ABSTRACT
Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.
ABSTRACT
Objective To explore the safety and feasibility of microwave ablation assisted laparoscopic resection of liver cancer.Method The clinical data of 40 patients with liver cancer were retrospectively analyzed from April 2013 to June 2016 in Shengjing Hospital.Results Procedures were completed successfully without conversion to open laparotomy or serious complications.The average operation time,blood loss and postoperative hospital stay were (160 ± 68) min,(36 ± 27) ml and (7.6 _± 2.7) d,respectively.There was no tumor recurrence in surgical margins.The postoperative median tumor-free survival was 30 months,with cumulative 1-year and 2-year tumor-free survival rates of 89.4％ and 65.5％,respectively.The postoperative median overall survival time was 38 months,with cumulative 1-year and 2-year survival rates of 100％ and 90.9％,respectively.Conclusion Microwave ablation can effectively control intraoperative bleeding,and prevent tumor recurrence in surgical margins.Microwave ablation assisted laparoscopic hepatectomy is safe and feasible for hepatocellular carcinoma.
ABSTRACT
OBJECTIVE To identify the possible risk factors for the development of surgical site infection (SSI). METHODS A total of 218 consecutive patients who received open cholecystectomy due to gallbladder disease and stone of common bile duct during from the Jun to Dec in 2007 were included in the study. The potential risk factors including clinical features,biochemical data,operative types and incision types were analyzed by univariate analysis. RESULTS The overall incidence of SSI was 5.04%.The incidence of SSI in cholecystectomy alone group was lower than in cholecystectomy with exploration of common bile duct group (10.9% vs 3.1%,P=0.022).The incidence of SSI in emergency group was higher than that in selective operation group (12.5% vs 3.8%,P=0.037). The incidence of SSI among patients with white blood cell count more than 10.0?109 befove surgery was higher (12.2% vs 3.0%,P=0.025). The incidence was 1.5%,6.1% and 26.3%,respectively,for patients with Ⅱ,Ⅲ and Ⅳ types incision (P=0.000). CONCLUSIONS These findings indicate that risk factors for the development of SSI after open cholecystectomy include operation manner,operation type,incision type and preoperative leucocyte count.
ABSTRACT
OBJECTIVE: To explore the effects of Shenfu Injection on prostacyclin, thromboxane A2 and the activities of ATPases in rats exposed to hepatic ischemia-reperfusion injury. METHODS: Twenty-four male Wistar rats weighing 200-250 g were randomly divided into two groups: Shenfu Injection (SF)-treated group (rats were treated with Shenfu Injection of 10 ml/kg through intraperitoneal injection) and untreated group (rats were administered with normal saline at the same dose and served as a control group). Hepatic ischemia was caused by Pringle's maneuver and lasted for fifteen minutes, and then one-hour or three-hour reperfusion was performed. Venous blood samples for the measurement of thromboxane B(2) (TXB(2)) and 6-keto-prostaglandin F(1 alpha)(6-keto-PGF(1 alpha)) were collected three hours after reperfusion. Liver tissue samples were collected one hour or three hours after reperfusion for the measurement of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase and for morphological studies. RESULTS: Plasma TXB(2) was lower in the SF-treated group than that in the untreated group after three-hour reperfusion (P>0.05), while 6-keto-PGF(1 alpha) was higher in the SF-treated group than that in the untreated group (P>0.05). The ratio of TXB(2) and 6-keto-PGF(1 alpha) was significantly lower in the SF-treated group than that in the untreated group (P<0.05). The activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)-ATPase in the SF-treated group were improved obviously. A three-hour reperfusion after fifteen-minute ischemia caused important hepatic histological alterations. Marked structural abnormalities were observed in the untreated group, such as massive hepatocyte swelling, necrosis, mitochondria edema and vacuolar changes. In the SF-treated group, hepatic tissue injury was reduced significantly. CONCLUSION: Shenfu Injection protects hepatic tissue from ischemia-reperfusion injury, and such protective effects are achieved by decreasing the ratio of thromboxane A(2) and prostacyclin, and increasing the activities of Na(+)-K(+)-ATPase and Ca(+)-Mg(+)- ATPase.
ABSTRACT
BACKGROUND: Bone marrow stromal cells(BMSCs) are the ideal gene target cells and will have a bright future in the gene therapy of spinal cord injury.OBJECTIVE :To detect the expression of glial cell line - derived neurotrophic factor(GDNF) gene after BMSCs were infected by adenovirus-medialed GDNF (Adv-GDNF) in vitro and to explore its biological activity.DESIGN: A randomized controlled trial study.SETTING: Laboratory of Orthopedic DepartmentMATERIALS: The experiment was completed in the Laboratory of Orthopedic Department, Affiliated Tongji Hospital of Tong ji Meidcal College,Huazhong University of Science and Technology. Twenty-four SD rats of either gender, weighing (180 ± 20) g.INTERVENTIONS: BMSCs were infected by Adv-GDNF in vitro and then cocultured with spinal cord dorsal root ganglion. The three methods, immunofluorescent chemistry, reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay(ELISA) were used to evaluate GDNF expression in the BMSCs. The biological activity of GDNF was observed by a phase contrast microscope.MAIN OUTCOME MEASURES:Primary outcomes:①RT-PCR;②results of immunofluorescent chemical examination;③biological activity of GDNF in vitro. Secondary outcomes:①culturing and identification of BMSCs②time-effect relationship of GDNF expression revealed by ELISA.RESULTS: Immunofluorescence displayed expression of GDNF in BMSCs 48hours after Adv-GNDF infection. RT-PCR analysis demonstrated expression of GDNF mRNA 24 hours after Adv-GNDF infection. ELISA confirmed the presence of GDNF in the liquid supernatant of BMSCs 24 hours after Adv-GDNF infectionn and showed that GDNF was secreted. The supernatant can promote the neurite outgrowth in the rat dorsal root ganglion(DRG).CONCLUSION: It is demonstrated that BMSCs infected by Adv-GDNF can express GDNF steadily and the expressed GDNF has the activity of promoting neurite outgrowth, which lays a foundation of the GDNF gene therapy for spinal cord injury.
ABSTRACT
In order to study the effects of electromagnetic fields (EMFs) on proliferation, differentiation and intercellular cyclic AMP (cAMP) in mouse bone marrow mesenchymal stem cells (MSCs) in vitro, the mouse bone MSCs were isolated and cultured in vitro. The third passage MSCs were divided into 4 groups and stimulated with EMFs. The cellular proliferation (MTT), the cellular differentiation (alkaline phosphatase activity, ALP), and the intercellular cAMP level were investigated at different time points. The results showed that EMF (50Hz pulse burst 2 mT peak) inhibited the cellular proliferation (P < 0.05), enhanced the cellular differentiation (P < 0. 05), and increased the intercellular cAMP level (P < 0.01) in the early time of the stimulation (1-3 days), but the intercellular cAMP level did not increased further in the later days. We are led to conclude that the cAMP may be involved in the mediation of the growth inhibitory and differentiation-inducing signals of specific EMFs in vitro.
Subject(s)
Alkaline Phosphatase/metabolism , Bone Marrow Cells/cytology , Cell Differentiation , Cell Proliferation , Cells, Cultured , Cyclic AMP/metabolism , Electromagnetic Fields , Mesenchymal Stem Cells/cytologyABSTRACT
In order to study the effects of electromagnetic fields (EMFs) on proliferation, differentiation and intercellular cyclic AMP (cAMP) in mouse bone marrow mesenchymal stem cells (MSCs) in vitro, the mouse bone MSCs were isolated and cultured in vitro. The third passage MSCs were divided into 4 groups and stimulated with EMFs. The cellular proliferation (MTT),the cellular differentiation (alkaline phosphatase activity, ALP), and the intercellular cAMP level were investigated at different time points. The results showed that EMF (50Hz pulse burst 2 mT peak) inhibited the cellular proliferation (P＜0.05), enhanced the cellular differentiation (P＜0.05), and increased the intercellular cAMP level (P＜0.01) in the early time of the stimulation (1-3 days), but the intercellular cAMP level did not increased further in the later days. We are led to conclude that the cAMP may be involved in the mediation of the growth inhibitory and differentiation-inducing signals of specific EMFs in vitro.
ABSTRACT
By culturing bone marrow mesenchymal stem cells of rabbits with fibrin glue in vitro, the biocompatibility of fibrin glue was investigated to study whether this material can be used as scaffolds in bone tissue engineering. After 2-months old New Zealand rabbits had been anesthetized, about 4-6 ml of bone marrow were aspirated from rabbit femoral trochanter. The monocytes suspension was aspirated after bone marrow was centrifuged with lymphocyte separating medium and cultured primarily. Then the cells were divided into two groups: one was cultured with complete medium and the other with induced medium. The cells of the two groups were collected and inoculated to the culture plate containing fibrin glue. In the control group, cells were inoculated without fibrin glue. The implanted cells and materials were observed at different stages under a phase-contrast microscope and scanning electron microscope. MTT and alkaline phosphatase (ALP) were measured. Bone marrow mesenchymal stem cells grew on the surface of fibrin glue and adhered to it gradually. Cells light absorption value (A value) and the ALP content showed no significant difference. Fibrin glue had no inhibitory effect on cell morphology, growth, proliferation and differentiation. It has good biocompatibility and can be used as scaffold materials for bone marrow mesenchymal stem cells in bone tissue engineering.
Subject(s)
Biocompatible Materials/pharmacology , Bone Marrow Cells/cytology , Cells, Cultured , Coculture Techniques , Fibrin Tissue Adhesive/pharmacology , Mesenchymal Stem Cells/cytology , Tissue EngineeringABSTRACT
By culturing bone marrow mesenchymal stem cells of rabbits with fibrin glue in vitro, the biocompatibility of fibrin glue was investigated to study whether this material can be used as scaffolds in bone tissue engineering. After 2-months old New Zealand rabbits had been anesthetized, about 4-6 ml of bone marrow were aspirated from rabbit femoral trochanter. The monocytes suspension was aspirated after bone marrow was centrifuged with lymphocyte separating medium and cultured primarily. Then the cells were divided into two groups: one was cultured with complete medium and the other with induced medium. The cells of the two groups were collected and inoculated to the culture plate containing fibrin glue. In the control group, cells were inoculated without fibrin glue. The implanted cells and materials were observed at different stages under a phase-contrast microscope and scanning electron microscope. MTT and alkaline phosphatase (ALP) were measured. Bone marrow mesenchymal stem cells grew on the surface of fibrin glue and adhered to it gradually. Cells light absorption value (A value) and the ALP content showed no significant difference. Fibrin glue had no inhibitory effect on cell morphology, growth, proliferation and differentiation. It has good biocompatibility and can be used as scaffold materials for bone marrow mesenchymal stem cells in bone tissue engineering.
Subject(s)
Animals , Rabbits , Biocompatible Materials , Pharmacology , Bone Marrow Cells , Cell Biology , Cells, Cultured , Coculture Techniques , Fibrin Tissue Adhesive , Pharmacology , Mesenchymal Stem Cells , Cell Biology , Tissue EngineeringABSTRACT
Objective To investigate the therapeutic time window and the dose response effects of epirubicin on the expression of c-FLIP in breast cancer.Methods MCF-7and MDA-MB-231 breast cancer cells were divided into two groups: epirubicin groups were treated with 4.0,2.0,1.0,0.5 and 0.25mg/L of epirubicin,and control groups were treated with 0.9% sodium chloride solution at the same dose.After treatment for 24,48 and 72 h,the incubated cells were collected for the measurement of c-FLIP by RT-PCR,and for examination of percent of apoptosis cells with flow cytometry.ResultsA dose-time-dependent pattern was observed.The expression of c-FLIP in MCF-7and MDA-MB-231 breast cancer cell lines declined gradually as the epirubicin concentration increased and treatment time was prolonged.Percentage of apoptosis breast cancer cells increased gradually as the epirubicin concentration was increased and treatment time was prolonged,and percentage of apoptosis cells was the highest when breast cancer cells were treated with 2 mg/L epirubicin for 72 h.ConclusionsEpirubicin can promote apoptosis of breast cancer cells by inhibiting the expression of c-FLIP,and its inhibitory effect is most pronounced when breast cancer cells are treated with 2 mg/L epirubicin for 72 h.