Meta-analysis of cement-augmented pedicle screw for thoracolumbar degenerative diseases with osteoporosis / 中国组织工程研究

OBJECTIVE:Cement-augmentation pedicle screws have been widely used in spinal internal fixation surgery combined with osteoporosis in recent years,which can significantly improve the fixation strength,but compared with conventional methods,whether it has more advantages is still inconclusive of evidence-based medicine.To systematically evaluate the efficacy and safety of cement-augmented pedicle screw in the treatment of thoracolumbar degenerative diseases with osteoporosis. METHODS:Clinical controlled trials concerning the cement-augmented pedicle screw and the traditional pedicle screw placement for thoracolumbar degenerative diseases with osteoporosis were retrieved from the electronic databases such as CNKI,CBM,WanFang,VIP,PubMed,Cochrane Library,Web of Science and Embase.According to the unified criteria,we performed literature screening and quality evaluation.The meta-analysis was performed using RevMan 5.4 software. RESULTS:(1)Totally 20 articles were selected eventually,involving 2 randomized controlled studies and 18 retrospective cohort studies,totally 1 566 patients.Among them,789 cases were in the cement-augmented screw group and 777 cases in the conventional screw group.(2)Meta-analysis results showed that Japanese Orthopaedic Association score,intervertebral space height and fusion rate were higher in the cement-augmented screw group than those in the conventional screw group(MD=1.60,95%CI:1.14,2.07,P<0.000 01;MD=1.26,95%CI:0.62,1.90,P=0.000 1;OR=11.24,95%CI:2.86,44.14,P=0.000 5).Operation time was longer in the cement-augmented screw group than that in the conventional screw group(SMD=0.82,95%CI:0.42,1.23,P<0.000 1).Postoperative visual analog scale score,Oswestry dysfunction index score and incidence of screw loosening were lower in the cement-augmented screw group than those in the conventional screw group(MD=-0.50,95%CI:-0.78,-0.21,P=0.000 7;SMD=-0.49,95%CI:-0.88,-0.10,P=0.01;OR=0.08,95%CI:0.05,0.12,P<0.000 01).Hospitalization time,intraoperative blood loss,and postoperative drainage volume were not significantly different between the two groups(P>0.05). CONCLUSION:Compared with conventional pedicle screw placement,cement-augmented pedicle screw is more effective in the treatment of osteoporotic thoracolumbar degenerative disease by improving fusion rate and interbody height,reducing the incidence of screw loosening,and elevating long-term efficacy.

Clinical observation of percutaneous vertebroplasty assisted by four-axis positioning 3D printing guide plate / 实用医学杂志

Objective To compare the difference between four-axis positioning 3D printing guide assisted puncture and manual puncture percutaneous vertebroplasty,to clarify the clinical efficacy of 3D printing guide assisted percutaneous vertebroplasty,and to explore its clinical application value.Methods A total of 70 patients who underwent single-segment vertebroplasty for osteoporotic vertebral compression fractures in our hospital were randomly divided into a manual group(control group)and a guide plate group(observation group).Thirty-five patients in the control group underwent PVP under the traditional manual puncture,and 35 patients in the observa-tion group underwent PVP under the four-axis positioning 3D printing guide assisted puncture.The general data,perioperative data,imaging data,preoperative and postoperative functional scores of the two groups were collected and compared.Results In terms of intraoperative fluoroscopy times,operation time,and postoperative adverse reactions,the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05).However,there was no significant difference between the two groups in intraoperative blood loss,bone cement leakage,and whether bone cement perfusion included fracture sites.In terms of clinical efficacy,the ratio of anterior vertebral height,postoperative VAS score and postoperative JOA score of the two groups were significantly better than those before operation,and the difference was statistically significant(P<0.05).At the same time point before and after operation,there was no significant difference in the height ratio of the anterior edge of the injured vertebra,VAS score and JOA score between the two groups(P>0.05).Conclusion The clinical efficacy of four-axis positioning 3D printing guide plate-assisted puncture is the same as that of experienced clinicians with free hand puncture for PVP,which can quickly relieve pain and improve dysfunction.However,guide plate assistance can shorten the operation time,reduce the number of fluoroscopy and postoperative adverse reactions,and make vertebroplasty faster and safer.

Meta-analysis of Shenling Baizhu Powder Combined with Aminosalicylic Acid Preparation in the Treatment of Ulcerative Colitis / 中国药房

OBJECTIVE:To evaluate clinical efficacy of Shenling baizhu powder combined with aminosalicylic acid in the treatment of ulcerative colitis (UC),and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Cochrane library,CJFD,VIP,Wanfang database and CBM,randomized controlled trials (RCTs) about Shenling baizhu powder combined with aminosalicylic acid preparations (trial group) vs.aminosalicylic acid preparations alone (control group) in the treatment of UC were collected.Meta-analysis was performed by using Rev Man 5.2 statistical software afder data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 14 RCTs were included,involving 1 177 patients.Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=3.40,95％ CI (2.44,4.74),P＜0.001],while Sutherland DAI score [MD=-1.31,95％ CI (-2.07,-0.56),P＜0.001],the levels of TNF-α [SMD=-1.90,95％CI(-2.90,-0.90),P＜0.001],IL-17[MD=-85.18,95％CI(-100.51,-69.85),P＜0.001] and IL-23 [MD=-113.27,95％CI(-132.34,-94.21),P＜0.001] in trial groups were significantly lower than control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Shenling baizhu powder combined with aminosalicylic acid preparation is better than aminosalicylic acid preparation alone in the treatment of UC,and can significantly reduce Suthedand DAI and the levels of serum cytokines.

Effects of rosiglitazone on pigment epithelium-derived factor, matrix metalloproteinase-2, and transforming growth factor-β1 expressions in diabetic rats kidney / 中华内分泌代谢杂志

Forty-five male SD rats were divided into normal group, diabetic control group, and rosiglitazone treatment diabetic group.By the end of 12 weeks, the expressions of pigment epithelium-derived factor(PEDF), matrix metalloproteinase-2 (MMP-2), and transforming growth factor-β1 (TGF-β1) in the kidney were determined by immunohistochemistry and RT-PCR.The results showed that rosiglitazone decreased the increased kidney weight/body weight ratio, serum creatinine, blood ureanitrogen, urinary albumin excretion, triglyceride levels in diabetic rats (all P＜0.01).Rosiglitazone prevented the decreasing of protein expressions of PEDF and MMP-2 and the increasing of protein expression of TGF-β1 (all P＜0.01).PEDF mRNA showed a similar change,suggesting that renoprotection of rosiglitazone on diabetic rats may be mediated through regulating the expressions of PEDF, MMP-2, and TGF-β1.

Ovine Follistatin gene expression and functional analysis of follistatin domains / 生物工程学报

In order to study ovine follistatin function, we amplified the total of 1038 base pair of ovine complete follistatin cDNA and cloned into pGEM-T vector by RT-PCR from ovine ovary RNA. After removal of the signal peptide it was subcloned into the pET41a to construct the prokaryotic expression vector, named pFSsig-. SDS-PAGE and Western blotting identified the 66 kDa product of the expression of follistatin cDNA. Based on the complete CDS sequence, we cloned follistatin N-terminal domain and domain 1 with PCR and inserted into pLEX-MCS lentiviral vector, named pFS-N+D1. After package and passage of lentivirus in 293T cells, and then infected sheep primary muscle cells (SPMC). The expression of FS N+D1 in SPMC was assayed by Western blotting. The cell growth curve of the infected SPMC and noninfected control cells displayed that FS N+D1 stablly transfected SPMC proliferated significantly faster than the control cells (P < 0.01). Our data inferred that ovine FS N+D1 domain had the function to stimulate sheep muscle cell growth.

Obesity and diabetic nephropathy in type 2 diabetes / 中国实用内科杂志

Obesity is not only the high risk factor of diabetes mellitus,coronary heart disease and hypertension,but also a cause of renal damage.Diabetic nephropathy is one of the most frequent chronic microvascular complications of diabetes mellitus,and one of the leading causes of end-stage kidney failure.It is documented that the obese patients with type 2 diabetes may have obviously multiple metabolic abnormalities and are more prone to develop diabetic nephropathy.This article summarized the pathogenetic mechanisms of kidney injury in diabetic obese patients and provided some ideas in the medical therapy of diabetic nephropathy.