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For the moment, the surgical treatment of severe rigid cervical kyphosis is still one of the difficulties in the treatment of spinal deformity. There were not consistent in the stage of correction, choice of osteotomy method, osteotomy scope and approach. In this paper, It was expected to get further understanding by sharing one case of severe cervical kyphosis treated by anterior and posterior approach, and reviewing literature. The patient was a 23-year-old female who had functional limitation due to cervical deformity for 3 years. It showed that the cervical kyphosis vertex was C 3, 4 segment, the Cobb angle was 86°, the flexibility was 8.1%, and the atlantoaxial vertebra was dislocated and unstable by the examination of X-ray, MRI, CT and CTA examination. The cervical segmental, sequence, morphological characteristics of pedicle and lateral mass, and running of the vertebral artery were also evaluated. The deformity was corrected by a one-stage operation combined anterior and posterior approaches for intervertebral and atlantoaxial release, osteotomy of the posterior lamina articular process and fusion with bone grafting. The cervical lordosis angle was recovered to 6.7°. The patients were followed up for 4 years. There were no operative and perioperative complications and we obtained satisfied surgical result.
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Objective:To investigate the clinical efficacy of percutaneous kyphoplasty (PKP) versus percutaneous vertebroplasty (PVP) in the treatment of single-segment osteoporotic vertebral compression fractures (OVCF) in the older adult patients. Methods:A total of 117 older adult patients with single-segment OVCF who received treatment in Binzhou Central Hospital from January 2016 to March 2018 were included in this study. They were randomly assigned to undergo either PVP (observation group, n = 60) or PKP (control group, n = 57). Therapeutic effects, treatment cost and the incidence of complications were compared between the two groups. Results:In the observation group, the amount of bone cement, operative time, treatment cost and the amplitude of increase in vertebral height post-operation relative to preoperative vertebral height were (4.69 ± 1.94) mL, (27.59 ± 5.81) minutes, (6 537.24 ± 898.36) yuan, (2.54 ±1.37) mm, respectively, and they were (5.78 ± 2.04) mL, (38.63 ± 8.17) minutes, (24 371.85 ± 2 365.54) yuan, (8.65 ± 1.48) mm, respectively in the control group. There were significant differences in these indices between the two groups ( t = 6.18, 9.25, 10.26, 7.23, all P < 0.05). Before treatment, there were no significant differences in Cobb angle and vertebral compression rate between the two groups (both P > 0.05). After treatment, Cobb angle of injured vertebrae in the control group was significantly lower than that in the observation group [(9.25 ± 2.36)° vs. (20.38 ± 3.87)%, t = 10.25, P < 0.05]. Vertebral compression rate in the control group was significantly lower than that in the observation group [(20.06 ± 3.53)% vs. (24.76 ± 5.35)%, t = 6.23, P < 0.05]. There was no significant difference in the incidence of complications between the two groups [26.67% (16/60) vs. 17.54% (10/57), χ2 = 8.92, P < 0.05). Conclusion:PVP is more simple and less expensive in the clinical treatment of OVCF than PKP, but PKP is more effective and has lower incidence of complications than PVP. PKP can be preferred if there is no concern about economic and medical conditions.
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OBJECTIVE To investigate the effect of overexpression of vascular cell adhesion molecule-1(VCAM-1)on the migration in vitro of the murine mesenchymal stem cells(MSCs)and its possible mechanism. METHODS The migration ability of normal mouse MSC (C3) ,empty vector-transfected MSC(C3+N) and VCAM-1 transfected MSC(C3+VCAM-1)was assessed by Transwell culture system in vitro after incubation for 8 and 12 h,respectively. The fetal bovine serum (FBS) was used as the chemotactic agent to induce MSC migration. The transmigrated cells were detected with methylosaniliam chloride(crystal violet)as well as DAPI staining.Furthermore,the specific chemical inhibitors of mitogen-activation protein kinase (MAPK) pathway ( SB203580,PD98059 and JNK inhibitorⅡ)were added to the Transwell system for 12 h and the alteration of the MSC migration ability was evaluated. RESULTS After incubation with FBS for 8 and 12 h,the absolute migrated cell number(7467 ± 485 and 8795 ± 255)and migration rate〔(14.9 ± 1.0)% and(17.6 ± 0.5)%〕of MSC in C3+VCAM-1 group were significantly increased compared with C3 group〔2731±562 and 4779±224, (5.5 ± 1.1)%and(9.6 ± 0.4)%〕and C3+N group〔2539 ± 321 and 5645 ± 1080,(5.1 ± 0.6)%and(11.3 ± 1.1)%〕(P<0.05,P<0.01),but there was no significant difference between C3 and C3+N groups. Moreover,the MSC migration ability of C3+VCAM-1 group was partially suppressed by addition of JNK inhibitorⅡ. The transmigrated cell number(4843 ± 167)and migration rate〔(9.7 ± 0.3)%〕were decreased compared with those of C3+VCAM-1 group without JNK inhibitorⅡ(P<0.01). SB203580 and PD98059,as specific chemical inhibitors of MAPK pathway,had no effect on MSC migration. CONCLUSION VCAM-1 can enhance mouse MSC migration in vitro and th4e mechanism may be related to JNK/MAPK pathway activation.
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AIM:To observe the expression and tissue localization of matrix metalloproteinase 9 (MMP-9) and transforming growth factor beta 1 ( TGF-β1 ) in the rat acute cerebral ischemia model.METHODS:Male Wistar rats were used to establish acute cerebral ischemia model by a suturing method.The rats were divided into normal control group, sham group and ischemia 6 h, 12 h, 1 d, 2 d, 6 d and 14 d groups.The rat cerebral cortex and hippocampus of the brain were collected at different time points.The mRNA and protein levels of MMP-9 and TGF-β1 in the brain tissues were detec-ted by real-time PCR and in situ histochemistry staining, respectively.The levels of MMP-9 and TGF-β1 in the plasma were also measured by ELISA.RESULTS:The results of real-time PCR showed that the mRNA levels of MMP-9 began to in-crease 6 h after acute ischemia and reached to a peak 2 d after acute ischemia.Similarly, the mRNA level of TGF-β1 began to rise 12 h after acute ischemia and reached to the highest level 6 d after acute ischemia.Compared with the sham rats, the mRNA levels of MMP-9 and TGF-β1 in the rat brains that collected at ischemic time of 12 h, 1 d, 2 d, 6 d and 14 d were significantly increased.Moreover, results of in situ histochemical staining showed that the expression of MMP-9 was detected at cerebral cortex and hippocampus 1 d after acute cerebral ischemia.Further studies showed that MMP-9 dyeing of the rat cerebral cortex was most obvious 2 d after the acute cerebral ischemia.Similarly, the rat cortex and hippocampus began to express TGF-β1 2 d after acute ischemia and TGF-β1 staining at rat cerebral cortex was most obvious 6 d after the acute cerebral ischemia.In addition, ELISA showed that the increase in MMP-9 and TGF-β1 was detected in the plasma 12 h after ischemia.Compared with the sham rats, the level of these 2 factors significantly upregulated since 1 d after ischemia. CONCLUSION:The brain tissue itself contributes to the upregulation of MMP-9 and TGF-β1 post acute cerebral ischemia, which shed light on the related research in the field.
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Translational medicine is a subject on translating basic research results to clinical applications and pathophysiology is a bridge course combining basic and clinical medicine.Results were good by applying concept of translational medicine in pathophysiology teaching and detailed measures included carrying out case analyses,adding clinical pathophysiology course,developing comprehensive experiments and opening laboratories,etc.
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Objective To evaluate the outcomes of single-point anastomosis of the fallopian tube under a laparoscope.Methods Totally,31 patients(58 fallopian tubes)were treated with laparoscopic single-point anastomosis using 3-mm laparoscopic instruments after ligation(17 cases)or failed hysteroscopic recanalization(14)of the fallopian tubes.Ureteral catheter or transcervical guidewire or stents were used if the sizes of the tubes were irregular.Results The 58 fallopian tubes were anastomosed successfully by a single operation.Radiography performed 3 months postoperation showed bilateral fallopian tube occlusion in 2 patients,and lateral tube occlusion in 5.The postoperative patency rate was 84.5%(49/58).A 6-to 36-month follow-up was carried out in 26 of the 31 patients.Among the 26 patients,17 had uterine pregnancy with a pregnancy rate of 65.4%(17/26),2 patients had fallopian tubal pregnancy,and 7 had no pregnancy.Conclusions Laparoscopic single-point anastomosis is feasible after ligation or failed recanalization of the fallopian tube.Patients have less surgical trauma,faster recovery and less intra-abdominal injury by treating with the procedure.