ABSTRACT
<p><b>OBJECTIVE</b>To compare the therapeutic effect of posterior lumbar interbody fusion by single and double B-Twin expandable spinal spacer with micro endoscopic discectomy (MED) for lumbar intervertebral disc protrusion accompanying degenerative instability.</p><p><b>METHODS</b>From March 2006 to May 2008, 45 patients with lumbar intervertebral disc protrusion accompanying degenerative instability were admitted and managed with posterior lumbar interbody fusion by B-Twin expandable spinal spacer with MED. The patients were randomly assigned to treatment with single B-Twin (Single group, n = 24) or double B-Twin (Double group, n = 21). There were 16 males and 8 females, with an average age of 45.5 years (43 - 60 years) in Single group; 13 males and 8 females, with an average age of 43.7 years (44-61 years) in Double group. All the cases suffered from only one level disc protrusion, L(3-4) 2 cases, L(4-5) 29 cases and L₅-S₁ 14 cases. Clinical outcomes were evaluated with surgical time, blood loss, visual analogue scale (VAS) scores preoperatively, 1, 3, 6 month postoperatively. Oswestry disability questionnaire (ODI) of the preoperative, 1 month postoperative, and latest follow-up and the disk space heights.</p><p><b>RESULTS</b>Forty three patients were followed-up for 1 to 3 years after surgery. The mean surgical time of Double group was longer than Single group [(152 ± 32) min vs. (91 ± 15) min, P < 0.01]. The average blood loss in Double group was more than that in Single group [(146 ± 73) ml vs. (95 ± 58) ml, P < 0.01]. The mean time of hospital stay in Single group was similar to that in Double group [(11.0 ± 3.2) d vs. (10.9 ± 3.3) d, P > 0.05]. Both groups could keep the disk space heights till the last follow-up [(7.7 ± 1.8) mm vs. (8.5 ± 1.7) mm]. In the 6 months follow-up post operation, the VAS score decreased from (8.1 ± 1.8) to (2.0 ± 1.0) in Single group, and (8.1 ± 1.9) to (2.1 ± 1.0) in Double group. At the last follow-up, the ODI decreased from (36 ± 7)% to (10 ± 4)% in Single group and (37 ± 6)% to (9 ± 4)% in Double group, but there was no significant difference between the two groups (P > 0.05). All the cases achieved fusion at the last follow-up, 3 patients in Single group and 2 patients in Double group suffered from intractable low back pain. One of the fins broke in one patient without any uncomfortable feeling.</p><p><b>CONCLUSIONS</b>Compared with the management of lumbar intervertebral disc protrusion accompanying degenerative instability by double B-Twin expandable spinal spacer with micro endoscopic discectomy, the single B-twin can get similar clinical outcomes, but shorter surgical time, less blood loss and less medical costs.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Endoscopy , Follow-Up Studies , Intervertebral Disc Displacement , General Surgery , Lumbar Vertebrae , Prospective Studies , Spinal Fusion , Methods , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of andrographolide on virulence factors production in Pseudomonas aeruginosa.</p><p><b>METHOD</b>Growth rate, pyocyanin, proteolytic activity and elastase activity were measured with or without the presence of andrographolide. The effect of andrographolide on pyocyanin production, proteolytic activity and elastase activity in PAO-JP2 was investigated simultaneously.</p><p><b>RESULT</b>The andrographolide did not affect the growth of PAO1 in planktonic culture. The production of pyocyanin, proteolytic activity and elastase activity were significanthy suppressed in P. aeruginosa cultures grown in the presence of andrographolide. However, these effects were not observed in PAO-JP2.</p><p><b>CONCLUSION</b>The inhibiting effect of andrographolide on virulence factors production in P. aeruginosa may play a role in its anti-infection activity.</p>
Subject(s)
Andrographis , Chemistry , Anti-Bacterial Agents , Pharmacology , Diterpenes , Pharmacology , Pancreatic Elastase , Metabolism , Peptide Hydrolases , Metabolism , Plants, Medicinal , Chemistry , Pseudomonas aeruginosa , Metabolism , Virulence , Pyocyanine , Metabolism , Virulence Factors , MetabolismABSTRACT
Objective To develop a real-time polymerase chain reaction(PCR)system to determine transcriptional level of MexAB-OprM multidrug efflux pump gene and to investigate the impact of androgra- pholide on MexAB-OprM gene transcription in Pseudomonas aeruginosa.Methods The fragments of mexB gene of mexAB-oprM operon and 30S rRNA gene rpsL were amplified and cloned into two plas- mids respectively.These plasmids were used as external standards for real-time PCR.Real-time PCR was applied to measure the mRNA transcripition of mexB and rpsL gene in Pseudomonas aeruginosa growing in medium with different concentrations of andrographolide.Results The plasmids for standard curve were constructed successfully.The relative mexB mRNA expressions in 50,100,150 and 200?g/mL andrographolide were 0.04?0.03,0.06?0.07,0.09?0.03 and 0.04?0.03 respectively, which were significantly lower than that in the control(0.24?0.04,P0.05).Conclusion Andrographolide can reduce the transcriptional level of MexAB-OprM,which may he one mechanism for its anti-infection effect.