、D-D(511.61±22.29) μg/L,差异有统计学意义(P＜0.05)。治疗前两组FSV与POPV检测结果对比,差异无统计学意义(P＞0.05);治疗后观察组FSV与POPV较治疗前对比,差异无统计学意义(P＞0.05);治疗后对照组FSV(7.03±1.79) mm与POPV(7.96±1.63) mm显著低于观察组FSV(8.52±1.23) mm与POPV(9.52±1.23)mm,差异有统计学意义(P＜0.05)。治疗期间两组用药不良反应发生率差异无统计学意义(P＞0.05)。结论 生骨胶囊与低分子肝素联合治疗有助于降低脊柱术后下肢深静脉血栓发生率,加速病人术后康复,改善血液流变学,安全性良好,临床普及价值高。     

Estimating lumbar bone mineral density from routine radiographs of the lumbar spine

Summary To evaluate the information content of lateral lumbar films with respect to bone mineral content, we compared reading criteria with values obtained by quantitative computed tomography (CT) of L1 at baseline and after 5 years. The highest correlations with mineral content were found for the criteria overall assessment of the vertebra, vertebral body density versus soft tissue, and amount of trabeculations. These three reading criteria yielded higher correlations with CT scores in subjects with lower body mass index. Changes in mineral content over the 5-year period could not be read adequately, the average difference representing only a loss of about 10% in the study subjects. We conclude that a rough estimate of bone density can be obtained from lateral radiographs which, in the presence of eventual risk factors for osteoporosis, may serve as an additional indication to timely bone densitometry with methods which allow precise short-term follow-up measurements.     

青海不同鼠疫自然疫源地内7种蚤前胃形态结构光镜研究

应用解剖剥离和光学显微镜研究青海7种染疫蚤前胃形态结构，结果显示两块疫源地内蚤前胃结构相似，外部形态多样。前胃刺末端形态有钩形、吸管形、U字形、舌形、锥形、梭镖形、勺形、指形、刀形等。每刺两侧具有齿，刺齿的分布占刺全长4／5，3／4，1／3，1／2。刺基部形态有四棱形、三角形、长方形、漏斗形、矛形、五棱形、六棱形。人蚤刺粗大、长、骨化深，齿大，占刺长4／5。提示前胃刺形态结构特征可能在鼠疫传播媒介上具有重要意义。     

Dysphagia caused by diffuse idiopathic skeletal hyperostosis

Summary Diffuse idiopathic skeletal hyperostosis (DISH) of the spine is often a hazardous radiological finding. Dysphagia, caused by ossification of the anterior longitudinal ligament, may be one of the most important clinical symptoms disturbing the patient. Diagnosis is done by esophagogram, and cervical decompression restores esophageal function. The case of a successfully operated patient is reported and a short overview of the literature is given.     

mri在椎体骨质疏松和转移瘤压缩性骨折诊断中的应用

目的:探讨椎体骨质疏松和转移瘤压缩性骨折的MRI诊断和鉴别诊断.材料与方法:回顾性分析经临床、病理及随访证实的35例(52个椎体)骨质疏松和48例(60个椎体)转移瘤致椎体压缩性骨折的MRI表现,并分析和记录各种征象.结果:骨质疏松压缩性骨折在T1WI上46.15％(24/52)椎体呈低信号,T2WI上32.69％(17/52)椎体呈高信号.转移瘤压缩性骨折在T1WI上91.67％(55/60)呈低信号,T2WI上95.0％(57/60)椎体呈高信号.骨质疏松压缩性骨折椎体形态以“楔形”和“凹陷型”多见,分别占46.15％(24/52)和44.23％(23/52).转移瘤压缩性骨折中,26.67％(16/60)的椎体为“倒楔形”,扁平型占58.33％(35/60).18个椎体伴随椎弓根骨质破坏和椎旁软组织肿块.结论:骨质疏松和转移瘤致椎体压缩性骨折在MRI上存在多种差别征象,MRI对于二者的鉴别有重要价值.     

脊柱外科患者术后谵妄的临床分析

目的探讨脊柱外科手术患者术后发生谵妄的危险因素和有效防治措施。方法 2007年1月2009年10月应用ICU谵妄诊断的意识状态评估法观察1 835例脊柱外科术后患者。对于发生术后谵妄的患者随机分为治疗组和未治疗组,治疗组于谵妄诊断明确时即静脉注射氟哌利多5mg。结果术后3d,136例发生谵妄,谵妄发生率为7.41%。筛选出术后谵妄的可能高危因素包括高龄、术前合并高血压、术前合并糖尿病、术中出血量〉600mL、手术时间〉4h、术中应用激素、术后电解质紊乱和低氧血症、术后疼痛。发生谵妄的患者中,治疗组（68例）住院时间短于未治疗组（68例）,差异有统计学意义（P〈0.05）。结论高龄,术前合并高血压、糖尿病,术中出血量〉600mL,手术时间〉4h,术中应用激素,术后电解质紊乱、低氧血症及疼痛是脊柱外科手术患者术后发生谵妄的主要高危因素。氟哌利多治疗术后谵妄有效。