Tuberculous spondylitis after vertebral augmentation: A case report with a literature review.

Tuberculous spondylitis of vertebral augmentation following percutaneous vertebroplasty or kyphoplasty is rare. We report an unusual case of tuberculous spondylitis diagnosed after percutaneous kyphoplasty (PKP). A 54-year-old woman presented to hospital complaining of back pain following a fall 20 days prior. Radiology showed an acute osteoporotic compression (L3 fracture). The patient denied a history of pulmonary tuberculosis and there were no signs of infection. The patient was discharged from hospital 2 days after undergoing L3 PKP with a dramatic improvement in her back pain. The patient was readmitted 10 months later with a history of recurrent back pain and low-grade fever for 3 months. Imaging examinations showed severe spondylitis at the L2-L3 level, with paravertebral abscess formation and bony destruction of L2 and L3. A positive result of the T-SPOT test preliminarily confirmed the diagnosis of tuberculous spondylitis. The tuberculosis test was positive, and serum C-reactive protein levels and erythrocyte sedimentation were relatively high. Treatment for tuberculous spondylitis was started. She underwent posterior fusion and instrumentation from T12-L5 after markers for infection returned to normal. After surgery, the patient continued antituberculous and anti-osteoporosis treatments. Her low back pain was relieved and low-grade fever and sweating disappeared.

Application of radiotherapy-assistance fixation device in salivary gland scintigraphy / 医疗卫生装备

Objective To apply a simple fixator to salivary gland scintigraphy to evaluate its effect on body position movement. Methods Totally 30 female patients complaining xerostomia were randomly and equally divided into a conventional scan group and a simple fixator group,who were injected with Technetium Tc-99m Pertechnetate intravenously. In the conventional scan group the patients had their necks fixed with the bracket and cushion,while in the other group the fixation was executed with the single fixator. SPECT imager was used for dynamic salivary gland scintigraphy, and two nuclear medicine physicians evaluated the maximum shift of the parotid gland along left-right(X)and head-foot(Y)axes in series of dynamic images. SPSS 16.0 software was used for data analysis. Results In the conventional scan group the maximum shift was(6.6±4.6)mm at X axis and(5.2±3.4)mm at Y axis;in the single fixator group the maximum shift was(3.2± 1.6)mm at X axis and(3.0±1.3)mm at Y axis.There were significant differences between the maximum shifts in the two groups (P=0.012,X axis;P=0.027,Y axis).Conclusion The single fixator assists in salivary gland scintigraphy,and alleviates the body position movement during dynamic acquisition and provides data support for functional parameter calculation and result determination.

A Retrospective Study of Percutaneous Balloon Kyphoplasty for the Treatment of Symptomatic Schmorl's Nodes: 5-Year Results.

BACKGROUND Despite literature supporting the efficiency of percutaneous balloon kyphoplasty (PKP) in treating osteoporotic and malignant vertebral compression fractures, few reports exist that document its use for treatment of symptomatic Schmorl's nodes (SNs) refractory to conservative treatment. Patients with symptomatic SNs could have pain in the vertebrae similar to an acute vertebral compression fracture. MRI is very helpful in diagnosing symptomatic SNs when x-ray and CT scan are unremarkable. In painful cases, the vertebrae bone marrow around the SNs is hyperintense on T2-weighted subsequence. We evaluated the long-term safety and effectiveness of PKP for the treatment of symptomatic SNs not responding to conservative therapy. MATERIAL AND METHODS From January 2008 to December 2012, 32 patients suffering from symptomatic SNs underwent 43 PKP procedures. Outcome data, including mean height ratio of anterior and middle vertebral body, Visual Analog Scale (VAS score) for pain measurement, Oswestry Disability Indexes (ODI score) and SF-36 questionnaires for function measurement were recorded preoperatively, postoperatively, and at one month, six months, two years, and five years after treatment. RESULTS Thirty-two patients were treated successfully with PKP. Clinically asymptomatic cement leakage was observed in three (6.98%) of the treated vertebral bodies. The mean height ratio of anterior and middle vertebral bodies changed from 98.2±1.6% preoperatively to 98.5±1.4% postoperatively (p>0.05) and 98.3±1.5% preoperatively to 98.8±1.9% postoperatively (p>0.05). The mean VAS scores, ODI score, and SF-36 scores for physical function (PF), bodily pain (BF), social functioning (SF), and vitality (VT) all showed significant improvements (p<0.05). During the 5-year follow-up, the stabilization of the height of the vertebral body and functional improvements were all maintained. CONCLUSIONS PKP is a safe and effective procedure for the treatment of symptomatic SNs refractory to conservative therapy.

Effect of axial vertical vibration on degeneration of lumbar intervertebral discs in modified bipedal rats: An in-vivo study

Objective To assess the effects of axial vibrations on gene expression and lumbar intervertebral disc degeneration in vivo. Methods A modified bipedal rat model was established using a brachial plexus rhizotomy approach to imitate human upright posture. The experimental animals were randomly divided into three groups: control, vertical vibration, and whole-body vibration. Gene expression in degeneration of the intervertebral discs was assessed by reverse transcription-quantitative polymerase chain reaction. Results The expression of aggrecan, Col1α1, Col2α1, and decorin were shown to be up-regulated in 14-week-old rats in the vertical vibration and whole-body vibration groups, whereas biglycan and versican expression was down-regulated in 14-week-old rats of the two experimental groups. Furthermore, biglycan and versican expression levels were shown to be lower in the whole-body vibration group than in the vertical vibration group (P < 0.05). Conclusions This in-vivo study demonstrated that vibrations can influence the expression of anabolic genes. Furthermore, whole-body vibrations seem to have a greater effect in this regard than vertical vibrations. A new method is expected to relieve the low back pain of the patients through our research.

Effect of axial vertical vibration on degeneration of lumbar intervertebral discs in modified bipedal rats: An in-vivo study

OBJECTIVE@#To assess the effects of axial vibrations on gene expression and lumbar intervertebral disc degeneration in vivo.@*METHODS@#A modified bipedal rat model was established using a brachial plexus rhizotomy approach to imitate human upright posture. The experimental animals were randomly divided into three groups: control, vertical vibration, and whole-body vibration. Gene expression in degeneration of the intervertebral discs was assessed by reverse transcription-quantitative polymerase chain reaction.@*RESULTS@#The expression of aggrecan, Col1α1, Col2α1, and decorin were shown to be up-regulated in 14-week-old rats in the vertical vibration and whole-body vibration groups, whereas biglycan and versican expression was down-regulated in 14-week-old rats of the two experimental groups. Furthermore, biglycan and versican expression levels were shown to be lower in the whole-body vibration group than in the vertical vibration group (P < 0.05).@*CONCLUSIONS@#This in-vivo study demonstrated that vibrations can influence the expression of anabolic genes. Furthermore, whole-body vibrations seem to have a greater effect in this regard than vertical vibrations. A new method is expected to relieve the low back pain of the patients through our research.

Rationality of the processing methods of aconiti lateralis radix (Fuzi) based on chemical analysis / 药学学报

In this study, we explored the rationality of processing methods and mechanism of Aconiti Lateralis Radix (Fuzi) through comparing the chemical contents of diester alkaloids (DAs) and monoester alkaloids (MAs) in the raw material of Fuzi and its processed products. The results showed that the toxicity potency of MAs is at least lower than 1/64 to 1/180 of the toxicity potency of DAs. The contents of DAs in processed Fuzi decreased to 1/76.5 to 1/38.3 of the value of raw Fuzi. The contents of MAs in processed Fuzi significantly increased by 4.6 to 5.2 fold or basically the same as that of the raw Fuzi. The values of MAs/DAs of processed Fuzi were enhanced by 30 to 390 fold of the raw Fuzi. It was found that the contents of DAs were insignificantly different between "Wu dan fu pian" (steaming or stir-frying without Danba) and "Dan fu pian" (steaming or stir-frying with Danba). The result suggested that the abilities of "eliminating toxicity" of different processing methods were equivalent at all. In contrast, the contents of MAs contained in "Wu dan fu pian" were of 5.3 to 8.7 fold higher than the values in "Dan fu pian". This result suggested the processing method by steaming or stir-frying without Danba might have better effect for "conserving property" than the method processed with Danba stipulated by China Pharmacopoeia. We believe that the new processing method without Danba can be recommended in further application due to it offers a simple procedure and it will not introduce inorganic impurities in the products.

Investigation on the microcirculation effect of local application of natural hirudin on porcine random skin flap venous congestion.

Medicinal leech therapy is commonly used to treat venous congestion by local application to skin flaps, which are frequently employed in re-construction surgery. In the present study, we investigated the effect of natural hirudin, which was applied locally to treat the venous congestion, in random skin flaps in a Guangxi Bama miniature pig model. The congestive random skin flaps were divided into 3 groups: Group A (control group that was locally applied with saline), Group B (locally applied with 20ATU natural hirudin per each flap), Group C (locally applied with 40ATU natural hirudin per each flap). The microcirculatory changes were observed by measuring myeloperoxidase (MPO), malondialdehyde (MDA) and superoxide dismutase (SOD). The level of MPO, MDA and SOD activities in the tissue in hirudin-treated groups was significantly different compared with control group (P < 0.05), but there was no significant difference between group B and group C. At 12 days, as compared to the control group, flap survival rate in hirudin-treated groups was significantly different (P < 0.05), but there was no significant difference between the groups receiving two different doses of hirudin. Natural hirudin can improve microcirculation by inhibiting oxygen free radical damage and also improve flap survival time.

How to Prevent Leaving "Needle Cast" or "Cement Tail" in Vertebroplasty and Kyphoplasty

No abstract available.

Expression of P-glycoprotein, multidrug resistance associated protein, lung resistance-related protein, P53 and c-erbB-2 in non-small cell lung cancer / 第二军医大学学报

Objective: To investigate the expression of P-glycoprotein (P-gp), multidrug resistance-related protein (MRP), lung resistance-related protein (LRP), P53 and c-erbB-2 in untreated non-small cell lung cancer (NSCLC) and their relationship with each other. Methods: The expression of P-gp, MRP, LRP, P53 and c-erbB-2 was detected in the carcinoma tissues of 78 NSCLC patients and 15 adjacent normal lung tissues (5 cm apart from tumors) by means of immunohistochemistry. Results: The positive rates of P-gp, MRP, LRP, P53 and c-erbB-2 in tumor tissues were 65.4%, 39.7%, 56.4%, 53.8% and 43.6%, respectively, all significantly higher than those in normal tissues(P<0.05). There was also significant difference in MRP and LRP expression between different pathologic types of NSCLC(squamous cell carcinoma, adenocarcinoma, large cell carcinoma) (P=0.008 and <0.001, respectively). Expression of LRP and P53 was also significantly different between different degrees of pathological differentiation (well, moderate, poor) (P=0.025 and 0.026, respectively). The expression of c-erbB-2 was correlated with those of P-gp, MRP, LRP and P53 (Spearman R=0.317, 0.401, 0.519 and 0.341, respectively; P=0.005, < 0.001, <0.001 and =0.002, respectively); the expression of P53 was correlated with that of MRP (Spearman R=0.260, P= 0.022); and the expression of LRP was correlated with that of MRP (Spearman R=0.371, P=0.001). Conclusion: Overexpression of P-gp, MRP, LRP, P53 and c-erbB-2 may play a cooperative role in the drug resistance and development of NSCLC.