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Objective To investigate the effect of transverse extrapedicular unilateral percutaneous vertebroplasty (PVP) via transverse process in treating the osteoporotic vertebral compression fractures.Methods A retrospective study was performed on 16 patients with osteoporotic vertebral compression fractures of upper lumbar treated from August 2016 through December 2016.There were seven males and nine females,at a mean age of 73.5 years (range,62-90 years).All the patients reported severe back pain,with an average history of 2 weeks (range,1-24 weeks).MRI confirmed the diagnosis of osteoporotic vertebral compression fractures,and the compression degree of the affected vertebral body was (25.4 ± 5.3) ％.All the patients were treated with extrapedicular unilateral PVP via transverse process under local anesthesia.The operation time,fluoroscopy frequency,bone cement injection volume,and bone cement dispersion were recorded.Back pain and function recovery were assessed by visual analogue scale (VAS) and Oswestry disability index (ODI),respectively.Results All patients were followed up for 6-12 months (mean,8 months).All operations were successful without complications.The average operation time was 20 min (range,15-30 minutes),and there were 3-6 times of fluoroscopy with successful incubation.The average volume of bone cement injected to each injured vertebral body was 6.2 ml (range,5-9 m1).The bone cement dispersed satisfactorily in the vertebral body.Complete relief of lumbar and back pain was achieved in 14 patients,and remarkable relief in two patients.The postoperative VAS and ODI at 24 hours,72 hours,and 6 months were significantly lower than those before operation (P ＜0.01).Conclusion Extrapedicular unilateral percutaneous vertebroplasty via transverse process has the advantages of uniform fractured bone cement perfusion,significant pain relief,and rapid recovery,and hence is a simple,safe and effective treatment for osteoporotic vertebral compression fractures of the upper lumbar vertebrae.
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Objective To screen 8 series of LY compounds, c-Met tyrosine kinase inhibitors, and evaluate their anti-tumor effects in vitro and in vivo. Methods Preliminary screening was carried out by detecting the c-Met kinase phosphor?ylation inhibition activity of the compounds. CCK-8 assay was adopted for secondary anti-tumor screen of the selected com?pounds using MKN-45, U87MG, Caki-1 and PC-3 cell lines in vitro. The transplanted tumor model of U87MG cells in nude mice was established to evaluate the antitumor activity in vivo. Results Four compounds (LY22, LY25, LY28 and LY32) with better activities were selected by HTRF method, in which LY28 had better inhibitory effect on c-Met than that of Crizo?tinib. The above active compounds showed different degrees of inhibition on the four kinds of target cells (MKN-45, U87MG, Caki-1 and PC-3) detected by CCK-8 method, and the inhibitory effect of LY28 showed the most obvious. Antitumor activi?ty in vivo showed that LY28 can significantly inhibited tumor growth in a dose-dependent manner. The tumor inhibitory rate in high-dose of LY28 was 78.13%. Conclusion The compound LY28 has good antitumor activity in vitro and in vivo, which will be a new tyrosine kinase inhibitor.
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Objective To evaluate the performance of emergency test and the applicability under complex field conditions of biochemical modules of field point-of-care test ( POCT ) system ( type A ) .Methods The precision and anti-interference ability of albumin ( ALB ) , total bilirubin ( TBIL ) , alanine transaminase ( ALT ) , aspartate transaminase (AST),blood area nitrogen(BUN),creatinine(CREA),uric acid(UA),lactate dohydrogenase(LDH),creatine kinase ( CK) ,and glucose( GLU) detected by field POCT system( A) were analyzed according to standards formulated by National Committee for Clinical Laboratory Standards(NCCLS).Field POCT system(A) and Coulter Beckman AU2700 automatic biochemical analyzer were used to detect the serum of 22 clinical cases respectively.After simulating the field environment by adjusting the temperature and humidity, we compared the results of mixed serum under different environment conditions. Results The coefficients of variation in total precision of ALB,TBIL,ALT,AST,BUN,CREA,UA,LDH,CK,and GLU detected by field POCT system(A) were 3.34%,6.54%,6.01%,4.80%,3.95%,5.59%,3.33%,6.19%,7.40%,and 4.56%(LevelⅠ);and 3.08%,4.47%,4.02%,4.31%,3.76%,4.22%,2.93%,5.25%,6.39%,and 4.35%(LevelⅡ) respectively.When triglycerides( TG) level was at 21 mmol/L, the interference rate was below 10%.When bilirubin level was at 120 μmol/L, the interference rate of ALT,AST and CREA was -33.33%,-22.99%,20.00%(LevelⅠ), and -22.13%,-14.55%,and 8.70%(LevelⅡ),respectively.When its level was at 240 μmol/L, the interference rate of UA was -16.67%and -24.69%, respectively at two levels;if hemoglobin( Hb) was at 170 mg/dl, the interference rate of TBIL and LDH was 20.00%,and 99.26%(LevelⅠ),and 15.38%,and 40.79%(LevelⅡ),respectively;if it was at 340 mg/dl, the interference rate of ALT and AST was 9.84% and 13.79%(LevelⅠ), and 12.30%,and 12.27%(LevelⅡ),respectively;if it was at 510 mg/dl, the interference rate of CREA,UA and Ck in LevelⅠwas 26.67%, 16.67%,and 11.74%.The R2 of linear regression between field POCT system( A) and AU2700 automatic biochemical analyzer were 0.961,0.995,0.989,0.995,0.990,0.989,0.989,0.963,0.978,and 0.993, respectively.The POCT system could not work at 35℃ or higher temperature, and there was no difference in the results of detection between temperatures of 10-30℃or RH of 70%-90% and normal temperature and humidity(20℃,RH 50%) (P>0.05). However, the result of ALT and CK at high temperature and humidity was significantly higher than at normal temperature and humidity(P<0.001,and P=0.011, respectively).Conclusion The biochemical module of field POCT system(A) has a good correlation with the common large biochemical analyzer, and its precision meets the requirement of laboratory detection, but jaundice and hemolytsis can interfere in several tests to varying degrees.The POCT system can basically ensure accurate detection under field conditions of temperature and humidity, but should not work under extreme environments.
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Objective To explore the relationship between the immune function of cellin peripheral blood with the virureplication and hepatitiviru(HCV)-cAg expression in the patientwith chronihepatiti(CHC) .MethodPeripheral blood lymphocytesubpopulation ,HCV-Rnand HCV core antigen (HCV-cAg) in 63 healthy people undergoing the physical exami-nation (control group) and 85 caseof CHC(Chgroup) were analyzed by the flow cytometry ,real-time Pcand ELIS,respec-tively .ResultThe percentageof total cell,T4 cell,T8 cell,double negative cell(DN) and double positive cell(DP) in the Chgroup were (67 .37 ± 10 .43)% ,(37 .11 ± 10 .28)% ,(21 .63 ± 8 .87)% ,(7 .80 ± 4 .57)% and (0 .20 ± 0 .29)% , respectively ,the absolute contentwere in turn (0 .70 ± 0 .44) × 109/L ,(0 .37 ± 0 .22) × 109/L ,(0 .22 ± 0 .17) × 109/L ,(0 .08 ± 0.06)×109/Land(0.19±0.68)×107/L,respectively.TheratioofT4/T8was(2.18±1.26)% .Theresultsindicatedthatthe percentage of T8 cellin the Chpatientwadecreased obviously (P＜0 .01) ,which resulted in the ratio of T4/T8 raising(P＜0 .05);meanwhile ,the absolute contentof the total cell,T4 cell,T8 celland Dnwere all decreased obviously (P＜0 .05);moreove,the percentage of T4 celland Dnin the patientwith HCV-Rnpositive and HCV-cAg positive wasignificantly in-creased (P＜0 .05) .Conclusion When HCV replicating in the patientwith CHC,the T lymphocyte subpopulation haobviouab-normity .The low immune function or immune tolerance ofT cells may be the important cause of recurrence and uncurability of CHC.
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Objective To investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) and anti-cyclic citrullinated peptide (anti-CCP) antibodies for ankylosing spondylitis (AS), and to establish a new diagnostic method of AS based on anti-citrullinated protein/peptide antibodies (ACPAs) detection.Methods Totally 121 AS patients(AS group), 97 rheumatoid arthritis(RA) patients (RA group)and 103 healthy people(control group) were enrolled for the detection of serum levels of anti-MCV and anti-CCP antibodies using ELISA method as a diagnostic test .HLA-B27 in AS patients was tested by flow cytometry , and RF-IgM in RA and AS patients was detected by immune rate nephelometry .Receiver operating characteristics ( ROC) curve was used to analyze the diagnostic value and to determine the cut-off value.Anti-MCV and anti-CCP antibodies among each group were compared by Mann-Whitney U test, Chi-square test or Fisher′s exact test was used to compare positive rate .Results The anti-MCV levels in AS group [11.60 ( 12.36-25.83 ) U/ml ] were significantly higher than control group [ 11.60 ( 8.41 -13.54)U/ml ],U=2 413,P <0.001, while the levels of anti-CCP had no difference between the two groups [AS group 6.22 (4.30 -8.07) U/ml], and control group [6.01 (3.77 -7.58) U/ml], respectively;U=5 421,P=0.094.The calculated area under the ROC curve of anti-MCV was 0.806,and 14.67 U/ml was the optimal cut-off value with sensitivity of 0.645 and specificity of 0.942.In both HLA-B27 positive and negative AS patients , anti-MCV antibodies levels and positive rate were significantly higher than control group using new cut-off value above (U =133.5, P =0.001; U =2 279.5,P <0.001). Sensitivity of the combination detection of anti-MCV and anti-CCP ( MCV+CCP-) or RF-IgM ( MCV+RF-) were 60.3%(73/121), 62.8% (76/121) and specificity were 89.7% (87/97), 90.7% (88/97) respectively in differential diagnosis of AS and RA , which were significantly higher than anti-MCV detection alone in specificity (16.5%,16/97).Conclusions Anti-MCV could be a new biomarker for the diagnosis of AS .With high sensitivity and specificity , anti-MCV has an equal diagnostic efficiency in HLA-B27 positive and negative AS patients using our new cut-off value.Additionally, the combination detection of anti-MCV and anti-CCP or RF-IgM could be an effective method for differential diagnosis of AS and RA .
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Objective To investigate relationship of single nucleotide polymorphism (SNP)at rs5029924 locus in A20 promoter region and posttraumatic sepsis.Methods PCR-DNA sequencing was used to analyze different gene distribution at rs5029924 locus of 103 trauma patients with sepsis (Group A),120 trauma patients without sepsis (Group B) and 135 healthy peoples (control group).Relation of different genotypes at rs5029924 locus to sepsis susceptibility was analyzed.Peripheral blood cells of healthy peoples of different genotypes were stimulated using lipopolysaccharides (LPS) in vitro.Expression of A20 mRNA was measured by fluorescent quantitative PCR,expression of A20 protein by flow cytometry,and levels of TNF-α and IL-1β by ELISA method.Results Frequency of rs5029924 genotypes CC,CT and TT was respective 77.8％,20.0％ and 2.2％ in control group； 63.1％,34.0％ and 2.9％ in Group A； 83.3％,15.0％ and 1.7％ in Group B.Significantly lower frequency of CC genotype was observed in Group A when compared to Group B and control group (P ＜0.05),but no statistical differences were recorded between Group B and control group (P ＞ 0.05).CT/TT genotype increased risk coefficient of sepsis to 2.397-fold higher level when compared to CC genotype.Allele T increased prevalence of sepsis significantly as well (OR =2.056) when compared to allele C.After LPS treatment in vitro,CC genotype individuals revealed significantly higher levels of A20 mRNA and protein in peripheral blood leukocytes,but significantly lower levels of TNF-α and IL-1 β when compared to CT/TT genotype individuals.Conclusion Polymorphism of rs5029924 locus is associated with sepsis susceptibility and the reason may be that mutant genes affect promoter activity and down-regulate A20 expression,which fails to suppress inflammation.
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Objective To explore a safe and effective posterior surgical operation for correction of the horacolumbar kyphotic deformity. Methods The study involved 16 patients with thoracolumbar kyphotic deformity treated with the modified posterior transpedicular-intervertebral disc wedge resection osteotomy and screws-rods internal fixation apparatus.There were 11 males and 5 females at an average age of 26.5 years(13-53 years).The kyphosis deformity was caused by ankylosing spondylit in four patients,old lumbothoracic fracture in nine,vertebral dysplasia in two and vertebral body in one.The preoperative kyphosis Cobb angle was 58.1(45°-85°),with the kyphosis deformity at T10 in two patients,at Thin two,at T12in six,at L1 in three and at L2 in three.The main clinical manifestations were different degrees of lower back pain and progressive aggravation of the deformity,influencing the work and living.The course of disease was 8.5 years(4-17 years).All patients underwent pesteriortotal vertebral osteotomy on the apex vertebra,trails-pedicular fixation combined with correction and fusion,after which the patients stayed in bed for four weeks and received orthosis fixation for three months after operation. Resuits The operation lasted for average 190 minutes(125-240 minutes),with average blood loss of 750 ml(450-1 900 m1).All patients were with single segment cut bone,with no spinal cord injury,neurological injury or hardware failure.The post-operative vertical plane facial deformity was corrected for average 55(44°-76°),wit average correction rate of 83%.The follow-up for 10-24 months showed firm internal fixation on the X-ray film and good fusion ofthe vertebral column,with no pseudoarticulation formation,loosening internal fixation or loss of correction.All the patients obtained obvious improvement in appearance of the deformity,with disappearance of the lower back pain and improvement of the quality of life. Conclusion One stage posterior transpedicular-interverte-bral disc wedge resection osteotomy is all effect and safe surgical technique for correction of horacolumbar kyphotic deformity.
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Objective To observe the oncololigcal and cosmetic outcomes and complication of breastconserving surgery and radiotherapy for early breast cancer. Methods A total of 78 early breast cancer patients, who were treated in the First People's Hospital of Pingdingshan between January 2001 and September 2008, were identified and followed. Among them, 36 were in stage Ⅰ and 42 in stage Ⅱ. Tangential irradiation was used with a dose of 50 Gy. Tumor bed received a boost dose of 10 Gy electron beam. For axillary lymph node-positive patients, ipsilateral supraclavicular field was hybrid irradiated with 50 Gy X and electron beam.Results The total follow-up ranged from 6 to 98 months. Local recurrence was observed among 4.9% of the patients. The 3-year and 5-year overall survival rate were 96.6% and 92.7% ,respectively. The breast cosmetic satisfaction rate was 94.9%. The main complications reported were acute skin reaction and upper limb edema.Conclusion Breast-conserving surgery and post-operative radiotherapy in early breast cancer patients can lead to satisfactory survival rates and cosmetic effects and hence improved life quality.
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Objective To detect the pathological expressions of TNF-? and VEGF in interspinous ligament of patients with ankylosing spondylitis(AS) in active stage. Methods The expressions of TNF-? mRNA and VEGF mRNA in the interspinous ligament of patient with AS group and control group were detected by hybridization in situ. Their different results were compared by image analysis system and the correlation between TNF-? mRNA, VEGF mRNA and both AS disease active index (DAI) and C reactive protein (CRP) was analysed respectively. Results The expressions of TNF-? mRNA and VEGF mRNA in the interspinous ligament of patients with active AS were positive,but those of the control group were negtive. Statistical differences existed in the positive cell numbers and in image gray scale value of AS group (P
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Objective To approach the expression and significance of connection tissue growth factor(CTGF) in articular cartilage after full-thickness osteochondral defect on the medial femoral condyle in young and adult rabbits model.Methods Totally 25 young(at an age from 10 to 12 weeks) and 25 adult New Zealand white rabbits(at an age from 34 to 39 weeks) were randomly divided into 5 groups(n=5) ,control group,24-hour,1-week,4-week and 8-week after full-thickness cartilage injury groups.A rabbit model of spontaneous healing of full-thickness cartilage defect in the medial femoral condyle in both knees was reproduced.Macroscopic and histological morphous of repairs were observed in each age group during repair.mRNA and protein expression of CTGF were detected with RT-PCR and immunohistochemistry,respectively.Results The morphologically good repairs with hyaline-like cartilage appearance were observed in young rabbit,but formation of fibrous tissue in adult rabbit.The expression of CTGF mRNA was detected in all groups.Expression of CTGF mRNA was significantly higher in young rabbit than in adult rabbits(P