Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological bi...Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.展开更多
目的:总结评价耳穴贴压对神经根型颈椎病(CSR)的护理疗效,以便为中医护理提供参考。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国生物医学文献服务系统、万方数据库、维普数据库和中国知网,搜集有关耳穴贴...目的:总结评价耳穴贴压对神经根型颈椎病(CSR)的护理疗效,以便为中医护理提供参考。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国生物医学文献服务系统、万方数据库、维普数据库和中国知网,搜集有关耳穴贴压治疗CSR的随机对照试验(RCT),检索时限为建库至2022年7月。参考Cochrane风险偏倚评估工具对文献质量进行评价,并进行Meta分析。结果:共纳入16项研究,1391例患者。结果显示,耳穴贴压可以提高CSR治疗效果,差异具有统计学意义[OR=3.59,95%CI(2.41,5.33),Z=6.32,P<0.00001];降低CSR患者的疼痛[MD=–1.39,95%CI(–1.81,–0.98),Z=6.57,P<0.00001];提高CSR患者的颈椎功能[MD=5.12,95%CI(4.25,5.98),Z=11.58,P<0.00001];减轻CSR患者颈浅部肌肉疼痛[MD=–1.24,95%CI(–1.30,–1.18),Z=42.68,P<0.00001]。结论:现有证据表明,耳穴贴压对CSR治疗有效,可降低颈椎疼痛,提高颈椎功能,减轻颈浅部肌肉疼痛感,但由于本研究文献质量普遍不高,未来仍需要高质量的RCT研究进一步验证。展开更多
基金supported by Hunan Provincial Key Research and Development Program,No.2021SK2002(to BW)the Natural Science Foundation of Hunan Province of China(General Program),No.2021JJ30938(to YL)。
文摘Degenerative cervical myelopathy is a common cause of spinal cord injury,with longer symptom duration and higher myelopathy severity indicating a worse prognosis.While numerous studies have investigated serological biomarkers for acute spinal cord injury,few studies have explored such biomarkers for diagnosing degenerative cervical myelopathy.This study involved 30 patients with degenerative cervical myelopathy(51.3±7.3 years old,12 women and 18 men),seven healthy controls(25.7±1.7 years old,one woman and six men),and nine patients with cervical spondylotic radiculopathy(51.9±8.6 years old,three women and six men).Analysis of blood samples from the three groups showed clear differences in transcriptomic characteristics.Enrichment analysis identified 128 differentially expressed genes that were enriched in patients with neurological disabilities.Using least absolute shrinkage and selection operator analysis,we constructed a five-gene model(TBCD,TPM2,PNKD,EIF4G2,and AP5Z1)to diagnose degenerative cervical myelopathy with an accuracy of 93.5%.One-gene models(TCAP and SDHA)identified mild and severe degenerative cervical myelopathy with accuracies of 83.3%and 76.7%,respectively.Signatures of two immune cell types(memory B cells and memory-activated CD4^(+)T cells)predicted levels of lesions in degenerative cervical myelopathy with 80%accuracy.Our results suggest that peripheral blood RNA biomarkers could be used to predict lesion severity in degenerative cervical myelopathy.
文摘目的:探讨行颈椎前路手术患者术后脊髓硬膜外血肿(spinal epidural hematoma,SEH)的发生率和危险因素。方法:回顾性分析2013年3月至2022年2月因颈椎病于北京大学第三医院择期行颈椎前路手术患者的临床资料,将术后出现SEH的患者作为SEH组,将术后未出现SEH的患者以4∶1的比例随机纳入非SEH组,匹配条件为相同术者、相同性别、相同手术年份和相似年龄(±5岁)。比较两组患者的一般状况、术前合并症、抗凝或抗血小板药物使用情况、术前凝血功能和血小板计数、美国麻醉医师协会体格情况分级、颈椎病分型、术前改良日本骨科学会评分和颈部残障指数评分、手术方式、手术节段、手术节段后纵韧带骨化、手术时间、失血量、术后引流量、术前与术后苏醒期间平均动脉压、住院时间和住院费用等,通过二元Logistic回归筛选出术后发生SEH的独立危险因素,并用受试者工作特征曲线及其曲线下面积(area under curve,AUC)评价指标的准确性。结果:共有85例患者纳入研究,其中SEH组共17例,非SEH组68例。17例SEH患者均接受了血肿清除术,所有患者均成功治疗并出院。椎体次全切除术(OR=7.247;95%CI:1.962~26.766;P=0.003)和术后苏醒期间最高平均动脉压增高(OR=1.056;95%CI:1.002~1.113;P=0.043)是导致SEH的危险因素,其AUC分别为0.713(95%CI:0.578~0.848)和0.665(95%CI:0.51~0.82)。SEH患者的住院时间更长(P<0.001),住院费用更高(P=0.035)。结论:椎体次全切除术和术后苏醒期间最高平均动脉压增高是颈椎前路手术患者出现术后SEH的危险因素,应在围术期对高风险患者进行密切观察。
文摘目的:总结评价耳穴贴压对神经根型颈椎病(CSR)的护理疗效,以便为中医护理提供参考。方法:计算机检索PubMed、EMbase、Cochrane Library、Web of Science、中国生物医学文献服务系统、万方数据库、维普数据库和中国知网,搜集有关耳穴贴压治疗CSR的随机对照试验(RCT),检索时限为建库至2022年7月。参考Cochrane风险偏倚评估工具对文献质量进行评价,并进行Meta分析。结果:共纳入16项研究,1391例患者。结果显示,耳穴贴压可以提高CSR治疗效果,差异具有统计学意义[OR=3.59,95%CI(2.41,5.33),Z=6.32,P<0.00001];降低CSR患者的疼痛[MD=–1.39,95%CI(–1.81,–0.98),Z=6.57,P<0.00001];提高CSR患者的颈椎功能[MD=5.12,95%CI(4.25,5.98),Z=11.58,P<0.00001];减轻CSR患者颈浅部肌肉疼痛[MD=–1.24,95%CI(–1.30,–1.18),Z=42.68,P<0.00001]。结论:现有证据表明,耳穴贴压对CSR治疗有效,可降低颈椎疼痛,提高颈椎功能,减轻颈浅部肌肉疼痛感,但由于本研究文献质量普遍不高,未来仍需要高质量的RCT研究进一步验证。
