Efficacy evaluation of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in treating lumbar disc herniation with lumbar instability / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical effects of modified lamina osteotomy replantation versus traditional lamina osteotomy replantation in the treatment of lumbar disc herniation with lumbar instability.</p><p><b>METHODS</b>The clinical data of 146 patients with unilateral lumbar disc herniation with lumbar instability underwent surgical treatment from March 2008 to March 2013 were retrospectively analyzed. Patients were divided into two groups according to osteotomy replantation pattern. There were 77 patients in the traditional group (underwent traditional lamina osteotomy replantation), including 42 males and 35 females with an average age of (49.4±18.5) years;the lesions occurred on L₄,₅ in 46 cases, on L₅5S₁ in 31 cases. There were 69 patients in modified group (underwent modified lamina osteotomy replantation), including 37 males and 32 females with an average age of (49.8±17.9) years;the lesions occurred on L₄,₅ in 40 cases, on L₅S₁ in 29 cases. The operation time, intraoperative blood loss, complication rate during operation, lamina healing rate, recurrence rate of low back and leg pain were compared between two groups. Visual analogue scales (VAS) and Japanese Orthopadic Association (JOA) scores were used to evaluate the clinical effects.</p><p><b>RESULTS</b>The operation time and intraoperative blood loss were similar between two group (>0.05). There was significantly different in nerve injury rate(5.80% vs 16.9%) and dural injury rate(1.45% vs 9.09%) between modified group and traditional group(<0.05). The recurrent rate of low back pain of modified group was higher (91.30%, 63/69) than that of traditional group (76.62%, 59/77), and the intervertebral fusion rate of modified group was lower(8.70%, 6/69) than that of traditional group (29.9%, 23/77) at 3 years after operation. Postoperative VAS scores of all patients were significantly decreased at 6 months, 1, 2, 3 years, and JOA scores were obviously increased (<0.05). At 1, 2, 3 years after operation, VAS scores of modified group were significantly lower than that of traditional group(<0.05), and JOA scores of modified group were higher than that of traditional group(<0.05).</p><p><b>CONCLUSIONS</b>Modified lamina osteotomy replantation has better long-term efficacy(in the aspect of recurrent rate of low back pain, intervertebral fusion rate, VAS and JOA score at three years follow-up) in treating lumbar disc herniation with instability.</p>

Association of FasL-844T/C gene polymorphism with FasL expression in the nucleus pulposus of degenerative lumbar intervertebral discs / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the association of FasL-844T/C gene polymorphism with the magnetic resonance imaging (MRI) findings and FasL expression in the nucleus pulposus of degenerative lumbar intervertebral discs.</p><p><b>METHODS</b>Lumbar MRI data, venous blood and nucleus pulposus were collected from 105 patients with lumbar disc herniation. The genotypes of FasL-844T/C gene of the patients were determined using matrix-assisted laser desorption ionization time-of-flight mass spectrometry. Immunohistochemistry was used to detect the expression of FasL in the nucleus pulposus of the degenerative lumbar intervertebral discs.</p><p><b>RESULTS</b>Compared with CC genotype, TT genotype of FasL-844T/C gene was associated with a significantly increased score of lumbar disc degeneration (P=0.003) as observed in MRI scan. FasL expression in the nucleus pulposus differed significantly between patients of FASL-844CC genotype and those of FASL-844TT genotype (P=0.048), but not between those of FASL-844CC and FASL-844CT genotypes (P=0.264). No significant association was found between MRI findings and FasL expression in the nucleus pulposus of the lumbar intervertebral discs.</p><p><b>CONCLUSION</b>FasL-844T/C gene polymorphism is correlated with the expression of FasL in the nucleus pulposus of the intervertebral disc in patients with lumbar disc herniation. MRI findings of the lumbar intervertebral discs do not correlate with the expression of FasL in the nucleus pulposus of the intervertebral discs.</p>

Case-control study of the risk factors of lumbar intervertebral disc herniation in 5 northern provinces of China / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the risk factors of lumbar intervertebral disc herniation in the 5 northern provinces of China.</p><p><b>METHODS</b>A total of 2010 patients with established diagnosis of lumbar disc herniation by CT and/or MRI and 2170 control subjects without a history of low back pain or sciatica were randomly selected from the community population and hospitalized patients. The family history of lumbar disc herniation, occupations, smoking status, and occupational psychosocial factors were investigated.</p><p><b>RESULTS</b>The positivity of family history of lumbar disc herniation was the highest risk factor (OR=3.551) followed by lumbar load (OR=2.132) and hard work (OR=1.763). Physical exercises (OR=0.435) were significantly related with the disease, and the OR of the type of bed was 0.364.</p><p><b>CONCLUSION</b>A family history of lumbar disc herniation, lumbar load and hard work are the major risk factors for lumbar disc herniation, and physical exercises and sleeping not in soft bed might be a protective factor against the disease.</p>

Expression of interleukin-1beta and tumor necrosis factor-alpha in the synovium and synovial fluid of patients with Kashin-Beck disease and osteoarthritis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) in the pathogenesis and progression of Kashin-Beck disease (KBD) and primary osteoarthritis (OA).</p><p><b>METHODS</b>The synovium and synovial fluid of the knee joint were collected from 20 adult patients with KBD, 18 with OA and 19 with meniscus injury (controls). The expression of IL-1beta and TNF-alpha in the synovium were analyzed by immunohistochemistry staining, and the levels of IL-1beta and TNF-alpha in the synovial fluid were determined by enzyme-linked immunosorbent assay.</p><p><b>RESULT</b>IL-1beta and TNF-alpha expressions in the synovium and their levels in the synovial fluid were significantly higher in patients with KBD and OA than in patients with meniscus injury (P<0.05), but comparable between KBD and OA groups (P>0.05).</p><p><b>CONCLUSION</b>IL-1beta and TNF-alpha may play an important role in the pathogenesis and progression of KBD and OA.</p>

The monitoring and treatment to sleeping breath suspension / 医疗卫生装备

Monitoring,recording and treatment can be made to sleeping breath suspension patient using the present physiology recorder,oximeter and breath sensor,change-over interface,therapy device.When it lasts more than 10 seconds for patient's breath suspension,stimulator will be on automatically in order to revive the patient and off automatically after the patient's breath is recovered.