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Objective To investigate the effect of arthroscopic arthroplasty on the short-term efficacy and stress factors in patients with primary osteoarthritis of the elbow and to guide the clinical application.Methods From February 2013 to February 2016,32 patients with primary primary osteoarthritis of the elbow underwent arthroscopic arthroplasty in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology.The levels of serum TNF-α,IL-6,IL-10,adrenocorticotrophic hormone(ACTH) and other stress factors were measured before and after the operation.The ROM,MEPS and VAS were used to evaluate the curative effect before,3 months and 6 months after operation.Results All patients were followed up successfully.The excellent rate was 96.9%(31/32) 1 year after the operation.Preoperative ROM,MEPS score,VAS score were (83.2±18.6) °,(63.2±14.5) points,(3.2±1.8) points;3 months,6 months postoperative ROM were (102.3±18.9) °,(124.3±15.4) °,and MEPS scores were (75.4±16.8) points and (89.5±14.3) points respectively,which were significantly higher than those before operation (ROM F value of 43.19,P0.05).Conclusion For the modest primary osteoarthritis of the elbow,arthroscopy arthroplasty can achieve good therapeutic effect,improve the patient′s motor function and life quality,and minimally invasive surgical approach is conducive to relieve systemic stress.
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Objective To study the clinical efficacy and safety of posterior laminoplasty combined with foraminotomy in the treatment of mixed cervical spondylosis.Methods A total of 70 patients with mixed type cervical spondylosis from January 2012 to January 2014 in our hospital were randomly divided into observation group and control group.Patients in observation group received posterior laminoplasty com-bined with foraminotomy,and patients in control group received anterior cervical discectomy and fusion surgery.The operation time,intraoper-ative blood lossing,postoperative JOA scores and NDI scores between two groups were compared.The cervical curvature and range of motion were measured by X-ray.Results There was no significant difference in postoperative JOA scores,cervical curvature and range of motion be-tween two groups(P >0.05).The operative time and intraoperative blood loss of observation group was less than those of control group,the difference was no significance.The NDI scores of carrying and drive in observation group were higher than those in control group,while the NDI scores of other items between two groups had no significant difference(P >0.05).The incidence of complications in observation group was 10.81% (4 /37),the control group was 24.42% (8 /33),the difference between two groups was statistically significant,(χ2 =3.428, P <0.05).Conclusion The posterior laminoplasty combined with foraminotomy have good clinical effect for mixed type cervical spondylosis with advantages of a shorter operation time,simple operation,less intraoperative bleeding,lower incidence of complications,which is a kind of safe and effective surgical method.
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BACKGROUND:For vertebral compression fractures treated by bal oon vertebroplasty, there were stil controversies in biomechanical and clinical studies about adjacent vertebral fractures is the result of osteoporosis progress, or the result of vertebral intervention and strengthening by injecting bone cement. More accurate conclusions can be obtained through more in-depth research and long-term fol ow-up. OBJECTIVE:To evaluate the effect of bal oon vertebroplasty on biomechanical properties of vertebral body with compression fractures and unstrengthened adjacent vertebral body. METHODS:Total y 40 pig specimens with vertebral compression fractures were prepared and randomly divided into study and control groups. Specimens in the study group were subjected to bal oon vertebroplasty. Specimens in the control group only wrapped with normal saline gauze. The biomechanical properties (vertebral height, maximum load), stress, strain and displacement values of specimens under 500 N loading in these two groups were compared. The stress and strain values of unstrengthened adjacent vertebral body before and after the bal oon vertebroplasty in the study group were measured, and compared with the control group. RESULTS AND CONCLUSION:Compared with the original height, specimens in the study group can restore to its original height after bal oon vertebroplasty, the differences were not significant (P>0.05). The former, back, left and right vertebral height in the study group were significantly higher than those in the control group (P0.05). There were no significant differences in the strain and stress values of the unstrengthened adjacent vertebral body after the bal oon vertebroplasty between study group and control group (P>0.05). These results suggest that vertebral maximum loading and stiffness recover wel after the treatment of bal oon vertebroplasty for vertebral compression fractures, which can achieve the effect of preventing vertebral fractures again. Meanwhile, bal oon vertebroplasty treatment can not alter the biomechanical properties of adjacent vertebrae, and it is difficult to influence and lead vertebral fractures again, with a better security.
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Objective To investigate the expression of Foxo3a in the lumbar dorsal root ganglia (DRG) after sciatic nerve injury in rats. Methods Forty-two adult rats were randomly divided into control group and experimental group. Rats in experimental group were subjected to sciatic nerve clamp. Expression and distribution of Foxo3a, growth associated protein (CAP) and axon regeneration in DRC were detected by Western blot and immunofluorescent staining. Results (1) After sciatic nerve injury, Foxo3a protein levels began to reduce at day 1, reached the lowest level at day 2 and then gradually rose to nomal level at four weeks after sciatic nerve injury. Proliferating cell nuclear antigen (PCNA) and GAP-43 were up-regulated from day 2, and the level of PCNA reached peak at day 7 after sciatic nerve injury in DRC. (2) Down-regulation of Foxo3a was observed predominantly in neurons and glial cells. PCNA mostly expressed in glial cells and hardly in neurons. Conclusion Down-regulation of Foxo3a in lumbar DRG may correlate with axonal regeneration and the proliferation of glial cells after sciatic nerve injury.