Pathologic features of paraspinal muscle biopsies in patients with adolescent idiopathic scoliosis / 北京大学学报(医学版)

OBJECTIVE@#To characterize the paraspinal muscles of adolescent idiopathic scoliosis (AIS) patients, and to further explore its etiology.@*METHODS@#Clinical records and paraspinal muscle biopsies at the apex vertebra region during posterior scoliosis correction surgery of 18 AIS were collected from November 2018 to August 2019. Following standardized processing of fresh muscle tissue biopsy, serial sections with conventional hematoxylin-eosin (HE) and histochemical and immunohistochemical (IHC) with antibody Dystrophin-1 (R-domain), Dystrophin-2 (C-terminal), Dystrophin-3 (N-terminal), Dystrophin-total, Myosin (fast), major histocompatibility complex 1 (MHC-1), CD4, CD8, CD20, and CD68 staining were obtained. Biopsy samples were grouped according to the subjects' median Cobb angle (Cobb angle ≥ 55° as severe AIS group and Cobb angle < 55° as mild AIS group) and Nash-Moe's classification respectively, and the corresponding pathological changes were compared between the groups statistically.@*RESULTS@#Among the 18 AIS patients, 8 were in the severe AIS group (Cobb angle ≥55°) and 10 in the mild AIS group (Cobb angle < 55°). Both severe and mild AIS groups presented various of atrophy and degeneration of paraspinal muscles, varying degrees and staining patterns of immune-expression of Dystrophin-3 loss, especially Dystrophin-2 loss in severe AIS group with significant differences, as well as among the Nash-Moe classification subgroups. Besides, infiltration of CD4+ and CD8+ cells in the paraspinal muscles and tendons was observed in all the patients while CD20+ cells were null. The expression of MHC-1 on myolemma was present in some muscle fibers.@*CONCLUSION@#The histologic of paraspinal muscle biopsy in AIS had similar characteristic changes, the expression of Dystrophin protein was significantly reduced and correlated with the severity of scoliosis, suggesting that Dystrophin protein dysfunctions might contribute to the development of scoliosis. Meanwhile, the inflammatory changes of AIS were mainly manifested by T cell infiltration, and there seemed to be a certain correlation between inflammatory cell infiltration, MHC-1 expression and abnormal expression of Dystrophin. Further research along the lines of this result may open up new ideas for the diagnosis of scoliosis and the treatment of paraspinal myopathy.

Research progress of Notch signaling pathway in spinal cord injury / 中国骨伤

Spinal cord injury is a severe central nervous system disease, which will cause a series of complex pathophysiological changes and activate a variety of signaling pathways including Notch signaling. Studies have evidenced that activation of the Notch signaling pathway is not conducive to nerve repair and symptom improvement after spinal cord injury. Its mechanisms include inhibiting neuronal differentiation and axon regeneration, promoting reactive astrocyte proliferation, promoting M1 macrophage polarization and the release of proinflammatory factors, and inhibiting angiogenesis. Therefore, it has become a promising therapeutic strategy to inhibit Notch signal as a target in the treatment of spinal cord injury. In recent years, some researchers have used drugs, cell transplantation or genetic modification to regulate Notch signaling, which can promote the recovery of nerve function after spinal cord injury, thereby providing new treatment strategies for the treatment of spinal cord injury. This article will summarize the mechanism of Notch signaling pathway in spinal cord injury, and at the same time review the research progress in the treatment of spinal cord injury by modulating Notch signaling pathway in recent years, so as to provide new research ideas for further exploring new strategies for spinal cord injury.

Advances in olfactory ensheathing cells for the treatment of spinal cord injury / 中国骨伤

Spinal cord injury is a highly disabled neurological disease, and there is still a lack of effective treatments. Studies have proved that olfactory ensheathing cells are one of the ideal seed cells for promoting nerve regeneration after spinal cord injury. Olfactory ensheathing cells can promote axonal germination and elongation through secretion, interaction with astrocytes, regulation of inflammatory reaction, migration characteristics, myelination, anti-oxidation, lipid regulation and other channels. Thus olfactory ensheathing cells play the role of neuroprotection and nerve repair. In recent years, some studies have used bioengineering, tissue engineering, reprogramming and other technologies to enhance the efficacy of olfactoryensheathing cells from different aspects, thereby providing new therapeutic strategies for optimizing the cell therapy of spinal cord injury. This article will summarize the mechanism of olfactory ensheathing cells in repairing spinal cord injury, and review the progress of optimizing strategy of olfactory ensheathing cells in treating spinal cord injury recently, so as to provide new research ideas for the further developing the repair potential of olfactory ensheathing cells and optimize the cell therapy effect of spinal cord injury.

Laryngeal function preserving surgery in hypopharyngeal carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the preservation of laryngeal function hypopharyngeal cancer surgery clinical effectiveness and impact of prognostic factors.</p><p><b>METHODS</b>A retrospective analysis in September 1974 - July 2003 treated 45 cases of hypopharyngeal cancer surgery retain the clinical treatment of laryngeal function effect. Among them there were 23 cases of original pyriform sinus cancer, 13 cases of post cricoid cancer and 9 cases of postero pharyngeal wall cancer. Two cases of preoperative radiotherapy, radiotherapy volume of 40-50 Gy; after 32 cases of radiotherapy, radiotherapy dose of 60-70 Gy. Analysis of impact on survival in patients with risk factors.</p><p><b>RESULTS</b>Forty five cases of preservation of laryngeal function after 88.9% who articulate pronunciation ambiguities were mild 11.1%; 23 cases of tracheostomy tube removal, decannulation rate was 51.1%, all can eat into the cape. Nineteen cases of post-operative complications (42.2%); after 20 cases of cervical lymph node metastasis, accounting for 44.4%. Statistics Kaplan-Meier method in patients with the whole group 5-year survival rate was 53.3%. T1 + T2 and T3 + T4 patients after 5-year survival rates were 66.7% and 43.3%; cN0 and cN1, cN2 group survival rates were 65.2% and 46.7%, 28.6%; pathological differentiation of high, medium and low-group survival rates were 62.3%, 42.1% and 30.8%. Single-factor analysis of survival and whether pre-operative cervical lymph node metastasis and the degree of pathological differentiation (chi2 value of 5.297 and 11.556, P value of 0.021 and 0.003). Multivariate Cox regression analysis showed that the availability of pre-operative cervical lymph node metastasis and pathological effects of the degree of differentiation is an independent risk factor for prognosis (chi2 value of 4.365 and 4.600, P value of 0.041 and 0.032, OR value of 1.151 and 0.610).</p><p><b>CONCLUSIONS</b>Preservation of laryngeal function hypopharyngeal cancer surgery for T1, T2 patients with the best surgical procedures, some of T3, T4 advanced hypopharyngeal cancer can also be used to retain the operation of laryngeal function; and preservation of laryngeal function can not affect the prognosis of patients with.</p>