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Objective@#This study aimed to assess the technical feasibility, efficacy, and safety of the safe triangular working zone (STWZ) approach applied in percutaneous vertebroplasty (PV) for spinal metastases involving the posterior part of the vertebral body. @*Materials and Methods@#We prospectively enrolled 87 patients who underwent PV for spinal metastasis involving the posterior part of the vertebral body, with or without the STWZ approach, from January 2019 to April 2022. Forty-nine patients (27 females and 22 males; mean age ± standard deviation [SD], 57.2 ± 11.6 years; age range, 31–76 years) were included in group A (with STWZ approach), accounting for 54 vertebrae. Thirty-eight patients (18 females and 20 males; 59.1 ± 10.9 years; 29–81 years) were included in group B (without STWZ approach), accounting for 57 vertebrae. Patient demographics, procedure-related variables, and pain relief as assessed using the visual analog scale (VAS) were collected at different time points. Tumor recurrence in the vertebrae after PV was analyzed using Kaplan–Meier curves. @*Results@#The STWZ approach was successful from T1 to L5 without severe complications. Cement filling was satisfactory in 47/54 (87.0%) and 25/57 (43.9%) vertebrae in groups A and B, respectively (v< 0.001). Cement leakage was not significantly different between groups A and B (p= 1.000). Mean VAS score ± SD before and 1 week and 1, 3, 6, 9, and 12 months after PV were 7.6 ± 1.8, 4.2 ± 2.0, 2.7 ± 1.9, 1.9 ± 1.5, 1.7 ± 1.4, 1.7 ± 1.1, and 1.6 ± 1.3, respectively, in group A and 7.2 ± 1.7, 4.0 ± 1.3, 3.4 ± 1.6, 2.4 ± 1.2, 1.8 ± 1.0, 1.4 ± 0.5, and 1.7 ± 0.9, respectively, in group B. Kaplan–Meier analysis showed a lower tumor recurrence rate in group A than in group B (p = 0.001). @*Conclusion@#The STWZ approach may represent a new, safe, alternative/auxiliary approach to target the posterior part of the vertebral body in the PV for spinal metastases.
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The quality markers(Q-markers) of Shujin Huoxue Capsules were comprehensively discriminated based on the five principles of transfer and traceability, specificity, compatibility, effectiveness and measurability. The compounds that could be transferred from the original medicinal materials to the preparation were selected with the principle of transfer and traceability. The specific components in the prescription were screened by reviewing literature with the principle of specificity. According to the principle of compatibility, the attributes of compounds were evaluated by the sovereign, minister, assistant and guide combination rules of the original medicinal materials in the prescription. According to the principle of measurability, the measurable components were summarized by reference to the pharmacopoeia and literature combined with the content. The mechanism of Shujin Huoxue Capsules in the treatment of osteoporosis was studied through network pharmacology based on the principle of effectiveness, which was the evaluation index of effectiveness. The chemical components screened out above were regarded as candidate Q-markers, and the cobweb model was plotted to obtain the comprehensive score of Q-markers. Hydroxysafflor yellow A, trachelosid, eleutheroside B, α-cyperone, protocatechuic acid, protocatechualdehyde and 4-methoxy salicylaldehyde were discriminated as the Q-markers of Shujin Huoxue Capsules based on the five principles combined with cobweb model.
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Biomarcadores , Cápsulas , Medicamentos Herbarios Chinos/farmacologíaRESUMEN
Objective: To establish the fingerprint chromatography of Shujin Huoxue products (Shujin Huoxue Capsule and Shujin Huoxue Tablet) and provide a reference for its overall quality evaluation. Methods: The analysis was performed on Agilent Poroshell 120 SB-C18 (150 mm × 4.6 mm, 2.7 μm) column with acetonitrile-0.2% formic acid solution for gradient elution, the flow rate was 0.5 mL/min, the detection wavelength was 277 nm, and the column temperature was 30 oC. HPLC of 23 batches of Shujin Huoxue products were analyzed by the software “Similarity Evaluation System for Chromatographic Fingerprint of TCM (2012 edition)” combined with principal component analysis (PCA), cluster analysis (CA), and orthogonal partial least squares discriminant analysis (OPLS-DA). Results: The similarity of 18 batches (S1-S17 and S23) of samples was more than 0.900, 23 batches of samples could be clustered into three groups by PCA, CA, and OPLS-DA analysis. Among these, S1-S16 were clustered into group I, S23 and S17 could be divided into group II, and S18-S22 were clustered into group III. Four common peaks with larger differences were determined from 10 common peaks, including peaks 1, 3 (5-hydroxymethylfurfural), 6 (phenylacetic acid), and 10 (4-methoxy salicylaldehyde). Conclusion: Fingerprint chromatography combined with chemical pattern recognition technique was stable and simple, which could be used to evaluate the quality of Shujin Huoxue products systematically and comprehensively.
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OBJECTIVE: To report our initial experience of percutaneous sacroplasty (PSP) with an interpedicular approach for treating painful sacral metastases involving multiple sacral vertebral bodies. MATERIALS AND METHODS: This study prospectively enrolled 10 consecutive patients (six men and four women; mean age, 56.3 ± 13.8 years) who underwent PSP for painful sacral metastases involving multiple sacral vertebral bodies from March 2017 to September 2018. Visual analogue scale (VAS) scores, Oswestry disability index (ODI) values, and the number of opioids prescribed to the patients were assessed before and after PSP. The procedure duration, length of hospitalization, and complications were also recorded. RESULTS: Mean VAS and ODI declined significantly from 6.90 ± 1.20 and 74.40 ± 5.48 before the procedure to 2.70 ± 1.34 and 29.60 ± 14.57 after the procedure, respectively (p < 0.01). The median number of opioids prescribed per patient decreased from 2 (interquartile range [IQR] 1-3) pre-procedure to 1 (IQR 0–3) post-procedure (p < 0.01). Nine of the 10 patients showed no or decreased opioid usage, and only 1 patient showed unchanged usage. The mean procedure duration was 48.5 ± 3.0 minutes. The average length of hospitalization was 4.7 ± 1.7 days. Extraosseous cement leakage occurred in three cases without causing any clinical complications. CONCLUSION: PSP with an interpedicular approach is a safe and effective treatment in patients with painful sacral metastases involving multiple sacral vertebral bodies and can relieve pain and improve mobility.
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Femenino , Humanos , Masculino , Analgésicos Opioides , Hospitalización , Metástasis de la Neoplasia , Estudios ProspectivosRESUMEN
OBJECTIVES@#To investigate the genetic polymorphisms of 18 autosomal short tandem repeats (STR) loci in Changsha Han population, and explore the population genetic relationships and evaluate its application value in forensic medicine.@*METHODS@#The DNA of 2 004 unrelated individuals in Changsha Han population were amplified using Goldeneye®DNA ID System BASIC, and the PCR products were analyzed by electrophoresis using 3130xl genetic analyzer. The fragment sizes of alleles were analyzed subsequently by GeneMapper® ID v3.2. The frequency data and forensic genetic parameters [observed heterozygosity (Ho), expected heterozygosity (He), power of discrimination (DP) and polymorphic information content (PIC)] of 18 STR loci were statistically analyzed. Total probability of discrimination (TDP), probability of exclusion in trio cases (PEtrio) and probability of exclusion in duo cases (PEduo) were calculated by Cervus 3.0. Hardy-Weinberg equilibrium and linkage disequilibrium of the loci were detected by Arlequin v3.5. The results were compared with the available data of other populations from different races and regions.@*RESULTS@#The power of discrimination (DP), and the polymorphic information content (PIC) of each locus of Changsha Han population ranged from 0.783 6 to 0.987 9 and 0.549 4 to 0.914 5, respectively. The TDP, cumulative probability of exclusion in trio cases (CPEtrio) and cumulative probability of exclusion in duo cases (CPEduo) were 0.999 999 999 999 999 999 999 865 2, 0.999 999 979 and 0.999 988 325, respectively. According to the Nei's DA genetic distance, the genetic distance between Changsha Han and Hunan Han populations was the smallest (0.014 1), while it was the largest (0.041 8) between Changsha Han and Xinjiang Kazakh populations.@*CONCLUSIONS@#The 18 STR loci shows abundant genetic polymorphisms in Changsha Han population. The study of genetic diversity among different populations has an important meaning for the research of their origins, migrations and their relationships.
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Humanos , Masculino , Alelos , Pueblo Asiatico/genética , China , ADN/análisis , Frecuencia de los Genes , Genética de Población , Repeticiones de Microsatélite , Polimorfismo GenéticoRESUMEN
Glucocorticosteroid-induced osteoporosis is the most frequent of all secondary types of osteoporosis, and can increase the risk of vertebral compression fractures (VCFs). There are promising additions to current medical treatment for appropriately selected osteoporotic patients. Few studies have reported on the efficiency of percutaneous vertebroplasty (PVP) or kyphoplasty for whole thoracic and lumbar glucocorticosteroid-induced osteoporotic vertebral compression fractures. We report a case of a 67-year-old man with intractable pain caused by successional VCFs treated by PVP.
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Anciano , Humanos , Masculino , Artritis Reumatoide/tratamiento farmacológico , Fracturas por Compresión/diagnóstico por imagen , Glucocorticoides/efectos adversos , Cifoplastia , Vértebras Lumbares/diagnóstico por imagen , Osteoporosis/inducido químicamente , Fibrosis Pulmonar/tratamiento farmacológico , Vértebras Torácicas/diagnóstico por imagen , VertebroplastiaRESUMEN
<p><b>OBJECTIVE</b>To study the mechanism of prophylactic effects of nasal tolerance with a dual analogue (Lys262-Ala207) on experimental autoimmune myasthenia gravis (EAMG).</p><p><b>METHODS</b>Clinical and immunological changes were observed in Lewis rats administered with dual analogue Lys262-Ala207 nasally, to compare the effects between the rats with predetermined dosage of Lys262-Ala207 and control peptides at two different time points, before the day (Group A or C) or on the day (Group B or D) of immunization with acetylcholine receptor (AChR) in complete Freud's adjuvant for 10 consecutive days. The clinical scores was evaluated for 50 days post immunization. Numbers of MNC expressing IFN-gamma, IL-4 or IL-10 and CD4+ and/or CD25+ from lymph nodes were enumerated by flow cytometry. Proliferative response, expressed as stimulation index (SI), was suppressed in response to antigen-specific stimulation in the rats receiving dual analogue, as compared with the rats receiving saline buffer only.</p><p><b>RESULTS</b>Group A and group B of Lewis rats developed EAMG with reduced severity, as compared to the control groups. Number of cells synthesizing IFN-gamma, IL-4 or IL-10 decreased, whereas numbers of CD4+CD25+ cells increased in group A and B than those in the control groups. Proliferative response was suppressed in response to antigen-specific stimulations in the rats receiving dual analogue Lys262-Ala207.</p><p><b>CONCLUSIONS</b>Nasal administration with a dual analogue Lys262-Ala207 at two different time points, before the day and on the day of immunization, could delay symptoms of muscular weakness in EAMG rats, which was associated with suppression of immune function in AChR antigen-specific T cells and lay a scientific foundation for treatment of human MG with nasal dual analogue.</p>
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Animales , Femenino , Ratas , Administración Intranasal , Afinidad de Anticuerpos , Autoanticuerpos , Alergia e Inmunología , Relación Dosis-Respuesta Inmunológica , Tolerancia Inmunológica , Inmunidad Celular , Inmunidad Mucosa , Activación de Linfocitos , Miastenia Gravis , Alergia e Inmunología , Mucosa Nasal , Alergia e Inmunología , Ratas Endogámicas LewRESUMEN
The purpose of the present study was to investigate the mechanism of the effect of estrogen on the production of acetylcholine in the brain and to study the regulatory role of acupuncture of Zusanli acupoint in acetylcholine production in the brain of ovariectomized rats. Experimental female Wistar rats were divided into three groups: intact group (INT), ovariectomized group (OVX), and ovariectomy and acupuncture group (OVX+AC). Radioimmunoassay (RIA) was used to measure the estrogen content in plasma. The mRNA expression of choline-acetyltransferase (ChAT) and glyceraldehyde phosphate dehydrogenase (GAPDH) in the brain of rats was measured by the RT-PCR technique and was tested by the method of agarose gel electrophoresis. The ChAT mRNA positive neurons in the hippocampus were observed by using in situ hybridization and the results were processed with a computerized image analysis system. The results are as follows. Compared with the control animals, the plasma estrogen level was significantly lowered in ovariectomized animals. However, the plasma estrogen level was higher in the OVX+AC group than that of the OVX group. The ChAT mRNA expression level of OVX+AC group was higher than that of the OVX group. The area and integral optical density of the ChAT mRNA positive neurons in the hippocampus increased more obviously in OVX+AC group than in the OVX group. The experimental results observed indicate that the expression of ChAT gene in the brain is possibly related to the estrogen level in the body. The expression of ChAT gene in the brain of the ovarietomized rat can be regulated by acupuncture of Zusanli acupoint and it may be one of the mechanisms that acupuncture increases acetylcholine content in the brain.