Comparison Between Percutaneous Kyphoplasty and Percutaneous Vertebroplasty in Terms of Efficacy in Osteoporotic Vertebral Compression Fractures: A Meta-analysis.

Background and Aim: Osteoporotic vertebral compression fractures (OVCFs) are acknowledged to be common fractures, especially in the elderly population. Minimally invasive percutaneous methods of treatment for these fractures such as kyphoplasty (KP) and vertebroplasty (VP) have been valid and effective tools for decreasing clinical problems, which are associated with more beneficial effects compared with traditional methods such as open surgery or conservative treatment. Hence, we conducted the current meta-analysis in order to gather updated evidence for the systematic assessment of clinical and radiographic outcomes of KP compared with VP. Methods: We searched articles published based on the electronic databases, including PubMed, EMBASE, and Cochrane Library. Publications of studies comparing KP with VP in the treatment of OVCFs were collected. After rigorous and thorough review of study quality, we extracted the data on the basis of eligible trials, which analyzed the summary hazard ratios (HRs) of the end points of interest. Results: Our inclusion criteria involved a total of 6 studies. In total, data from 644 patients, 330 who received VP and 284 who received KP, were included in the review. There was no significant difference in either group in terms of visual analog scale (VAS) scores (MD = 0.17; 95% CI, -0.39 to 0.73; P = .56), risk of cement leakage (odds ratio [OR] = 1.31; 95% CI, 0.62 to 2.74; P = .47) or Oswestry Disability Index (ODI) scores (MD = 0.51; 95% CI, -1.87 to 2.88; P = .68). Nevertheless, the injected cement volume (MD = -0.52; 95% CI, -0.88 to -0.15; P = .005) in the VP group was linked to a markedly lower statistically significant trend compared with the KP group. Conclusion: This meta-analysis evaluated acceptable efficacy levels across the involved trials. VP injected cement volume had several advantages in this meta-analysis. Yet, no significant differences were observed in terms of VAS scores, ODI scores, or cement leakage when KP was compared to VP therapy. Given the combined results of our study, the optimal treatment for patients with OVCFs should be determined by further high-quality multicenter randomized controlled trials with longer follow-up and larger sample sizes.

Hyperbaric oxygen therapy ameliorates acute brain injury after porcine intracerebral hemorrhage at high altitude.

INTRODUCTION: Intracerebral hemorrhage (ICH) at high altitude is not well understood to date. This study investigates the effects of high altitude on ICH, and examines the acute neuroprotection of hyperbaric oxygen (HBO) therapy against high-altitude ICH. METHODS: Minipigs were placed in a hypobaric chamber for 72 h before the operation. ICH was induced by an infusion of autologous arterial blood (3 ml) into the right basal ganglia. Animals in the high-altitude ICH group received HBO therapy (2.5 ATA for 60 min) 30 min after ICH. Blood gas, blood glucose and brain tissue oxygen partial pressure (PbtO2) were monitored continuously for animals from all groups, as were microdialysis products including glucose, lactate, pyruvate and glutamate in perihematomal tissue from 3 to 12 h post-ICH. RESULTS: High-altitude ICH animals showed significantly lower PbtO2, higher lactate/pyruvate ratio (LPR) and glutamate levels than low-altitude ICH animals. More severe neurological deficits, brain edema and neuronal damage were also observed in high-altitude ICH. After HBO therapy, PbtO2 was significantly increased and LPR and glutamate levels were significantly decreased. Brain edema, neurological deficits and neuronal damage were also ameliorated. CONCLUSIONS: The data suggested a more serious disturbance of tissue oxygenation and cerebral metabolism in the acute stage after ICH at high altitude. Early HBO treatment reduced acute brain injury, perhaps through a mechanism involving the amelioration of the derangement of cerebral oxygenation and metabolism following high-altitude ICH.

Curcumin attenuates acute inflammatory injury by inhibiting the TLR4/MyD88/NF-κB signaling pathway in experimental traumatic brain injury.

BACKGROUND: Traumatic brain injury (TBI) initiates a neuroinflammatory cascade that contributes to substantial neuronal damage and behavioral impairment, and Toll-like receptor 4 (TLR4) is an important mediator of thiscascade. In the current study, we tested the hypothesis that curcumin, a phytochemical compound with potent anti-inflammatory properties that is extracted from the rhizome Curcuma longa, alleviates acute inflammatory injury mediated by TLR4 following TBI. METHODS: Neurological function, brain water content and cytokine levels were tested in TLR4⁻/⁻ mice subjected to weight-drop contusion injury. Wild-type (WT) mice were injected intraperitoneally with different concentrations of curcumin or vehicle 15 minutes after TBI. At 24 hours post-injury, the activation of microglia/macrophages and TLR4 was detected by immunohistochemistry; neuronal apoptosis was measured by FJB and TUNEL staining; cytokines were assayed by ELISA; and TLR4, MyD88 and NF-κB levels were measured by Western blotting. In vitro, a co-culture system comprised of microglia and neurons was treated with curcumin following lipopolysaccharide (LPS) stimulation. TLR4 expression and morphological activation in microglia and morphological damage to neurons were detected by immunohistochemistry 24 hours post-stimulation. RESULTS: The protein expression of TLR4 in pericontusional tissue reached a maximum at 24 hours post-TBI. Compared with WT mice, TLR4⁻/⁻ mice showed attenuated functional impairment, brain edema and cytokine release post-TBI. In addition to improvement in the above aspects, 100 mg/kg curcumin treatment post-TBI significantly reduced the number of TLR4-positive microglia/macrophages as well as inflammatory mediator release and neuronal apoptosis in WT mice. Furthermore, Western blot analysis indicated that the levels of TLR4 and its known downstream effectors (MyD88, and NF-κB) were also decreased after curcumin treatment. Similar outcomes were observed in the microglia and neuron co-culture following treatment with curcumin after LPS stimulation. LPS increased TLR4 immunoreactivity and morphological activation in microglia and increased neuronal apoptosis, whereas curcumin normalized this upregulation. The increased protein levels of TLR4, MyD88 and NF-κB in microglia were attenuated by curcumin treatment. CONCLUSIONS: Our results suggest that post-injury, curcumin administration may improve patient outcome by reducing acute activation of microglia/macrophages and neuronal apoptosis through a mechanism involving the TLR4/MyD88/NF-κB signaling pathway in microglia/macrophages in TBI.

Selenium attenuates high glucose-induced ROS/TLR-4 involved apoptosis of rat cardiomyocyte.

The potential mechanism of high glucose-induced cardiomyocyte apoptosis and selenium's protective effects were investigated in this study. Myocytes isolated from neonate rats were cultured in high-glucose medium (25.5 mmol/L glucose) to mimic sustained hyperglycemia. Before high-glucose incubation, myocytes were pretreated by sodium selenite solution. Cell apoptosis was evaluated by annexin V/propidium iodide (PI) staining and caspase activation. Expression of Toll-like receptor 4 (TLR-4) and myeloid differentiation factor 88 (MyD-88) was examined at both mRNA and protein levels. The intracellular reactive oxygen species (ROS) production and glutathione peroxidase (GPx) activity in myocytes were also detected. We found high glucose-induced cell apoptosis and activation of TLR-4/MyD-88/caspase-8/caspase-3 signaling, accompanied by increased production of ROS. Selenium pretreatment attenuated apoptosis in high glucose-incubated myocytes, and mechanically, this protective effect was found to be associated with attenuating oxidative status by increasing activity of GPx, decreasing the generation of ROS, as well as inhibition of the activation of TLR-4/MyD-88/caspase-8/caspase-3 signaling in myocytes. These results suggest that activation of TLR-4/MyD-88 signaling pathway plays an important role in high glucose-induced cardiomyocyte apoptosis. Additionally, by modulating TLR-4/MyD-88 signaling pathway, which is linked to ROS formation, selenium exerts its antioxidative and antiapoptotic effects in high glucose-incubated myocytes.

[Pharmacognostic identification of radix actinidiae chinensis].

OBJECTIVE: To provide the scientific basis for gruffs identification and utilization of Radix Actinidiae chinensis. METHODS: Radix Actinidiae chinensis was studied through the morphological, microscopical and UV spectrum identifications. RESULTS: There were 1-3 stone cell girdle bands in cork layer of root cross section. Sclerotic nests and mucilage cavities which contained calcium oxalate raphides existed in phloem. Endodermis cells separated by radial paries, were fusiform. In powder, port-hole was deep, striation was manifest, and starch grain calcium oxalate acicular crystal was plenty. CONCLUSION: These characteristics can provide the scientific basis for gruffs identification of Radix Actinidiae chinensis.

[Identification on three kinds of Diphylleia sinensis (II)].

OBJECTIVE: In order to provide reference for the development of quality standards and distinction of authenticity, some sources of Diphylleia sinensis Li. in the maket were identified by sampling. METHODS: The TLC of six batches of Diphylleia sinensis Li. in the market were identified. RESULTS: They were the dried rhizome of Diphylleia sinensis Li., Dysosma versipellis (Hance.) M. Cheng and D. pleiantha (Hance) Woods. According to the pharmaceutical characteristics, retrieval tables of identification on plants, traits, microscopic and TLC were established. CONCLUSION: It is simple and reliable to use TLC and retrieval table to identify three sources of Diphylleia sinensis Li.

[Identification on three kinds of Diphylleia sinensis (I)].

OBJECTIVE: In order to provide reference for the development of quality standards and distinction of authenticity, some sources of Diphylleia sinensis Li. in the market were identified by sampling. METHODS: To identify the traits and microscopic features of six batches of Diphylleia sinensis Li. in the market. RESULTS: They were the dried rhizome of Diphylleia sinensis Li., Dysosma versipellis (Hance) M. Cheng and D. pleiantha (Hance) Woods. CONCLUSION: The differences in traits and microscopic features of them are obvious.

[Pharmacognostical study of tall monkshood root].

OBJECTIVE: To provide the scientific basis for gruffs identification and utilization of tall monkshood root. METHODS: We studied tall monkshood root through the macroscopic, microscopical and Physicochemical identification. RESULTS: In the cross section of tall monkshood root, there were cork cortex cells, a cricoid range hetero-vascular bundle, radial-cell including radial little brown cell, a great deal of starch grain, cortex organize fragment was brown, cell squareness and polygon. CONCLUSION: These character can provide scientific basis for its quality standard and development.

[Pharmacognostic identification of Rodersia aesculifolia].

OBJECTIVE: To establish pharmacognostical methods of Rodersia aesculifolia. METHODS: Macroscopical, microscopic and physicochemical identification were used to authenticate this crude drug, and the identification characteristics were studied. RESULTS: There were some palea on the rhizoma superior extremity and some white flare dot on transverse section. Vascular bundle formed into interval circularity in rhizoma transverse section, and some small atypia bundle appeared in lateral of core. Xylem of root was tetrarch. A lot of starch grain and acicular cyrstal were observed in parenchyma cell. Brown cell was present as single or several linked. CONCLUSION: These characteristics can be used as identification basis for Rodersia aesulifolia Batal.

[Macroscopic and microscopic identification of Memorialis hirta].

OBJECTIVE: To provide the scientific basis for identification and utilization of Memorialis hirta ( BL) Wedd. METHODS: Macroscopical identification and microscopic identification. RESULTS: To make system pharmacognostical studies on stalk and fine powder of Memorialis hirta (BL) Wedd. CONCLUSION: These characteristic can provide the scientific basis for identification of Memorialis hirta (BL) Wedd.