The Clinical Results of Percutaneous Endoscopic Interlaminar Discectomy (PEID) in the Treatment of Calcified Lumbar Disc Herniation: A Case-Control Study.

BACKGROUND: Percutaneous endoscopic interlaminar discectomy (PEID), which poses advantages for certain types of herniated disc, is gaining wider acceptance in clinical practice. We retrospectively analyzed the efficacy of the PEID technique in treatment of calcified lumbar disc herniation. STUDY DESIGN: A retrospective case-control study. SETTING: University hospital in China. OBJECTIVE: To evaluate the efficacy of the PEID technique in treatment of calcified lumbar disc herniation, and a comparison between calcified and noncalcified disc herniation was drawn to analyze the causes of herniated disc calcification. METHODS: Data from patients who underwent full-endoscopic lumbar discectomy in our department between March 2011 and May 2013 were collected. Thirty cases with calcified lumbar disc herniation were included in the study group, and 30 age-, gender-, and body mass index (BMI)-matched cases with noncalcified lumbar disc herniation served as controls. Perioperative data, preoperative and postoperative Visual Analog Scale (VAS) scores, Oswestry Disability Index (ODI) values, MacNab scores, and postoperative low-extremity dysesthesia among patients in the 2 groups were collected. RESULTS: The values of computed tomography (CT) in the calcified group were significantly higher than those in the noncalcified group (P < 0.01). The preoperative disease courses in the 2 groups were similar. However, there was a statistically significant difference in the duration of traditional Chinese medicines (TCM) administration (P < 0.01). VAS and ODI scores improved significantly after surgery, but there were no significant differences between the 2 groups (P > 0.05). Three months after surgery, the rate of low-extremity dysesthesia in the calcified group was significantly higher than that in the control group (P = 0.03) but became similar at 6 months. By applying MacNab criteria the proportions of good and excellent were greater than 90% in both groups, and there was no difference between groups (P > 0.05). LIMITATIONS: The sample size was small in this retrospective study. CONCLUSION: The PEID technique is an effective method in the treatment of calcified lumber disc herniation, although the rate of postoperative dysesthesia is higher in this group during the early postoperative period. Long-term TCM administration may be related to the calcification of herniated lumbar discs.

Progress on nano-sized drug delivery system reversing tumor and multidrug resist-ance of osteosarcoma / 药学实践杂志

Multidrug resistance (MDR) of tumor cell is the major problem for chemotherapy.However,there is no ef-fective strategy to overcome MDR due to the complicated mechanism.The nano-sized drug delivery system could target to the tumor cell.Moreover,it could delivery different kinds of drugs.Therefore,the nano-sized drug delivery system has become a promising approach to reverse MDR.The nano-sized drug delivery system which is applied to treat the MDR of tumor (osteo-sarcoma) was summarized and the reverse mechanism was discussed.

Changhai fulcrum bending radiographic technique to assess curve flexibility in patients with adolescent idiopathic scoliosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the role and value of Changhai fulcrum bending radiograph(CH-FBR) in curve flexibility assessment of adolescent idiopathic scoliosis(AIS) patients.</p><p><b>METHODS</b>Thirty-seven AIS patients treated between June 2012 and August 2013 were enrolled, including 31 female and 6 male patients whose age ranged from 10 to 19 years, averaged of 15.0 years. The assessment of radiographs included preoperative standing posterior-anterior radiograph, supine side-bending radiograph, traditional fulcrum bending radiograph, Changhai fulcrum bending radiograph and postoperative standing posterior-anterior radiograph. Postoperatively, radiographs were assessed at one week. The CH-FBR was performed at the lowest height and the optimized height which means the weight on the fulcrum touch the maximum. All measurements of angle were made with use of the Cobb method. The flexibility of the curve as well as the correction rate and fulcrum bending correction index (FBCI) were calculated for all patients. The maximum height of CH-FBR, basic weight and maximum weight were measured for all AIS. Paired t-tests were used to assess differences between preoperative and postoperative curves within group samples. The Pearson correlation coefficients were calculated using bivariate analysis between CH-FBR flexibility rate and correction rate, the maximum height of CH-FBR and maximum weight, the height changes of CH-FBR and weight changes.</p><p><b>RESULTS</b>A total of 46 curves were involved in this study, including 28 thoracic and 18 thoracolumbar/lumbar curves. Preoperatively, the mean Cobb angle of the 46 structural curves was 47° ± 11°. Postoperatively, the mean Cobb angle was 11° ± 5°. Cobb's angle in supine side-bending(t = 7.2, P = 0.001), traditional fulcrum bending (t = 7.1, P = 0.001) and lowest height of Changhai fulcrum bending (t = 6.5, P = 0.001) were significantly different from the postoperative Cobb angle; Cobb's angle in traditional FBR (t = 11.0, P = 0.001) and lowest height of Changhai fulcrum bending (t = 13.6, P = 0.001) were significantly different from the optimized height CH-FBR Cobb angle. There was no significant difference found between traditional FBR Cobb angle and lowest height CH-FBR Cobb angle (t = 2.0, P = 0.051), optimized height CH-FBR Cobb angle and postoperative Cobb angle (t = 0.9, P = 0.36), lowest height CH-FBR Cobb angle and traditional FBR Cobb angle(t = 2.0, P = 0.051). The maximum height of CH-FBR, basic weight and maximum weight were (29.6 ± 1.4)cm,(20 ± 6)kg, and (40 ± 6) kg. Preoperatively, the mean Cobb angle of the 28 structural curves(main thoracic curves) was 46° ± 11°. Postoperatively, the mean Cobb angle was 12° ± 6°. Preoperatively, the mean Cobb angle of the 18 structural curves(thoracolumbar/lumbar curves) was 49° ± 12°. Postoperatively, the mean Cobb angle was 10° ± 5°. The results were same in 28 structural curves, 18 structural curves as well as 46 curves. Correlation analysis of 46 curves indicated that the maximum height of CH-FBR positively correlated with maximum weight (r = 0.69, r(2) = 0.47, P = 0.001), the height changes of CH-FBR positively correlated with weight changes on CH-FBR (r = 0.62, r(2) = 0.38, P = 0.001).</p><p><b>CONCLUSIONS</b>CH-FBR is a more reliable and effective method than traditional FBR and supine side-bending for curve flexibility evaluation in AIS patients. Moreover, compared to the traditional FBR and side-bending radiograph, the flexibility suggested by the optimized height CH-FBR more closely approximates the postoperative result made by pedicle screws fixation and fusion.</p>

Neurobehavioral effects of occupational exposure to acrylonitrile in Chinese workers.

We examined neurobehavioral outcomes of Chinese workers exposed to acrylonitrile, a potentially neurotoxic substance. We used the WHO-recommended neurobehavioral core test battery to assess the neurobehavioral functions of all study subjects. We compared 81 workers in an acrylonitrile-monomer plant and 94 workers in an acrylic fibers plant with 174 workers with no workplace acrylonitrile exposure. Acrylonitrile workers reported increased tension, depression, anger, fatigue and confusion on the Profile of Mood States. Performances in the Simple Reaction Time, Digit Span, Benton Visual Retention and Pursuit Aiming II were also poorer among exposed workers compared to unexposed workers. Some of these poor performances in tests were also related to exposure duration. Given the findings of our study and the limitations of neurobehavioral workplace testing, we found evidence of neuropsychological impairment induced by exposure to acrylonitrile. Further studies are needed to characterize potential neurotoxicity from chronic and acute exposures to acrylonitrile.

Effects of nordihydroguaiaretic acid on genomic methylation pattern of malignant glioma cells and its significance / 第三军医大学学报

Objective　To investigate the genomic methylation pattern of a malignant glioma cell line in the process of differentiation induced by nordihydroguaiaretic acid (NDGA). Methods　Methylation-sensitive arbitrarily primed PCR was used to study the genomic methylation changes. Results　Fragments of genomic DNA of PCR products in control groups digested with MspⅠ were smaller than those with HpaⅡ. No large fragment could be identified and at least three fragments of different sizes were demonstrated in the control group. In NDGA treatment group, comparing MspⅠ digestion with HpaⅡ digestion, the amount of PCR products was smaller with more DNA bands. The amount of PCR products in NDGA treatment group was increased with more DNA bands compared with that in the control groups. Conclusion　The genomic methylation level in SHG-44 cells was increased by NDGA in the differentiation process of SHG-44 cells. It suggests that genomic methylation pattern may be one of the targets for glioma cell differentiation induced by NDGA.

Effects of nordihydroguaiaretic acid on the expression of GFAP gene of human malignant glioma cell line SHG-44 / 第三军医大学学报

Objective　To investigate the expression of glial fibrillary acidic protein (GFAP) gene and its significance in the process of glioma cell differentiation induced by nordihydroguaiaretic acid (NDGA). Methods　Immunohistochemistry (IHC) and in situ hybridization were used to detect the expression changes of GFAP protein and GFAP mRNA qualitatively and quantitatively. Results　The expression levels of GFAP protein and GFAP mRNA in NDGA treatment group were significantly increased compared with the control group (P<0.01). Conclusion　NDGA could induce GFAP gene in malignant glioma cells and the up-regulation of this gene expression might be one of the mechanisms by which NDGA induces glioma differentiation.

Roles of cyclin-dependent kinase 4 (CDK4) in nordihydroguaiaretic acid-induced inhibitory effect on proliferation of human malignant glioma cells / 第三军医大学学报

Objective　To investigate roles of cyclin-dependent kinase 4 (CDK4) in nordihydroguaiaretic acid (NDGA)-induced inhibitory effect on proliferation of human malignant glioma cells. Methods　The techniques of cell culture, cell counts, flow cytometry, immunoprecipitation, immunohistochemistry and image analysis were employed in this study. Results　①A concentration-dependent inhibition of proliferation was demonstrated in the SHG-44 cells incubated for 24 hours in the presence of NDGA, and cell proliferation was blocked in the G1→S phase. ②The activity of CDK4 was decreased apparently in the SHG-44 cells treated for 24 hours with 10 to 200 μmol/L NDGA in a concentration-dependent way. ③The expression of CDK4 gene was downregulated in the cells after NDGA treatment. Conclusion　CDK4 plays an important role in NDGA-induced inhibition of glioma cell proliferation.

Significance of bcl-2 and c-myc gene expression in nordihydroguaiaretic acid-induced apoptosis of a human malignant glioma cell line / 第三军医大学学报

Objective　To investigate the changes and their significance of bcl-2 and c-myc in nordihydroguaiaretic acid (NDGA)-induced apoptosis of human malignant glioma cell line SHG-44. Methods　The apoptosis of SHG-44 cells was observed with light and electron microscopy and TUNEL method. The expression of bcl-2 and c-myc gene was measured with immunohistochemistry, in situ hybridization and image analysis. Results ① The SHG-44 cell apoptosis was induced by NDGA at a concentration lower than 200 μmol/L in a time-dependent manner. ② The expressions of bcl-2 and c-myc gene in SHG-44 cells were decreased after the treatment of 100 μmol/L NDGA with the elapse of time, indicating a close association with cell apoptosis. ③ The expressions of bcl-2 and c-myc mRNA in SHG-44 cells were decreased after the treatment with 100μmol/L NDGA, which was apparently consistent with the immunohistochemical results. Conclusion　The NDGA-induced apoptosis in human malignant glioma cells might be related with the down-regulated expressions of bcl-2 and c-myc gene. The exact mechanism needs further research.