RESUMEN
Objective: To compare the volumetric changes of cervical disc herniation (CDH) after cervical microendoscopic laminoplasty(CMEL),expansive open-door laminoplasty (EOLP) and conservative treatment. Methods: A retrospective study was conducted involving 101 patients with cervical spondylotic myelopathy(CSM),at the Department of Orthopaedic Surgery,the First Affiliated Hospital of Zhengzhou University from April 2012 to April 2021. The patients included 52 males and 49 females with an age of (54.7±11.8) years(range:25 to 86 years). Among them, 35 patients accepted CMEL treatment,33 patients accepted EOLP treatment,while 33 patients accepted conservative treatment. Volume data of CDH were measured by three-dimensional analysis of the initial and follow-up MRI images. The absorption rate and reprotrusion rate of CDH were calculated. The happening of resorption or reprotrusion was defined when the ratio was greater than 5%. The clinical outcomes and quality of life were evaluated by the Japanese Orthopaedic Association (JOA) score and the neck disability index (NDI).Quantitative data was analyzed by one-way ANOVA with post LSD-t test (multiple comparison) or Kruskal-Wallis test. Categorical data was analyzed by χ2 test. Results: The follow-up time of the CMEL group,EOLP group and the conservative treatment group were (27.6±18.8)months,(21.6±6.9)months and(24.9±16.3)months respectively with no significant difference(P>0.05). Changes of CDH volume in patients:(1) There were 96 CDH of 35 patients in the CMEL group,among which 78 showed absorption. The absorption frequency was 81.3%(78/96) and the absorption rate was ranged 5.9% to 90.9%;9 CDH showed reprotrusion,the reprotrusion frequency was 9.4% (9/96) and the reprotrusion rate was 5.9% to 13.3%;(2) There were 94 CDH of 33 patients in the EOLP group,of which 45 showed absorption. The absorption prevalence was 47.9% (45/94) and the absorption rate was 5.0% to 26.7%;20 CDH showed reprotruded,with the reprotrusion frequency of 21.3% (20/94) and the reprotrusion rate was 5.8% to 28.3%;(3) There were 102 CDH in 33 patients of the conservative group. Among them, 5 showed absorption. The absorption frequency was 4.9% (5/102),and the absorption rate was 7.2% to 14.3%;58 CDH showed reprotruded with the re-protrusion ratio of 56.9% (58/102) and the re-protrusion rate was 5.4% to 174.1%. The absorption ratio and reprotrusion ratio of the CMEL group were statistically different from EOLP group or the conservative group (P<0.01).The absorption ratio and reprotrusion ratio of the EOLP group was different from conservative group (all P<0.01). In terms of clinical outcomes, the excellent/good rate of the JOA score and NDI scores in the CMEL group were different from that of conservative group (all P<0.01) but not from that of the EOLP group(P>0.05). Conclusions: CMEL is an effective method for the treatment of CSM,making CDH easier to resorption compared to the EOLP or conservative treatment,thus making a better decompression effect on the nerves. This study enlightened on a new strategy for the clinical treatment of CSM.
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Masculino , Femenino , Humanos , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Estudios Retrospectivos , Desplazamiento del Disco Intervertebral/cirugía , Tratamiento Conservador , Calidad de Vida , Resultado del Tratamiento , Espondilosis/cirugía , Vértebras Cervicales/cirugía , Enfermedades de la Médula Espinal , Laminoplastia/métodos , DescompresiónRESUMEN
Titanium dioxide nanoparticles (TiO2 NPs) are massively produced and widely used in daily life, which may pose potential risk to human health via uncharacterized interaction between DNAs. This research aims to examine the interaction between DNA and three types of TiO2 NPs of different sizes and crystallines. The interaction between TiO2 NPs and liver DNA molecules obtained from Sprague-Dawley rats was systematically evaluated in vivo using atomic force microscopy, transmission electron microscopy, various spectroscopic techniques and gel electrophoresis. We found that TiO2 NPs (diameter <25 nm and <100 nm) in anatase crystalline can covalently interact with liver DNA by either inserting itself in between DNA base pairs or binding to DNA nucleotide via P-O-Ti-O bond. Such interaction may not be NP size-dependent but may be crystalline phase-dependent, because such interaction did not occur in rutile crystal phase, in which the DNA damage was potentially caused by reactive oxygen species.
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ADN/efectos de los fármacos , Hígado/efectos de los fármacos , Nanopartículas del Metal/toxicidad , Titanio/toxicidad , Animales , ADN/química , ADN/metabolismo , Electroforesis en Gel de Agar , Histocitoquímica , Hígado/química , Hígado/metabolismo , Nanopartículas del Metal/química , Microscopía de Fuerza Atómica , Microscopía Electrónica de Transmisión , Conformación de Ácido Nucleico , Tamaño de la Partícula , Ratas , Ratas Sprague-Dawley , Titanio/química , Titanio/metabolismoRESUMEN
Titanium dioxide nanoparticles are massively produced and widely used in daily life, which has posed potential risk to human health. However, the molecular mechanism of TiO(2) nanoparticles (NPs) with different crystal phases is not clear. In this study, the characterization of two crystalline phases of TiO(2) NPs is evaluated by transmission electron microscopy and X-ray absorption fine structure spectrum; an interaction of these TiO(2) NPs with HaCaT cells is studied in vitro using transmission electron microscopy, chemical precipitation method, and X-ray absorption fine structure spectrometry. The coordination and surface properties indicate that only the anatase-TiO(2) NPs allow spontaneous reactive oxygen species (ROS) generation, but rutile-TiO(2) NPs do not after dispersion. The interaction between TiO(2) NPs and cellular components might also generate ROS for both anatase-TiO(2) NPs and rutile-TiO(2) NPs. The ROS generation could lead to cellular toxicity if the level of ROS production overwhelms the antioxidant defense of the cell or induces the mitochondrial apoptotic mechanisms. Furthermore, Ti had a direct combination with some protein or DNA after NPs enter the cell, which could also lead to cellular toxicity.