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BACKGROUND: Current studies have shown that ultrasound-guided paravertebrospinai nerve block widely used has a significant effect in the clinical treatment of thoracolumbar zoster-associated pain. OBJECTIVE: To systematically evaluate the efficacy and safety of ultrasound-guided paravertebral nerve block in the treatment of thoracolumbar zoster-associated pain and to provide reference for clinical treatment. METHODS: We searched relevant literature in PubMed, The Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP) and Chinese Biomedical Literature Database (CBM). The limit of searching time was from inception until January 1, 2019. Randomized controlled trials addressing ultrasound-guided paravertebral nerve block (experimental group) versus drug therapy (control group) for the treatment of acute zoster-associated pain or postherpetic neuralgia were collected according to the criteria for inclusion and exclusion. Literature quality was assessed according to Cochrane Handbook 5.1.0 bias risk assessment tool. The literature data were analyzed using Revman 5.3 software through a Meta-analysis. RESULTS AND CONCLUSION: A total of 11 randomized controlled trials involving 916 patients met the inclusion criteria. The results of Meta-analysis showed that compared with the control group, the ultrasound-guided paravertebral nerve block group had better analgesic effect and the optimal analgesic effect appeared within 1-4 weeks. A random effects model was then used [1st week: Mean difference (MD)=-0.91, 95% confidence interval (Cl) (-1.22, -0.61), P < 0.000 01; 2nd week: MD=-1.11, 95%C/(-1.52, -0.70), P < 0.000 01; 3rd week: MD=-1.26, 95%C/(-1.79, -0.74), P < 0.000 01; 4th week: MD=-0.90, 95%C/(-1.57, -0.24), P=0.007], At the same time, the quality of sleep and the effective rate of treatment were improved, and a fixed effects model was used [odds ratio=3.63, 95%C/(2.38, 5.53), P < 0.000 01]. The statistical results showed significant difference. There was no increase in post-treatment adverse reactions. Therefore, ultrasound-guided paravertebral nerve block is safe and effective for the treatment of zoster-associated pain in the thoracolumbar region.
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BACKGROUND: Pathological mechanism of ossification of the ligamentum flavum is unclear. There is no effective drug or non-surgical treatment in clinical practice. Current studies have found that osteopontin and autophagy play an important role in the process of osteogenesis, but their role in ossification of the ligamentum flavum has not been elucidated. OBJECTIVE: To seek for the potential target of drug therapy by exploring the mechanism of ossification of the ligamentum flavum. METHODS: (1) Surgical specimens of the ligamentum flavum were taken from patients with ossification of the ligamentum flavum, thoracic vertebrae or simple lumbar disc herniation undergoing posterior total laminectomy and decompression. These specimens were divided into two groups: An ossification group and a non-ossification group. Eight specimens from each group were collected. Osteopontin, osteocalcin and autophagy indexes Beclin-1, LC3 and P62 were stained by immunohistochemistry. (2) The ligamentum flavum cells were isolated and cultured by adherence method. The third generation cells were treated with osteopontin at different concentrations for different time to construct an in vitro model of ligamentum flavum ossification. (3) Autophagy inhibitor 3-methyladenine with different concentrations was used to intervene with non-ossified ligamentum flavum cells, followed by induction with 100 μg/L osteopontin. Western blot assay was used to detect the expression of alkaline phosphatase, osteocalcin. (4) Non-ossified ligamentum flavum cells were induced with 100 μg/L osteopontin, and the induction was terminated at 0, 15, 30, 60, and 120 minutes, respectively. The phosphorylation of ERK1/2, JNK and P38, which are important molecules in the MAPK signaling pathway, was detected by western blot. (5) Finally, after inhibition by ERK1/2 phosphorylation blocker U0126, the expression of alkaline phosphatase and osteocalcin was detected by western blot after induction with 100 μg/L steopontin. RESULTS AND CONCLUSION: (1) Immunohistochemical staining of osteopontin and osteocalcin in ossified and non-ossified ligamentum flavum was positive. In the ossified ligamentum flavum, Beclin-1 was positive, but LC3 and P62 were not. Beclin-1, LC3 and P62 were all positive in the non-ossified ligamentum flavum. (2) The expression of alkaline phosphatase and osteocalcin in the ossified ligamentum flavum cells was higher than that in the non-ossified ligamentum flavum cells. Osteopontin could induce ossification of the ligamentum flavum in a concentration- and time-dependent manner. (3) The degree of ossification was negatively correlated with the degree of autophagy, that is, the more obvious autophagy was, the weaker ossification was. (4) Osteopontin could phosphorylate the MAPK signaling pathway in a time-dependent manner. After inhibiting the phosphorylation of MAPK, osteopontin could still induce the ossification of ligamentum flavum cells. To conclude, in the process of ligamentum flavum ossification, the upstream and downstream relationships of ERK1/2, osteopontin, alkaline phosphatase and osteocalcin molecules in signaling pathway are ERK1/2→osteopontin→osteocalcin/alkaline phosphatase.
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Objective: To explore the feasibility and effects of teaching with tissue construction thinking of organ in histology and embryology. Methods: One hundred twenty students from four year 2017 clinical major classes in Mudanjiang medical university, who participated in the study of histology and embryology, were consecutively selected. Traditional teaching mode which is lecture-base learning was used in the control class, while the experimental class was taught by tissue construction thinking of organ, the evaluations were taken at the end, including questionnaires and exam scores of four classes. Results: The experimental class was distinctly superior to the control class in learning interest, innovation ability, self-study ability, manipulative ability, psychological quality and team spirit (P<0.01), and in exam scores also (P < 0.05). Conclusion: Tissue construction thinking of organ is particulary adapted to the teaching of histology and embryology. The thinking can play a vital role in resolving the problems in teaching of Histology and embryology. And it will also help to cultivate high-quality applied medical talents with innovative ability.
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BACKGROUND:Tougu Xiaotong capsule is the clinical prescription for the treatment of osteoarthritis, however, its mechanism has not been fuly elucidated. Urokinase type plasminogen activator system which participated in the degradation of the extracelular matrix of articular cartilage and hyperplasia of joint synovium plays an important role in the pathological process of osteoarthritis. OBJECTIVE: To determine the effect ofTougu Xiaotong capsule on urokinase-type plasminogen activator system in knee cartilage tissues of knee osteoarthritis rats. METHODS: Of 144 Sprague-Dawley rats, 120 rats were randomly made into models of knee osteoarthritisvia intra-articular injection of papain, and randomly assigned to model group,Zhuanggu Guanjie Wan group [1.2 g/(kg?d)], low-doseTougu Xiaotong capsule group [0.092 g/(kg?d)], moderate-doseTougu Xiaotong capsule group [0.184 g/(kg?d)] and high-doseTougu Xiaotong capsule group [0.368 g/(kg?d)]. Each group contained 24 rats. Every 2 weeks was considered as a course, with a 2-day interval, totaly 4 courses. The remaining 24 normal rats were included in the blank group. After every two courses, a batch of experimental animals was sacrificed. The pathological changes were observed folowing staining with hematoxylin and eosin. The positive cels of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor and plasminogen activator inhibitor were measured by immunohistochemistry. The protein levels of urokinase-type plasminogen activator, urokinase-type plasminogen activator receptor and plasminogen activator inhibitor were measured by western blot assay. RESULTS AND CONCLUSION:Mankin’s score was significantly lower in theTougu Xiaotong capsule group and Zhuanggu Guanjie Wan group compared with the model group (P < 0.01), in a time-dependent manner. Immunohistochemical staining indicated that the positive cels of urokinase-type plasminogen activator and urokinase-type plasminogen activator receptor were significantly decreased, but plasminogen activator inhibitor was significantly increased in theTougu Xiaotong capsule group andZhuanggu Guanjie Wangroup in a time-dependent manner. Western blot assay results had an identical trend to immunohistochemistry. These indicated thatTougu Xiaotong capsule showed preventive and therapeutic effects on osteoarthritis by regulating urokinase-type plasminogen activator system.
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BACKGROUND: Vascular endothelial growth factor play an important role in promoting healing of osteoporotic fractures, but whether it can affect the bone mineral density is not clear. OBJECTIVE: To observe the correlation between serum vascular endothelial growth factor, bone mineral density and the number of osteoblasts in the ovariectomized rats. METHODS: Forty female Sprague-Dawley rats were randomly divided into ovariectomized group and control group. After 3 months, the bone mineral density of the whole body, femur and lumbar spine was measured. Rat enzyme-linked immunosorbent assay kit was used to measure the level of serum vascular endothelial growth factor. Then, the rats in two groups received femoral metaphyseal fixation, decalcified, dehydrated, embeding in paraffin, slicing and hematoxylin-eosin staining. Each slice was free to take five fields of view (10×40) in order to count the osteoblasts of femur distal metaphysis under optical microscope. RESULTS AND CONCLUSION: After ovariectomized for 3 months, the rats body mass was increased significantly (P 0.05), and the difference of the osteoblast number between ovariectomized group and control group was not significant (P > 0.05). This indicated that there was no correlation between bone mineral density and the number of osteoblasts and vascular endothelial growth factor level in the ovariectomized group and the control group. These findings suggest that the bone mineral density is reduced and the body mass is increased in the ovariectomized rats, and the reduced bone mineral density of ovariectomized rats may be irrelevant with the change of serum vascular endothelial growth factor.
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BACKGROUND: Now, dual-energy X-ray absorptiometry is international y recognized as gold standard for the diagnosis of osteoporosis, but the errors can be found in the measurement results due to the heterotopic ossification and bone hyperplasia exists in the measurement part. OBJECTIVE: To investigate the clinical significance of bone metabolic markers in the diagnosis and treatment of elderly patients with osteoporotic fractures, and to research its correlation with the changes of pathological histology and bone mineral density. METHODS: Four bone biochemical markers in 50 elderly patients with osteoporosic fractures were measured preoperatively. According to the results, 25 patients had significantly increased tartrate-resistant acid phosphatase 5b (considered as the increased tartrate-resistant acid phosphatase 5b group), and 25 patients had increased bone alkaline phosphatase (considered as the increased bone alkaline phosphatase group). During operation, the bone tissues of eight patients in each group were treated with hematoxylin-eosin staining and electron microscopy scanning in order to detect the pathological changes. After operation, the patients in the increased tartrate-resistant acid phosphatase 5b group received salmon calcitonin anti-osteoporosis treatment, and the patients in the increased bone alkaline phosphatase group received the anti-osteoporosis treatment of bone peptide injection. The bone mineral density and the four bone biochemical markers were detected again at 6 months after treatment. RESULTS AND CONCLUSION: There were no significant differences in the preoperative bone mineral density and four biomechanical markers between two groups (P > 0.05). The pathological examination results of bone tissue on the fracture site showed that the number of osteoblasts was reduced and the number of oeteoclasts was increased in the increased tartrate-resistant acid phosphatase 5b group; while in the increased bone alkaline phosphatase group, the pathological examination results showed the number of osteoblasts was reduced; the trabecular bone/bone area ratio was decreased in two groups, and there was a significant difference in the decrease degree between two groups (P < 0.05). The electron microscope scanning showed that the osteoclasts of two groups were more active than that of the normal group. The sloppy of trabecular bone in the increased tartrate-resistant acid phosphatase 5b group was more obvious than that in the increased bone alkaline phosphatase group, and the absorption vacuoles were increased. There were significant differences in the bone mineral density and four biomechanical markers between two groups before and after anti-osteoporosis treatment (P < 0.05). The detection of bone metabolic markers could help us to make it clearly that the main function of osteoblast reduce or osteoclast increase in bone tissue of patients, and guide us to use anti-osteoporosis drugs in target. Pathological histology examination can better reflect the condition of osteoblasts, osteoclasts and trabecular bone in bone tissue on the fracture site. Target application of anti-osteoporosis drugs in the osteoporosis patients can effectively improve the efficacy and reduce the relative complications.
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BACKGROUND: Therapeutic methods for of peripheral facial nerve injury include surgery, physical therapy and drug treatment, but the treatment effect is not ideal in some certain cases. OBJECTIVE: To study the effect of autologous platelet rich plasma on repair of facial nerve injury. METHODS: The bilateral destroyed buccal nerve branches of the 10 white rabbits were put in silica gel nerve regeneration chamber, one side injected with platelet rich plasma as experimental group, the other side injected with normal saline as control group. The general observation, neuroelectrophysiology detection, histological observation, image analysis and evaluation of facial nerve regeneration recovery were performed at 8 weeks after surgery. RESULTS AND CONCLUSION: The action potential latency of the orbicularis oris at the experimental side was significantly lower than that at the control side, and the action potential amplitude (M wave) of compound nerve muscle of the experimental side was significantly higher than that of the control side (P < 0.01). Compared with the control side, the regenerative nerves of the experimental side were more mature with more regenerative axons, and the differentiation of myelin sheath was more mature and the thickness of myelin sheath was wel -distributed. Meanwhile, the diameters of axons were closed to the normal diameter, and the nerve axons were more intensive and arranged more regularly, the outer membrane of nerve fiber was thicker and the col agen fiber and elastic fiber layer were increased when compared with the control group. The number of regenerative axons of the control side was less, and the axons were distributed irregularly and poorly developed, and a large number of fibrous connective tissues were observed. The vacuolar degeneration at the control side was more than the experimental side. The regenerated nerve in the experimental side was better than the control side in the diameter of myelinated axon, area, myelin sheath thickness and axon count, and there were significant differences between two groups (P < 0.01). It indicates that platelet rich plasma has a promoting effect in the repair and regeneration of facial nerve.
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BACKGROUND: There are different methods to isolate and culture human nucleus pulposus cells, and the differences in digestive enzymes components and digestion time quite are significant. So how to rapidly and efficiently harvest human nucleus pulposus cells has become a research hotspot. OBJECTIVE: To optimize the digestive enzymes components and digestion methods for the preparation of human nucleus pulposus cells. METHODS: Nucleus pulposus tissue specimens were selected from three adult discs in the Department of Orthopedics, China-Japan Union Hospital of Jilin University. The acute traumatic disc tissues that outstanding to the spinal canal were taken under aseptic conditions, and then the peripheral white annulus and jel y-like nucleus pulposus in the center could be seen. According to different mixed enzyme concentration ratio, the samples were divided into two groups. The enzyme Ⅰ group was treated with 0.2% Ⅱ col agenase; and the mixed enzymeⅡ group was digested with 0.25% trypsin for 30 minutes, and then treated with 0.2% Ⅱ col agenase. According to digestion time, each group was divided into three subgroups: 2 hours group, 4 hours group, and overnight group. Final y, suspended cel volume was decided as 2 mL to count cells. Dulbecco’s modified Eagle’s medium containing fetal bovine serum was used for cel culture in vitro. Trypan blue staining was performed to count total cel number and ratio of living cells. Methylthiazolyldiphenyl-tetrazolium bromide assay was used to detect the growth curve of nucleus pulposus cells. RESULTS AND CONCLUSION: Based on the two digestion enzyme concentration, the number of digested cells in the enzyme Ⅰ group was larger than that in the enzyme Ⅱ group after digested for 2 and 4 hours, but the difference was not significant (P > 0.05). Overnight, cellsurvival rate was decreased in the enzyme Ⅰ group after digested for 2 and 4 hours when compared with the enzyme Ⅱ group, and the difference was significant (P < 0.05). After digested for 4 hours, tissue blocks disappeared, and the number of cells reached maximum. The results indicate that enzyme Ⅰgroup composite with Ⅱ col agenase is benefit for the separation of nucleus pulposus cells, and the digestion time is appropriate to 4 hours. This condition has the advantages of simple operation, high efficiency and low cost, and it considered that digestion of nucleus pulposus tissues with 0.2% Ⅱ col agenase for 4 hours is the best condition to obtain nucleus pulposus cells.
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BACKGROUND: Icari n as one of the main components of Epimedium has an inhibitory effect on osteoclasts.. OBJECTIVE: To further investigate the influence of icariin on the root absorption of the maxil ary first molar at mesial part during orthodontic treatment in rats. METHODS: Orthodontic root resorption models were established in the left maxil a of rats. Local injection of 200 mg/kg icari n (icari n group) or normal saline (positive control group) was administrated into the left first molar buccal periosteum. The right maxil a of rats served as negative control group that was treated with neither appliance nor drug injection. The mesial distance between bilateral first molars and the contralateral maxil ary incisor was measured before and after the appliance was placed. Mesial surface of the mesial root of bilateral maxil ary first molars was observed using scanning electron microscope. RESULTS AND CONCLUSION: Mesial movement of the maxil ary molars in the icari n group was significantly less than that in the positive control group (P < 0.05). Under the scanning electron microscope, smal absorption lacunae were scattered in the icari n group, while the positive control group showed a large amount of absorption lacunae and they were interconnected into a sheet, showing a stark contrast with the smooth root surface of the negative control group. It is indicated that icari n can inhibit root resorption caused by orthodontic treatment, while reducing the amount of mesial movement of the molar under corrective force.
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BACKGROUND: Rapid expansion of the dental arch is an effective way to rapidly expanse the jaw. Compared with rapid expansion, the slow expansion has higher stability and less recurrence, but the reports on the long-term stability of quad helix expansion are rare. OBJECTIVE: To retrospectively analyze the clinical effect of quad helix expansion in orthodontics. METHODS: Twenty-two subjects with dental arch stenosis in mixed dentition and early permanent dentition who experienced an expansion of at least 3 mm with quad helix appliance were selected for this study. Plaster dental casts and posteroanterior radiographs were evaluated at the beginning of the treatment (T1), at the completion of phase I quad helix expansion or ful treatment (T2), and approximately 2 years fol owing the completion of treatment (T3). The distance between two first molars was measured on the model. J point was drawn on the posteroanterior radiograph in order to measure the distance between the bilateral base bones and the molar inclination, as wel as to evaluate the corrective and orthopedic effects of dental arch expansion. RESULTS AND CONCLUSION: Compared with that before expansion, the first permanent molar inclination and the distance between base bones on two sides were significant increased after quad helix expansion; there were no significant differences in the distance between two first permanent molars, first permanent molar inclination and the distance between bilateral base bones on two sides when compared after quad helix expansion and after 2-year fol ow-up (P > 0.05). The results indicate that the long-term effect of quad helix expansion is stable with orthopedic effect.
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BACKGROUND: The cel density is one of the factors involved in the state of cel differentiation, and the effect of cel density on transforming growth factor-β1-induced epithelial-mesenchymal transition of HaCaT cells is stil unclear. OBJECTIVE: To observe the effect of cel density on transforming growth factor-β1-induced epithelial-mesenchymal transition of HaCaT cells. METHODS: HaCaT cells was seeded in 6-wel plates at low density of 103/cm2 and high density of 105/cm2 then treated by 2 μg/L transforming growth factor-β1 for 48 hours, thereafter observed the changes in cel morphology. The transcription levels of epithelial cadherin, tight junction protein-1, vimentin, neuronal-cadherin were detected by real-time PCR, and expression levels of epithelial cadherin and vimentin were detected by Western blot. RESULTS AND CONCLUSION: Cel gap of HaCaT cells grew larger after treated with transforming growth factor-β1 for 48 hours, and cel morphology was long spindle rather than polygonal in low-density group, while in high-density group without obvious morphological changes. The real-time PCR showed that the transcriptions of epithelial cel marker epithelial cadherin and tight junction protein-1 were suppressed when compared with the control group (P < 0.05), and the decreasing deree in the high-density group was higher than that in the low-density group (P <0.05), mesenchymal cel marker neuronal-cadherin and vimentin were upregulated in the high-density group and the low-density group when compared with the control group (P < 0.05), and there were no significant differences between high-density group and low-density group. Western blot results verified the changes of neuronal-cadherin and vimentin expression level. These results suggest that the high seeding density can inhibit transforming growth factor-β1-induced epithelial-mesenchymal transition of HaCaT cells.
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BACKGROUND: Dlx gene family is highly expressed in the cranial neural crest cells, and regulates the cranial neural crest cel migration and differentiation. OBJECTIVE: To review the mechanism that the highly-expressed Dlx genes mediate the cranial neural crest cel migration and differentiation. METHODS: An online search of CNKI and Medline databases was performed for articles published before 2013 using keywords of “cranial neural crest cells, migration of cranial neural crest cells, Dlx, Dlx overexpression, Fgf, chodrogenesis, osteogenesis” in Chinese and English, respectively. Relevant articles were summarized from three aspects: the migration of cranial neural crest cells, Dlx over-expression’s impact on the migration of cranial neural crest cells, interaction between the environment and Dlx genes. A total of 63 articles were included. According to inclusion criteria, 43 articles were retained at last. RESULTS AND CONCLUSION: Dlx abnormal-expression wil lead to cel -cel adhesion. Dlx over-expression wil induce most of the cranial neural crest cells aggregate and migrate to a wrong place, and result in skeletal dysmorphology. Dlx over-expression wil also lead to ectopic chondrogenesis, and the interaction between cel factors can be the possible reason for this.
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BACKGROUND: p38 mitogen-activated protein kinase signal transduction pathway is a member of the mitogen-activated protein kinase family. It plays an important role in the development of osteoarthritis. OBJECTIVE: To review the progress of p38 mitogen-activated protein kinase signal transduction pathway in the pathological process of osteoarthritis. METHODS: An online search of CNKI and PubMed databases was performed for articles using keywords of “p38 mitogen-activated protein kinase signal transduction pathway, osteoarthritis, articular cartilage, chondrocyte” in Chinese and English, respectively. Relevant articles were summarized from three aspects of introduction of p38 signal transduction pathway, the role of p38 mitogen-activated protein kinase signal transduction pathway in osteoarthritis and the inhibitor of p38 in osteoarthritis. A total of 90 articles were included. According to inclusion criteria, a number of 46 articles were retained at last. RESULES AND CONCLUSION: p38 mitogen-activated protein kinase signal transduction pathway has a close relation with chondrocyte hypertrophy and calcification, chondrocyte apoptosis, synthesis of cartilage matrix metal oproteinase, production of proinflammatory cytokines, and exerts a significant effect on the development of osteoarthritis. p38 mitogen-activated protein kinase is involved in the formation and development of osteoarthritis through a variety of complex mechanisms and plays a very important role. Therefore, blocking p38 mitogen-activated protein kinase signaling pathway may be a new target in the treatment of osteoarthritis.
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10.3969/j.issn.2095-4344.2013.24.003
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10.3969/j.issn.2095-4344.2013.24.006
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10.3969/j.issn.2095-4344.2013.24.008
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10.3969/j.issn.2095-4344.2013.24.010
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10.3969/j.issn.2095-4344.2013.24.014
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10.3969/j.issn.2095-4344.2013.24.023
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10.3969/j.issn.2095-4344.2013.24.024