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Objective To explore the correlations relating functional MRI ( fMRI) and diffusion tensor imaging ( DTI) parameters with pre-operative neurological status and post-operative outcomes for patients with cervi-cal spondylotic myelopathy ( CSM ) . Methods Eighty-seven CSM patients treated with surgical decompression and 38 healthy counterparts were enrolled as the CSM and control groups respectively. DTI and fMRI of the cervical spine were performed while the subjects performed a finger-tapping task with their right hands before the operation and 6 months later. The control group was evaluated only when they were enrolled. All of the patients were given systematic rehabilitation treatment after the surgery. The Japanese Orthopaedic Association ( JOA) scoring system for CSM was used to evaluate neurological status, and a JOA recovery rate <50％ was defined as a poor recovery. Results Compared with the healthy controls, the pre-operative patients showed significantly higher volume of acti-vation ( VOA) in the left precentral gyrus ( PrCG) , but that had decreased significantly 6 months after the surgery. Before the surgery, the patients' fractional isotropy ( FA) was significantly less than that of the controls, but it had increased significantly 6 months after the operation. There was no difference in VOA in the left postcentral gyrus (PoCG) between the CSM patients and the controls before the surgery. The VOA ratio (PrCG/PoCG), VOA-PrCG, VOA-PoCG and FA were significantly correlated with both the JOA scores and recovery rates. Receiver oper-ating characteristic ( ROC) curve analyses were performed for the predictive ability with respect to surgical out-comes. The largest area under the ROC curve was observed for the VOA ratio (0.805), followed by FA (0.740), and the VOA-PrCG (0.715). The fMRI and DTI showed better potential for predicting functional outcomes than with standard MRI parameters. Multivariate logistic regression revealed that the VOA ratio and FA were independ-ently associated with poor outcomes. Conclusions fMRI and DTI parameters may be more valuable than conven-tional MRI results for neurological assessment and prognosis with CSM patients. They can also provide references for making up rehabilitation plans.
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Objective@#To explore the correlations relating functional MRI (fMRI) and diffusion tensor imaging (DTI) parameters with pre-operative neurological status and post-operative outcomes for patients with cervical spondylotic myelopathy (CSM).@*Methods@#Eighty-seven CSM patients treated with surgical decompression and 38 healthy counterparts were enrolled as the CSM and control groups respectively. DTI and fMRI of the cervical spine were performed while the subjects performed a finger-tapping task with their right hands before the operation and 6 months later. The control group was evaluated only when they were enrolled. All of the patients were given systematic rehabilitation treatment after the surgery. The Japanese Orthopaedic Association (JOA) scoring system for CSM was used to evaluate neurological status, and a JOA recovery rate <50% was defined as a poor recovery.@*Results@#Compared with the healthy controls, the pre-operative patients showed significantly higher volume of activation (VOA) in the left precentral gyrus (PrCG), but that had decreased significantly 6 months after the surgery. Before the surgery, the patients′ fractional isotropy (FA) was significantly less than that of the controls, but it had increased significantly 6 months after the operation. There was no difference in VOA in the left postcentral gyrus (PoCG) between the CSM patients and the controls before the surgery. The VOA ratio (PrCG/PoCG), VOA-PrCG, VOA-PoCG and FA were significantly correlated with both the JOA scores and recovery rates. Receiver operating characteristic (ROC) curve analyses were performed for the predictive ability with respect to surgical outcomes. The largest area under the ROC curve was observed for the VOA ratio (0.805), followed by FA (0.740), and the VOA-PrCG (0.715). The fMRI and DTI showed better potential for predicting functional outcomes than with standard MRI parameters. Multivariate logistic regression revealed that the VOA ratio and FA were independently associated with poor outcomes.@*Conclusions@#fMRI and DTI parameters may be more valuable than conventional MRI results for neurological assessment and prognosis with CSM patients. They can also provide references for making up rehabilitation plans.
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Objective@#To investigate the genetic characteristics of VP1 coding region of enterovirus Coxsackievirus A16(CV-A16) and etiological features of hand, foot and mouth disease (HFMD) in 2017 in Xining city.@*Methods@#The pharyngeal swab specimens were collected from HFMD patients, and detected by real-time reverse transcription-polymerase chain reaction (RT-PCR). For CV-A16 positive samples, virus isolation was performed. Then RNA was extracted, and then VP1 coding region was amplified by RT-PCR. The phylogenetic tree was constructed by comparing with other genotypes and sub-genotypes strains of EV-A71.@*Results@#It was shown that 70 strains of CV-A16 were isolated from 2017 to 2018 in Xining city. In 2017, 10 strains were isolated and divided into two different lineages by phylogenetic analysis, 3 strains of B1a and 7 stains of B1b. In 2018, 60 stains were isolated, which were all belong to B1b.@*Conclusions@#B1a and B1b of CV-A16 are prevalent in Xining city from 2017 to 2018, in which B1b is the prominent isolates.
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Objective@#To observe the clinical effect of hyperbaric oxygen therapy on cervical spondylotic myelopathy (CSM) in the peri-operative period, and to explore its neural mechanism.@*Methods@#Eighty patients who underwent surgical decompression for CSM were randomly divided into a hyperbaric oxygen group (n=40) and a control group (n=40). Both groups received cervical laminoplasty and systematic rehabilitation treatment after the surgery, while the hyperbaric oxygen group was additionally provided with hyperbaric oxygen therapy in the peri-operative period. The patients′ neurological status was evaluated using Japanese Orthopaedic Association (JOA) scores. Both groups received conventional MRI and diffusion tensor imaging (DTI) before and 6 months after the surgery.@*Results@#After the surgery, both groups gained significant improvement in their average JOA score, with the improvement of the hyperbaric oxygen group significantly greater than in the control group. Pearson correlation analysis showed that the average pre-operative JOA score was significantly correlated with the anisotropic fraction (FA) and the apparent dispersion coefficient (ADC) of the compressed spinal cord. Six months after the surgery such correlation still persisted. During the six months, significant increase was observed in the average FA and significant decrease in the average ADC in both groups, with the average FA of the hyperbaric oxygen group (0.726±0.087) significantly higher at the end of the 6 months than that in the control group. The average ADC (1.148±0.079)×10-3 mm2/s) was significantly lower.@*Conclusions@#DTI′s quantitative indicators can objectively show changes in the microstructure and pathological state of spinal cords. Exposure to hyperbaric oxygen may relieve ischemia and hypoxia of the spinal cord, promoting the repair of injured neurons and accelerating the regeneration of nerve fibers.