Serum monocyte chemoattactant protein-1 level and spinal tuberculosis susceptibility / 中国组织工程研究

BACKGROUND:The monocyte chemoattactant protein-1 gene polymorphism is associated with spinal tuberculosis susceptibility. OBJECTIVE:To investigate the association between serum monocyte chemoattactant protein-1 expression level and spinal tuberculosis susceptibility in Han population of Hunan province. METHODS:The patients with spinal tuberculosis and the healthy volunteers were recruited in Xiangya Hospital of Central South University from December 2004 to December 2010. The empty peripheral venous blood 2 mL were col ected from the subjects in early morning, then the monocyte chemoattactant protein-1-362 genotypes were detected by polymerase chain reaction and DNA sequencing technology. And the serum monocyte chemoattactant protein-1 level was detected by enzyme linked immunosorbent assay technology. The ROC curve was used for diagnostic tests to calculate diagnostic threshold value of serum monocyte chemoattactant protein-1 level to spinal tuberculosis susceptibility, and to analyze the diagnostic titer. RESULTS AND CONCLUSION:208 patients with spinal tuberculosis and 210 healthy volunteers were included. The serum monocyte chemoattactant protein-1 level of the spinal tuberculosis patients was significantly higher than that of the healthy volunteers [(134.58±51.63) ng/L vs. (39.18±17.45) ng/L, P<0.01]. The serum monocyte chemoattactant protein-1 level could not be affected by gender, but over-expressed in patients with monocyte chemoattactant protein-1-362-CC genotypes. The serum monocyte chemoattactant protein-1 level higher than 101.65 ng/L indicated that the patients might suffered from spinal tuberculosis (sensitivity:85.5%, specificity:94.3%, Youden index:0.799, area under curve of ROC:0.946, 95%confidence interval:0.916-0.975, P<0.01). The serum monocyte chemoattactant protein-1 level may be associated with spinal tuberculosis susceptibility in Han population of Hunan province, highly expressed serum monocyte chemoattactant protein-1 can be used as one of the indicators for the diagnosis of spinal tuberculosis.

The correlative factors affected the early clinical efficiency of surgical management of lumbar disc degeneration / 中国医师杂志

Objective To explore the correlative factors that affected the early clinical efficacy of surgical management of lumbar disc herniation.Method 208 cases of lumbar disc herniation were recruited since December 2007.The details of their therapy in different periods were compared and analyzed.Result The aggressive discectomy was the most powerful factor related to the better early clinical outcome.The patients with preoperative JOA score ＞ 17 were associated to the poor clinical outcome.The patients with postoperative JOA score ≥ 25 on 3 month and ≥ 24 on 1 year after operations were associated to better early clinlcal outcome.Conclusion The pre- and post-operative JOA score and aggressive discectomy were the factors affected the clinical outcome.

Hormonal application after spinal fusion using allograft bone in scoliosis / 中国医师杂志

Objective To study the effect of short course of mini dose hormonal application after long-segment spinal fusion using allograft bone in scoliosis.Methods A retrospective study was made in 106 patients with scoliosis,who underwent posterior spinal fusion during May,2004 to Jan,2007 in our hospital.These patients were divided into two groups.Hormone group,68 cases,were 13 to 28 years old with a mean age of 16.5 years old.The average fused segments were 9.0 vertebrae(range from 7 to 12 vertebra).Glucocorticoid was used after operation about 5 to7 days.No hormone group,38 eases,were 14 to 30 years old with a mean age of 17.5 years old.The average fused segments also were 9.0 vertebrae(range from 6 to 12 vertebra).No glucocorticoid was used after operation.All patients received spinal instrumentation with TSRH system and spinal fusion with allograft bone.The temperature,white blood cell(WBC),ESR,drainage and complications between two groups after operation were comparative analyzed.Result Between two groups,the variance of the figures of the temperature,WBC,ESR and drainage are statistically significant.There was less complication in hormone group than that in no hormone group.Conclusion After the operation of the segments spinal fusion by allograft bone,using mini-close glucocorticoid by short course of treatment can significantly decrase some complications and ensure spinal fusion.