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Objective:To observe any therapeutic effect of repeated transcranial direct current stimulation (tDCS) on rats modeling neuropathic pain and explore possible mechanisms.Methods:Forty adult male Sprague-Dawley rats were randomly divided into a normal group ( n=10), a sham operation group ( n=10), a treatment group ( n=10) and a sham treatment group ( n=10). A model of chronic constriction injury of the sciatic nerve was established in the latter two groups. Fourteen days after the modeling, the treatment group was given tDCS for 8 consecutive days, while the sham treatment group received sham stimulation, and the other 2 groups did not receive any intervention. Von Frey and hotplate tests were used to test the rats′ pain thresholds 1 day before, as well as 14 and 22 days after the surgery (i.e., 8 days after the end of the treatment). Spinal cord tissue samples were taken to detect the protein expressions of N-methyl-D-aspartic acid receptor 2B, gamma-aminobutyric acid receptor types A (GABA a-R) and B (GABA b-R) using western blotting. Results:On the 14th day after the operation the average 50% MWT and WTL values of the sham treatment and treatment groups had decreased significantly compared with the sham operation group. By the 22nd day the average 50% MWT and WTL values of the treatment group were significantly higher than those of the sham treatment group, but there was no significant change in the treatment group′s average WTL between the 21st and 22nd days. On the 22nd day after the operation the average NR2B-NMDA-R level of the sham treatment group were significantly higher than that of the sham operation group, while the average GABA a-R and GABA b-R levels were significantly lower. At the same time point the treatment group′s average NR2B-NMDA-R level had decreased significantly compared to the sham treatment group, while the average GABA a-R level had increased significantly. There was no significant difference in average GABA b-R level between the treatment group and the sham treatment group at that point. On the 22nd day there was also no significant difference in the average NR2B-NMDA-R level between the treatment group and the sham operation group. Conclusions:Repeated tDCS can effectively relieve neuropathic pain. The relief of hyperalgesia is more significant than that of mechanical allodynia. A possible mechanism may be the down-regulation of spinal NR2B-NMDA-R to normal levels and modest up-regulation of GABA a-R.
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Objective:To compare the application value of prefabricated path with an awl for guiding pin and traditional screw placement during anterior odontoid screw fixation.Methods:A retrospective case-control study was conducted to analyze 35 patients with fresh odontoid fractures treated from January 2010 to August 2017 in Henan Provincial People's Hospital, including 25 males and 10 females with age range of 19-55 years (mean, 36.9 years). The preoperative odontoid fractures were classified into type IIA in 15 patients, type IIB in 20 patients according to Anderson and D'Alonzo classification. Among them, 16 patients in Group A were treated with prefabricated path by an awl for guiding pin during anterior odontoid screw fixation, and 19 patients in Group B were implanted screws according to traditional experience in anterior odontoid screw fixation. Operation time, intraoperative fluoroscopy time, success rate of first-time guiding pin implantation, intraoperative blood loss, fracture healing outcomes and American Spinal Injury Association (ASIA) grade at the latest follow-up were collected and compared between the two groups.Results:All patients were followed up for 13-20 months [(16.8±1.5)months]. Two groups had significant differences in operation time [Group A: (73.5±12.9)minutes; Group B: (82.6±13.6)minutes], intraoperative fluoroscopy time [Group A: (3.1±0.6)minutes, Group B: (7.0±0.9)minutes], and success rate of first-time guiding pin implantation (Group A: 94%, Group B: 58%) ( P<0.05), but not in intraoperative blood loss [Group A: (129.4±40.6)ml; Group B: (135.8±38.4)ml] and fracture healing rate (Group A: 94%, Group B: 95%) and ASIA grade at the latest follow-up (Group A: grade C in 1 patient, grade D in 3, grade E in 12; Group B: grade C in 2 patients, grade D in 2, grade E in 15) ( P>0.05). All patients were successfully operated without occurrence of cerebrospinal fluid leakage, neurovascular injury or incision infection. Conclusions:Prefabricated path with an awl for guiding pin during anterior odontoid screw fixation is superior to traditional experience, which can reduce operation time, intraoperative fluoroscopy time and improve the success rate of first-time guiding pin implantation. Meanwhile, there is no effect on intraoperative blood loss or fracture healing outcomes.
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Objective@#To establish a mouse model of osteoarthritis (OA) and study the bone microarchitecture and bone metabolism of tibial subchondral bone in early stage of OA.@*Methods@#The mouse model of post-traumatic osteoarthritis (PTOA) with anterior cruciate ligament (ACLT) was established by using c57 mice. The Sham operation group served as the control group. All mice were fed with conventional diet. All mice were sacrificed after 4 weeks. The degeneration of knee joint was observed by HE staining and Safranin O-Fast Green staining. The number of osteoclasts was counted by TRAP staining. Micro CT was used to analyze the quantitative parameters of the microstructure of tibia subchondral bone in mice. Serum levels of bone resorption biomarker CTX I and cartilage degeneration marker CTX II were determined.@*Results@#After ACLT 4 weeks, the average score of OARSI in ACLT group was 3.2, which was higher than that in Sham group, and the joint degeneration occurred in mice, presenting the pathological characteristics of early OA. Compared with the sham operation phase, the total subchondral bone volume (TV) of ACLT group was 4.72 mm3, increased by 13.6%; the bone trabecular resolution (Tb.Sp) was 0.130 and 0.154 mm, respectively, and the ACLT group also increased by 18.8%; the bone volume/tissue volume (BV/TV) was 0.470 and 0.294, respectively, and the ACLT group decreased by 48.9%; the bone trabecular thickness (Tb.Th) was 0.162 and 0.083 mm groups, ACLT decreased by 37.5%. Trap staining showed that the number of osteoclasts per unit volume in ACLT group was 72, which was significantly higher than that in sham operation group. The CTX I of mice in the sham operated ACLT group and sham operated group were 20.9 ng/ml and 18.29 ng/ml, with an increase of 48.9% in the ACLT group; the CTX II of mice in the ACLT group and sham operated group were 35.5 ng/ml and 28.6 ng/ml, with an increase of 24.1% in the ACLT group.@*Conclusion@#ACLT Mouse model can successfully construct early OA, which confirms the early loss of osteochondral bone and the pathological changes of osteoclast activation in OA, and provides a new specific target for the treatment of OA.
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Chronic hepatitis B is caused by infection with hepatitis B virus (HBV), which can lead to the development of cirrhosis and primary hepatocellular carcinoma. Viral persistence and clinical outcomes after HBV infection depend on viral factors and host factors. With the rapid development of the invasion mechanism of HBV infection, host?related genes and proteins involved in HBV infection have been found and used as new diagnostic markers both in the treatment evaluation and prognosis of HBV infection. This review mainly introduces the clinical application and related progress of laboratory serum markers in chronic HBV infection based on host factors for optimizing clinical diagnosis.
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Objective To investigate the clinical efficacy of non-fusion and fusion internal fixation with posterior pedicle screw for odontoid fractures. Methods A retrospective case control study was conducted to analyze the clinical data of 46 patients with odontoid fractures admitted to Henan Provincial People's Hospital from January 2013 to June 2015. There were 35 males and 11 females, aged 19-62 years [(36. 9 ± 1. 6)years]. The preoperative odontoid fractures were classified as type IIA in five patients, type IIB in eight, type IIC in 22, shallow type III in six according to Anderson and D'Alonzo typing. The fractures of five patients were not classified. According to the ASIA grading, the preoperative spinal cord function was graded as D or E in the 46 patients. Among the patients, 15 underwent posterior pedicle screw non-fusion internal fixation ( Group A) , with 60 pedicle screws removed 12-29 months after operation. A total of 31 patients were treated with fusion internal fixation with posterior pedicle screw ( Group B) , with 124 pedicle screws free from removal after operation. The follow-up time, operation time, intraoperative fluoroscopy time, intraoperative blood loss as well as visual analog scale (VAS), cervical rotation degree, and neck disability index ( NDI) before operation, 1 year after surgery ( when no internal fixation was removed ) and at the last follow-up were compared between the two groups. Results There were no significant differences between the two groups in the follow-up time, operation time, intraoperative fluoroscopy time, intraoperative blood loss, VAS score, neck rotation degree, NDI score before operation and at 1 year after operation (P >0. 05). There were significant differences between two groups in VAS scores, neck rotation degree, NDI scores indicating driving and walking and recreational activities at the last follow-up ( P <0. 05 ) . There were no significant differences between two groups in other NDI scores items, including neck discomfort, personal care, lifting heavy objects, reading & watching TV, headache situation, attention, working status, and sleep disorder at the last follow-up ( P> 0. 05 ) . Conclusions Posterior pedicle screw internal fixation for odontoid process fracture has good curative effect. Non-fusion internal fixation with posterior pedicle screw is more conducive to the recovery of cervical spine rotation function, the relief of neck and back pain, and the improvement of patients' driving, walking and entertainment activities.
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BACKGROUND:Percutaneous vertebroplasty for vertebral fractures can effectively relieve acute pain and has the advantages of smal trauma, good curative effect and less complications, but for patients with osteoporotic compression fractures, there were varying degrees of osteoporosis after surgery, which have a longer course of disease and cannot be easy to cure. So the effectiveness of percutaneous vertebroplasty cannot be ful y evaluated based on the pain relief. OBJECTIVE:To study the curative effect of percutaneous vertebroplasty for patients with fresh osteoporotic thoracolumbar vertebral compression fractures. METHODS:We selected 24 patients undergoing percutaneous vertebroplasty and 24 patients receiving conservative treatment at the same time who had fresh osteoporotic compression fractures as research objects;and compared pain degree, vertebral body height and the kyphosis Cobb angle, function activity of the lower lumbar before and after treatment, the quality of life and clinical incidence of complications within 6 months after treatment in the two groups. RESULTS AND CONCLUSION:The degree of pain, the vertebral body height, kyphosis Cobb angle, function activity of the lower lumbar were al improved in the two groups after treatment (P<0.05), and these indexes in the percutaneous vertebroplasty group were better than those in the conservative treatment group (P<0.05). The quality of life and incidence of complications within 6 months after treatment were improved better in the percutaneous vertebroplasty group than the conservative treatment group (both P<0.05). These results suggest that the percutaneous vertebroplasty for fresh osteoporotic thoracolumbar vertebral compression fractures can effectively reduce the pain of patients, improve vertebral deformity and activities of the lower lumbar, and has obvious role in promoting the postoperative quality of life of patients.
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Objective To evaluate the clinical aesthetic effect of immediate implant and immediate prosthesis by the free connec-tive tissue transplantation with periosteum in the maxillary anterior region.Methods 65 appropriate patients were selected and per-formed the immediate implant after minimally invasive tooth extraction.6 5 pieces of implants were implanted immediately by the free connective tissue transplantation with periosteum in the aesthetic area,among them,10 cases were implanted by Bio-oss bone. All missing teeth were immediately repaired by temporary denture,after the implant osseointegration,the permanent repair was per-formed.From the preoperation to 1 8 months after permanent repair,the aesthetic evaluation was conducted by stages,including the labial peri-implant soft tissue fullness and pink aesthetic scores(PES).Results In the tracing assessment period,the peri-implant fullness evaluation showed that degree 0 was found in 5 tooth positions before the operation,degree Ⅰin 60 tooth positions,degreeⅡ in 0 tooth position,but after immediate restoration,degree 0 in 0 tooth position,degree Ⅰin 45 tooth positions and degree Ⅱ in 20 positions.The PES total value reached the maximum in 3 months after permanent restoration.Conclusion Immediate implant and immediate prosthesis by the free connective tissue transplantation with periosteum in the maxillary aesthetic area can obtain better aesthetic results.
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Objective To study the clone sequencing and expression of fibroblast growth factor 10(Fgf10) gene in corneal opaci-ty (B6-Co) mouse .Methods Normal mice mate with B6-Co mice ,the skin tissue separation from B6 and B6-Co mice at embryo 16 . 5 d ,total RNA extraction and reverse transcription ,the target gene was fragment amplification by RT-PCR ,connection with T vec-tor ,transformed to competent cells ,selection positive clone ,sequencing analysis .The gene expression in B6-Co mice was detected by real-time PCR .Results The base A inserted between 1 914 and 1 915 in Fgf10 gene by sequencing .The expression of Fgf10 was significant down regulation in B6-Co mice by real-time PCR(P< 0 .05) .Conclusion Fgf10 is relevant with phenotype of B6-Co mouse ,and the regulation mechanism was expected further study .
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Objective Make a scientific approach to the validity of 3D-VIBE MRI on breast tumor's evaluation.Methods 141 breast processes were examined by 3D Dynamic scanning technique with high speed and resolution, Compared with postop pathological appearance, the diagnosis of breast tumor, the ductal carcinoma in situ, their circumscriptions, and axillary lymph node metastasis were evaluated. Results The coincidence of tumor existence diagnosis was 97.2 ％(137/141). The accuracy, sensitivity and specificity of progression in duct were 69.4 ％(93/134), 75 ％(100/134), 57.1％(77/134), respectively.The accuracy,sensitivity and specificity of axillary lymph node metastasis were 92.5 ％(124/134), 53.8 ％(72/134), and 96.7 ％(129/134) respectively. Conclusion The reconstruction images through 3D Dynamic scanning technique with high speed and resolution could discover minute breast tumor and the extent of axillary lymph node metastasis around breast,and the extent of diseases in duct can also be effectively evalnated.
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BACKGROUND: The biomechanical studies about calcium sulfate cement vertebroplasty are only limited to the single fracture vertebra, not performed in spinal compression fracture unit with posterior transpedicular screw fixation. Furthermore, performing experimental study in the whole function spine unit (FSU) conforms to actual clinical situation. OBJECTIVE: To assess the biomechanical properties of calcium sulfate vertebroplasty combined with posterior transpedicular screw fixation in treatment of thoracolumbar compression fractures. DESIGN, TIME AND SETTING: A controlled experiment was performed at the Biomechanical Laboratory of Shanghai University in March 2009. MATERIALS: Fifteen fresh thoracolumbar spines were harvested from male calves and made into T_(11)-L_1 FSU, then divided into 3 groups randomly: normal control group, posterior transpedicular screw fixation group and transpedicular screw fixation plus vertebroplasty group. METHODS: T_(12) flexion-compression fracture models were made in all specimens of posterior transpedicular screw fixation group and transpedicular screw fixation plus vertebroplasty group, undergoing reduction and posterior transpedicular screw fixation, and calcium sulfate vertebroplasty combined with posterior transpedicular screw fixation respectively. MAIN OUTCOME MEASURES: All specimens were placed on the WE-10A universal testing machine for mechanical test. Load-straining, load-displacing, rigidity, strength and torsion of the FSU were performed in axial compression, flexion, extension and lateral bending states. The experimental outcomes were collected and compared by statistic analysis. RESULTS: The load-strain and loed-displacement showed a linear relationship. Straining values in vertebral body and intervertebral disc of calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 14% and 12% less than that of posterior transpedicular screw fixation group, 21% and 13% less than that of normal control group. The thoracolumbar displacement in calcium sulfate vertebroplasty Plus posterior transpedicular screw fixation group decreased 25% and 37% as compared with other 2 groups respectively. Compared with normal control and posterior transpedicular screw fixation group, the thoracolumbar stiffness in calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group increased 53% and 44% respectively. The strength in vertebral body and intervertebral disc of calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 14% and 24% higher than that of posterior transpedicular screw fixation group, 13% and 20% higher than that of normal control group. The maximal twisting strength of FSU in calcium sulfate vertebroplasty plus posterior transpedicular screw fixation group were 18% and 30% higher than that of other 2 groups, the twisting stiffness were 30% and 40% higher than that of other 2 groups. The data above were significant differences statistically (P < 0.05). CONCLUSION: Posterior transpedicular screw fixation combined with calcium sulfate vertebroplasty show superior biomechanical properties for treatment of thoracolumbar compression fractures, which exhibits not only strong strength and stiffness, but also stable FSU, thus could decrease the stress loading of the internal fixation, the incidences of screw breakage and avoid the altitude loss of vertebral body.
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[Objective]To study the effect and complications of percutaneous vertebroplasty and kyphoplasty in treating osteoporotic spinal compression fractures.[Method]Eighteen patients with twenty-seven vertebras in group,PVP(percutaneous vertebroplasty)were performed in fourteen patients(twenty-three vertebras),PKP(percutaneous kyphoplasty)were performed in four patients(four vertebras),VAS(Visual analogue scale) and mobility were evaluated 3 days before and after operation.Relief of back pain、recovery of living ability and complications were observed in the follow-up.[Result]All patients were operated on successfully and their back pain relieved immediately after operation,VAS was distinctly decreased from(7.5?0.7)pre-operation to(2.5?0.6)at 3 day after operation with a significant difference(P