Efficacy of percutaneous cement-augmented screw fixation plus percutaneous kyphoplasty in the management of unstable osteoporotic vertebral compression fractures.

OBJECTIVE: The present study was performed to compare the efficacy of percutaneous kyphoplasty (PKP) vs. percutaneous cement-augmented screw fixation plus PKP in the management of unstable osteoporotic vertebral compression fractures (OVCF). PATIENTS AND METHODS: A total of 197 patients with unstable OVCF treated in the Department of Spine Surgery, Lianyungang First People's Hospital from September 2019 to September 2021 were recruited and assigned via random number table method 1:1 to receive either PKP (group A, n=106) or PKP plus percutaneous cement-augmented screw fixation (group B, n=91). The outcome measures for the evaluation of different surgical methods included visual analogue scale (VAS), the height of the anterior-posterior border of the injured spine, Cobb angle of the posterior convexity, Oswestry disability index (ODI) scores, and Japanese Orthopaedic Association (JOA) scores. RESULTS: PKP exhibited shorter operative time and length of hospital stay and less intraoperative blood loss vs. PKP plus percutaneous cement-augmented screw fixation (p<0.05). Patients with PKP plus percutaneous cement-augmented screw fixation experienced milder postoperative pain vs. those with PKP alone at 7 days postoperatively, as evidenced by the lower VAS scores (p<0.05). PKP plus percutaneous cement-augmented screw fixation provided more restoration of anterior margin height and posterior convexity Cobb angle vs. PKP alone (p<0.05). Patients with PKP only showed slightly higher Japanese Orthopaedic Association (JOA) scores than those with combined surgery, while the postoperative clinical signs between the two arms were similar (p>0.05). CONCLUSIONS: Single PKP features the benefits of minimal trauma, simple operation, and rapid postoperative recovery in the treatment of OVCF. PKP plus percutaneous cement-augmented screw fixation for severe OVCF provided distinctly better performance than PKP alone in terms of early pain relief, restoration of vertebral body height, correction of posterior convexity deformity, and firm spinal stability.

Efficacy of minimally invasive transforaminal lumbar interbody fusion plus cement-augmented pedicle screw fixation in the treatment of degenerative lumbar spine disease with osteoporosis in the elderly.

OBJECTIVE: The aim of this study was to evaluate the efficacy of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) plus cement-augmented pedicle screw fixation in the treatment of degenerative lumbar spine disease with osteoporosis in the elderly. PATIENTS AND METHODS: From February 2020 to January 2021, 40 elderly patients with degenerative lumbar spine disease with osteoporosis admitted to our hospital were randomly assigned (1:1) to receive either MIS-TLIF plus cement-augmented pedicle screw fixation (group A) or TLIF plus cement augmentation (group B), with 19 cases in group A and 21 cases in group B. Outcome measures included visual analogue scale (VAS), Oswestry Dysfunction Index (ODI) and Japanese Orthopedic Association Scores (JOA), operative duration, intraoperative bleeding, postoperative drainage volume, and the incidence of complications. Frontal and lateral radiographs of the lumbar spine and computed tomography (CT) were performed 3 days after surgery to observe the distribution of bone cement. At 12 months postoperatively, the fusion of the bone graft was evaluated according to the Bridwell intervertebral fusion criteria based on the lumbar frontal and lateral radiographs. RESULTS: All 40 cases completed the surgery successfully and were followed up for 12 months. The two groups did not differ significantly in terms of operative duration (p>0.05). MIS-TLIF plus cement-augmented pedicle screw fixation was associated with significantly less intraoperative bleeding volume (142.25±40.93 mL) and (76.25±17.54 mL) vs. TLIF plus cement augmentation (322.00±93.45 mL, 159.75±54.74 mL) (p<0.05). The difference in the VAS scores, ODI, and JOA scores between the two groups preoperatively and at the final follow-up showed no statistical significance (p>0.05). Patients receiving MIS-TLIF plus cement-augmented pedicle screw fixation had significantly lower VAS scores and ODI and higher JOA scores vs. TLIF plus cement augmentation (p<0.05). The lumbar frontal and lateral radiographs and CT of the two groups 3 days after surgery showed good cement distribution and no cement leakage. At the final follow-up, no complications were seen in group A, and there was one case of intervertebral cement leakage in group B. The intervertebral graft fusion was grade I in both groups. CONCLUSIONS: MIS-TLIF plus cement-augmented pedicle screw fixation shortens the operative time, alleviates postoperative pain, facilitates operative lumbar spine function restoration, and provides favorable intervertebral implant fusion.

Palmatine, a protoberberine alkaloid, inhibits both Ca(2+)- and cAMP-activated Cl(-) secretion in isolated rat distal colon.

BACKGROUND AND PURPOSE: The protoberberine alkaloid berberine has been reported to inhibit colonic Cl(-) secretion. However, it is not known if other protoberberine alkaloids share these effects. We have therefore selected another protoberberine alkaloid, palmatine, to assess its effects on active ion transport across rat colonic epithelium. EXPERIMENTAL APPROACH: Rat colonic mucosa was mounted in Ussing chambers and short circuit current (I (SC)), apical Cl(-) current and basolateral K(+) current were recorded. Intracellular cAMP content was determined by an enzyme immunoassay. Intracellular Ca(2+) concentration was measured with Fura-2 AM. KEY RESULTS: Palmatine inhibited carbachol-induced Ca(2+)-activated Cl(-) secretion and the carbachol-induced increase of intracellular Ca(2+) concentration. Palmatine also inhibited cAMP-activated Cl(-) secretion induced by prostaglandin E(2) (PGE(2)) or forskolin. Palmatine prevented the elevation of intracellular cAMP by forskolin. Determination of apical Cl(-) currents showed that palmatine suppressed the forskolin-stimulated, apical cAMP-activated Cl(-) current but not the carbachol-stimulated apical Ca(2+)-activated Cl(-) current. Following permeabilization of apical membranes with nystatin, we found that palmatine inhibited a carbachol-stimulated basolateral K(+) current that was sensitive to charybdotoxin and resistant to chromanol 293B. However, the forskolin-stimulated basolateral K(+) current inhibited by palmatine was specifically blocked by chromanol 293B and not by charybdotoxin. CONCLUSIONS AND IMPLICATIONS: Palmatine attenuated Ca(2+)-activated Cl(-) secretion through inhibiting basolateral charybdotoxin-sensitive, SK4 K(+) channels, whereas it inhibited cAMP-activated Cl(-) secretion by inhibiting apical CFTR Cl(-) channels and basolateral chromanol 293B-sensitive, KvLQT1 K(+) channels.

In vivo and in vitro evaluation of erianin, a novel anti-angiogenic agent.

This study evaluated the anti-angiogenic activities of erianin in vivo and in vitro. Erianin, a natural product from Dendrobium chrysotoxum, caused moderate growth delay in xenografted human hepatoma Bel7402 and melanoma A375 and induced significant vascular shutdown within 4 h of administering 100 mg/kg of the drug. Erianin also displayed potent anti-angiogenic activities in vitro: it abrogated spontaneous or basic fibroblast growth factor-induced neovascularisation in chick embryo; it inhibited proliferation of human umbilical vein endothelial cells (EC(50) 34.1+/-12.7 nM), disrupted endothelial tube formation, and abolished migration across collagen and adhesion to fibronectin. Erianin also exerted selective inhibition toward endothelial cells, and quiescent endothelium showed more resistance than in proliferative and tumour conditions. In a cytoskeletal study, erianin depolymerised both F-actin and beta-tubulin, more significantly in proliferating endothelial cells than in confluent cells. In conclusion, erianin caused extensive tumour necrosis, growth delay and rapid vascular shutdown in hepatoma and melanoma models; it inhibited angiogenesis in vivo and in vitro and induced endothelial cytoskeletal disorganisation. These findings suggest that erianin has the therapeutic potential to inhibit angiogenesis in vivo and in vitro.

The electroretinogram in patients with retinal vascular occlusion.

PURPOSE: To measure and analyze the electroretinogram (ERG) in patients with retinal vascular occlusion. METHOD: Fifty-eight cases (59 eyes) of retinal vascular occlusion and the fellow eyes of 47 cases were tested with Ganzfeld ERG. The scotopic and photopic ERG, and oscillatory potentials were tested according to the ERG standard of ISCEV. RESULTS: The abnormal rates of OPs and b wave were higher in retinal vascular occlusion. The abnormal ERG appeared mostly in CRVO among four types of retinal vascular occlusion. The comparisons of some amplitudes and latencies between the fellow eyes and the affected eyes showed statistically significant difference. CONCLUSION: The oscillatory potentials and b waves have important roles in evaluating the retinal function of patients with retinal vascular occlusions. There are some clinical significance for comparing ERG between the affected eye and the fellow eye.

Motion perception of short-wavelength sensitive cones in glaucoma using random dots moving.

PURPOSE: To determine whether motion perception of short-wavelength sensitive(SWS) cones is capable of predicting primary open angle glaucoma(POAG) optic neuropathy. METHODS: Motion perceptions of SWS cones were isolated by Blue random dot stimulus displayed on the Yellow background, then the detecting displacement threshold of motion perception from SWS cone in POAG was measured, and compared with the age-matched normal group. RESULTS: The detecting displacement thresholds of motion perception from SWS cones in 8 sites of 15 degrees were all elevated in POAG compared with the normal group. CONCLUSION: These findings suggest that motion perception of SWS cones may reveal preclinical visual nerve damage in early POAG.

[Effect of satragaloside IV on the increase of microvascular permeability induced by histamine in pial microvessels of rat].

OBJECTIVE: To study the effect of satragaloside IV on the microvascular permeability induced by histamine in pial microvessels. METHOD: The microvascular permeability was expressed by changes in the transendothelial electrical resistance which was measured with technique using microelectrode impaled into the vascular lumen and based on cable analysis of vessels in rat. RESULT: The transendothelial electrical resistance of microvessels superfused with artificial cerebrospinal fluid was about 2500 omega.cm2, indicating a tight barrier with extremely low ion permeability, and application of 10(-4) mol.L-1 histamine in superfusate caused a rapid and reversible decrease in transendothelial electrical resistance. In paired experiment, the decrease of transendothelial electrical resistance induced by 10(-4) mol.L-1 histamine was inhibited by adding 0.8 x 10(-4) mol.L-1 satragaloside IV in superfusate. CONCLUSION: The results indicated that increases in the microvascular permeability induced by histamine, and satragaloside IV can inhibit the increases in the microvascular permeability induced by histamine. It is necessary that the cellular mechanism of permeability response induced by satragaloside IV be further elucidated.

A comparative evaluation of Humphrey perimetry and the multi-channel pattern visual evoked potentials.

PURPOSES: To compare the multi-channel pattern visual evoked potentials to Humphrey perimetry in the assessment of central visual function in primary open angle glaucoma. METHODS: The multi-channel checkerboard reversal PVEPs waves to full-field and half-field stimulus of 25 normal persons and 74 patients with primary open angle glaucoma were recorded and analyzed, All patients were examined using Humphrey Field Analyzer. The area of visual field corresponding to the area of retina stimulated during multi-channel PVEPs testing were analysed, straight-line correlation and regression analyses of the various multi-channel PVEPs parameters and the total dB losses were performed. RESULTS: The multi-channel PVEPs demonstrated a low detection rate compared with Humphrey perimetry in the early glaucoma, absolute latency and field loss were correlated in the late stage of glaucoma, and absolute amplitude and field loss were not correlated. CONCLUSIONS: In relation to signalling "early" loss the multi-channel PVEPs was inferior to Humphrey perimetry, in late loss of primary open angle glaucoma, multi-channel PVEPs can provide a valuable, objective complement to Humphrey perimetry.

Detection of glutamate and gamma-aminobutyric acid in vitreous of patients with proliferative diabetic retinopathy.

PURPOSE: To study the levels of glutamate and gamma-aminobutyric acid (GABA) in vitreous of patients with proliferative diabetic retinopathy (PDR) and to investigate their roles in retinal ischemia. METHOD: Vitreous samples were collected from 25 patients (27 eyes) with PDR and 14 patients (14 eyes) with idiopathic macular hole. Glutamate and GABA detection were performed by high-performance liquid chromatography (HPLC). RESULTS: Patients with PDR had significantly higher concentrations of glutamate and GABA than the control group. The glutamate level has a significantly positive correlation with GABA level. CONCLUSION: Detection of glutamate and GABA in vitreous provides biochemical support for the mechanism and treatment of ischemic retinal damage in patients with PDR.

[The clinical application of different brightness and different saturation D-15 tests].

PURPOSE: To compare the clinical application of different brightness and different saturation D-15 tests. METHODS: Eighteen normal subjects (30 eyes), 19 cases (38 eyes) of congenital color vision defects and 36 cases (59 eyes) of eye diseases were tested with Panel D-15 test, Hann's double D-15 test, middle and low saturation CAS-PI (Psychological Institute, Chinese Academy of Sciences) D-15 tests. RESULTS: A few of the normal eyes made minor errors in the low saturation D-15 tests. All of the protanopes and deuteranopes could be detected correctly. Protanomalias and deuteranomalias showed normal arrange or some type of abnormal arranges in all of the 5 sets of D-15 tests. In sick eyes, the abnormal rates were the highest in the low saturation D-15 tests and the lowest in Panel D-15 test. CONCLUSION: The five sets of different brightness and different saturation D-15 tests had similar efficiencies of detecting congenital color vision defects. The abnormal rates of CAS-PI(4/5)D-15 tests and the CAS-PI(2/5)D-15 tests were similar to those of Panel D-15 test and Hann's Double D-15 test. Both tests can be used in the clinical setting.

[Effects of components isolated from Astragalus membranaceus Bunge on cardiac function injured by myocardial ischemia reperfusion in rats].

OBJECTIVE: To investigate the effects of components isolated from Astragalus membranaceus on myocardial ischemia reperfusion injury. METHODS: The myocardial ischemia reperfusion injury model was created by the left anterior descending coronary artery occlusion from the oracotouated rats, and the total saponins, total flavonids and astragaloside i.v. isolated from A. membranaceus on hemodynamics during acute myocardial ischemia, Na(+)-K(+)-ATPase activity, cAMP and malondialdehyede (MDA) contents in the ischemic myocardium were observed. RESULTS: The total saponins, total flavonids and astragaloside i.v. attenuated the declines of the amplitudes of LVSP and +/- LVdp/dtmax in rat heart injured by ischemia reperfusion in vivo, and decreased Na(+)-K(+)-ATPase activity in the ischemic myocardium. Otherwise, the total saponins increased the cAMP content and the total flavonids decreased the level of MDA production in the ischemic myocardium. CONCLUSION: The effects of different components isolated from A. membranaceus on protecting the cardiac function in the process of ischemia reperfusion may be related to the mechanism of improving energy metabolism, scavenging the oxygen free radicals and inhibiting the production of free radicals in the ischemic myocardium.

Elevated vascular endothelial growth factor levels in the vitreous of patients with proliferative diabetic retinopathy.

OBJECTIVE: To detect the levels of vascular endothelial growth factor (VEGF) in the vitreous of patients with proliferative diabetic retinopathy (PDR) and to investigate the possible role of VEGF in the development of neovascularization in PDR. METHODS: Undiluted vitreous samples and fasting venous blood samples were obtained from 27 patients with PDR and 14 subjects with idiopathic macular hole who underwent pars plana vitrectomy. The concentration of VEGF was determined by quantitative enzyme-linked immunosorbent assay (ELISA). RESULTS: The level of vitreous VEGF in patients with PDR (median 0.41 ng/ml, range 0.09-11.56 ng/ml) was significantly elevated when compared with that in control subjects (median 0.017 ng/ml, range 0.008-0.04 ng/ml) (P < 0.001). The median of PDR patients' serum VEGF concentration was 0.19 ng/ml (0.090.46 ng/ml) which was far lower than vitreous VEGF concentration (P < 0.05). Vitreous VEGF concentration was higher in PDR patients with retinal detachment than that in patient without retinal detachment (P < 0.05). CONCLUSIONS: Vitreous levels of VEGF were remarkably elevated in eyes with PDR, and they were not influenced by its serum concentrations. VEGF played an important role in neovascularization of PDR.

Characteristics of indocyanine green angiography in exudative age-related macular degeneration.

OBJECTIVE: To observe the characteristics of indocyanine green angiography (ICGA) in exudative age-related macular degeneration (AMD). METHODS: Thirty-one cases (39 eyes) were diagnosed as exudative AMD by ocular examination, fundus color photography, fundus fluorescein angiography (FFA) and ICGA. Their ages ranged from 50 to 82 years and visual acuities from FC/30 cm to 0.7. We analyzed and compared the characteristics of ICGA and FFA in these patients. RESULTS: Of 26 eyes with occult choroidal neovascularization (CNV) by FFA, 15 (57.7%) had classic CNV by ICGA. Of 4 eyes with serous retinal pigment epithelial detachment (PED) without CNV by FFA, 1 had serous PED with classic CNV by ICGA. The hyperfluorescence of the scar staining was detecfed by ICGA. CONCLUSION: ICGA adds clinically useful information and is an important adjunct in the evaluation, classification, and laser treatment of patients with occult CNV in AMD.

Gene therapy for human hepatocellular carcinoma with cytosine deaminase gene and prodrug flucytosine.

AIM: To investigate the antitumor effects of cytosine deaminase (CD) gene in combination with prodrug flucytosine (Flu, 5-fluorocytosine) on human hepatocellular carcinoma. METHODS: CD gene was transduced into human hepatocellular carcinoma cell line SMMC7721 with retroviral method and the cytotoxicity of Flu on the tumor cells was assayed in vitro with clonogenic techniques. The xenograft tumor model in nude mice was used to study in vivo therapeutic effects of CD gene/Flu system against human hepatocellular carcinoma. RESULTS: CD gene/Flu system had significant antitumor activities on human hepatocellular carcinoma cells in vitro and in nude mice. The antitumor activities of Flu 500 mg.kg-1 on hepatocellular carcinoma xenografts in nude mice were more potent than those of 5-fluouracil 10 mg.kg-1. CD gene/Flu system possessed bystander killing effects on hepatocellular carcinoma xenografts in nude mice. CONCLUSION: The experiment demonstrates the potential value of the CD gene/Flu system in the treatment of human hepatocellular carcinoma.

Analysis of oscillatory potentials of flash electroretinogram in frequency domain and time domain in retinal vein occlusion.

PURPOSE: To analyse the parameters of frequency domain and time domain of the OPs in branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). METHODS: OPs from 9 eyes of BRVO, 9 eyes of CRVO and 40 normal control eyes were tested. The frequency spectra of the OPs were derived through Fast Fourier Transform (FFT). The mean frequency spectra, the total power, the maximum magnitude, the maximum power and the dominant frequency in frequency domain of the OPs from the eyes of BRVO, CRVO and the normal control group were compared with each other. The OPs waveforms were reconstructed with the OPs frequency spectra data by counter-FFT. In time domain, the latencies, the amplitudes and the sum of the amplitudes of the four wavelets of OPs were measured and compared in the above subjects. RESULTS: There were no statistically significant differences in the magnitudes of frequency spectra, the total power, the maximum magnitude and the maximum power in the frequency range from 110 to 250 Hz between BRVO and normal subjects. However, in BRVO, the dominant frequency decreased significantly, the latencies of the first to the third OPs wavelet prolonged significantly, the amplitudes of the first and the second OPs wavelet and the summed amplitude of the four OPs wavelets attenuated significantly. Comparing the results of CRVO with those of normal subjects, there were statistically significant decrease in the magnitudes of frequency spectra from 150 to 180 Hz, there were statistically significant decrease in the total power, the maximum magnitude, the maximum power and the dominant frequency in the frequency range from 110 to 250 Hz, the latencies of the first to the fourth OPs wavelet prolonged significantly, the amplitudes of the first to the third OPs wavelet and the summed amplitude of the four OPs wavelets attenuated significantly. CONCLUSION: Some parameters of OPs in frequency domain and time domain are abnormal in branch retinal vein occlusion and in central retinal vein occlusion, which is more marked in the latter.

The multi-channel VEP topographies in patients with late-stage glaucoma.

PURPOSE: To study the clinical application of multi-channel VEP topographies in patients with late-stage glaucoma. METHODS: The multi-channel checkerboard reversal VEP waves of 25 normal persons and 15 patients with late-stage glaucoma were recorded and analyzed, All patients were examined using Humphrey Field Analyzer. The VEP topographies of multi-channel VEP waves were shown by computer processing system. RESULTS: In normal subjects, the topographies showed symmetric distribution to full-field pattern stimulation. In all patients with late-stage glaucoma, even whose visual field was severely damaged, multi-channel VEP could be recorded, All channels showed simple 'NPN' wave form, N1, N2 waves were not conspicuous, even both were lost, all channels showed the reduced amplitudes of P1 waves, and longer latency. The multi-channel VEP topographies showed irregular distribution, Some showed amplitude asymmetry, other limited or widespread, lateralized. CONCLUSIONS: Despite the severely damaged visual field, the patients with late-stage glaucoma showed special multi-channel VEPs topographies, Multi-channel VEP topographies should be useful in following up patients suffering from late-stage glaucoma and studying visual processing in human brain.

The study of local electrophysiology in macular diseases.

PURPOSES: To observe the features and clinical utility values of local electroretinogram (LERG) and local visual evoked potentials (LVEP) in macular diseases. METHODS: The spot stimuli were obtained by changing the shutters with different sizes of hole at the posterior of Ganzfeld ball. The recording electrode for LERG was made with the filament of platinum as blepharophthalmostat like. The LERG and LVEP were simultaneously recorded in macular diseases. RESULTS: The exudative AMD, Stargardt's disease, central serous chorioretinopathy and idiopathic macular hole had seriously decreased amplitudes of LERG and higher abnormal rates, comparing with atrophic AMD and idiopathic preretinal membranes in the region of 2.5 degrees and 5 degrees at macula. The abnormal rates in these diseases were higher for LERG than for LVEP. CONCLUSION: The LERG can objectively measure the variation of macular function in maculopathies. The sensitivities of LVEP are lower than those of LERG for macular diseases.

[Objective assessment of visual acuity with visual evoked potential].

PURPOSE: To study the technique for objectively assessment of visual acuity with Pattern Visual Evoked Potential (PVEP) and Discrete Fourier Transform (DFT). METHOD: Thirty-three normal eyes were tested in this study. Reversal square-wave gratings of eight different sizes (30, 20, 18, 12, 10, 6, 4, 2 min. of arc) were used as stimuli. The reversal rate of the stimuli was 10 times/sec. The harmonic amplitudes of VEP at 10 Hz were calculated with Discrete Fourier Transform. A relation curve between the harmonic amplitude and the size of grating was plotted from the data of each tested eye. Regression line was fitted to the data points in the approximately linear section of the curve which is near the threshold of zero amplitude. The threshold of the grating size was obtained by extrapolating of the regression line to zero amplitude, and the visual acuity was assessed with the threshold. RESULT: In seventy percent of tested eyes, the visual acuities assessed with VEPs were consistent with those measured with the International Standard Test Chart. CONCLUSION: The VEP technique for visual acuity assessment is reliable.

[Indocyanine green choroidal angiography in macular hemorrhage of uncertain origin].

PURPOSE: To search for the underlying pathology of macular hemorrhage of uncertain origin with Fundus Fluorescein Angiography (FFA). METHODS: 18 Patients (20 eyes) were tested and analyzed using Indocyanine Green Choroidal Angiography (ICGCA). RESULTS: ICGCA clearly demonstrated the underlying pathology of macular hemorrhage as the choroidal neovascularization secondary to age-related macular degeneration (14 eyes), abnormality of retinal vascular (3 eyes) and accidental macular hemorrhage (3 eyes). CONCLUSIONS: The results showed that ICGCA is very usefull for detecting the underlying pathology of macular hemorrhage of uncertain origin.

[Effect of levodopa on visual evoked potential in amblyopia].

PURPOSE: To evaluate the efficacy of levodpa treatment for amblyopia. METHODS: The patients with amblyopin were given a single dose of levodopa, and the normal control group was established with the other normal eye in unilateral amblyopia. Their pattern visual evoked potential(PVEP) were tested before and after taking levodopa. RESULTS: After taking a single dose of levodopa, the PVEP in the normal eyes showed that the N1P1 amplitudes evoked by middle spatial frequency stimuli and the P1N2 amplitudes evoked by high spatial frequency stimuli increased, however, in the amblyopic eyes showed that the N1 latency evoked by low spatial frequency stimuli and P1 latency evoked by middle spatial frequency decreased. CONCLUSION: A single dose of levodopa administration can induce improvement of PVEP in the amblyopic eyes, and levodopa may be efficacious in the amblyopic therapy.