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<p><b>OBJECTIVE</b>To determine the tricuspid annular plane systolic excursion (TAPSE) using M-mode echocardiography, and to evaluate the right ventricular systolic function in patients with pneumoconiosis.</p><p><b>METHODS</b>One hundred and eighty-three patients with pneumoconiosis were enrolled as subjects, and one hundred and ninety-nine healthy volunteers were used as controls. According to the types of ventilation dysfunction, patients were divided into four groups: normal type, obstructive type, restrictive type, and mixed type. In the apex four-chamber sections, the displacement of tricuspid annular plane on the right ventricular free wall side was measured from end-diastole to end-systole using M-mode echocardiography.</p><p><b>RESULTS</b>The average TAPSE in the pneumoconiosis group was significantly lower than that in the control group (18.61 ± 3.08 vs 22.38 ± 3.03 mm, P < 0.01). Along with the progression of pneumoconiosis, the TAPSE values in patients with stage I, II, and III pneumoconiosis were significantly decreased compared with those in the control group (P < 0.01). The TAPSE values in patients diagnosed with normal, obstructive, restrictive, and mixed types of pneumoconiosis in pulmonary function tests were all significantly lower than those in the control group (P < 0.01). Among all patients, patients with mixed type of pneumoconiosis had the most significant reduction in the TAPSE.</p><p><b>CONCLUSION</b>The TAPSE is substantially decreased in patients with pneumoconiosis and further decreased along with the progression of pneumoconiosis. Measurement of the TAPSE is an easy way to evaluate the right ventricular systolic function in patients with pneumoconiosis.</p>
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Humans , Case-Control Studies , Echocardiography , Pneumoconiosis , Systole , Tricuspid Valve , Ventricular Function, RightABSTRACT
ObjectiveTo establish a new biomechanical test for evaluating biomechanical properties of femoral metaphysis in ovariectomized rats.MethodsTwenty-five-month-old female Sprague-Dawley rats were randomly divided into ovariectomized (OVX) group and the sham-operated (Sham) group (n=10).Twelve weeks after operation,femur BMD and histomorphometry of distal femur were detected.Furthermore,femur biomechanical parameters were determined by diaphysis three-point bending test and a new designed metaphysis bending test.The relationships between the biomechanical parameters and BMD or bone histomorphometry were assessed with Pearson correlations.ResultsThe femur BMD,bone histomorphometrical indexes(％Th.Ar,Tb.N,Tb.Th),and biomechanical parameters(maximum load,yield load and stiffness) of OVX group significantly decreased compared with Sham group.In metaphysis bending test,the mean difference of the maximum load(Fmax),yield load(Fy) between group OVX and Sham were significant higher than that in diaphysis three-point bending test.Positive correlations between biomechanical parameters and femur BMD or bone histomorphometry indexes were observed in both the diaphysis bending and metaphysis bending test.The biomechanical parameters in the metaphysis bending test showed stronger correlations with BMD and bone.ConclusionFemur metaphysis bending test could be used to evaluate the biomechanical properties of osteoporosis.When compared with diaphysis bending test,femur metaphysis bending test is more sensitive in evaluating the change of biomechanical properties of femur in osteoporotic rats.
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ObjectiveTo compare the clinical effect of posterior circumferential fusion with versus without intertransverse process fusion on lumbar instability in aged patients. MethodsThe elderly with lumbar instability were treated with the posterior instrumented circumferential fusion technique in 80 cases. Among 58 patients followed up for at least 2 years, 28 cases (group A)underwent posterior circumferential fusion with intertransverse process, while 30 cases (group B)without intertransverse process. X-ray examination was used before and 1, 3, 6, 12 and 24 months after operation to evaluate the fusion condition of the bone graft, and visul analogue scale (VAS) and Oswestry disability index (ODI) questionnaire were applied to assess the pain of center back and leg,and the conventional activity.ResultsThe operation time and blood loss were more in group A[(185.3±56.6) min and (376.3±92.9) m1] than in group B [(146.4±46.3) min and (234.3±64.5)ml (t=12.37, 37.49, P＜0.01)]. All the 58 cases were followed for at least 2 years. The 27 cases (96.4％) of group A and 28 cases (93.3％) of group B got bone fusion (x2 =0.004, P＞0.05).There were marked differences in the VAS of center back at 1 and 3 months after operation between the 2 groups (t=3.178, 2.158, both P＜0.05), while no difference at the other 3 time point. VAS about the leg pain and the ODI showed no differences between group A and B after operation (all P＞0.05). ConclusionsFor the lumbar instability in the elderly, the posterior circumferential fusion with or without intertransverse process fusion can achieve a similar high rate of fusion and satisfactory clinical results,andtheposteriorcircumferentialfusionwithoutintertranaverseprocess is recommended for less trauma.
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Objective To analyze and evaluate the effect of posterior circumferential fusion for treatment of the mechanical instability of lumbar spine, and discuss the relative merits,indications and contraindications in this procedure. Methods Two hundred and two patients with mechanical instability of lumbar spine treated by the posterior instrumented circumferential fusion technique from January 2001 to January 2007. One hundred and thirty-two patients were selected who were treated with only one segment fusion and followed up for at least 1 year, of them 97 patients suffered lumbar spondylolisthesis, 35 patients suffered degenerative lumbar instability. X-ray was used to evaluate the fusion condition of the bone graft, and VAS and ODI questionnaire were applied to assess the pain of back and leg,and the conventional function. Results All patients were followed up for 12-84 months, averaged (43±23) months,125 patients got bone fusion, accounted for 94.7%(125/132). The VAS of low back pain was (6.71 ± 1.31) points before operation, while (3.20 ± 1.14) points after operation (P < 0.05) ,and the VAS of leg pain was (8.33 ± 1.78) points before operation,while (4.31 ± 1.15) points after operation (P< 0.05). The ODI was (68.6 ± 14.7) % before operation, while (13.6 ± 1.5) % after operation (P < 0.05). Conclusions Posterior circumferential fusion is a positive and excellent treatment for the mechanical instability of lumbar spine. With its merits, the high fusion rate and good clinical results can be received.
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BACKGROUND:Antedor canulated screw has been considered an ideal method to treat odontoid fracture.OBJECTIVE:To compare the biomechanical properties of different anterior screws.DESIGN,TIME AND SETTING:A randomized contrast study was performed at the Biomechanics Laboratory of Southern Medical University from March to September 2006.MATERIALS:Double-thread canulated screws and single-thread canulated screws were made of titanium alloy and provided by Shuangyang Medical Apparatus Co.,Ltd.,Suzhou.METHODS:A total of head-neck complexes (C0-C3) which were collected from 20 corpses were maintained in formaldehyde for less than 3 months;thereafter,the muscles and ligaments were removed to obtain the axis specimens so as to make type Ⅱ odontoid fracture models.The fracture samples were individually treated with double-thread and single-thread canulated screws,with 10 samples for each group.MAIN OUTCOME MEASURES:The shear stiffness and the maximum resistance of the two kinds of screw were tested in this study.RESULTS:The shear stiffness of the double-thread screw group was significantly higher than the single-thread screw group (P＜0.01 );however,there was no significant different in the maximum resistance between the two groups (P＞0.05).CONCLUSION:Double-thread canulated screws have a strong biomechanical stability for treating odontoid fracture;therefore,the first choice of the internal fixation should be double-thread canuiated screws for patients with osteoporosis or those who are susceptible to expanded screw pathway during surgical procedures.
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BACKGROUND:Hydroxyapatite (HA) artificial bone,as bone grafting substitute,would not cause inflammatory reaction or immunological rejection and possesses good biocompatibility after transplantation into human body.It is a novel implant material with bone conduction ability.OBJECTIVE:To investigate the efficacy of HA artificial bone in bilateral open-door posterior cervical expansive laminoplasty and to make a comparison with autogenous bone.DESIGN,TIME AND SETFING:A retrospective case analysis was performed at the Department of Spine Surgery,Hungpuyuan Branch,the First Affiliated Hospital of Sun Yat-sen University from March 2001 to December 2008.PARTICIPANTS:Seventy patients with cervical spondylosis complicated by compression in 3 or more segments or by cervical stenosis and additional fifteen patients with cervical stenosis complicated by cervical trauma were included in this study.METHODS:A bilateral open-door posterior cervical expansive laminoplasty was performed,in which,23 patients received autogenous bone transplantation (autogenous bone group) and 62 patients underwent HA artificial bone transplantation (HA group).MAIN OUTCOME MEASURES:① Japanese Orthopaedic Association (JOA) score pdor to and after surgery,surgery time,and intraoperative bleeding.② HA artificial bone-host biocompatibility.RESULTS:All eighty-five patients were followed up for more than 3 months.There was no significant difference in JOA scores no matter prior to or after surgery between the autogenous bone and HA groups (P＞0.05).The surgery time averaged 85.2 minutes (range 65-110 minutes) in the HA group and averaged 116.4 minutes (range 75-150 minutes) in the autogenous bone group.The intraoperative bleeding averaged 210 mL (range 130-400 mL) in the HA group and averaged 260 mL (range 170-500 mL) in the autogenous bone group.There were no material-host response and other severe complications found in each group,except HA artificial bone fragmentation in 3 patients from the HA group.CONCLUSION:HA artificial bone yields good efficacy and causes fewer complications in bilateral open-door posterior cervical expansive laminoplasty;in addition,it requires less time for surgery and causes less bleeding.
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Objective To compare the biomechanical properties of mono-segTnent pedicle instru-mentation and its combination with bone cement fixation in treatment of thoracolumbar fractures. Meth-ods Eight fresh specimens of calf spines ( T11 -L3 ) were used for development of incomplete burst frac-ture models at the vertebral body of L1. Mono-segment pedicle instrumentation and its combination with vertebroplasty were respectively applied in each specimen subsequently to restore spinal stability. A cyclic loading with pure moment of 4 Nm was applied to specimens, with load frequency of 0.5 Hz for 2 000 cy-cles. Range of motion (ROM) at flexion/extension, left/right lateral bending and left/right axial rotation of the fixated segment at different status of intact, injury, fixation and cyclic loading was determined by spinal three-dimensional instability test system. Results ROM after treatment with two fixation tech-niques and that at different directions after cyclic loading were distinctly smaller than that of intact and fractured models (P <0.05 ). Under mono-segment pedicle instrumentation combined with bone cement fixation, ROM at flexion, extension, lateral bending and axial rotation was 0.40°, 0. 53°, 0.86° and 0.55° respectively and that after cyclic loading was 0.10°, 0.07°, 0.19° and 0.08°respectively, which were all lower than those of monosegmental fixation, especially at flexion and axial rotation, with statisti-cal difference (P <0.05 ). Conclusions Both fixation techniques can provide instant stabihty of the fractured spine and have good fatigue resistance effect. However, mono-segment pedicle instrumentation is inferior to mono-segment pedicle instrumentation plus bone cement fixation in treatment of fractured verte-bral body at flexion and axial rotation.
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Pretreatment with brain-derived neurotrophic factor (BDNF) reduces ischemic damage after focal cerebral ischemia, and bone marrow mesenchymal stem cells(MSCs) were reported to ameliorate functional deficits after stroke in rats. Here we investigate the synergistically therapeutic effects of BDNF gene-modified MSCs on cerebral infarction. We transfected MSCs with the BDNF gene using a lentivirus-based system and investigated whether the BDNF-modified MSCs contributed to improved functional recovery in a rat transient middle cerebral artery occlusion (MCAO) model. Compared to untreated rats, rats that received both MSCs and BDNF-MSCs showed significantly more functional recovery. The difference in modified neurological severity score(mNSS) was statistically significant (P < 0.001). Recovery was better in BDNF-MSCs than in MSCs (P < 0.001). At the second week and second month after the systemic delivery of blank vector-modified MSCs and BDNF-modified MSCs, the treated rats exhibited more significant recovery than the control, including the accumulation and living of enhanced green fluorescence protein (EGFP)-positive cells in the infarct area and surrounding areas, neuron-like changes, expression of surface markers of neural cells, and a large amount of BDNF expression in the BDNF-MSCs-treated group. Our findings suggest that BDNF-gene-modified rMSCs can migrate to surrounding areas of the cerebral infarction lesion, differentiate into neural cells, and survive for extended periods. With the synergy of BDNF, they may promote the recovery of the neurological function following cerebral infarction and represent a new strategy for stem cell-based therapy.
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Animals , Male , Rats , Brain-Derived Neurotrophic Factor , Genetics , Genetic Vectors , Genetics , Infarction, Middle Cerebral Artery , Genetics , Therapeutics , Lentivirus , Genetics , Metabolism , Mesenchymal Stem Cell Transplantation , Methods , Mesenchymal Stem Cells , Cell Biology , Metabolism , Rats, Inbred F344 , Recovery of Function , TransfectionABSTRACT
BACKGROUND: Epidural block(EB) is one of the effective and widely used remedies for lumbar disc herniation(LDH) . Animal experiments have been conducted to study the changes in the local tissue structure in the spinal canel after several treatments with EB.OBJECTIVE: To study the effect of EB for LDH on the local tissue structures in the spinal canel.DESIGN: A non-randomized and controlled clinical observation.PARTICIPANTS: Department of Pathology and Laboratory of Electron Microscope of an Affiliated Hospital of a University.SUBJECTS: Forty patients with LDP, who failed to respond to EB treatment and subsequently received discectomy in the Department of Orthopaedics,First Affiliated Hospital of Sun Yat-sen University from May 1992 to December 1997, were enrolled in this study, with 20 patients receiving discectomy but not EB treatment serving as the control group.METHODS: From the 60 cases, totally 120 specimens of yellow ligament and the disc tissues were obtained during discectomy for optical microscopical examination. A portion of the yellow ligament and the lumbar disc tissues were chosen from EB group(12 cases) and non-EB group(10 cases), respectively, for electron microscope examination(involving altogether 44specimens) . The changes in histology and ultrastructnres in the specimens were compared between the two groups.MAIN OUTCOME MEASURES: ① Main results: the reactive proliferation of the tunica adventitia and inflammatory reaction of the intervertebral disc and yellow ligament; ② Secondary results: changes in the ultrastructure of the anulus fibrosus, nucleus pulposus and yellow ligament.RESULTS: No significant difference was found between the two groups either in light microscopy or electron microscopy in the degree of smoothness and the inflammatory reaction of the cavosurface of the yellow ligament and the disc tissues, nor in the cellular ultrastructures and fibrous arrangement.CONCLUSION: There is no direct relationship between lumbar EB and epidural scar adhesion formation. EB does not affect the ultrastructures of the local tissues in the spinal canal, but care must be taken of the sterilization in the surgical procedure, as chronic inflammatory reaction in the yellow ligament and disc tissues can be present in some patients.
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【Objective】To study the effect of light weight-bearing activity on postmenopausal osteoporosis.【Methods】36 female rats were randomly divided into 3 groups:① Sham,② Ovx (ovarietomized),③ Ovx+Im (ovarietomized and immobilized).All the group's maintained daily activity.And because of being immobilized,the right hind limbs of the third group lacked weight-bearing activity.12 weeks after ovarietomy,the BMD (bone mineral density),histomorphometry and biomechanics of the right femurs of rats were measured and analyzed.【Results】Comparing with the Sham group,the Ovx group's right femurs were manifested with the decrease of BMD,TBV (trabecular bone volume),MTT(mean trabecular thickness) and MCT(mean cortex thickness),while the increase of RS(resorption surface) and OS(osteotoid surface).Meanwhile their biomechanic nature declined.But statistically the BMD,MCT and the criteria of mechanical strength were not significant decrease.Otherwise,the Ovx+Im group's right femurs showed more apparent decrease of BMD,TBV,MTT and MCT.And the biomechanic nature was worse.Comparing with the Sham group,the BMD,MCT and the criteria of mechanical strength of the Ovx+Im group were statistically significant decreased.【Conclusion】If maintaining light weight-bearing activity,the ovarietomized rats were able to maintain relatively better bone quality.A lack of light weight-bearing activity wouldcause thedecline of bone quality.Thusthestudy suggested light weight-bearing activity was significantly effective on the prevention and treatment of postmenopausal osteoporosis.
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AIM: To construct lentiviral vector carrying the angiopoietin-1(Ang-1) gene,and make it express Ang-1 in the rat mesenchymal stem cells(rMSCs).METHODS: The cDNA encoding the CDS of Ang-1 gene was obtained from the placenta of the adult Fisher 344 rats with RT-PCR.After digestion with restrication endonuclease,the Ang-1 gene was recombined to construct the transfer plasmid PNL-Ang1-IRES2-EGFP.The three-plasmid system of lentiviral vector was consisted of PNL-Ang1-IRES2-EGFP,the packaging plasmid HELPER,and the envelope plasmid VSVG,which were co-transfected to 293T cells mediated by lipofectamin2000 to produce lentiviral particles.The rMSCs were infected by obtained lentiviral particles.The insertion of Ang-1 gene was detected by PCR,the mRNA expression of Ang-1 in rMSCs was detected with RT-PCR,the protein expression of Ang-1 was observed with immunocytochemistry and Western blotting methods.RESULTS: The result of sequencing showed that the cloned Ang-1 gene was consistent with the sequence reported in GenBank.After digestion with restrication endonuclease,the 1 512 bp fragment of Ang-1 gene and the 10.5 kb vector fragment of PNL-IRES2-EGFP were observed with gel electrophoresis.The insertion of Ang-1 gene in viral genome was confirmed.The EGFP expression was observed with the fluorescent microscope.In infected rMSCs,the mRNA and protein expressions of Ang-1 were confirmed.CONCLUSION: Lentiviral vector carrying Ang-1 gene has been successfully constructed.The infected rMSCs are able to express the Ang-1 mRNA and Ang-1 abundantly.This will facilitate the following exploratory development of Ang-1 gene-modified rMSCs.
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Aim To observe the infarct size, apoptosis of the neurocytes,the expressions of Bcl-2 and Bax pro-teins after focal cerebral ischemia-reperfusion injury (CIRI) in the brain tissue of rats and the protective effects of rofecoxib.Methods The model of local CIRI was induced by reversible middle cerebral artery occlusion (MCAO) with inserting a thread through internal carotid artery,2 h occlusion followed by 24 h reperfusion.Rofecoxib was administrated (ig) at the reperfusion initiation. Using TTC staining technique to measure the infarct size of brain,TUNEL technique to examine apoptosis of the neurocytes,immunohistochemical method to examine the expression level of Bcl-2 and Bax proteins in brain tissue.Results After focal CIRI,the infarct focus of brain was showed,both apoptosis rate of the neurocytes and Bax protein expression were significantly increased and the ratio of Bcl-2 to Bax was significantly reduced.With the use of both 1.12 and 2.24 mg?kg -1 doses of rofecoxib,the brain infarct size was dramatically reduced. With the use of 2.24 mg?kg -1 dose of rofecoxib,both apoptosis rate of the neurocytes and Bax protein expression were significantly decreased,both Bcl-2 protein expression and the ratio of Bcl-2 to Bax were significantly higher than that in the group Model.Conclusion The highly selective COX-2 inhibitor rofecoxib may increase Bcl-2 protein expression and decrease Bax protein expression then increase the ratio of Bcl-2 to Bax and so reduce the neurocytes apoptosis in brain tissue thus significantly improve the brain injury after CIRI.