ABSTRACT
Objective To investigate the effect of bone cement distribution near fracture line after percutaneous vertebroplasty (PVP) on patients with osteoporotic vertebral compression fractures (OVCF). Methods One hundred and twenty OVCF patients who had underwent PVP from September 2015 to August 2017 were selected. The range of fracture line was determined by magnetic resonance lipid suppressor sequence imaging before operation, and the three-dimensional modeling was carried out by computer aided design software. Three dimensional imaging of CT bone cement was performed after PVP. The patients were divided into 2 groups according to the bone cement distribution near fracture line. The bone cement distribution near fracture line area was not good in 52 cases (group A), and the bone cement distribution near fracture line was good in 68 cases (group B). The pain visual analogue score (VAS) and the Oswestry dysfunction index (ODI) were measured before operation, second day after operation and 3 months after operation. Results All the patients completed the operation successfully, and the postoperative pain was significantly relieved. In group A, there were 3 cases of with postoperative bone cement leakage, and 4 cases in group B. There were no obvious clinical symptoms, no serious complications such as nerve injury and infection. There was no significant difference in the amount of bone cement between group A and group B: (4.08 ± 0.74) ml vs. (4.03 ± 1.03) ml, P＞0.05. There were no significant differences in VAS and ODI before operation between 2 groups (P>0.05). The VAS and ODI second day and 3 months after operation were significantly lower than those before operation in 2 groups, VAS: (4.54 ± 0.81) and (1.46 ± 0.51) scores vs. (7.38 ± 0.94) scores, (2.68 ± 0.88) and (1.18 ± 0.58) scores vs. (7.21 ± 1.12) scores; ODI: (70.23 ± 2.70) and (19.42 ± 2.21) scores vs. (90.46 ± 1.79) scores, (48.85 ± 2.23) and (18.85 ± 1.84) scores vs. (90.50 ± 2.02) scores, and there were statistical differences (P＜0.05). The VAS and ODI second day after operation in group B were significantly lower than those in group A, and there were statistical differences (P＜0.01). There were no significant differences in VAS and ODI 3 months after operation between 2 groups (P>0.05). Conclusions PVP can obviously relieve the pain of OVCF patients. The bone cement is well distributed near the fracture line, and the early effect is obvious.
ABSTRACT
Objective To prepare 99Tcm-succinimidyl-6-hydrazinonicotinate hydrochloride (SHNH)-AC133 and evaluate its targeting ability on CD133 positive colon cancer by Gamma imaging,and to explore its feasibility as a molecular probe for cancer stem cells (CSCs).Methods CD133 expression was detected by immunofluorescence assay and flow cytometry on Lovo cell lines and tumor xenografts.CD133 specific monoclonal antibody (AC133) was conjugated with SHNH,and then labeled with 99Tcm to prepare 99Tcm-SHNH-AC133.The radiolabeled yield and radiochemical purity were investigated.Colon cancer xenografts were developed and Gamma imaging were performed.Region of interest (ROI) was drawn and the tumor/non-tumor (T/NT) ratio was calculated.For the blocking experiment,animals were pre-injected with excess unlabeled AC133.Two-sample t test was used to analyze the data.Results CD133 was expressed on the surface of Lovo cells.And the percentage of CD133 positive cells in Lovo tumor tissues was (29.5±3.4)％.The radiolabeled yield of 99Tcm-SHNH-AC133 was more than 85％ and radiochemistry purity was (97.7±2.4)％.Gamma imaging demonstrated that 99Tcm-SHNH-AC133 could specifically target to Lovo tumors which could be gradually visible after 12 h.The tumor uptake was obvious at 24 h and T/NT ratio was 8.16±0.45.In blocking study,the tumor uptake was significantly reduced by pre-injection of excess unlabeled AC133 (3.52±0.13;t=19.8,P＜0.05).Conclusions 99Tcm-SHNH-AC133 has high labeling yield and radiochemistry purity.The excellent targeting properties of 99Tcm-SHNH-AC133 on CD133 positive colon cancer demonstrate that it is a promising imaging agent for CSCs tracking in vivo.
ABSTRACT
Objective To evaluate the value of radiofrequency ablation (RFA) combined with percutaneous vertebroplasty (PVP) in the treatment of metastatic spinal tumor. Methods The clinical data of 94 hospitalized patients with metastatic spinal tumor from January 2013 to January 2017 were retrospectively analyzed.The patients were divided into PVP group(43 cases)and RFA+PVP(51 cases) according to the different treatment methods. The visual analogue scores (VAS) before operation and 1 month after operation were observed.The serum levels of N-telopeptide of typeⅠcollagen(NTx),carboxy terminal telopeptide typeⅠcollagen(ICTP)and bone alkaline phosphatase(BAP)before operation and 1 month after operation were monitored.The recurrence rate of tumor 6 months after operation was record. Results The VAS before operation in PVP group was (7.67 ± 1.12) scores, in RFA + PVP group was (7.71 ± 1.04) scores, and there was no statistical difference (P>0.05). The VAS of 2 groups after operation was significantly lower than that before operation:PVP group(3.17 ± 0.26)scores,RFA+PVP group (2.66 ± 0.31) scores, and there were statistical differences (P<0.05). The VAS in RFA + PVP group was significantly lower than that in PVP group(P<0.05).The serum levels of NTx,ICTP and BAP before operation in PVP group were(25.39 ± 9.77)nmol/L,(36.71 ± 8.77)μg/L,(73.66 ± 14.60)μg/L;after operation were (19.34 ± 6.32) nmol/L, (21.14 ± 6.66) μg/L, (33.63 ± 7.50) μg/L, and there were statistical differences before and after operation (P<0.05). The serum levels of NTx, ICTP and BAP before operation in RFA+PVP group were(26.63 ± 10.53)nmol/L,(35.37 ± 9.42)μg/L,(75.24 ± 13.01) μg/L; those after operation were (12.10 ± 5.17) nmol/L, (15.14 ± 5.08) μg/L, (27.19 ± 8.22) μg/L, and there were statistical differences before and after operation(P<0.05).The serum levels of NTx,ICTP and BAP after operation in RFA + PVP group were significantly lower than those in PVP group (P < 0.05). The recurrence rate of tumor 6 months after operation in RFA+PVP group was significantly lower than that in PVP group: 3.92% (2/51) vs. 16.28% (7/43), and there was statistical difference (P<0.05). Conclusions Compared with simple PVP, RFA combined with PVP can reduce the pain symptoms, reduce the recurrence rate and improve the quality of life in patients with metastatic spinal tumor.