Anterior versus posterior decompression for the treatment of thoracolumbar fractures with spinal cord injury:a Meta-analysis / 中国骨伤

OBJECTIVE@#To systematically evaluate the efficacy and safety of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury, so as to provide a good scientific basis for more effective treatment of thoracolumbar fractures with spinal cord injury.@*METHODS@#A clinical data about comparative study of anterior decompression and posterior decompression in the treatment of thoracolumbar fractures with spinal cord injury was searched and collected. The databases of Pubmed, Embase, Cochrane Library, CNKI, CBM, Wanfang Medical Network were searched by computer. Artificially collected journals included Spine, European Spine Journal, The Journal of Bone and Joint Surgery. Two spine surgeons independently screened the literature according to established inclusion and exclusion criteria and assessed the quality of the included studies. Meta-analysis was performed on the data using Review Manager 5.3 software, the indicators included operative time, intraoperative blood loss, postoperative tactile score, postoperative motor score, postoperative vertebral height, hospitalization time, neurological function recovery, efficiency of treatment, postoperative complications.@*RESULTS@#Fifteen randomized controlled trials (RCTs) were enrolled in a total of 1 360 patients, including 680 anterior decompression and 680 posterior decompression. The results of Meta-analysis showed that the anterior decompression group had longer operation time [MD=80.09, 95% CI(36.83, 123.34), P=0.000 3], more intraoperative blood loss [MD=225.21, 95%CI(171.07, 279.35), <0.000 01], longer hospitalization time [MD=2.31, 95% CI(0.32, 4.31), P=0.02]. And the postoperative tactile score [MD=13.39, 95% CI(9.86, 16.92), <0.000 01], postoperative motor score [MD=13.15, 95% CI(7.02, 19.29), <0.000 1], vertebral height [MD=1.36, 95% CI(0.79, 1.92), <0.000 01] in anterior decompression were higher than that in posterior decompression. There was no statistically significant differences in the efficacy of treatment [OR=1.14, 95% CI(0.56, 2.31), P=0.72], neurological recovery [OR=0.87, 95% CI(0.57, 1.33), P=0.52] between two groups.@*CONCLUSIONS@#Compared with posterior decompression, the anterior decompression has the advantages of longer operating time, more intraoperative blood loss, longer hospitalization time, higher postoperative tactile score, higher postoperative motor score, and higher injury vertebral height, But there was no significant difference in the treatment efficiency and nerve function recovery between two groups.

Effect of axial vertical vibration on degeneration of lumbar intervertebral discs in modified bipedal rats: An in-vivo study

Objective To assess the effects of axial vibrations on gene expression and lumbar intervertebral disc degeneration in vivo. Methods A modified bipedal rat model was established using a brachial plexus rhizotomy approach to imitate human upright posture. The experimental animals were randomly divided into three groups: control, vertical vibration, and whole-body vibration. Gene expression in degeneration of the intervertebral discs was assessed by reverse transcription-quantitative polymerase chain reaction. Results The expression of aggrecan, Col1α1, Col2α1, and decorin were shown to be up-regulated in 14-week-old rats in the vertical vibration and whole-body vibration groups, whereas biglycan and versican expression was down-regulated in 14-week-old rats of the two experimental groups. Furthermore, biglycan and versican expression levels were shown to be lower in the whole-body vibration group than in the vertical vibration group (P < 0.05). Conclusions This in-vivo study demonstrated that vibrations can influence the expression of anabolic genes. Furthermore, whole-body vibrations seem to have a greater effect in this regard than vertical vibrations. A new method is expected to relieve the low back pain of the patients through our research.

Effect of axial vertical vibration on degeneration of lumbar intervertebral discs in modified bipedal rats: An in-vivo study

OBJECTIVE@#To assess the effects of axial vibrations on gene expression and lumbar intervertebral disc degeneration in vivo.@*METHODS@#A modified bipedal rat model was established using a brachial plexus rhizotomy approach to imitate human upright posture. The experimental animals were randomly divided into three groups: control, vertical vibration, and whole-body vibration. Gene expression in degeneration of the intervertebral discs was assessed by reverse transcription-quantitative polymerase chain reaction.@*RESULTS@#The expression of aggrecan, Col1α1, Col2α1, and decorin were shown to be up-regulated in 14-week-old rats in the vertical vibration and whole-body vibration groups, whereas biglycan and versican expression was down-regulated in 14-week-old rats of the two experimental groups. Furthermore, biglycan and versican expression levels were shown to be lower in the whole-body vibration group than in the vertical vibration group (P < 0.05).@*CONCLUSIONS@#This in-vivo study demonstrated that vibrations can influence the expression of anabolic genes. Furthermore, whole-body vibrations seem to have a greater effect in this regard than vertical vibrations. A new method is expected to relieve the low back pain of the patients through our research.

Preventive and therapeutic effects of penehyclidine hydrochloride on morphine-induced increased bladder pressure, urinary bladder sphincter pressure and histological damage in rabbits / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Morphine has become the preferred drug for analgesia. However, analgesic doses of morphine can result in urinary retention, which is an intractable problem in clinical practice. Though bladder catheterization is one available therapeutic option, data supporting the technique's effectiveness are controversial. As a novel anti-cholinergic medicine developed in China, penehyclidine hydrochloride (PHC) exhibits greater selectivity for M(3)/M(1) receptors than M(2) receptors. Therefore, this study aimed to determine the efficacy of PHC in treating urinary retention.</p><p><b>METHODS</b>Thirty-two healthy male New Zealand white rabbits were randomly divided in four groups (n = 8 each) as follows: control group (C group), PHC low-dose group (PL group, 0.01 mg/kg of PHC intramuscularly), PHC middle-dose group (PM group, 0.02 mg/kg of PHC intramuscularly), and PHC high-dose group (PH group, 0.05 mg/kg of PHC intramuscularly). All rabbits were injected intravenously with morphine (1 mg/kg) to induce urinary retention and different doses of PHC were injected intramuscularly in the PL, PM and PH groups. In the C group, 1 ml saline was administered instead of PHC. The bladder pressure and the bladder sphincter pressure were recorded at different time points. The plasma concentration of PHC was measured at different time points with high performance liquid chromatography. Arterial blood pressure and heart rate (HR) were recorded at different time points.</p><p><b>RESULTS</b>Bladder pressure and urinary bladder sphincter pressure rose significantly from 30 minutes after morphine administration until the end of the experiment. PHC markedly attenuated the elevations in pressure induced by morphine. Morphometric analysis also revealed histological damage, erythrocytes and ruptures of the microcirculation in regions of the submucosa and smooth muscle. Morphometric damage was ameliorated with PHC but not with saline. Hemodynamic data (mean arterial pressure (MAP) and HR) did not differ between groups over the observation period.</p><p><b>CONCLUSIONS</b>This study demonstrated that intravenous morphine significantly increased bladder pressure and urinary bladder sphincter pressure and induced histological damage in the bladder and urinary bladder sphincter. Importantly, preliminary data showed that PHC could decrease the extent of these changes.</p>

A study on the relationship between the expression of apoptosis-related gene and the injury time in earlier period following cerebral contusion / 法医学杂志

OBJECTIVE@#To investigate the relationship between the expressive variety of apoptosis-related gene Bcl-2, Fas and the brain injury time during earlier period after cerebral contusion.@*METHODS@#The morphologia feature of brain tissue was observed under microscopy and immunohistochemistry, image analyze technique was applied to detected the expression of Bcl-2 and Fas.@*RESULTS@#Typical apoptotic cells were seen 8 hours after cerebral contusion. The expression of apoptosis-related gene was noted after 30 minutes and keep increase subsequently. The expression of Bcl-2 reached maximum level at 4 hours after brain trauma and then declined.@*CONCLUSION@#Detecting the expression of Bcl-2 and Fas would be of valuable in the distinguishment of promortem and postmortem injury, and the estimation of brain injury time during the earlier period after cerebral contusion.

Trauma brain injury and apoptosis / 法医学杂志

The evidence and the feature of apoptosis following tyrauma brain injury(TBI) and the possible mechanisms underlying apoptosis were reviewed. Recently research showed that apoptosis play an important role in TBI, the occurring time and area of apoptosis were found significant differences compared with that of necrosis. The neural cell apoptosis can undergo following many pathways after TBI. In our review, the foreground of apoptosis after TBI research in forensic pathology were also discussed.