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Objective:To examine the correlation between intraoperative pain scores during puncturing and postoperative complications in elderly patients with osteoporotic vertebral fractures(OVF)treated with vertebroplasty(VP).Methods:In a retrospective case-control study, clinical data of 326 patients with single-segment OVF treated with VP, including 42 patients(12.9%)(the complication group)with complications within 1 month of surgery and 284 patients(87.1%)without complications(the control group), were compared.Changes in patient numerical evaluation scale(NRS)scores were recorded and compared for the complication group and the control group at different time points, which concluded preoperative(T0), intraoperative puncturing of soft tissues(T1), bone puncturing(T2), bone cement injection into the vertebral body(T3), 24 hours(T4), 1 month(T5)and 3 months(T6)after surgery.Results:NRS scores for patients in the complication group vs.those in the control group at different phase were(5.78±2.11 vs.6.10±2.21)points at T0, (7.59±1.46 vs.4.63±0.86)points at T1, (7.30±1.35 vs.5.14±1.07)points at T2, (6.97±1.24 vs.6.11±1.58)points at T3, (4.09±0.82 vs.2.19±0.87)points at T4, (2.07±0.80 vs.1.93±0.78)points at T5, and(1.83±0.72 vs.1.74±0.65)points at T6, but there was no significant difference between the two groups at T0( P>0.05).The complication group had higher NRS scores than the control group at T1, T2, T3, and T4(all P<0.05).For intra-group comparisons, both the complication group and the control group showed statistically significant differences between T0 and T4, between T0 and T5, and between T4 and T5(all P<0.05). Conclusions:Elderly OVF patients who are treated with VP and exhibit post-surgery complications often experienced severe pain during surgery, and an NRS score greater than 7 may be an independent risk factor for postoperative complications of VP.Effort should be made to avoid or reduce complications related to surgery, reduce pain and improve treatment outcomes of VP for elderly patients.
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Objective:This study was conducted to further investigate the clinical value of ERCP plus EST and pancreatic duct (PD) stent placement in treatment of ABP.Methods:The data of 115 patients with ABP in People′s Hospital of Chongqing Banan District between February 2018 to October 2020 were retrospectively analyzed. Of the patients, 46 cases received ERCP plus EST and PD stent placement(PD stent group), and other 69 cases only received ERCP plus EST(control group), all patients received surgery within 72 h. Outcome measures: preoperative complications, APACHE II score, Glasgow score, preoperative and postoperative laboratory indicators (white blood cell, C-reactive protein, serum amylase, total bilirubin, alanine aminotransferase), postoperative complications, hospitalization time, hospitalization cost. All patients received outpatient or telephone follow-up after discharge, patients were followed up for recurrence of pancreatitis and complications, follow-up ended in June 2021. Continuous data were represented as ( ± s), and comparisons between the two groups were performed using Student′s t tests for normally distributed data with homogeneity of variance. The Mann-Whitney U test was used for nonnormally distributed data. Categorical data are expressed as rates values and were analyzed with the chi-square test or Fisher′s exact test. Results:There were no significant differences between two groups in age, complications, APACHEII score, Glasgow score, preoperative laboratory examination, postoperative CRP, total bilirubin and ALT ( P>0.05). Postoperative WBC[8.5(7.6, 10.3)]×10 9/L, serum amylase [197.5(143.0, 256.0) U/L] in the PD stent group were significantly lower than control group[9.9(8.2, 12.8) 10 9/L, 270.0(168.0, 419.0) U/L]( P<0.05). The overall incidence of complications in the PD stent group (6.5%) was significantly lower than the control group (20.3%), there were statistical differences between groups( P<0.05). Hospitalization time and hospitalization cost were not significantly different between the two groups ( P> 0.05). All patients were followed up, with an average follow-up of 16 months, all recovered well postoperatively in patients with stent group, but a patient who suffered from peripancreatic abscess with severe infection needed hospitalization again in control group, another two patients with pancreatic pseudocyst, 1 case were followed up for 3 months to gradually absorbed, and 1 case underwent another surgical treatment. Conclusion:The placement of temporary pancreatic duct stent provided adequate drainage of pancreatic fluid to reverse the course of ABP, and the complication rate was significantly lower than that of the control group, with superior clinical outcome to ABP patients treated with ERCP+ EST alone.
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Objective:To investigate the impact of osteoporosis on clinical outcomes in elderly patients treated with short segment transforaminal lumbar interbody fusion.Methods:From May 2016 to May 2018, elderly patients who had undergone transforaminal lumbar interbody fusion(TLIF)in our hospital were retrospectively analyzed.Based on bone mineral density(BMD), patients were divided into the osteoporosis group(the OP group, n=75, T≤-2.5 in BMD)and the control group(the CO group, n=103, T>-1.0 in BMD). General patient information, clinical data and postoperative follow-up clinical results were compared between the two groups.Results:Eventually 178 cases were enrolled, including 68 with lumbar disc herniation and 110 with lumbar spinal stenosis.Preoperative Visual Analogue Scale(VAS)scores were 7.35±1.30 in the lower back and 7.32±1.30 in the leg for the OP group and 7.35±1.33 and 7.22±1.40, respectively, for the CO group, and there was no significant difference between the two groups( t=0.140 and 0.468, P=0.989 and 0.640). The proportions of cage collapse and internal fixation loosening were 70.7%(53/75)and 37.3%(28/75)in the OP group, which were higher than 22.3%(23/103)and 14.6%(15/103)in the CO group( χ2=41.440 and 12.280, both P=0.000). However, there was no significant difference between the OP group and the CO group in 1-and 2-year postoperative interbody fusion rates(postoperative 1-year rate: 89.3% or 67/75 vs.91.3% or 94/103, χ2=0.187, P=0.666; postoperative 2 year rate: 94.6% or 71/75 vs.95.1% or 98/103), χ2=0.021, P=0.885). There was no significant difference in VAS score and Oswestry disability index(ODI) between the OP group and the CO group at 6 months, 1 year and 2 years after surgery(all P>0.05). Conclusions:Although there are some osteoporosis-related complications such as cage subsidence and screw loosening, short-segment TLIF can still achieve good clinical results in elderly patients with osteoporosis.
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Objective:To investigate the status of vitamin D deficiency in middle aged and elderly patients at an orthopedic department.Methods:The data of 25-hydroxy vitamin D[25(OH)D]in patients aged over 55 years at an orthopedic department in Beijing Hospital from November 2014 to January 2020 were collected.The differences in serum 25(OH)D status were compared in different gender and age.Results:A total of 3004 subjects were included with 725 males and 2279 females, ranged from 55 to 102 years old with an average of(71.1±9.7)years.The average serum 25(OH)D level was(17.77±9.92)ng/ml, which was diagnosed as vitamin D deficiency status.Serum 25(OH)D levels were(19.66±9.77)μg/L, (18.34±9.78)μg/L, (16.19±9.51)μg/L and (14.74±10.49)μg/L, at different age groups of 55-64, 65-74, 75-84, 85 years and over, respectively, with statistically significant differences( F=29.357, P<0.05). Serum(OH)D levels of patients were severely deficient, deficient, insufficient and sufficient, with their proportion of 21.3%, 44.6%, 23.3% and 10.8%, respectively.The proportion of patients achieving from vitamin D levels severe deficiency to deficiency to insufficient to sufficient were 18.2%, 44.8%, 25.1% and 11.9% in men, and 22.2%, 44.6%, 22.7% and 10.5% in women, respectively. Conclusions:The deficiency of vitamin D is prevalent in elderly patients visiting at orthopedic department.Serum 25-hydroxy vitamin D has a decreased trend along with age increasing, showing an increased trend of vitamin D deficiency.Patients with severe vitamin D deficiency are the focus for the intervention.
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Objective:To investigate the efficacy and safety of perioperative aspirin use in elderly patients with osteoporotic vertebral fractures(OVF)undergoing vertebroplasty(VP).Methods:This was a retrospective cohort study.Clinical data of 136 OVF patients treated with VP in our department from Jan.2016 to Dec.2020 were analyzed.Differences in clinical data, treatment efficacy, intraoperative and postoperative complications and hematomas were compared between the aspirin group(n=71, receiving aspirin100 mg/d before VP and not taking other anticoagulant drugs)and the control group(n=65, not taking aspirin).Results:There was no significant difference in the analgesic score or physical activity scale score between the two groups before, 1 week after surgery and at the last follow-up( P>0.05). There were significant differences in the visual analog score(VAS), the analgesic score and the physical activity scale score before, 1 week after surgery and at the last follow-up within the aspirin group(7.12±1.33, 2.37±1.01 vs.2.63±1.04, 3.01±0.95, 1.56±0.65 vs.1.61±0.57, 2.75±0.53, 1.32±0.63 vs.1.44±0.52, P<0.01). No surgical site infection, injury of large vessels, intraspinal hematoma or pulmonary embolism was found in the aspirin group or the control group during the follow-up period.There was no difference in intraoperative or postoperative blood loss(12±3.5 ml vs.11.0±3.6ml, t=1.60), cement injection volume for a single vertebral body(4.5±1.9 ml vs.4.0±1.7 ml, t=1.40), cement spillage(14 cases or 19.7% vs.9 cases or 17.0%, χ2=0.15), nerve root irritation(3 cases or 4.2% vs.1 case 1.9%, χ2=0.43), re-fractures(5 cases 7.0 vs.3 cases 5.7%, χ2=0.10)or spinal epidural hematoma(8 cases or 11.3% vs.5 cases or 9.4%, χ2=0.11)between the aspirin group and the control group(all P>0.05). Conclusions:In OVF patients taking perioperative aspirin, the postoperative pain score, pain medication administration and mobility are significantly improved after VP, compared with pre-treatment.Surgical efficacy and safety show no significant difference between patients with and without aspirin administration.
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Objective:To compare the minimally invasive transforaminal lumbar interbody fusion (MTLIF) with open transforaminal lumbar interbody fusion (OTLIF) in treatment of lumbar degenerative disease.Methods:Clinical data of 63 patients with single segment lumbar degenerative disease treated in Department of Orthopedics of Beijing Hospital from November 2015 to September 2016 were retrospectively analyzed, among whom 30 cases received MTLIF and 33 cases received OTLIF. The operative time, intraoperative X-ray exposure times, intraoperative blood lose, postoperative drainage,perioperative fever, adjacent segment degeneration, loosening of internal fixation and cage collapse were observed in two groups 4 years after operation, and the visual analog scale (VAS) score of the lower back and the leg, the Oswestry disability index (ODI) score were compared between two groups.Results:The operation time [(191.6±50.5) min] and radiation exposure times [(15.5±6.4) times] in MTLIF group were significantly more than those in OTLIF group [(105.8±23.1) min, (7.2±1.4)times, t=17.210, t=10.850,all P<0.01]. The intraoperative blood loss [(150.4±70.4) ml], postoperative drainage [(90.4±30.7)ml], VAS score (2.4±0.7) and ODI score (24.5±3.7) 2 weeks after surgery in MTLIF group were significantly lower than those in OTLIF group [(250.7±43.9)ml,(216.3±67.8)ml,(4.5±1.6),(30.6±4.6), t=-12.830, t=-14.070, t=-6.890, t=-5.805,all P<0.01]. There were no significant differences in the incidence of fever [1 case(3.3%) vs. 4 cases(12.1%),χ2=-1.661, P=0.20], VAS score[(1.2±0.7) vs. (1.3±0.6), t=-0.628, P=0.53], ODI score[(14.2±2.7) vs. (14.7±2.5), t=-0.756, P=0.45], fusion rate of Bridwell grade Ⅰ [86.7%(26/30) vs. 84.8%(28/33),χ2=0.042, P=0.84] 1 year after surgery; and the adjacent segment degeneration [0 case(0) vs. 1 case(3.0%),χ2=0.924, P=0.34], internal fixation loosening [1 case(3.3%) vs. 1 case(3.0%),χ2=0.005, P= 0.95] and cage collapse 4 years after surgery [1 case(3.3%) vs. 1case(3.0%),χ2=0.005, P=0.95] between MTLIF group and OTLIF group. Conclusion:Compared with OTLIF, MTLIF has longer operation time and more radiation exposure, but it can achieve full decompression, the same fusion rate, less bleeding, less trauma, faster recovery, fewer complications and satisfactory long-term effect.
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Objective:To investigate the clinical effectiveness of vertebroplasty for osteoporotic vertebral compression fractures in the elderly aged 90 years and over.Methods:Clinical data of 64 elderly patients aged 90 years and over who had undergone percutaneous vertebroplasty for vertebral compression fractures between January 2015 and January 2021 were retrospectively analyzed.Changes in preoperative and postoperative pain, intraoperative bone cement leakage, postoperative pneumonia, bedsores, urinary tract infections, lower extremity venous thrombosis and changes in preoperative and postoperative physical mobility were evaluated.Pain scores, physical mobility scores, bone cement extravasation and complications such as re-fractures of the vertebral body, postoperative pneumonia, bedsores, urinary tract infections and thrombosis were recorded before surgery, 3 and 30 days after surgery.Results:The visual analogue scale(VAS)scores of 64 patients before surgery, 3 and 30 days after the procedure were 8.34±1.12, 2.17±1.45 and 1.83±1.15, retrospectively( F=540.876, P<0.01). The physical mobility scores before surgery, 3 and 30 days after the procedure were 2.83±0.94, 1.59±0.70 and 1.39±0.60, retrospectively( F=65.492, P<0.01). There were 18 cases(28.13%)of bone cement leakage during surgery, 4 cases(6.25%)of pneumonia within 30 days after surgery, 9 cases(14.06%)of urinary tract infections, 3 cases(4.69%)of lower extremity venous thrombosis, 1 case(1.56%)of bedsores, and 2 cases(3.13%)of vertebral re-fractures after surgery.No patient died during the 30-day follow-up. Conclusions:Percutaneous vertebroplasty can reduce pain and improve physical mobility and is an effective and safe minimally invasive treatment for elderly patients with spinal compression fractures aged 90 years and over.
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Objective:To explore the advantages and disadvantages of anterior versus posterior approach surgery in the treatment of cervical spinal cord injury without radiographic abnormality in elderly patients.Methods:Clinical data of 31 geriatric patients of spinal cord injuries without radiographic abnormality in our department from January 2014 to December 2018 were retrospectively analyzed for the cause of injury and the extent of injury.The patients were divided into two groups: anterior approach operation group and posterior approach operation group.The operation time, blood loss, volume of drainage, Japanese Orthopaedic Association(JOA)score before operation and 3 weeks, 3 months, 6 months, 12 months after operation, were recorded in the two groups.Results:Comparing the anterior versus posterior approach operation groups, the median operation time were 100.0(90.0, 110.0)min versus 132.5(123.7, 140.0)min, the median bleeding volume was 30.0(20.0, 35.0)ml versus 175.0(150.0, 202.5)ml, and the median postoperative drainage volume was 20.0(10.0, 20.0)ml versus 210.0(197.5, 237.5)ml, respectively, with statistically significantly differences between the two groups( U=18.00、0.00、0.00, all P<0.01). When comparing the anterior versus posterior approach operation groups, the median JOA scores at 5 time points were 4.0(3.0, 5.0), 6.0(5.5, 8.5), 9.0(8.5, 11.0), 11.0(10.0, 12.5), 12.0(11.0, 13.0)in the anterior operation group, and 4.0(3.0, 7.3), 6.5(5.7, 10.0), 10.5(8.7, 12.3), 12.5(11.0, 13.0), 13.0(11.0, 13.3)in the posterior operation group, with no significantly difference between the two groups( U=89.01, 90.03, 85.50, 74.02, 89.54, P=0.52, 0.55, 0.42, 0.20, 0.52), but there was significant difference in the median JOA scores at each of five different time points( χ2=82.46, 39.23, all P<0.01). Interestingly, the JOA score was higher at the latter time point than at the previous time point, with statistically significantly differences(all P<0.05). Conclusions:Both anterior and posterior approaches for decompression surgery have good effects on the recovery of spinal cord function in geriatric patients with cervical spinal cord injury without radiographic abnormality.Anterior approaches for decompression surgery are better than posterior approaches for the less operation time, less bleeding, less drainage and quickly recovery.
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Human adenoviruses are widespread causative agent that induces respiratory diseases, epidemic keratoconjunctivitis and other related diseases. Adenoviruses are commonly used in experimental and clinical areas. It is one of the most commonly used virus vectors in gene therapy, and it has attracted a lot of attention and has a high research potential in tumor gene therapy and virus oncolytic. Here, we summarize the biological characteristics, epidemiology and current application of adenovirus, in order to provide reference for engineering application of adenovirus.
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Humans , Adenovirus Infections, Human , Epidemiology , Virology , Adenoviruses, Human , Genetics , Genetic Engineering , Methods , Genetic Vectors , Oncolytic Virotherapy , Oncolytic Viruses , Genetics , Virus ReplicationABSTRACT
Objective:To investigate the surgical efficacy and safety of vertebroplasty as a day surgery procedure for osteoporotic vertebral fracture(OVF).Methods:A total of 159 patients with OVF undergoing vertebroplasty in Department of Orthopaedics, Beijing Hospital were enrolled and the clinical data were analyzed in this retrospective cohort study.They were grouped as the day-surgery group(n=81, the hospitalization, operation, briefly observation, recovered and discharged after treatment were completed during 1 working day)and as the hospitalized surgery group(n=78, patients stayed overnight in hospital or were hospitalized more than 24 hours). The mean follow-up time was 12.3 months(12-14 months). Pain score, analgesic drug use and activity ability were compared between the two groups before operation, 1 week after operation and at the last follow-up.Clinical effect, intra-operative and post-operative complications in the two groups were observed.Results:In intra-group comparison in the day-surgery group, the pain score, analgesic drug use and activity ability showed statistically significant differences at 1 week after surgery and at last follow-up as compared with those before treatment( P<0.01). No significant differences in pain score, analgesic drug use and activity ability were found between the day-surgery group and the hospitalized surgery group at 1 week after operation and at the last follow-up(2.3±1.2 vs.2.4±1.2, 1.7±0.9 vs.1.6±0.8; 1.5±0.3 vs.1.3±0.7, 1.8±0.4 vs.1.6±0.6; 1.3±0.7 vs.1.3±0.9, 1.3±0.6 vs.1.4±0.5; all P>0.05). The blood loss during surgery, postoperative complications including cerebrospinal fluid leakage, bone cement leakage, hematoma or infection at the puncture site, nerve root stimulation symptoms and re-fracture had no statistical difference between the two group(all P>0.05). Conclusions:The vertebroplasty as a day-surgery mode for osteoporotic vertebral fracture can improve the postoperative VAS score and activity ability, and decrease pain medication use.Efficacy and safety of a day-surgery for OVF are comparable to those of the hospitalized operation.
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Yeast autolysis under solid-state fermentation can effectively promote the release of various active substances, thereby improving the quality of yeast products. The optimal process for yeast autolysis under solid-state fermentation was obtained by optimizing the autolysis temperature, autolysis time and the zinc ion concentration. We analyzed the indexes of free amino acid, soluble protein and α-amino nitrogen in the fermentation material, as well as A₂₆₀/A₂₈₀ ratio to determine yeast autolysis process conditions in the solid-state fermentation. On the basis of the obtained data, L₉ (3³) orthogonal test was designed to optimize the solid-state fermentation parameters for yeast autolysis: temperature at 40, 50 and 55 °C; time 12, 18 and 24 h; zinc ion concentration 2, 4 and 8 mg/kg. The optimum process conditions for yeast autolysis were: autolysis temperature 55 °C, time 18 h, zinc ion concentration 2 mg/kg, and soluble protein content reached 9.31 mg/g, free amino acid 14.36 mg/g, α-amino nitrogen 10.16 μg/g and A₂₆₀/A₂₈₀ 1.73. After optimization of the process, the soluble protein, free amino acid and α-amino nitrogen contents of the yeast autolysis production can be significantly increased, thereby obviously improving the quality of the composite culture.
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Humans , Amino Acids , Autolysis , Fermentation , Hydrogen-Ion Concentration , Nitrogen , Saccharomyces cerevisiae , TemperatureABSTRACT
Objective To compare the clinical efficacy of laparoscopic cholecystectomy(LC) + endoscopic sphincterotomy combined with balloon dilation(ESBD) with laparoscopic cholecystectomy(LC) + common bile duct exploration(LCBDE) on cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 102 patients with gallbladder stones with common bile duct stones from October 2015 to October 2017 were reviewed from the Second Affiliated Hospital of Chongqing Medical University.Forty eight patients received LC + ESBD and 54 patients subjected to LC ± LCBDE.The operation time,intraoperative blood loss,abdominal drainage time,antibiotic utilization rate,stone residue rate were compared between the two groups.Measurement data with normal distribution were represented as (Mean ± SD),and t test was used to compare between groups.Measurement data with skewed distribution were represented as M(P25,P75),Mann-whitney U test was used to compare between groups.Categorical variables were describedas counts and percentages and were compared using chi-square test.Results The operation time,intraoperative blood loss,postoperative abdominal drainage time,and antibiotic utilization rate in the LC + ESBD group were (108.0 ± 23.4) min,(18.0 ± 7.1) ml,(1.83 ± 1.57) d,and 47.9％(23/48).The LC +LCBDE groupa were (169.6±37.8) min,(86.4±37.0) ml,(4.80±2.02) d,and 87.0％ (47/54),respectively,there were statistically significant differences between the two groups(P ＜0.05).The stone residual rate of the LC + ESBD group was 0,and the LC + LCBDE group was 5.6％ (3/54),respectively.There was no significant difference between the two groups(P ＞ 0.05).Conclusions LC + ESBD and LC + LCBDE both are safe and effective methods to treat cholecystolithiasis combined with choledocholithiasis.However,some data of LC + ESBD group are better than the LC + LCBDE group,such as general anesthesia time,surgical trauma and recovery time.Therefore,compared with LC + LCBDE,LC + ESBD may be the more suitable operation type for patients who have cardiovascular diseases and poor tolerance.
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Objective To evaluate the role of infliximab trough levels(IFX-TL)and C reactive protein(CRP)concentration in prediction secondary loss of response(LOR)to infliximab(IFX)in patients with Crohn′s disease(CD)during IFX maintenance therapy since 14 weeks after induced treatment.Methods From November 2015 to October 2016,43 CD patients received IFX treatment were enrolled.IFX was initially given at zero,two,and six weeks at 5 mg/kg as induced therapy,and then the same dose was given every eight weeks as long-term maintenance treatment.Serum IFX-TL and CRP concentration were measured at 14thweek after the first IFX injection.The disease activity of CD was assessed by the Harvey-Braddshaw index.According to the follow-up results,the enrolled patients were divided into LOR group and continuous response group,and then the differences in IFX-TL and CRP concentrations at the 14thweek after induced therapy were compared between two groups.Mann-Whitney U test and receiver operating characteristic(ROC)curve were performed for statistical analysis.Results After a median 54 weeks of follow-up,18(41.9%)of 43 CD patients achieved a sustained response to IFX therapy,while 11 patients(25.6%)were LOR to IFX therapy.At the 14thweek after induced therapy,serum IFX-TL of LOR group was 2.30 μg/mL(0.52 μg/mL,2.92 μg/mL),which was lower than that of continuous response group(5.10 μg/mL(3.54 μg/mL,9.34 μg/mL)),and the difference was statistically significant(Z= -3.236,P=0.001).The CRP concentration of LOR group was 3.10 mg/L (0.38 mg/L,21.70 mg/L),which was higher than that of continuous response group(0.51 mg/L(0.27 mg/L, 1.50 mg/L)),and the difference was statistically significant(Z= -1.732,P=0.015).The results of ROC curve analysis indicated that at 14thweek after induced therapy the area under curve(AUC)value of predictive role of serum IFX-TL and CRP level in LOR to IFX was 0.864(95% confidence interval(CI)0.728 to 0.999),sensitivities were 83.3% and 81.8%,specificities were 94.4% and 54.5%,cut-off values of accuracies were 3.115 μg/mL and 5.93 mg/L.Conclusion IFX-TL<3.115 μg/mL and CRP concentration>5.93 mg/L at 14thweek since IFX induced therapy might be used as effective predictors of LOR in CD patients during maintenance therapy.
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Objective To investigate the effect of pedicle screw augmentation with bone cement perfusion on the long segment fixation and fusion in the elderly patients with spinal deformity treated by osteotomy.Methods The cohort data of the older patients aged ≥70 years with spinal kyphosis were retrospectively analyzed in Beijing Hospital,Department of Orthopedic Surgery,Division of Spine Surgery from January 2012 to June 2014.32 cases with complete clinical date were included in this study.The kyphosis of all patients was secondary to thoracolumbar osteoporotic compression fracture.All patients were treated by posterior thoracolumbar spinal osteotomy with long segment fixation and fusion.The patients with fusions including sacral vertebral body fusion or the T score of BMD were less than-5 were excluded.Some patients with neurological compression symptoms also underwent selective decompression in spinal canal and nerve root foramen.All patients were divided into two groups:with (n=14)versus without(n=18)screw augmentation with bone cement perfusion(augmentation vs.non-augmentation/control group).The follow-up time was no less than 12 months.The data of age,gender,operative time,blood loss volume and preoperative bone mineral density were compared between two groups.Cobb angle of postoperative spinal surgery region,lordosis angle of postoperative lumbar,VAS and ODI improvement were analyzed.Data of surgical fixation and fusion segments were recorded.Pedicle screw loosening was compared between two groups.Results In the augmentation group,the pedicle screw loosening didn't occur.But control group showed screw loosening in 7 cases,a euphoric zone around screw in 4 cases,pedicle screw pullout in 2 cases,and vertebral cutting phenomenon with euphotic zone around screw in 1 case.There were no significant differences in ODI improvement rate and surgical satisfaction between the two groups.Conclusions When operative procedures of surgeon are in precision and skillful,bone cement augmentation technique for pedicle screw can reduce the occurrence of pedicle screw loosening in older patients during osteotomy and long segment fixation and fusion operation for spinal kyphosis.
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Background:With the extensive use of infliximab (IFX)in treatment of patients with Crohn's disease (CD),some of the patients had losing of response to IFX treatment. The specific mechanism is not clear yet,and may be related to the formation of antibodies to infliximab (ATI). However,there is no report on the positivity rate of ATI in China so far. Aims:To investigate the clinical effects of serum IFX trough levels (IFX-TLs)and ATI in CD patients treated with IFX. Methods:A total of 76 CD patients receiving IFX treatment from Jan. 2016 to Mar. 2017 at Shanghai Renji Hospital were enrolled. Serum IFX-TLs and ATI were detected. CD patients were divided into active stage group and remission group according to CDAI score,and serum IFX-TLs,ATI,C-reactive protein (CRP)and erythrocyte sedimentation rate (ESR) levels were analyzed. Results:Of the 76 patients with CD,positive ATI was found in 2 patients (2. 6%). Forty-five (59. 2%)patients were in remission,while 31 (40. 8%)in active stage. No significant differences in IFX-TLs [2. 84 (1. 30,4. 96)μg/ mL vs. 4. 08 (1. 29,6. 72)μg/ mL,P =0. 484],ATI [8. 00 (5. 27,14. 89)ng/ mL vs. 7. 00 (4. 40, 25. 00)ng/ mL,P = 0. 454]were found between active CD and remission CD. Serum CRP,ESR levels were significantly increased in active CD than in remission CD (P = 0. 038,P = 0. 009). Logistic regression analysis showed that activity of CD was related to CRP (OR = 6. 082,95% CI:1. 348-27. 436,P = 0. 019),but not related to IFX-TLs,ATI and ESR (P > 0. 05). Conclusions:The activity of CD may be correlated with CRP,but not with IFX-TLs,ATI and ESR.
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Objective To understand the distribution condition of resources of medicinal plant of Euodiae Fructus;To provide references for resource conservation and standardized plantation of Euodiae Fructus. Methods Literature search, interview survey and field survey were conducted to investigate the resource conditions of the main producing areas of Euodiae Fructus. Samples were collected and TKW of the medicinal plant was weighted. Results Currently, the main producing areas of Euodiae Fructus are provinces of Jiangxi, Guizhou, Hubei, Hunan and part of provinces and places of Guangxi, Anhui, Zhejiang, Shanxi, and Chongqing. Commercial Euodiae Fructus mainly comes from private investors. The wild resources of Euodiae Fructus are few. The TKW of the medicinal plant is within 5.34-45.62 g, with great differences. The national annual output of cultivated Euodiae Fructus is around 3500 t. The production and marketing is in balance. The price for Euodiae Fructus is relatively stable. Conclusion The plantation of Euodiae Fructus is dispersing, with small scale, low degree of standardization and intensification, and great quality differences. Standardized, large-scale, and industrialized plantation base should be established, and the assessment system for medicine quality should be perfected, with a purpose to ensure the qualified and stable production of Euodiae Fructus. Meanwhile, wild resource production should be enhanced to maintain the biological diversity and promote the sustainable development of Euodiae Fructus.
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<p><b>OBJECTIVE</b>To construct enterohemorrhagic Escherichia coli (EHEC) O157:H7 strains with delection espF gene and its nucleotide fragment and with espF gene complementation.</p><p><b>METHODS</b>A pair of homologous arm primers was designed to amplify the gene fragment of kanamycin resistance, which was transformed into EHEC O157:H7 EDL933w strain via the PKD46 plasmid by electroporation. The replacement of the espF gene by kanamycin resistance gene through the PKD46-mediated red recombination system was confirmed by PCR and sequencing. The entire coding region of espF along with its nucleotide fragment was amplified by PCR and cloned into pBAD33 plasmid, which was transformed into a mutant strain to construct the strain with espF complementation. RT-PCR was used to verify the transcription of espF and its nucleotide fragment in the complemented mutant strain.</p><p><b>RESULTS AND CONCLUSION</b>We established EHEC O157:H7 EDL933w strains with espF gene deletion and with espF gene complementation. Both espF and its nucleotide fragment were transcribed in the complemented mutant strain. The two strains provide a basis for further study of the regulatory mechanism of espF.</p>
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Carrier Proteins , Genetics , DNA Primers , Escherichia coli O157 , Genetics , Escherichia coli Proteins , Genetics , Gene Deletion , Plasmids , Polymerase Chain ReactionABSTRACT
Objective To investigate the surgical curative effect of long-segment fixation and fusion on the degenerative scoliosis (DS) in the elderly.Methods The clinical data of 27 patients with DS undergoing surgical treatment from January 2011 to December 2013 in our department in Beijing Hospital were retrospectively analyzed.All patients suffered from degenerative scoliosis accompanied with lumbar canal stenosis, lumbar spondylolisthesis, lumbar vertebrae lateral slip in coronal surface, spinal vertebral rotation deformity and kyphosis.The decompression osteotomy and fixed segment, blood loss volume and operation time were recorded.The differences in scoliosis angle (Cobb angle), lumbar lordotic angle, top vertebral rotation degree (Nash-Moe vertebral rotation grade), apical vertebral offset distance, visual analogue scale (VAS) score and Oswestry disability index (ODI) score were compared between pretreatment versus the last follow-up.Results The selective 1-5 segment decompression and 5-10 segment fusion were selected in a total of 27 patients.Some patients were treated with Smith-Petersen osteotomy (SPO).All of 27 cases were treated with a lamina and inter-transverse fusion, among which 25 cases took inter-vertebral fusion additionally.The time of postoperative follow-up was more than 1 year.The Cobb angle, lumbar lordotic angle, apical vertebral offset distance, VAS and ODI scores were improved after treatment as compared with pretreatment [(11 6) vs.35 6 , (32±10) vs.(17±9) , (16.3±8.2) mm vs.(32.2±9.8) mm, (3.3±1.6) vs.(7.3±2.1), (18±14) vs.(33±14), t=2.469, 2.313, 2.331, 2.362, 2.395, P=0.021, 0.030, 0.029, 0.026, 0.023 respectively].The satisfaction survey result was excellent in 19cases, good in 5 cases, fair in 3 cases.Complications were found in 9 patients, among whom 2 cases had screw loosening in the internal fixation, 2 cases had adjacent segment degeneration, 1 case had pulmonary infection, 1 case had urinary tract infection, 2 eases had spinal fluid leakage, 1 case had epidural hematoma.No serious complications and deaths were observed.Conclusions Under strictly controlling the therapeutic indications, the limited decompression and long-segmental fixation and fusion have good therapeutic efficacy on degenerative scoliosis in elderly patients.
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Objective To evaluate efficacy,safety and complication of percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) in≥90 years patients.Methods Clinical data of 56 cases aged ≥ 90 years with osteoporotic vertebral compression fracture undergoing percutaneous kyphoplasty were retrospectively analyzed.Visual analog scale (VAS) score,analgesics administration score,locomotor activity score,bone cement leakage and incidence of refracture were evaluated before and 3 days after treatment,and at the last follow-up.Results The mean follow-up was 18.6 months (6-32 months) in all patients.The mean VAS score was (7.1 ±2.1) before treatment,(2.6±1.1) at 3 days after the procedure,and (1.8±0.7) at last follow-up,respectively (F=455.794,P＜0.001).Analgesics administration score were (2.0±1.7),(1.4±0.5) and (1.1±0.7) respectively before and 3 days after treatment,and at the last follow-up (F=9.631,P＜0.001).Locomotor activity score were (2.5±0.6),(1.2±0.5) and (1.0±0.3)before and 3 days after treatment,and at the last follow-up (F=63.254,P＜ 0.001) respectively.Bone cement leakage occurred in 10 cases(17.9％),recurrent fracture in 6 cases(10.7％),cerebrospinal leak in 3 cases (5.3％),and nerve root stimulation in2 cases(3.6％).Total complication rate was 33.9％(19/56),and all complications were transient and well tolerated.Conclusions Kyphoplasty for osteoporotic vertebral compression fracture in the very elderly is effective and safe.It alleviates fracture-induced pain,reduces analgesic drug use and improves spinal activity,and provides a better choice for minimal invasive treatment for nonagenarian OVCF patients.
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<p><b>OBJECTIVE</b>To construct enterohemorrhagic Escherichia coli (EHEC) O157: H7 ppk gene deletion strains and study its biological characteristics.</p><p><b>METHODS</b>The gene fragment of kanamycin resistance was amplified using a pair of homologous arm primers whose 5' and 3' ends were homologous with ppk gene and kanamycin resistance gene, respectively. EHEC O157: H7 EDL933w competent strains were prepared and transformed via electroporation with the amplification products. The ppk gene was replaced by kanamycin resistance gene using pKD46-mediated Red recombination system. The recombinant strain was confirmed by PCR and sequencing, and its morphology, growth ability and adhesion were assessed using Gram staining, OD600 value and Giemsa staining.</p><p><b>RESULTS AND CONCLUSION</b>We established a ppk-deleted EHEC O157:H7 EDL933w strain with kanamycin resistance and compared the biological characteristics of the wild-type and mutant strains, which may facilitate further study of the regulatory mechanism of ppk gene.</p>