الملخص
OBJECTIVE@#To observe the clinical efficacy of targeted sealing with high viscosity bone cement and secondary injection of low viscosity bone cement in the treatment of OVCFs patients with the fracture lines involved vertebral body margin.@*METHODS@#The elderly patients who underwent vertebroplasty for osteoporotic vertebral compression fractures from January 2019 to September 2021 were selected as the screening objects. Through relevant standards and further CT examination, 56 patients with fracture lines involving the anterior wall or upper and lower endplates of the vertebral body were selected for the study. There were 21 males and 35 females, aged from 67 to 89 years old with an average of (76.58±9.68) years. All 56 patients underwent secondary injection of bone cement during operation. Only a small amount of high viscosity cement was targeted to seal the edge of the vertebral body for the first time, and low viscosity cement was injected to the vertebral bodies during second bolus with well-distributed. The operation time, bone cement volume and bone cement leakage were recorded, and the pain relief was evaluated by visual analogue scale (VAS).@*RESULTS@#All patients were followed up for more than 3 months and the surgeries were successfully complete. The operation time was (50.41±10.30) min and the bone cement volume was (3.64±1.29) ml. The preoperative VAS was (7.21±2.41) points, which decreased significantly to (2.81±0.97) points 3 days after operation(P<0.05). Among the 56 patients, 2 cases(3.57%) had bone cement leakage, 1 case leaked to the paravertebral vein, and 1 case slightly bulged to the paravertebral through the crack when plugging the vertebral crack. Both patients had no obvious clinical symptoms.@*CONCLUSION@#In vertebroplasty surgery, targeted sealing of high viscosity bone cement and secondary injection of low viscosity bone cement can reduce intraoperative bone cement leakage and improve the safety of operation.
الموضوعات
Male , Female , Humans , Aged , Aged, 80 and over , Bone Cements/therapeutic use , Fractures, Compression/etiology , Spinal Fractures/surgery , Viscosity , Osteoporotic Fractures/surgery , Retrospective Studies , Vertebroplasty/adverse effects , Treatment Outcomeالملخص
OBJECTIVE@#To explore the application of three-dimensional CT and image classification in the treatment of osteoporotic vertebral compression fracture(OVCFs) by percutaneous vertebroplasty(PVP).@*METHODS@#A total of 90 patients with OVCFs who were treated with PVP in Linqu People's Hospital of Shandong Province from April 2016 to March 2018 were selected as subjects. There were 31 males and 59 females, aged from 63 to 84 years old. Bone mineral density measurements were performed in all patients to confirm the presence of osteoporosis and imaging examinations were performed to confirm the presence of vertebral fractures. The fracture area was determined by MRI fat surpressed image before operation and three-dimensional modeling was performed to calculate the volume of fracture area. Three dimensional CT imaging of bone cement in fracture area was performed after PVP and the volume ratio of bone cement in fracture area was calculated by computer aided design software, by which patients were divided into groups for study. Forty-one patients whose volume ratio of bone cement in fracture area less than 50% are control group and the rest of 90 patients are observation group. Visual analogue scale (VAS) and Oswestry Disability Index(ODI) were collected in two groups before operation and 1 day, 3 months after operation. The amount of bone cement was recorded after operation.@*RESULTS@#All operations were successful. There were 3 cases of cement leakage in control group and 4 cases in observation group. All patients had no obvious clinical symptoms. After continuous observation and follow-up for 3 months, no complications such as adjacent vertebral fracture, infection, bone cement displacement were found. There was no significant difference in bone cement doses and bone cement leakage between two groups(>0.05). There was no significant difference in preoperative VAS and ODI between two groups(>0.05). All VAS and ODI obviously decreased(<0.05) at 1 day after operation and in observation group the decrease was more significant (<0.05). At 3 months after operation there was no significant difference between two groups. This may have been due to basically healing of vertebral fractures at 3 months after surgery and the pain was no longer significantly related.@*CONCLUSIONS@#PVP can significantly improve clinical symptoms of OVCFs and bone cement filling in fracture area is the key to the short-term effect of PVP.
الموضوعات
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Bone Cements , Fractures, Compression , Osteoporotic Fractures , Retrospective Studies , Spinal Fractures , Tomography, X-Ray Computed , Treatment Outcome , Vertebroplastyالملخص
The purpose of the study was to observe changes in endolymphatic hydrops by using intratympanic injection of gadolinium and magnetic resonance imaging (MRI) before and after endolymphatic sac surgery in patients with unilateral Meniere's disease. Thirteen patients with unilateral Meniere's disease undergoing endolymphatic sac surgery were retrospectively and prospectively analyzed. Three-dimensional fluid-attenuated inversion recovery or three-dimensional real inversion recovery MRI was performed 24 h after an intratympanic injection of gadolinium to grade the presence of endolymphatic hydrops. Among the 13 patients with hydrops confirmed by preoperative MRI, vestibular hydrops had no significant change in all patients; cochlear hydrops became negative in 2 patients, and remained unchanged in the other 11 patients after surgery. Definite vertigo attacks were substantially controlled in one patient and completely controlled in 12 patients during a follow-up period of 8-34 months after surgery. The hearing levels were improved in 3 patients, remained unchanged in 7 patients, and decreased in 3 patients. In conclusion, endolymphatic sac surgery does not always alleviate endolymphatic hydrops in patients with Meniere's disease. Relief from vertigo cannot always be attributed to the remission of hydrops. A change in hearing levels cannot be explained by hydrops status alone.
الموضوعات
Adult , Aged , Female , Humans , Male , Middle Aged , Contrast Media , Endolymphatic Hydrops , Diagnostic Imaging , Pathology , General Surgery , Endolymphatic Sac , Diagnostic Imaging , Pathology , General Surgery , Gadolinium , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Meniere Disease , Diagnostic Imaging , Pathology , General Surgeryالملخص
Objective To investigate Notch1 protein expression of leukemic cells in children with pediatric Bcell acute lymphoblastic leukemia(B-ALL) and its effect on prognosis.Methods The expression of Notch1 protein of leukemic cells in bone marrow smears was detected by immunohistochemistry(SABC) in primarily diagnosed childhood ALL,including 63 cases of B-ALL and 14 cases of T-ALL,a group of 34 children with no malignancy served as controls.Reverse transcription-ploymerase chain reaction was used to assay Notch1 mRNA expression in ALL patients.Results The incidence of Notch1 expression was 31.7% in B-ALL patients,71.4% in T-ALL patients,and 8.8% in control group,respectively.Notch1 protein was aberrantly expressed in both B-ALL and T-ALL compared with the controls(P < 0.05,P < 0.001).Multivariate analysis revealed that the expression of Notch1 protein in B-ALL was not associated with patients' age,gender,WBC count at diagnosis(all P > 0.05),it had no influence on the early treatment response.Nevertheless,the Kaplan-Meier curve of event-free survival showed that,in the patients without Notch1 protein expression,the long-term event-free survival rate was as high as 92.7 %,in contrast,in the children with Notch 1 expression,the event-free survival was only 54.5 % (P =0.0054).Conclusions The expression of Notch 1 protein in pediatric B-ALL may predict a poor prognosis,and interfering with Notch1 signaling could be employed as a potential therapeutic target for those patients with Notch1 expression.
الملخص
<p><b>OBJECTIVE</b>To investigate the biological characteristics of childhood T-lineage acute lymphoblastic leukemia (T-ALL) and their clinical significance.</p><p><b>METHODS</b>Immunophenotyping was performed by three-color flow cytometry analysis using CD45 /SSC gating in 23 children with newly diagnosed T-ALL. Meanwhile cytogenetic analysis was performed.</p><p><b>RESULTS</b>CD3(+) expression of T-lineage antigens was apparently higher than CD7(+) and CD5(+) expression. CD19(+) expression of B-lineage antigens was apparently higher than CD22(+), CD10(+) and CD20(+) expression. Myeloid antigen was expressed in 4 cases (17%). CD34(+) and HLA-DR(+) were observed in 4 cases (17%) and 5 cases (22%), respectively. cCD3(+) and cCD79(+) were expressed in 23 cases (100%) and 22 cases (96%), respectively. The chromosome detection in 8 cases with T-ALL showed hyperdiploid or Ph(+) chromosome (one case each). The fusion gene detection in 5 cases showed MLL rearrangements in two cases and positive SIL/TAL1 fusion gene in one case. CD3 expression was related with the complete remission rate.</p><p><b>CONCLUSIONS</b>Immunophenotyping is an important tool for diagnosis of T-ALL. However, the immunophenotype of T-ALL is heterogeneous. So, immunophenotyping along with cytogenetic and molecular genetic analysis is needed in the treatment and prognosis evaluation of T-ALL.</p>
الموضوعات
Child , Child, Preschool , Female , Humans , Male , Chromosome Aberrations , Immunophenotyping , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma , Drug Therapy , Genetics , Allergy and Immunologyالملخص
<p><b>OBJECTIVE</b>To investigate the expression of CD147 and matrix metalloproteinase-9 (MMP-9) in children with non-Hodgkin's lymphoma (NHL) and its correlation with clinical stage, tumor size, bone marrow invasion, immunological typing, serum lactate dehydrogenase (LDH) concentration, and prognosis.</p><p><b>METHODS</b>Specimens excised from NHL patients were prepared. Expression of CD147 and MMP-9 were tested by streptavidin-biotin complex (SABC) immunohistochemistry and its correlation with clinical results were analyzed.</p><p><b>RESULTS</b>The positive rate of CD147 expression was 73% (45/62), 17 cases were (-), 11 cases (+), 34 cases (++) and 21 cases (+++). The positive rate of MMP-9 expression was 81% (50/62), 12 cases were (-), 13 cases (+), 18 cases (++) and 19 cases (+++). The Spearman rank correlation analysis indicated that there was a positive correlation between CD147 and MMP-9 expressions in NHL (r(S) = 0.763, P = 0.034). Expression of CD147 was determined in relation to factors that included clinical bone marrow invasion, tumor size, LDH level as well as the clinical stage; expression of MMP-9 had a positive correlation with bone marrow invasion, tumor size and clinical phases. The 5-year survival rates (5YSR) were 78% (22/28) and 45% (15/34) in the cases whose CD147 expression was (-)-(+) and (++)-(+++), respectively, and 5YSR were 84% (21/25) and 43% (16/37) in the cases whose MMP-9 expression was (-)-(+) and (++)-(+++) respectively, the difference was significant. Cox multivariate analysis showed that both CD147 and MMP-9 were important prognostic factors.</p><p><b>CONCLUSION</b>The increased expression of CD147 and/or MMP-9 correlates with a poor clinical outcome in patients with NHL.</p>
الموضوعات
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Basigin , Metabolism , Lymphoma, Non-Hodgkin , Diagnosis , Metabolism , Pathology , Matrix Metalloproteinase 9 , Metabolism , Prognosis , Survival Rateالملخص
<p><b>OBJECTIVE</b>To study the relationship between human parvovirus B19 infection and childhood idiopathic thrombocytopenic purpura (ITP) by the principle of evidence based medicine.</p><p><b>METHODS</b>Papers related to the relationship between human parvovirus B19 infection and childhood ITP published between 1994 and 2008 were retrieved electronically from the Chinese Journals Full-text Database and the Wanfang Data. These relevant papers on case-control trials were statistically studied by meta analysis.</p><p><b>RESULTS</b>Eight papers that met the inclusion criteria were included for this meta analysis. Five hundred and sixteen cases of childhood ITP and 246 healthy controls were enrolled. The meta analysis showed that the incidence of human parvovirus B19 infection in the ITP group was significantly higher than that in the control group (OR=13.71, 95% CI=7.07-26.59, Z=7.75, p<0.01).</p><p><b>CONCLUSIONS</b>Human parvovirus B19 infection is closely associated with childhood ITP.</p>
الموضوعات
Child , Female , Humans , Male , Erythema Infectiosum , Purpura, Thrombocytopenic, Idiopathicالملخص
<p><b>OBJECTIVE</b>To probe into effects of acupuncture on rehabilitation of nervous functions in the stroke patient of different OCSP types.</p><p><b>METHODS</b>The stroke patients were randomly divided into 4 subtypes (LACI, TACI, PACI, POCI) based on the OCSP clinical classification. The patients of every subtype were randomly sub-divided into an observation group and a control group. The patients in the 2 groups were treated with routine western medicine, and acupuncture at Baihui (GV 20), Sanyinjiao (SP 6), Taixi (KI 3), Xuehai (SP 10), etc. were added with reinforcing and reducing manipulation in the observation group and without manipulation of the needle in the control group. They were assessed with daily living ability scale (BI) at the time of enrollment, the end of 1, 3, 6, 12 months after the stroke, respectively.</p><p><b>RESULTS</b>There was no significant difference between the two groups for BI in LACI (P>0.05); there were significant differences 3, 6 and 12 months after the stroke between the two groups in PACI, POCI (P<0.05); in the TACI, there was a significant difference between the two groups for BI 3 and 6 months after stroke (P<0.05), with no significant difference 12 months after stroke (P>0.05).</p><p><b>CONCLUSION</b>Acupuncture has different effects on rehabilitation of daily living function in the stroke patient of different OCSP types.</p>
الموضوعات
Aged , Female , Humans , Male , Middle Aged , Acupuncture Therapy , Nervous System , Stroke , Stroke Rehabilitationالملخص
This study was aimed to investigate the changes of silencer of death domains (SODD), survivin, caspase 3, caspase 8 and caspase 9 in the apoptotic process of human leukemia cells induced by chemotherapeutic drugs in order to explore the molecular mechanism of apoptotic modulatory genes and to search for the new target of chemotherapeutic drugs. After Jurkat cells were induced by chemotherapeutic drugs, the translocated phosphatidylserine was labeled with annexin V/PI, and the apoptosis incidence was measured by FCM; The expression changes of SODD, caspase 3, caspase 8 and caspase 9 were determined by Western blot; the changes of survivin mRNA and protein were determined by RT-PCR and immunohistochemistry SABC method respectively. The results indicated that high expressions of SODD and survivin could inhibit apoptotic signaling pathway; VCR down-regulated the function of SODD protein and effectively induced the apoptosis of Jurkat cells in a time-dependent manner and activates caspase 3 through the death receptor-mediated activation of caspase 8, in which caspase 9 and survivin were not degraded. It is concluded that SODD participates in the apoptotic process induced by VCR which induces the Jurkat cell apoptosis by downregulating expression of SODD protein and priming death receptor pathway. In the apoptotic process, the mitochondrion apoptotic pathway is not trigged.
الموضوعات
Humans , Adaptor Proteins, Signal Transducing , Metabolism , Antineoplastic Agents , Pharmacology , Apoptosis , Caspase 3 , Metabolism , Caspase 8 , Metabolism , Caspase 9 , Metabolism , Inhibitor of Apoptosis Proteins , Jurkat Cells , Microtubule-Associated Proteins , Metabolism , Vincristine , Pharmacologyالملخص
<p><b>OBJECTIVE</b>To investigate Daxx expression and its clinical significance in children with acute leukemia.</p><p><b>METHODS</b>The expression of Daxx protein was detected by immunohistochemical assay in 50 children with newly diagnosed acute leukemia (34 cases of acute lymphocytic leukemia and 16 cases of acute non-lymphocytic leukemia). Twenty children with normal bone marrow were used as the control group.</p><p><b>RESULTS</b>Daxx protein was expressed in 38.0% of 50 children with acute leukemia, which was significantly higher than that of the control group (5.0%) (P < 0.05). The children with acute non-lymphocytic leukemia had significantly higher Daxx expression levels (62.5%) than those with acute lymphocytic leukemia (26.5%; P < 0.05) as well as the control group (P < 0.05). There were no significant differences in the Daxx expression between acute lymphocytic leukemia children and the control group. Daxx protein was expressed in 55.6% of high risk group of acute lymphocytic leukemia but it was not expressed in standard risk group of acute lymphocytic leukemia (P < 0.05).</p><p><b>CONCLUSIONS</b>Daxx expression is abnormal in children with acute leukemia and associated with some clinical features of acute leukemia, suggesting that it may play an important role in the genesis and development of acute leukemia.</p>
الموضوعات
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Adaptor Proteins, Signal Transducing , Immunohistochemistry , Leukemia, Myeloid, Acute , Drug Therapy , Metabolism , NF-kappa B , Metabolism , Nuclear Proteins , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Drug Therapy , Metabolismالملخص
Objective To study the expression of cyclooxygenase-2(COX-2) and survivin in children with acute leukemia(AL) and its significance.Method The expression of COX-2 and survivin were determined by immunohistochemical SABC assay.Results The expression rate of COX-2 and survivin were 52.4%(22/42 cases)and 45.2%(19/42 cases)in AL,and the expression rate of COX-2 and survivin were 46.9%(15/32 cases)and 40.6%(13/32 cases)and in acute lymphonate leukemia(ALL),both of them were higher than those in control group(Pa0.05).The positive rate of COX-2 was 84%(16/19 cases)in 19 cases with survivin positive expression,and the negative rate of COX-2 was 85%(17/20 cases)in 20 cases with survivin negative expression,and there was positive correlation between COX-2 expression and survivin expression(r=0.579 P
الملخص
<p><b>OBJECTIVE</b>Survivin, a unique member of the inhibitor of apoptosis protein (IAP) family, plays an important role in regulating both apoptosis and cell division. Overexpression of survivin is associated with increased risk of recurrence and poor outcome in cancer patients. This study aimed to investigate the expression of survivin and its location as well as the relationship between cellular location and expression of survivin and the therapeutic efficacy at the cellular level.</p><p><b>METHODS</b>The expression of survivin protein was detected by immunohistochemical assay in bone marrow cells from 62 children with acute leukemia and 40 hospitalized children who did not have leukemia (Control group), and in a human acute T lymphocytic leukemia cell line (Molt-4 cells) treated in vitro with daunorubicin (DNR). Cell apoptosis was detected using flow cytometry.</p><p><b>RESULTS</b>Survivin protein was expressed in 41.9% of the 62 children with acute leukemia but in only 5.0% of the Control group (chi(2)=16.66; P < 0.01). The expression rate of survivin was 46.2% in cytoplasm and 53.9% in nucleus in the children with acute leukemia (chi(2)0.3077; P> 0.05). However, the remission rate of patients in whom survivin expression was seen in the nucleus was significantly higher than that in patients in whom survivin was expressed in cytoplasm after chemotherapy. The survivin expression in Molt-4 cells decreased remarkably by DNR treatment in a time and dosage-dependent manner. DNR treatment also induced survivin transllocation from cytoplasm to nucleus and cell apoptosis in a time and dosage-dependent manner.</p><p><b>CONCLUSIONS</b>Survivin may play an important role in the development and prognosis of childhood acute leukemia. The different expression pattern of survivin in the cytoplasm and the nucleus may be associated with therapeutic efficacy and prognosis in acute leukemia. DNR may reduce the survivin expression in leukemic cells and induce cell apoptosis.</p>
الموضوعات
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Apoptosis , Bone Marrow Cells , Chemistry , Daunorubicin , Pharmacology , Therapeutic Uses , Immunohistochemistry , Inhibitor of Apoptosis Proteins , Leukemia, Myeloid, Acute , Drug Therapy , Metabolism , Pathology , Microtubule-Associated Proteins , Neoplasm Proteins , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Drug Therapy , Metabolism , Pathologyالملخص
<p><b>OBJECTIVE</b>To screen the FANCA gene mutation and explore the FANCA protein function in Fanconi anemia (FA) patients.</p><p><b>METHODS</b>FANCA protein expression and its interaction with FANCF were analyzed using Western blot and immunoprecipitation in 3 cases of FA-A. Genomic DNA was used for MLPA analysis followed by sequencing.</p><p><b>RESULTS</b>FANCA protein was undetectable and FANCA and FANCF protein interaction was impaired in these 3 cases of FA-A. Each case of FA-A contained biallelic pathogenic mutations in FANCA gene.</p><p><b>CONCLUSIONS</b>No functional FANCA protein was found in these 3 cases of FA-A, and intragenic deletion, frame shift and splice site mutation were the major pathogenic mutations found in FANCA gene.</p>
الموضوعات
Humans , Cell Line , DNA Mutational Analysis , Fanconi Anemia , Genetics , Metabolism , Fanconi Anemia Complementation Group A Protein , Genetics , Metabolism , Mutationالملخص
Objective To explore the expression of silencer of death domains(SODD) and its clinical significance and relationship with phospho-NF-?B-p65 proteins in bone marrow cells of acute lymphoblastic leukemia(ALL)in children,and the expression of SODD and phospho-NF-?B-p65 in Jurkat cells treated with chemotherapeutic drugs in order to find a new chemotherapeutic target.Methods The expressions of SODD and phospho-NF-?B-p65 proteins in bone marrow cells were detected by immunohistochemistry in 25 children with ALL.The apoptosis incidence was measured by Annexin-V-Fluorescence/PI double-labeling flow cytometry and the expression of SODD and phospho-NF-?B-p65 proteins were determined by Western blotting in Jurkat cells.Results It was found that the expression of SODD and active p65 expression in ALL were significantly higher than those in healthy control group.The expression of SODD and phospho-NF-?B-p65 proteins in the high-risk(HR) group was significantly higher than those in standard-risk(SR) group(Pa