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Objective:To investigate the relationship of osteoporotic vertebral body compression fracture(OVCF)with multifidus muscle and intervertebral disc degeneration in the lower lumbar spine and the lumbar-pelvic parameters in elderly women.Methods:Clinical data of a total of 108 elderly women with osteoporosis were retrospectively analyzed.They were divided into the fracture group(n=56)and the control group(n=52)according to the presence of vertebral body compression fractures.Age, body mass index(BMI)and bone mineral density(BMD)were collected in two groups.The angle of pelvic incidence(PI), angle of pelvic tilt(PT), low lumbar lordosis(LLL)and sacral slope(SS)were measured by the standing lumbar lateral X-ray photography.The degree of degeneration of intervertebral disc L 3-S 1 and multifidus muscle were detected by using the lumbar MRI.These parameters were compared between the two groups. Results:The age, BMI and BMD had no significant difference between the two groups( P>0.05). The degree of intervertebral disc degeneration of L 3-L 4 and L 4-L 5 was statistically significant higher in the fracture group than in the control group( Z=-4.656 and -2.675, P=0.000 and 0.007), while the degree of intervertebral disc degeneration of L 5-S 1 had no statistically significant difference between the two groups( Z=-1.784, P=0.075). There were statistically significant higher multifidus muscle degeneration of L 3-L 4 and L 4-L 5 in the fracture group than in the control group( Z=-3.248 and -4.073, P=0.001 and 0.000), while no significant difference between the two groups in multifidus muscle degeneration of L 5-S 1( Z=-1.096, P=0.282). No statistically significant differences were found in PI, PT, SS and LLL between the two groups( t=1.162, 0.827, -0.082 and -0.677, P=0.248, 0.410, 0.935 and 0.500). Conclusions:The degeneration of intervertebral disc and multifidus muscle of L 3-L 4 and L 4-L 5 is positively correlated with OVCF in elderly women.
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Objective To analyze the multi-component,multi-target and multi-pathway mechanism of peony leaf in the treatment of cervical cancer based on network pharmacology. Methods The possible active components and targets in peony leaf were screened and predicted by pharmacological database and analysis platform of traditional Chinese medicine system,and the related targets of cervical cancer diseases were ob-tained by searching Therapeutic Target Database and others. The potential targets for the disease regulation were screened according to the active components of peony leaves entering blood,then the key target names and the pathways involved in the treatment of peony leaf were selected according to the network topological characteristic parameters. Then,the enrichment analysis was carried out by using ClueGO software plug-in. Results There were 194 target sites for 11 blood entry components in peony leaves. Finally,171 signal pathways were ob-tained,and 21 key pathways related to cervical cancer were obtained after the wide pathway was excluded,such as estrogen signaling pathway,neurotrophin signaling pathway and so on. Conclusion Peony leaves may play a vital role in the treatment of cervical cancer by acting on inflammatory,metabolic,immunological,endocrine and cell cycle related protein targets and pathways.
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OBJECTIVE:To provide reference for strengthening the safety of the combination use of CYP3A4 inhibitors with statins in clinical treatment. METHODS:30 cases per month(totally 300 cases)(the hospitalization time was more than 10 days) discharged from the cardiology department of a third-level class A hospital during Jan. to Oct. 2013 were selected randomly,and statistical analysis was made into general information of patients,whether to use statins and CYP3A4 inhibitor,and whether to monitor safety indicators of liver and kidney function and creatine kinase. RESULTS:Totally 291 patients were treated with statins with a total use rate of 97%,including 265 cases of atorvastatin and 11 cases of simvastatin. The CYP3A4 inhibitors were com-bined with amlodipine,diltiazem,verapammy,amiodarone,Ginkgo biloba leaf,fenofibrate and clarithromycin,etc.,and 162 (59%) patients were given the combination use of simvastatin or atorvastatin with CYP3A4 inhibitors. But the liver and kidney function,creatine kinase and other safety indicators were not monitored by laboratory examination during medication. CONCLU-SIONS:Atorvastatin and simvastatin are used commonly in patients with cardiovascular disease,and the combination use rate with CYP3A4 inhibitor is relatively higher and needs long-term medication,drug dosage should be limited according to the direction of instructions and the adverse reactions induced by drug interactions should be noticed to strengthen medication monitor and education for patients.
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Objective To research the forming technology of Chuansu Jiuxin dropping pills.Methods The pills were prepared by dropping method.The forming technology of the pills was optimized by single factor test and orthogonal experiment by using the amount of PEG4000 to PEG6000, ratio of drug-matrix ,dropping temperature and speed as factors and with pill weight RSD,the time limit of collapse and appearance quality of the pills as evaluation indexes.Results Using PEG 4000 and PEG 6000 as matrix with the ratio of 4:1 and dimethyl silicone oil(100 mPa· s)as refrigerant at 5~15℃,the optimized parameters for the forming technology were as follows:the ratio of herbal extract to matrix was 1:3,the dropping temperature was at 90 ℃ and the dropping speed was 35 drops per minute,dropping from 4 cm.Conclusion The optimized technology is sample and feasible,and can provide a reference for industrial production of Chuansu Jiuxin dropping pills.
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Objective To observe the fusion rate by using cage filled with osteophyte in anterior cervical disectomy and fusion.Methods From January 2010 to July 2012,81 patients receiving anterior cervical disectomy and spine fusion underwent treatment with cages containing exclusively autologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space.There were 52 males and 29 females,aged from 55 to 78 years,average 64.1 years in this study.46 patients received one-level fusion,and 35 patients received two-level fusion respectively.Patients were followed up at 3 months,6 months and 1 year after operation.The fusion was evaluated by X-ray film and reconstructive CT.Results The total fusion rate after 3 months of operation was 76.5％ (62/81),the one-level and two-level fusion rate were 78.3％ (36/46) and 74.3％ (26/35),respectively.The total fusion rate after 6 months of operation was 93.8％ (76/81),the one-level and two-level fusion rate were 95.7％ (44/46) and 91.4％ (32/35),respectively.The total fusion rate was 100％ (81/81) after 1 year of operation.No statistically significant difference in fusion rate was found between the two groups.Conclusions The method of using cage filled with osteophyte can acquire ideal fusion rate in one-and two-level anterior cervical disectomy,fusion and plate fixation.
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Objective To discuss the feasibility and the effects of percutaneous vertebroplasty (PVP) in the treatment of the osteoporotic compression fracture in theupper and middle thoracic vertebrae.Methods The study included 101 patients.55 cases were treated with PVP (observation group) and 46 cases were treated with conservative treatment (control group).The clinical efficacy of those two different treatment methods was evaluated by the changes of VAS score,ODI score,vertebral height and Cobb angle before versus after treatment.Results VAS and ODI scores at 48 hours and 6 weeks after treatment was significantly lower in observation group than in the control group (all P＜0.05).Although there was no significant difference in VAS and ODI scores between the two groups after 6 months of treatment (both P＞0.05),the anterior and middle vertebral height was decreased and Cobb angle of spine was increased in control group as compared with observation group (both P＜ 0.05).Conclusions PVP is an effective and safe method in the treatment of osteoporotic vertebral compression fractures in upper and middle thoracic vertebrae.The short-and long-term evaluation indexes are better in PVP than in conservative treatment.But the surgery should be proceeded under highly clear perspective equipment by the surgeons with highly level professional technology.Because the surgery is highly risky,surgery should be proceeded with cautions.
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Objective To explore the feasibility and clinical efficacy of modified transforaminal lumbar interbody fusion for the treatment of lumbar spinal stenosis with lumbar instability in the elderly.Methods Retrospective study was done on 45 elderly patients diagnosed as lumbar spinal stenosis with lumbar instability treated by modified transforaminal lumbar interbody fusion from June 2011 to December 2012.There were 25 males and 20 females aged from 65 to 78 years [mean (70.64.0) years].The operation time,blood loss,and complications were recorded and analyzed.The visual analog scale (VAS) score,and Japanese Orthopaedic Association (JOA) score were used to assess clinical outcomes before and 3 months after treatment and at the last follow-up.According to the criteria of Brantigan-Steffe,intervertebral fusion was evaluated.Results The operation of 45 patients was successful,and there were no severe complication.The average operative time was (126 23) min,(range,100～ 185 min),and the average amount of blood loss was (272±89) ml (range,180-550 ml).There was no injury of nerve root,dural tear,or deep infection.All patients were followed up for 12 months to 30 months with an average of (20.6±5.8) months.The VAS score of low back pain was decreased from (4.8 ± 1.7) before operation to (1.6 ± 0.5) at 3 months after operation and (1.3±0.3) at last follow-up.The VAS score of leg pain was decreased from (6.7±1.6) before operation to (1.2±0.5) at 3 months after operation and (0.6±0.3) at last follow-up.The JOA score was increased from (13.2±4.9) before operation to (23.8±4.0) at 3 months after operation and (24.1 4.2) at last follow-up.There were significant differences in the VAS score and JOA score between pre-and post-operation (F=68.35,98.58,89.73,all P＜0.05),but no significant difference between 3 months after operation and final follow-up (all P ＞ 0.05).We observed no pedicle screw loosening,breaking,orany pullingout of intervertebral fusion cage.All patients showed evidence of fusion in each operated segment according to the criteria of BrantiganSteffe.Conclusions Modified transforaminal lumbar interbody fusion has the advantages including less invasion,sufficient decompression,and less interference to neural structures,and it may provide an ideal surgical method for lumbar spinal stenosis with lumbar instability in the elderly.
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AIM: The 6-minute walk test (6MWT) has been acknowledged as a simple and feasible study method of evaluating cardiorespiratory function, motor ability and quality of life in all testees. This study was designed to evaluate the value of 6MWT in patients with chronic obstructive pulmonary disease (COPD). METHODS: ①Fifty patients diagnosed with COPD were enrolled from Department of Respiratory Medicine in the Second Clinical Medical College of Jinan University from January 2001 to December 2006, including 34 males and 16 females, with a mean age of (70.1?8.9) years; and 62 patients with other diseases admitted in Department of Respiratory Medicine were taken as controls, including 30 males and 32 females, with a mean age of (66.5?10.1) years. Informed consents were obtained from all testees.②All patients were tested with 6MWT, lung function and MRC dyspnea scale, and the results were conducted for t test, ROC curve analysis, linear correlation analysis and multiple stepwise regression analysis. Pearson correlation coefficient was also calculated. RESULTS: All the testees were involved in the result analysis.①6MWT results: Compared with control group, the degression fraction of blood oxygen saturation was significantly higher and 6-minute walk distance was significantly shorter in the COPD patients (P