Impact of meteorological factors on hospital admissions for spinal diseases in Shanghai during 2015-2019.

PURPOSE: To assess the correlation between meteorological factors and spinal disease admissions. METHODS: Data was obtained from the electronic medical records of a tertiary general hospital. Meteorological data was collected from China Meteorological Science Data Sharing Service. Distributed lag nonlinear models were used to evaluate the impact of meteorological variables on weekly spinal disease admissions. RESULTS: A total of 2739 spinal cases were documented. Compared with estimates at the 50th, the cumulative relative risk (RR) for extremely high temperatures at the 97.5th over lag week 18 to lag week 20 increased by 75.7%. When the weekly maximum temperature reached 38°C during lag week 20, the maximum RR was 1.96 (95% CI:1.095-3.506). Moreover, the effects of extremely high temperatures on spinal disease admissions were more obvious in females and the age group ≥65 years old compared with males and the age group<65 years old. CONCLUSIONS: Extremely high temperatures were significantly associated with higher risks of spinal disease admissions.

Etiology for Degenerative Disc Disease.

Degenerative disc disease is a multifaceted progressive irreversible condition and an inevitable part of aging, which has been found to be a contributing factor for low back pain and might cause radiculopathy, myelopathy, spinal stenosis, degenerative spondylolisthesis, and herniations. Its etiology is complex and multifactorial. Although genetics influence more dominant, the occupational and mechanical influences still persist as a major risk factor. This review emphasizes up-to-date knowledge regarding etiology of disc degeneration with special consideration on occupational, lifestyle factors, and genetic polymorphisms.

Quantitative assessment of the effect of ABCA1 gene polymorphism on the risk of Alzheimer's disease.

ATP-binding cassette transporter A1 (ABCA1) is a membrane-associated protein which has attracted considerable attention as a candidate gene for Alzheimer's disease (AD) based on its function as a key factor in lipid metabolism by mediating cellular cholesterol efflux, the rate-limiting step in the production of nascent high-density lipoprotein (HDL) particles. The relationship between ABCA1 common variations (R219 K rs2230806, I883 M rs4149313 and R1587 K rs2230808) and AD has been reported in various ethnic groups; however, these studies have yielded contradictory results. To investigate this inconsistency, we performed a meta-analysis of 13 studies involving a total of 12,248 subjects to evaluate the effect of ABCA1 on genetic susceptibility for AD. Overall, the summary OR of AD was 1.01 (95 % CI: 0.93-1.10; P = 0.77), 1.10 (95 % CI: 0.96-1.26; P = 0.16), and 1.08 (95 % CI: 0.96-1.23; P = 0.21) for R219 K, I883 M and R1587 K polymorphism, respectively. No significant results were observed in dominant and recessive when compared with wild genotype for these polymorphisms. In the stratified analyses by ethnicity and sample size, no evidence of any gene-disease association was obtained. In conclusion, the present meta-analysis does not support the notion that common SNPs on ABCA1 is a major genetic risk factor for AD.

Proteasome inhibitor bortezomib targeted tumor-endothelial cell interaction in T-cell leukemia/lymphoma.

Endothelial cells have special relevance in tumor progression. Here, we investigated the effect of the proteasome inhibitor bortezomib on tumor-endothelial cell interaction in T-cell leukemia/lymphoma. In vitro, T-leukemia/lymphoma cell lines and primary T-leukemia/lymphoma cells were cultured with endothelial cells, either together or separately in Millicell Hanging Cell Culture system, the latter permits mutual cell exchange. At clinically achievable concentrations, in addition to a direct cytotoxicity on T-leukemia/lymphoma cells, bortezomib inhibited tumor cell adhesion to endothelial cells and endothelial cell migration toward tumor cells. In vivo, a murine tumor xenograft model was achieved by subcutaneous injection of Jurkat cells. Bortezomib also triggered an inhibition on tumor-endothelial cell contact and subsequent tumor cell infiltration. Cell adhesion molecule intracellular cell adhesion molecule-1 expression was significantly downregulated both on the tumor cells and on the endothelial cells. Taken together, bortezomib could not only act on tumor cells themselves but also abrogate tumor cell interaction with endothelial cells. This delineates another therapeutic mechanism of bortezomib in T-cell malignancies.

[360 degrees fixation of lumbar spine].

OBJECTIVE: To estimate the effects of the treatment of 360 degrees fixation of lumbar spine. METHODS: Twenty-five cases were operated to 360 degrees fixation of lumbar spine from May 2002 to May 2005. There were 11 male and 14 female, the age ranging from 45 to 67 years, mean 56, including 16 cases of spondylolysis, 7 cases of lumbar spinal instability and 2 cases of degenerative disc undergone with anterior laparoscopic lumbar interbody fusion with syncage and autograft and posterior decompression with facet fixation. The chief complains were low back pain and radiating to lag. Fourteen cases were fused at L(4), 5 and 11 cases at L(5)-S(1). The Oswestry Disability Index (ODI) were recorded to evaluate the function at pro-operation, the second week, the third, sixth and twelfth month post-operation. The X-ray was taken to observe the fusion and the sinking cage. RESULTS: The time intro-operation was from 110 to 180 minutes, mean 120 minutes. There was one complication in 1 case by the main vein injury. All of the 25 cases were followed-up post-operation from 12 to 35 months, mean 22.3 months. The ODI was found prominent difference compared with pro-operation in 2 weeks, 3, 6 and 12 months post-operation (P < 0.05). Twenty-five cases were fused in the third month. Two cases sank 1 mm in the third month images but solid fusion. No cage displacement was found. No retrograde ejaculation happened. CONCLUSIONS: 360 degrees fixation of lumbar spine adapts to deal with lumbar instability, degenerative disc disease and I, II degree spondylolysis. It shows less bleeding and injury, but during exposure and traction the main vessels should be very careful.

18F-FDG PET, combined FDG-PET/CT and MRI for evaluation of bone marrow infiltration in staging of lymphoma: a systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Evaluation of bone marrow infiltration is an essential step in the staging of lymphoma. The accuracy of (18)F-fluorodeoxyglucose-positron emission tomography ((18)F-FDG PET), combined (18)F-fluorodeoxyglucose-positron emission tomography/computed tomography ((18)F-FDG-PET/CT) and magnetic resonance imaging (MRI) in diagnosing bone marrow involvement of lymphoma has never been systematically assessed, and the present systematic review was aimed at this issue. METHODS: MEDLINE, EMBASE, Cochrane library and some other databases, from January 1995 to July 2010, were searched for initial studies. All the studies published in English or Chinese relating to the diagnostic value of (18)F-FDG PET, PET/CT and MRI for patients with bone marrow involvement of lymphoma were collected. We extracted data to calculate sensitivity, specificity, SROC curves and AUC and to test for heterogeneity. The statistic software called "Meta-Disc 1.4" was used for data analysis. RESULT: In 32 included studies, PET/CT had the highest pooled sensitivity, 91.6% (95%CI: 85.1, 95.9) and highest pooled specificity, 90.3% (95%CI: 85.9, 93.7). PET/CT also had the highest pooled DOR, 68.89 (95%CI: 15.88, 298.92). The AUC of PET, PET/CT, and MRI were 0.9430, 0.9505 and 0.8764. There was heterogeneity among studies and no evidence of publication bias. CONCLUSION: PET/CT was a highly sensitive and specific modality in diagnosing patients with bone marrow involvement in lymphoma. Compared with MRI and PET alone, PET/CT can play important roles in the staging of lymphoma.

Short-term outcome of bilateral decompression via a unilateral paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation.

The purpose of this study was to evaluate the clinical and radiologic outcomes of bilateral decompression via a unilateral paramedian approach for transforaminal lumbar interbody fusion. Forty consecutive patients satisfying the inclusion criteria were divided randomly into groups 1 and 2. Patients were treated with unilateral (group 1) or bilateral (group 2) pedicle screw fixation and bilateral decompression via 1-sided (group 1) or bilateral (group 2) paramedian approach. Perioperative parameters (operation time, blood loss, hospital stay, complications, and implant cost), clinical outcome parameters (Japanese Orthopedic Association [JOA] scores, visual analog scale [VAS] scores, and Oswestry Disability Index [ODI] preoperatively and at 1 week and 3 months postoperatively), and radiologic parameters (radiograph and computed tomography [CT] scan preoperatively and at 1 week postoperatively) were compared.No differences were seen between groups 1 and 2 with respect to operation time, blood loss, or hospital stay. No complications were observed in either group. The ODI, JOA, and VAS values of both groups showed significant differences between the preoperative and 1-week or 3-month postoperative values. No significant differences were seen in the improvements of the ODI, JOA, and VAPS values between groups 1 and 2 at any postoperative time point. Postoperative CT indicated that the contralateral decompression was sufficient in both groups.The short-term results indicate that bilateral decompression via a unilateral paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation is safe, feasible, and effective over the short-term and is more cost-efficient than a bilateral paramedian approach.

Endoscopic ultrasound-guided fine-needle aspiration biopsy in the evaluation of bile duct strictures and gallbladder masses: a systematic review and meta-analysis.

STUDY OBJECTIVES: Recently, there are very few research on endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of bile duct and gallbladder masses. The objective of this study was to assess the overall diagnostic accuracy of EUS-FNA in the evaluation of patients with bile duct strictures and gallbladder masses with a meta-analysis. METHODS: The MEDLINE, EMBASE, Cancerlit and Cochrane Library, and other database, from January 1995 to July 2010, were searched for studies evaluating EUS-FNA accuracy. Meta-analysis methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio, summary receiver operating characteristic curves, and the Q* index. RESULTS: A total of nine studies with 284 patients, who fulfilled all the inclusion criteria, were considered for the analysis. EUS-FNA had a pooled sensitivity of 0.84 (95% confidence interval: 0.78-0.88) and a pooled specificity of 1.00 (95% confidence interval: 0.94-1.00). Overall area under the curve was 0.9254, The Q* index was 0.8598 and the calculated diagnostic odds ratio was 75.1. No complications occurred. CONCLUSION: EUS-FNA was an accurate and safe tool in the evaluation bile duct and gallbladder masses. High-quality prospective studies regarding EUS-FNA in the evaluation of patients with bile duct and gallbladder masses are still needed to be conducted.

Eriocalyxin B induces apoptosis in lymphoma cells through multiple cellular signaling pathways.

OBJECTIVE: Eriocalyxin B (EriB) is a natural diterpenoid purified from Isodon eriocalyx var. laxiflora and possesses strong antileukemic activity. In this study, we further investigated its effect and mechanism of action in human lymphoma. MATERIALS AND METHODS: In vitro, a series of B- and T-lymphoma cells were treated with EriB. Cell apoptosis was analyzed using flow cytometric assay. Expression of proteins related to apoptosis and cell signal transduction were assessed using Western blot. In vivo antitumor activity of EriB was examined in murine xenograft B- and T-lymphoma models, with in situ cell apoptosis detected by terminal deoxytransferase-catalyzed DNA nick-end labeling assay. RESULTS: EriB significantly inhibited lymphoma cell proliferation and induced apoptosis in association with caspase activation. Antiapoptotic Bcl-2 family members Bcl-2 and Bcl-xL were downregulated, with proapoptotic member Bax stable or upregulated, resulting in reduced Bcl-2/Bax and Bcl-xL/Bax ratios. Meanwhile, multiple signal transduction pathways were involved in lymphoma cell apoptosis in response to EriB, including inhibition of nuclear factor (NF)-kappaB and AKT pathways, and the activation of extracellular signal-related kinase (ERK) pathway. AKT inactivation was related to increased expression of cyclin-dependent kinase inhibitor P21, decreased expression of antiapoptotic phosphorylated form of Bad, and NF-kappaB activator IkappaB kinase alpha/beta. ERK activation corresponded to reactive oxygen species production and could be blocked by antioxidant dithiothreitol. In murine xenograft lymphoma models, EriB remarkably inhibited tumor growth and induced in situ tumor cell apoptosis. CONCLUSION: These findings broaden the value of EriB as a promising candidate targeting apoptosis cascade in treatment of hematological malignancies.

[Synergistic effects of proteasome inhibitor and histone deacetylase inhibitor on apoptosis and aggresome formation in T lymphoma cells].

The aim of the study was to explore the synergistic effect of the proteasome inhibitor bortezomib (bor) and the histone deacetylase inhibitor suberoylanilide hydroxamic acid (SAHA) on apoptosis of T lymphoma cell lines Jurkat and Hut78, and on the formation of aggresome. Jurkat and Hut78 cells were treated with bor (10 nmol/L) or bor (10 nmol/L) combined with SAHA (2 micromol/L) respectively. Cell growth inhibition was estimated by trypan blue dye exclusion test. Cell morphology was evaluated by light microscopy with Wright's staining of cytocentrifuge preparations. Cell apoptosis was analyzed by flow cytometry. Ultrastructure of cell apoptosis and aggresome were observed by transmission electron microscopy. The results showed that proliferation of both Jurkat and Hut78 cells was significantly inhibited in the bor+SAHA group, as compared with the control group and the bor alone group. Flow cytometric analysis confirmed that the percentage of apoptosis in Jurkat and Hut78 cells in the bor+SAHA group (41.8+/-4.7% and 72.7+/-11.7% respectively) was remarkably higher than those in the control group (3.6+/-1.3% and 7.0+/-1.9% respectively) and the bor alone group (6.3+/-2.3% and 18.7+/-9.2% respectively) (p<0.01). Ultrastructure examination revealed that typical aggresomes in cells could be observed in bor alone group. The combination of bor and SAHA diminished both the amount and density of aggresomes, or even eliminated them, accompanied by the increased rate of apoptosis. It is concluded that proteasome inhibitor combined with histone deacetylase inhibitor synergically induces T lymphoma cell apoptosis. Bortezomib stimulates the formation of aggresome, while SAHA destroys this aggresome structure, which may be one of the mechanisms underlying the enhancement of bortezomib-induced apoptosis.

Changes with age and the effect of recombinant human BMP-2 on proteoglycan and collagen gene expression in rabbit anulus fibrosus cells.

In order to compare the difference between young and old intervertebral disc cells and their responsiveness to recombinant human bone morphogenetic protein-2 (rhBMP-2), disc cells were isolated from the anulus fibrosus (AF) and transition zones of lumbar discs from eight old and eight young New Zealand white rabbits. Compared with the cells from the young rabbits, cells from old rabbits respond less to rhBMP-2 treatment with respect to sulfated-glycosaminoglycan (sGAG) synthesis and aggrecan gene expression. But in collagen I and collagen II gene expressions, there are no significant differences between the old and the young. When comparing sGAG content, aggrecan, and collagen II gene expression of the old AF cells after rhBMP-2 treatment with that of the young AF cells without rhBMP-2 treatment, the old AF cells with rhBMP-2 treatment have a greater capacity to synthesize sGAG bound in the cells and to release sGAG in the media, as well as to express aggrecan and collagen II gene. It can be concluded that old AF cells after rhBMP-2 treatment have a greater capacity to synthesize sGAG and express aggrecan and collagen II as compared to young AF cells without rhBMP-2 treatment. Thus rhBMP-2 can reverse the decline in the anabolic capacity of the disc cells with ageing. So it seems that rhBMP-2 has potential for use as an agent to retard a key component of disc degeneration and loss of disc matrix.