Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid / 中国骨伤

OBJECTIVE@#To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs).@*METHODS@#The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed.@*RESULTS@#Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved (0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up.@*CONCLUSION@#VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.

Study on early screening of high saponin ginseng lines / 中国中药杂志

The study aims at screening the specific bands by PCR, quickly and accurately evaluating the quality of ginseng seeding, accelerating the process of ginseng breeding. Based on the correlation of genetic differences and saponin content between individuals, a pair of specific primer GC1 was screened by PCR. According to the experiment by L16 (45) orthogonal test, a PCR system most suitable for GC1 was established, which came out total 25 μL reaction system containing DNA 2.60 mg•L⁻¹, Mg²⁺ 1.44 mmol•L⁻¹, dNTP 0.19 mmol•L⁻¹, primer 0.32 μmol•L⁻¹ and Taq enzyme concentration 0.076 U•μL⁻¹. By comparing the saponin content and the GC1 PCR electrophoretogram of samples, the ginseng, with 1 200 bp specific band by PCR of GC1, the contents of 9 monosodium saponins and their additions were higher than others, which provided a reliable method for accelerating the process of ginseng breeding. The sequence was sequenced and 99% homologous to glycerol-3-phosphate dehydrogenase.

A 10-year-review (1998-2007) on 3449 cases of osteoporotic hip fractures: trend of hospitalization and inpatient casts / 中华流行病学杂志

Objective The purpose of this retrospective research was to analyze the trend of hospitalized prevalence in the past 10 years (1998 -2007) and to estimate resource utilization associated with osteoporotic hip fractures, including hospital length of stay and inpatient costs in Guangzhou,China. Methods 3449 patients aged 50 years and older,hospitalized for primary diagnose of hip fractures in both hospitals in the past ten years were included in our study. Completed data was obtained retrospectively from the hospital medical records. Clinical parameters such as sex-specifics, hospital length of stay, inpatient costs and the constitutions of the inpatient costs were analyzed with multiple statistics methods and regrcssions Results Over the 10-year study period, the number of hospitalizations for hip fractures increased with a curve model. Male and female ratio was 1:1.95 with an average age of the patients as76.32±9.52 years old. Average hospital length of stay was 23.59±13.48 days with no significant difference between males and females, years of admission and the different diagnoses. The number of hospitalization went to the top at the age of 70 to 79 years old (38.45%), followed by 80-89 years old(33.08 % ). Femoral neck fractures was significantly more than that of inter-trochanteric fractures in those patients aged 50 to 79 years (P<0.01 ) but less than those intertrochanteric fractures aged 90 years and older (P<0.05). Average inpatient costs is about 23.52±17.00 thousand Yuan (RMB) (femoral neck fractures is about 25.09±17.62 thousand Yuan and intertrochanteric fracture is 21.44±15.92 thousand Yuan) of which treatment costs (included implants, materials used in the theatre and routinely care of the wound) contributed 52 %, pharmacy intervention 25 %, operation 6 %, ward expenditure 5 %, radiology and physical investigation 5 %, and chemistry test 4 %. The inpatient cost went to a peak at the age of 60-69 years old and were significantly correlated with the hospital length of stay. The coat increased every year in the past 10 years by 6.18%. Conclusion These results emphasized that the growing economic impact arising from the inpatient treatment of ostcoporotic hip fractures and most of which related to treatment cost(include implants, materials used in the theatre and routinely care of the wound), and drugs and always correlated to length of hospital stay. Cost control should be paid more attention to the implants and drugs.

Association of 86 bp variable number tandem repeat polymorphism of interleukin-1 receptor antagonist gene with lumbar disc disease / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the association of 86 bp variable number tandem repeat (VNTR) polymorphism of interleukin-1 receptor antagonist (IL-1Ra) gene with lumbar disc disease and intervertebral disc degeneration.</p><p><b>METHODS</b>The 86 bp VNTR polymorphism of IL-1Ra gene was analyzed with PCR and electrophoresis for 81 patients with lumbar disc disease and 101 volunteers without sciatica (control). The grade of intervertebral disc degeneration was determined with magnetic resonance imaging, and the association of 86 bp VNTR polymorphisms with lumbar disc disease and intervertebral disc degeneration in those younger than 45 years was assessed.</p><p><b>RESULTS</b>The presence of 86bp VNTR polymorphisms of IL-1Ra gene was detected in both patients with lumbar disc disease and the control subjects. The distribution of 86 bp VNTR polymorphisms of IL-1Ra gene showed no significant difference between the two groups, but the distributions of 1/1, 1/2 and 2/2 or 1, 2 genotypes differed significantly. The current data did not support a significant association between the distribution of IL-1Ra gene 86bp VNTR polymorphism and lumbar disc degeneration.</p><p><b>CONCLUSIONS</b>IL-1Ra gene 86bp VNTR polymorphism is present among Chinese population in association with lumbar disc disease, but not with lumbar disc degeneration.</p>

Effect of interleukin-6 on the chondrocytes in the cartilage endplate of rabbits in vitro / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the effect of interleukin-6 (IL-6) on the biological behaviors of the chondrocytes in the cartilage endplate of rabbits.</p><p><b>METHODS</b>Chondrocytes isolated from the cartilage endplate of New Zealand rabbits, verified for their biological characteristics by such means as toluidine blue staining for type II collagen, were treated with IL-6 at different concentrations. The proliferation of the chondrocytes was evaluated by MTT assay at different time points following the treatment, the cell cycle changes were determined by flow cytometry and the changes of aggrecan and type II collagen mRNAs detected by RT-PCR.</p><p><b>RESULTS</b>At the concentrations of 10, 50 and 100 ng/ml, IL-6 did not obviously affect the rate of chondrocyte proliferation. IL-6 at 50 ng/ml resulted in no obvious changes of the cell cycle of the chondrocytes, but significantly decreased the expression of collagen IIa mRNA.</p><p><b>CONCLUSION</b>IL-6 has no effect on the proliferation and cell cycle of the chondrocytes, but at higher concentrations, it inhibits matrix synthesis of the chondrocytes to promote intervertebral disc degeneration.</p>

The application of METRx microendoscopes diskectomy system in the treatment of far lateral lumbar disc herniation / 中华外科杂志

<p><b>OBJECTIVE</b>To introduce the METRx microendoscopes diskectomy system in the treatment of far lateral lumbar disc herniation.</p><p><b>METHODS</b>Fourteen cases of far lateral lumbar disc herniation were operated with METRx from February 1999 to December 2002. Among them, the average age was 49 years old (range 41 - 55 years old), male in 10 cases, female in 4 cases. All cases were single disc herniation; L(4), 5 herniation in 6 discs, L(5)-S(1) herniation in 8 discs; foraminal disc herniation in 6 cases, extra-foraminal disc herniation in 8 cases.</p><p><b>RESULTS</b>All the cases were followed up from 12 to 46 months (average 26.5 months) with the results of excellence in 10 cases, good in 3 cases, fair in 1 case and no failure case. There were no disc infection, dura laceration, nerve root injury and herniation recurrence.</p><p><b>CONCLUSIONS</b>METRx is suitable for far lateral lumbar disc herniation with the advantages of minimal invasive, complete decompression of nerve root and rapid recovery. The correct approach and precise surgical technique are the key points for this operation.</p>

The risk factors and preventive strategies of heterotopic ossification after artificial disc replacement in lumbar spine / 中华外科杂志

<p><b>OBJECTIVE</b>To analyze the risk factors of heterotopic (HO) ossification after total lumbar disc replacement and probe the preventive strategies for it.</p><p><b>METHODS</b>The radiographs and clinical data of 78 discs in 65 patients who received artificial lumbar disc replacement (ADR) from April 1998 to December 2003 were analyzed retrospectively by two radiologists and one orthopaedic surgeon and then postoperative HO were graded according to McAfee system. The bony formations in disc spaces, time of HO were found, and range of motion (ROM) of the operated levels were measured on radiographic films. In addition, the risk factors such as preoperative peri-annulus ossification, bony endplates injuries, and subsided or mal-position of the prostheses were also analyzed by Logistic regression analysis.</p><p><b>RESULTS</b>Postoperative HO was found in 10 spaces of 9 cases. Class I of HO were occurred in 7 patients at means 2.1 years postoperatively with normal range of motion preserved. Three of them turned into class II or III with 10 degrees of mean ROM in the following 2.5 years. Another 2 (2/9) cases with preoperative peri-annulus ossification had bridging trabecular bone (class III) between the endplates and 9 degrees of ROM 2 years after surgery, then turned into class IV at 6 years with 0 degrees and 4 degrees of motion in the operated levels. As the risk factors of HO, preoperative annulus ossification (2 cases), bony endplates injuries (5 cases), mal-positioned prostheses (2 cases) and subsided prostheses (2 cases) were found simultaneity with significant positive relation to HO occurred (P < 0.05).</p><p><b>CONCLUSIONS</b>Factors such as preoperative ossification of annulus, endplate injuries, prosthesis subsided and mal-position would have higher risks to have HO occurred after ADR, but ROM of most affected levels are preserved. Strict control indication and avoid all above risk factors can prevent HO occurring effectively.</p>

Stability of lumbar spine after artificial disc replacement / 中南大学学报(医学版)

OBJECTIVE@#To determine the influence of artificial disc replacement on the stability of lumbar.@*METHODS@#Ten fresh human cadaveric lumbar spine specimens (9 males, 1 female) were tested. The donors had a mean age of 29.3 years old. The segments were fixed on a special testing device mounted in a universal testing machine. Physiological load with a maximum of 10 Nm was applied in the flexion, extension, right and left side bending. Moments were applied in 6 load steps: 0, 2, 4, 6, 8, and 10 Nm. Linearity migration and angle migration were recorded,and the mean flexibility coefficients were calculated. Four procedures of measurement were performed in every specimen: intact segments, segments after discectomy, segments after the artificial disc replacement, and segments after the artificial disc replacement with cutting posterior longitudinal ligament locally.@*RESULTS@#The indexes we calculated of the segments after the discectomy were statistically different compared with the intact segments (P0.05).@*CONCLUSION@#Artificial intervertebral disc replacement could keep the stability of the lumbar functional spine unit. There was no harmful effect of cutting posterior longitudinal ligament locally on the stability of lumbar while performing artificial intervertebral disc replacement when it is necessary.

Design and experiment of the pedicle aiming device for the cervical spine / 中国医学科学院学报

<p><b>OBJECTIVE</b>To probe the accuracy and safety of using an aiming device in the transpedicular fixation of cervical spine.</p><p><b>METHODS</b>Eight cervical specimens were obtained. We used the computed tomography (CT) to scan C3 to C7, measured the medial angle of the pedicle, and determined the location of the pedicle projecting on the articular process. Then we took the oblique X-ray film, measured the cephalic/caudal angle of the pedicle, and determined the location of the pedicle projecting on the articular process. All the specimens were equally divided into two groups. Screws of 2.8 mm x 30 mm, were used. Specimens in one group were inserted with the transpedicular screw manually, while specimens in the other one inserted with the transpedicular screw using a self-designed aiming device that can be modulate at the three dimensions according to the angles of the pedicles.</p><p><b>RESULTS</b>The first group totally had 40 screws from C3 to C7. There were 13 screws in the pedicle, 9 violated the walls of the pedicle but not involved the adjunct structure, and 18 injured the important structure such as spinal cord, verteberal artery, or nerve root. In the other group, only 4 screws violated the walls of the pedicle but not involved the adjunct structure, and the others all in the pedicles. The difference was of statistical significance (P < 0.01).</p><p><b>CONCLUSION</b>In the cervical spine, transpedicular fixation using an aiming device can improve the accuracy and safety during operation.</p>

Comparative study of vertebral body stress distribution following insertion of artificial lumbar intervertebral disc / 中华外科杂志

<p><b>OBJECTIVE</b>To study vertebral body stress distribution of normal disc, post-Diskectomy and artificial disk respectively by 3-D finite element methods, and to explore artificial intervertebral disk insertion impact on stress distribution of vertebral body.</p><p><b>METHODS</b>Models of normal disk, post-Diskectomy, artificial disk and L(4 - 5) motion segment were established by using finite element software MSC. MARK, then vertebral body stress was analyzed through model of L(4 - 5) motion segment respectively.</p><p><b>RESULTS</b>The vertebral body's stress was the smallest after insertion of artificial intervertebral disk (AID), and its stress distributed equally. But the stress under post-discectomy was bigger than the normal disc's in all the motion state. On the other hand, the stress distribution state of the post-discectomy changed while the spine were in different motion state, during the spine flexion, the stress in the anterior of vertebral body was the biggest; While extension, in the posterior and in right flexion state, the biggest stress was in the right. While vertical compression and rotation, the stress distributed equally.</p><p><b>CONCLUSION</b>The results illustrate that the vertebral body's stress is the smallest after insertion of AID in 3 groups of all motion state, and its stress distributes equally. But the level of vertebral body stress increases after discectomy comparing with the normal group. In generally, it is much more reasonable that the disc is reconstructed with AID because of the biomechanical effect on vertebral body made by AID insertion.</p>

Effects of nerve growth factor on treatment of peripheral nerve injuries / 中华创伤骨科杂志

Objective To observe the effects of nerve growth factor (NGF) on the early treatment of pe- ripheral nerve injuries.Methods From April 2004 to October 2005,48 cases with peripheral nerve injury were randomly divided into therapeutic and control groups which were treated with NGF and Vitamin B12 for four weeks respectively.The changes in pain,numbness as well as neurophysiology in the two groups were assessed and compared. Results Compared with the control group,symptoms of pain and numbness in the therapeutic group were significantly alleviated (P＜0.05),the number of regenerative nerves was greater (P＜0.01),latent periods for the recovered sensory and motorial potentials of the regenerative nerves shorter,amplitudes significantly higher (P＜0.05 ),and side effects fewer.Conclusion NGF is safe and effective for early treatment of peripheral nerve injuries.