Clinical study of modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise on lumbar disc herniation / 国际中医中药杂志

Objective:To observe the clinical effect of modified Shishi Niubangzi Decoction combined with strengthening muscle-waist exercise on lumbar disc herniation (LDH).Methods:Randomized controlled trial. A total of 60 patients with LDH admitted to the Pinggu Hospital, Beijing Traditional Chinese Medicine Hospital, were enrolled as the research objects between September 2020 and September 2021. According to the random number table, they were randomly divided into the treatment group and control group, 30 in each group. Both groups were given routine basic treatments (strengthening tendons-waist exercise and three-position six-step manipulation). On this basis, the treatment group was treated with modified Shishi Niubangzi Decoction, while the control group was treated with non-steroidal anti-inflammatory drugs (ibuprofen codeine sustained-release tablets). Both groups were treated for 4 weeks. The responsive rates, back pain intensity, leg pain and numbness by Visual Analogue Scale (VAS) and lumbar function by Oswestry Disability Index (ODI), and Japanese Orthopaedic Association (JOA) were compared between the two groups.Results:The response rate of treatment group was significantly higher than that of control group (93.3% vs. 73.3%; χ2=4.32, P=0.038). After treatment, scores of JOA (subjective symptoms, signs, activities of daily living) in the treatment group were significantly higher than those in the control group ( t=3.86, 2.71, 2.21, P<0.05). After treatment, scores of back pain (2.12±0.21 vs. 3.02±0.32, t=12.88), leg pain (2.04±0.64 vs. 2.64±0.66, t=3.58), lower limb numbness (1.75±0.24 vs. 2.41±0.70, t=4.89) in the treatment group were significantly lower than those in the control group ( P<0.01). At 1 week and 1 month after treatment, ODI scores in treatment group were significantly lower than those in control group ( t=10.22, 5.59; P<0.05). Conclusion:The modified Shishi Niubangzi Decoction combined with strengthening tendons-waist exercise can improve responsive rates, improve lumbar pain and function in LDH patients.

Risk factors of postoperative acute kidney injury and the impact on outcome in non-senile patients undergoing cardiac valvular surgery / 中华心血管病杂志

Objective@#To investigate the risk factors of postoperative acute kidney injury (AKI) in patients aged between 40 and 50 years old undergoing cardiac valvular surgery and the impact on outcome.@*Methods@#The clinical data of 286 patients aged between 40 and 50 years old undergoing cardiac valve surgery in Guangdong Provincial People′s Hospital from January 2012 to December 2016 were analyzed retrospectively. Preoperative coronary angiography was performed in all patients. All patients enrolled were divided into AKI group and non-AKI group according to the existence or not of postoperative AKI. Patients with AKI were further divided into AKI stage 1, stage 2, and stage 3 groups according to KDIGO guideline. Demographic characteristics, preoperative clinical data including serum creatinine, estimated glomerular filtration rate, hemoglobin, uric acid, urinary protein, presence or absence of chronic kidney disease, left ventricular ejection fraction, pulmonary artery pressure, New York Heart Association (NYHA) functional classification, preoperative co-morbidity (hypertension, diabetes, anemia, cerebrovascular disease, peripheral artery disease), preoperative medication(vasoactive drugs, diuretic, renin-angiotensin system inhibitor (RASI), surgical data (contrast dosage in coronary angiography, type of cardiac valve surgery) were recorded and analyzed in this retrospective study. The risk factors for postoperative AKI and its impact on clinical outcomes (mortality, hospitalization expenses and Intensive Care Unit stay duration) were evaluated. Logistic regression analysis was used to determine the risk factors for postoperative AKI and the adjusted variables with P<0.2 were selected for the multivariate logistic regression analysis to define the independent determinants for AKI.@*Results@#AKI was defined in 106 out of 286 enrolled patients, including 96 patients with AKI stage 1, 10 patients with AKI stage 2 and no patients with AKI stage 3. The proportion of coexisting cerebrovascular diseases was higher in AKI group than in non-AKI group (9(8.49%) and 5(2.78%), χ2=4.677, P=0.031), while there was no difference among other baseline data between the two groups. Multivariate logistic regression analysis showed that preoperative complications of cerebral vascular disease was an independent risk factor of postoperative AKI (OR=3.578, 95%CI 1.139-11.242, P=0.029). Five out of 106 AKI patients died during hospitalization while there was only 1 patient died among 180 patients without AKI. Patients with AKI after cardiac valve operation experienced higher mortality than patients without AKI (χ2=5.625, P=0.028). Further analysis showed that there was no difference in hospitalization mortality between patients with AKI stage 2 and stage (χ2=0.686, P=0.408) while the hospitalization mortality in patients with AKI stage 2 was higher than those without AKI (χ2=8.113, P=0.004). The hospitalization expenses in patients with AKI were 10.38(8.59,12.54) ×104 RMB, significantly higher than that in patients without AKI (9.72(8.03,11.93) ×104 RMB)(P=0.043). There was no difference in hospitalization expenses between patients with AKI stage 1 and without AKI (P=0.635). The hospitalization expenses in patients with AKI stage 2 was higher than those without AKI (P=0.023). Intensive Care Unit stay duration in patients with AKI was 3(1,4) days, significantly higher than those without AKI (P=0.044). There was no difference in Intensive Care Unit stay duration in patients with AKI stage 1 and without AKI (P=0.978), while Intensive Care Unit stay duration in patients with AKI stage 2 was significantly longer than those without AKI (P=0.006).@*Conclusions@#Preoperative complications of cerebral vascular disease is an independent risk factor of postoperative AKI. Non-senile patients with AKI after cardiac valvular surgery is associated with a higher proportion of mortality, hospitalization expenses and Intensive Care Unit stay duration as compared patients without postoperative AKI.

Incidence and risk factors of hyperkalaemia after acute kidney injury in cardiology department / 实用医学杂志

Objective To investigate the incidence of hyperkalaemia and analyze the risk factors in pa-tients with acute kidney injury(AKI)in cardiology department.Methods We conducted a retrospective case-con-trol study,using the electronic medical information of the patients in Guangdong General Hospital. Results A to-tal of 37 837 patients were included in this study and 1 571(4.3%)patients with AKI were detected.Hyperkalae-mia occurred in 517 patients(1.4%).The incidence of hyperkalaemia in AKI patients was higher than that in non-AKI patients(10.1% vs. 1.0%,P < 0.001)and the incidences of hyperkalaemia at AKI stage 1~3 were 2.6 %, 13.9% and 20.6 %,respectively. Multiple logistic regression analysis demonstrated that AKI stages,chronic kid-ney disease and heart failure were risk factors for hyperkalaemia.AKI and hyperkalaemia were related to increased hospitalization expenses,delayed hospital stay,renal replacement therapy and in-hospital mortality. Based on AKI,the combination of hyperkalemia could significantly increase clinical burden and adverse outcomes. Conclu-sion In cardiology department,the monitoring of serum creatinine and potassium level should be emphasized.

1H-NMR-based metabonomics studyon urine of rat with Spleen-Qi deficiency pattern / 中国药理学通报

Aim To establish the rat model of Spleen-Qi deficiency, analyse the metabolic pathways and investigate the connection between the changed urinary metabolites and Spleen-Qi deficiency, in order to explore the potential mechanisms of Spleen-Qi deficiency.Methods With the binding methods of diarrhea induced by bitter and cold, abnormal of starvation and excessive tiredness, the rat Spleen-Qi deficiency model was established.Then the activity of creatine phosphokinase(CPK) was detected.The endogenous metabolites in the urine were detected by NMR, and the data were analyzed with multivariate and statistical methods.Then the metabolites were selected that could be clearly distinct in the two groups with the fold change value(>1.2) and the P<0.05 of Student′s t-test.Both the pathway analysis and enrichment analysis were performed with Metabo Analyst 3.0.Results Compared with the normal rats, the activity of CPK decreased significantly in model rats(P<0.05).A significant separation appeared in the principal components analysis(PCA) score plot when the control group and the model group were compared, indicating that the Spleen-Qi deficiency model was successfully duplicated.The 33 differential metabolites, which mainly involved in the metabolic pathways, were distinguished from the comparision of Spleen-Qi deficiency model group and control group.The metabolic pathways was related to energy metabolism, amino acid metabolism, nucleotide metabolism and disturbance of gut microbes.Conclusions The main energy metabolic pathways (tricarboxylic acid cycle, glycolysis and liquid oxidation) may be disturbed in Spleen-Qi deficiency rats.The energy supply function is suppressed, which leads to the fatigue and weight loss in rats.

Different bone cement implantation ways for osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND: After the treatment of osteoporotic vertebral compression fractures with bone cement implantation,deteriorative osteoporosis and the distance augment between bone cement and bones result in a decrease in bone cement-bone interface compression strength and torsion strength, and then the bone cement tends to displace, which is easy to cause a secondary vertebral fracture.OBJECTIVE: To investigate the clinical efficacy of bone cement implantation via three approaches on osteoporotic vertebral compression fractures.METHODS: Sixty patients with single osteoporotic vertebral compression fracture were treated with vertebroplasty,percutaneous kyphoplasty or fraction cement vertebroplasty. All data were collected to analyze the correlation between the bone cement morphology and treatment method, and to detect the visual analogue scale, Oswestry disability index,Cobb angle and incidence of secondary vertebral fractures.RESULTS AND CONCLUSION: The visual analogue scale scores, Oswestry disability index, and Cobb angle in thethree groups were significantly improved after treatment (P < 0.05). All above indicators showed no significant difference among groups at each time point after treatment, suggesting that these three kinds of treatments exert the same effects on pain relief, functional recovery, preventing the vertebral height loss and maintaining spinal mechanical properties.Bone cement displacement and secondary vertebral fracture occurred after clotted cement implantation. Therefore,mixed and trabecular-shaped grafts are preferred, aiming to achieve good long-term treatment outcomes in osteoporotic vertebral compression fractures.

CT-guided bone cement infusion for metastatic tumor to the ilium / 中国组织工程研究

BACKGROUND: Iliac bones are common habitant parts in metastatic tumor of bone, and the affiliate cortex is easy to be penetrated into soft tissue blots. The irregular iliac shape and its complex surrounding tissues create the difficulties in puncture operations and cement perfusion.OBJECTIVE: To investigate the clinical outcomes of CT-guided versus DSA-guided puncture combined with bone cement perfusion for metastatic tumor to the ilium.METHODS: Sixty-four patients with metastatic tumor to the ilium udergoing bone cement perfusion were enrolled, and then divided into control and experimental groups (n=32 per group), followed by treated with DSA-guided percutaneous injection of bone cement, and CT-guided puncture, respectively. Subsequently, the diffuse distribution of bone cement was observed using CT. The success rate, leakage rate, Visual Analogue Scale scores and Oswestry Disability Index were compared between two groups.RESULTS AND CONCLUSION: (1) All patients received the surgery successfully, and bone cement leakage happened in two cases of control group and one case of experimental group. (1) The Visual Analog Scale and Oswestry Disability Index scores in the two groups were significantly better than those before treatment (P 0.05). (3) No difference was found in the pain relief and functional recovery between two groups. (4) To conclude, CT-guided treatment can achieve satisfactory outcomes for metastatic tumor to the ilium by bone cement infusion in appropriate time.

Therapy and research progress of pediatric epiphyseal injury / 中华实用儿科临床杂志

The epiphysis is an unique structure in pediatric skeletons,which mainly reflect in its unique blood supply,anatomical structure,pathological basis and so on.Epiphyseal injury is common in children with skeletal injury.Fracture,tumor,infection can cause epiphysis injury,and inappropriate treatment is often easy to cause growth obstacle and skeletal deformity.Its treatment is relatively difficult.At present,there had not yet formed a consistent therapeutic strategy.Aiming at the pathobiologic basis,causes,mechanism and clinical manifestation of pediatric epiphyseal injury,now,its diagnosis,therapeutic strategy,the principle of treatment and the latest research progress were summarized,which would provide useful guidance for clinical treatment of pediatric epiphysis injury.

Basic Magnesium Carbonate-Based Diffusive Gradients in Thin Films Technique for in situ Measurement of Dissolved Phosphorus in Eutrophic Waters / 分析化学

A technique of diffusive gradients in thin films (DGT) was developed for the in situ measurement of reactive phosphorus species in natural waters, sediments and potentially soils. Polyacrylamide / basic magnesium carbonate was used as the novel binding phase of DGT. Various factors, such as initial concentration, deployment time, pH and ionic strength, which may affect the adsorption of phosphate to the DGT were investigated. H2 SO4(0. 25 mol/ L, 10 mL) was used for elution of phosphate from the binding gel, and an elution efficiency of 85±5% was obtained. The DGT measurement was independent of ionic strength (0. 001-0. 05 mol/ L) and pH (4. 10-9. 15). The results indicated that the maximum adsorption capacities of DGT were limited to 20. 4 μg per disc ( T = 25℃, pH = 7. 00, [ P] = 2 mg / L). Good agreement was obtained between the measurement results of DGT method and molybdenum blue method in the P concentration from 0. 001 to 20 mg / L. The method detection limit (MDL) was 102. 4 ng / L. Field performances of DGT in synthetic seawater, the coastal seawater of Xiamen, Lake Yihai, Lake Chaohu and Nanfei River indicated that the basic magnesium carbonate-DGT method was more reliable than the commonly used ferrihydrite-DGT method.

Observation on the efficacy of acupoint massage plus moxibustion for refractory insomnia / 针灸推拿医学（英文版）

Objective:To observe the clinical efficacy of acupoint massage plus moxibustion in treating refractory insomnia. Methods:Sixty patients with refractory insomnia were randomized into two groups, 30 in each group. The treatment group was intervened by acupoint massage on the face and head plus moxibustion at Yongquan (KI 1);the control group was intervened only by the same acupoint massage. For both groups, the treatment was given once a day, and the therapeutic efficacy was evaluated after 4-week treatment. Results:The total effective rate was 93.3%in the treatment group versus 80.0%in the control group, and the difference was statistically significant (P Conclusion:Acupoint massage plus moxibustion can produce a better efficacy than acupoint massage alone in treating refractory insomnia.

Bone filling mesh container for treatment of vertebral compression fractures can reduce the leakage of bone cement / 中国组织工程研究

BACKGROUND:By using the bone filing mesh container, a smal amount of bone cement can be penetrated to the trabecular space to form a microscopic twist, thereby strengthening the vertebral body. But there is no report about bone filing mesh container for treatment of osteoporotic vertebral compression fractures. OBJECTIVE:To compare the vertebral uplift and cement leakage of bone filing mesh container, percutaneous vertebroplasty and percutaneous kyphoplasty for the treatment of wedge-shaped osteoporotic vertebral compression fractures. METHODS:Ninety patients with wedge-shaped osteoporotic vertebral compression fractures were randomly divided into three groups. Polymethylmethyl acrylic bone cement type II was perfused into these three groups by bone filing mesh container, percutaneous vertebroplasty and percutaneous kyphoplasty, respectively. Bone cement type, vertebral uplift, leakage rate, visual analogue scale score, Oswestry disability index and Cobb’s angle were calculated and compared among the three groups. RESULTS AND CONCLUSION:The operation was successful in al patients. The success rate of puncture was 100%. There were 2 cases of bone cement leakage for percutaneous vertebroplasty and one case for percutaneous kyphoplasty. The vertebral uplift, visual analog scale score, Oswestry disability index and Cobb’s angle were improved significantly in the three groups after treatment (P 0.05). No difference in pain relief and action recovery was found among the three groups. These findings demonstrate that the bone filing mesh container with polymethylmethyl acrylic bone cement for treatment of osteoporotic vertebral compression fractures can have a promising result in relieving the pain, lifting the injured vertebral height, and the correction of kyphosis, which can also reduce the leakage rate of bone cement.

Simultaneous determination of borneol and its metabolite in rat plasma by GC-MS and its application to pharmacokinetic study / 药物分析学报

A gas chromatography mass spectrometry (GC-MS) method has been developed and fully validated for the simultaneous determination of natural borneol (NB) and its metabolite, camphor, in rat plasma. Following a single liquid-liquid extraction, the analytes were separated using an HP-5MS capillary column (0.25 mm ? 30 m ? 0.25μm) and analyzed by MS in the selected ion monitoring mode. Selected ion monitor (m/z) of borneol, camphor and internal standard was 95, 95 and 128, respectively. Linearity, accuracy, precision and extraction recovery of the analytes were all satisfactory. The method was successfully applied to pharmacokinetic studies of NB after oral administration to Wistar rats.

Calcium phosphate bone cement and biodegradable mesh-like microporous balloon for vertebroplasty / 中国组织工程研究

BACKGROUND:In vitro experiments have demonstrated that the biodegradable mesh-like microporous baloon made of macromolecular materials has obvious advantage of anti-leakage, which is capable of maintaining calcium homeostasis, has no inhibitory effects on cel growth and on microscopic interdigitation formation between new bone and bone cement. OBJECTIVE:To evaluate the therapeutic effects of biodegradable mesh-like microporous baloon with calcium bone cement on vertebral fractures based on animal experiments. METHODS:The fracture model was established in 48 New Zealand rabbits, in which a bone dril was introduced after successful puncture at sites near left low extremity of the femur. These rabbit models were randomized into two groups: experimental group with calcium phosphate bone cement and biodegradable mesh-like microporous baloon and control group only with calcium phosphate bone cement. Clinical parameters such as blood cel count, biochemistry, and CT/X ray were examined at 1, 3 and 6 months after implantation of the baloon and bone cement. After that, the specimens were fixed for pathological analysis. RESULTS AND CONCLUSION:The operation was performed under general anesthesia with no eventful infusion of bone cement. The expansion of baloon was satisfactory without definite extravasation of bone cement in the experimental group. In the control group, cement diffusion was found with pulmonary embolism occurring in three New Zealand rabbits. No statistical significance for blood cel counts and biochemistry was found between pre- and postoperation or between two groups. The materials in the two groups had favorable biocompatibility with injured bones without obvious immunological response. In the experimental group, the baloon wal was thinned and partial bone tissues grew into the cement at 1 month; at 3 months, a large amount of bone tissues grew into the cement and cement volume diminished; at 6 months, the baloon disappeared and only a smal amount of cement left in the bone tissues. In the control group, it was difficult to determine when the cement degraded. The biodegradable mesh-like microporous baloon combined with calcium bone cement is superior to bone cement alone in the management of vertebral fractures.

The differential requirement of mushroom body α/β subdivisions in long-term memory retrieval in Drosophila

The mushroom body (MB), a bilateral brain structure possessing about 2000-2500 neurons per hemisphere, plays a central role in olfactory learning and memory in Drosophila melanogaster. Extensive studies have demonstrated that three major types of MB neurons (α/β, α'/β' and Γ) exhibit distinct functions in memory processing, including the critical role of approximately 1000 MB α/β neurons in retrieving long-term memory. Inspired by recent findings that MB α/β neurons can be further divided into three subdivisions (surface, posterior and core) and wherein the α/β core neurons play an permissive role in long-term memory consolidation, we examined the functional differences of all the three morphological subdivisions of MB α/β by temporally precise manipulation of their synaptic outputs during long-term memory retrieval. We found the normal neurotransmission from a combination of MB α/β surface and posterior neurons is necessary for retrieving both aversive and appetitive long-term memory, whereas output from MB α/β posterior or core subdivision alone is dispensable. These results imply a specific requirement of about 500 MB α/β neurons in supporting long-term memory retrieval and a further functional partitioning for memory processing within the MB α/β region.

Application status and prospects of thrombectomy devices for acute ischemic stroke / 中国医疗器械杂志

The character and application status of interventional thrombectomy devices for acute ischemic stroke (AIS) are briefly introduced and the development trend is also analyzed.

Cystoscopic Extraction Technique and External Drainage Rescue of a Failed Attempt to Traverse a Severe Transplanted Ureteral Obstruction

PURPOSE: The aim of this research was to evaluate the efficacy of the cystoscopic extraction and external drainage techniques for unsuccessful antegrade stenting in transplanted severe ureteral obstruction. MATERIALS AND METHODS: A total of 26 patients with severe transplanted ureteral obstruction in whom the cystoscopic extraction technique and/or external drainage technique was performed were retrospectively evaluated. After the severe obstruction was successfully traversed, balloon dilatation followed by double-J stent insertion was performed. RESULTS: Of the 26 patients (male:female, 9:4; mean age, 38.1 years) who underwent failed ureteral stenting with the conventional procedure, 16 patients underwent successful stenting with the cystoscopic extraction technique, and 10 patients underwent successful stenting following external drainage. The mean serum creatinine of the 26 patients before stenting was 42.9 mg/dL (range, 32.7 to 54.1 mg/dL), which decreased to 10.3 mg/dL (range, 8.7 to 11.8 mg/dL) after stenting. The complications of the procedure were lower abdominal pain in 22 patients and gross hematuria in 9 patients. All complications were relieved with medical care within 3 to 5 days after the procedure. No major complications occurred. CONCLUSIONS: The cystoscopic extraction technique and external drainage technique are safe and useful for traversing a severe transplanted ureteral obstruction after a failed conventional procedure.

Absorption mechanism of oxysophocarpine across Caco-2 cell monolayer mode / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the absorption mechanism of oxysophocarpine across Caco-2 cell monolayer model.</p><p><b>METHOD</b>The safety concentration of oxysophocarpine in Caco-2 cell was first selected by using MTT method. Then the Caco-2 cell monolayers drug transport model was assigned to study the bi-direction transport mechanism of oxysophocarpine by evaluating the influent factors such as time, concentration, pH, P-gp inhibitor of verapamil, on its absorption characterization.</p><p><b>RESULT</b>In the Caco-2 cell monolayer model, the transport volume was correlated positively with the time and concentration of oxysophocarpine, and affected by pH value. Verapamil had no influence on its transport since the transport of oxysophocarpine from apical (AP) to basolateral (BL) was similar to the transport from basolateral to apical.</p><p><b>CONCLUSION</b>The intestinal absorption mechanism of oxysophocarpine was deduced as passive transference by Caco-2 cell monolayer model.</p>

Fatigue life analysis of coronary stent by finite element analysis / 医用生物力学

Objective After the implantation,coronary stent is expected at least to keep its integrity and maintain the predicated function for over 10 years or 4e8 cycles under the pulsatile loading conditions,so the fatigue property of the stent should be evaluated.Method The finite method was used to analyze the stress distribution of different phases and evaluate the fatigue life according to Goodman criteria,meanwhile,the accelerated fatigue experiment was also performed.Results It can be concluded that the dangerous points are all but located in the lateral inner surface of stent curvature.Conclusions The results prove that the fatigue property can be simulated through the finite element analysis,which can provide the theoretical guidance for the stent design.

Imaging and pathologic study of intravertebral vacuum phenomenon in vertebral compression fracture / 中华放射学杂志

Objective To investigate the features of intravertebral vacuum phenomenon (IVP)in vertebral compression fractures (VCFs). Methods Two hundred and nine patients with VCFs underwent percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP). The biopsies and the images of X-ray, CT, MRI of VCFs were obtained. The consistency between IVP and osteonecrosis on histology and the positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and Youden index of IVP for diagnosing local osteonecrosis in VCFs were analyzed. Fisher exact probability test was used to analyze the coherence between IVP and osteonecrosis. Results Histological examination revealed 146(69.9%) osteoporoses, 10 (4.8%) osteonecroses with osteoporoses, 53 (25.4%) neoplasms. Prior to surgery,10 cases of IVP were found. Plain radiograph showed horizontally oriented lucent cleft in the vertebral body;CT further confirmed the location of gas;T_1-weighted MR image appeared hypointensity,while the signal intensity of T_2-weighted MR image differed, depending on the duration of recumbency. Nine of 10 patients with IVP showed osteonecrosis on histology, while 9 of 10 patients with osteonecrosis contained IVP. The association of osteonecrosis on histology and the IVP was statistically significant(P <0.01). The PPV, NPV, sensitivity, specificity, and Youden index for diagnosing local osteonecrosis was 90% (9/10), 99.5% (198/199), 90.0% (9/10), 99.5% (198/199), and 0.9, respectively. Conclusion The IVP is stongly suggestive of local osteonecrosis in vertebral compression fracture.

Percutaneous vertebroplasty for treatment of metastatic tumor in axis / 中华放射学杂志

Objective To explore the safety and effectiveness of percutaneous vertebrophasty(PVP)in the treatment of the metastatic tumor involved axis.Methods Ten patients(8 male,2 female)with osteolytic metastases involved axis were treated with PVPs.The anterolateral approach with fluoroscopy guidance was selected in 9 cases,while the posterolateral approach with CT guidance was selected in 1 case.Results Successful unilateral-paracentesis for PVP were achieved in all patients without intervention related complications such as bleeding and symptomatic polymethylmethacrylate(PMMA)leakage.CT scan taken following PVP showed that over 70% of the osteolytic metastatic area was well filled with PMMA in all cases.Varying degrees of pain relief were observed(CR in 7 cases,PR in 3 cases)within 7 days.All patients could support their heads without brackets.During a 3 to 24 months follow up after the procedures,No aggravated pain was found in the group.Two patients died in 4 months,3 Patients died in 8 to 11 months 4 patients died in 13 to 15 months,and 1 patient still was alive after 24 months.Conclusion Anterolateral or posterolateral approach to Aixs in PVP is safe and effective in treating osteolytic metastatic tumors.

Kyphoplasty with single balloon inflation followed by cement filling for osteoporotic vertebral compression fractures / 中国组织工程研究

BACKGROUND: In kyphoplasty procedure, two balloons are inserted into the vertebral body and inflated simultaneously for height symmetric restoration of the vertebral body. However, the expensive cost of balloon of kyphoplasty limits the extensive development of this procedure in developing countries. In this study, we try to inflate single balloon with bilateral transpedicular routes alternatively to achieve vertebral body height balanced restoration and reduce operation expenditure. But biocompatibility of bone cement and effect of kyphoplasty still need further observation.OBJECTIVE: To investigate the biocompatibility of bone cement and the clinical efficacy of bipedicular kyphoplasty for osteoporotic vertebral compression fractures by inserting single inflatable balloon into injured vertebral body and filling bone cement in the cavity caused by inflating balloon via bipedicular approach.DESIGN: Controlled observation.SETTING: Department of Medical Imaging, General Hospital of Jinan Military Area Command of Chinese PLA.PARTICIPANTS: Twenty-two patients (31 vertebral bodies) undergoing kyphoplasty with single balloon in Department of Medical Imaging, General Hospital of Ji'nan Military Area Command of Chinese PLA from May 2004 to May 2005 were selected, including 5 males and 17 females aged 68-85 years. Patients with painful compression fractures caused by osteoporosis were enrolled, and confirmed by CT and MRI with complete vertebral posterior wall but no spine deformity. The informed consent was obtained from all subjects, and the experiment and treatment were approved by Ethics Committee. METHODS: The especial instrument for kyphoplasty including puncturing device and balloon were provided by Shandong Guanlong Medical Utensils Co., Ltd. [LDAI (T) 2004 No. 2150017]; bone cement (Polymethymethacrylate) was made in China [MAIT 2005(T) No. 3650267]. Under X-ray fluoroscopy monitoring, single inflatable balloon was inserted into fractured vertebral body by puncturing needle and inflated via bipedicular approach to restore vertebral height. MAIN OUTCOME MEASURES: ①Bone cement biocompatibility during and after surgery; ②pain relief within 72 hours after surgery, restoration of vertebral height and correction of kyphotic deformity.RESULTS: ①Bone cement biocompatibility: Little cement leakage was observed at one intervertebral space of one patient by X-ray film, but no clinical symptoms, inflammatory reaction or rejection were found. ②Obvious pain relief was found in 22 cases with within 72 hours after kyphoplasty. ③The height loss of the anterior and middle vertebral body reduced from (14.70±4.21) mm and (10.62±4.11) mm preoperatively to (10.38±4.23) mm and (6.45±4.04) mm postoperatively after single balloon inflation and cement filling. Cobb angle was corrected averagely from (21.15±6.33)° preoperatively to (11.64±4.33)° postoperatively. CONCLUSION:Biocompatibility of bone cement is good, and no specific adverse effects are found in despite of cement leakage. Bipedicular kyphoplasty with single balloon for painful osteoporotic vertebral compression fractures effectively restores vertebral heights and relieves pain.