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BACKGROUND:Percutaneous vertebroplasty technique has become an effective means for clinical treatment of spinal osteoporotic fractures, but there is the risk of bone cement leakage. OBJECTIVE:To explore the clinical effect of percutaneous vertebroplasty with low-dose bone cement for acute osteoporotic vertebral compression fractures. METHODS:From September 2008 to February 2011, 32 patients with osteoporotic compression fractures were treated by percutaneous vertebroplasty. According to the dose of bone cement, the patients were divided into low dose group (2-4 mL) and routine dose group (4-6 mL). In addition, another patients who were hospitalized over the same period for acute osteoporotic compression and could not receive vertebroplasty due to urgical contraindication served as control group. RESULTS AND CONCLUSION:The pain relief and vertebral height restoration rate of the low dose group and routine dose group were significantly better than the control group (P<0.05). The bone cement leakage rate and last fol ow-up incidence of adjacent segment vertebral fractures of the low dose group were also significantly lower than those in the routine dose group (P<0.05). Vertebroplasty with modified low dose bone cement can achieve satisfactory clinical effects, and effectively reduce the leakage of bone cement and incidence of adjacent segment secondary fractures.
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Objective To explore the clinical effect of low-dose bone cement injection in percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures .Methods 41 cases of osteoporotic vertebral compression fractures from February 2009 to February 2012 were treated with percutaneous vertebroplasty .The patients were divided into the low-dose group and the conventional dose group according to the amount of bone cement injection .The postoperative VAS score ,cement leakage rate ,verte-bral height restoration degree and incidence rate of adjacent segment fracture were observed ,evaluated and compared .Results The follow-up period ranged from 3 months to 15 months(average 11 .2 months) .The postoperative pain relief effect in the conventional dose group and the low dose group was similar .The vertebral height restoration rate of the conventional dose group was superior to that of the low-dose group .In the aspects of the bone cement leakage rate and adjacent segment vertebral secondary fracture ,the low-dose group was superior to the conventional dose group .Conclusion In the procedure of percutaneous vertebroplasty ,applying the low-dose bone cement injection can reach the satisfactory clinical effect ,at same time can effectively reduce the complication oc-currence rate of bone cement leakage and adjacent segments secondary fractures .
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Objective To evaluate the accuracy of Cr measurement value from commonly used homogenous detection systems,to investigate the variation among different systems and the corresponding bias of eGFR.Methods According to the CLSI EP14-A2 protocol,commutability of LN24 was validated among 10 enzymatic assays and 1 picrate assay.LN24 included 6 vials of solution with Cr values assigned by IDMS at NIST,and concentrations of Cr for each vial were 68.1,126.9,185.7,244.5,303.2 and 361.9μmol/L LN24 was used to evaluate the accuracy of the included systems and the variation among them,and the assigned values were taken as the target values.eGFR were calculated by MDRD equation using IDMStraced picrate Cr and CKD-EPI equation using enzymatic Cr.Results Commutability was exist among the 11 systems for LN24 detection.Four systems showed bias ＜ 4.4 μmol/L at each level of LN24,two system showed bias ＞4.4 μmol/L at each level of LN24,one system showed a fixed negative bias( -4.2 ±0.7)μ mol/L,the other 4 systems showed diverse bias at different levels.Cr-bias-caused eGFR bias could reach 14.9 ml · min-1 · (1.73 m2) -1 at Cr level of 68.1 μmol/L SD among systems ascended with Cr level (2.6 -6.1 μmol/L) ;CV among systems descended with Cr level(4.0％ - 1.7％ ) ;After the 2 systems with obvious negative bias were removed,SD,CV among systems and eGFR bias decreased obviously.By measuring fresh serum,it was found that Cr bias among enzymatic systems was mostly ＜ 10 μmol/L;that between enzymatic assays and picrate assay was much diffused(from - 15 to 20 μmol/L).When Cr ＜ 100μmol/L,the eGFR difference between result of MDRD equation and that of CKD-EPI equation ranged from - 18 to 40 ml · min-1 (1.73 m2) -1.Conclusions Some enzymatic systems show good accuracy.Difference of Cr value is relatively fixed among enzymatic systems,and comparability can be reached through mathematic way.Un-acceptable difference between picrate assay and enzymatic assays still exists,thus comparability cannot be reached through mathematic way.At low Cr level,bias of Cr and using different equations may lead to significant bias of eGFR.We recommend that clinical laboratory should pay much attention to the accuracy and comparability at low level of Cr,and use uniform equation to calculate eGFR.
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Objective To establish reference methods for the measurement of catalytic activity concentrations of enzymes at 37℃ which have been published by IFCC and evaluate accuracy of reference methods.Methods Six reference methods for the measurement of catalytic activity of enzymes were established with two sets of apparatus systems of PE and Agilent according to International Federation of Clinical Chemistry(IFCC)37℃ reference procedures in two reference labs respectively.The commercial Roche calibrator c.f.a.s was used to monitor the precision of two reference labs as quality control material.Certified Reference Materials(CRMs)represented an efficient tool to assess the analytic performance for the verification of trueness and in two labs.The measurement accuracy of the assays for catalytic activity concentrations of 6 enzymes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),lactate dehydrogenase(LDH),creatine kinase(CK),gamma-glutamyhransferase(GGT),amylase(AMY)]was further verified and validated by international ring trial program.Results The within-laboratory variations of 6 enzymes in both of the reference lab were ranged from 0.5%-1.9%.Their results showed fully agreement with deviation less than 2.1%.The value of CRM was in the tolerant limit and analytic accuracy was verified.The results of four enzymes(ALT,AST,GGT,AMY)lay within (x)±s.However,the result of CK and LDH lay within (x)±2s.Except sample A for the LDH testing,we did not find any deviation variable in the detection of other enzymes.Conclusions The reference methods for the measurement of catalytic activity of enzymes(ALT,AST,LDH,CK,GGT,AMY)at 37℃ in the two labs by use of two sets of apparatus systems of PE and Agilent have been established and these methods showed excellent stability and accuracy.
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BACKGROUND: The cluster of multiple metabolic disorders, namely raised blood pressure, overweight or obesity, raised triglyceride level, reduced high density lipoprotein cholesterol (HDL-C) level were the predictor of type 2 diabetes mellitus (DM). However, similar data especially the old people's data is relatively rare in China.OBJECTIVE: To analyze the relationship between the components of metabolic syndrome (MetS), their clusters and the risk of diabetes among Chinese old population.DESIGN: Cross-sectional study.SETTING :Beijing Institute of Geriatrics, Beijing Hospital, Ministry of Public Health.PARTICIPANTS: The study was carried out from February 2001 until November 2001.4 499 volunteers aged 60 and over were recruited from the academic institutes in Beijing Xicheng, Haidian and Shijingshan districts through cluster sampling methods. They were selected after excluding those who did not have integral data.METHODS: Diabetes was considered when fasting glucose was ≥7.0 mmol/L and was treated for or diagnosed as DM. Chi-square tests were performed to compare the categorical data. Age and sex adjustment were taken in the comparison of the levels of blood pressure, waist circumference (WC), The body mass index (BMI), and lab variables, Multifactor stepwise (backward)Logistic regression analyses were used to select the factors which would have association with the risk of DM. When analyzing the relationship between number of clustering of the traits of MetS and DM, the group without any metabolic abnormalities was set as control group. The dummy variables were set for 1,2,3,4 clusters of metabolic abnormalities. The Logistic regression model was used again to test the relationship and adjusted by age and the family history of DM.MAIN OUTCOME MEASURES: The blood glucose, waist, BMI, blood pressure, triglyceride (TG), HDL-C, and family history of diabetes of subjects.RESULTS: 4 444 people in the mean age of 65±5 were retrieved. 556cases of DM were found in this survey. Age, family history of diabetes,systolic blood pressure, waist and TG were independently associated with the risk of DM, with OR (95%CI) being 1.02 (1.00-1.04), 3.48(2.76-4.39), 1.02 (1.01-1.02), 1.03 (1.00-1.03), 1.13 (1.05-1.21), respectively. When TG was not in the model, HDL-C was also inversely associated with DM (OR=0.67, 95%CI 0.49-0.91). The risk of DM increased with clustering of abdominal obesity, raised blood pressure, raised TG, and reduced HDL-C level in individuals.CONCLUSION: In addition to age and genetic factors, metabolic factors, especially their clusters are closely related to the risk of diabetes. Therefore, the features of MetS are important indicators for the risk of DM in aged people.