Curcumin Improves Human Umbilical Cord-Derived Mesenchymal Stem Cell Survival via ERK1/2 Signaling and Promotes Motor Outcomes After Spinal Cord Injury.

Human umbilical cord-derived mesenchymal stem cell (hUC-MSC) transplantation is thought to be a promising strategy for treating spinal cord injury (SCI). However, the low survival rate of transplanted hUC-MSCs limits their clinical application in cell replacement therapy. Curcumin can suppress inflammation after SCI; however, it remains unknown whether curcumin can modulate the survival of transplanted hUC-MSCs. In this study, to investigate whether curcumin could strengthen the therapeutic effects of hUC-MSC transplantation on SCI, we induced hUC-MSC apoptosis with TNF-α, transplanted hUC-MSC into SCI rats, and assessed the antiapoptotic effect and mechanism of curcumin. LDH release analysis and flow cytometry demonstrated that TNF-α led to hUC-MSC apoptosis and that curcumin increased the hUC-MSC survival rate in a dose-dependent manner. In addition, we showed that the phosphorylation levels of ERK1/2, JNK, and P38 were upregulated in apoptotic hUC-MSCs, while curcumin increased the phosphorylation of ERK1/2 but did not activate JNK or P38, and these effects were reversed by the p42/44 antagonist U0126. Furthermore, we found that the motor function scores and number of surviving HNA-positive cells were significantly increased after curcumin and hUC-MSC transplantation therapy 8 weeks post-SCI, while U0126 markedly attenuated these effects. These data confirmed that curcumin suppressed hUC-MSC apoptosis through the ERK1/2 signaling pathway and that combined curcumin and hUC-MSC treatment improved motor function in rats after SCI. The current research provides a strong basis for hUC-MSC replacement therapy in conjunction with curcumin in the treatment and management of SCI in humans.

Mechanism of Gegen Qinliantang against Vulnerable Plaque of Atherosclerosis： Based on Macrophage Pyroptosis Mediated by NF-κB/NLRP3/Caspase-1 Pathway / 中国实验方剂学杂志

ObjectiveTo explore the effect of Gegen Qinliantang （GQL） on vulnerable plaque of atherosclerosis based on the macrophage pyroptosis mediated by nuclear factor （NF）-κB/NOD-like receptor protein 3 （NLRP3）/cysteine-aspartic acid protease （Caspase）-1 pathway. MethodA total of 12 normal C57BL/6CNC mice were used as the control group， and 60 ApoE-/- mice of the same line were randomized into 5 groups： model group， low-dose， medium-dose， and high-dose GQL groups （GQL-D， GQL-Z， GQL-G groups， respectively）， and western medicine group. The control group and model group were given （ig） equal volume sterile distilled， and GQL-D， GQL-Z， GQL-G and western medicine groups received （ig） corresponding concentration of drugs for 8 weeks. Aortic plaques were observed based on hematoxylin and eosin （HE） staining. Serum levels of interleukin （IL）-1β and IL-18 were detected by enzyme-linked immunosorbent assay （ELISA）， protein levels of macrophage mannose receptor （CD206）/apoptosis-associated speck-like protein containing a CARD （ASC） and CD206/NLRP3 by double-labeling immunofluorescence， and C-terminal gasdermin D （GSDMD）， N-terminal GSDMD， NLRP3， pro-cysteinyl aspartate specific proteinase 1 （pro-Caspase-1） and NF-κB p65 by Western blot. ResultCompared with the control group， model group demonstrated serious pathological changes， rise of the levels of serum IL-1β and IL-18 and tissue ASC， NLRP3， C-terminal GSDMD， N-terminal GSDMD， pro-Caspase-1， and NF-κB p65， and decrease of CD206 level （P<0.05）. As compared with model group， the administration groups showed alleviation of the lesions in aortic wall， decrease in levels of serum IL-1β and IL-18 and tissue ASC， NLRP3， C-terminal GSDMD， N-terminal GSDMD， pro-Caspase-1， and NF-κB p65， and rise of CD206 level， with significant difference between some groups （P<0.05）. ConclusionGegen Qinliantang alleviates vulnerable plaque of atherosclerosis by regulating NF-κB/NLRP3/Caspase-1 pathway and further relieving macrophage pyroptosis.

Research progress of continuous manufacturing and process knowledge system of traditional Chinese medicine / 中国中药杂志

In the past few years, continuous manufacturing(CM) has been put forward by the FDA. Pharmaceutical enterprises are encouraged to promote the implementation of CM, which has become a hot research direction of pharmaceutical technology. In February 2019, the FDA issued a draft guideline for the implementation of CM, which greatly promoted the development of CM and provided reference for continuous manufacturing of traditional Chinese medicine(TCM). The production process of TCM is a complex system. With the innovation of production equipment and the promotion of automation and informatization of TCM production, the exis-ting policies, regulations and traditional production control capacity are difficult to meet the market demand for high-quality TCM pro-ducts. In this paper, we reviewed the new technologies and methods of quality control in accordance with the characteristics of TCM production by referring to modern manufacturing technology, information technology and quality control technology. Based on the "QbD" theory and "PAT" technology, process knowledge system(PKS), an advanced control strategy, was proposed to provide a reference for the implementation of CM in TCM production.

Rapid determination of active components in Ginkgo biloba leaves by near infrared spectroscopy combined with genetic algorithm joint extreme learning machine / 中国中药杂志

Near-infrared spectroscopy(NIRS) combined with band screening method and modeling algorithm can be used to achieve the rapid and non-destructive detection of the traditional Chinese medicine(TCM) production process. This paper focused on the ginkgo leaf macroporous resin purification process, which is the key technology of Yinshen Tongluo Capsules, in order to achieve the rapid determination of quercetin, kaempferol and isorhamnetin in effluent. The abnormal spectrum was eliminated by Mahalanobis distance algorithm, and the data set was divided by the sample set partitioning method based on joint X-Y distances(SPXY). The key information bands were selected by synergy interval partial least squares(siPLS); based on that, competitive adaptive reweighted sampling(CARS), successive projections algorithm(SPA) and Monte Carlo uninformative variable(MC-UVE) were used to select wavelengths to obtain less but more critical variable data. With selected key variables as input, the quantitative analysis model was established by genetic algorithm joint extreme learning machine(GA-ELM) algorithm. The performance of the model was compared with that of partial least squares regression(PLSR). The results showed that the combination with siPLS-CARS-GA-ELM could achieve the optimal model performance with the minimum number of variables. The calibration set correlation coefficient R_c and the validation set correlation coefficient R_p of quercetin, kaempferol and isorhamnetin were all above 0.98. The root mean square error of calibration(RMSEC), the root mean square error of prediction(RMSEP) and the relative standard errors of prediction(RSEP) were 0.030 0, 0.029 2 and 8.88%, 0.041 4, 0.034 8 and 8.46%, 0.029 3, 0.027 1 and 10.10%, respectively. Compared with the PLSR me-thod, the performance of the GA-ELM model was greatly improved, which proved that NIRS combined with GA-ELM method has a great potential for rapid determination of effective components of TCM.

Analysis on the causes and prevention strategies of the vascular injury caused by the oblique lateral lumbar fusion / 中国骨伤

OBJECTIVE@#To analyze the causes of vascular injury occurred in oblique lateral interbody fusion for treating lumbar degenerative diseases, and put forward preventive measures.@*METHODS@#There were 235 patients analyzed from October 2014 to May 2017 in five hospitals, who were treated with oblique lateral interbody fusion with or without posterior pedicle screw fixation. There were 79 males and 156 females with an average age of (61.9±13.5) years old (ranged from 32 to 83 years). There were 7 cases of vascular injury, including 4 cases of segmental vessel injury, 1 case of left common iliac artery injury, 1 case of left common iliac veininjury and 1 case of ovarian vein injury.@*RESULTS@#The follow up time ranged from 6 to 36 months, averagely (15.6±7.5) months. There was no pedicle screw loosen or fracture. The low back pain VAS decreased from preoperative 6.7±2.3 to 1.4±0.8 at the latest follow-up, which was statistically difference(@*CONCLUSION@#Oblique lateral interbody fusion technique provides a new method for minimally invasive fusion of lumbar internal fixation. However, it has a risk of vascular injury. In order to effectively prevent the occurrence of vascular injury, the operative indications and careful and meticulous operation should be strictly grasped.

Simultaneous determination of five saponins in Yaobitong capsule by HPLC-CAD / 药学学报

A high performance liquid chromatography charged aerosol detector (HPLC-CAD) method was established for the simultaneous determination of five saponins (notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, Ginsenoside Rd) in Yaobitong capsule, providing a method for quality control. The sample was extracted with methanol and chromatographic separation was performed on a Waters Xbridge Phenol column (150 mm×4.6 mm, 3.5 μm) using acetonitrile-water as the mobile phase with gradient elution at a flow rate of 1.0 mL·min-1. The column temperature was 30 ℃ and the injection volume was 10 μL. The nebulizer temperature of CAD was 35 ℃ and the air pressure was 60.2 psi, the filtration was 3.6 s, and the collection frequency was 5 Hz. Notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1 and ginsenoside Rd showed a good linear relationship in the range of 16.96-203.5 μg·mL-1 (R2 = 0.999 3), 54.46-653.5 μg·mL-1 (R2 = 0.999 3), 10.96-131.5 μg·mL-1 (R2 = 0.999 6), 51.50-618.0 μg·mL-1 (R2 = 0.999 0), 15.94-191.3 μg·mL-1 (R2 = 0.999 4), respectively. The average recoveries were 98.96%, 100.8%, 94.76%, 100.1%, 103.1%, and RSDs were 0.87%, 1.46%, 1.85%, 2.06%, 0.96% (n = 6), respectively. The proposed method is accurate, simple and reliable, and can be used for the determination of five saponins in Yaobitong capsule.

Dendrimer-coupled sonophoresis-mediated transdermal drug-delivery system for diclofenac.

The purpose of the present study was to develop a novel transdermal drug-delivery system comprising a polyamidoamine dendrimer coupled with sonophoresis to enhance the permeation of diclofenac (DF) through the skin. The novel transdermal drug-delivery system was developed by using a statistical Plackett-Burman design. Hairless male Wistar rat skin was used for the DF-permeation study. Coupling media concentration, ultrasound-application time, duty cycle, distance from probe to skin, and a third-generation polyamidoamine-dendrimer concentration were selected as independent variables, while in vitro drug release was selected as a dependent variable. Independent variables were found to be statistically significant (P<0.05). DF gel without dendrimer and ultrasound treatment to skin (passive delivery, run 13) showed 56.69 µg/cm(2) cumulative drug permeated through the skin, while the DF-dendrimer gel without sonophoresis treatment (run 14) showed 257.3 µg/cm(2) cumulative drug permeated through the skin after 24 hours. However, when the same gel was applied to sonophoresis-treated skin, drastic permeation enhancement was observed. In the case of run 3, the cumulative drug that permeated through the skin was 935.21 µg/cm(2). It was concluded that dendrimer-coupled sonophoresis-mediated transdermal drug delivery system has the potential to enhance the permeation of DF through the skin.

The Surgical Management of Traumatic Lower Cervical Spondylolisthesis with Posterior Percutaneous Pedicle Screw Fixation

We reported a technical report of traumatic lower cervical spondylolisthesisca used by bilateral pedicle fracture, without neurological compression. The patient was treated with the minimally invasive technique of percutaneous pedicle screw fixation. Fracture healing and normal cervical motion were confirmed by plain films and physical examinations on the 18-monthpostoperatively. The technique of percutaneous pedicle screw fixation might be an alternative strategy for the treatment of traumatic lower cervical spondylolisthesis with pedicle fracture.

Thrombolysis efficiency of urokinase plasminogen activator-loaded anionic lipid microbubbles combined with low-frequency ultrasound in vitro / 中华核医学与分子影像杂志

Objective To prepare urokinase plasminogen activator (uPA)-loaded anionic lipid microbubbles (uPA-MBs) for thrombolysis with low-frequency ultrasound in vitro.Methods Anionic microbubbles composing of 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC),1,2-dipalmitoyl-sn-glycero-3-phospho-(l'-rac-glycerol) (DPPG),1,2-distearoyl-sn-glycero-3-phosphoethanol amine-N (succinyl PEG2000) (DSPE-PEG2000) and perfluoropropane (C3F8) were prepared by the mechanical vibration method.Then,the resulting anionic microbubbles were incubated with uPA.uPA-MBs were obtained via electrostatic adsorption.Bubble size and distribution were measured by particle size analyzer.FITC-labeled uPA-MBs were obtained and observed under fluorescence microscope.The surface potential of uPA-MBs and plain microbubbles (P-MBs) were detected by Zeta potential analyzer.Sodium dodecyl sulfonate-polyacrylamide gel electrophoresis (SDS-PAGE) was used for confirming the binding of uPA protein and anionic microbubbles.The encapsulation efficiency of uPA-MBs was determined by bicinchoninic acid (BCA) protein assay kit under three different dosages of uPA (10 000,50 000 and 100 000 U).The thrombolysis efficiency of uPA-MBs combined with low-frequency ultrasound was examined in vitro.Two-sample t test,one-way analysis of variance and Bonferroni test were performed to analyze the data.Results UPA-MBs were successfully obtained with the mean particle size of (1.76±0.29) μm.The surface potential of these bubbles was significantly higher than that of P-MBs:(-36.64±0.21) mV vs (-66.33±2.38) mV (t =21.538,P＜0.05).Fluorescence microscope showed a green shell of FITC-labeled uPA-MBs.The encapsulation efficiency of uPAMBs with the added dosage of 10 000 U was (42.01±2.02) ％,which was significantly higher than those of 50000 and 100 000 U ((33.24±1.95)％ and (33.10±1.65)％ respectively,F=22.340,P＜0.05).The thrombolysis efficiency by saline was (4.09±0.80)％,saline + ultrasound (8.50±1.48)％,MBs + ultrasound (14.27± 1.59) ％,uPA-MBs + ultrasound (35.72±6.31) ％ and uPA (16.87±0.46) ％,respectively (F =48.783,t =-8.613,-7.273,-5.942,-6.908,all P＜0.05).Conclusion Anionic microbubbles can successfully load uPA,and achieve significantly better thrombolysis effect when combined with low-frequency ultrasound.

The correlations of LMX1A and osteopontin expression to the clinicopathologic stages in pancreatic adenocarcinoma.

AIM: To test the association of LMX1A and osteopontin (OPN) expression with histologic differentiation or pathologic stage in pancreatic ductal adenocarcinoma. METHODS: Immunohistochemical analysis was performed to determine LMX1A and OPN expression in 100 surgical specimens obtained from Chinese patients with well-differentiated (n=15), moderately differentiated (n=65), and poorly differentiated (n=20) pancreatic ductal adenocarcinomas. RESULTS: LMX1A and OPN immunoreactivities were undetectable in normal pancreatic glandular epithelia. Stronger immunostaining for LMX1A and OPN was associated with advanced nuclear grades of pancreatic ductal adenocarcinomas (70.7 and 87.1 for grade I, 109.8 and 118.3 for grade II, and 171.3 and 183.8 for grade III), and advanced TNM and American Joint Committee on Cancer stages of pancreatic ductal adenocarcinomas. CONCLUSIONS: A higher expression of LMX1A and OPN is well correlated with histologic grade and pathologic stage of pancreatic ductal adenocarcinomas.

Treatment of hepatic cancer in mice by beta-elemene combined DC/Dribble vaccine: an immune mechanism research / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effects of beta-elemene combined DC/Dribble vaccine in treating mice with hepatic cancer, thus exploring their anti-tumor mechanisms.</p><p><b>METHODS</b>Dentritic cells were derived from Balb/c mice's spleen and their phenotypes were identified. Using hepatic cancer cell line BNL1MEA.7R.1 (abbreviated as BNL) originated from Balb/c mice as target cell, DC/Dribble vaccine was prepared via raising the antigen representing carrier autophagosomes (DRips in Blebs, DRibbles), which were rich in tumor antigen information. The mice previously immunized were divided into 4 groups, i.e., the control group, the beta-elemene group, the vaccine group, and the combined group. The PBS was subcutaneously and intraperitoneally injected to mice in the control group. The beta-elemene was intraperitoneally injected at the daily dose of 50 mg/kg to mice in the beta-elemene group and the combined group for 7 successive days. DC/Dribble vaccine was injected into the lymph node of mice in the vaccine group and the combined group on the 1st day, and DC/Dribble vaccine was subcutaneously injected on the 3rd day and the 5th day. All the mice were sacrificed on the 10th day. Their spleens were obtained sterilely, and the suspension was incubated with or without Dribble. The cells were inoculated for 72 h. The contents of IFN-gamma in the supernatant were measured by ELISA. In addition, the spleen cells obtained from the combined group were incubated with different stimulations for 72 h, which were then divided into the control group, the DRibble group, the DC group, and the DC/Dribble vaccine group. The supernatant of cultured cells were collected and the contents of IFN-gamma were measured by ELISA. The liver tumor-bearing mouse model was established, and then the BNL bearing mice were randomly divided into 4 groups, i.e., the control group, the beta-elemene group, the vaccine group, and the combined group. The treatment ways were the same as the immune ways. The tumor size and the survival period were observed in each group. On the 23rd day the mice were sacrificed. The tumor tissue was stripped and stained by HE staining. The pathomorphological manifestations of the tumor tissue were observed by light microscope.</p><p><b>RESULTS</b>In vitro detection of mice immunized previously by different ways showed that the secretion of IFN-gamma was significantly higher in the combined group than in the rest groups (P < 0.01). The secretion of IFN-gamma was significantly higher in the beta-elemene group and the vaccine group than in the control group (P < 0.01). The spleen cells could be stimulated to secrete a large amount of IFN-gamma in the vaccine group and the Dribble group (P < 0.01). When the beta-elemene was 10 microg/mL as the stimulating dose, the secretion of IFN-gamma obviously increased (P < 0.01). In vivo observation showed that the growth velocity of tumors in mice of the combined group was slowed down. There was statistical difference in the tumor area or the survival period of mice in the combined group, when compared with the other groups (P < 0.01). In HE staining, the surrounding connective tissues of the tumor were wrapped tightly and compactedly, with infiltration of a large amount of inflammatory cells.</p><p><b>CONCLUSIONS</b>beta-elemene combined DC/Dribble vaccine could induce specific immune cells to secrete secretory cells, thus exerting its anti-tumor effect. Its immunological effects might be associated with enhancing the DC antigen presenting function.</p>

Finite element model testing on Coflex dynamic fixation for L4/5 and L5/S1 segment of lower lumbar / 医用生物力学

Objective To simulate clinical operation and investigate feasibility of Coflex dynamic device for fixing L5/S1 segment of lower lumbar degenerative diseases. Methods The lower lumbar-sacral digital model was extracted from platform of the second generation of Chinese Digitized Human “Male No.23” data set, and three finite element (FE) models (the model of normal lower lumbar sacrum, L4/5 and L5/S1 segment fixed with Coflex) were developed respectively using a series of CAX software. According to the spinal three-column loading theory and the lower lumbar physiological behaviors, FE model tests were analyzed, validated and compared under the physiological load of upright standing, anteflexion and extension. Results The FE models of normal lower lumbar sacrum (Healthy), Coflex fixed-L4/5 segment (L4/5), Coflex fixed-L5/S1 segment (L5/S1) were developed, respectively. Based on biomechanical indexes (stability and compatibility) of the controlled trial for the FE model, the two Coflex-fixed FE models showed similar biomechanical effects for fixing the lower lumbar. Conclusions The controlled trials of FE models provide biomechanical evidence for the fixation of lower lumbar L5/S1 segment by Coflex dynamic device, which is of significance for application of Coflex in fixing L5/S1 segment in clinic.

Discectomy and discectomy plus Coflex fixation for lumbar disc herniation, a clinical comparison study / 中华外科杂志

<p><b>OBJECTIVE</b>To compare clinical efficacy between discectomy and discectomy plus Coflex fixation for lumbar disc herniation.</p><p><b>METHODS</b>From December 2007 to August 2008, 50 patients (31 males and 19 females) were treated by surgery of discectomy and discectomy plus Coflex fixation. The average age was 52.5 years (range, 30 - 72 years). There were 24 cases in the group of discectomy plus Coflex fixation and 26 cases in the group of discectomy. Preoperative and postoperative visual analogue scales (VAS), Japanese Orthopadic Association (JOA) and Oswestry disability index (ODI) were recorded, as well as radiological index. And use a paired t-test and one-way analysis of variance (one-way ANOVA) statistical method to evaluate the Coflex dynamic stabilization system in value in the treatment of lumbar disc herniation.</p><p><b>RESULTS</b>Both groups received significant improvement of JOA, ODI and VAS (t = -33.2 - 64.5, P < 0.01), but the group of discectomy was found with deterioration of ODI at last follow-up, 12 months after surgery 6.7 ± 1.5 to 10.2 ± 2.3 (t = -19.3, P < 0.05). The group of discectomy plus Coflex fixation was found with significant increase of height of dorsal intervertebral discs (HD), distance across the two adjacent spinous processes (DS), distance of intervertebral foramina (DIF) and spinal canal area(SA) (t = -34.4 - 4.5, P < 0.05). In contrast, the group of discectomy was found with significant decrease of HD, DS, DIF and SA (t = 3.4 - 52.8, P < 0.05). Coflex fixed group in HD, DIF, DS significant difference with simple discectomy group, with a statistically significant (F = 14.1 - 25.6, P < 0.05).</p><p><b>CONCLUSIONS</b>Both discectomy and discectomy plus Coflex fixation are apparently effective when treating lumbar disc herniation. Coflex can significantly increase the HD and DIF when used for lumbar disc herniation, and it has positive influence for keeping height of lumbar vertebral space and treating the nerve root symptom of lumbar disc herniation. Discectomy plus Coflex is better than pure discectomy in preventing lumbar degeneration.</p>

Vertebral Compression Fracture with Intravertebral Vacuum Cleft Sign: Pathogenesis, Image, and Surgical Intervention

The intravertebral vacuum cleft (IVC) sign in vertebral compression fracture patients has obtained much attention. The pathogenesis, image character and efficacy of surgical intervention were disputed. Many pathogenesis theories were proposed, and its image characters are distinct from malignancy and infection. Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) have been the main therapeutic methods for these patients in recent years. Avascular necrosis theory is the most supported; PVP could relieve back pain, restore vertebral body height and correct the kyphotic angulation (KA), and is recommended for these patients. PKP seems to be more effective for the correction of KA and lower cement leakage. The Kummell's disease with IVC sign reported by modern authors was incomplete consistent with syndrome reported by Dr. Hermann Kummell.

Association between Osteopontin and EGFR Expression with Clinicopathological Parameters in Hepatocellular Carcinoma.

Osteopontin (OPN) and epidermal growth factor receptor (EGFR) are important factors associated with tumor progression, invasion and metastasis in humans. The aim of this study was to assess the correlation of OPN and EGFR expression with hepatocellular carcinoma (HCC) progression. Expression of OPN and EGFR was assessed by immunohistochemistry in 100 HCC specimens. Immunostaining scores (0 to 400) were calculated from the percentage of cells (0 to 100) at each immunostaining intensity and the immunostaining intensity (0 to 4). The average immunostaining score for OPN was correlated with tumor grade (56.1 for grade I, 104.6 for grade II, and 141.2 for grade III; P = 0.023) and T stage (58.6 for stage T1, 85.9 for stage T2, 126.8 for stage T3, and 189.1 for stage T4; P = 0.029). Similarly, the average immunostaining score for EGFR was correlated with tumor grade (80.5 for grade I, 142.1 for grade II, 230.6 for grade III; P = 0.011) and T stage (96.4 for stage T1, 135.5 for stage T2, 221.3 for stage T3, and 261.4 for stage T4; P = 0.026). In addition, OPN and EGFR immunostaining scores were also correlated with M, N, and AJCC stages. In conclusion, higher expression of OPN and EGFR is significantly associated with advanced histological grades, advanced pathological stages and poorer survival rates in HCC. OPN and EGFR may be used as novel biomarkers for diagnosis or monitoring of progression of hepatocellular carcinoma.

Clinical evaluation of interspinous process device Coflex for degenerative disk diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To study indications and complications of interspinous process device Coflex for degenerative disk diseases.</p><p><b>METHODS</b>One hundred and eight patients with degenerative lumbar disc diseases were underwent procedures of surgical decompression and additional fixation of Coflex between November 2007 and October 2010. Sixty-eight patients were male and the other fourty were female, and their average age was 53.5 years (range from 37 to 75 years). Fifty-nine patients were underwent surgery of excision of nucleus pulposus and Coflex fixation, 41 patients were underwent surgery of decompression by fenestration and Coflex fixation, 6 patients were underwent surgery of topping-off, and 2 patients were underwent surgery of Coflex fixation for two level. Preoperative and postoperative visual analogue scales (VAS) and Oswestry disability index (ODI) were recorded, as well as height of ventral intervertebral space (HV), height of dorsal intervertebral space (HD), height of intervertebral foramen (HIF) and segmental range of motion (ROM). One-way ANOVA was used for statistical analysis. Surgical complications were also recorded.</p><p><b>RESULTS</b>The average follow-up time was 28.8 months. All groups had apparent improvement of VAS and ODI, and maintained well to last follow-up (F = 6.16-25.92, P = 0.00). Statistical analysis showed that HD and HIF increased significantly in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation (F = 7.37 - 11.68, P < 0.05). Although both HD and HIF decreased one-year after surgery, they were still higher than those preoperatively (F = 6.31 and 7.05, P = 0.00). Preoperative segmental ROM was respectively 6.3° ± 1.8° and 6.2° ± 1.7° in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation, and 3.1° ± 0.6° and 3.0° ± 0.8° at last follow-up. Three cases were found with device-related complications and five with non-device-related complications, and all five cased were cured after appropriate treatment.</p><p><b>CONCLUSIONS</b>Surgical method assisted with Coflex has significant clinical efficacy for degenerative disc disease, it can maintain segmental stability, simultaneously, partly reserve movement. It's key to strictly master indications and precisely choose patients.</p>

Influence of intravertebral cleft for outcome of percutaneous kyphoplasty / 中华外科杂志

<p><b>OBJECTIVES</b>To study incidence and radiological features of intravertebral cleft (IVC) in patients with chronic pain due to osteoporotic vertebral compression fractures (OVCFs), and analyze influence of IVC for surgery of percutaneous kyphoplasty (PKP).</p><p><b>METHODS</b>Seventy-six patients with osteoporotic vertebral compression fractures and pain duration more than one month were underwent procedures of PKP between August 2005 and August 2010. The incidence and radiological features of IVC were analyzed. Sixty-one patients with single-level OVCFs were divided into two groups with and without IVC. Preoperative and postoperative kyphotic angle and relative anterior vertebral height were recorded, as well as visual analogue scales (VAS) and Oswestry disability index (ODI). Cement patterns of opacification and leakage were also recorded.</p><p><b>RESULTS</b>Thirty two patients with 39 vertebrates were found with IVC sign. The diagnostic sensitivity of X ray, CT and MRI for IVC was respectively 33.3%, 85.7% and 84.6%. Two groups with IVC and without IVC both had apparent correction of kyphotic angle and reduction of anterior height at 3 days after surgery and last follow-up (F = 21.82 - 72.18, P < 0.01). There was no statistical significance between two groups (P > 0.05). In addition, both groups had significant improvement as regard to VAS and ODI (F = 131.06 - 364.12, P < 0.01). Solid pattern accounted for 72.0% of all cemented vertebrates in the group with IVC and 19.4% in the group without IVC. Four cement leakage were found in the group with IVC and another four in the group without IVC.</p><p><b>CONCLUSIONS</b>There is a high incidence of IVC in patients with chronic pain due to osteoporotic vertebral compression fractures. CT and MRI are sensitive for detection of IVC. The procedure of PKP is effective for both groups with and without IVC. IVC produces an apparent influence on cement opacification and leakage location during the procedure of PKP.</p>

Effects of qingchang huashi recipe on the dendritic cells of the colonic mucosa and the mesenteric lymph nodes in experimental colitis rats / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effects of qingchang huashi recipe (QHR) on the dendritic cells (DCs) of experimental colitis rats, thus exploring its possible mechanisms for treating ulcerative colitis (UC).</p><p><b>METHODS</b>The UC rat model was induced by TNBS/anhydrous alcohol. Forty male Wistar rats were randomly divided into 4 groups, i.e., the normal group, the model group, the QHR group, and the Mesalazine group, 10 in each group. Since the 2nd day of modeling, corresponding medication was respectively administered to each treatment group by gastrogavage for 10 successive days. The number of DCs in the colonic mucosa was observed using iMmunohistochemical assay. The DCs ratio in the mesenteric lymph nodes, and the expressions of surface molecules MHC-II and CD86 were detected using flow cytometry.</p><p><b>RESULTS</b>Compared with the model group, the number of DCs in the colonic mucosa significantly decreased, the expression of MHC-II in the mesenteric lymph nodes significantly decreased in the QHR group and the Mesalazine group, showing statistical difference (P < 0.01). There was no statistical difference between the two groups (P > 0.05). There was no statistical difference in the DCs ratios and the CD86 expression among the 4 groups (P > 0.05).</p><p><b>CONCLUSION</b>QHR could decrease the infiltration of DCs in the colonic mucosa, and suppress the activation of DCs in the mesenteric lymph nodes, which might be one of its mechanisms for treating UC.</p>

Therapeutic effects and complications of percutaneous pedicle screw fixation for thoracolumbar fractures / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effects and complications of percutaneous pedicle screw fixation for thoracolumbar fractures.</p><p><b>METHODS</b>From January 2002 to December 2008, 103 patients with thoracolumbar fractures were treated with percutaneous pedicle screw fixation, including 75 males and 28 females, the average age was 45.6 years (range, 18 - 72 years). All of them were of no neurological deficits. There were 65 cases of traffic injury, 23 cases of fall injury and 15 cases of smashed injury. According to the Denis classification, 64 patients were of compression fractures, and 39 patients of burst fractures. There were 5 cases had fractures in T(11), 30 in T(12), 42 in L(1), 15 in L(2), 4 in L(3), 3 in L(4), 2 in T(11-12), 1 in L(1-2), and 1 in L(2-3). Radiological examinations, including X-ray and CT examinations, and clinical examinations were carried out to evaluate the therapeutic effects.</p><p><b>RESULTS</b>Twenty one patients were lost to follow up, the remaining were followed up from 10 to 48 months with an average of 27.4 months. Before the operation, the vertebral height, the kyphosis angle and the occupation of spinal canal were (54.5 ± 8.7)%, 16.4° ± 2.9° and 1.2 ± 1.0, and were improved to (88.6 ± 6.4)%, 11.6° ± 2.7° and 0.5 ± 0.6 respectively after the operation. Preoperatively the visual analogue scale and the Oswestry disability index were 8.0 ± 1.2 and 41.2 ± 9.3, and were improved to 1.7 ± 1.8 and 6.7 ± 5.6 postoperatively, respectively. All of these values between pre- and post-operatively were significantly different (P < 0.01). Screw misplacement was found in 7 patients, superficial wound infection in 1, screw breakage in 3, screw dislodgment in 2, cement leakage in 5, transient neurological symptoms in 4, and 8 patients with low back pain remained, of which 2 patients required occasional oral analgesics. Bone fusion achieved in all cases.</p><p><b>CONCLUSIONS</b>The clinical efficacy of percutaneous pedicle screw fixation is similar with conventional open surgery. With the advantages of convenient procedure, less invasive, and rapid recovery, percutaneous pedicle screw fixation is an alternative method for thoracolumbar fractures without neurological deficits.</p>

Application of anterior percutaneous screw fixation in treatment of odontoid process fractures in aged people / 中国骨伤

<p><b>OBJECTIVE</b>To explore the efficacy of anterior percutaneous screw fixation in the treatment of odontoid process fractures in aged people.</p><p><b>METHODS</b>From February 2001 to April 2009, 15 elderly patients with odontoid fracture were treated with anterior percutaneous screw fixation,including 13 males and 2 females; the average age was 69.3 years (ranged, 60 to 86 years). According to Anderson classification, there were 10 patients with type II fractures (type II A in 7 cases, type II B in 3 cases, based on Eysel and Roosen classification), 4 patients with shallow type III fractures, 1 patient with deep type III fractures. Thirteen patients were fresh fractures, 2 patients were obsolete fractures. All patients had varying degrees of neck or shoulder pain, and limit activity of neck. There were 4 patients with neural symptoms including 2 grade D and 2 grade C according to Frankel classification. All the patients were followed up and were assessed by radiology. Clinical examination included neck activity, neurological function and the degree of neck pain. Radiology examinations including anteroposterior, lateral, open mouth position and flexion-extension radiographs of cervical vertebra were performed.</p><p><b>RESULTS</b>After surgery, all patients were followed up,and the duration ranged from 6 to 60 months (averaged 31.3 months). Two patients died of other diseases during the follow-up period (18 and 22 months after surgery respectively). All patients got satisfactory results, and all screws were in good position. As the screw was too long, esophagus was compressed by screw tail in one case. One case showed fibrous union, 12 cases had achieved solid bony union, 2 cases showed nonunion without clinical symptoms. The rotation of neck in 3 cases was mildly limited,the neck function of the remaining patients were normal. Four patients with symptoms nerve injuries improved after operation (Frankel E in 3 cases, Frankel D in 1 case). The symptom of neck pain had a significant improvement after surgery (P < 0.001). The VAS score decreased from preoperative (6.07 +/- 1.44) (4 to 8 scores),to postoperative (1.13 +/- 0.92) (0 to 3 scores). And there were no severe postoperative complications.</p><p><b>CONCLUSION</b>The anterior percutaneous screw fixation is less traumatic than conventional approaches for aged people in dealing with odontoid process fractures. Most patients will achieve satisfactory clinical results, as long as the general conditions of them are comprehensively assess. However, this procedure should not be used in patients with comminuted odontoid fractures or severe osteoporosis.</p>