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BACKGROUND: Water stress is one of the serious abiotic stresses that negatively influences the growth, development and production of sugarcane in arid and semi-arid regions. However, silicon (Si) has been applied as an alleviation strategy subjected to environmental stresses. METHODS: In this experiment, Si was applied as soil irrigation in sugarcane plants to understand the mitigation effect of Si against harmful impact of water stress on photosynthetic leaf gas exchange. RESULTS: In the present study we primarily revealed the consequences of low soil moisture content, which affect overall plant performance of sugarcane significantly. Silicon application reduced the adverse effects of water stress by improving the net photosynthetic assimilation rate (Anet) 1.35-18.75%, stomatal conductance to water vapour (gs) 3.26-21.57% and rate of transpiration (E) 1.16-17.83%. The mathematical models developed from the proposed hypothesis explained the functional relationships between photosynthetic responses of Si application and water stress mitigation. CONCLUSIONS: Silicon application showed high ameliorative effects on photosynthetic responses of sugarcane to water stress and could be used for mitigating environmental stresses in other crops, too, in future.
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Silicon , Saccharum , Photosynthesis , Water , Plant Leaves , DehydrationABSTRACT
In the era of climate change, due to increased incidences of a wide range of various environmental stresses, especially biotic and abiotic stresses around the globe, the performance of plants can be affected by these stresses. After oxygen, silicon (Si) is the second most abundant element in the earth's crust. It is not considered as an important element, but can be thought of as a multi-beneficial quasi-essential element for plants. This review on silicon presents an overview of the versatile role of this element in a variety of plants. Plants absorb silicon through roots from the rhizospheric soil in the form of silicic or monosilicic acid. Silicon plays a key metabolic function in living organisms due to its relative abundance in the atmosphere. Plants with higher content of silicon in shoot or root are very few prone to attack by pests, and exhibit increased stress resistance. However, the more remarkable impact of silicon is the decrease in the number of seed intensities/soil-borne and foliar diseases of major plant varieties that are infected by biotrophic, hemi-biotrophic and necrotrophic pathogens. The amelioration in disease symptoms are due to the effect of silicon on a some factors involved in providing host resistance namely, duration of incubation, size, shape and number of lesions. The formation of a mechanical barrier beneath the cuticle and in the cell walls by the polymerization of silicon was first proposed as to how this element decreases plant disease severity. The current understanding of how this element enhances resistance in plants subjected to biotic stress, the exact functions and mechanisms by which it modulates plant biology by potentiating the host defence mechanism needs to be studied using genomics, metabolomics and proteomics. The role of silicon in helping the plants in adaption to biotic stress has been discussed which will help to plan in a systematic way the development of more sustainable agriculture for food security and safety in the future.
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Silicon , Stress, Physiological , Plants , Soil , AgricultureABSTRACT
OBJECTIVE@#To investigate the clinical characteristics, laboratorial and bone marrow pathological features of primary thrombocytopenia (ET) patients with different mutations of CALR, JAK2 and MPL genes.@*METHODS@#The chinical data of 120 cases of ET in Jiangsu provincial people's hospital/ The First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2017 were collected and analyzed, including 76 cases with JAK2 gene mutation, 40 cases with CALR gene mutation, 2 cases with MPL gene mutations, 2 cases without gene mutation.@*RESULTS@#Among the ET patients, compared with the JAK2 gene mutation, CALR gene mutation showed statistically significant deareament of white blood cells and hemoglobin (P=0.001, P=0.01) and the male platelets in CALR group showed significant increament (P=0.04). Fourthermore, the average number of megakaryocytes and its cluster numbers in each hight power field of vision showed statistically significant decreament in CALR group as compared with JAK2 group (P=0.001, P=0.001), and thrombotic events in CALR group were signicantly lower than those in JAK2 group (7.5% vs 18.4%) (P=0.03).@*CONCLUSION@#Mutations of CALR, JAK2 have different clinical characteristics and blood pathological changes of Chinese ET patients, and their clinical significance is worth to explore.
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Humans , Male , Bone Marrow , Calreticulin , Genetics , China , Janus Kinase 2 , Genetics , Mutation , Receptors, Thrombopoietin , Genetics , Thrombocythemia, EssentialABSTRACT
OBJECTIVE: To investigate the influence of HBV and HCV co-infection on the plasma concentrations, efficacy and hepatotoxicity of efavirenz in HIV/AIDS patients. METHODS: The peripheral blood HIV RNA viral loads, CD4+ T-cells, liver function and plasma efavirenz concentrations of 494 cases of HIV monoinfected, HIV/HBV and HIV/HCV co-infected patients were determined by PCR, flow cytometry, automatic biochemical analysis and HPLC and statically compared. RESULTS: The median (IQR) efavirenz concentrations at week 48 of HIV-monoinfected patients, HBV- and HCV-coinfected patients were 3.781 mg•L-1(3.012-4.980 mg•L-1), 3.057 mg•L-1(2.040-5.144 mg•L-1), 2.557 mg•L-1(2.212-4.334 mg•L-1), respectively (P<0.05), while the proportions of patients achieving partial and complete virus inhibition were 78.59%, 76.36%, and 100.00%, respectively. The mean±SD CD4 cell counts steadily increased over time from (290±118), (273±120), and (282±134)cells•mm-3 at baseline to (442±184), (457±221), and (391±151) cells•mm-3 at week 48, respectively(P<0.05). The indexes of liver functions were all basically within normal limits. CONCLUSION: The immune reconstruction of most patients is smooth and they also have favorable prognosis. Co-infection with HBV or HCV will not cause accumulation of efavirenz or hepatic damage. Efavirenz is safe and effective for treatment-naive HIV/AIDS patients with HBV and HCV co-infection.
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OBJECTIVE: To analyze the clinicopathologic characteristics and molecular subtype in male breast cancer(MBC). METHODS: The clinical features, histological features and molecular subtype of 38 cases of male breast cancers admitted from January 2013 to March 2019 in Clinical Pathology Diagnostic Center of Ningbo were analyzed retrospectively. RESULTS: Thirty-eight patients were diagnosed with MBC, accounting for 0.83% of all the breast cancer in the same term. The median age was 68.5(range from 24 to 88). Tumor were located in left side in 20 cases, right side in 18 cases. Twenty-nine cases were diagnosed as invasive ductal carcinoma, two cases of secretory breast cancer, one case of invasive solid papillary carcinoma, two cases of intraductal papillary carcinoma with microinvasive, and four cases of encapsulated papillary carcinoma(two of them with microinvasive). Sixteen patients had lymphatic metastasis when the tumor was diagnosed. Imunohistochemically, ER was positive in 36 cases, while PR was positive in 35 cases.Eighteen cases were Luminal A type, while sixteen were Luminal B type and two cases were basal-like subtype.CONCLUSION: MBC is a rare malignant neoplasm, and most patients are diagnosed older and at advanced clinical stage,what is more, there is more possibility of second non-breast primary cancer. All suggesting that early diagnosis,treatment and more intensive surveillance are important. MBC needs further study.
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Using the lipidomics method based on UHPLC-Q-Exactive Orbitrap/MS, the change of phospholipid metabolism in lung tissue of mice induced by lipopolysaccharide (LPS)-induced acute lung injury was analyzed to observe the regulation of abnormal lipids by Jiegeng Decoction and to explore the regulation effect of Jiegeng Decoction on LPS-induced acute lung injury. The lung tissue samples from control group, model group, dexamethasone (positive drug) group, and Jiegeng Decoction group were collected and the lipid components of the sample were extracted. All procedures over mice were performed in accordance with the Guidelines for Care and Use of Laboratory Animals of Nanjing University of Chinese Medicine, and the experiments were approved by the Animal Ethics Committee of our university. The lipidomics technique of UHPLC-Q-Exactive Orbitrap/MS was used to study change of phospholipids in lung tissue of each group. LPS induced acute lung injury in mice with metabolic abnormalities of phospholipids, the specific performance of the PC was significantly upregulated, phosphatidyl ethanolamine (PE), phosphatidyl glycerol (PG), phosphatidyl serine (PS),phosphatidylinositol (PI) and other metabolic disorders, Jiegeng Decoction have a certain role in these phospholipids. LPS-induced acute lung injury caused disturbances of phospholipid in vivo, and Jiegeng Decoction regulates metabolic phospholipids.
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Objective To explore the changed trend of endogenous lipid metabolites in rats with rheumatoid arthritis during different disease periods and the regulation of Zushima Tablets on differential metabolites based on UPLC-Q-Exactive Orbitrap MS. Methods The collagen-induced arthritis (CIA) rats were established using bovine type II collagen. The serum samples were collected before (0 d) and 14, 21, and 36 d after model construction from control, model, and Zushima Tablets groups [0.6 g/(kg•d)], respectively. The lipids were extracted and identified by bioinformatics analysis to find the lipid differential metabolites. Results It was obviously observed that lipid metabolism disordered in CIA rats compared with the control group. The content of three acylcarnitines was increased significantly while the level of TG showed a downward trend in the CIA model group when the TG carbon chain was shorter than 58 carbon atoms. To the opposite, the content of TG substances with atomic number greater than fifty-eight in the model group was significantly higher than that of the control group. Zushima tablet obviously regulated the metabolism levels of a phosphatidylserine, a ceramide, two acylcarnitines, four phosphatidylcholines, and four triglycerides. Conclusion This study demonstrated that rheumatoid arthritis caused the disorder of lipid metabolism while Zushima Tablets had regulatory effects on some lipid metabolites.
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BACKGROUND: Mechanisms undelying diagnosis and treatment of arthritis can be analyzed by metabonomics to study the metabolites. The combination of metabonomics and bibliometrics can systematically clarify the research status of osteoarthritis. OBJECTIVE: To analyze and summarize the research status of metabonimics in arthritis, and to prospect the future tendency. METHODS: CNKI, VIP, WanFang, CBM, PubMed, EBSCO, Web of Science and Elsevier databases were searched for the articles addressing the metabonimics in arthritis published before May 2017. The keywords were "metabolomics and arthritis" in English and Chinese, respectively. Initially 201 articles were retrieved, and finally 59 articles were included based on the inclusion and exclusion criteria for basic information and result analysis. RESULTS AND CONCLUSION: (1) Literature of metabonomics on arthritis began to be reported from 2007, and the number of literature increased with time. (2) The first author's affiliations were concentrated in universities 37(63%), hospitals 15 (25%) and institutes 7 (12%). (3) The articles included 44 articles from journals (75%), 12 dissertation (19%), 4 conference papers (7%), and the 44 papers were published in 38 kinds of journals. (4) Totally 36 articles were funded, 29 articles (49%) funded by the National Natural Science Foundation, 18 (31%) funded by department-level foundation, 10 (17%) funded by provincial foundation, 5 (8%) foreign foundation and 5 (8%) funded by school foundation. (5) The types of arthritis were mainly rheumatoid arthritis 40 (68%), osteoarthritis 7 (12%), gouty arthritis 6 (10%) and others 6 (10%). (6) The main research directions were metabonomis on treatment effectiveness 30 (51%), pathogenesis of arthritis 17 (29%), Chinese medicine syndromes 6 (10%) and research progress 6 (10%). (7) Metabolomics samples in the literature included the body fluid samples 53 (90%) and tissue samples 6 (10%). (8) Metabonomics analysis techniques included liquid chromatography-mass spectrometry 33 (56%), nuclear magnetic resonance technology 15 (25%), gas chromatography-mass spectrometry 10 (17%), NMR combined with GC-MS 1 (2%). In summary, metabonomics has been extensively applied in arthritis and has been an issue of concern. Understanding the side events in Chinese medicines for arthritis based on metabonomics can provide reference for the following prospective study and clinical application.
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Exhaled breath condensate (EBC) was analyzed by gas chromatography-mass spectrometry (GC-MS / MS) in childhood asthma and healthy control, aiming to find the potential markers of EBC in children with asthma, and provide a scientific reference for its pathogenesis and early screening. EBC samples were collected from 21 asthmatic children (age (8. 2 ±1. 6) years) and 17 healthy children ( age (8. 1 ±1. 3) years). GC-MS / MS was used to obtain the full scan data of chemical components. Cluster analysis was performed on the two groups of metabolites by principal component analysis (PCA), and potential biomarkers were found using Metaboanalyst 3. 0 attributable metabolic pathways. The results showed that the EBC metabolic maps of asthmatic group and normal group were very different, and eight endogenous potential biomarkers were identified, suggesting that starch and sucrose metabolism, lysine degradation, aminoglycan nucleoside metabolism, phenylalanine metabolism may play important roles in the development of asthma in children.
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Objective: To observe the regulating action of Zushima Gancao Tablet on abnormal metabolites by analyzing the changes of endogenous metabolites in plasma of rheumatoid arthritis (RA) rats, and to explore the mechanism of Zushima Gancao Tablet in treating RA from the perspective of metabonomics. Methods: Rats were divided into normal group (NG), model group (MG), positive medicine group (PMG), and Zushima Gancao Tablet group (ZGG). Adjuvant arthritis (AA) rats were established with freund complete adjuvant, rats in PMG and ZGG groups were ig administered with tripterygium glycosides and Zushima Gancao Tablet respectively for a month. Plasma samples were collected on days 1, 10, 20, and 28 before and after administration. UPLC/LTQ-Orbitrap-MS was applied to analyzing the metabolic profile changes of each group in different durations of the disease and mechanism of drug intervention. Results: The related pathways of AA mainly involved metabolisms of amino acids, lipids, nucleic acids, and vitamins. Zushima Gancao Tablet had great effect on AA by regulating 12 biomarkers. Conclusion: Small molecule metabolites in AA rats are deviated from the normal ones. The effects of Zushima Gancao Tablet and positive medicine (tripterygium polyglycoside) on AA are similar, but the mechanisms were different. Zushima Gancao Tablet down-regulates the level of LPC in secondary lesions while tripterygium polyglycoside tablets could effectively inhibit the metabolisms of a variety of amino acids during acute inflammation.
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<p><b>OBJECTIVE</b>To measure the proportions of blood T cell subsets, Th1, Th2, Th17, Th22, and Treg cells, and other parameters in patients with chronic immune thrombocytopenia (CITP) before and after treatment with Yiqi Tongyang Decoction (, YTD) to explore T cell status of patients with CITP, and to defifine the mechanism of action of YTD.</p><p><b>METHODS</b>The changes in peripheral blood T lymphocyte subsets, and those of Th1, Th2, Th17, Th22, and Treg cells in 30 patients with CITP (22 females and 8 males) were analyzed using multiparametric flflow cytometry before and after treatment with YTD for 6 months, and 26 healthy volunteers (14 males and 12 females) acted as a control. T-box expressed in T-cells (T-bet) and GATA binding protein 3 (GATA-3) mRNA levels in patients and controls were analyzed using real-time reverse transcription-polymerase chain reaction.</p><p><b>RESULTS</b>The proportions of Th1, Th17, Th22, Th1/Th2, and Th17/Treg cells increased in the peripheral blood of patients with CITP compared to those in controls before YTD therapy (P<0.05). Th1 cell numbers and the Th1/Th2 ratio fell in the treated patients with CITP to approximate the values of the control group (P>0.05). Th17 cell numbers and the Th17/Treg ratio also decreased in the treatment group (P<0.05), but not to the levels of the controls. The number of Treg cells in the peripheral blood of patients with CITP before treatment was lower than that in the control group (P<0.05), but increased after YTD treatment P<0.05), but not to the level of controls. T-bet and GATA-3 mRNA levels in peripheral blood were initially higher in patients before treatment than controls (P<0.05), but decreased after YTD therapy (P<0.05).</p><p><b>CONCLUSIONS</b>Imbalances in T lymphocyte levels, particularly those of Th1/Th2 and Th17/Treg cells, play important roles in the pathogenesis of CITP. YTD effificiently regulated the dynamics of Th1/Th2 and Th17/Treg equilibria.</p>
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Objective To establish a method for specific gene editing of the second exon of mouse MAD2L1 gene by CRISPR/Cas9, and analyze its off-target effect. Methods The gene editing site for MAD2L1 gene was designed by CHOP?CHOP, and the Cas9?MAD2L1 vector was constructed based on the designed editing site. Cas9?MAD2L1 was then transfected into NIH/3T3 cells and screened with puromycin, followed by observing GFP expression using fluorescence microscopy. The genomic DNA from transfected cells was extracted and a partial fragment of MAD2L1 gene was amplified by PCR. T7E1 analy?sis and Sangger sequencing were used for gene editing and off?target analysis. Results After Cas9?MAD2L1 transfection and puromycin screening, a large number of GFP?expressing cells were observed under the fluorescence microscope. Combined the PCR result with TE71 analysis, the amplified 228 bp PCR products can be digested into 166 bp and 62 bp fragments. The se?quencing result showed that the second exon of MAD2L1 gene was successfully edited, and the off?target effect was undetected in our system. Conclusions The method for specific gene editing of the second exon of mouse MAD2L1 gene by CRISPR/Cas9 is successfully established, and off?target effect of MAD2L1 gene is not detected.
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OBJECTIVE: Individuals taking aspirin but who fail to appropriately respond to the medication may remain at higher risk of thrombotic events. To provide reference for rational use of aspirin and reduce the risk of adverse reactions, clinical pharmacists need to comprehend the status of aspirin resistance. METHODS: We have reviewed, analyzed, and summarized domestic and foreign literatures published in the last five years that are related to aspirin resistance. RESULTS: The term "aspirin resistance" still has no standard accepted definition in the literature. Researchers focus on molecular insights into the mechanisms of aspirin resistance. The absolute as well as relative contributions of various factors to the phenomenon of aspirin resistance are the subject of current research. There are diverse platelet function testing methods and each has its strengths and weaknesses, which will greatly increase the difficulty of selection. CONCLUSION: In order to have a comprehensive assessment and interpretation of laboratory data, clinical pharmacists need to understand the research progress of aspirin resistance, which will promote personalized medication of aspirin.
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The objective of the present study was to establish a method based on principal component analysis (PCA) for the study of transdermal delivery of Chinese medicinal formulae, and to choose the best penetration enhancers for Qingfei Xiaocuo gel depend on this method. Using improved Franz type diffusion cell and excised rat skin in vitro as transdermal barrier, the receptive solution fingerprint was established by HPLC, harvesting the areas of the common peaks in the fingerprint, then the total factor scores of the concentrations at different times were calculated using PCA and were employed instead of the concentrations to compute the cumulative amounts (Q12) and enhancement ratio (ER), the latter of which were considered as the indexes for optimizing penetration enhancers. Compare to the control group, the ER of the other groups increased significantly and furthermore, 2.5% azone with 2.5% menthol manifested the best effect. PCA represent most information in the receptive solution, the method above could choose the best penetration enhancers, it could be a reference for the study of transdermal delivery of Chinese medicinal formulae.
Subject(s)
Animals , Male , Mice , Administration, Cutaneous , Drugs, Chinese Herbal , Pharmacokinetics , Gels , In Vitro Techniques , Medicine, Chinese Traditional , Principal Component Analysis , Skin , MetabolismABSTRACT
In this study, we sought to determine the association between environmental factors and nonsyndromic cleft of the lip and/or palate (NSCLP) to understand the etiology of the disease. A total of 200 NSCLP cases and 327 controls were recruited at the Maternal and Child Health Hospital of Xuzhou City. We conducted face-to-face interviews with the mothers of both cases and controls. The factors increasing the risk of NSCLP were a positive family history [odds ratio (OR)=56.74], pesticide exposure (OR=8.90), and indoor decoration pollution (OR=4.32). On the other hand, the factors decreasing the risk of NSCLP were a high education level (OR=0.22) and supplementation of folic acid (OR=0.23) and multivitamins (OR=0.16). Positive family history, pesticide exposure, and indoor decoration pollution are associated with the risk of NSCLP. In contrast, high education level and folic acid and multivitamin supplementation are protective factors against NSCLP.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Case-Control Studies , China , Epidemiology , Cleft Lip , Epidemiology , Cleft Palate , Epidemiology , Environmental Pollutants , Toxicity , Folic Acid , Therapeutic Uses , Logistic Models , Maternal Exposure , Risk Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To evaluate clinical efficacy of suture anchors in treating acute injuries of medial collateral ligament (MCL) of knee at degree III.</p><p><b>METHODS</b>Twenty-seven patients with degree III acute MCL injuries of knee were treated with suture anchors from January 2007 to June 2011. There were 15 males and 12 females, aged from 19 to 56 (averaged 32.6) years old. The time from injury to operation was 3 to 10 days, averaged 6 days. Symptoms and physical signs before and after treatment were observed, Lysholm scoring were used to evluated clinical efficacy.</p><p><b>RESULTS</b>All patients were followed up from 16 to 30 months with an average of 21.6 months. The stability of knee joints was good in all patients. Abduction stress test was negative when the knee joint was straightened at 0 degrees and flexed at 30 degrees. The average degree of flexed knee (67.00 +/- 5.80) degrees preoperatively was lower than that of postoperatively (136.50 +/- 6.30) degrees at 1 year. According to Lysholm scoring, preoperative scores ranged from 30 to 43 points, averaged 36.46 +/- 1.48; 1 year after operation ranged from 87 to 100 with an average of 91.50 +/- 3.80 and higher than postoperative. Twenty patients got an excellent results, 5 good and 2 fair.</p><p><b>CONCLUSION</b>Suture anchors in treating acute injuries of medial collateral ligament of knee at degree III has following advantages: small range of tissue dissection, easy to operate, reliable fixation and less complications.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Acute Disease , Collateral Ligaments , Wounds and Injuries , General Surgery , Knee Injuries , General Surgery , Suture AnchorsABSTRACT
Ten compounds were isolated from the leaf of Eucommia ulmoides by means of recrystallization and chromatographic techniques such as D-101 macroporous resin, MCI resin, ODS gel, Sephadex LH-20 and Rp-HPLC. Their structures were identified by NMR spectral analyses as kaempferide 3-O-beta-D-glucoside (1), quercetin-3-O-beta-D-glucoside (2), quercetin (3), quercetin-3-O-beta-D-xylosyl-(1-->2)-beta-D-galactoside (4), kaempferol-3-O-alpha-L-rhamnosyl-(1-->6)-beta-D-glucoside (5), (2S,3S)-taxifolin 3-O-beta-D-glucoside (6) ,4-hydroxy cinnamic acid (7), (+)-cycloolivil (8), pinoresinol beta-D-glucoside (9), squalene (10). Among them compounds 1,5-7,10 were isolated from the Eucommia genus for the first time. In the DPPH free radical scavenging assay, compound 2 exhibited significant activity (IC50 13.7 micromol x L(-1)), compared with vitamin C (IC50 59.9 micromol x L(-1)); compounds 1, 3 and 9 showed moderate activity (IC50 161,137, 214 micromol x L(-1)), compared with 2,6-di-tert-butyl-4-methylphenol (IC50 236 micromol x L(-1)); compound 4 and 6 showed weak activity (IC50 264, 299 micromol x L(-1)).
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Antioxidants , Chemistry , Chromatography, High Pressure Liquid , Drugs, Chinese Herbal , Chemistry , Eucommiaceae , Chemistry , Magnetic Resonance Spectroscopy , Molecular Structure , Plant Leaves , ChemistryABSTRACT
Ten compounds were isolated from the barks of Jasminum giraldii by means of various of chromatographic techniques such as silica gel, Sephadex LH-20 and Rp-HPLC. Their structures were identified by spectroscopic data analysis as (+)-medioresinol (1), (+) -syringaresinol (2), syringaresinol-4'-O-beta-D-glucopyranoside (3), oleanic acid (4), 3-methoxy-4-hydroxy-trans-cinnamaldehyde (5), trans-sinapaldehyde (6), syringaldehyde (7), 1-(4-methoxy -phenyl) -ethanol (8), trans-cinnamic acid (9), and 4-(1-methoxyethyl) -phenol (10). Among them, compounds 1-3, 5-8 and 10 were isolated from the J. genus for the first time and compounds 4 and 9 were obtained from J. giraldii for the first time. In the DPPH free radical scavenging assay, compound 1 exhibited significant activity (IC50 55.1 micromol x L(-1)), compared with vitamin C(IC50 59.9 micromol x L(-1)); and compound 2 showed moderate activity (IC50 79.0 micromol x L(-1)), compared with 2, 6-di-tert-butyl4-methylphenol (IC50 236 micromol x L(-1)).
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Antioxidants , Chemistry , Drugs, Chinese Herbal , Chemistry , Jasminum , Chemistry , Magnetic Resonance Spectroscopy , Molecular Structure , Spectrometry, Mass, Electrospray IonizationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and clinical outcome of reduction and pedicle screws fixation at the fracture level with the approach through para-vertebral muscles in treating thoraeolumbar fractures.</p><p><b>METHODS</b>From January 2007 to March 2010,27 patients with thoracolumbar fractures were treated with posterior open reduction and internal fixation with the approach through para-vertebral muscles. There were 19 males and 8 females with the mean age of 36.3 years old (ranged,21 to 57). According to Magerl type, type A2 was in 5 cases, A3 in 14, B1 in 3, B2 in 5. According to Frankel classification of spinal cord injury: grade D was in 6 cases and grade E in 21 cases. X-rays and CT scans were performed after operation. Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagittal diameter stenosis rate of the injured spinal canal were observed by radiographic data. Neurological function was evaluated by the Frankel grade.</p><p><b>RESULTS</b>All patients were followed up from 12 to 28 months with an average of 19.6 months. The percentage of vertebral compression, Cobb angle of the injured vertebral segment, spinal canal sagittal diameter stenosis rate were respectively corrected from (46.6 +/- 10.5)%, (18.3 +/- 7.2) degrees, (30.2 +/- 7.2)% to postoperative (5.2 +/- 3.7)%, (5.3 +/- 5.1) degrees, (6.3 +/- 4.2)% and (6.7 +/- 4.6)%, (7.1 +/- 3.1), (7.2 +/- 4.5)% at last follow-up. There were significant difference in above items between preoperation and postoperation (P < 0.05); and there was no significant difference in above items between postoperation and last follow-up (P > 0.05). In aspect of nerve function, 3 cases with Frankel grade D recovered to grade E.</p><p><b>CONCLUSION</b>Using reduction and short-segment pedicle screws fixation at the fracture level through para-vertebral muscles approach is an effective method in treating thoracolumbar fractures. The method has advantages of simple operation,easy establishing screw, short operative time, less blood loss, which can obtain good reduction and stable, reliable fixation after operation.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Bone Screws , Fracture Fixation, Internal , Methods , Lumbar Vertebrae , Wounds and Injuries , General Surgery , Operative Time , Spinal Fractures , General Surgery , Thoracic Vertebrae , Wounds and Injuries , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the feasibility and safety of the treatment for thoracolumbar fractures with pedicle screw at the fracture level and vertebroplasty via paraspinal approach.</p><p><b>METHODS</b>From August 2007 to August 2010, 22 old patients with thoracolumbar fractures were treated with pedicle screw at the fracture level and vertebroplasty via paraspinal approach. There were 14 males and 8 females, ranging in age from 60 to 71 years (mean, 64.6 years). The time from injury to surgery varied from 1 to 4 d (mean,2.7 d). All the patients suffered from single thoracolumbar fractures and located at T11 in 2 cases, at T12 in 5 cases, at L1 in 11 cases and at L2 in 4 cases. According to the Denis fracture classification, there were 6 compression fractures and 16 burst fractures. The mean preoperative load-sharing classification of spine fractures was 5.4 score. The mean preoperative thoracolumbar injury classification and scoring was 5.2. Based on the ASIA neurologic grading system, preoperative neurological function was grade B in 2 cases,grade C in 3 cases, grade D in 7 cases and grade E in 10 cases. The neurological function, vertebral central and anterior height, kyphotic angle of the vertebral fractures by radiographs and visual analog scale were calculated pre-operatively, post-operatively and at the last follow-up.</p><p><b>RESULTS</b>Median operating time was 60.8 min (ranged from 50 to 95 min) and median blood loss was 84 ml (ranged from 50 to 130 ml). The operative incisions were healed well. The duration of follow-up averaged 21.6 months (ranged from 12 to 48 months). The anterior vertebral body height was corrected from preoperative (52.3 +/- 10.3) % to postoperative (6.1 +/- 4.2) % and (6.8 +/- 5.4) % at the last follow-up. The central vertebral body height was corrected from preoperative (38.9 +/- 11.2) % to postoperative (8.3 +/- 4.7) % and (9.4 +/- 4.5)% at the last follow-up. The Cobbs angle of the injured vertebral segment was corrected from preoperative (19.5 +/- 9.5) degrees to postoperative (4.3 +/- 4.1) degrees and (6.2 +/- 4.7) degrees at the last follow-up. The VAS scores reduced from preoperative 8.56 +/- 0.88 to post-operative 3.48 +/- 0.91 and 3.20 +/- 0.92 at the last follow-up. The postoperative neurologic function of all 22 patients improved 1 to 2 degrees except 10 patients of grade E. There were no instances of instrumentation failure and no patient had persistent postoperative back pain.</p><p><b>CONCLUSION</b>The pedicle screw at the fracture level and vertebroplasty via paraspinal approach has the advantages of less invasive and blood loss, and could prevent the development of kyphosis and offers improvement of the spinal cord function. Furthermore, it could decrease the risks of postoperative back pain and the failure of instrumentation.</p>