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BACKGROUND:Mesenchymal stem cels can secrete a variety of cytokines and growth factors that promote the survival of surrounding cels and play a paracrine role. OBJECTIVE:To investigate the effect of human umbilical cord mesenchymal stem cels on the proliferation and apoptosis of ectopic endometrial cels. METHODS:After isolation and culture, human umbilical cord mesenchymal stem cels and ectopic endometrial cels were co-cultured as observation group, and ectopic endometrial cels cultured alone served as control group. At 24, 48, 72 hours of culture, the proliferation and apoptosis of ectopic endometrial cels were detected by MTT and flow cytometry, respectively; RT-PCR was used to measure the expression ofPTEN gene in ectopic endometrial cels. RESULTS AND CONCLUSION:At 24, 48 and 72 hours, the proliferation of ectopic endometrial cels in the observation was inhibited significantly as compared with the control group, and the hypodiploid peak ratio also increased significantly (P < 0.05). Over time, the cel inhibition rate was gradualy declined, and there were significant differences at different time points (alP < 0.05). Compared with the control group, the expression of PTEN gene was up-regulated significantly in the observation group (P < 0.05). In the observation group, the expression ofPTEN gene at 48 and 72 hours was significantly higher than that at 24 hours (P < 0.05). These findings indicate that in the human umbilical cord mesenchymal stem cels can inhibit the proliferation of ectopic endometrial celsin vitro and promote their apoptosis by up-regulation ofPTEN mRNA expression.
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BACKGROUND:For reason of pathological particularity, treatments for young adult patients with lumbar disc herniation require more demanding procedures. Traditional discectomy and rigid fixation and fusion receive a lower clinical satisfaction rate because of their concomitant complications. Waveflex is a semi-rigid fixation system with non-fusion pedicle screws. Once combined with the technology of annulus repair, it can maintain the normal movement of the segments, and can thus raise clinical satisfaction rate. OBJECTIVE:To evaluate the short-term efficacy of the treatment of young adult lumbar disc herniation through the technology of the posterior Waveflex non-fusion pedicle screw elastic fixed smal window nucleus pulposus extirpation associated with annulus repair. METHODS: Thirty-eight patients with lumbar disc herniation were involved in this study, among which, 18 cases in the elastic fixation group were subjected to a posterior lumbar smal window nucleuspulposus extraction along with annulus repair together bound with Waveflex elastic fixation; the rest 20 cases in the nucleus pulposus removal group underwent simple nucleus pulposus extirpation. After these operations, a series of folow-up study was conducted, including: folow-up analysis of clinical efficacy and complications, colection of low-back pain visual analogue scores, colection of Japanese Orthopaedic Association scores (JOA), regular assessment of Oswestry dysfunction index, and reevaluation of the lumbar lateral radiographs related indicators. RESULTS AND CONCLUSION:Folow-up visits to the patients were conducted 12-20 months later since the operations. Both groups showed a better performance than before treatment in the pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain (P < 0.05) during the last visit. The pain visual analogue scale, low back pain JOA score, and Oswestry dysfunction index of low-back pain in the dynamic fixation group were superior to those in the nucleus pulposus removal group (P <0.05). Stil in the last folow-up, operative segment disc height in the dynamic fixation group was greater than that before treatment, and the operative segment range of motion was smaler than that before treatment (P <0.05). These results suggest that compared to nucleus pulposus removal, Waveflex system associated with nucleus pulposus excision annulus repair has a more satisfactory effect in the early recovery of lumbar spine function and exerts a positive effect on the stability of the operated segments in the treatment of lumbar protrusion of the intervertebral disc in young adults.
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BACKGROUND:Spinal posterior surgery is the most common treatment method for thoracolumbar fracture. During exposure of conventional posterior surgery, a wide-range stripping and pul ing of paraspinal muscles easily induced failure syndrome of lumbar surgery. OBJECTIVE:To compare the reset conditions and stability of thoracolumbar fractures after treatment with pedicle screw paraspinal muscle approach and conventional posterior median approach fixation. METHODA total of 62 patients with thoracolumbar fractures without nerve injury were retrospectively analyzed. 22 patients were treated with paraspinal muscle approach and general spine system. 21 patients were treated with conventional median approach and general spine system. 19 patients were treated with conventional median approach and AF internal fixation system. The therapeutic effects of the three kinds of fixation methods were compared by comparing clinical indexes in patients of the three groups, including operation time, intraoperative blood loss, postoperative drainage, dead space volume, scores of the Visual Analogue Scale of back pain, wound complications, height of injured vertebrae and the Cobb angle. RESULTS AND CONCLUSION:Operation time, intraoperative blood loss, postoperative drainage and dead space volume were better in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group (P0.05). No significant difference in scores of the Visual Analogue Scale of back pain was visible among the three groups at 1 week after fixation (P>0.05). The scores of the Visual Analogue Scale of back pain were apparently lower in the paraspinal muscle approach and general spine system group than in the conventional median approach and general spine system group and conventional median approach and AF internal fixation system group at 3 and 6 months after fixation. No incision infection was observed in patients of the three groups. These results suggested that compared with conventional posterior median approach, paraspinal muscle approach has some advantages, such as smal trauma, less bleeding, postoperative rapid recovery, and high degree of satisfaction. The effects of general spine system and AF internal fixation system in the repair of thoracolumbar fractures on internal fixation are similar, but general spine system has some advantages such as simple to be operated, save time, less bleeding, stable fixation and good reduction. General spine system combined with paraspinal muscle approach is a good method to repair thoracolumbar spine fracture.
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Objective To explore the clinical value of the dynamic change of serum carbohydrate antigen 125 (CA125) in the evaluation of the therapeutic effect and prognosis in patients with epithelial ovarian cancer (EOC).Methods The clinical data of 84 patients with EOC were retrospectively analyzed.The change of before and after treatment,the half-life of CA125,the relationship between the clearance time of CA125 and the survival time and recurrence of patients were investigated.Results After operation,the serum level of CA125 was significantly lower than that before treatment(t =11.306,P ＜0.01).After 6 cycles of standard chemotherapy,the serum CA125 again decreased evidently(t =6.265,P ＜ 0.01).In the half-life of CA125 (T1/2) ≤ 20d group,the survival time was significantly longer than T1/2 ＞ 20d group(t =3.394,P ＜ 0.01).Compared with CA125 negative conversion time(NT) ＞ 8 weeks group,the survival time of NT ≤ 8 weeks was significantly longer (t =2.791,P ＜ 0.01),the recurrence rate was significantly lower(22.9％ vs.58.3％) (x2 =10.941,P ＜0.01),the recurrence time was later(t =15.965,P ＜0.01).Conclusion The dynamic change of CA125 has important clinical value in the evaluation of the therapeutic effect and prognosis of patients with EOC.EOC patients with short CA125 half-life,faster negative conversion time have better treatment effect,longer survival,lower recurrence rate after operation.
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Objective\ To observe the practicality of sonography for differentiating the compression factors and judging whether thorough decompression anterior to the dura sac has been obtained. Methods Posterior midline incision was used in a total of 16 cases. After the laminae were resected, normal saline was poured into the operation field, and ultrasound examination performed with a 5.0 MHz sectorscanner. Combined with preoperative imaging (CT or MRI),the compression factors were differentiated. The isolated tissue(bone or disc)pieces in spinal canal were removed first,then reduction of approximate and distal parts of the injuried spinal column was obtained with the help of the Dick devices. Posteriorly protruded bone mass was tumbled in carefully supervised with sonography. The sonographic criterion for thorough decompression consisted of the reappearance of the anterior subarachnoid and an even and smooth echo of posterior dura mater. Results\ The sonographic criterion for thorough decompression was achieved in all cases. No bone mass posterior displacement was observed on postoperative rontgenogram or CT examination. Partial or complete recovery of neural function was obtained in 13 cases. Conclusion\ All elements contributing to anterior dura sac compression can be readily recognized by sonography,which offers a reliable criterion for complete decompression.