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Objective:To investigate the changes of thickness and area of the ligamentum flavum after lateral lumbar interbody fusion (LLIF) for lumbar degenerative diseases.Methods:From 2019 to 2021, a total of 54 patients with lumbar degenerative diseases who underwent LLIF combined with percutaneous pedicle screw internal fixation were retrospectively analyzed. There were 9 males and 45 females, aged 59.46±6.91 years (range, 45-76 years), followed up for 14.69±6.87 months (range, 12-33 months). The disc height (DH), midsagittal canal diameter (CD), dural sac axial cross-sectional area (DCSA), ligamentum flavum area (LFA) and ligamentum flavum thickness (LFT) before and after surgery and at the last follow-up were evaluated and compared. Pearson correlation analysis was used to assess the relationship between the amount of change in the DCSA and LFA in the immediate postoperative period and at the last follow-up, as well as the correlation between the two and the amount of change in the DH. The data of patients at the last follow-up of 12 months after operation were extracted. Pearson correlation was used to evaluate the changes in DCSA and LFA at the last follow-up and the visual analogue scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI) at 1 year after surgery.Results:All patients were followed up for 14.69±6.87 months (range, 12-33 months). The differences in DH ( F=354.93, P<0.001), sagittal CD ( F=44.78, P<0.001) and DCSA ( F=130.97, P<0.001) before, immediately after surgery and at the last follow-up were statistically significant. The DH, sagittal CD, and DCSA immediate after surgery and last follow-up were higher than those before surgery ( P<0.05). The differences in LFA ( F=51.59, P<0.001) and bilateral LFT ( F=53.49, P<0.001; F=50.53, P<0.001) before and after surgery and at the last follow-up were statistically significant, and both LFA and bilateral LFT at immediate after surgery and last follow-up were smaller than those before surgery ( P<0.05). Pearson correlation analysis showed that the change of DH immediately after surgery was moderately correlated with the change of DCSA ( r=0.57, P<0.001), and was strongly correlated with the change of LFA ( r=0.65, P<0.001). The change of DH at the last follow-up was moderately correlated with the change of DCSA ( r=0.43, P<0.001), and was weakly correlated with the change of LFA ( r=0.25, P=0.042). The differences in VAS-leg ( F=199.51, P<0.001), VAS-low back ( F=233.90, P<0.001), and ODI ( F=199.17, P<0.001) were statistically significant in patients before operation, 3 months after operation and 12 months after operation. There was no correlation between the changes of DCSA and LFA at the last follow-up and the changes of VAS and ODI at 1 year after operation ( P>0.05). Conclusion:LFA and LFT decrease and DCSA increase in patients with lumbar degenerative diseases after LLIF. LFA and LFT gradually decrease with time, and VAS and ODI are significantly improved compared with those before surgery. The DH loss caused by a certain degree of cage subsidence after surgery does not affect the clinical efficacy. There is no correlation between the improvement of DCSA and LFA and the improvement of clinical symptoms.
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Objective To explore the genotype distribution of lipoprotein lipase gene polymorphism at Ser447Stop locus and its possible association with metabolic syndrome and dietary intakes. Method Ser447Stop polymorphism was determined by PCR-PFLP method in 222 adults with MS and 222 normal adults as control. Their physical examination,dietary investigation and levels of biochemical profile,including BG,TG,TC and HDL-C were analyzed. Results (1) The genotype frequencies of Ser447Stop SS,SX and XX were 85.6%,13.3% and 1.1% respectively,which were in agreement with Hardy-Weinberg equilibrium. There was no significant difference in frequencies of genotypes or allele between MS and the control,and between male and female. (2) After adjusting age and gender,the levels of serum TG were significantly different among three genotype groups,the highest in SS genotype and the lowest in XX genotype. (3) After adjusting age,gender and body mass index,the intakes of protein and carbohydrate were significantly different among three genotype groups. (4) There was significantly different in negative correlation between the intakes of protein and serum TG levels after adjusting age,gender and body mass index. Conclusion Lipoprotein lipase gene polymorphism influenced serum TG levels,while associated with protein intakes. It might contribute to the predisposition in metabolic syndrome response to dietary intervention.
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Objective To study the genotype frequencies of peroxisome proliferator-activated- receptors- gamma (PPAR?) C161→T gene and its possible association with serum lipid levels and dietary intakes. Methods PCR-PFLP method was used to detect the polymorphism of PPAR?C161→T gene of 800 adults in Shanghai. Their physical examinations,dietary survey and the levels of serum lipid profile , including TG、TC ,HDL and LDL were analyzed. Results (1) The genotype frequencies of PPAR?C161→T CC,CT and TT were 35.1 %, 47.0 % and 17.9 % respectively , which were in agreement with Hardy- Weinberg equilibrium. There was no significant difference in distribution of genotypes or allele between the hyperlipidemia group and the control group and the result was same between male and female subjects. (2)After adjusting age,gender and body mass index, the levels of TG were significantly different among three genotypes groups,the highest in CC genotype. (3) After adjusting age and gender, the intakes of protein were significantly different among three genotype groups. (4) There was significant difference in the negative correlation between energy,protein and carbohydrate and serum TG levels in hyperlipidemia group.Conclusion PPAR? C161→T gene polymorphism influenced serum TG level, while associated with protein intakes. It might contribute to the heterogeneity in TG response to dietiary intervention.