Interplay among pain intensity, sleep disturbance and emotion in patients with non-specific low back pain.

BACKGROUND: Low back pain (LBP) is the most common problem worldwide. There are several negative consequences of LBP, such as sleep disorders, work leave, disability, depression, anxiety, and poor quality of life. In this study, we designed to evaluate the prevalence of sleep disturbance in patients with non-specific LBP(NSLBP), and cross-correlation among sleep disorder, anxiety, depression and pain intensity in patients with NSLBP. AIM: In this study, we designed to evaluate the prevalence of sleep disturbance in patients with NSLBP, and cross-correlation among sleep disorder, anxiety, depression and pain intensity in patients with NSLBP. METHODS: A cross-sectional self-assessment questionnaire survey was carried out in an outpatient clinic. Anonymous assessments were used to characterize the presence of NSLBP, PSQI, VAS, SF-36 form, ODI, BAI and BDI. Cross-correlation among the severity of NSLBP and sleep disturbance, anxiety, depression and life quality were evaluated. RESULTS: Patients with NSLBP have a higher incidence of sleep disorder, anxiety and depression, and higher ODI scores than healthy people without LPB (P < 0.01). NSLBP patients with sleep disorders have more severe anxiety, depression, an increased VAS score and poor daily living (P < 0.05). NSLBP patients with anxiety have declined sleep quality, poor daily living, decreased work and social skills, and increased LBP severity (P < 0.05). NSLBP patients with depression have declined sleep quality, poor daily living, decreased work and social skills (P < 0.05). Significant associations were found between the severity of NSLBP and sleep disorders, anxiety and ODI scores. CONCLUSION: Psychological and social factors play an important role in the development of NSLBP. NSLBP leads to sleep disorders, which decrease the sleep quality and increase the unpleasant emotions and memories in return; these can exacerbate the severity of LBP, with the cycle repeating to form a vicious circle.

Risk of New Vertebral Fracture and Combination Therapy with Zoledronic Acid and Teriparatide in Diabetic Patients after Percutaneous Kyphoplasty

Methods@#Total 106 diabetic patients who had undergone PKP and had received anti-osteoporosis treatment for osteoporotic vertebral compression fracture were enrolled and allocated into the following two groups: group I (n=52, zoledronic acid) and group II (n=54, zoledronic acid plus teriparatide). The operating time, bone cement volume, and complications related to anti-osteoporosis treatment or PKP, if any, were recorded. The Visual Analog Scale (VAS) score and Oswestry Disability Index (ODI) were assessed at admission, at discharge, and at the final follow-up. Dual-energy X-ray absorptiometry scan of the hip for the measurement of the bone mineral density (BMD) was performed preoperatively and at the final follow-up for all the patients. @*Results@#There was no significant difference in the age, body mass index, bone cement volume, or follow-up time of the groups. The mean follow-up duration was 22.5±1.6 months. All the patients had improved VAS and ODI, and group II had significantly better clinical outcomes than group I. All the patients had increased BMD at the latest follow-up, while group II exhibited significantly more improvement. The prevalence of NVF was lower in group II (11.5% vs. 7.4%, p=0.523). Male patients had a higher prevalence of NVF although the difference was not statistically significant. @*Conclusions@#Combination therapy with zoledronic acid and teriparatide could improve the clinical outcomes, and BMD and had the potential to reduce NVF in diabetic patients following PKP.

Risk Factors Associated with Pain Severity in Patients with Non-specific Low Back Pain in Southern China

STUDY DESIGN: A prospective cross-sectional study. PURPOSE: To evaluate the risk factors associated with the severity of pain intensity in patients with non-specific low back pain (NSLBP) in Southern China. OVERVIEW OF LITERATURE: Low back pain (LBP) is the leading cause of activity limitation and work absence throughout the world, so a firm understanding of the risk factor associated with NSLBP can provide early and prompt interventions that are aimed at attaining long-term results. METHODS: Participants were recruited from January 2014 to January 2016 and were surveyed using a self-designed questionnaire. Anonymous assessments included Short Form 36-Item Health Survey (SF-36) and Visual Analogue Scale (VAS). The association between the severity of NSLBP and these potential risk factors were evaluated. RESULTS: A total of 1,046 NSLBP patients were enrolled. The patients with primary school education, high body mass index (BMI), those exposed to sustained durations of driving and sitting, smoking, recurrent LBP had increased VAS and Oswestry Disability Index (ODI) scores with lower SF-36 scores (p10 kg objects in a quarter of their work time for >10 years had higher VAS and ODI scores with lower SF-36 scores (p<0.01). Multiple logistic regression showed lower levels of education, LBP for 1–7 days, long-lasting LBP in last year, smoking, long duration driving, and higher BMI were associated with more severe VAS score. CONCLUSIONS: The severity of NSLBP is associated with lower levels of education, poor standards of living, heavy physical labor, long duration driving, and sedentary lifestyle. Patients with recurrent NSLBP have more severe pain. Reducing rates of obesity, the duration of heavy physical work, driving or riding, and attenuating the prevalence of sedentary lifestyles and smoking may reduce the prevalence of NSLBP.

TGF-β1 suppresses CCL3/4 expression through the ERK signaling pathway and inhibits intervertebral disc degeneration and inflammation-related pain in a rat model

The objective of this study was to investigate the regulatory effects of TGF-β1 on CCL3/4 expression and inflammation-related pain during intervertebral disc degeneration (IVDD). TGF-β1 and CCL3/4 expression patterns in different degenerative human nucleus pulposus (NP) tissues were measured by qPCR and immunohistochemistry (IHC), and the effects of TGF-β1 on CCL3/4 expression were measured by qPCR, ELISA and immunofluorescence. The roles of NF-κB and MAPK in TGF-β1-mediated CCL3/4 promoter activity were studied using siRNAs, western blotting and qPCR. After establishing an IVDD rat model in vivo, we administered intradiscal injections of TGF-β1. The effects of TGF-β1 on IVDD were determined by MRI and histological analyses, and the effects of TGF-β1 on dorsal root ganglion (DRG) inflammation and pain development were determined by IHC staining and pain-behavior testing, respectively. TGF-β1 and CCL3/4 expression was elevated in degenerative NP tissue. CCL4 expression was significantly inhibited by TGF-β1 treatment. Pharmacological inhibition or siRNA knockdown of the ERK1/2 signaling attenuated TGF-β1-mediated suppression of CCL4 expression. In vivo, TGF-β1 injection inhibited the development of degenerative features in the IVDD model. Moreover, TGF-β1 prevented the inflammatory response and pain development. The results of this study show that TGF-β1 downregulates CCL4 expression through ERK1/2 signaling activation in NP cells. Furthermore, TGF-β1 can prevent degenerative processes, inhibit inflammatory responses in the DRG and prevent pain development in the IVDD rat model. The results of this study indicate that TGF-β1 may represent a therapeutic target for the control of inflammation-related pain associated with IVDD.

Sagittal balance evaluation of spinal deformities using curve harmony angles / 中华骨科杂志

Objective To introduce Curve Harmony Angle (CHA)to quantify the relationship between adjacent curves of the spine and pelvis and evaluate sagittal balance in spinal deformities. Methods Radiographic analysis of 93 asymptomatic vol-unteers and 95 patients including Degenerative Scoliosis(DS), Adolescent Idiopathic Scoliosis(AIS)and Ankylosing Spondylitis (AS)was performed by measuring sagittal parameters. Correlation study among parameters was further conducted. Curve Harmony Angles(CHAs)including the following three parameters were measured. Cervical-Thoracic Angle (CTA), Thoracic-Lumbar Angle (TLA) and Lumbar-Sacral Angle (LSA). Comparative study between normal population and different spinal disorders were per-formed in order to describe the characteristic changes of CHAs. Besides, according to Schwab SRS adult deformity classification, comparative study of CHAs in different balance status was performed to test the reliability of CHA on sagittal balance evaluation. Results All subjects showed typical changes of sagittal parameters. Different spinal disorders showed characteristic patterns of CHAs. In Schwab-SRS Adult Deformity Classification, Compensatory Balance group showed smaller LSA compared to Balance group;Imbalance group showed significantly smaller CTA, LSA and significantly greater TLA. Conclusion CHAs are parame-ters used to quantify the relationship between adjacent curves. Comparative study of CHA between normal population and different spinal disorder or among different balance status showed specific characters respectively. It is feasible to use CHA to evaluate the clinical sagittal balance and the results of deformity correction.

Efficacy of tolvaptan for delusional hyponatremia in decompensated liver cirrhosis / 中华传染病杂志

Objective To investigate the efficacy and safety of vasopressin receptor antagonist tolvaptan for treating dilutional hyponatremia casused by decompensated liver cirrhosis.Methods Ninety-six subjects with decompensated liver cirrhosis complicated by dilutional hyponatremia were divided into test group (n =56) and control group (n =40) by double blind method.Test group were treated with a single dose of tolvaptan 15 mg orally in addition to routine therapy,while control group were treated with routine therapy plus placebo.The changes in serum sodium concentration,liver functions,ascites,and edema of lower extremities between the two groups were observed.Measurement data were compared by t test,and categorical data were compared by chisquare test.Results On day 7,36 (64.3％) patients in test group and 9 (22.5％) patients in control group reached normal serum sodium concentrations (x2 =5.241,P＜0.01).All the patients in test group and only 3 patients in control group had 24 hours' total urine volume above 3500 mL.Difference of 24 hours' total urine volume during 7-day treatment between the two groups was statistically significant (t=20.899,P＜0.01).Thirty-nine patients in test group and 15 patients in control group had reduced ascites (x2 =4.260,P=0.039),but improvement of edema in lower extremities of both groups was comparable (12 cases in test group and 7 cases in control group; x2 =0.227,P=0.634).Serum alanine aminotransferase (ALT),total bilirubin (TBil),potassium and creatinine levels of test group were improved after treatment,but were not significantly different from either baseline levels (t=1.509,0.783,1.107,1.237; both P＞0.05) or those of the control group (t=1.712,1.635,1.121,0.873; both P＞0.05).Conclusions Single dose of tolvaptan (15 mg) exerts a strong diuretic effect and is able to greatly increase serum sodium concentration,thus has distinct therapeutic effect for patients with decompensated liver cirrhosis complicated by dilutional hyponatremia.

The role of absent in melanoma 2 in the pathogenesis of hepatitis B virus associated glomerulonephritis / 中华传染病杂志

ObjectiveTo explore the role of activation and expression of absent in melanoma 2 (AIM2) in pathogenesis of hepatitis B virus (HBV) associated glomerulonephritis (HBV-GN).MethodsFifty-four patients with HBV-GN were recruited into the investigational group,and 25 patients with chronic glomerulonephritis (CGN) and 6 patients with chronic hepatitis B (CHB) were included as negative control group and positive control group,respectively.Immunohistochemistry was used to detect AIM2,Caspase-1 and interleukin (IL)-1β expressions in both kidney tissues from the investigational group and negative control group and liver tissues from positive control group.The differences between groups were compared by chi-square test,and the correlation analysis was conducted by Spearman correlation test.ResultsThe positive expression rates of AIM2 in 54 patients of HBV-GN group and 25 of CGN group were 81.4 ％ and 4.0％,respectively (x2 =38.746,P＜ 0.01).AIM2 was found to be expressed in all 6 CHB patients.In HBV-GN group,the expression of AIM2 was positively correlated with Caspase-1 (rs =0.444,P＜0.01),and the expression of IL-1β was also positively correlated with Caspase-1 (rs =0.515,P＜0.01 ).In HBV-GN group,the expression of AIM2 in patients with HBV DNA≥1 ×105 copy/mL was significantly higher than that in those with HBV DNA＜1 × 105 copy/mL (x2 =6.097,P＜0.05).ConclusionThe activation of AIM2 may play a role in the pathogenesis of HBV-GN through Caspase-1 activation and inflammatory factor IL-1β release.

Efficacy of combined monitoring with TES-MEP and CSEP during anterior or posterior surgery for cervical spondylitic myelopathy / 中华创伤杂志

Objective To evaluate of the efficacy of transcranial electrical stimulation motor evoked potential (TES-MEP)in combination with cortical somatosensory evoked potential (CSEP) monitoring during the anterior or posterior approach spinal surgery for cervical spondylitie myelopathy (CSM).Methods TES-MEP on the bilateral anterior tibial muscle and flexor hallucal brevis and thenar muscles and CSEP on the bilateral posterior tibial nerve and ulnar nerve were observed simultaneously in 135 patients during spinal surgery.Intravenous anesthesia was employed in all the patients.The results of TES-MEP,CSEP and combined monitoring were analyzed statistically.Pre-oporative and post-operative motor and sensory functions of the spinal cord were compared. Result Success rate of TES-MEP,CSEP and the combined monitoring was 87.4%.97.8%and 100%,respectively.Out of 135 patients,nine patients (6.7%) were detected with the positive evoked potentials due to surgical operation.The sensitivity of TES-MEP and CSEP in assessing the spinal cord motor function was 100%and 83.3%,respectively,while that in assessing the spinal cord sensory function was 77.8%and 100%,respectively.The sensitivity and specificity of the combined monitoring was both 100%. Conclusion The successful detection rate and accuracy of the combined monitoring for spinal cord function are apparently higher than that of simple TES-MEP or CSEP.The causes for operative maneuvers evoking a positive evoked potential include complete anterior decompression of the spinal canal,intervertebral bone graft,laminoplasty for OPLL and hematoma compression caused by a failed drainage in a posterior-anterior approach surgery.

Radiological observation of intervertebral disc degeneration caused by bilateral zygopophysial joint resection in rabbit / 中国矫形外科杂志

[Objective]To study the intervertebral disc degeneration induced by bilateral zygopophysial joint resection in New Zealand rabbits.[Method]Forty-five New Zealand rabbits were randomly divided into 3 groups:group A,L_(4) and L_(5) inferior articular processes were en bloc excised,L_(5) and L_(6) superior articular processes were retained;its L_(6、7) and L_(3、4) as self-control group B;L_(3) to L_(7) paravertebral muscles were stripped and took L_(4、5),C_(5、6) as control group C.At one,two,four and eight months postoperatively,anterior-posterior and lateral X-ray film abnormal signs,including intervertebral space wedging,osteophyma formation at the edge of vertebral body and cartilage end plate celcification,were examined and counted.[Result]In the group C,cartilage end plate calcification,seldom intervertebral space narrowing,rare osteophyma formation at the edge of vertebral body and no lumbar spinal kyphosis were found in some rabbits.In the group A,cartilage end plate calcification began to found in the early stage on the L_(4、5) and L_(5、6),as time went on to the 8~(th) month postoperatively,almost all rabbits were found intervertebral space narrowing,osteophyma formation of vertebral space narrowing,osteophyma formation of vertebral body and cartilage end plate calcification.Conform kyphosis of L_(5、6) were also occurred at some rabbits.There was significant difference between group A and group C,but no difference with group B.[Conclusion]Radiological changes of L_(5、6) intervetevbral disc degeneration can be induced by excision of L_(5) and L_(6) zygopokhysial joint of rabbit.

Histological observation of intervertebral disk degeneration caused by bilateral zygapophysial joints destruction / 中国矫形外科杂志

[Objective]To study whether intervertebral disk degeneration can be induced by destroying bilateral zygapophysial joints of New-Zealand rabbit.[Method]Thirty male New-Zealand rabbits were randomly divided into operation group on the bone and operation group on the soft tissue.In operation group on the bone,L4 and L5 inferior articular processes were en bloc excised,L5 and L6 superior articular processes were retained.In the operation group on the soft-tissue,Only L3 to L7 paravertebral muscles were stripped.In operation group on the bone,L4、5 and L5、6 intervertebral disks acted as experimental group;L3、4 and L6、7 acted as self-control group.In the operation on the soft tissue,L4、5 and L5、6 acted as experimental control group.One,two,four and eight months post-operation,histological and ultrastructure organizations of intervertebral disks of New-Zealand rabbits were performed.[Result]The normal rabbit discs formed a very complex system,with an outer anulus fibrosus surrounding a central nucleus pulposus in which collagen fibers aligned parallelly and intervertebral disk cells distributed evenly.Collagen fibers derangly aligned and intervertebral disk ceils declined with time post-operation.At the end of four months post-operation,many degenerative cells were found in the study group,which features as irregular cell contours,swelling chondrosome,rough endoplasmic reticulum,and condense nucleus located in the cellular nucleus.Eight months after operation,many dead cells were found.Cytolysosomes increased,cellular nucleus became twisted,rough endoplasmic reticulums swelled,and chondrosome became vacuolization.Dead intervertebral disk cells were located in nidi which were made of multilayer degenerative collagen fibers.[Conclusion]Histological changes of intervertebral disk degeneration can be induced by destroying L4、5 and L5、6 zygapophysial joints of New-Zealand rabbit.

Quantitative MRI analysis of intervertebral disk degeneration caused by bilateral zygapophysial joint destruction / 中国矫形外科杂志

[Objective]To study the MRI changes in rabbit lumbar intervertebral disk degeneration induced by spinal intervertebral instability through destroying L4、5 and L5、6 zygapophysial joints.[Method]Thirty male New-Zealand rabbits were randomly divided into operation group on the bone and operation group on the soft tissue.In operation group on the bone,L4 and L5 inferior articular processes were en bloc excised,L5 and L6 superior articular processes were retained.In the operation group on the soft-tissue,Only L3 to L7 paravertebral muscles were stripped.In operation group on the bone,L4、5 and L5、6 intervertebral disks were acted as experimental group;L3、4 and L6、7 acted as self-control group.In the operation on the soft tissue,L4、5 and L5、6 were acted as experimental control group.One,two,four and eight months post-operation,lumbar spine MRI of New-Zealand rabbits were performed.The area fractions of high T2 signal zone of the nucleus pulposus were calculated according to the reference reports.[Result]On the T2 sagittal image,the nucleus pulposus showed uniform high signal intensity.On the axial image,high signal area of the nucleus pulposus located at the center of the intervertebral disk,and the areal fraction was 50%.High sagittal T2 signal and area fraction of high axis T2 signal of the nucleus pulposus not obviously declined in the normal rabbit with time.There was no statistical difference by t test.However,MRI showed the most significantly decreased the axial T2 high-signal area fraction in the experimental group,and the smallest declined in the experiment-control group.At the end of eight months after operation,L4、5 and L5、6 appeared the dark discs in the experiment group.[Conclusion]Disc degeneration may be caused by spine instability.The decline of the axial T2 high-signal area fraction of the nucleus pulposus is a earlier and common sign of intervertebral disk degeneration.

Human insulin-like growth factor-1 gene expression on intervertebral disk degeneration / 中国矫形外科杂志

[Objective]To study hIGF-1 gene expression on intervertebral disk degeneration.[Method]Twenty-four male New-Zealand rabbits IVDD models were made according to reference and randomly divided into Ad/CMV-hIGF-1,hIGF-1 growth factor and PBS group.Twenty five microlitre the second generation Ad/CMV-hIGF-1(T=80?109 PFU/L),hIGF-1 growth factor(100 ?g/L)and PBS were respectively injected into L4、5,L5、6 intervertebral disk under fluoroscopic guidance.One,two,four and eight weeks post-operation,rabbits were sacrificed,intervertebral disk samples were harvested.Total proteins of equal mass intervertebral disks were extracted,isolated in SDS-polyacrylamide gel electrophoresis(SDS-PAGE)and transferred to polyvinylidene difluoride(PVDF)Millipore.The hIGF-1 growth factor expression were indentified with Western blot.[Result]The hIGF-1 interest protein existed at 7.6 kilo-Dalton.At one week after injection,its expression quantities were almost equal between Ad/CMV-hIGF-1 and hIGF-1 growth factor group.At two week after injection,it obviously declined in hIGF-1 growth factor group.At four week after injection,it still expressed in Ad/CMV-hIGF-1 group.At eight week after injection,it did not express in three groups.[Conclusion]Ad/CMV-hIGF-1 successfully infects degenerative intervertebral disk.In Ad/CMV-hIGF-1 group,the hIGF-1 gene expression lasts longer than that in hIGF-1 growth factor group.

Role of human insulin-like growth factor-1 gene on collagen type Ⅱ expression of degenerative intervertebral disk / 中国矫形外科杂志

[Objective]To study the role of hIGF-1 gene on collagen type Ⅱ expression of degenerative intervertebral disk.[Method]Twenty-four male New-Zealand rabbits intervertebral disk degenerontion(IVDD) models were done according to reference and randomly divided into Ad-CMV-hIGF-1,hIGF-1 growth factor and PBS group.Twenty five microlitre the second generation Ad/CMV-hIGF-1(T=80?109 PFU/L),hIGF-1 growth factor(100 ?g/L)and PBS were respectively injected into L4、5,L5、6 intervertebral disk under fluoroscopic guidance.One,two,four and eight weeks post-operation,rabbits were sacrificed,intervertebral disk samples were harvested.Total proteins of equal mass intervertebral disks were extracted,isolated in SDS-Polyacrylamide gel electrophoresis(SDS-PAGE)and transferred to polyvinylidene difluoride(PVDF)Millipore.The hIGF-1 growth factor expression were indentified with Western blot.Collagen type Ⅱ gene fragments were amplified with RT-PCR,and relative expression was done with GAPDH as intern control.[Result]The hIGF-1 interest protein existed at 7.6 Kilo-Dalton.At one week after injection,its expression quantities were almost equal between Ad/CMV-hIGF-1 and hIGF-1 growth factor group.At two week after injection,it obviously declined in hIGF-1 growth factor group.At four week after injection,it still expressed in Ad/CMV-hIGF-1 group.At eight week after injection,it did not express in theree groups.Collagen type Ⅱ mRNA relative expressions increased significantly from one to four weeks after injection,declined slightly at the end of eight weeks in Ad/CMV-hIGF-1 group.However,they appeared to decrease continuously in the other two groups with time.At the corresponding phases,those in PBS group were the lowest.[Conclusion]Ad/CMV-hIGF-1 could successfully infect degenerative intervertebral disk.The hIGF-1gene expression could last four weeks and could stimulate collagen type Ⅱ synthesis in Ad/CMV-hIGF-1 group.

Molecular biology of intervertebral disk degeneration caused by bilateral zygapophysial joint unstability / 基础医学与临床

Objective To study aggrecan, collagen type Ⅰ and collagen type Ⅱ gene expression of intervertebral disk degeneration through destroying bilateral zygapophysial joints of New-Zealand rabbit. Methods Thirty male New-Zealand rabbits were randomly divided into operation groups on the bone and operation group on the soft tissue. In operation group of the bone, L4 and L5 inferior articular processes were en bloc excised, L5 and L6 superior articular processes were retained. In the operation group of soft-tissue, only L3 to L7 paravertebral muscles were stripped. In operation group of the bone, L4-5 and L5-6 intervertebral disks were acted as experimental group; L3-4 and L6-7 acted as self-control group. In the operation of soft tissue, L4-5 and L5-6 were acted as experimentalcontrol group. One、two、four and eight months post-operation, New-Zealand rabbits were killed. Aggrecan, collagen type Ⅰ and collagen type Ⅱ gene expression were performed with semiquantitative reverse transcriptase polymerase chain reaction (RT-PCR). Results Aggrecan and collagen type Ⅱ mRNA levels decreased markedly, whereas type Ⅰ collagen mRNA gradually increased. At the same time, aggrecan, collagen type Ⅱ gene expression were the least in experiment group, whereas were most in the experiment-control group. Collagen type Ⅰ showed the contra-tendency. Conclusion Intervertebral disk degeneration can be induced through destroying L4-5 and L5-6 zygapophysial joints of New-Zealand rabbit.Aggrecan, collagen type Ⅰ and collagen type Ⅱ gene expression can reflect intervertebral disk degeneration.

Enhancement effect of human insulin-like growth factor-1 gene on aggrecan expression of degenerative intervertebral disk in rabbits / 基础医学与临床

Objective To study hIGF-1 gene expression and the influence on aggrecan expression of degenerative intervertebral disk. Methods Twenty four male New-Zealand rabbits IDD models were established and randomly divided into Ad/CMV-hIGF-1、hIGF-1 growth factor and PBS group. Twenty five mL of Ad/CMV-hIGF-1(T=80?109 PFU/L), hIGF-1 growth factor(100 ?g/L) and PBS were respectively injected into L4-5, L5-6 intervertebral disk through fluoroscopic guidance. One,two,four and eight weeks after-operation, rabbits were sacrificed, intervertebral disk samples were collected. Total protein of equal mass intervertebral disks were extracted, isolated by SDS-PAGE and transferred to polyvinylidene difluoride (PVDF) Millipore. The hIGF-1 growth factor expression were indentified with Western blot. Aggrecan gene fragments were amplified with RT-PCR,and relative expression was checked with GAPDH as intern control. Results The hIGF-1 interest protein existed at 7.6 kilo-Dalton. One week after injection, its expression quantities were almost equal between Ad/CMV-hIGF-1 and hIGF-1 growth factor group. At two week after injection, it obviously declined in hIGF-1 growth factor group. Four week after injection, it was still expressed in Ad/CMV-hIGF-1 group. Eight week after injection, it did not express in three groups. Aggrecan gene relative expression increased significantly from one to four weeks after injection, declined slightly by the end of eight weeks in Ad/CMV-hIGF-1 group. However, it appeared to decrease continuously in the other two groups with time. Conclusion Ad/CMV-hIGF-1 successfully infected degenerative intervertebral disk. The hIGF-1 gene expression lasted four weeks and could stimulate aggrecan synthesis in Ad/CMV-hIGF-1 group.

Five Pathogen Mixed Infection in STDs of Female Genitourinary Tract:Analysis and Status / 中华医院感染学杂志

OBJECTIVE To study the status of five pathogen mixed infection in sexually transmitted diseases(STDs) and analyze the clinical meaning.METHODS We detected five common pathogens by fluorescence polymerase chain reaction,which were Neisseria gonorrhoeae(NG),Chlamydia trachomatis(CT),Ureaplasma urealyticum(Uu),human papilloma virus(HPV),Candida albicans(Ca),and herpes simplex virus.RESULTS We analyzed the status of infection among 4 601 patients,got 279 mixed infection cases,accounted for 6.1% in all cases;and the population with ages from 21 to 40 years was accounted for 89.6%. CONCLUSIONS Fluorescence polymerase chain reaction is a simple,rapid,high sensibility technique for quantitation testing of STDs pathogens,and we should pay great heed to its effective control.

Percutaneous vertebral augmentation with the Vessel-X bone void filling container system: A preliminary clinical trial / 中国微创外科杂志

Objective To explore the clinical effectiveness and safety of percutaneous vertebral augmentation with the Vessel-X bone void filling container system (Vesselplasty). Methods Three cases of fresh osteoporotic vertebral compression fracture were treated with Vesselplasty. After procedure, the pain relief, the fracture reduction, and the cement distribution in the vertebra were observed. Results All the 3 cases were treated with the unipediclar injection technique. The operative time was 45, 32 and 30 min, respectively. The hemorrhage volume was

The study on hematological changes of nontraumatic osteonecrosis of the femoral head / 中华骨科杂志

Objective To study the hematological changes o f nontraumatic osteonecrosis of the femoral head,select the sensitive molecular symbols for early diagnosis and distinguish the high risk peopl e.Methods The studied subjects were divided in to three groups:1)NONFH early stage group(n=30);2)NONFH late stage group(n=30);3)the normal controlled group(n=30).Blood samples from cubital veins were collected.GMP -140,PC,D -Dime r were examined using ELISA.PAI was e xamined with chromogenic assay.Results1)The platelet GMP -140levels of early or late stage groups NONFH were signi ficantly higher than that of the normal contro lled group;the plasma PC levels of both groups were lower than that of the normal controlled group significan tly(P

Clinical application of artificial lumbar intervertebral disc replacement / 中华骨科杂志

Objective To introduce the use of artificial lumbar intervertebral disc replacement for the treatment of lumbar disc degenerative diseases and lumbar disc herniation accompanying evident disc space narrowing. Methods Thirty-one cases(37 discs) of artificial lumbar disc replacement were performed using SB Charite Ⅲ from April 1998 to April 2000. Among them, disc degenerative diseases were seen in 16 cases (18 discs), disc herniation accompanying evident disc space narrowing in 13 cases (17 discs), recurrent disc herniation in 2 cases. Results All the cases were followed up from 17 to 41 months(mean, 26 months) . The clinical outcomes were excellent in 23 cases, good in 6 cases, fair in 2 cases. The mobility of the operated level had 4.0? anterior flexion and 5. 1? posterior extension after operation and 9. 1? on total mobility. Meanwhile, the operated intervertebral space got an average of 4. 2 mm higher than that before the surgery. Because of technical problem, a slight displacement of the core occurred in one case without any clinical symptoms and signs. Conclusion Artificial disc replacement is a new operation for the treatment of lumbar disc degenerative diseases and disc herniation accompanying evident disc space narrowing.