ABSTRACT
Spinal fusion is a standard operation for treating moderate and severe intervertebral disc diseases. In recent years, the proportion of three-dimensional printing interbody fusion cage in spinal fusion surgery has gradually increased. In this paper, the research progress of molding technology and materials used in three-dimensional printing interbody fusion cage at present is summarized. Then, according to structure layout, three-dimensional printing interbody fusion cages are classified into five types: solid-porous-solid (SPS) type, solid-porous-frame (SPF) type, frame-porous-frame (FPF) type, whole porous cage (WPC) type and others. The optimization process of three-dimensional printing interbody fusion cage and the advantages and disadvantages of each type are analyzed and summarized in depth. The clinical application of various types of 3D printed interbody fusion cage was introduced and summarized later. Lastly, combined with the latest research progress and achievements, the future research direction of three-dimensional printing interbody fusion cage in molding technology, application materials and coating materials is prospected in order to provide some reference for scholars engaged in interbody fusion cage research and application.
Subject(s)
Humans , Intervertebral Disc Degeneration , Intervertebral Disc Displacement , Porosity , Printing, Three-Dimensional , Spinal FusionABSTRACT
Objective:To establish a predictive model and investigate its value in evaluating short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods:Patients with HBV-ACLF admitted to Tianjin Second People's Hospital and Beijing Youan Hospital, Capital Medical University from May 2015 to October 2018 were enrolled. The data of gender, age, laboratory markers at admission, model for end-stage liver disease (MELD) score and clinical complications were collected for analysis. According to the prognosis on 12-week, patients were divided into survival group and death group. Univariate analysis and binary Logistic regression analysis were used to test the risk factors for short-term prognosis of the patients with HBV-ACLF, and a prediction model was established. The accuracy of each index and the established model were verified by the receiver operating characteristic (ROC) curve.Results:A total of 148 patients with HBV-ACLF were enrolled in the study, 91 cases survived while 57 cases died during the 12-week period. The age, total bilirubin (TBIL), neutrophil percentage (NEUT%), hepatitis B surface antigen (HBsAg), MELD score of death group were higher than those of survival group [age (years old): 50.00 (44.50, 55.00) vs. 43.00 (34.00, 53.00), TBIL (μmol/L): 310.30 (240.70, 405.70) vs. 266.40 (184.20, 360.20), NEUT%: (74.52±13.05)% vs. (66.64±12.35)%, lg HBsAg (kU/L): 3.72 (3.29, 3.92) vs. 2.97 (2.49, 3.78), MELD score: 24.27 (19.71, 27.40) vs. 21.88 (18.83, 24.38), all P < 0.05], while albumin (ALB), total cholesterol (CHO), prothrombin activity (PTA) and alpha-fetoprotein (AFP) were lower than those of survival group [ALB (g/L): 29.80 (27.05, 31.05) vs. 30.80 (28.00, 33.90), CHO (mmol/L): 1.98 (1.50, 2.38) vs. 2.49 (2.05, 3.01), PTA: (30.37±7.09)% vs. (32.94±6.03)%, AFP (μg/L): 21.54 (9.28, 51.54) vs. 66.16 (24.50, 152.80), all P < 0.05]. Logistic regression analysis showed that NEUT%, HBsAg and AFP were independent risk factors for short-term prognosis of patients with HBV-ACLF [odds ratio ( OR) was 77.843, 1.439, 0.995, respectively, all P < 0.05]. According to the results of regression analysis, the NHA-ACLF model (NEUT%+HBsAg+AFP) was established. The formula was logit (NHA-ACLF) = -5.441+5.688×NEUT%+0.430×lg HBsAg-0.005×AFP. The area under the ROC curve (AUC) of the NHA-ACLF model for pred HBV-ACLF patients was 0.790, which was better than NEUT% (AUC = 0.696), lg HBsAg (AUC = 0.670), AFP (AUC = 0.703) and MELD score (AUC = 0.640). When the cut-off value of NHA-ACLF model score was 0.459, the sensitivity was 73.7%, and the specificity was 79.1%. Conclusions:NEUT%, HBsAg and AFP are independent predictive indicator for short-term prognosis in patients with HBV-ACLF. Compared with MELD score, the risk assessment model NHA-ACLF has a greater value in predicting the short-term prognosis of patients with HBV-ACLF.
ABSTRACT
ObjectiveTo investigate the clinical features of patients with decompensated liver disease complicated by acute stroke. MethodsA retrospective analysis was performed for the clinical data of 15 patients who were hospitalized in Beijing You'an Hospital, Capital Medical University and diagnosed with decompensated liver disease complicated by acute stroke from January 2011 to December 2015, including medical history, neurological manifestations, treatment, and prognostic features. ResultsAmong the 15 patients, 11 had acute hemorrhagic stroke (AHS), and 4 had acute ischemic stroke (AIS); among the 11 patients with AHS, 4 (36.36%) had hemorrhage caused by brain metastatic tumor of liver cancer (tumor-associated stroke), and 3 (27.27%) were complicated by liver failure. Among the 15 patients, 12 (80%) had disturbance of consciousness as the early neurological manifestation, and the confirmed diagnosis was made based on head CT findings; the treatment mainly included symptomatic support and rehabilitation training. The patients with AHS had poor prognosis. Four (26.67%) of the 15 AHS patients died, among these patients, 2 had liver failure complicated by AHS, 1 had liver cirrhosis complicated by AHS, and 1 had brain metastases complicated by AHS. ConclusionPatients with decompensated liver disease complicated by acute stroke tend to develop the manifestations of AHS, which may be related to a poor clotting mechanism and brain metastasis of liver cancer, and have poor prognosis. Head CT scan should be performed for patients with decompensated liver disease accompanied by neuropsychiatric abnormalities as early as possible to help with early diagnosis and timely treatment.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of herbs-partitioned moxibustion combined with curcumin in the treatment of Crohn's disease. METHODS:80 patients with mild and middle Crohn's disease were randomly divided into ob-servation group and control group with 40 patients in each group. Both groups were given western medicine treatment,such as sul-fasalazine;control group was additionally given curcumin,and observation group were given curcumin combined with herbs-parti-tioned moxibustion. 2 months later,Therapeutic efficacy,ADR and complications of 2 groups were observed after treatment. RE-SULTS:The total effective rate of control group and observation group were 87.50% and 95.00%,respectively;that of observa-tion group was better than that of control group,with statistical significance(P<0.05). The incidence of ADR in control group and observation group were 22.50% and 7.50% respectively;that of observation group was significantly lower than that of control group,with statistical significance(P<0.01). The incidence of complications in control group and observation group were 22.50%and 7.50%,respectively;that of observation group was significantly lower than that of control group,with statistical significance (P<0.01). CONCLUSIONS:The clinical efficacy of herbs-partitioned moxibustion combined with ccurcumin is effective in the treatment of Crohn's disease,and can reduce the incidence of ADR and complications.
ABSTRACT
Objective To evaluate the clinical effects of Qufeng Jiedu Huoluo Decoction in treating the acute stage of periph-eral facial paralysis.Methods 60 cases of acute stage of peripheral facial paralysis were randomly divided into 2 groups,30 cases in each group.The two groups were treated by acupuncture.In addition the treatment group was added with oral Qufeng Jiedu Huoluo Decoction.Results The relief time of posterior auricular pain in the treatment group was shorter than that in the control group (P <0.05);the alleviation situation of the accompanying symptoms after 7 d and the neural function recovery situation after 14 d in the treatment group were superior to those in the control group (P < 0.05);the total effective rate in the treatment group was 93.3%,which was higher than 83.4% in the control group,the difference had statistical significance(P < 0.05).Conclusion Qufeng Jiedu Huoluo Decoction can effectively alleviate the clinical symptoms and signs of acute stage in peripheral facial paralysis.
ABSTRACT
Objective To investigate the changes of extracellular histones during the course of acute liver failure in mice as well as its therapeutic potential.Methods WT mice (C57BL/6) were randomly (random number) allocated to inducing acute liver failure by lethal doses of GalN/LPS injected i.p.Hepatic function,apoptosis of hepatocytes and histological indexes were measured at different intervals following GalN/LPS challenge.The levels of extracellular histones were determined by using ELISA and Western blot methods.Meanwhile,GalN/LPS-treated mice were administered with anti-histone H3 and antihistone H4 neutralized antibodies,respectively.Results Administration of GalN/LPS to mice caused acute liver failure,characterized by significant elevation of plasma ALT levels and massive hepatocyte apoptosis or necrosis.All mice died within 9-12 hours.The levels of nucleosomes and extracellular histones H3 and H4 were increased considerably in a time-dependent manner.The survival rates in GalN/LPS-treated mice were improved remarkably following administration of anti-histone H3 and H4 neutralized antibodies (P =0.037,P =0.025),likely due to the significant inhibition of TNF-production.Conclusions Extracellular histones are an important mediator implicated in the pathogenesis of acute liver failure.Anti-histones show promising potential in the treatment of acute liver failure,which deserves further investigation in the future.