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OBJECTIVE@#To investigate the effectiveness of sagittal top compression reduction technique in the treatment of thoracolumbar vertebral fractures.@*METHODS@#A retrospective analysis was conducted on the clinical data of 59 patients with thoracolumbar vertebral fractures who met the selection criteria and were admitted between November 2018 and January 2022. Among them, 34 patients were treated with sagittal top compression reduction technique (top pressure group), and 25 patients were treated with traditional reduction technique (traditional group). There was no significant difference in baseline data between the two groups ( P>0.05), including gender, age, fracture segment, cause of injury, AO classification of thoracolumbar vertebral fractures, thoracolumbar injury classification and severity (TLICS) score, American Spinal Injury Association (ASIA) grading, surgical approach, preoperative vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, segmental kyphosis angle, visual analogue scale (VAS) score, and Oswestry disability index (ODI). The operation time, intraoperative blood loss, and incidence of complications between the two groups were recorded and compared. After operation, VAS score and ODI were used to evaluate effectiveness, and X-ray and CT examinations were performed to measure imaging indicators such as vertebral body index, height ratio of the anterior margin of injured vertebra, injured vertebra angle, and segmental kyphosis angle.@*RESULTS@#There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). No complication such as dural sac, nerve root, or vascular injury was found during operation, and all incisions healed by first intention. Patients in both groups were followed up 6-48 months, with an average of 20.6 months. No loosening, breakage, or failure of internal fixation occurred during follow-up. The imaging indicators, VAS score, and ODI of the two groups significantly improved at 1 week and last follow-up when compared to preoperative ones ( P<0.05). At last follow-up, the VAS score and ODI further significantly improved when compared to 1 week after operation ( P<0.05). At 1 week after operation and last follow-up, the vertebral body index, segmental kyphosis angle, injured vertebra angle, and ODI in the top pressure group were significantly better than those in the traditional group ( P<0.05). There was no significant difference in VAS score and height ratio of the anterior margin of injured vertebra between the two groups at 1 week after operation ( P>0.05), but the two indicators in the top pressure group were significantly better than those in the traditional group at last follow-up ( P<0.05).@*CONCLUSION@#The treatment of thoracolumbar vertebral fractures with sagittal top compression reduction technique can significantly improve the quality of vertebral reduction, and is superior to traditional reduction techniques in relieving pain and improving spinal function.
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Humans , Thoracic Vertebrae/injuries , Lumbar Vertebrae/injuries , Retrospective Studies , Blood Loss, Surgical , Treatment Outcome , Pedicle Screws , Spinal Fractures/surgery , Kyphosis , Fracture Fixation, Internal , Fractures, Compression/surgeryABSTRACT
Objective:To investigate the value of serum gastrin 17 (G-17), pepsinogen I (PG I), pepsinogen II (PG II), and programmed cell death protein 5 (PDCD5) in the identification of gastric precancerous state and the diagnosis of early gastric cancer.Methods:A total of 86 patients with early gastric cancer who received treatment at the Marine Police Corps Hospital of Chinese People's Armed Police Force from July 2018 to June 2022 were included in the gastric cancer group. Eighty patients with gastric precancerous states who concurrently received treatment in the same hospital were included in the precancerous state group. An additional 80 partiapants who concurrently received physical examination in the same hospital were included in the healthy group.The value of G-17, PG I, PG II, and PDCD5 in the diagnosis of early gastric cancer was analyzed.Results:The levels of G-17 and PG II in the precancerous state group [(10.87 ± 3.23) pmol/L, (15.78 ± 3.33) μg/L] and gastric cancer group [(18.78 ± 4.10) pmol/L, (21.25 ± 4.48) μg/L] were significantly higher compared with the healthy group [(5.56 ± 1.43) pmol/L, (13.52 ± 3.02) μg/L, F = 362.65, 94.12, all P < 0.05]. The levels of PG I and PDCD5 in the precancerous state group [(79.52 ± 16.62) μg/L, (1.35 ± 0.15) μg/L] and gastric cancer group [(50.06 ± 15.58) μg/L, (0.85 ± 0.13) μg/L] were significantly lower than those in the healthy group [(110.12 ± 30.23) μg/L, (1.60 ± 0.12) μg/L, F = 151.07, 650.56, all P < 0.05)].There were significant differences between the precancerous state and the gastric cancer groups in terms of family history of gastric cancer, consumption of high salt fried foods, alcohol consumption history, and Helicobacter pylori (Hp) infection ( χ2 = 10.39, 4.68, 11.47, 36.49, all P < 0.05). Family history of gastric cancer ( OR = 1.42, 95% CI = 1.03-1.96) and Hp infection ( OR = 3.76, 95% CI = 1.30-10.85) were identified as risk factors for gastric cancer ( P < 0.05). The combination of G-17, PG I, PG II, and PDCD5 had the highest predictive efficiency for early gastric cancer ( P < 0.05), with the area under the receiver operating characteristic curve being 0.982, sensitivity and specificity of 98.84% and 90.00%, respectively. Conclusion:Family history of gastric cancer and Hp infection are risk factors for gastric cancer. Patients with precancerous state and early gastric cancer have elevated serum levels of G-17 and PG II and reduced serum levels of PG I and PDCD5 protein. Combined detection of these four indicators has a high diagnostic value for early gastric cancer.
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In recent years, with the development of neurointerventional techniques, transradial approach (TRA) has been able to meet most needs of neurointerventional procedures. Compared with tranfemoral approach (TFA), TRA can obviously reduce access-site complications, shorten hospital stays and improve patient satisfaction. However, due to the long learning curve, lack of radial-specific catheters, small artery diameter and specific vascular access-site complications, TRA development is relatively slow, and relevant domestic and foreign studies are still at initial stage. Therefore, this article mainly focuses on the anatomy, advantages and limitations, approaches of radial artery, and discuss the safety and feasibility of TRA in neurointerventional diagnosis and treatment, in order to provide more references for neurointerventionalists.
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During pandemic of corona virus disease 2019 (COVID-19), emergency orthopedic trauma is commonly seen. It is particularly important to ensure the emergency treatment quality of orthopedic trauma but avoid cross-infection between doctors and patients. The double-buffered diagnosis and treatment mode refers to the model of patients first undergoing medical observation in the comprehensive buffer ward and the inpatient buffer rooms of various disciplines after admission to confirm the exclusion of COVID-19 and then receiving specialist diagnosis and treatment. The authors summarize the experiences of using the double-buffered diagnosis and treatment model in the Department of Orthopedics, Renmin Hospital of Wuhan University during the prevention and control of COVID-19 pandemic so as to provide a reference for treatment of orthopedic patients.
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Ependymal stem cells (EpSCs) are dormant stem cells in the adult spinal cord that proliferate rapidly and migrate to the site of injury after spinal cord injury (SCI). Although they can differentiate into neurons under appropriate conditions in vitro, EpSCs mainly differentiate into astrocytes in vivo. Our previous study confirmed that alternatively polarized macrophages (M2) facilitate the differentiation of EpSCs towards neurons, but the detailed mechanism remains elusive. In the present study, we found that M2 conditioned medium could upregulate the expression of Sirtuin 2 (SIRT2) in EpSCs in vitro through the BDNF/TrkB-MEK/ERK signaling pathway. As an important deacetylase, SIRT2 deacetylated stable Ac-α- tubulin (Acetyl alpha Tubulin) in microtubules and thus promoted EpSC differentiation into neurons. The present study provides a theoretical basis and a new way to improve neural recovery, such as regulating the growth and differentiation of EpSCs by increasing the proportion of M2 cells in the local microenvironment or upregulating the expression of SIRT2 in EpSCs.
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Objective To investigate the effect of tissue engineered cartilage on the repair of artic ular cartilage defects in rabbits with calcium alginate gel (CAG) loaded transforming growth factor beta 3 (TGF-β3) and compounded with adipose mesenchymal stem cells (ADSCs).Methods The ADSCs were separated and cultured in subcutaneous fat of New Zealand white rabbits.The full-thickness articular cartilage defect model was made at the patellar groove by exposure of the femoral ankle joint.ADSCs were implanted into calcium alginate scaffolds loaded with TGF-β3 to construct tissue-engineered cartilage and transplanted into rabbit articular cartilage defects.The animals were divided into four groups:control group (injected with sterile isotonic saline),CAG group (injected with CAG),ADSCs + CAG group (injected with CAG loaded with ADSCs),TGF-β3 + CAG group (injected with CAG loaded with TGF-β3) and TGF-β3 + ADSCs + CAG group (injected with CAG loaded with TGF-β3 and ADSCs).At the end of 12 weeks,the repair of articular cartilage defects was observed by gross observation,hematoxylin-eosin (HE) staining,immunohistochemical staining of safranin-O and type Ⅱ] collagen,and the scoring method developed by In ternational Association of Cartilage Repair (ICRS) Histological score.Results The cartilage repair effect of TGF-β3 + ADSCs + CAG group was better than that of other groups,not only the neonatal tissue and the surrounding normal tissue closely,but also the secretion of extracellular matrix and normal tissue similar.The ICRS scores of each group were (7.06 ±+ 0.18) score,(7.15 + 0.23) score,(7.45 + 0.25) score,(7.47 + 0.24) score and (15.78 ±+ 0.24) score.That of TGF-β3 + ADSCs + CAG group was better than that of other groups,the difference was significant (P ＜ 0.05).Conclusions CAG loaded with TGF-β3 and combined with ADSCs has a good effect in repairing articular cartilage defects in rabbits,and is a structural repair.
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Objective To investigate the changes of TLR4 and nuclear factor kappa B(NF-κB) levels in peripheral blood mononuclear cells(PBMC) of the patients with ulcerative colitis(UC) and its possible pathogenesis mechanism.Methods In our hospital from January 2014 to January 2015,30 cases of UC were selected as the observation group,and other 10 individuals undergoing healthy physical examination in this hospital were selected as the control group.Flow cytometry was used to detect the positive expression rate of TLR4 on surface of peripheral blood CD14+ mononuclear cells.The levels of TLR4,MyD88,NF-κB(P65)mRNA expression were detected by RT-PCR.Western blot was adopted to detect the levels of TLR4,MyD88,NF-κB(P65) protein.Results The positive expression rate of TLR4 on the surface of peripheral blood CD14+ mononuclear cells in the observation group was significantly higher than that in the control group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) B mRNA and protein in the control group were significantly lower than those in the observation group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) protein were positively correlated with the severity of UC.Conclusion The levels of TLR4 and NF-κB in PBMC of the patients with UC are significantly increased,clinic can judge the UC development degree by detecting TLR4 and NF-κB levels.
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Objective To evaluate the effect of free NgR-modified bone marrow stromal cell (BMSC) transplantation on axon regeneration in rats after spinal cord injury. Methods Genes encoding free NgR protein were cloned and transduced into BMSCs at passage 3 using a lentivirus vector.Indirect immunofluorescence was used to detect the expression of free NgR protein.Meanwhile a spinal cord contusion model was established in 36 adult Sprague-Dawley rats at the T10 segment.The rats were then divided randomly into an experimental group and a control group.NgR + BMSCs were transplanted into the injured site 1 week post-trauma in the experimental group.BMSCs were also transplanted at the same time into the control group.Expression of free NgR at the injury site was detected by immunohistochemical staining at 1 week post-transplantation.The functional recovery of both groups was evaluated at 4 and 6 weeks post-transplantation.Longitudinal sections of the spinal cord were studied for axon regeneration using horseradish peroxidase staining. Results Expression of free NgR was found in the cell plasma of BMSCs by indirect immunofluorescence post-transfection.Positive immunohistochemical staining for NgR was found at the transplant site in the experimental group 1 week post-transplantation.Better axon plasticity could be observed in the experimental group.The Basso-Beattie-Bresnahan scoring of the experimental group was significantly higher than that of the controls at both observation times. Conclusions Free NgR-modified BMSCs can prompt injured axons to regenerate and thus to promote the recovery of neurological function.This might provide a new strategy to treat spinal cord injury.
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This study aims to investigate the preventive role and potential mechanisms of blocking extracellular HMGB1 function on doxorubicin induced cardiac injury. Mice were treated with HMGB1 blocker glycyrrhizin 1 h before and one time every day (intraperitoneal, 10 mg per mouse) after doxorubicin injection, and sacrificed on the day 14 after doxorubicin challenge. Cardiac function was evaluated by echocardiography and hemodynamic measurement. Myocardial inflammation and collagen deposition were analyzed by immunohistochemistry and picrosirius red staining. The interaction of HMGB1 and TLR2 was assessed by co-immunoprecipitation and confocal microscopy. The protein contents of HMGB1, MyD88, p65NF-kappaB and phospho-p65NF-kappaB were measured by Immunoblot. Compared with mice treated with saline, doxorubicin treatment led to an upregulation in HMGB1 expression. Blocking HMGB1 activity with glycyrrhizin protected mice against cardiac dysfunction, inflammatory response, and cardiac fibrosis induced by doxorubicin challenge. Glycyrrhizin inhibited the interaction of HMGB1 and TLR2, and blocked the downstream signaling of TLR2. In conclusion, blocking HMGB1 protected against doxorubicin induced cardiac injury by inhibiting TLR2 signaling pathway.
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<p><b>OBJECTIVE</b>To study the toxicity-attenuating effect and the dose-toxicity relationship of rhubarb by processing based on correspondence.</p><p><b>METHOD</b>The effects of different processed materials of rhubarb on the hepatic and renal functions of mice was researched in a way of parallel comparison, as well as the chemical alteration induced by processing was observed. Correspondence analysis, a kind of multivariate statistical analysis, was performed to explore the dose-toxicity relationship of processed materials of rhubarb.</p><p><b>RESULT</b>No obvious toxic effect was found in mice after single intragastric administration of crude drug of rhubarb at dosage of 76 g x kg(-1), while some lesions to liver and kidney tissues were observed in mice after repeated administration of rhubarb and its processed materials for 14 days at the same dosage. In the correspondence analysis diagram, it could be deduced that there was definite dose-toxicity relationship of processed rhubarb as the distance between trial groups and control group increased along with the dosage and the toxicity. The distance of the processed rhubarb showed as the following consequence: crude drug of rhubarb > vinegar-processed rhubarb > alcohol-processed rhubarb > steamed rhubarb > carbonized rhubarb > Qingning pian. Theerefoer, the toxicity of processed rhubarb was much lower than that of crude drug and the extent of toxicity attenuation was related to the processing intensity. Meanwhile, the toxicity-attenuating effect of processed rhubarb was related to the decline of the contents of both anthraquinone glycosides and tannins, and the former was contributed remarkably to toxicity.</p><p><b>CONCLUSION</b>The toxicity-attenuating effect of processed rhubarb was verified in this study and the toxicity of steamed rhubarb attenuated notably while the pharmacological substances degraded little. The correspondence analysis would be useful to assess the pharmacological and toxic effects with multiple indexes of traditional Chinese medicines.</p>
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Animals , Female , Male , Mice , Chemistry, Pharmaceutical , Methods , Dose-Response Relationship, Drug , Drugs, Chinese Herbal , Chemistry , Toxicity , Kidney , Liver , Random Allocation , Rheum , ChemistryABSTRACT
AIM To investigate the anticonvulsive action of supercritical CO2 ethanol extract from Pinellia Pedatisecta Schott(SEE-CO2PP). METHODS The rat convulsive model was induced by penicillin localized injected in rat cortex. The effects of SEE-CO2PP on the latency of seizure and changes of convulsive behaviors were investigated. The latency of epileptiform discharge, and frequency and amplitude of highest wave in cortex and hippocampus were recorded by using RM6240C multichannel physiological signal collection and analysis recorder. At the same time, the contents of glutamic acid (Glu), aspartic acid (Asp), glycine (Gly) and γ-aminobutyric acid (GABA) in hippocampus were determined with high performance liquid chromatography. RESULTS SEE-CO2PP 15 and 30 g·kg-1, ig, prolonged the latent period of seizure and weakened the extent. SEE-CO2PP also prolonged the latent period of epileptiform discharge, reduced the frequency and decreased amplitude of the highest wave in both cortex and hippocampus. Moreover, SEE-CO2PP increased the content of GABA in hippocampus, but the levels of Gly,Asp and Glu had no obvious changes. CONCLUSION SEE-CO2PP inhibits the epileptiform discharge and convulsive behaviors of convulsive model rats, which suggests SEE-CO2PP has anticonvulsive action.
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BACKGROUND: Studies in recent years have suggested the involvement of chemoattractant cytokines in the recruitment of peripheral blood cells to the injured spinal tissue. Monocyte chemoattractant protein-1(MCP-1) belongs to the CC-type chemokines and is capable of specific chemotactic attraction of the macrophages.OBJECTIVE: To observe MCP-1 expression in the serum of patients with acute spinal cord injury and explore the possible mechanism of secondary spinal cord injury.DESIGN: A non-randomized and controlled concurrent pilot study.SETTING and PARTICIPANTS: Eight patients with acute incomplete spinal cord injury and 8 with compression fracture of the spine were treated in the Department of Orthopaedics, Renmin Hospital of Wuhan University during the period from January 2001 to December 2002. Another 8 healthy subjects were included as the controls.METHODS: In the next morning after hospitalization, totally(8-10) mL of fasting peripheral venous blood was collected from the patients and the serum separated for determination of MCP-1 level with enzyme-linked immunosorbent assay(ELISA) . Serum MCP-1 level was also measured in the healthy subjects in the same manner.MAIN OUTCOME MEASURES: Serum level of MCP-1 in each group.RESULTS: Serum levels of MCP-1 in the healthy subjects, patients with compression fracture of the spine and those with acute incomplete spinal cord injury were(124 ± 15), (184 ±21) and(428 ± 11) ng/L, respectively, with significant differences between any two groups( P ＜ 0.01 ).CONCLUSION: MCP-1 may induce secondary inflammation by recruiting inflamnatory cells to the injury site and thus aggravate the spinal cord injury.
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BACKGROUND: Available evidence suggests that following spinal cord injury, obvious reduction of Mg2+ level occurs in both the serum and the injured spinal cord, which has significant effects on cell membrane permeability, vascular regulation as well as secondary spinal cord injury.OBJECTIVE: To investigate the protective effects of magnesium sulfate (Mg2SO4) administered via intraperitoneal injection on the injured spinal cord of SD rats.DESIGN: A randomized controlled experiment.SETTING: Department of Orthopedics, Renmin Hospital of Wuhan UniversityMATERIALS: Forty-eight adult male SD rats were allocated randomly into experiment group and control group with 24 rats in each.INTERVENTIONS: The experiment was conducted in the Laboratory of Department of Orthopedics, Renmin Hospital of Wuhan University from April to August 2002. One hour after establishment of spinal cord injury models, the rats in the controlled group were injected intraperitoneally with normal saline, while those in the experiment group were given intraperitoneal injection of 300 mg/kg Mg2SO4. At each time point of 4, 8 and 24 hours after the treatment, 6 rats were selected from each group for measuring free Ca2+ concentration in the cells at the site of injury with spectrofluorometer . The activities of superoxide dismutase (SOD) in the spinal cord were detected by means of xanthine oxidation and thiobarbituric acid was used to determine the concentration of malondialdehyde (MDA). Lowered SOD activity and decreased MDA level were considered to suggest the protective effect of Mg2SO4 against spinal cord injury. Inclined plane test was used to assess the spinal cord function at 8, 24 hours and 1 week after the injury, in which the rat was made to stand on an inclined plate covered by a piece of rubber and the plate was inclined gradually until the rat was no longer able to stay in the original position for 5 s, and the inclination of the plate was recorded. The test was performed 3 times for each rat and the plate inclinations were averaged. An increased inclination indicated improvement of the spinal cord function.MAIN OUTCOME MEASURES: ① Intracellular Ca2+ concentration at the injury site. ② Changes in SOD activity and MDA concentration in the spinal cord. ③ Results of spinal cord function evaluation of the rats.RESULTS: Intracellular Ca2+ concentration at 8 and 24 hours after the injury was significantly lower in the experimental group than in the control group [(376.5±36.2)×10-9vs (425.9±32.7)×10-9 mol/L and (316.3±13.9)×10-9vs (350.2±29.4)×10-9 mol/L, respectively, P ＜ 0.05]. Compared with the control group at each time point, MDA concentration was significantly decreased, while SOD activity of SOD was increased in the experiment group (P ＜ 0.01). The improvement of spinal cord injury was not obvious in the experiment group and was significantly higher than that in the control group until I week after the injury [(53.3±4.3)° vs (44.3±5.7)°, P ＜ 0.05].CONCLUSION: Intraperitoneal Mg2SO4 injection may significantly lower the concentration of intracellular Ca2+ at the injury site and alters the product of lipid peroxidation, suggesting its neuroprotective effect against spinal injury so as to lighten secondary spinal injury in rats.
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Objective:To measure the expression of the MCP-1(Monocyte Chemoattractant Protein-1) in the serum of patients with acute spinal cord injury and explore the possible mechanism of secondary spinal cord injury.Methods:MCP-1 in the serum of patients with acute spinal cord injury,single spine compression and healthy subjects were detected by ELISA irrespectively.The MRI data of these patients were studied at the same time on a blind base.Results:MCP-1 in the serum of patients with acute spinal cord injury was correlated positively with the degree of spinal cord compression,which was elevated markedly(P