RESUMO
OBJECTIVE To study the correlation of novel organic cation transporter 2 （OCTN2） with the chemosensitivity of prostate cancer cells to oxaliplatin. METHODS Tumor samples of patients receiving radical prostatectomy were collected， and OCTN2 protein was detected with immunohistochemistry； the primary cells of the specimen were cultivated to obtain prostate cancer cell line. Inductively coupled plasma mass spectrometry was used to detect the uptake of low concentration （0.1 μmol/L） of oxaliplatin by cancer cells. Real-time PCR and Western blot were used to detect the mRNA and protein expressions of OCTN2 in cancer cells； the prostate cancer cells with the highest and lowest expression of OCTN2 protein were selected， and IC50 of oxaliplatin to prostate cancer cells was analyzed by ATP-TCA method. The inhibitory rate of plasma peak concentration of oxaliplatin （50 μmol/L） to prostate cancer cells was detected by MTT assay. Spearman method was used to analyze the relationship of the uptake of oxaliplatin by prostate cancer cells with inhibitory rate of oxaliplatin to prostate cancer cells and 505916443@qq.com mRNA expressions of OCTN2. RESULTS OCTN2 was located on the membrane of cancer cells， and the uptake of zjdtztougao@163.com oxaliplatin by cancer cells was 0.283±0.264 （n＝12）mRNA and protein expression of OCTN2 varied significantly among different cancer cells. The sensitivity of cancer cells with high expression of OCTN2 to oxaliplatin （IC50 of 4.61 μmol/L） was higher than that of cancer cells with lower expression of OCTN2 （IC50 of 26.23 μmol/L）. The inhibitory rate of oxaliplatin to cancer cells was （25.4±10.8）% （n＝12）. There was a correlation between the uptake of oxaliplatin by prostate cancer cells and the inhibition rate of oxaliplatin to prostate cancer cells and mRNA expression of OCTN2 （P＜0.05）. CONCLUSIONS High-expressed OCTN2 may promote the uptake of oxaliplatin by prostate cancer cells， and its expression can serve as a reference for predicting the sensitivity of prostate cancer cells to oxaliplatin chemotherapy.
RESUMO
Hierarchical diagnosis and treatment system is an important measure to rationally allocate medical resources and promote the homogenization of basic medical services. The medical alliance is an important service mode and service system of hierarchical diagnosis and treatment, whose role is to perfect the up-down linkage and meet the patient′s medical needs. Informatization construction is an important starting point to promote the services of the medical alliance. In order to solve the problem of connectivity, the medical alliance needs to establish a regional referral platform and realize the integrated service of all medical institutions. Renji Hospital, Shanghai Jiaotong University School of Medicine, has built a blockchain based referral system for hierarchical diagnosis and treatment, incorporating the S2B2C mode concept, and using the traceability, tamper proof and distributed accounting features of blockchain technology, realized independent storage of data in hospitals, realized real-time information sharing and interconnection, and provided a feasible solution for medical alliance management.
RESUMO
Objective:To analyze the clinical effect, adverse events and prognosis of microwave hyperthermia combined with radiotherapy in the treatment of patients with advanced gastric cancer.Methods:From May 2017 to May 2019, 80 patients with advanced gastric cancer admitted to Cancer Hospital of Shanxi Province were selected and divided into two groups according to the random digital table method, with 40 cases in each group.The control group was treated with radiotherapy, and the study group was treated with microwave hyperthermia on the basis of the control group.The clinical efficacy, adverse events and prognosis of the two groups were compared.Results:The total effective rate in the study group was 90.00%(36/40), which was higher than 70.00%(28/40) in the control group (χ 2=5.000, P<0.05). After treatment, the diameter of tumor in the study group was lower than that in the control group[(2.30±0.20)cm vs.(2.66±0.23)cm, t=7.470, P<0.05]. The incidence of adverse events in the study group was 10.00%(4/40), which was lower than 27.50%(11/40) in the control group(χ 2=4.020, P<0.05). The quality of life scores of the study group[physiological function (74.17±5.23)points, physical pain (73.07±5.49)points, general health (75.13±5.50)points, mental state (75.16±3.27)points and social function (75.49±3.24)points] were better than those of the control group[(62.55±5.70)points, (63.24±6.37)points, (65.72±5.30)points, (63.05±2.49)points, (65.34±4.59)points]( t=9.500, 7.393, 7.791, 18.634, 11.425, all P<0.05). Conclusion:Microwave hyperthermia combined with radiotherapy can reduce adverse events and improve the quality of life of patients with advanced gastric cancer.
RESUMO
Objective To observe the incidence,clinical characteristics,related factors,adverse events during hospitalization and short-term prognosis of postprandial hypotension (PPH) in elderly patients with coronary heart disease.Methods One hundred and sixty-eight elderly patients with coronary heart disease hospitalized in the Department of Cardiology,Second Hospital of Hebei Medical University from January 2014 to January 2015 were selected as the research subjects.They were monitored by 24 h ambulatory blood pressure monitoring.According to the diagnostic criteria of PPH,they were divided into postprandial hypotension group (PPH group) 34 cases and non-postprandial hypotension group (NPPH group) 134 cases.The clinical characteristics,risk factors related to PPH,occurrence of adverse events and prognosis of all-cause death,cardiovascular and cerebrovascular adverse events were compared between the two groups.Results Among 168 elderly patients with coronary heart disease,thirty-four patients had PPH,and the incidence rate was 20.2％ (34/168).The average systolic blood pressure before meals in PPH group was (139.8± 18.6) mmHg (1 mmHg =0.133 kPa).The proportion of taking calcium antagonists was 50.0％ (17/34) higher than that in NPPH group (127.4± 13.2) mmHg,27.6％ (37/134).The difference between the two groups was statistically significant (t =6.463,x2=6.232,P＜ 0.05).PPH was higher in breakfast and dinner than in lunch;the higher the basal systolic blood pressure level,the higher the incidence of PPH.Logistic regression analysis showed that the basal systolic blood pressure level and age were positively correlated with the occurrence of PPH (r =0.301,r =0.208,P＜ 0.05).Follow-up for 26 months showed that the incidence of all-cause death and cerebrovascular events in PPH group was higher than that in NPPH group (x2 =5.800,11.560,P＜ 0.05).Conclusion The incidence of PPH in elderly patients with coronary heart disease during hospitalization is 20.2％.Breakfast and dinner at three meals are prone to PPH.Older age and high systolic blood pressure level will increase the incidence of PPH.PPH will increase the incidence of mid-term all-cause death and cerebrovascular events.
RESUMO
Objective To compare the efficacy and toxicity of paclitaxel and carboplatin regimen concurrent chemoradiotherapy and radiotherapy alone in the treatment of stage Ⅲ cervical cancer.Methods A retrospective analysis of 158 patients with stage Ⅲ cervical cancer who were admitted to Shanxi Provincial Cancer Hospital from May 2009 to October 2012 was conducted.According to different treatment methods,86 patients were in the concurrent chemoradiotherapy group and 72 patients were in the radiotherapy group.The efficacy and adverse reactions of the two groups were compared.Results The effective rate (complete remission + partial remission) in the concurrent radiotherapy group and radiotherapy group was 95.3％ (82/86) and 84.7 ％ (61/72),respectively,and the difference was statistically significant (x2 =5.15,P =0.023).The 1-,2-,3-,and 5-year survival rates of the concurrent radiotherapy group and radiotherapy group were 93.0 ％ (80/86),77.9 ％ (67/86),68.6 ％ (59/86),60.5 ％ (52/86),and 81.9 ％ (59/72),61.1％ (44/72),41.7 ％ (30/72),36.1％ (26/72),respectively,and the differences were statistically significant (x2 values were 4.55,5.29,11.56,9.30,all P ＜ 0.05).The short-term adverse reactions in the concurrent chemoradiotherapy group and radiotherapy group were mainly myelosuppression and gastrointestinal reactions,and the incidence of myelosuppression was 87.2 ％ (75/86) and 50.0 ％ (36/72),respectively,and the difference was statistically significant (x2 =25.96,P ＜ 0.01);the incidence of gastrointestinal reactions was 91.9 ％ (79/86) and 20.8 ％ (15/72),respectively,and the difference was statistically significant (x2 =82.04,P ＜ 0.01).The incidence of radiation proctitis in the concurrent radiotherapy and chemotherapy group was 17.4 ％ (15/86) and 16.7 ％ (12/72),respectively,and the difference was not statistically significant (x2 =0.017,P =0.89);the incidence of radiation cystitis was 7.0 ％ (6/86) and 5.6 ％ (4/72),respectively,and the difference was not statistically significant (x2 =0.134,P =0.71).Conclusion Paclitaxel and carboplatin regimen chemotherapy combined with radiotherapy can improve the survival rate of patients with stage Ⅲ cervical cancer,and the adverse reactions are tolerable.
RESUMO
Objective To evaluate the efficacy and adverse reactions of preoperative intensity-modulated radiotherapy (IMRT) combined with mFOLFOX6 chemotherapy regimen for locally advanced rectal cancer (LARC). Methods A total of 86 patients with LARC who received preoperative IMRT combined with chemotherapy in Shanxi Provincial Cancer Hospital from June 2010 to December 2012 were enrolled. The patients were randomly divided into 2 groups according to the random number table method. Forty-six patients were treated with mFOLFOX6 regimen (mFOLFOX6 group) and 40 patients were treated with fluorouracil (5-Fu) single drug injection (5-Fu group). The total dose of IMRT target region was 45-54 Gy, 25 times in total. Short-term efficacy, adverse reactions, survival and metastasis were evaluated respectively. χ 2test or Fisher test were used to compare the count variable. Kaplan-Meier method was used to calculate the survival rates and Log-rank was used to detect. Results The total follow-up rate was 97.67 % (84/86). There were no statistical differences in the rate of resection (93.5 % vs. 80.0 %), pathological complete remission (pCR) rate (6.5 % vs. 0) and 3-year overall survival (OS) rate (87.0 % vs. 70.0 %) in the mFOLFOX6 group and 5-Fu group respectively (all P ＞ 0.05). Down-staging rate, 3-year disease free survival (DFS) rate and distant metastasis free survival (DMFS) rate in the mFOLFOX6 group were significantly higher than those in 5-Fu group (58.7 % vs. 32.5 %, 79.1 % vs. 50.0 %, 89.1 % vs. 72.5 %, all P ＜0.05). Conclusions Preoperative IMRT combined with mFOLFOX6 regimen can decrease the preoperative staging of LARC patients, improve 3-year DFS rate and DMFS rate. The adverse reactions may increase, but it is tolerant.
RESUMO
Objective: To study the clinical efficacy of Yangxindingji capsule combined with metoprolol in patients with coronary heart disease complicated with rapid arrhythmia. Methods: A total of 86 cases of patients with coronary heart disease complicated with tachyarrhythmia diagnosed in our hospital from January 2017 to December 2017 were selected as the subjects of this study. All the patients were divided into a control group and a study group according to the principle of the random number table, with 43 cases in each group. The patients in the control group were received oral metoprolol for treatment, and the patients in the study group were treated with oral Yangxindingji capsule combined with Metoprolol for treatment. The treatment effect and the change of heart function and blood rheology were compared between the two groups before and after the treatment. Results: The total effective rate of treatment in the study group was 83.7％ (36/43), which was higher than that in the control group (67.4％ ) (29/43). The difference was statistically significant (P ＜ 0.05); After the treatment, the HR levels in both groups were lower than before treatment, and the study group was lower than the control group, with a significant difference (P ＜ 0.05); The LVEF levels after treatment in the two groups were higher than before treatment, and the study group was higher than the control group. The difference was statistically significant (P ＜ 0.05); The fibrinogen, high-cutting whole blood viscosity, plasma viscosity, and low-cut whole blood viscosity of the two groups after treatment were lower than before treatment, and the study group was lower than the control group. The difference was statistically significant (P ＜ 0.05). Conclusion: Yangxindingji capsule combined with metoprolol has significant effects on coronary heart disease combined with rapid arrhythmia, which can effectively relieve clinical symptoms, improve cardiac function, regulate hemorheology, correct arrhythmia, and is worthy of clinical promotion.
RESUMO
Objective To observe the efficacy of Tongmai Acupoint Plaster combined with Alprostadil injection for treatment of lower extremity arteriosclerosis obliterans (ASO). Methods Totally 180 cases of ASO Ⅱ(intermittent claudication period) patients were randomly divided into acupoint sticking group, combination group, Western medicine group, with 60 cases in each group. All groups quit smoking, had diet control, proper exercise, control of blood sugar, stop hypolipidemic and anti-coagulation medicine. The acupoint sticking group was treated with Tongmai Acupoint Plaster, each selected with the efficacy of treatment of lower limbs paralysis acupoint 10-12, alternating dressing; dressing was changed 1 time a day, 40 day as a treatment course. Western medicine group was given Alprostadil injection 10 μg, with 10 mL of normal saline, intravenous infusion, once a day, 15 d as a treatment course, for two courses, with 10 d as interval. Combination group was treated with Tongmai Acupoint Plaster combined with Alprostadil injection, the same as the application method above. The clinical efficacy, the scores of symptoms and signs, the ankle brachial index, blood lipid, the peak value of blood flow in the tibial anterior,posterior tibial, and dorsalis pedis arteries were observed and compared between the 2 groups. Results The total effective rate was 78.33% (47/60) in the acupoint sticking group, 80.00% (48/60) in the Western medicine group, and 93.33%(56/60) in the combination group, with the combination group better than the acupoint sticking group and Western medicine group (P0.05). There was statistical significance in scores of symptoms and signs, ankle brachial index before and after treatment in the three groups (P0.05). There was statistical significance in blood lipids before and after treatment in acupoint sticking group and combination group (P<0.05). There was statistical significance in tibial anterior, posterior tibial, and dorsalis pedis artery peak before and after treatment in the three groups (P<0.05, P<0.01). Conclusion Tongmai Acupoint Plaster has good efficacy in the treatment of ASO, equivalent with the efficacy of Alprostadil injection, which can regulate blood lipids and improve arterial blood flow. Ther combination of them has better efficacy.
RESUMO
Objective To explore the surgical feasibility and clinical efficacy of one-stage anterior-posterior approaches in treatment of severe fracture and dislocation of lower cervical spine in "beach chair position".Methods Sixteen male cases of severe fracture and dislocation of lower cervical spine and with a mean age of 49.8 years (range,36-78 years) treated surgically from May 2012 to May 2016 were analyzed retrospectively by using case series study.The segment of injury was C4-5 in 4 cases,C5-6 in 7 and C6-7 in 5.The degree of spinal cord injury according to the American Spine injury Association (ASIA) score was Grade A in 4 cases,Grade B in 7 and Grade C in 5.Sub-axial injury classification (SLIC) score was 8 points in 9 cases and 9 points in 7.After a general anesthesia,a ring with a hole was hanged on patient's head before the operation.Then,under the protection of hole traction,the upper of operating bed was swung up slowly,so that the patient was restricted in vertical "beach chair position" with traction on the halo in order to immobilize the head and partially reduce the kyphotic deformity.Routine cervical anterior-posterior approach was done with the exposure of damaged section of the front and rear structure.Pedicle screw system or lateral mass screw displacement was conducted.Anterior intervertebral discectomy or fracture vertebral was performed,using collaborative reset prying method before and after the road.In the front of intervertebral cage or titanium net support bone graft,rear pedicle screws or lateral mass screws fixation and bone graft fusion were implemented.The operation time and blood loss were recorded.The healing of the wound was observed.The recovery of neurological function was evaluated according to the ASIA grade.Postoperative review X-ray,CT and MRI were done to evaluate the reset and bone graft in position and fusion.Results All the surgeries were done well without aeroembolism and other related complications.The mean operative time was 153 minutes (range,150-180 minutes),and the mean amount of blood loss was 543 ml (range,400-800 ml).Sixteen cases were followed-up from 6 to 24 months (mean 13.7 months).All the incision were healed at Ⅰ stage.Spinal cord function did not aggravate.The ASIA grade was improved with an average of one to two Grades 6 months after surgery.Postoperative X-ray and CT confirmed that graft object position was favorable and cervical sequence was recovered well.The Cobb angle decreased from (23.6 ± 5.3) ° preoperatively to (4.0 ± 0.4)°postoperatively,and the translational displacement of vertebral body was restored into (2.7 ±0.4) mm (P ＜ 0.01) from (10.9 ± 1.6) mm before operation.The cervical spinal canal was not obstructed and the cervical spinal cord was relieved,showed by MRI.Conclusions One-stage anterior-posterior approaches for severe fracture and dislocation of lower cervical spine circumferential reconstruction in "beach chair position" is a beneficial and effective method,without the need of changing positions in a collaborative reduction and fixation.The method can reduce the interference of spinal cord,shorten the operation time and save anterior extra fixation.
RESUMO
Objective:To study the expression and regulation of TLR2/4 in mycobacterium tuberculosis heat shock proteins 16. 3 (mycobacterium tuberculosis heat shock proteins 16. 3,MTB Hsp16. 3) effect on mouse bone marrow-derived macrophages in vitro. Methods:Bone marrow cells were isolated from tibia and femurs of BALB/c mice and incubated with GM-CSF,then detected the expression of CD11b and F4/80 with flow cytometry and observed morphology. The M0 macrophages were stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4 in intracellular at different time point. Silencing macrophages cell surface TLR2/4 molecules by siRNA technology which stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4,Ym-1,Fizz1,IL-10,TNF-α,iNOS and TGF-βin intracellular at different time point. Results:Morphology analysis showed that MTB Hsp16. 3 stimulated macrophages were round cells stretching out pseudopodia,whereas MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages had elongated fibroblastoid. Real time PCR detected the expression of TLR2/4 were upregulated after MTB Hsp16. 3 stimulated M0 macrophages. MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages the expression of IL-6, TNF-α, iNOS were upregulated, whereas IL-10, TGF-β, Ym-1 and Fizz1 were downregulated. Conclusion:MTB Hsp16. 3 may stimulated M0 macrophages to M2 macrophages and suppress M1 macrophages through binding with TLR2/4 receptor,which may be involved the progresss of MTB evaded macrophage phagocytosis.
RESUMO
Objective To explore the surgical feasibility and clinical efficacy of one-stage anterior-posterior approaches in treatment of severe fracture and dislocation of lower cervical spine in "beach chair position".Methods Sixteen male cases of severe fracture and dislocation of lower cervical spine and with a mean age of 49.8 years (range,36-78 years) treated surgically from May 2012 to May 2016 were analyzed retrospectively by using case series study.The segment of injury was C4-5 in 4 cases,C5-6 in 7 and C6-7 in 5.The degree of spinal cord injury according to the American Spine injury Association (ASIA) score was Grade A in 4 cases,Grade B in 7 and Grade C in 5.Sub-axial injury classification (SLIC) score was 8 points in 9 cases and 9 points in 7.After a general anesthesia,a ring with a hole was hanged on patient's head before the operation.Then,under the protection of hole traction,the upper of operating bed was swung up slowly,so that the patient was restricted in vertical "beach chair position" with traction on the halo in order to immobilize the head and partially reduce the kyphotic deformity.Routine cervical anterior-posterior approach was done with the exposure of damaged section of the front and rear structure.Pedicle screw system or lateral mass screw displacement was conducted.Anterior intervertebral discectomy or fracture vertebral was performed,using collaborative reset prying method before and after the road.In the front of intervertebral cage or titanium net support bone graft,rear pedicle screws or lateral mass screws fixation and bone graft fusion were implemented.The operation time and blood loss were recorded.The healing of the wound was observed.The recovery of neurological function was evaluated according to the ASIA grade.Postoperative review X-ray,CT and MRI were done to evaluate the reset and bone graft in position and fusion.Results All the surgeries were done well without aeroembolism and other related complications.The mean operative time was 153 minutes (range,150-180 minutes),and the mean amount of blood loss was 543 ml (range,400-800 ml).Sixteen cases were followed-up from 6 to 24 months (mean 13.7 months).All the incision were healed at Ⅰ stage.Spinal cord function did not aggravate.The ASIA grade was improved with an average of one to two Grades 6 months after surgery.Postoperative X-ray and CT confirmed that graft object position was favorable and cervical sequence was recovered well.The Cobb angle decreased from (23.6 ± 5.3) ° preoperatively to (4.0 ± 0.4)°postoperatively,and the translational displacement of vertebral body was restored into (2.7 ±0.4) mm (P ＜ 0.01) from (10.9 ± 1.6) mm before operation.The cervical spinal canal was not obstructed and the cervical spinal cord was relieved,showed by MRI.Conclusions One-stage anterior-posterior approaches for severe fracture and dislocation of lower cervical spine circumferential reconstruction in "beach chair position" is a beneficial and effective method,without the need of changing positions in a collaborative reduction and fixation.The method can reduce the interference of spinal cord,shorten the operation time and save anterior extra fixation.
RESUMO
Day care is described in the paper in terms of its meaning and management.As to areas deserving attention given the initial success,the authors proposed to priortize medical insurance compensation policy,medical resource deployment,patient safety and follow-up for discharged patients.These efforts may further quality of care and patient satisfaction.
RESUMO
Objective To investigate the effect and clinical significance of neoadjuvant radiotherapy for the expression of CD44v6 in lung squamous cell carcinoma tissues. Methods Fifty cases lung squamous cell carcinoma patients confirmed by aspiration biopsy from May 2013 to January 2015 were collected in Yangquan Coal Mine Group Genernal Hospital,including 20 cases of patients with stageⅢA were treated with neoadjuvant radiotherapy before surgery,and then performed surgery after neoadjuvant therapy. The expression of CD44v6 was detected by immunohistochemistry. The correlation between CD44v6 and clinicopathological features was analyzed by chi?square test. Results Immunohistochemical staining of CD44v6 was performed in tumor tissue of puncture biopsy, the positive rate expression of CD44v6 was 72%( 36/50 ) , it was associated with lymphatic metastasis(χ2 =3. 964, P=0. 046 ) and advanced TNM stage (Ⅲ+Ⅳstage ) (χ2 =4. 276, P=0. 039 ) . The positive expression of CD44v6 protein in tumor tissue was significantly decreased in 20 patients with neoadjuvant radiotherapy compared with before radiotherapy(7. 23±1. 45 vs. 11. 42±1. 31,t=2. 524,P=0. 025). Conclusion Positive expression of CD44v6 in human lung squamous cell carcinoma is related to the malignant clinicopathological features. Neoadjuvant radiotherapy before operation may improve prognosis via down?regulating CD44v6 expression.
RESUMO
Objective To investigate the change and clinical value of serum procalcitonin (PCT ) in the patients with severe dia‐betic foot .Methods The serum PCT level was detected before treatment and at 1 ,2 weeks of treatment in 86 patients with severe diabetic foot .Results With the infection severity aggravating before treatment ,the elevation of PCT was more significant .The PCT level after 1 week treatment showed a decreasing trend ,but the difference was not statistically significant (P>0 .05);in the patients with Wagner grade 3-5 ,the PCT level after 2 week treatment showed a obvious decreasing trend ,moreover the difference was sta‐tistically significant(P<0 .05) .Conclusion PCT could serve as one of sensitive indexes to judge the outcome in the patients with diabetic foot .
RESUMO
Objective: To observe influence of porphyromonas gingivalis (Pg, a main pathogenic bacterium of periodontal disease) on vascular intima adhesion factors and metalloproteinases. Methods: A total of 60 rats were randomly and equally divided into blank control group, Pg low dose group (Pg 2ml) and Pg high dose group (Pg 5ml) according to number table. The latter two groups respectively received intramuscular injection of corresponding dose Pg every three days without antibiotic intervention for 12 weeks. Then their venous blood was taken to measure levels of intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), matrix metalloproteinase (MMP)-3 and MMP-9 in three groups. Results: Compared with blank control group, there were significant increase in contents of ICAM-1 [（175.79±14.30）ng/ml vs.（182.62±15.07）ng/ml, （189.39±14.93）ng/ml]、VCAM-1 [（256.49±37.17）ng/ml vs.（271.58±32.85）ng/ml , (286.66±30.66)ng/ml] 、 MMP-3 [（3.23±0.69）ng/ml vs.（3.61±0.82）ng/ml, (3.97±0.83)ng/ml]及 MMP-9 [（1.30±0.39）mg/L vs.（1.48±0.39）mg/L, 1.67±0.45）mg/L ]（P <0.05，or <0.01），Compared with Pg low dose group, there were significant increase in levels of above indexes in Pg high dose group (P<0.05). Conclusion: Porphyromonas gingivalis can significantly increase serum contents of vascular intima adhesion factors and metalloproteinases, aggravating pathological development of coronary heart disease.
RESUMO
Objective To observe and compare in vivo segmental lumbar motion between symptomatic L4 isthmic spondy?lolisthesis (IS) patients and L4 degenerative spondylolisthesis (DS) patients during functional weight?bearing activities. Methods Fifteen symptomatic L4 IS patients and fifteen symptomatic L4 DS patients were recruited. Fifteen asymptomatic volunteers were en?rolled as the control group. The L4,5 vertebral segment motion of each subject was reconstructed using three?dimensional computed tomography and a solid modeling software. In vivo, lumbar vertebral motion during functional postures (flexion?extension, left?right twisting and left?right bending) was observed using a dual fluoroscopic imaging technique. The spinal function unit was divided in?to anterior and posterior segments by the isthmic cleft. Local coordinate systems were established at the vertebral body, to obtain the 6 degree?of?freedom (DOF) intervertebral range of motion (ROM) at L4,5 and the ROM between the anterior and the posterior segments of L4 IS. Results The motion of IS at L4,5 was found to be increased. The migrations along both sagittal and vertical axis were significantly larger than control group (P<0.05). During left?right twisting, the migration along sagittal axis was significantly larger than control group (P<0.05);the rotation along vertical axis was significantly larger than DS and control group (P<0.05). During left?right bending, the migration along frontal axis was significantly larger than DS and control group ( P<0.05). The inter?vertebral ROM at L4,5 showed no significant difference between DS and control group. The migration between anterior and posteri?or segments of IS L4 was larger in standing than supine (P<0.05). The relative migration along sagittal axis between anterior and posterior segments of IS L4 was significantly larger in flexion than standing (P<0.05). Conclusion A spondylolytic defect does lead to detectable instability or hypermobility in the lumbar spine compared with degenerative spondylolisthesis and normal group. From supine to standing posture, migration at isthmic cleft along sagittal and coronal axis are identified in IS spondylolithesis.
RESUMO
Objective:To explore the relationship between periodontitis and coronary heart disease (CHD)by meas-uring changes of serum inflammatory cytokine levels.Methods:A total of 197 patients from our hospital were en-rolled,including CHD + periodontitis group (123 cases),pure CHD group (CHD group,39 cases)and pure peri-odontitis group (periodontitis group,35 cases).Another 45 healthy subjects were enrolled as healthy control group. Concentrations of tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),serum amyloid-a (SAA),high sensitive C reactive protein (hsCRP)and plasma fibrinogen (Fg)were measured in all groups,and levels of above inflammatory cytokines were compared among four groups.Results:Compared with healthy control group,there were significant rise in levels of above inflammatory cytokines in CHD + periodontitis group (P0.05 all).Conclusion:Serum inflammatory cytokine levels significant rise in palients with periodontitis,it is related with coronary heart disease.
RESUMO
BACKGROUND:Gait deviations are the important diagnosis criteria and surgical indications of cervical myelopathy. Conventional three-dimensional gait laboratory failed to apply in clinics due to complex operations and time consuming. In recent years, a portable gait analyzer based on the micro-sensors is emerging and developing, it has been verified by clinical practice, al owing gait analysis in the ward. OBJECTIVE:To quantitatively analyze gait characteristics of patients with cervical spondylotic myelopathy (CSM) by a portable gait analyzer. METHODS:From March 2013 to November 2013, 15 CSM patients and 30 healthy subjects were enrol ed in the study. The involved patients were accompanied by gait abnormalities. A portable gait analyzer was used for gait analysis. Subjects walked on a 30-meter corridor back and forth for 120 meters. Total y 12 gait parameters were involved in this study, including seven common parameters (single limb support, double limb support, gait cycle, speed, cadence, step length and stride length) and five new parameters (pul ing acceleration, swing power, ground impact, foot fal , and pre-swing angle). Three patients underwent cervical decompression surgery. The gait characteristics were re-evaluated one week later, carrying neck support. RESULTS AND CONCLUSION:The double limb support and gait cycle duration of CSM group were significantly longer than control group (P0.05). after cervical decompression surgery, the mean remission rate of Japanese Orthopedics Association scores was 32.5%and lower limb acceleration was improved obviously in the graph one week after surgery. Varying degree of correlation was seen between Japanese Orthopedics Association scores and the detected 12 gait parameters in CSM patients. The portable gait analyzer can effective measure the pathological gait deviation in CSM patients with abnormal gaits, and assists to evaluate the lower limb functions.
RESUMO
Objective To employ intraoperative discography to determine the injured intervertebral disc segments that can not be identified on the preoperative MRI in patients with cervical spinal cord injury without fracture and dislocation for confirming the responsible segments needing surgical decompression and fusion.Methods The study involved 85 patients with cervical spinal cord injury without fracture and dislocation treated from January 2007 to December 2011,among which sixteen patients had not been identified with the responsible segments by preoperative MRI.The average preoperative Japanese Orthopedic Association (JOA) score was (9.1 ± 1.8) points.There was no obvious fracture or dislocation of the cervical spine on preoperative X-ray film,CT and MRI,but all patients displayed high intense signal in cervical spinal cord on MRI T2 weighted imaging.Besides,MRI revealed hemorrhagic swelling of anterior cervical soft tissue in nine patients and cervical intervertebral disk hernia in all patients.Annulus fibrosus rupture of cervical intervertebral disc with contrast leakage in intraoperative discography of suspected injury segments in all patients under direction of C-arm X-ray machine was set as the injury criterion.The patients with pure ruptured discs received cervical discectomy,interbody fusion and titanium plate fixation.The patients associated with multilevel cervical intervertebral disc hernia or ossification of posterior longitudinal ligament underwent anterior cervical corpectomy,bone graft with titanium cageand titanium plate fixation of ruptured discs.Results Nineteen injured discs were identified eventually by discography,including 2 discs at C3/4,4 at C4/5,8 at C5/6 and 5 at C6/7.Moreover,anterior annulus fibrosus rupture with intact anterior longitudinal ligament was found in 11 patients.The follow-up lasted for (24.4 ± 10.0) months.JOA scores were (13.3 ± 1.5) points and (14.5 ± 1.6) points at two weeks and three months after operation,and (15.1 ± 1.5) points at the last follow-up,indicating a relevant improvement rate of 53％,68％ and 76％ respectively.Mean operation time was 110 minutes and blood loss was 120 ml.Three patients had pain on shoulder and back and one patient had hoarse voice,but all the patients were relieved in two weeks after conservative treatments.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury or internal fixation failure were noticed intra-or post-operatively.Conclusion For the intradiscal rupture that is hard to be determined by the conventional imaging methods,intraoperative discography can be used as an auxiliary method of imaging diagnosis in early surgical determination of responsible segments for cervical spinal cord injury without fracture and dislocation.
RESUMO
Objective To evaluate the effect of en bloc open-door laminectomy and pedicle screw fixation for extremely severe cervical ossification of posterior longitudinal ligament (OPLL).Methods From January 2007 to December 2011,16 cases of serious cervical OPLL were treated,in which there were 13 males and 3 females,aged from 45 to 74 years (average,56.5 years).Spinal cord functional deterioration was related to minor activities of the neck,such as sneeze,cough or hyperextension of the neck,in 15 cases.One case suffered from aggravating neurological symptoms without a definite precipitating factor.The average preoperative Japanese Orthopaedic Score (JOA) was 7.1 ±1.8.Preoperative CT scans displayed the average stenotic rate (thickness of OPLL/sagittal diameter of the spinal canal) was 83.7％.All the patients received en bloc laminectomy and pedicle screw fixation of the cervical spine.Results All the patients were followed up for 3 months to 4 years (average,24.4±10 months).The JOA scores at 2 weeks,3 months,and the last follow-up postoperatively were 13.2±1.7,13.5 ±1.6 and 14.1 ±1.5,respectively; the improvement rates were 61.6％,64.6％ and 70.7％,respectively.The operative time ranged from 80 to 150 minutes (average,130 minutes),and blood loss ranged from 150 to 600 ml (range,300 ml).One case of postoperative wound hematoma,1 case of cerebrospinal fluid leakage and 3 cases of trapezius muscle pain occurred in this group.No serious complications,such as deep infection,deterioration of neurological dysfunction,vertebral artery injury and internal fixation failure,were noticed.Conclusion Owing to the minimum interference to the cervical spinal cord,stabilization of the decompressed segments and maintenance of cervical lordosis,en bloc open-door laminectomy and pedicle screw fixation is suitable for extremely severe cervical OPLL.