[Visual trephine arthroplasty assisted percutaneous transforaminal endoscopic discectomy for lumbar disc herniation].

OBJECTIVE: To compare the clinical efficacy between visual trephine arthroplasty assisted percutaneous transforaminal endoscopic discectomy (VPTED) and traditional percutaneous transforaminal endoscopic discectomy(PTED) in the treatment of lumbar disc herniation. METHODS: The clinical data of 60 patients with lumbar disc herniation admitted from June 2019 to December, 2020 was retrospectively analyzed. There were 38 males and 22 females, aged from 26 to 58 years old with an average of (43.63±8.48) years, 47 cases were on L4,5 segment and 13 cases were on L5S1 segment. Among them, 32 were treated with VPTED (group A) and 28 were treated with traditional PTED (group B). The general conditions of all the patients were recorded, including intraoperative fluoroscopy times, operation time, hospital stay and surgical complications during follow-up. The arthroplasty area ratio was observed by sagittal CT at the middle level of the intervertebral foramen. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score of low back pain, Oswestry disability index (ODI) were used to evaluate the clinical efficacy between two groups. RESULTS: All patients were followed up from 9 to 15 months with an average of (12.10±1.16) months. There was no statistical difference of preoperative general data between two groups. The operation time, fluoroscopy times and hospital stay were (70.47±5.87) min, (13.66±1.34) times and (6.31±0.69) d in group A, and (90.71±7.66) min, (22.82±2.48) times and (6.54±0.92) d in group B. The operation time and intraoperative fluoroscopy times in group A were lower than those in group B(P<0.05). There was no significant difference in hospital stay between two groups (P>0.05). No obvious surgical complications were found during the follow-up in both groups. The arthroplasty area ratio in group A was (29.72±2.84)% and (29.57±2.20)% in group B, respectively, with no significant difference (P>0.05). There was no significant difference in VAS, ODI and JOA score between two groups before operation and at the final follow-up(P>0.05), but the final follow-up was significantly improved(P<0.05). CONCLUSION: The two surgical methods have definite clinical efficacy in the treatment of lumbar disc herniation. Visual trephine arthroplasty assisted percutaneous transforaminal endoscopic discectomy has the advantages of high efficiency and rapidity when establishing the channel, and can significantly reduce the operation time and intraoperative fluoroscopy times.

Autophagy Attenuates MnCl2-induced Apoptosis in Human Bronchial Epithelial Cells.

OBJECTIVE: To investigate the role of autophagy in MnCl2-induced apoptosis in human bronchial epithelial 16HBE cells. METHODS: Cell proliferation was measured by MTT assay. Mitochondrial membrane potential (MMP) and apoptosis were measured by flow cytometry. Autophagic vacuoles were detected by fluorescence microscopy. Cellular levels of apoptosis and autophagy-related proteins were measured by western blotting. RESULTS: 16HBE cell proliferation was inhibited by MnCl2 in a dose- and time-dependent manner. MnCl2-induced 16HBE cell growth inhibition was related to MMP depolarization prior to the induction of apoptosis. Our data revealed that MnCl2-induced apoptosis in 16HBE cells was mediated by decreased expression of Bcl-2 and increased levels of cleaved caspase-3. It was observed that when we exposed 16HBE cells to MnCl2 in a dose-dependent manner, the formation of autophagic vacuoles and the levels of LC-3B-II were elevated. RNA interference of LC3B in these MnCl2-exposed cells demonstrated that MMP loss and apoptosis were enhanced. Additionally, the pan-caspase inhibitor Z-VAD-FMK increased the cellular levels of Bcl-2 and decreased apoptosis, but did not affect the cellular levels of LC3B in MnCl2-treated 16HBE cells. CONCLUSION: MnCl2 dose- and time-dependently inhibits 16HBE cell proliferation and induces MMP loss and apoptosis. Autophagy acts in a protective role against MnCl2-induced apoptosis in 16HBE cells.

Cancer incidence in urban Shanghai, 1973-2010: an updated trend and age-period-cohort effects.

BACKGROUND: To provide a comprehensive overview of temporal trends in cancer incidence during 1973-2010 in urban Shanghai. METHODS: The estimated annual percent changes (EAPCs) for the whole period and for the time segments in age-standardized incidence rates (ASR) were evaluated with Joinpoint analysis. Age-period-cohort (APC) models were modeled to examine the effects of age, period and birth cohort on cancer incidence. RESULTS: The overall ASR decreased slightly and significantly in males (EAPC of -0.41) but increased significantly in females (EAPC of 0.57) during 1973-2010 in urban Shanghai. The incidence trend was not linear and varied by time segments. During the most recent 10 years (2001-2010), the ASR in males decreased by 1.65% per year and stabilized in females. Incidence rates continued to decline during 1973-2010 for esophagus, stomach, and liver cancer in both sexes, as well as male lung cancer and cervix cancer. It should be noted that it was the first time to document a significant decline in lung cancer incidence among males during 1973-2010 with EAPC of -0.58%, and a notable upward for cervix cancer since 1996 with EAPC of 8.94%. Unfavorable trends in incidence were observed for the most common cancer sites in the 38 years period: colorectum, gallbladder & biliary tract, pancreas, kidney, bladder, brain & central nervous system (CNS), thyroid, non-Hodgkin's lymphoma (NHL), prostate, female breast, corpus uteri, and ovary. APC analysis showed age, period and birth cohort yielded different effects by cancer sites. CONCLUSIONS: The observed trends primarily reflect dramatic changes in socioeconomic development and lifestyles in urban Shanghai over the past four decades.

Pedestrian injuries and the relevant burden in shanghai, china: implications for control.

OBJECTIVE: To study the associations of pedestrian injuries with age, income and educational level in Shanghai and to analyze the relative disease burden. METHODS: Information on pedestrian-related cases and deaths were collected from 494 hospitals and mortality registry systems from 1992 to 2010, and a multistage cluster sampling survey conducted in 2006. Logistic regression model was used in the analyses. RESULTS: The age group of 5-9 had the highest mortality and morbidity among children. Mortality increased obviously among those aged 60 or above. Individuals with an educational level under the primary school and with the lower family average income were more likely to suffer pedestrian-related injuries. Multivariate Logistic analysis demonstrated that lower income and lower educational level increased the risk of pedestrian injuries with the odds ratio of 1.40 (95% CI: 1.15-1.71) and 1.70 (95% CI: 1.20-2-40), respectively. About 13.54% of the share of GDP for the healthcare, social security and welfare industries in Shanghai was occupied by the burden of pedestrian-related injuries in 2006. CONCLUSION: Pedestrian-related injury has inverse association with victims' income and educational level. Children of 5-9 years old and adults over 60 with lower educational level and lower monthly income are the target persons to be intervened.

Sensory innervation around immediately vs. delayed loaded implants: a pilot study.

Although neurophysiological and psychophysical proof of osseoperception is accumulating, histomorphometric evidence for the neural mechanisms of functional compensation following immediate and delayed implant loading is still lacking. For this randomized split-mouth study, six mongrel dogs randomly received one of four treatment protocols at 36 implant-recipient sites over 16 weeks (third maxillary incisor, third and fourth mandibular premolar): immediate implant placement and immediate loading (IIP+IL); delayed implant placement and delayed loading (DIP+DL); delayed implant placement and immediate loading (DIP+IL); and natural extraction socket healing (control). Histomorphometry was performed in the peri-implant bone and soft tissues within 300 µm around the implants. Immunocytochemistry and transmission electron microscopy were used to confirm the presence of neural structures and to reveal their ultrastructural characteristics, respectively. Myelinated nerve fibres densely populated the peri-implant crestal gingival and apical regions, although they were also identified in the woven bone and in the osteons near the implant threads. Compared with the control group in the mandible, the group that received IIP+IL showed a higher innervation (in N⋅mm⁻², 5.94 ± 1.12 vs. 3.15 ± 0.63, P<0.001) and smaller fibre diameter (in µm, 1.37 ± 0.05 vs. 1.64 ± 0.13, P=0.016), smaller axon diameter (in µm, 0.89 ± 0.05 vs. 1.24 ± 0.10, P=0.009) and g-ratio (0.64 ± 0.04 vs. 0.76 ± 0.05, P<0.001) in the middle region around the implants. Compared with DIP+IL in the mandible, IIP+IL had a higher nerve density (in N⋅mm⁻², 13.23 ± 2.54 vs. 9.64 ± 1.86, P=0.027), greater fibre diameter (in µm, 1.32 ± 0.02 vs. 1.20 ± 0.04, P=0.021), greater axon diameter (in µm, 0.92 ± 0.01 vs. 0.89 ± 0.03, P=0.035) and lower g-ratio (0.69 ± 0.01 vs. 0.74 ± 0.01, P=0.033) in the apical region around the implants. It may be assumed that the treatment protocol with IIP+IL is the preferred method to allow optimized peri-implant re-innervation, but further functional measurements are still required.

Bio-Oss(®) for delayed osseointegration of implants in dogs: a histological study.

We evaluated the effects of Bio-Oss® (a natural bone substitute derived from the mineral portion of bovine bone) on delayed osseointegration of implants. The bilateral third and fourth mandibular premolars of 4 adult, healthy, male and female dogs were extracted. We randomly selected 2 extraction sockets in each dog to be filled with Bio-Oss® (the experimental group); the other 2 extraction sockets, which were not treated, served as controls. Dental implants were inserted into the alveolar bone of the experimental group and the control group 3 months after insertion of the Bio-Oss®. The osteogenic activity in the bone around the implants was assessed by evaluating the histological morphology and estimating histomorphometric variables at 3 and 6 months after delayed implantation. After 3 months, Goldner's trichrome staining analysis showed that the rate of content between the bone and the implant and the mineralised area of bone around the implant were significantly higher in the experimental group (76%(9%) and 69.5% (9.6%), respectively) than those in the control group (56.1% (8.2%) and 52.8% (7.3%), respectively, p=0.003 and 0.000). However, the 2 groups did not differ significantly at 6 months. Fluorescence microscopy showed that the mean rates of mineralisation of the bony tissue around the implant in the experimental group at months 3 and 6 were 6.8 (0.4) µm and 8.4 (0.8) µm, respectively, which were significantly higher than those in the control group (p=0.000 and 0.03). These data indicate that putting Bio-Oss® into the extraction sockets can promote osseointegration after delayed implantation, and may be a promising option for clinical use.

[Study on risk factors and behavior features related to chronic diseases among adults in Shanghai].

OBJECTIVE: To investigate the risk factors and behavior features related to chronic diseases among adults in Shanghai. METHODS: A total of 15 516 subjects aged over 18 years old were selected from the investigation project on chronic diseases and relevant risk factors in Shanghai in 2010. Questionnaire were used to investigate the general information of the subjects, such as behavior features as smoking, drinking, diet, physical activity as well as the prevalence and control of chronic diseases as hypertension and diabetes. The physical examination included height, weight, waist circumference, blood pressure, blood glucose and blood lipids. RESULTS: Being preprocessed by complex weighting method, the data showed that the overweight rate of Shanghai adults aged above 18 was 32.4% (5288), separately 32.2% (2506) and 32.5% (2782) (χ(2) = 0.10, P = 0.844) in urban and rural areas; the obesity rate was 8.8% (1538), separately 8.7% (738) and 8.8% (800) (χ(2) = 0.06, P = 0.901) in urban and rural areas. The overweight rate was separately 36.0% (2888) in males and 28.6% (2400) in females (χ(2) = 96.61, P < 0.01); while the obesity rate was separately 8.7% (745) in males and 8.9% (793) in females (χ(2) = 0.06, P = 0.851). Abdominal obesity rate was 44.3% (7419), separately 47.8% (3892) in males and 40.6% (3527) in females (χ(2) = 81.23, P < 0.01), 46.5% (3703) in urban areas and 42.6% (3716) in rural areas (χ(2) = 24.37, P = 0.069). Current smoking rate was 25.0% (3813), separately 48.4% (3722) and 1.2% (91) in males and females (χ(2) = 4572.06, P < 0.01); 23.6% (1609) and 26.0% (2204) in urban and rural areas (χ(2) = 11.92, P = 0.018). The regular smoking rate was 22.1% (3402). The rate of having the habit of drinking at least once a month in males was 39.5% (3102), separately 35.1% (1262) and 42.7% (1840) in urban and rural areas (χ(2) = 45.98, P = 0.012). The rate of drinking almost every day was 16.3% (1380), and the percentage of excessive alcohol consumption was 28.9% (2483). The percentage in group of subjects aging between 45-59 years old was 38.5% (1191), which was higher than that in any other groups (22.8% (641) in group aging 18-44 years old and 22.9% (651) in group aging ≥ 60 years old) (χ(2) = 241.38, P < 0.01). The percentage of over-drinking in rural area was higher than that in urban area, which was 33.5% (1578) and 22.8% (905) respectively (χ(2) = 117.12, P < 0.01). The percentage of once over-drinking was 11.3% (903). It was higher in group aging between 45-49 years old (15.3% (461)) than in other groups (9.0% (222) in group aging 18-44 years old and 8.2% (220) in group aging ≥ 60 years old) (χ(2) = 78.21, P < 0.01). It was also higher in rural area (13.5% (605)) than in urban area (8.3% (298)) (χ(2) = 51.74, P < 0.01). There were 75.0% (11 993) of the Shanghai adults never took physical activity. And the most important problems in dietary habit were insufficient intake of dairy products (98.0%, 15 218), vegetables (53.0%, 7864) and fruits (84.6%, 13 372), excess consumption of sodium (52.0%, 8257) and oil (51.7%, 7884). CONCLUSION: The risk factors of chronic diseases were highly prevalent in Shanghai. The prevalence of risk factors as overweight or obesity, lack of physical activity, smoking, over-drinking and unhealthy dietary habits were higher among adults living in suburban areas than those living in urban areas; the prevalence was also higher among the young adults than that among the elderly people, higher among males than that among females.

[Study on the effects of different compatibility of guizhi decoction on component of volatile oil from Cinnamomum cassia by GC-MS].

OBJECTIVE: To study the changes of volatile oil from different compatibility of Guizhi decoction and explore their connection. METHODS: The volatile oil of Cinnamomum cassia and different compatibility of Guizhi decoction extracted by steam distillation were analyzed by GC-MS. RESULTS: The main components of volatile oil in Cinnamomum cassia were found in different compatibility of Guizhi decoction and they accounted the most amount of total volatile oil,but the contents of the main components were decreased, there were more components existed in different compatibility of Guizhi decoction than those in Cinnamomum cassia, the new components came from Zingiber officinale mostly. CONCLUSION: GC-MS can be used to reflect the changes of volatile oil from different compatibility of Guizhi decoction, and the result will provide some evidence for the research of regular pattern of compatibility in Guizhi decoction.

Increasing prevalence of type 2 diabetes in Chinese adults in Shanghai.

OBJECTIVE: Our objective was to determine the secular trend in prevalence of type 2 diabetes in Shanghai, China. RESEARCH DESIGN AND METHODS: Two consecutive population-based surveys for type 2 diabetes were conducted in randomly selected adults aged 35-74 years in Shanghai in 2002-2003 (n = 12,329) and in 2009 (n = 7,423). Diagnosed type 2 diabetes was determined based on self-report, whereas those undiagnosed were identified by measured fasting and postload glucose according to 2009 American Diabetes Association criteria. RESULTS: Age-standardized prevalence of diagnosed and undiagnosed type 2 diabetes increased from 5.1 and 4.6% in 2002-2003 to 7.4 and 5.2% in 2009. The prevalence of type 2 diabetes increased with age and was higher among men and in urban residents in both surveys (P < 0.001). Between the two surveys, the increase in the prevalence was more evident in the rural population (P < 0.001) and appeared more rapid in younger birth cohorts (P < 0.05). CONCLUSIONS: Our results suggest that Shanghai has experienced an increasing burden of type 2 diabetes.

Restorative effects of zinc and selenium on cadmium-induced kidney oxidative damage in rats.

OBJECTIVE: To investigate whether cadmium-induced oxidative stress in the kidney is influenced by zinc and selenium. METHODS: Five groups of rats were maintained: (A) Cd (CdCl2, 400 micrograms.kg-1.day-1 intraperitoneal injection); (B) Cd + Zn (ZnCl2, 20 mg.kg-1.day-1 hypodermic injection); (C) Cd + Se (Na2SeO3, 350 micrograms.kg-1.day-1 via a stomach tube); (D) Cd + Zn + Se; (E) treated with physiological saline as a sham-handled control. The rats were given treatment for a period of 4 weeks. The activities of superoxide dismutase (SOD), glutathione peroxidase (GH-Px), catalase (CAT), and the level of malondialdehyde (MDA) in the kidney tissue were measured to assess the oxidative stress. Urinary lactate dehydrogenase (LDH) activity was used as an indicator of tubular cell damage caused by lipid peroxidation. RESULTS: In group C and D, activities of SOD (110.5 +/- 5.2, 126.8 +/- 7.0; P < 0.05) and GSH-Px (85.7 +/- 4.9, 94.6 +/- 7.3; P < 0.05) were higher than those in group A (84.7 +/- 3.3; 56.9 +/- 3.8); and in group B, only the activity of GSH-Px (80.0 +/- 4.3, P < 0.01) increased in comparison with that in group A (56.9 +/- 3.8). Significant increase of MDA (P < 0.05) was seen in group B (31.1 +/- 4.7) and C (35.0 +/- 4.1) when compared with control values (17.2 +/- 1.8). No difference was found in the level of MDA between group D (18.9 +/- 2.6) and control. The activity of LDH in urine of control group (0.06 +/- 0.02) was lower than that of group A (0.46 +/- 0.19, P < 0.05), B (0.10 +/- 0.05, P < 0.05) and C (0.14 +/- 0.07, P < 0.05), and there was no significant change between control (0.06 +/- 0.02) and group D (0.08 +/- 0.02). CONCLUSION: Zinc or selenium could partially alleviate the oxidative stress induced by cadmium in kidney, but administration cadmium in combination with zinc and selenium efficiently protects kidney from cadmium-induced oxidative damage.