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1.
International Eye Science ; (12): 1737-1740, 2023.
Article in Chinese | WPRIM | ID: wpr-987900

ABSTRACT

AIM:To explore the effect of genetic factors on the pathogenesis of keratoconus and its genetic model.METHODS: Genetic epidemiological methods were used to investigate the prevalence of keratoconus in 280 first-degree relatives of 100 patients with keratoconus who attended Henan Eye Hospital between July 2020 and April 2023. The heritability was estimated by Falconer regression method. The general genetic model was calculated using Penrose method, and the genetic model was confirmed by Falconer formula, Edwards approximation formula and the projection formula of San-Duo Jiang's threshold model theory.RESULTS: The results showed that there were 16(5.714%)first-degree relatives of keratoconus probands suffering from keratoconus, and the heritability of keratoconus was(86.100±7.400)%. The S/q score calculated by the Penrose method was 35.348, which was near to 1/(q)1/2, suggesting that the genetic model of keratoconus might be polygenic inheritance. The expected prevalence in first-degree relatives of keratoconus patients by Falconer formula, Edwards approximation formula and the projection formula of San-Duo Jiang's threshold model theory were 5.900%, 7.714% and 5.700%, respectively, which showed no significant differences from the actual prevalence(5.714%), suggesting that keratoconus was a polygenetic disease.CONCLUSION:Genetic factors might play an important role in the pathogenesis of keratoconus, and keratoconus is a polygenetic disease.

2.
International Eye Science ; (12): 1333-1337, 2023.
Article in Chinese | WPRIM | ID: wpr-978629

ABSTRACT

Myopia has become a major public health problem affecting the eye health of our nationals, especially adolescents, and is listed as one of the three major diseases in the world. The etiology of myopia is complex and it is currently considered to be mainly related to environmental factors and genetic factors. Dietary factors are less concerned, but it has been reported that there is a correlation between high-sugar diet and the occurrence and development of myopia. Studies have found that high-sugar diet can cause hyperinsulinemia, which mediates the increase of retinal insulin-like growth factor(IGF-1, IGF-2)expression level, and the decrease of insulin-like growth factor binding protein-3(IGFBP-3)expression level in scleral fibroblasts, thereby activating signal transduction and transcriptional activator protein 3(STAT3)signaling pathway, and then acting on scleral matrix metalloproteinases(MMP)/transforming growth factor-β(TGF-β)and other factors, resulting in a decrease in scleral extracellular matrix(ECM), eventually leading to scleral remodeling, eye axis growth and myopia. This article explores the relationship between high-sugar diet and the occurrence and development of myopia from the aspects of epidemiology and biological mechanisms by consulting relevant literature, and provides research directions for the prevention and control of myopia.

3.
Chinese Journal of Contemporary Pediatrics ; (12): 159-165, 2023.
Article in Chinese | WPRIM | ID: wpr-971054

ABSTRACT

OBJECTIVES@#To study the value of basal luteinizing hormone (LH) level combined with uterine volume measurement in the early diagnosis of central precocious puberty (CPP) in girls with different Tanner stages.@*METHODS@#A retrospective analysis was performed on the girls who presented with breast development before the age of 8 years and attended the Third Affiliated Hospital of Zhengzhou University from January 2017 to September 2022. According to the results of gonadotropin-releasing hormone (GnRH) agonist test, the girls with peak LH ≥5.0 IU/L and peak LH/follicle stimulating hormone ≥0.6 were enrolled as the positive group, and the other girls were enrolled as the negative group. The two groups were compared in terms of the basal LH level and uterine volume. The receiver operating characteristic (ROC) curve was used to analyze their value in the early diagnosis of CPP.@*RESULTS@#For the girls with Tanner B2 and B3 stages, the positive group had significantly higher basal LH level and uterine volume than the negative group (P<0.05). The basal LH level had an optimal cut-off value of 0.325 IU/L and 0.505 IU/L respectively in the diagnosis of Tanner stage B2/B3 CPP, while uterine volume had an optimal cut-off value of 1.639 mL and 2.158 mL respectively. Basal LH level combined with uterine volume measurement had a significantly larger area under the ROC curve than uterine volume measurement alone (P<0.001), but with no significant difference compared with that of basal LH level measurement alone (P>0.05).@*CONCLUSIONS@#Basal LH level combined with uterine volume measurement is valuable in the early diagnosis of CPP in girls with different Tanner stages, which provides a basis and guiding significance for clinical diagnosis of CPP.


Subject(s)
Child , Female , Humans , Early Diagnosis , Luteinizing Hormone/chemistry , Puberty, Precocious/diagnosis , Retrospective Studies , Uterus/pathology
4.
Chinese Journal of Industrial Hygiene and Occupational Diseases ; (12): 260-266, 2022.
Article in Chinese | WPRIM | ID: wpr-935788

ABSTRACT

Objective: To observe the dynamic changes of brainstem locus coeruleus (LC) damage in Parkinson' s disease (PD) -like mice by paraquat (PQ) . Methods: In October 2019, 36 male C57BL/6 mice were randomly divided into the exposure group and the control group, with 18 mice in each group. The mice in the exposure group were given intraperitoneal injection of 15 mg/kg PQ, and the mice in the control group were given intraperitoneal injection of 0.9% saline, twice a week for 8 weeks. Neurobehavioral changes (pole climbing test, swimming test, open field test, tail hanging test, high plus maze test and water maze test) were observed at 4 weeks, 6 weeks and 8 weeks, respectively, and the changes of motor ability, emotion and cognitive function were evaluated. The brain tissue of mice were taken and stained with Hematoxylin-Eosin (HE) to observe the pathological changes of LC. Nissl staining was used to detect the changes of neuronal Nissl bodies in LC. Immunohistochemistry (IHC) staining was used to detect the expression of neuron nuclear antigen (NeuN) , dopamine (DA) neurons and norepinephrine (NE) neuron markers tyrosine hydroxylase (TH) , α-synuclein (α-syn) in substantia nigra (SN) and LC. The expression levels of NeuN, TH and α-syn in the midbrain and brainstem were detected by Western blotting. TUNEL staining was used to detect neuronal apoptosis in LC. Results: Compared with the 4th week of PQ exposure group, the time of pole climbing and swimming immobility were gradually increased, the ratio of open arm residence time of high plus maze test and the number of times of the platform and the residence time of platform quadrant in water maze test were gradually decreased (P<0.05) in the exposure group with the progress of exposure time. The results of HE and Nissl staining showed that the neurons in LC gradually arranged loosely, the nucleus were deeply stained, the cytoplasm was pyknosis, and the number of Nissl bodies gradually decreased (P<0.05) in the exposure group with the progress of exposure time. IHC results showed that the number of NeuN and TH positive cells in SN and LC of mice were gradually decreased, and the positive expression of α-syn was gradually increased (P<0.05) in the exposure group with the progress of exposure time. Western blotting results showed that the expression levels of NeuN and TH in the midbrain and brainstem were gradually decreased, and the expression level of α-syn was gradually increased (P<0.05) in the exposure group with the progress of exposure time. TUNEL staining showed that the apoptosis rates of neurons in LC were gradually increased (P<0.05) in the exposure group with the progress of exposure time. Conclusion: PQ induces progressive damage in the LC area of PD-like mice, which may be caused by the abnormal accumulation of pathological α-syn in the LC area.


Subject(s)
Animals , Male , Mice , Dopaminergic Neurons , Locus Coeruleus/pathology , Mice, Inbred C57BL , Paraquat/toxicity , Parkinson Disease/metabolism , Substantia Nigra , Tyrosine 3-Monooxygenase/metabolism
5.
Chinese Pharmacological Bulletin ; (12): 669-675, 2022.
Article in Chinese | WPRIM | ID: wpr-1014205

ABSTRACT

Aim To investigate the inhibitory effect of copper gluconate and disulfiran on the PLpro of SARS-CoV-2 and to explore the effect of combination of them on PLpro.Methods SARS-CoV-2 PLpro was purified by recombinant expression technology of he effects of copper gluconate and disulfiram on PLpro activity were studied by enzyme kinetic method.Results Copper gluconate and disulfiram had high inhibitory activity on SARS-CoV-2 PLpro,Ubiquitin-7-Amino-4-methylcoumarin(Ub-AMC)was used as the fluorescent substrate.The IC50 of copper gluconate was 33.02 nmol·L-1,showing competitive inhibition,and the IC50 of disulfiram was 480.4 nmol·L-1,showing non competitive inhibition,and the combination of the two inhibitors showed the advantage of synergistic inhibition.Conclusions Copper gluconate and disulfiram have a high inhibitory effect on SARS-CoV-2 PLpro protein,and the combination shows the advantage of synergistic inhibition.

6.
Chinese Pharmacological Bulletin ; (12): 884-888, 2021.
Article in Chinese | WPRIM | ID: wpr-1014452

ABSTRACT

Aim To establish a method for the stable expression of recombinant humanized Anti-her2 monoclonal antibody and to measure its bioactivity. Methods Anti-her2 heavy chain and light chain eukaryotic expression vectors were used to transfect CHO cells, and then scaled-up after screening the stably expressed cell line. Protein A affinity chromatography was utilized to purify the fusion protein. Western blot was used to identify the properties of the product, SDS-PAGE and HPLC were employed to detect its specificity, and CCK8 assay was used to detect its effect on cell viability. Results One cell line with stable expression of recombinant antibody was selected for scale-up. The supernatant was gained for the purification with protein concentration of 135.9 mg · L

7.
China Journal of Orthopaedics and Traumatology ; (12): 73-80, 2021.
Article in Chinese | WPRIM | ID: wpr-879409

ABSTRACT

OBJECTIVE@#To compare the clinical effects of three different methods of binding multi-fold rib graft, iliac bone graft and titanium mesh graft in tuberculosis of thoracic vertebra by approach of transverse rib process.@*METHODS@#A hundred and seven patients with tuberculosis of thoracic vertebra received surgical treatment from January 2010 to December 2016 were retrospectively analyzed. The patients were divided into three groups according different methods of bone graft. The surgical approach of the transverse rib process was used in all 107 patients, after thoroughly remove the necrotic tissue of tuberculosis, three different bone grafts were used respectively including iliac bone graft (36 cases, group A), binding multi-fold rib graft (35 cases, group B), titanium mesh bone graft (36 cases, group C). Perioperative indexes, the time required for bone graft during operation, intraoperation blood loss, the loss rate of the anterior edge of the lesion, Cobb angle, postoperative bone graft fusion time, spinal nerve recovery and Oswestry Disability Index were compared among three groups.@*RESULTS@#All the patients were followed up for 13 to 24 months, and the operation time required for bone graft was (23.2±4.1) min in group A, (23.8± 4.4)min in group B, and (25.5±4.2) min in group C, with no statistically significant difference among three groups (@*CONCLUSION@#The approach of transverse rib process for debridement of lesions can effectively treat tuberculosis of thoracic vertebra by binding multi-fold rib graft, iliac bone graft and titanium mesh graft, but binding multi-fold rib graft can effectively avoid iliac bone donor complications, and is an effective alternative to iliac bone graft, which is worth popularizing.


Subject(s)
Humans , Bone Transplantation , Lumbar Vertebrae , Retrospective Studies , Ribs/surgery , Spinal Fusion , Surgical Mesh , Thoracic Vertebrae/surgery , Titanium , Treatment Outcome , Tuberculosis, Spinal/surgery
8.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 186-192, 2021.
Article in Chinese | WPRIM | ID: wpr-906005

ABSTRACT

Gegen Qinliantang, a classic traditional Chinese medicine(TCM) compound, has been verified in modern research to possess various pharmacological effects such as anti-inflammation,anti-oxidative stress,protecting intestinal mucosal barrier, and regulating intestinal flora and immune response. Ulcerative colitis (UC) is a chronic idiopathic inflammatory disease involving the colorectal mucosa, which mainly results from genetic susceptibility, intestinal mucosal barrier damage, abnormal immune response, intestinal flora disturbance, and bile acid metabolism disorders. By reviewing the literature published in recent years, this paper sorted out the relevant pathways and mechanisms involved in the treatment of UC by Gegen Qinliantang to provide ideas for further clinical and basic research. This literature review uncovered that Gegen Qinliantang exerted the therapeutic effects against UC mainly via interleukin-6(IL-6)/Janus tyrosine kinase 2(JAK2)/signal transducer and activator of transcription 3(STAT3) signaling pathway, Toll like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB) signaling pathway,Notch signaling pathway, and matrix metalloproteinase-9(MMP-9)/p38 mitogen-activated protein kinase(p38 MAPK) signaling pathway. Gegen Qinliantang regulates the intercellular molecular transmission in multiple pathways to protect the intestinal mucosal barrier, adjust the immune response and anti-oxidative stress, and relieve UC, demonstrating the multi-target, multi-mechanism, and multi-pathway advantages of TCM compounds.

9.
China Journal of Orthopaedics and Traumatology ; (12): 166-172, 2020.
Article in Chinese | WPRIM | ID: wpr-792974

ABSTRACT

OBJECTIVE@#To investigate the clinical effect of One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion for the treatment of lumbosacral tuberculosis.@*METHODS@#The clinical data of 31 patients with lumbosacral tuberculosis treated by one-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion from January 2013 to February 2018 were retrospectively analyzed. There were 18 males and 13 females, aged from 18 to 77 years old with an average of (45.9±9.1) years. The lesion segment was form L to S. The preoperative ASIA grading showed that 2 cases were grade B, 17 cases were grade C, 12 were grade D. Pre- and post-operative C reactive protein (CRP), visual analogue scale (VAS), erythrocyte sedimentation rate (ESR), ASIA grade, lumbosacral angle and intervertebral space height were analyzed, the surgery complications, stability of internal fixation, bone fusion were observed.@*RESULTS@#All the 31 patients were followed up for 10 to 24 months with an average of (16.0±3.1) months. One patient with local infection and subcutaneous hydrops was cured by dressing change. Other 30 cases got primary healing without sinus formation and no recurrence of spinal tuberculosis. All the patients were cured, no internal fixation loosening and breakage were found. All bone fusion was successful with an average fusion time of (4.7±1.1) months. At the final follow-up, ESR and CRP were normal, the VAS was decreased from (6.13±1.21) points preoperatively to (1.92±0.57) pioints, the ASIA grading showed that 2 cases were grade C, 6 cases were grade D, and 23 cases were grade E. The lumbosacral angle and intervertebral space height was increased from preoperative (21.42±3.75) °, (7.84±0.41) mm to (27.21±3.12) °, (9.80±0.38) mm at the final follow-up, respectively.@*CONCLUSION@#One-stage posterior debridement combined with lumbar-ilium fixation and bone graft fusion is a practicable, effective and safe method for the treatment of lumbosacral tuberculosis. It can be recommended in clinical application.

10.
Journal of Peking University(Health Sciences) ; (6): 1063-1068, 2020.
Article in Chinese | WPRIM | ID: wpr-942117

ABSTRACT

OBJECTIVE@#To investigate the prevalence of sleep disorders and the relevant determinants in a cohort of primary Sjögren' s syndrome (pSS) patients.@*METHODS@#One hundred and eighty-six pSS patients were included in the study, who were admitted to Peking University People' s Hospital and met the criteria of inclusion and exclusion. Sleep quality was assessed using the Pittsburgh sleep quality index(PSQI).Depression, anxiety were evaluated by patient health questionnaire (PHQ)-9, generalized anxiety disorder(GAD)-7, respectively. The demographic and clinical data were also recorded.Disease activity and damage were evaluated with the European League Against Rheumatism Sjögren's syndrome disease activity index (ESSDAI). According to the PSQI score>7, the pSS patients were divided into 152 cases of sleep disorder group and 34 cases of normal sleep group. Mann-Whitney U test, Chi-square test or Fisher' s exact test, independent samples t test, Spearman correlation analysis and Logistic regression were used for statistical analysis.@*RESULTS@#The prevalence of sleep disturbance (PSQI > 7) was 81.7% (152 / 186) in the pSS patients, and 52.7% (98/186) had moderate or severe sleep disorders (PSQI≥ 11). The mean PSQI score of sleep disordered group was (12.29±3.30), while the normal sleep group PSQI score was (5.50±1.20). The PSQI score, PHQ-9 score and GAD-7 score in the sleep-disordered group were significantly higher than those in the normal sleep group (P=0.000, 0.035, 0.031). The PSQI score in the sleep disordered group were significantly higher than those in the normal sleep group in seven aspects: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disorders, hypnotic drug use and daytime dysfunction. All of them had statistical significance. According to the results of Spearman correlation analysis, PSQI had significantly positive correlation with course of disease, anxiety, depression score (r=0.151, 0.240, 0.421, P < 0.05), but negatively correlated with C3, C4 (r=-0.021, -0.235, P < 0.05). Logistic analysis identified the course of disease(OR=2.809, 95%CI: 1.21-6.52)and PHQ-9 score(OR=1.422, 95%CI: 1.04-1.94)as predictors of sleep disorders.@*CONCLUSION@#The incidence of sleep disorder in the pSS patients was higher, which was closely related to the course of disease, anxiety, depression and other factors. It is critical to assess and manage comprehensively the disease.


Subject(s)
Humans , Anxiety/etiology , Cohort Studies , Sjogren's Syndrome/epidemiology , Sleep , Sleep Wake Disorders/epidemiology
11.
Journal of Peking University(Health Sciences) ; (6): 1040-1047, 2020.
Article in Chinese | WPRIM | ID: wpr-942114

ABSTRACT

OBJECTIVE@#To investigate the clinical characteristics of patients with elderly-onset rheumatoid arthritis (EORA), and the risk factors of EORA complicated with cardiovascular disease (CVD).@*METHODS@#A cross-sectional study was conducted in Peking University People's Hospital from July 2009 to December 2014 and 1 116 patients were recruited. The patients' characteristics and CVD, including ischemic heart disease, cerebral and peripheral vascular disease, were recorded. The patients were divided into EORA group (n=212) and younger-onset rheumatoid arthritis (YORA) group (n=904) according to the age of onset ≥60 years and < 60 years. Then, the differences between the groups were analyzed by Student's t test, Mann-Whitney U test or χ2test, and risk influencing CVD were analyzed using Logistic regression.@*RESULTS@#There was no significant difference in the disease activity between the EORA and YORA groups. The proportion of male, pulmonary interstitial disease (ILD), and numbers of deformity joint count (DJC) were significantly higher in the EORA group compared with the YORA group [32.1% vs. 18.5%, χ2=19.11, P < 0.001; 23.6% vs. 13.6%, χ2=16.50, P < 0.001; 6 (2, 12) vs. 3 (2, 7), Z=-3.60, P < 0.001], while the prevalence of Sjögren's syndrome was lower than that of the YORA group (13.5% vs. 5.2%, χ2=11.29, P=0.001). Moreover, there were lower prevalences in the patients treated with disease-modifying antirheumatic drugs (DMARDs) in EORA group (35.4%) than in YORA group (26.7%) (χ2=6.43, P=0.011), especially in methotrexate (MTX), hydroxychloroquine (HCQ) and sulfasalazine (SSZ). In addition, the patients with EORA had a higher prevalence of CVD (27.8%) than the YORA group (11.6%, χ2=40.46, P < 0.001), accompanied with higher prevalence of smoking, hypertension, and hyperlipidemia. Multivariate Logistic regression analysis showed that elder age (OR=1.10, 95%CI: 1.00-1.20), DJC (OR=3.17, 95%CI: 1.04-9.68), rheumatoid nodules (OR=3.56, 95%CI: 1.03-12.23), hypertension (OR=2.37, 95%CI: 1.09-5.13) and hyperlipidemia (OR=8.85, 95%CI: 2.50-31.27) were independent risk factors, while HCQ (OR=0.22, 95%CI: 0.07-0.70) and MTX (OR=0.32, 95%CI: 0.14-0.73) were protective factors of EORA complicated with CVD.@*CONCLUSION@#Compared with YORA, patients with EORA have higher ratio of male, ILD and DJC, which may be attributed to inappropriate therapies. EORA is more likely to be complicated with CVD than YORA. Elder age, DJC, rheumatoid nodules, hypertension, and hyperlipidemia are independent risk factors, while HCQ and MTX are protective factors of EORA complicated with CVD.


Subject(s)
Aged , Humans , Male , Age of Onset , Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/epidemiology , Cardiovascular Diseases/etiology , Cross-Sectional Studies , Risk Factors
12.
Chinese Journal of Experimental Traditional Medical Formulae ; (24): 73-80, 2019.
Article in Chinese | WPRIM | ID: wpr-802033

ABSTRACT

Objective:To investigate the mechanism of Oxymatrine on epithelial-mesenchymal transition mediated by RhoA/Rho-associated kinase(ROCK) signaling pathway to prevent and treat ulcerative colitis(UC) and its related canceration by detecting the changes of ROCK, E-cadherin and transforming growth factor-β(TGF-β)in colon tissues of mice. Method:Totally 48 male Balb/c mice were randomly divided into normal control group, model group, low, medium and high-dose Oxymatrine groups (25,50,100 mg·kg-1)and Y-27632 group(10 mg·kg-1), with 8 mice in each group. Mice in control group received distilled water, while all the other mice were treated with 3% dextra sulfate sodium for 7 days to induce the ulcerative colitis model. Since the first day of modeling,Y-27632(10 mg·kg-1)and different doses of Oxymatrine(25, 50, 100 mg·kg-1) were intraperitoneally injectedfor 7 days, and equal volume of PBS was intraperitoneally injected in normal group and model group. Body weight loss, stool consistency and fecal blood loss were observed on a daily basis. On the 8thday, mice were put to death,colon was collected and its length was measured; the scores of disease activity index (DAI) were evaluated; part of the colons were fixed and stained with hematoxylin and eosin (HE) for a histopathological analysis; the ultrastructural changes of mucosa tissue in ulcerative colitis were observed by transmission electron microscope. The expression levels of TGF-β in tissue mucosa were tested by enzyme-linked immunosorbentassay(ELISA). The expression levels of Rho-associated kinase-1, Rho-associated kinase-2, E-cadherin and TGF-β in colon were measured by Western blot and Real-time PCR. Result:Compared with normal group, model group showed the infiltration of a large number of inflammatory cells in mucosa and submucosa, disordered gland arrangement, varying degrees of intestinal mucosal defect and even ulcer formation. Under electron microscopy, microvilli were sparse on the surface of intestinal epithelial cells, the gap between cell junctions was widened, goblet cells were reduced and organelles were swollen. The disease activity index,and the expression levels of ROCK-1 and ROCK-2 proteins in the colonic mucosa of model group were increased(Pβ were decreased(PPPβ were increased(PPPβ and E-cadherin protein and mRNA levels were significantly decreased(PConclusion:Oxymatrine may alleviate ulcerative colitis by down-regulating the expression of Rho kinase,up-regulating the expressions of E-cadherin and TGF-β, inducing the apoptosis of intestinal epithelial cells, and mediating epithelial-mesenchymal transition.

13.
China Journal of Chinese Materia Medica ; (24): 1674-1681, 2019.
Article in Chinese | WPRIM | ID: wpr-774506

ABSTRACT

As a new concept in clinical research,the real world research(RWR) has attracted the attention of researchers in the world with its unique advantages. This research mainly analyzed it through visual methods,the specific steps were as follows. Firstly,the Chinese Biomedical Literature Database,China National Knowledge Infrastructure,Wan Fang Database,Medline and EMbase were searched and RWS were included,414 articles in Chinese and 2 158 articles in English were included in this research after layer-bylayer screening; secondly,the main information was extracted and sorted by BICOMS 2 software and generated its co-occurrence matrix; the network relationship diagram was drawn by Net Draw software; the cluster analysis was carried out by using g CLUTO software;finally,this research results show that the numbers of domestic and foreign literatures have shown an overall growth trend,but compared with foreign countries,China's research on the real world started late,the overall strength of research was not as good as abroad;and the domestic and foreign research on the real world was uneven in the region,the research in China was mainly distributed in developed provinces and cities,such as Beijing,Guangdong,Shanghai,etc,and there was a lack of close cooperation between provinces and cities; the foreign research are mainly distributed in developed countries such as the United States,the United Kingdom,Germany,et al; the cooperation between countries was relatively close. And the hotspots and core directions of domestic and foreign research were also different. This research was intended to provide reference for the further research of Chinese researchers through the current description of the themes and capability of the real world research in the world.


Subject(s)
China , Databases, Bibliographic , Germany , Research , United Kingdom , United States
14.
China Journal of Orthopaedics and Traumatology ; (12): 361-367, 2018.
Article in Chinese | WPRIM | ID: wpr-689983

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical value of percutaneous endoscopic focal cleaning and drainage in the treatment of single-level suppurative spondylitis.</p><p><b>METHODS</b>The clinical data of 18 patients with single-level suppurative spondylitis treated by percutaneous endoscopic focal cleaning and drainage from June 2014 to December 2015 were retrospectively analyzed. There were 11 males and 7 females, aged from 46 to 75 years old with an average of (58.89±9.46) years. According to the patient's diagnosis and drug sensitivity results to anti-infection therapy after operation. All the patients were followed up for 12 to 24 months with an average of(15.50±3.45) months. Disease control status was evaluated by laboratory examination of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) before and after operation. Relief of pain was evaluated using visual analogue scale(VAS). Nerve function was assessed by ASIA classification. Clinical effects were evaluated by Kirkaldy-Willis standard. Spinal stability and recurrence of infection were observed by imaging data.</p><p><b>RESULTS</b>All the operations were successful, and no complication as hematoma, nerve injury, infection, cerebrospinal fluid leakage, sinus formation at the site of tube placement, or mixed infection were found. Postoperative bacteriological report was positive in 12 cases, while 6 cases showed no bacterial growth, and the infection status in 13 cases were confirmed by pathological examination. ESR, CRP, VAS at 2 weeks, 3 months after surgery and at the final follow-up were obviously improved(<0.05). Clinical symptoms were improved significantly at 1 week to 3 months after operation. According to Kirkaldy-Willis standard to evaluate the clinical effect, 14 cases obtained excellent results, 3 good, and 1 fair. Nerve function recovery was based on ASIA grading at the final follow-up. The lost Cobb angles were (1.11±1.18)° on average, with no statistically significant difference before and after operation (>0.05). During the follow-up, no recurrent infection has occurred.</p><p><b>CONCLUSIONS</b>Percutaneous endoscopic focal cleaning and drainage is a minimally invasive, effective and safe surgical method, which serves as a new choice for surgical treatment of suppurative spondylitis.</p>


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Blood Sedimentation , C-Reactive Protein , Debridement , Drainage , Endoscopy , Retrospective Studies , Spinal Fusion , Spondylitis , General Surgery , Treatment Outcome
15.
China Journal of Orthopaedics and Traumatology ; (12): 987-992, 2018.
Article in Chinese | WPRIM | ID: wpr-772589

ABSTRACT

OBJECTIVE@#To explore the clinical effects and advantages of percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation in the treatment of tuberculosis of lumbar spine in elderly.@*METHODS@#The clinical data of 32 patients with tuberculosis of lumbar spine received percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation from May 2013 to May 2016 were retrospectively analyzed. There were 13 males and 19 females, aged from 62 to 85 years old with an average of 75 years. Lesion segmental Cobb angle was 13° to 21° with an average of (16.52±3.20)°. Tuberculosis focal involved L₁-L₂ of 1 case, L₂-L₃ of 4 cases, L₃-L₄ of 15 cases, L₄-₅ of 10 case, L₅-S₁ of 2 cases. Cobb angle, VAS score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ASIA grade were compared before and after operation. The stability of the spine and the recurrence of tuberculosis were evaluated.@*RESULTS@#All patients were followed up for 12-36 months with the mean of 24 months. Three patients complicated with giant paravertebral psoas abscess occurred sinus tract in canal orifice of drainage tube after irrigation, and healed in 3 months after operation. Other 29 patients obtained healing of phase I without sinus tract formation. The clinical symptoms of all patients obvious improved at 2 weeks to 3 months after operation and no complications such as severe heart and lung, liver and kidney dyfunction were found. VAS scores and Cobb angles were improved from preoperative(6.77±1.23) points and(16.52±3.20)° to(4.71±0.69) points and (4.24±1.22)° at 1 week after operation. No infection and tuberculosis recurrence were found at follow-up period. ESR and CRP were normal at final follow-up and ASIA grade had obvious improved.@*CONCLUSIONS@#Percataneous endoscopic focal cleaning and drainage combined with posterior internal fixation is a simple, effective and safe method for tuberculosis of lumbar spine in elderly, and is worthy to recommend its clinical use.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Debridement , Drainage , Fracture Fixation, Internal , Lumbar Vertebrae , Retrospective Studies , Spinal Fusion , Thoracic Vertebrae , Treatment Outcome , Tuberculosis, Spinal
16.
Chinese Journal of Tissue Engineering Research ; (53): 1743-1748, 2018.
Article in Chinese | WPRIM | ID: wpr-698607

ABSTRACT

BACKGROUND: Although more and more accurate and personalized detection and assistive tools are used in the field of orthopedics with the development of technology, the preoperative CT is still the first-line examination choice of many orthopedic surgeons. Therefore, to master the lumbar spine CT imaging performance is not only the basis of spine surgeons, but also the cornerstone of spinal nail surgery. OBJECTIVE: Through CT imaging technique, we measured the parameters of lumbar pedicle imaging, and understood its internal structure as the basis for the choice of screws, in order to improve the safety and accuracy of nail surgery. METHODS: Totally 36 cases without lumbar vertebrae-related disease undergoing lumbar vertebra and abdominal cavity CT scan were randomly selected, including 20 males and 16 females at the age of (43.3±12.3) years. PACS was used to reconstruct lumbar vertebrae, and the related imaging parameters were measured. RESULTS AND CONCLUSION: (1) There was no significant difference between the left and right sides of the pedicle for paired t-test (P >0.05). (2) Pedicle sagittal angle had downward trend, the level of change was small; L4increased relative to L3; L5level was minimum at the average of -1.3°. Pedicle transverse angle had gradually increased trend, and maximum at L5; the average was 25.4°. (3) The length of the pedicle channel increased first and then decreased in the lumbar segment; the longest average was 52.2 mm in the L2segment, the shortest at L5, with an average of 47.4 mm. (4) The pedicle height was slightly narrowed at L1-L3levels; the smallest was 15.4 mm (L3mean), and reached the maximum in the L5at 22.7 mm (L5mean). Cancellous bone height also showed the same trend, the minimum in the L3at 10.2 mm, the maximum in the L5at 17.9 mm. (5) Lumbar pedicle width showed an upward trend, L1minimum of 7.7 mm, L5maximum of 12.5 mm. Cancellous bone width also became a similar upward trend; the narrowest L1, averagely 4.9 mm; the maximum L5, averagely 8.5 mm. (6) Overall, the upper lumbar pedicle channel was slender, while the lower lumbar spine was slightly short. (7) The parameters of the pedicle can be used as the basis for selecting the appropriate screw. At the same time, lumbar pedicle morphology has a certain difference, and there is a certain law. Accurately grasping its structure and image characteristics of pedicle screw fixation is the basis of surgery. The preoperative imaging data collection and assessment, combined with the general situation of patients, and the development of personalized programming, will help in improving the safety and accuracy of screw placement.

17.
China Journal of Orthopaedics and Traumatology ; (12): 787-791, 2017.
Article in Chinese | WPRIM | ID: wpr-324610

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the application value of Xpert MTB/RIF in diagnosis of spinal tuberculosis and detection of rifampin resistance.</p><p><b>METHODS</b>The 109 pus specimens were obtained from patients who were primaryly diagnosed as spinal tuberculosis. All of the pus specimens were detected by acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay to definite the differences in sensitivity and specificity of mycobacterium tuberculosis among detecting methods. Pus specimens obtained by different methods were deteceded by MTB/RIF test to analyze the self-influence on Xpert MTB/RIF test. The result of liquid fast culturing by BACTEC MGIT 960 was used as the gold standard; and the value of Xpert MTB/RIF assay in detecting rifampin resistance was analyzed.</p><p><b>RESULTS</b>The sensitivity of acid-fast stain, liquid fast culturing by BACTEC MGIT 960 and Xpert MTB/RIF assay were 25.92%, 48.15%, 77.78%, respectively. The sensitivity of pus specimens obtained from open surgery, ultrasound positioning puncture and biopsy the sensitivity were 83.78%, 76.47%, 44.68% respectively deteceded by MTB/RIF test. According to the gold standard of the results of liquid fast culturing by BACTEC MGIT 960 assay, the sensitivity and specificity of Xpert MTB/RIF assay in detecting rifampin resistance were 80%(4/5) and 90.70%(39/43), respectively.</p><p><b>CONCLUSIONS</b>Xpert MTB/RIF assay has higher value in diagnosis of spinal tuberculosi, and also can detect rifampin resistance. The number of mycobacterium tuberculosis in pus specimens has a great influence in the sensitivity of Xpert MTB/RIF assay.</p>

18.
China Journal of Orthopaedics and Traumatology ; (12): 517-521, 2016.
Article in Chinese | WPRIM | ID: wpr-230432

ABSTRACT

<p><b>OBJECTIVE</b>To explore clinical outcomes and advantages of anterior small-incision focus debridement with posterior internal fixation through muscle spa ring in treating patients with lumbar spinal tuberculosis.</p><p><b>METHODS</b>From February 2010 to February 2014, totally 82 patients with lumbar spinal tuberculosis were treated by posterior individual fixation with small-incision focus debridement,including 50 males and 32 females with an average of 50.5 years old. All patients were divided into two groups according to different procedures. Forty-nine patients in group A were treated with anterior small-incision focus debridement with posterior internal fixation through muscle spa ring at stage I ; and 33 patients in group B were treated with focus debridement with posterior internal fixation by extraperitoneal approach at stage I . Postoperative mechanical ventilation time, preoperative and postoperative Cobb angle, visual analogue scale (VAS), erythrocyte sedimentation rate (ESR) and Frankel grading were observed and compared. Postoperative complications, stability of internal fixation and bone union were compared.</p><p><b>RESULTS</b>All patients were followed-up from 15 to 36 months with an average of 23.7 months. Psoas abscess of three patients in group A and 1 patient in group B on the opposite side increased and were healed by the secondary apocenosis. The other 78 cases were healed at stage I, and no sinus tract formation, incisional hernia, leakage of cerebrospinal and occurrence of spinal tuberculosis were occurred. Fracture healing time ranged from 3 to 7 months with an average of 4.6 months. Postoperative mechanical ventilation time and VAS score in group A was better than group B. There were no statistical differences in Cobb angle, ESR and Frankel grading at the final following-up between two groups.</p><p><b>CONCLUSION</b>Anterior small-incision focus debridement with posterior internal fixation through muscle spa ring in treating patients with lumbar spinal according to degree of damage is a safe and effective method.</p>


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Debridement , Methods , Fracture Fixation, Internal , Minimally Invasive Surgical Procedures , Methods , Treatment Outcome , Tuberculosis, Spinal , General Surgery
19.
Chinese Medical Journal ; (24): 3153-3157, 2015.
Article in English | WPRIM | ID: wpr-275545

ABSTRACT

<p><b>BACKGROUND</b>Laparoscopic cholecystectomy (LC) has been a standard operation and replaced the open cholecystectomy (OC) rapidly because the technique resulted in less pain, smaller incision, and faster recovery. This study was to evaluate the value of blunt dissection in preventing bile duct injury (BDI) in laparoscopic cholecystectomy (LC).</p><p><b>METHODS</b>From 2003 to 2015, LC was performed on 21,497 patients, 7470 males and 14,027 females, age 50.3 years (14-84 years). The Calot's triangle was bluntly dissected and each duct in Calot's triangle was identified before transecting the cystic duct.</p><p><b>RESULTS</b>Two hundred and thirty-nine patients (1.1%) were converted to open procedures. The postoperative hospital stay was 2.1 (0-158) days, and cases (46%) had hospitalization days of 1 day or less, and 92.8% had hospitalization days of 3 days or less; BDI was occurred in 20 cases (0.09%) including 6 cases of common BDI, 2 cases of common hepatic duct injury, 1 case of right hepatic duct injury, 1 case of accessory right hepatic duct, 1 case of aberrant BDI 1 case of biliary stricture, 1 case of biliary duct perforation, 3 cases of hemobilia, and 4 cases of bile leakage.</p><p><b>CONCLUSION</b>Exposing Calot's triangle by blunt dissection in laparoscopic cholecystectomy could prevent intraoperative BDI.</p>


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Bile Duct Diseases , Cholecystectomy, Laparoscopic , Methods , Common Bile Duct , Wounds and Injuries , General Surgery , Retrospective Studies
20.
China Journal of Orthopaedics and Traumatology ; (12): 194-198, 2014.
Article in Chinese | WPRIM | ID: wpr-301858

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the clinical outcomes of percutaneous intervertebral foramina endoscopic lumbar discectomy for elder patients with lumbar spinal stenosis syndrome.</p><p><b>METHODS</b>From July 2006 to July 2011, 60 elder patients with lumbar spinal stenosis syndrome were treated with surgical operation, including 32 males and 28 females with an average age of (66.7 +/- 2.5) years old ranging from 72 to 83 years. These patients were divided into the traditional surgery group and percutaneous intervertebral foramina endoscopic discectomy groups (PTED group), 30 cases in each group. The index of the preoperative and postoperative, operative incision visual analogue scale (VAS) of two groups were compared. The Oswestry disability index (ODI) of two groups at 6, 24 months of the follow-up were also evaluated on activity of daily living.</p><p><b>RESULTS</b>The average operative time, the average blood loss, the number of cases using analgesic drug, hospitalization time of PTED group were better than those of the traditional surgery group (P < 0.05). The improvement of incision VAS in PTED group was better than that in the traditional surgery group (P < 0.05). All patients were followed up for 24 months at least. The ODI at 1, 24 month after operation were better than that of preoperative in two group respectively (P < 0.05), but the improvement of PTED group was better than that of the traditional surgery group (P < 0.05).</p><p><b>CONCLUSION</b>PTED has the advantages of smaller incision, less bleeding, less postoperative stay and hospitalization time, tissue trauma and quicker recovery. It is a safe and efficacious minimally invasive surgical technique for elder patients with lumbar spinal stenosis syndrome.</p>


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Decompression, Surgical , Diskectomy, Percutaneous , Endoscopy , Lumbar Vertebrae , General Surgery , Spinal Stenosis , General Surgery , Treatment Outcome
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