Objective To study the effectiveness of artificial disc replacement for cervical diseases and the adjacent segment degeneration. Methods Between January 2008 and October 2010, 39 cases of cervical spondylosis underwent cervical disc replacement. Of them, there were 20 males and 19 females with an average age of 45.7 years (range, 32-60 years)and an average disease duration of 30 months (range, 1 month to 10 years), including 26 cases of cervical myelopathy, 11 cases of nerve root cervical spondylosis, and 2 cases of mixed cervical spondylosis. Single level disc lesion was observed in 27 cases while bi-level lesion in 12 cases. Prestige disc prosthesis was used in 9 patients, Prodisc-C prosthesis in 4 patients, and Discover disc prosthesis in 26 patients. The neurological functional recovery was assessed after operation by Japanese Orthopaedic Association (JOA) score. The range of motion of replaced segment and adjacent segments was measured (Cobb angle), and Kellgren’s X-ray assessment was used to evaluate the degree of adjacent segment degeneration. Results The operation was successfully performed in all cases, with primary heal ing of all the incisions. All patients were followed up from 12 to 36 months with an average of 23.1 months. JOA score was significantly improved at last follow-up when compared with preoperative score (P lt; 0.05), and no significant difference was observed in the Cobb angle of replaced segment and adjacent segments between pre- and postoperation (P gt; 0.05). According to the Kellgren’s X-ray assessment, degeneration of the adjacent segments occurred in 5 cases at last follow-up, including 3 cases of degeneration from grade 0 to grade 1 or 2, 1 from grade 1 to grade 2, and 1 from grade 2 to grade 3, with a degeneration rate of 12.8%, but no significant difference was found in degeneration degree when compared with preoperative value (χ2=1.793，P=0.406). No degeneration of adjacent segments occurred in 32 patients at 15 months after operation. Conclusion Artificial disc replacement has a good effectiveness in treating cervical spondylosis, which can maintain the range of motion of the replaced segment and adjacent segments, and may have a protective effect on adjacent segment discs.
ObjectiveTo explore the expression and clinical significance of plasma soluble podoplanin (sPDPN) in patients with colorectal cancer (CRC). MethodsTCGA-READ, TCGA-COAD datasets were obtained to compare expression level of PDPN mRNA in CRC tissues and adjacent tissues, and to explore the relationship between expression of PDPN mRNA and the prognosis of CRC patients. A total of 85 CRC patients (CRC group) underwent surgery in the Second Affiliated Hospital of Xuzhou Medical University from November 2020 to December 2022, and 100 healthy volunteers from the hospital were collected as a control group to detect the expression levels of plasma sPDPN of the two groups, and exploring the relationship between sPDPN expression and the clinicopathological characteristics of the CRC patients. The ROC curves of sPNPD, sugar antigen 199 (CA199) and carcinoembryonic antigen (CEA) were drawn simultaneously, and the predictive value of sPDPN for CRC was explored by logistic regression model. ResultsThe results of TCGA dataset showed that expression level of PDPN mRNA was upregulated in CRC tissues compared with adjacent tissues/paired adjacent tissues (P<0.05), and patients with high expression level of PDPN mRNA had better prognosis than low expression patients (P=0.045). The expression level of sPDPN was (3.50±1.77) ng/mL in CRC group, which was higher than (1.95±0.46) ng/mL of the control group (P<0.01). The expression level of sPDPN was higher in CRC patients at Ⅲ+Ⅳ clinical stage (P=0.026) and N1–2 stage (P=0.049). Compared with CA199 and CEA, sPDPN had the highest area uncer curve value of 0.882 (0.832, 0.932), and was an risk predictor of CRC [OR=14.769, 95%CI (5.867, 37.174), P<0.001]. ConclusionThe sPDPN is highly expressed in the plasma of CRC patients and has a certain clinical utility for diagnosis of CRC, and evaluation of clinical staging and lymph node metastasis.