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1.
Zhonghua Wai Ke Za Zhi ; 61(8): 656-665, 2023 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-37400208

RESUMO

Objective: To investigate the clinical outcome and preventive effect of polyetheretherketone(PEEK) rod hybrid surgery on proximal junction failure(PJF) after long-segment fusion of adult spinal deformity. Methods: A retrospective study was conducted to analyze patients with degenerative scoliosis/kyphosis who underwent long-segment decompression and fusion surgery at Department of Orthopedics, Peking University First Hospital from January 2017 to December 2021. A total of 75 patients were included in the study, including 14 males and 61 females, aged (67.2±6.8)years (range:55 to 84 years). According to the operation method chosen by the patients, the patients were divided into PEEK rod hybrid group (20 cases) and traditional titanium rod group (55 cases). The general information of the patients was collected, and the coronal and sagittal parameters of the spine were measured before operation, at 1 month after operation, and at the last follow-up. The clinical effect of surgery was judged by the visual analogue scale (VAS) and Oswestry disability index (ODI). Whether proximal junctional kyphosis (PJK) and PJF occurred during the follow-up and the time of occurrence were recorded. Comparisons between groups were performed using independent sample t test, Mann-Whitney U test, χ2 test and Fisher's exact probability method. The data before and after surgery in the same group were compared using the paired sample t test and the Wilcoxon test. Results: There were no significant differences in age, gender, body mass index, bone mineral density, distal instrumented vertebrae, surgical segments, osteotomy method, operation time, and intraoperative bleeding between the two groups (all P>0.05). The follow-up time of the PEEK rod group was shorter(M(IQR)16.5(4.8) vs. 25.0(12.0),Z=-4.230,P<0.01). There were no significant differences in coronal, sagittal parameters, VAS and ODI between the two groups before operation (all P>0.05). Postoperative coronal Cobb angle, pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, sagittal vertical axis (SVA), VAS and ODI were significantly improved in both groups(all P<0.05). At the last follow-up, the SVA of the PEEK rod hybrid group was(3.74±2.40)cm, which was significantly lower than that of the titanium rod group (6.28±4.06)cm (t'=-3.318, P=0.002). At the last follow-up, the ODI of the PEEK rod hybrid group was 30.7±6.1, significantly better than the titanium rod group 39.3±17.2(t=-3.203, P=0.046). PJK occurred in 2 patients (10.0%) in the PEEK rod hybrid group, and no PJF phenomenon was observed. In the titanium rod group, 18 patients (32.7%) developed PJK, and 11 patients (20.0%) developed PJF. There was a statistically significant difference in the incidence of PJF between the PEEK rod hybrid group and the titanium rod group (P=0.031). Conclusions: PEEK rod hybrid surgery can achieve good clinical results in the treatment of adult spinal deformities. Compared with traditional titanium rod surgery, it can significantly reduce the incidence of postoperative PJF and improve the clinical function of patients.


Assuntos
Cifose , Fusão Vertebral , Masculino , Feminino , Animais , Humanos , Adulto , Estudos Retrospectivos , Titânio , Cifose/cirurgia , Cifose/etiologia , Sacro , Osteotomia/efeitos adversos , Fusão Vertebral/métodos , Vértebras Lombares , Resultado do Tratamento , Complicações Pós-Operatórias/epidemiologia
2.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(4): 734-739, 2021 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-34393237

RESUMO

OBJECTIVE: To investigate clinical efficacy and safety of single and double segmental percutaneous lumbar discectomy for young and middle-aged patients with double-segment disc herniation. METHODS: Retrospective analysis was undertaken for 32 young and middle-aged patients with percutaneous endoscopic lumbar discectomy (PELD) in the treatment of double-segment lumbar disc herniation from January 2015 to October 2018 in Peking University First Hospital. In the study, 18 cases were treated with single-segment treatment and 14 cases with double-segment treatment. Visual analogue score (VAS) and oswestry disability index (ODI) assessment were used to compare clinical symptom outcomes before surgery, 3 months after surgery and at the last follow-up. Macnab criteria were used to assess the patients' overall satisfaction after surgery. Imaging parameters included lumbar lordosis, intervertebral height at each segment and endplate angle of lesion segment on the X-ray. And Michigan State University(MSU) rating and Pfirrmann scoring system were used to evaluate the grade of disc herniation and disc degeneration respectively on magnetic resonance imaging (MRI). The perioperative parameters included the surgeon, anesthesia method, operation time, postoperative hospital stay, postoperative bracing time and perioperative complications. RESULTS: The mean follow-up time was (26.78±10.64) months. There was no significant difference in the follow-up time and baseline information between the two groups(P > 0.05). ODI scores 3 months post-operatively and at the last follow-up were lower in the double segment (P < 0.05). The ODI improvement was also more significant in the double-segment group at the last follow-up (P < 0.05). There was no significant difference in radiographic parameters at baseline (P>0.05). MSU scale for the primary segment was significantly lowered after both operations (P < 0.05). MSU scale for secondary segment was significantly lowered in double segment group but not in single segment group. Other imaging parameters were similar between the two groups (P > 0.05). The operation time of the single-segment group was significantly shorter than that of the double-segment group(P < 0.001). No perioperative complications were found in either group, but three patients underwent secondary lumbar surgery during the postoperative follow-up period in the single-segment group. CONCLUSION: For young and middle-aged patients with double-segment disc herniation, this study suggests double-segment PELD may be more advantageous than single-segment PELD in terms of asuring clinical efficacy without increasing perioperative risks.


Assuntos
Discotomia Percutânea , Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Discotomia , Endoscopia , Humanos , Degeneração do Disco Intervertebral/cirurgia , Deslocamento do Disco Intervertebral/diagnóstico por imagem , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 875-880, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047722

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of short-term halo-pelvic traction (HPT) combined with surgery in the treatment of severe spinal deformities. METHODS: In the study, 24 patients diagnosed as severe spinal deformity accepted the treatment of one-stage short-term HPT and two-stage surgery from January 2015 to May 2018 in our orthopedics department. 24 cases (9 males and 15 females) were retrospectively reviewed. The average age of the cohort was (28.8±10.0) years (12-48 years). The height, scoliosis angle, kyphosis angle, the height difference of shoulders, the height difference of crista iliaca, C7PL-CSVL and the perpendicular distance of S1 and the convex point of the patients were assessed at pre-traction, post-traction and post-surgery. The paired t test was used to analyze the difference among pre-traction, post-traction and post-surgery. RESULTS: The average traction time of 24 cases was (2.5±1.1) weeks (1-5 weeks). The height of pre-traction and post-traction were (141.7±11.2) cm (116-167 cm) and (154.1±9.5) cm (136-176 cm) respectively, showing significant difference (P < 0.05), and the increased height was (12.4±4.6) cm (4-20 cm). The average scoliosis angle before traction was 104.9°±35.0°(25°ï¼158°), and it was significantly decreased in post-traction[64.8°±21.0°(19°ï¼92°)] and post-surgery[39.3°±17.0° (10°-70°)] (P < 0.05). The traction's coronal correction rate was 37.2%±10.9% (11.9%-51.2%) and the total coronal correction rate was 61.9%±12.6%(26.9%-79.0%). The average kyphosis angle before traction was 106.9°±29.2°(54°ï¼163°), and it was significantly decreased in post-traction [63.1°±17.1°(32°ï¼92°)] and post-surgery [39.0°±16.8°(10°ï¼68°)](P < 0.05). The traction's sagittal correction rate was 40.0%±10.7%(16.7%-55.5%) and the total sagittal correction rate was 64.3%±10.7%(49.0%-87.5%). The average C7PL-CSVL before traction was (3.2±2.8) cm, and it was significantly decreased in post-traction [(2.5±2.5) cm] (P < 0.05). The perpendicular distance of S1 and the convex point before traction was (10.5±4.8) cm, and it was significantly decreased in post-traction[(8.4±3.5) cm] (P < 0.05). CONCLUSION: The one-stage short-term HPT combined with two-stage surgery is a safe and effective procedure for severe spinal deformities. The clinical efficacy is satisfactory and the complication is relatively less.


Assuntos
Cifose , Escoliose , Adolescente , Adulto , Feminino , Humanos , Cifose/cirurgia , Masculino , Estudos Retrospectivos , Escoliose/cirurgia , Tração , Resultado do Tratamento , Adulto Jovem
4.
Zhonghua Bing Li Xue Za Zhi ; 48(9): 694-699, 2019 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-31495089

RESUMO

Objective: To investigate the expression and potential role of heterogeneous nuclear ribonucleo-protein A2B1 (HNRNPA2B1) in mouse cerebellar development and the significance of HNRNPA2B1 in human medulloblastoma. Methods: The data of HNRNPA2B1 RNA expression in mouse and human cerebella were obtained from databases. Western blot and immunohistochemical staining were performed to detect the protein level of HNRNPA2B1 in mouse cerebella at different ages. The expression level of HNRNPA2B1 in control human cerebellum and medulloblastoma was detected by immunohistochemical staining. m6A-IP-qPCR method was applied to confirm whether HNRNPA2B1 RNA in Daoy cells was modified with m6A.Western blot was used to detect the effect of MG132 treatment on the HNRNPA2B1 protein level in Daoy cells. Results: The level of HNRNPA2B1 protein in postnatal mouse cerebella was higher than that in adult mouse cerebella, with weak HNRNPA2B1 staining in external granular cells while strong staining in mature Purkinje cells and molecular layer. Compared with control normal human cerebella, the RNA expression level of HNRNPA2B1 increased in medulloblastoma, while immunohistochemical staining showed that the mean intensity of HNRNPA2B1 decreased in medulloblastoma. HNRNPA2B1 RNA in medulloblastoma and Daoy cells was modified by m6A. The HNRNPA2B1 protein level in Daoy cells increased upon MG132 treatment. Conclusions: HNRNPA2B1 is dynamically expressed during mouse cerebellar development. Compared with normal human cerebella, HNRNPA2B1 is significantly up-regulated at transcriptional level but obviously down-regulated at translational level in medulloblastoma. These results indicate that HNRNPA2B1 may be involved in cerebellar development process and medulloblastoma tumorigenesis. The m6A methylation in HNRNPA2B1 transcript and protein ubiquitin-proteasome pathway may account for the down-regulation of HNRNPA2B1 at protein level.


Assuntos
Neoplasias Cerebelares , Meduloblastoma , Animais , Linhagem Celular Tumoral , Cerebelo , Regulação para Baixo , Ribonucleoproteínas Nucleares Heterogêneas Grupo A-B , Humanos , Camundongos
5.
Zhonghua Wai Ke Za Zhi ; 56(9): 656-660, 2018 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-30157570

RESUMO

Sagittal alignment of the spine significantly affects the physical function. In this article, we review the clinical application of several spinal-pelvic parameters, analyze the impact factors of sagittal alignment and provide calculating methods to value the correcting degrees. Spine surgeons should get a deep understanding of the spinal-pelvic parameters, differentiate the functional and structural imbalance. Every patient needs thorough preoperative evaluation to restore the proper alignment during surgery and avoid overcorrection.


Assuntos
Lordose , Humanos , Lordose/diagnóstico por imagem , Lordose/cirurgia , Pelve/cirurgia , Radiografia , Coluna Vertebral/cirurgia
6.
Beijing Da Xue Xue Bao Yi Xue Ban ; 50(2): 347-351, 2018 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-29643538

RESUMO

OBJECTIVE: To investigate the clinical effectiveness of polytheretherketone (PEEK) cages assisted anterior cervical discetomy and fusion (ACDF) to treat cervical spondylosis with sympathetic symptoms. METHODS: Retrospective analysis was undertaken for 39 patients who were diagnosed as cervical spondylosis with sympathetic symptoms and underwent ACDF with PEEK cages. Radiographs obtained before surgery, after surgery, and at the final follow-up were assessed for quality of fusion. The following criteria were used for assessing radiographic success of fusion: (1) endplate obliterated with no lucent lines; (2) obliteration of disc space by bony trabeculae; (3) less than 2°of intervertebral motion or 2 mm of motion between the spinous processes at the operated segment on flexion-extension lateral radiographs. The sympathetic symptoms including vertigo, headache, tinnitus, nausea and vomiting, heart throb, hypomnesia and gastroenterological discomfort were scored by 20-point system preoperatively, 2 months postoperatively and at the final follow-up. The recovery rate and clinical satisfaction rate were also evaluated. Surgical complications were also assessed. RESULTS: They were followed up for at least one year. The mean follow-up was 15.6 months. Radiographs of the cervical spine at the last follow-up revealed a solid fusion with no signs of a pseudoarthrosis in 36 cases. In two patients delayed union and bony fusion were achieved at the end of 9 and 11 months. Pseudoarthosis was found in 1 case but the patient had no symptoms. The score of sympathetic symptoms before surgery, 2 months after surgery and at the final follow-up were 8.4±1.0,2.2±0.3,and 2.4±0.3, respectively. There were 22 excellent cases, 15 good cases, 1 fair case and 1 bad case in terms of RR. Good to excellent results were attained in 95% of theses patients. The sympathetic symptoms improved in all the patients and the score was significantly improved after surgery. There was one patient who had cerebral spinal fluid leakage but he recovered one week after surgery. Two patients felt a mild swallowing discomfort, but it disappeared within one month after surgery. Subcutaneous hematoma occurred in one patient due to obstructed drainage. It was cleared two days after surgery. CONCLUSION: Cervical spondylosis patients with sympathetic symptoms may be managed successfully with ACDF using PEEK cages. Successful clinical results regarding symptom improvement and general satisfaction with the surgical procedure depend not only on obtaining successful decompression and radiographic fusion but also on patient selection.


Assuntos
Discotomia , Fusão Vertebral , Espondilose/cirurgia , Vértebras Cervicais/cirurgia , Descompressão Cirúrgica , Humanos , Masculino , Náusea , Procedimentos Neurocirúrgicos , Radiografia , Estudos Retrospectivos , Espondilose/diagnóstico por imagem , Resultado do Tratamento , Vômito
7.
Eur Rev Med Pharmacol Sci ; 21(15): 3402-3411, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28829501

RESUMO

OBJECTIVE: To investigate the expression levels of lncRNA HOXA11-AS in HCC tissues and cells, and to explore its biological role in the development and progression of HCC. PATIENTS AND METHODS: We detected the relative expression level of HOXA11-AS in 72 HCC tissues and cells by the real-time quantitative PCR (qRT-PCR) assay. After interference with HOXA11-AS expression in HCC cells, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), clone formation, flow cytometry and an established nude mice transplanted tumor model were used to detect the biological behavior of HCC cells. qRT-PCR and Western blotting assays were used to detect the expression level of large tumor suppressor kinases 1 (LATS1). The subcellular localization of HOXA11-AS in HCC was detected by separating nuclei from the cytoplasm. The molecular mechanism of HOXA11-AS was regulated by ribonucleoprotein immunoprecipitation-microarray (RIP-Chip) experiments. RESULTS: qRT-PCR assays showed that HOXA11-AS was relatively highly expressed in HCC tissues and cells. In vivo and in vitro experiments showed that HOXA11-AS could inhibit the proliferation of HCC cells, promote their apoptosis and retard the cell cycle progression from G1 to G0 phase. qRT-PCR and Western blotting assays results showed that LATS1 genes were the downstream target genes of HOXA11-AS. RIP and CHIP experiments showed that HOXA11-AS inhibited the expression of LATS1 genes by binding enhancer of zeste homolog 2 (EZH2) proteins. CONCLUSIONS: HOXA11-AS inhibited the malignant transcription of the LATS1 genes and promoted the malignant proliferation of HCC cells. Interactions among HOXA11-AS, PRC2, and LATS1 may provide a new target for the treatment of HCC.


Assuntos
Carcinoma Hepatocelular/metabolismo , Proteínas de Homeodomínio/farmacologia , Neoplasias Hepáticas/metabolismo , Proteínas Serina-Treonina Quinases/biossíntese , RNA Longo não Codificante/genética , Animais , Apoptose/efeitos dos fármacos , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/terapia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Citoplasma/metabolismo , Terapia Genética , Humanos , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/terapia , Camundongos , Camundongos Nus , Transplante de Neoplasias , Proteínas Serina-Treonina Quinases/efeitos dos fármacos , Proteínas Serina-Treonina Quinases/genética , Interferência de RNA , RNA Interferente Pequeno
8.
Beijing Da Xue Xue Bao Yi Xue Ban ; 49(2): 252-255, 2017 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-28416834

RESUMO

OBJECTIVE: To evaluate the feasibility of transforaminal endoscopic nerve root decompression for degenerative lumbar spinal stenosis (DLSS). METHODS: From July 2011 to April 2016, 96 cases of single segment DLSS were involved. All the patients had unilateral lower extremity neurological symptoms, signs, neurogenic intermittent claudication of less than 500 m. Imaging examinations (CT or MRI) or diagnostic nerve root block confirmed single segment degeneration. The mean age was (71.6±5.4) years, male: 55 cases, female: 41 cases. Their intraoperative blood loss, operation time, complications, ambulation time and discharge time were recorded. Leg pain VAS, ODI were used to evaluate the pain and lumbar function of the patients. The clinical efficacy was evaluated by Nakai evaluation. RESULTS: All the patients were performed endoscopic decompression of the lateral recess and nerve root by removing the ventral part of the superior facet joint, the ligamentum flavum and the intervertebral disc. The decompression range was from the inferior edge of the upper pedicle to the superior edge of the lower pedicle. The nerve root was detected to have no compression and the pulse of nerve root returned to normal. The patient got ambulant on the operation day and discharged if he had no discomfort symptom. In the study, 68 cases got follow up. The mean follow-up time was 12.1 months (6-63 months). The VAS at different follow-up time points was improved relative to the baseline, and the difference was statistically significant (F=491.60, P<0.001). The ODI at different follow-up time points was improved relative to the baseline, and the difference was statistically significant (F=189.91, P<0.001). The excellent and good rates of Nakai evaluation were 79.4% (excellent in 42 cases, good in 12 cases, fair in 10 cases and poor in 4 cases). The mean intraoperative blood loss was (49.29±11.86) mL. The mean operation time was (92.46±21.34) min. The mean ambulation time was 1.8 h. The mean discharge time was 2.3 days. Postoperative epidural hematoma was found in 1 case. Foot drop was found in 1 case. Second stage open surgery was performed in 6 cases. CONCLUSION: We can apply transforaminal endoscopic decompression for the patients of lumbar spinal stenosis who have unilateral nerve root irritation. Patients with transforaminal endoscopic decompression can get less surgical trauma, quick recovery and obtain good short-term outcome.


Assuntos
Descompressão Cirúrgica , Endoscopia , Fusão Vertebral , Estenose Espinal/cirurgia , Idoso , Perda Sanguínea Cirúrgica , Feminino , Humanos , Vértebras Lombares , Imageamento por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos , Duração da Cirurgia , Medição da Dor , Resultado do Tratamento
9.
Beijing Da Xue Xue Bao Yi Xue Ban ; 49(2): 256-261, 2017 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-28416835

RESUMO

OBJECTIVE: To describe the application of polymethylmethacrylate (PMMA) augmentation of cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar scoliosis with osteoporosis. METHODS: Retrospective cohort study was used to compare cement injectable cannulated pedicle screws (CICPs) group with PMMA augmentation and control group with traditional method in the correction surgery for Lenke-silva level III and level IV degenerative scoliosis cases with osteoporosis. Both groups were followed up for 1 year. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, Oswestry disability index (ODI) score and EuroQol-5 dimensions (EQ-5D) score. The coronal major curve Cobb angel in coronal plane and thoracic kyphosis Cobb angle, lumbar lordosis Cobb angle and sagittal vertical axis (SVA) in sagittal plane were tested in whole long spine X ray. The fusion rates were evaluated by lumbar X ray and dynamic X ray. RESULTS: In this study 34 cases were enrolled, 15 cases in CICPs group and 19 cases in control group. The general characteristics including age, gender, weight, height, BMI and BMD were without statistical difference between the two groups. There were (5.7±2.2)PMMA augmentation screws in CICPs group. The operation time, blood loss and blood transfusion were higher in CICPs group than in control group, but without statistical difference. Lumbar VAS, lower limbers VAS, ODI score and EQ-5D were all better in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups. lumbar VAS scores of CICPs group in 6 months postoperation (CICPs group 3.1±1.3 vs. control group 4.4±1.4, P<0.01) together with lumbar VAS scores (CICPs group 3.3±1.0 vs. control group 5.2±1.4, P<0.01), ODI scores (CICPs group 22.7±17.2 vs. control group 31.4±18.5, P<0.01) and EQ-5D in 1 year postoperation (CICPs group 2.9±2.0 vs. control group 3.5±2.5, P<0.01)were lower than those of control group. The coronal major curve Cobb angels were all lower in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups; thoracic kyphosis Cobb angle and lumbar lordosis Cobb angle were all higher in 1 month postoperation, 6 months postoperation and 1 year postoperation than in preoperation in both groups. The coronal major curve Cobb angel was lower in CICPs group than that in control group in 1 year postoperation (CICPs group 17.6°±6.9° vs. control group 21.2°±7.2°, P<0.01)and thoracic kyphosis Cobb angle was higher in CICPs group than that in control group in 6 months postoperation (CICPs group -33.5°±8.8 ° vs. control group -28.9°±8.3°, P<0.01) and 1 year postoperation (CICPs group -33.0°±8.1° vs. control group -26.3°±7.4°, P<0.01) together with lumbar lordosis Cobb angle were higher in CICPs group than that in control group in 1 year postoperation (CICPs group 26.4°±8.1° vs. control group 22.1°±7.3°, P<0.01). CONCLUSION: Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar scoliosis with osteoporosis was effective and safe, the short-term clinical result was good.


Assuntos
Cimentos Ósseos , Osteoporose/cirurgia , Parafusos Pediculares , Polimetil Metacrilato , Escoliose/cirurgia , Humanos , Cifose , Lordose , Vértebras Lombares , Duração da Cirurgia , Osteoporose/complicações , Medição da Dor , Período Pós-Operatório , Radiografia , Estudos Retrospectivos , Escoliose/complicações , Fusão Vertebral , Resultado do Tratamento
10.
Beijing Da Xue Xue Bao Yi Xue Ban ; 48(6): 1019-1025, 2016 12 18.
Artigo em Chinês | MEDLINE | ID: mdl-27987507

RESUMO

OBJECTIVE: To describe the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis. METHODS: Observation group included 14 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws from November 2014 to July 2015, control group included 12 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation with traditional pedicle screws.The operation time, blood loss, number of pedicle screws and number of augmented pedicle screws in the two groups were compared. The bone cement leakage and pulmonary bone cement embolism in the two groups were also compared. The fusion rate and pedicle screws loosening by lumbar X ray and dynamic X ray were evaluated. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopaedic Association scores (JOA), Prolo functional scores and Oswestry disability (ODI) scores. RESULTS: Differences of operation time and blood loss in the two groups were not statistically significant. The average number of pedicle screws was 9.9±4.7 and the average number of augmented pedicle screws was 5.9±2.6 in observation group while the average number of pedicle screws was 7.1±2.8 and the average number of augmented pedicle screws was 3.0±1.9 in control group. The ratio of augmented pedicle screws was higher in observation group than in control group (0.69±0.30 vs.0.47±0.30,P<0.05). The bone cement leakage rate was lower in observation group than in control group (5/83 vs. 12/42, P<0.01). All the cases in observation group were without leakage to the interspinal canal while one case in control group suffered from bone cement leakage to the interspinal canal with augmentation of 3 pedicle screws. The follow up period was (10.6±2.3) months in observation group and (36.5±7.2) months in control group. In final follow up, no case with non-fusion or pedicle screws loosening was found in both groups. Lumbar VAS, lower limbers VAS, lumbar JOA scores, Prolo functional scores and ODI scores were all better than pre-operation (P<0.01). CONCLUSION: Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis was effective, with simple working processes and lower risk of bone cement leakage. The short-term clinical result was good.


Assuntos
Cimentos Ósseos/efeitos adversos , Cimentos Ósseos/uso terapêutico , Dor Lombar/cirurgia , Vértebras Lombares/cirurgia , Osteoporose/cirurgia , Parafusos Pediculares/efeitos adversos , Polimetil Metacrilato/efeitos adversos , Polimetil Metacrilato/uso terapêutico , Doenças da Coluna Vertebral/cirurgia , Fusão Vertebral/métodos , Perda Sanguínea Cirúrgica , Pesquisa Comparativa da Efetividade , Humanos , Duração da Cirurgia , Medição da Dor , Embolia Pulmonar/etiologia
11.
Zhonghua Yi Xue Za Zhi ; 96(29): 2332-5, 2016 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-27524191

RESUMO

OBJECTIVE: To explore the clinical effect of different surgical methods in the treatment of cesarean scar pregnancy, the decline trend of human chorionic gonadotropin (hCG) and the indications of different treatment methods. METHODS: This study was a prospective cohort study. The clinical data of 120 patients with cesarean scar pregnancy who were treated with four different surgical methods in the Beijing Obstetrics and Gynecology Hospital from June 2013 to December 2014 were collected. Seven cases ultrasonic curettage, 63 cases uterine arterial embolization (UAE) with hysteroscopic pregnancy embryo removal surgery, 41 cases UAE + B-ultrasound or laparoscopic monitoring hysteroscopic pregnancy embryo clearance surgery and 9 cases UAE + hysteroscopic and laparoscopic removal of pregnancy scar and uterine repair. The clinical efficacy of different surgical methods and the decrease trend of serum HCG in postoperative period were analyzed. RESULTS: (1)The levels of serum beta hCG in patients with cesarean scar pregnancy after different surgical treatments decreased (84.5±9.7)%, (97.7±3.2)% and (99.6±1.2)% after the 2 days, 7 days and 14 days respectively. The average time of blood beta hCG level dropped to normal was (22.4±6.7) d. (2)There was a significant difference in the amount of bleeding and the time of hospitalization among the patients treated with different surgical methods. (3)There was a significant difference in the analysis of the decline percentage rate of serum beta hCG under the interactive effect between different surgical methods and postoperative recovery time (P<0.01). CONCLUSION: The level of serum beta hCG in patients with cesarean scar pregnancy were reduced to normal range after 3 weeks of operation. The choice of surgical approach should be based on the degree of implantation of embryo sac scar, the thinnest muscle thickness, local blood flow, serum beta hCG levels, gestational sac size, process to the bladder and fertility desire to determine.


Assuntos
Cesárea , Cicatriz , Gonadotropina Coriônica , Gonadotropina Coriônica Humana Subunidade beta , Curetagem , Embolização Terapêutica , Feminino , Humanos , Histeroscopia , Laparoscopia , Período Pós-Operatório , Gravidez , Estudos Prospectivos , Útero , Cicatrização
12.
Beijing Da Xue Xue Bao Yi Xue Ban ; 48(2): 250-6, 2016 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-27080276

RESUMO

OBJECTIVE: To evaluate the over 5-year follow-up clinical outcomes of degenerative lumbar scoliosis treated with operation of decompression and fusion, and the effectiveness and risks factors about revision surgery cases. METHODS: A total of 47 cases of diagnosis of degenerative lumbar scoliosis treated with posterior decompression and instrument fusion recorded from Jun. 2003 to Jun. 2008 were analyzed. Lumbar Japanese Orthopedic Association (JOA) score and visual analogue score (VAS) were applied to evaluate the improvement of the clinical effect after surgery treatment, and the clinical effect and reasons of revising operation were recorded and analyzed. RESULTS: All the 47 patients had finished the over 5-year followed-up time with an average time of (8.2±3.6) years (range from 5.2 years to 12.5 years). The patient's mean age was (67.0±9.6) years and the age of patient range from 56 years to 81 years. There were 10 patients who underwent revision surgery since primary operation, in whom 8 cases because of proximal failure of internal fixation and the other 2 cases because of distal failure of fusion segment. The average clinical improvement excellent rate was 83.3% after 5 years since primary operation of 37 cases while the average fine rate of revision operation was 67.6%. CONCLUSION: In the over 5-year follow-up, there was a better clinical outcome of degenerative lumbar scoliosis treated with posterior decompression and instrumented fusion, which had a certain rate of revision operation and had a worse effect of clinical results compared with primary operation. The risks of revision surgery included the poor bone quality of patients, with fusion to L1 at proximal terminal and the fusion end to S1 at distal terminal.


Assuntos
Descompressão Cirúrgica , Vértebras Lombares/patologia , Escoliose/cirurgia , Fusão Vertebral , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Fixação Interna de Fraturas , Humanos , Vértebras Lombares/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Reoperação , Resultado do Tratamento
13.
Eur J Gynaecol Oncol ; 37(5): 627-631, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-29786999

RESUMO

PURPOSE: To investigate the effects of bortezomib alone and in combination with 5-fluorouracil (5-FU) on proliferation and apoptosis in the human choriocarcinoma cell line JEG-3. MATERIALS AND METHODS: Cells were treated with bortezomib, 5-FU or with a combination. Proliferation and apoptosis were measured. NF-iB protein expression was examined using immunofluorescence. RESULTS: Following treatment with ten nM bortezomib, rates of apoptosis were significantly higher than controls (p < 0.05) and NF-kB expression increased. 5-FU at 0.025 µg/ml or 0.25 µg/ml resulted in 60.1 ± 0.4% and 67.0 ± 0.2% growth inhibition, respectively, an increase compared to individual treatment (p < 0.05). Apoptosis in cells treated with bortezomib +5-FU was significantly higher than either treatment alone (p < 0.05). Inhibition of proliferation by the combination treatment was synergistic. CONCLUSION: Bortezomib alone or in combination with 5-FU inhibited JEG-3 cell proliferation and induced apoptosis by increasing NF-kB expression. Combination treatment exerted synergistic effects on growth inhibition.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Apoptose/efeitos dos fármacos , Bortezomib/uso terapêutico , Coriocarcinoma/tratamento farmacológico , Fluoruracila/administração & dosagem , Neoplasias Uterinas/tratamento farmacológico , Bortezomib/administração & dosagem , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Coriocarcinoma/patologia , Feminino , Humanos , NF-kappa B/fisiologia , Neoplasias Uterinas/patologia
14.
Beijing Da Xue Xue Bao Yi Xue Ban ; 47(2): 242-7, 2015 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-25882937

RESUMO

OBJECTIVE: To investigate the clinical characteristics of vertebral compression fracture (VCF) in glucocorticosteroid-induced osteoporosis (GIOP) and risk of vertebral refracture after percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP). METHODS: In the study, 570 cases who received PVP or PKP as treatments of VCF from January 2010 to December 2013 were retrospective reviewed, of which 42 were GIOP and 21 were followed up as GIOP group, and the other 528 were primary osteoporosis and 391 were followed up, of which 84 were selected as Control group based on age and gender. The fracture location, ratio of single segment fracture and multiple segments fracture in the two groups were compared. In the final follow up, the reoperation rates for vertebral refractures by the Kaplan-Meier method in the two groups were compared. RESULTS: The follow up periods were (24.0± 13.1) months in GIOP group and (25.8±14.4) months in control group(P>0.05). In GIOP group, there were 11 cases with one-segment fracture, 2 with two-segments fracture, 3 with three-segments fracture, 2 with four-segments fracture, 2 with five-segments fracture and 1 with eight-segments fracture. In Control group, there were 67 cases with one-segment fracture, 12 with two-segments fracture, 3 with three-segment fracture, and 2 with four-segments fracture. The ratio of single segment fracture in GIOP group was significantly lower than that in Control group(52.4% vs. 79.8%,P=0.01). There were 50 fracture segments in GIOP group and 109 fracture segments in Control group. The ratios of fracture segments located in thoracic segments(T1-T10), thoracolumbar segments(T11-L1)and lumbar segments(L2-L5)were 18%, 46% and 36% in GIOP group and 11.9%, 58.7% and 29.4% in Control group (P>0.05). The refracture rate in GIOP group was higher than that in control group (23.8% vs. 6.0%). The survival rate was lower in GIOP group than that in control group (P<0.01). CONCLUSION: The predilection site of VCF was similar in GIOP and primary osteoporosis (thoracolumbar segments> thoracic segments> lumbar segments). The risk of multiple segments VCF was higher in GIOP than in primary osteoporosis. The risk of vertebral refractures after PVP or PKP was higher in GIOP than in primary osteoporosis.


Assuntos
Fraturas por Compressão/induzido quimicamente , Glucocorticoides/efeitos adversos , Cifoplastia , Fraturas por Osteoporose/induzido quimicamente , Fraturas da Coluna Vertebral/induzido quimicamente , Vertebroplastia , Humanos , Osteoporose , Reoperação , Estudos Retrospectivos
15.
Drug Res (Stuttg) ; 65(11): 597-601, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25514117

RESUMO

Osteosarcoma (OS) is the most common type of malignant bone tumor in adults and children. Despite the great strides in biology and medicine, the survival rate of patients with metastatic disease remains very poor. This rate has been staggering with recurrence and metastasis. In the present study, we proposed Wnt/ß-catenin pathway as a key biological target for the effective treatment in OS. Wnt signaling has been reported to play important roles in osteoblastogenesis. We hypothesized that docetaxel (DTX) will effectively arrest the osteosarcoma progression by suppressing the Wnt/ß-catenin pathway in OS cells. Our results show that DTX significantly inhibited the cell proliferation of U2OS and SaOS-2 cancer cells in a time-dependent and dose-dependent manner. DTX inhibited the intrinsic transcriptional activity of ß-catenin/Tcf in U2OS cancer cells and SaOS-2 cancer cells. GSK-3ßinhibitor (SB216763) treatment remarkably increased the ß-catenin/Tcf transcriptional activities. The transcriptional activities have been increased by around ~200% due to the decrease in the degradation of ß-catenin mediated through GSK-3ß. Summarizing, present study clearly showed that DTX inhibited Wnt/ß-catenin signalling pathways and significantly reduced the matrix metallopeptodase 9 (MMP-9) protein expressions and its activity. Taken together, our findings provide novel insight on the effect of anticancer small molecules to improve the outcomes in osteosarcoma.


Assuntos
Neoplasias Ósseas/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Taxoides/farmacologia , Via de Sinalização Wnt/efeitos dos fármacos , Antineoplásicos/administração & dosagem , Antineoplásicos/farmacologia , Neoplasias Ósseas/patologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Progressão da Doença , Docetaxel , Relação Dose-Resposta a Droga , Quinase 3 da Glicogênio Sintase/metabolismo , Glicogênio Sintase Quinase 3 beta , Humanos , Indóis/farmacologia , Maleimidas/farmacologia , Metaloproteinase 9 da Matriz/metabolismo , Osteossarcoma/patologia , Taxoides/administração & dosagem , Fatores de Tempo
16.
Acta Neurol Scand ; 130(1): 18-26, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24382157

RESUMO

OBJECTIVES: The main aims of this study were to classify patients with hypothalamic hamartoma (HH) based on neuroimaging features and describe the clinical manifestations of HH. MATERIALS AND METHODS: A retrospective review of 214 consecutive patients with HH treated in Beijing Tiantan Hospital was performed. RESULTS: HH were diagnosed and divided into Types I-IV based on MRI. Types I and II were defined as the HH attached to the floor of the third ventricle with narrow (Type I) or broad (Type II) interfaces. Type III ('straddling') was defined by the HH extending into the third ventricle and interpeduncular cistern. Type IV was defined as the HH located totally within the third ventricle. The percent distribution of patients was 35.9% Type I, 12.1% Type II, 40.7% Type III, and 11.2% Type IV. The percentage of patients with precocious puberty was highest in Type I (81.8%). The percentage of patients with gelastic seizures was highest in Type IV (91.7%). After surgery, 20% (1/5) of patients with Type II HH, 48.8% (20/42) with Type III, and 91.7% (11/12) with Type IV were free of epileptic seizures. Significant prognostic factors for surgical outcome were HH size, surgical approach, and resection level. CONCLUSIONS: The clinical manifestations of HH are correlated with the topology of the HH in relation to the hypothalamus. Our results suggest that patients with Type IV HH have the best outcome from surgery and neurosurgeons should be cautious about performing surgery on patients with Type II and Type III HH.


Assuntos
Hamartoma/classificação , Hamartoma/patologia , Hamartoma/cirurgia , Doenças Hipotalâmicas/classificação , Doenças Hipotalâmicas/patologia , Doenças Hipotalâmicas/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Epilepsia/etiologia , Epilepsia/cirurgia , Feminino , Humanos , Lactente , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Prognóstico , Puberdade Precoce/etiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
17.
J Pathol ; 177(2): 129-34, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7490678

RESUMO

A rapid non-isotopic PCR-SSCP (polymerase chain reaction-single-stranded conformation polymorphism) method was developed in this study to detect polymorphism and loss of heterozygosity (LOH) of p53 in formalin-fixed and paraffin-embedded samples of normal breast tissue and of breast cancer. p53 expression was also examined by immunohistochemistry. In 35 paired samples, heterozygosity in exon 4 of p53 was detected in 17 cases (49 per cent) and LOH of the p53 gene in breast cancer tissues was observed in 7 out of 15 informative cases (47 per cent). The correlation of LOH of p53 with positive p53 immunostaining did not reach statistical significance, but all immunostaining-positive tumours among informative cases had LOH of p53. The results support the hypothesis that in most cases the allelic deletion of p53 may uncover the 'recessive mutation' in the remaining allele. However, LOH of p53 was more frequent than positive immunostaining and was significantly associated with poor differentiation of breast cancer (P < 0.05). The results suggest that the allelic deletion of p53 may also contribute to the development and progression of breast cancer by reducing the amount of normal p53 protein. These results show that non-isotopic PCR-SSCP is a simple, fast, and effective method for detecting polymorphism and LOH of the p53 gene, which is especially useful for retrospective studies.


Assuntos
Neoplasias da Mama/genética , Deleção Cromossômica , Genes p53/genética , Adulto , Idoso , Sequência de Bases , Feminino , Heterozigoto , Humanos , Pessoa de Meia-Idade , Dados de Sequência Molecular , Inclusão em Parafina , Reação em Cadeia da Polimerase , Polimorfismo Genético , Polimorfismo Conformacional de Fita Simples
18.
Zhonghua Jie He He Hu Xi Za Zhi ; 16(6): 342-4, 374, 1993 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-7913415

RESUMO

Seventy-three cases of lung cancer were studied using two different methods, immunostaining for the proliferating cell nuclear antigen (PCNA) and nucleolar organizer region staining (AgNORs), to assess the degree of cell proliferation. Both PCNA immunostaining and AgNOR staining were found to be significantly correlated with histological grade of lung cancer. The mean number of AgNOR per nucleus was found to be associated with LI of PCNA (r = 0.70, P < 0.01). The results suggest that the two proliferation-associated factors may be used as the additional diagnostic parameters in the grading of lung cancer.


Assuntos
Antígenos de Neoplasias/análise , Neoplasias Pulmonares/química , Proteínas Nucleares/análise , Região Organizadora do Nucléolo/patologia , Adenocarcinoma/química , Adenocarcinoma/patologia , Carcinoma de Células Escamosas/química , Carcinoma de Células Escamosas/patologia , Divisão Celular , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/patologia , Antígeno Nuclear de Célula em Proliferação , Coloração pela Prata
19.
Jpn J Clin Oncol ; 20(4): 420-5, 1990 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-2178198

RESUMO

The case is presented of a 64-year-old male with a left adrenal mass and multiple liver lesions. Preoperative image work-ups included ultrasonography, computed tomography, selective liver and adrenal angiographies, and magnetic resonance imaging. Serial serum alpha-fetoprotein monitoring and the adrenal hormone profile were within the normal ranges. A left adrenalectomy and a right lobectomy of the liver were performed, and the pathology revealed hepatocellular carcinoma with left adrenal metastasis. The clinical significance of the present case, together with the diagnosis and management of the disease is discussed.


Assuntos
Neoplasias das Glândulas Suprarrenais/secundário , Carcinoma Hepatocelular/secundário , Neoplasias Hepáticas/cirurgia , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Humanos , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade
20.
Chem Biol Interact ; 41(2): 141-53, 1982 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-6809344

RESUMO

The enzymes involved in the initial steps in the biosynthesis of glycosaminoglycans were examined in the murine B16 melanoma. Approximately 60% of the melanoma xylosyltransferase activity and nearly all of the galactosyltransferase activity were membrane-bound; these enzymatic activities were solubilized by treatment with Nonidet P-40 and potassium chloride, and the Michaelis constants for the substrates and acceptor molecules were determined and found to be comparable to those reported for these enzymes from the chick embryo and a rat chondrosarcoma. Dialdehyde nucleosides, which have been reported to alter the activity of several enzymes involved in nucleic acid synthesis, inhibited both xylosyltransferase and galactosyltransferase activities, with galactosyltransferase being considerably less sensitive than xylosyltransferase. The inhibition of xylosyltransferase by dialdehyde nucleosides was irreversible, with no apparent specificity for the base moiety of the dialdehyde nucleosides.


Assuntos
Galactosiltransferases/metabolismo , Melanoma/enzimologia , Pentosiltransferases/metabolismo , Adenosina/análogos & derivados , Adenosina/farmacologia , Aldeídos/farmacologia , Animais , Fracionamento Celular , Linhagem Celular , Citidina/análogos & derivados , Citidina/farmacologia , Galactosiltransferases/antagonistas & inibidores , Concentração de Íons de Hidrogênio , Inosina/análogos & derivados , Inosina/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neoplasias Experimentais/enzimologia , Octoxinol , Pentosiltransferases/antagonistas & inibidores , Polietilenoglicóis/farmacologia , Cloreto de Potássio/farmacologia , Fosfato de Piridoxal/farmacologia , Uridina/análogos & derivados , Uridina/farmacologia , UDP Xilose-Proteína Xilosiltransferase
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