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1.
Materials (Basel) ; 17(20)2024 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-39459745

RESUMO

This study aimed to enhance the performance of dental resin composites (DRCs) by increasing the content of inorganic fillers while addressing potential health risks associated with Bisphenol A (BPA). To achieve this, the BPA-based resin monomer Bis-GMA was replaced with BPA-free Bis-EFMA. The study then explored the impact of varying inorganic filler contents on the physiochemical properties of Bis-EFMA-based bulk-fill dental resin composites (BF-DRCs). Four distinct Bis-EFMA-based BF-DRCs were formulated, each with different inorganic filler contents ranging from 70 wt% to 76 wt%. The study tested the depth of cure (DOC), double-bond conversion (DC), water sorption (WS), solubility (SL), and cytotoxicity of the system. It notably investigated the effects of increasing filler content on mechanical properties through flexural strength (FS), flexural modulus (FM), Vickers microhardness (VHN), and wear resistance, as well as the impact on polymerization shrinkage, including volumetric shrinkage (VS) and shrinkage stress (SS). To assess the commercial application potential of Bis-EFMA-based BF-DRC, the research used the commercially available BF-DRC Filtek Bulk-Fill Posterior (FBF) as a control. The results indicated that a higher filler content did not affect the DOC of Bis-EFMA-based BF-DRCs. Inorganic fillers at higher concentrations significantly enhanced overall mechanical properties while significantly reducing volumetric shrinkage (VS; p < 0.05). When the concentration of inorganic fillers in the resin system reached 76 wt%, most of the performance of the Bis-EFMA-based BF-DRC surpassed that of the commercial control FBF, except for FS, FM, and SS. These findings highlight the potential of Bis-EFMA-based BF-DRC as a long-term restorative material for dental applications.

2.
Pharm Dev Technol ; 29(3): 153-163, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38330994

RESUMO

Shikonin (SHK) has been evidenced to possess effects against various cancer cells. However, poor aqueous solubility and high toxicity restrict its application. In the study, RGD-decorated liposomes loaded with SHK (RGD-Lipo-SHK) were prepared via thin-film hydration method. Characterization and cellular uptake of liposomes was evaluated. Cytotoxicity of blank liposomes and different SHK formulations was measured against breast cancer cells (MDA-MB-231, MCF-7, and MCF-10A). Anti-tumour effects and pharmacokinetic parameters of different SHK formulations were appraised in tumour spheroids and in rat model, respectively. Liposomes displayed a particle size of less than 127 nm with a polydispersity index about 0.21. The encapsulation efficiency was about 91% for SHK, and drug leakage rate of liposomes was less than 6%. RGD-Lipo-SHK showed superior cellular internalization in the αvß3-positive MDA-MB-231 cells. Blank liposomes had no cytotoxicity to MDA-MB-231 and MCF-7 cells. Howbeit, different SHK formulations obviously inhibited proliferation of MCF-10A cells, especially free SHK. Meanwhile, RGD-Lipo-SHK significantly inhibited growth inhibition of tumour spheroids. The pharmacokinetics study indicated that the peak concentration, area under plasma concentration-time curves, half-life, and mean residence time of RGD-Lipo-SHK distinctly increased compared with those of free SHK. Altogether, these results demonstrated RGD-Lipo-SHK could reduce cytotoxicity, strengthen the antitumor-targeted effect, and prolong circulation time, which provides a foundation for further in vivo experimentations.


Assuntos
Lipossomos , Naftoquinonas , Humanos , Ratos , Animais , Naftoquinonas/farmacologia , Células MCF-7 , Oligopeptídeos , Linhagem Celular Tumoral
3.
Biofactors ; 50(4): 624-633, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38158592

RESUMO

The protein kinase casein kinase 2 (CK2) exerts its influence on the metabolism of three major cellular substances by phosphorylating essential protein molecules involved in various cellular metabolic pathways. These substances include hormones, especially insulin, rate-limiting enzymes, transcription factors of key genes, and cytokines. This regulatory role of CK2 is closely tied to important cellular processes such as cell proliferation and apoptosis. Additionally, tumor cells undergo metabolic reprogramming characterized by aerobic glycolysis, accelerated lipid ß-oxidation, and abnormally active glutamine metabolism. In this context, CK2, which is overexpressed in various tumors, also plays a pivotal role. Hence, this review aims to summarize the regulatory mechanisms of CK2 in diverse metabolic pathways and tumor development, providing novel insights for the diagnosis, treatment, and prognosis of metabolism-related diseases and cancers.


Assuntos
Caseína Quinase II , Neoplasias , Caseína Quinase II/metabolismo , Caseína Quinase II/genética , Humanos , Neoplasias/metabolismo , Neoplasias/genética , Neoplasias/patologia , Proliferação de Células , Apoptose , Animais , Glicólise , Fosforilação , Redes e Vias Metabólicas/genética , Regulação Neoplásica da Expressão Gênica
4.
Anal Chem ; 95(39): 14805-14815, 2023 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-37738392

RESUMO

The DNA frame structure as a natural shell to stably shield the sequence-templated Ag nanocluster core (csAgNC) is intriguing yet challenging for applicable fluorescence biosensing, for which the elaborate programming of a cluster scaffold inside a DNA-based cage to guide csAgNC nucleation might be crucial. Herein, we report the first design of a symmetric tetrahedral DNA nanocage (TDC) that was self-assembled in a one-pot process using a C-rich csAgNC template strand and four single strands. Inside the as-constructed soft TDC architecture, the template sequence was logically bridged from one side to another, not in the same face, thereby guiding the in situ synthesis of emissive csAgNC. Because of the strong electron-repulsive capability of the negatively charged TDC, the as-formed csAgNC displayed significantly improved fluorescence stability and superb spectral behavior. By incorporating the recognizable modules of targeted microRNAs (miRNAs) in one vertex of the TDC, an updated TDC (uTDC) biosensing platform was established via the photoinduced electron transfer effect between the emissive csAgNC reporter and hemin/G-quadruplex (hG4) conjugate. Because of the target-interrupted csAgNC switching in three states with the spatial proximity and separation to hG4, an "on-off-on" fluorescing signal response was executed, thus achieving a wide linear range to miRNAs and a limit of detection down to picomoles. Without complicated chemical modifications, this simpler and more cost-effective strategy offered accurate cell imaging of miRNAs, further suggesting possible therapeutic applications.

5.
Nutrients ; 15(18)2023 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-37764646

RESUMO

Dark tea has great potential in regulating glycolipid metabolism, and theabrownin (TB) is considered to be the characteristic and bioactive constituent of dark tea. This study evaluated the ability of TB1 (fermented for 7 days) and TB2 (fermented for 14 days) isolated from dark tea to reverse insulin resistance (IR) in HepG2 cells. The results indicated that TB significantly ameliorated oxidative stress by improving mitochondrial function. In addition, TB improved glycogen synthesis and glucose consumption, and inhibited gluconeogenesis and fatty acid synthesis, by regulating GSK3ß (Glycogen synthase kinase 3ß), G6Pase (Glucose-6-phosphatase), GCK (Glucokinase), PEPCK1 (Phosphoenolpyruvate carboxy kinase 1), SREBP-1C (sterol regulatory element-binding protein 1C), FASN (fatty acid synthase), and ACC (Acetyl-CoA carboxylase). Additionally, the results of Western blot and real-time PCR experiments demonstrated that TB modulated glucolipid metabolism through the IRS-1 (Insulin receptor substrate 1)/PI3K (phosphatidylinositol-3 kinase)/Akt (protein kinase B) signaling pathway. Treatment with the PI3K inhibitor demonstrated a favorable correlation between PI3K activation and TB action on glycolipid metabolism. Notably, we observed that TB2 had a greater effect on improving insulin resistance compared with TB1, which, due to its prolonged fermentation time, increased the degree of oxidative polymerization of TB.

6.
Nutrients ; 15(18)2023 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-37764687

RESUMO

Tea is one of the most popular drinks in the world. Dark tea is a kind of post-fermented tea with unique sensory characteristics that is produced by the special fermentation of microorganisms. It contains many bioactive substances, such as tea polyphenols, theabrownin, tea polysaccharides, etc., which have been reported to be beneficial to human health. This paper reviewed the latest research on dark tea's potential in preventing and managing cancer, and the mechanisms mainly involved anti-oxidation, anti-inflammation, inhibiting cancer cell proliferation, inducing cancer cell apoptosis, inhibiting tumor metastasis, and regulating intestinal flora. The purpose of this review is to accumulate evidence on the anti-cancer effects of dark tea, the corresponding mechanisms and limitations of dark tea for cancer prevention and management, the future prospects, and demanding questions about dark tea's possible contributions as an anti-cancer adjuvant.


Assuntos
Adjuvantes Imunológicos , Neoplasias , Humanos , Apoptose , Proliferação de Células , Fermentação , Chá , Neoplasias/prevenção & controle
7.
Thorac Cancer ; 14(13): 1179-1191, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36965165

RESUMO

BACKGROUND: Diacylglycerol kinase α (DGKA) is the first member discovered from the diacylglycerol kinase family, and it has been linked to the progression of various types of tumors. However, it is unclear whether DGKA is linked to the development of lung cancer. METHODS: We investigated the levels of DGKA in the lung cancer tissues. Cell growth assay, colony formation assay and EdU assay were used to examine the effects of DGKA-targeted siRNAs/shRNAs/drugs on the proliferation of lung cancer cells in vitro. Xenograft mouse model was used to investigate the role of DGKA inhibitor ritanserin on the proliferation of lung cancer cells in vivo. The downstream target of DGKA in lung tumorigenesis was identified by RNA sequencing. RESULTS: DGKA is upregulated in the lung cancer cells. Functional assays and xenograft mouse model indicated that the proliferation ability of lung cancer cells was impaired after inhibiting DGKA. And cyclin D3(CCND3) is the downstream target of DGKA promoting lung cancer. CONCLUSIONS: Our study demonstrated that DGKA promotes lung tumorigenesis by regulating the CCND3 expression and hence it can be considered as a potential molecular biomarker to evaluate the prognosis of lung cancer patients. What's more, we also demonstrated the efficacy of ritanserin as a promising new medication for treating lung cancer.


Assuntos
Diacilglicerol Quinase , Neoplasias Pulmonares , Humanos , Animais , Camundongos , Diacilglicerol Quinase/genética , Diacilglicerol Quinase/metabolismo , Ciclina D3/genética , Ciclina D3/metabolismo , Ritanserina , Neoplasias Pulmonares/genética , Transformação Celular Neoplásica/genética , RNA Interferente Pequeno/genética , Proliferação de Células , Pulmão , Linhagem Celular Tumoral , Regulação Neoplásica da Expressão Gênica
8.
Respir Res ; 24(1): 25, 2023 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-36694200

RESUMO

BACKGROUND: Radiation-induced lung injury (RILI) is the most common and serious complication of chest radiotherapy. However, reported radioprotective agents usually lead to radiation resistance in tumor cells. The key to solving this problem is to distinguish between the response of tumor cells and normal lung epithelial cells to radiation damage. METHODS: RNA-Seq was used to recognize potential target of alleviating the progression of RILI as well as inhibiting tumor growth. The activation of NLRP3 inflammasome in lung epithelial cells was screened by qRT-PCR, western blotting, immunofluorescence, and ELISA. An in vivo model of RILI and in vitro conditioned culture model were constructed to evaluate the effect of NLRP3/interleukin-1ß on fibroblasts activation. ROS, ATP, and (NADP)+/NADP(H) level in lung epithelial cells was detected to explore the mechanism of NLRP3 inflammasome activation. The lung macrophages of the mice were deleted to evaluate the role of lung epithelial cells in RILI. Moreover, primary cells were extracted to validate the results obtained from cell lines. RESULTS: NLRP3 activation in epithelial cells after radiation depends on glycolysis-related reactive oxygen species accumulation. DPYSL4 is activated and acts as a negative regulator of this process. The NLRP3 inflammasome triggers interleukin-1ß secretion, which directly affects fibroblast activation, proliferation, and migration, eventually leading to lung fibrosis. CONCLUSIONS: Our study suggests that NLRP3 inflammasome activation in lung epithelial cells is essential for radiation-induced lung injury. These data strongly indicate that targeting NLRP3 may be effective in reducing radiation-induced lung injury in clinical settings.


Assuntos
Inflamassomos , Lesão Pulmonar , Lesões Experimentais por Radiação , Animais , Camundongos , Células Epiteliais/metabolismo , Inflamassomos/metabolismo , Interleucina-1beta/genética , Interleucina-1beta/metabolismo , Pulmão/metabolismo , Lesão Pulmonar/etiologia , Lesão Pulmonar/genética , Lesão Pulmonar/metabolismo , NADP/metabolismo , NADP/farmacologia , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Lesões Experimentais por Radiação/complicações , Lesões Experimentais por Radiação/genética , Lesões Experimentais por Radiação/metabolismo
9.
Front Oncol ; 12: 1065027, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36530985

RESUMO

Protein kinase CK2, a conserved serine/threonine-protein kinase, is ubiquitous in cells and regulates various intracellular processes, especially in tumor cells. As one of the earliest discovered protein kinases in humans, CK2 plays a crucial role in phosphorylating or associating with hundreds of substrates to modulate several signaling pathways. Excellent reviews have reported that the overexpression of CK2 could be observed in many cancers and was closely associated with tumor occurrence and development. The elevation of CK2 is also an indicator of a poor prognosis. Recently, increasing attention has been paid to the relationship between CK2 and tumor immunity. However, there is no comprehensive description of how CK2 regulates the immune cells in the tumor microenvironment (TME). Also, the underlying mechanisms are still not very clear. In this review, we systematically summarized the correlation between CK2 and tumor immunity, primarily the effects on various immune cells, both in innate and adaptive immunity in the TME. With the comprehensive development of immunotherapy and the mounting transformation research of CK2 inhibitors from the bench to the clinic, this review will provide vital information to find new treatment options for enhancing the efficacy of immunotherapy.

10.
Anal Chem ; 94(22): 8041-8049, 2022 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-35617342

RESUMO

It is intriguing to modulate the fluorescence emission of DNA-scaffolded silver nanoclusters (AgNCs) via confined strand displacement and transient concatenate ligation for amplifiable biosensing of a DNA segment related to SARS-CoV-2 (s2DNA). Herein, three stem-loop structural hairpins for signaling, recognizing, and assisting are designed to assemble a variant three-way DNA device (3WDD) with the aid of two linkers, in which orange-emitting AgNC (oAgNC) is stably clustered and populated in the closed loop of a hairpin reporter. The presence of s2DNA initiates the toehold-mediated strand displacement that is confined in this 3WDD for repeatable recycling amplification, outputting numerous hybrid DNA-duplex conformers that are implemented for a transient "head-tail-head" tandem ligation one by one. As a result, the oAgNC-hosted hairpin loops are quickly opened in loose coil motifs, bringing a significant fluorescence decay of multiple clusters dependent on s2DNA. Demonstrations and understanding of the tunable spectral performance of a hairpin loop-wrapped AgNC via switching 3WDD conformation would be highly beneficial to open a new avenue for applicable biosensing, bioanalysis, or clinical diagnostics.


Assuntos
Técnicas Biossensoriais , COVID-19 , Nanopartículas Metálicas , DNA/química , DNA/genética , Humanos , Nanopartículas Metálicas/química , SARS-CoV-2 , Prata/química , Espectrometria de Fluorescência
11.
Biosens Bioelectron ; 199: 113871, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34915217

RESUMO

To explore the fluorescence bio-responsiveness of emissive silver nanoclusters (AgNCs) populated in DNA-branched scaffolds is intriguing yet challenging. In response to a desired targeting model (T*) as a vehicle, herein a customized three-way-junction DNA construct (TWJDC) is assembled via competitive hybridizing cascade among three stem-loop hairpins with specific base sequences, where the repeated recycling of T* enables the exponentially amplifiable output of rigid TWJDC. As designed, these stable hybridization products are highly T*-stimulated responsive and constructing-directional. In the three branched-arms, the unpaired sticky ends provide isotropic binding sites for a signaling hairpin encoded with two C-rich templates of green- and red-AgNCs clustering. The identical ligation of signal probe with three arms of TWJDC liberates its locked stem, enabling the separate growth of red-clusters in three branches. As demonstrated, three clusters of red-AgNCs possess advantageous self-enhancing fluorescent performance relative to single or two cluster(s), good biocompatibility and low cytotoxicity. Utilizing the bicolor AgNCs as dual-emitters with reversely changed emission intensity, we developed an innovative ratiometric strategy displaying sensitively linear dose-dependence on variable T* down to 1.9 pM, which can afford a promising platform for biosensing, bioanalysis, cell imaging, or even clinical theranostics.


Assuntos
Técnicas Biossensoriais , Nanopartículas Metálicas , DNA , Fluorescência , Prata , Espectrometria de Fluorescência
12.
Analyst ; 146(16): 5067-5073, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34297024

RESUMO

Designing antibody-powered DNA nanodevice switches is crucial and fascinating to perform a variety of functions in response to specific antibodies as regulatory inputs, achieving highly sensitive detection by integration with simple amplified methods. In this work, we report a unique DNA-based conformational switch, powered by a targeted anti-digoxin mouse monoclonal antibody (anti-Dig) as a model, to rationally initiate the hybridization chain reaction (HCR) for enzyme-free signal amplification. As a proof-of-concept, both a fluorophore Cy3-labeled reporter hairpin (RH) in the 3' terminus and a single-stranded helper DNA (HS) were individually hybridized with a recognition single-stranded DNA (RS) modified with Dig hapten, while the unpaired loop of RH was hybridized with the exposed 3'-toehold of HS, isothermally self-assembling an intermediate metastable DNA structure. The introduction of target anti-Dig drove the concurrent conjugation with two tethered Dig haptens, powering the directional switch of this DNA structure into a stable conformation. In this case, the unlocked 3'-stem of RH was implemented to unfold the 5'-stem of the BHQ-2-labeled quench hairpin (QH), rationally initiating the HCR between them by the overlapping complementary hybridization. As a result, numerous pairs of Cy3 and BHQ-2 in the formed long double helix were located in spatial proximity. In response to this, the significant quenching of the fluorescence intensity of Cy3 by BHQ-2 was dependent on the variable concentration of anti-Dig, achieving a highly sensitive quantification down to the picomolar level based on a simplified protocol integrated with enzyme-free amplification.


Assuntos
Técnicas Biossensoriais , DNA , Animais , DNA/genética , DNA de Cadeia Simples/genética , Corantes Fluorescentes , Imunoensaio , Limite de Detecção , Camundongos , Hibridização de Ácido Nucleico
13.
Clin Neurol Neurosurg ; 207: 106711, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34102421

RESUMO

STUDY DESIGN: A prospective study and technique description. OBJECTIVE: This study introduced a method for posterior cervical pedicle screw placement by using the bilateral posterior lamina nutrient foramens as the entry point. METHODS: Firstly, 30 dry C3-C7 vertebrae specimens were harvested for measurement. The lamina nutrient foramens were used as the entry points for posterior cervical pedicle screw placement and four linear and two angle parameters were obtained from a computed tomography scan(CT). Then, 60 patients who underwent C3-C7 pedicle screw fixation using this method were included, linear and angle parameters were obtained from a postoperative CT. RESULTS: The average incidences of lamina nutrient foramen on the C3-C7 specimens were 88.3%, 90.0%, 95.0%, 95.0%, and 96.7%, respectively. The distances from the entry point to the pedicle screw tip (OD), the pedicle transverse angles (α), and the pedicle sagittal angles (ß) measure for the entry points from C3-C7 were 28.74 ± 3.45-30.15 ± 2.01 mm, 26.88 ± 6.89° to 32.72 ± 5.91°, and 12.48 ± 9.31° to 19.71 ± 8.45°, respectively, with no significant differences between the left and right sides. In the 60 patients who underwent surgery, the lengths of the pedicle screws (PL) were 28.34 ± 2.25-30.15 ± 2.31 mm, the pedicle transverse angles (α) were 26.89 ± 6.86° to 32.36 ± 5.65°, and the pedicle sagittal angles (ß) were 12.49 ± 9.11° to 20.06 ± 8.91°. The new method had a 96.8% (454/469) success rate among these patients, with no screws penetrating the spinal canal or signs of vertebral artery injury. CONCLUSION: Entry at the bilateral lamina nutrient foramen represents an alternative posterior cervical pedicle screw placement technique that is feasible and safe.


Assuntos
Vértebras Cervicais/cirurgia , Fusão Vertebral/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Parafusos Pediculares , Estudos Prospectivos
14.
Spine (Phila Pa 1976) ; 43(10): 732-737, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-28922276

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: The purpose of this study was to identify the independent risk factors for postoperative surgical site infection (SSI) after posterior lumbar spinal surgery based on the perioperative factors analysis. SUMMARY OF BACKGROUND DATA: SSI is one of the most common complications after spinal surgery. Previous studies have identified different risk factors for postoperative SSI after lumbar spinal surgery. However, most of the studies were focused on the patient and procedure-related factors. Few studies reported the correlation between laboratory tests and postoperative SSI. METHODS: A retrospective study was carried out in a single institution. Patients who underwent posterior lumbar spinal surgery between January 2010 and August 2016 were included in this study. All patients' medical records were reviewed and patients with postoperative SSI were identified. Perioperative variables were included to determine the risk factors for SSI by univariate and multivariate regression analysis. RESULTS: A total of 2715 patients undergoing posterior lumbar spinal surgery were included in this study. Of these patients, 64 (2.4%) were detected with postoperative SSI, including 46 men and 18 women. Diabetes mellitus (P = 0.026), low preoperative serum level of calcium (P = 0.009), low preoperative and postoperative albumin (P = 0.025 and 0.035), high preoperative serum glucose (P = 0.029), multiple fusion segments (P < 0.001), increased surgical time and estimated blood loss (P = 0.023 and 0.005), decreased postoperative hemoglobin (P = 0.008), and prolonged drainage duration (P = 0.016) were found to be the independent risk factors for SSI. Multilevel fusion and a history of diabetes mellitus were the two strongest risk factors (odds ratio = 2.329 and 2.227) for SSI. CONCLUSION: Based on a large population analysis, previous reported risk factors for SSI were confirmed in this study while some new independent risk factors were identified significantly associated with SSI following lumbar spinal surgery, including preoperative low serum level of calcium, decreased preoperative and postoperative albumin, and decreased postoperative hemoglobin. LEVEL OF EVIDENCE: 4.


Assuntos
Vértebras Lombares/cirurgia , Doenças da Coluna Vertebral/epidemiologia , Doenças da Coluna Vertebral/cirurgia , Infecção da Ferida Cirúrgica/epidemiologia , Idoso , Diabetes Mellitus/sangue , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Estudos Retrospectivos , Fatores de Risco , Doenças da Coluna Vertebral/sangue , Infecção da Ferida Cirúrgica/sangue
15.
Int Orthop ; 41(11): 2297-2302, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28852822

RESUMO

PURPOSE: Spinal epidural haematoma (SEH) is a common complication after lumbar spinal decompression surgery, and symptomatic SEH usually causes devastating neurological deficits. Although different risk factors for post-operative SEH have been reported, few studies focused on patients' laboratory tests. The purpose of this study was to analyze the incidence of symptomatic SEH following lumbar spinal surgery, as well as identify the risk factors for it. METHODS: Patients who underwent posterior lumbar spinal decompression surgery between January 2010 and August 2016 were included in this study and their medical records were retrospectively reviewed. Those who developed post-operative symptomatic SEH after the surgery were identified. The risk factors for SEH were analyzed by univariate and multivariate regression analysis. RESULTS: In total, 2715 patients were included in this study and 31 (1.14%) were identified with post-operative symptomatic SEH. Of these patients, 19 were males and 12 were females, with an average age of 59.39 ± 11.66 years. After multivariate logistic regression analysis, low serum calcium level (P = 0.025), blood type A (P = 0.04), increased estimated blood loss (P = 0.032), prolonged surgical duration (P = 0.018), and decreased post-operative globulin (P = 0.016) were identified as the independent risk factors for post-operative SEH following lumbar spinal surgery. Furthermore, prolonged surgical duration (odds ratio = 3.105) was the strongest risk factor for SEH. CONCLUSION: Based on a large population investigation, the incidence of symptomatic SEH following lumbar spinal decompression surgery was 1.14%. Blood type A, increased estimated blood loss, and prolonged surgical duration were identified as the independent risk factors for post-operative SEH while two new risk factors, including low serum calcium level and decreased post-operative globulin, were firstly identified in this study.


Assuntos
Hematoma Epidural Espinal/epidemiologia , Vértebras Lombares/cirurgia , Fusão Vertebral/efeitos adversos , Adulto , Idoso , Feminino , Hematoma Epidural Espinal/etiologia , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Fusão Vertebral/métodos , Adulto Jovem
16.
Spine (Phila Pa 1976) ; 41(16): 1279-1283, 2016 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-26913463

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: The purpose of this study was to identify the rates and reasons, and the risk factors for unplanned reoperation of lumbar spinal surgery during the primary admission in terms of a multicenter and a large patient population study. SUMMARY OF BACKGROUND DATA: Unplanned reoperation is suggested to be a useful quality indicator for spinal surgery. However, the rates of unplanned reoperation in patients underwent lumbar spinal surgery during the primary admission are not well established. METHODS: This study was performed to review all the patients who underwent lumbar spinal surgery at three institutions from January 2010 to April 2015. Patients with unplanned reoperations after primary surgery during the same admission were included in this study. The demographics, diagnosis, surgical procedure, and complications of patients were reviewed and statistical analysis was performed to investigate the incidences and risk factors of unplanned revision. RESULTS: A total of 3936 patients who underwent lumbar spinal surgery from three institutions were reviewed, and 82 (2.08%) required unplanned reoperation during the primary admission because of wound infection (0.94%), screw misplacement (0.53%), cerebrospinal fluid leakage (0.27%), wound hematoma (0.18%), and neurologic deficit (0.15%). For the diagnosis, patients with lumbar spinal spondylolisthesis had a much higher rate of reoperation (4.3%) than those of lumbar stenosis (2.3%), vertebral tumor (2.2%), vertebral fracture (1.2%), and disc herniation (1.1%) with a significant difference (P < 0.001). The revision rate was significantly higher in patients underwent posterior lumbar interbody fusion than those received transforaminal lumbar interbody fusion (P = 0.007). CONCLUSION: Unplanned reoperation rate of lumbar spinal surgery was 2.08% and the most common reasons for it were wound infection and screw misplacement. Patients with a diagnosis of lumbar spinal spondylolisthesis or who underwent posterior lumbar interbody fusion were more likely to required unplanned reoperation during the primary admission. LEVEL OF EVIDENCE: 4.


Assuntos
Vértebras Lombares/cirurgia , Complicações Pós-Operatórias/etiologia , Reoperação , Doenças da Coluna Vertebral/cirurgia , Parafusos Ósseos , Humanos , Procedimentos Neurocirúrgicos/efeitos adversos , Procedimentos Neurocirúrgicos/métodos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Fatores de Risco
17.
Eur Spine J ; 25(5): 1575-1580, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-26126415

RESUMO

BACKGROUND: Both posterior lumbar interbody fusion (PLIF) and transforaminal lumbar interbody fusion (TLIF) are accepted surgical techniques for the treatment of degenerative lumbar spondylolisthesis (DLS). However, it is still unclear one technique offers distinct advantages over the other. OBJECTIVE: A retrospective study was performed to compare perioperative complications and functional outcomes of patients undergoing TLIF versus PLIF for DLS. METHODS: A total of 226 consecutive patients who underwent surgery for treatment of DLS at three institutions were evaluated from January 2012 to December 2014. In this series, 125 patients underwent PLIF and 101 received TLIF. The operative time, blood loss, allogeneic blood transfusion rate and perioperative complications (including re-operative rate, nerve root injury, dural tear, wound infection) were compared between the two groups. Pain (VAS) and functional outcomes of patients (Kirkaldy-Willis criteria) were quantified before surgery and 1 week after surgery. RESULTS: Patients involved in the two groups had similar baseline demographic, clinical and radiographic characteristics. The PLIF group was associated with a higher incidence of post-operative iatrogenic nerve root dysfunction [12 cases (9.6 %) versus 2 cases (1.9 %), P = 0.018] and dural tears [15 cases (12 %) versus 4 cases (3.9 %), P = 0.030]. The re-operation rate was significantly higher in patients undergoing PLIF [13 cases (10.4 %) versus 2 cases (1.9 %), P = 0.011]. In addition, intra-operative blood loss, operative times, and allogeneic blood transfusion rates were higher in the PLIF group when compared to the TLIF group (P < 0.05). The wound infection rate of the PLIF group was similar to that of the TLIF group (7.2 versus 5.0 %, P = 0.486). VAS scores were decreased from 7.08 ± 1.13 to 2.84 ± 0.89 in the PLIF group, and from 7.18 ± 1.09 to 2.84 ± 0.91 in the TLIF group, respectively (P = 0.32). 85.6 % of patients in the TLIF group had good or excellent functional outcomes within the first post-operative week compared to 83.2 % in the PLIF group (P = 0.64). CONCLUSION: Both PLIF and TLIF were equally beneficial in improving short-term functional outcomes for patients with DLS. However, PLIFs were associated with statistically significant higher incidences of nerve root injury, dural tears, allogeneic blood transfusion, increased intra-operative times, blood loss and re-operations. Therefore, caution should be exercised when considering PLIFs.


Assuntos
Vértebras Lombares/cirurgia , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Espondilolistese/cirurgia , Adulto , Idoso , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Transfusão de Sangue/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Escala Visual Analógica
18.
Artigo em Chinês | MEDLINE | ID: mdl-23858721

RESUMO

OBJECTIVE: To investigate the correlation of serum specific IgE and skin prick test in allergic rhinitis patients sensitive to dust mite and the difference between the results. METHOD: Data of 349 allergic rhinitis patients who had positive result in either Dermatophagoides pteronyssinus(Der p) or Dermatophagoides farinae (Der f) by serum specific IgE and skin prick test were statistically analyzed. RESULT: Grades of Skin prick test and specific IgE levels were notably relevant in these two dust mites(Der p r= 0. 568, Der f r= 0. 506, P<0. 01). There was significant difference of positive rates between serum specific IgE and skin prick test in Der p(Chi2 = 11. 605, P<0. 01)but not in Der f(Chi2 =0, P>0.05). There was no correlation between positive degree of two methods and score of clinical symptoms in allergic rhinitis. CONCLUSION: Serum specific IgE and skin prick test were notably relevant in allergic rhinitis patients sensitive to dust mites. The positive rates of the two methods were different due to different allergen. Therefore, they could not substitute for each other. The level of serum specific IgE and positive degree of skin prick test could not reflect the degree of symptom in allergic rhinitis.


Assuntos
Imunoglobulina E/sangue , Pyroglyphidae/imunologia , Rinite Alérgica Perene/sangue , Rinite Alérgica Perene/diagnóstico , Rinite Alérgica Perene/imunologia , Adolescente , Adulto , Idoso , Animais , Antígenos de Dermatophagoides/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rinite Alérgica , Testes Cutâneos , Adulto Jovem
19.
Artigo em Chinês | MEDLINE | ID: mdl-23213755

RESUMO

OBJECTIVE: To study the effects of subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination in management of perennial allergic rhinitis. METHOD: Thirty-eight cases of the perennial allergic rhinitis received the subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination for 3 years or more than 3 years. The clinical symptoms and signs were compared before and after treatment. RESULT: Good result were obtained in 21 of 38 cases, 7 cases effective, and 10 cases ineffective. Total effective rate was 73.68%. CONCLUSION: The subcutaneous allergen immunotherapy by Alutard SQ allergy vaccination was very effective for the perennial allergen rhinitis.


Assuntos
Dessensibilização Imunológica , Pyroglyphidae/imunologia , Rinite Alérgica Perene/terapia , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Rinite Alérgica , Resultado do Tratamento , Vacinação , Adulto Jovem
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