Pain Location Is Associated with Fracture Type in Acute Osteoporotic Thoracolumbar Vertebral Fracture: A Prospective Observational Study.

OBJECTIVE: This study investigated the relationship between pain location and fracture type in patients with acute osteoporotic vertebral fracture (OVF). DESIGN: A prospective observational study. SUBJECT: A total of 306 patients with acute OVF were included. METHODS: The site of pain of each patient was recorded, and the patients were divided into a group with pain at the fracture site (group 1) and a group with pain at a non-fracture site (group 2). Fractures were classified into four types: type I, upper endplate type; type II, central type; type III, lower endplate type; and type IV, burst type. RESULTS: There were 146 patients in group 1, of whom 20.55% (30/146) had type I fractures, 33.56% (49/146) had type II fractures, 15.75% (23/146) had type III fractures, and 30.14% (44/146) had type IV fractures. There were 227 patients in group 2, of whom 57.27% (130/227) had type I fractures, 5.29% (12/227) had type II fractures, 35.24% (80/227) had type III fractures, and 2.20% (5/227) had type IV fractures. There was a statistical difference in the fracture type distribution between the two groups (P < 0.05). The visual analog scale score in group 1 was higher than that in group 2 at the initial diagnosis (P < 0.05). CONCLUSIONS: For patients with acute OVF, the site of pain is related to the type of fracture. The pain at the fracture site is more often observed in the central type and burst type of fractures, whereas pain at a non-fracture site is more often observed in the upper and lower endplate types of fractures. Additionally, when OVF is suspected, radiological assessment of the thoracic and lumbar spine is recommended to better detect fractures that could cause pain distal to the site of the fracture.

Pattern Formation in Drying Sessile and Pendant Droplet: Interactions of Gravity Settling, Interface Shrinkage, and Capillary Flow.

We reported the interactions of the gravitational sedimentation, interface shrinkage, and outward capillary flow in drying droplets. This coupling effect is the inference we draw from deposition patterns of both sessile and pendant droplets, which contain particles of different sizes, evaporating on a patterned substrate. The deposition difference between sessile and pendant droplets containing microparticles indicated that gravitational sedimentation has a significant influence on the deposition morphology. The phase diagram shows that the particle deposition process can be divided into two stages: in the first stage, the competition between the interface shrinkage and the gravitational sedimentation determines whether the particles can be captured by the liquid-air interface; in the second stage, the capillary flow takes the particles inside the droplet toward the edge. The deposition morphology is the result of competition and cooperation interactions of the free setting, interface shrinkage, and outward capillary flow.

Drop Capturing Based on Patterned Substrate in Space.

In this work, we introduced a method for capturing aqueous drop based on a patterned substrate in space. Through the manipulation test of a colloidal drop, it could be verified that this patterned substrate had excellent control ability for aqueous drop in microgravity condition. The confinement mechanism of this substrate was clarified, which showed that drops with different volume could be pinned and attracted at a given area on the substrate. The confinement capability was related to the gravity effect, and the patterned substrate could confine aqueous drops with larger volume under microgravity than in normal gravity. With advantages of simple operation and strong capability to control large drops, this technique exhibited the wide application prospect in the fields of fluid management, biosensing, and pharmacy in microgravity condition in the future.

Low-level laser irradiation modulates brain-derived neurotrophic factor mRNA transcription through calcium-dependent activation of the ERK/CREB pathway.

Low-level laser (LLL) irradiation has been reported to promote neuronal differentiation, but the mechanism remains unclear. Brain-derived neurotrophic factor (BDNF) has been confirmed to be one of the most important neurotrophic factors because it is critical for the differentiation and survival of neurons during development. Thus, this study aimed to investigate the effects of LLL irradiation on Bdnf messenger RNA (mRNA) transcription and the molecular pathway involved in LLL-induced Bdnf mRNA transcription in cultured dorsal root ganglion neurons (DRGNs) using Ca2+ imaging, pharmacological detections, RNA interference, immunocytochemistry assay, Western blot, and qPCR analysis. We show here that LLL induced increases in the [Ca2+] i level, Bdnf mRNA transcription, cAMP-response element-binding protein (CREB) phosphorylation, and extracellular signal-regulated kinase (ERK) phosphorylation, mediated by Ca2+ release via inositol triphosphate receptor (IP3R)-sensitive calcium (Ca2+) stores. Blockade of Ca2+ increase suppressed Bdnf mRNA transcription, CREB phosphorylation, and ERK phosphorylation. Downregulation of phosphorylated (p)-CREB reduced Bdnf mRNA transcription triggered by LLL. Furthermore, blockade of ERK using PD98059 inhibitor reduced p-CREB and Bdnf mRNA transcription induced by LLL. Taken together, these findings establish the Ca2+-ERK-CREB cascade as a potential signaling pathway involved in LLL-induced Bdnf mRNA transcription. To our knowledge, this is the first report of the mechanisms of Ca2+-dependent Bdnf mRNA transcription triggered by LLL. These findings may help further explore the complex molecular signaling networks in LLL-triggered nerve regeneration in vivo and may also provide experimental evidence for the development of LLL for clinical applications.

Ryanodine Receptor 2 Plays a Critical Role in Spinal Cord Injury via Induction of Oxidative Stress.

BACKGROUND/AIMS: Spinal cord injury (SCI) is a severe health problem worldwide. Ryanodine receptors (RyRs) are a class of intracellular calcium channels in various excitable tissues such as muscles and nervous tissues. The current study was designed to investigate the possible role of RyR2 upregulation in SCI and to elucidate the possible molecular mechanisms. METHODS: Rats were injected with LVshRNAi- RyR2 and then exposed to spinal cord contusion injury. RESULTS: The results showed that knockdown of RyR2 significantly promoted the recovery of structural and functional injury in spinal cord, as evidenced by reduction of lesion volume and increase of Basso, Beattie and Bresnahan (BBB) and combined behavioral score (CBS) scores. Knockdown of RyR2 inhibited the increase of proinflammatory cytokines, including IL-1ß and TNFα. Moreover, downregulation of RyR2 increased oxygen consumption rate and decreased the expression of glucose-regulated protein 78 (GRP78), activating transcription factor 3 (ATF3) and ATF6, indicating the improvement of mitochondrial dysfunction and endoplasmic reticulum stress after SCI. Furthermore, silence of RyR2 reduced oxidative stress, as reflected by decrease of TBARS and GSSG content and increase of GSH level. The expression of NADPH oxidase 2 (NOX2), NOX4 and p66(shc) were increased in SCI rats. Knockdown of RyR2 significantly decreased NOX2 expression, but had no evident effect on NOX4 and p66shc expression. These results indicated NOX2 may be involved in RyR2-induced ROS generation which mediated contusion-induced spinal cord injury. CONCLUSION: The data provide novel insights into the mechanism of RyR2-mediated injury and the potential therapeutic targets for injury in spinal cord.

Oxymatrine induces mitochondria dependent apoptosis in human osteosarcoma MNNG/HOS cells through inhibition of PI3K/Akt pathway.

The cytostatic drug from traditional Chinese medicinal herb has acted as a chemotherapeutic agent used in treatment of a wide variety of cancers. Oxymatrine, classified as a quinolizidine alkaloid, is a phytochemical product derived from Sophora flavescens, and has been reported to possess anticancer activities. However, the cancer growth inhibitory effects and molecular mechanisms in human osteosarcoma MNNG/HOS cell have not been well studied. In the present study, the cytotoxic effects of oxymatrine on MNNG/HOS cells were examined by MTT and bromodeoxyuridine (BrdU) incorporation assays. The percentage of apoptotic cells and the level of mitochondrial membrane potential (Δψ m) were assayed by flow cytometry. The levels of apoptosis-related proteins were measured by Western blot analysis or enzyme assay Kit. Our results showed that treatment with oxymatrine resulted in a significant inhibition of cell proliferation and DNA synthesis in a dose-dependent manner, which has been attributed to apoptosis. Furthermore, we found that oxymatrine considerably inhibited the expression of Bcl-2 whilst increasing that of Bax. This promoted mitochondrial dysfunction, leading to the release of cytochrome c from the mitochondria to the cytoplasm, as well as the activation of caspase-9 and -3. Moreover, addition of oxymatrine to MNNG/HOS cells also attenuated phosphatidylinositol 3-kinase (PI3K) /Akt signaling pathway cascade, evidenced by the dephosphorylation of P13K and Akt. Likewise, oxymatrine significantly suppressed tumor growth in female BALB/C nude mice bearing MNNG/HOS xenograft tumors. In addition, no evidence of drug-related toxicity was identified in the treated animals by comparing the body weight increase and mortality. Therefore, these findings should be useful for understanding the apoptotic cellular mechanism mediated by oxymatrine and might offer a therapeutic potential advantage for human osteosarcoma chemoprevention or chemotherapy.

Plastic instability of annular crystalline membrane in circular confinement.

Understanding the mechanical instabilities of two-dimensional membranes has strong connection to the subjects of structure instabilities, morphology control, and materials failures. In this work, we investigate the plastic mechanism developed in the annular crystalline membrane system for adapting to the shrinking space, which is caused by the controllable gradual expansion of the inner boundary. In the process of plastic deformation, we find the continuous generation of dislocations at the inner boundary and their collective migration to the outer boundary; this neat dynamic scenario of dislocation current captures the complicated reorganization process of the particles. We also reveal the characteristic vortex structure arising from the interplay of topological defects and the displacement field. These results may find applications in the precise control of structural instabilities in packings of particulate matter and covalently bonded systems.

Conformal order and Poincaré-Klein mapping underlying electrostatics-driven inhomogeneity in tethered membranes.

Understanding the organization of matter under the long-range electrostatic force is a fundamental problem in multiple fields. In this work, based on the electrically charged tethered membrane model, we reveal regular structures underlying the lowest-energy states of inhomogeneously stretched planar lattices by a combination of numerical simulation and analytical geometric analysis. Specifically we show the conformal order characterized by the preserved bond angle in the lattice deformation and reveal the Poincaré-Klein mapping underlying the electrostatics-driven inhomogeneity. The discovery of the Poincaré-Klein mapping, which connects the Poincaré disk and the Klein disk for the hyperbolic plane, implies the connection of long-range electrostatic force and hyperbolic geometry. We also discuss lattices with patterned charges of opposite signs for modulating in-plane inhomogeneity and even creating 3D shapes, which may have a connection to metamaterials design. This work suggests the geometric analysis as a promising approach for elucidating the organization of matter under the long-range force.

A family with mental disorder as the first symptom finally confirmed with Gerstmann-Sträussler-Scheinker disease with P102L mutation in PRNP gene - case report.

Gerstmann-Sträussler-Scheinker (GSS) disease is an autosomal dominant neurodegenerative disease, and it is characterized by progressive cerebellar ataxia. Up to now, GSS cases with the p.P102L mutation have mainly been reported in Caucasian, but rarely in Asian populations. A 54-year-old female patient presented with an unstable gait in the hospital. Last year, she was unable to walk steadily and occasionally choked, could not even walk independently gradually. After taking her medical history, we found that she was misdiagnosed with schizophrenia before the gait problems. The patient's father showed similar symptoms and was diagnosed with brain atrophy at the age of 56, but her daughter showed no similar symptoms at present. On arrival at the Neurology Department, the patient's vital signs and laboratory examinations showed no abnormality. As the proband presented with cerebellar ataxia and had an obvious family history, we were sure that she had hereditary cerebellar ataxia. Then, patient's brain MRI showed an abnormal signal in the right parietal cortex and bilateral small ischaemic lesions in the frontal lobe. A gene panel (including 142 ataxia-related genes) was performed, and a heterozygous mutation PRNP Exon2 c.305C>T p. (Pro102Leu) was identified. Her daughter had the same heterozygous mutation. The patient was diagnosed with GSS with mental disorders as initial symptoms. After 2 months of TCM treatment, the patient's walking instability decreased, and her emotional fluctuations were less than before. In conclusion, we have reported a rare case of GSS in Sichuan, China, and the family with mental disorder as the first symptom was finally confirmed with GSS PRNP P102L mutation.

Retrospective analysis of reasons and revision strategy for failed thoracolumbar fracture surgery by posterior approach: a series of 31 cases.

OBJECTIVES: This study aimed to analyze the reasons for failed thoracolumbar fracture treated with posterior surgical approaches and to discuss the revision strategies for the surgical treatment. METHODS: We retrospectively studied the patients that received failed thoracolumbar fracture (T11-L2) treatment with posterior approach and underwent revision surgery in our spine department from March 2010 to December 2020. RESULTS: A total of 31 patients were included in this study. There were 4 (12.9%) cases of A3, 2 (6.5%) cases of B1, 5 (16.1%) cases of B2, 7 (22.6%) cases of B3, and 13 (41.9%) cases of C, according to the AO classification for thoracolumbar injuries. For load sharing classification, 26 (83.9%) cases ≥7, and 5 (16.1%) cases < 7. Regarding to the reasons for surgery failure, 26 cases (83.9%) were due to fracture of the internal fixation (pedicle screw or connecting rod) and kyphosis, 3 cases (9.7%) were due to misplacement of the posterior pedicle screw, 1 case (3.2%) was due to incomplete posterior decompression, and 1 case (3.2%) was due to scoliosis after the removal of the internal fixation. The revision surgery methods included: 2 cases (6.5%) with anterior approach, 17 cases (54.8%) with posterior approach, and 12 cases (38.7%) with posterior and anterior approach. All the patients were followed-up for 12-24 months after the revision surgery, and successful bony fusion with no internal fixation failure was observed. The kyphosis angle improved significantly after the revision surgery in 26 patients at the last follow-up, and the final correction rate was 91.8%. Frankel grading system, visual analog scale (VAS), Oswestry Disability Index (ODI) showed significant improvement at the last follow-up. CONCLUSIONS: Types B and C of thoracolumbar fracture, load sharing classification ≥7, and the posterior approach could lead to a high failure rate. Fracture of the internal fixation was the main reason for surgery failure. Performing the posterior approach is inappropriate for every thoracolumbar fracture. Reasonable revision surgery can achieve good results for posterior surgery failure in most cases.

Consecutive Kummell's Disease Combined with Parkinson's Disease and Experienced Internal Fixation Failure: A Case Report and Literature Review.

BACKGROUND: The continuous occurrence of Kummell's disease is extremely rare in clinical practice, and its treatment is difficult. The study aimed to present a rare case of consecutive Kummell's disease combined with Parkinson's disease (PD) and experienced internal fixation failure. CASE PRESENTATION: A 69-year-old female patient had a history of PD for 10 years, and was treated by posterior decompression, fixation, and fusion because of Kummell's disease of T12 with neurological damage. The patient's back pain and lower limb pain were significantly improved after surgery. Twenty-two months later, the patient was rehospitalized for Kummell's disease of L4 with neuropathic pain of left lower extremity. She received almost identical surgical procedures as T12 lesion, and the difference was no L4 vertebroplasty preformed due to the fact that the L4 vertebrae collapse was not obvious, the intravertebral vacuum cleft (IVC) range was small, and the pedicle screw fixation strength was high. The pain symptoms were significantly relieved after operation. Unfortunately, there was a complication of internal fixation failure that occurred a month later, and a revision operation was carried out. CONCLUSION: Osteoporosis combined with PD may lead patients to become prone to consecutive Kummell's disease, and patients are prone to experience failure of internal fixation. Bone cement filling of vertebral IVC and effective support of anterior vertebral column are very important procedures to ensure the clinical efficacy of treating Kummell's disease.

Novel techniques for solitary atlas osteochondroma: a case report and literature review.

Osteochondroma is a common benign bone tumor that is rarely seen in the spine, especially in the atlas. Although most solitary atlas osteochondromas have no symptoms, some exostosis may cause severe clinical symptoms that need treatment within the spine. Here, we report a 21-year-old male who presented with apsychia as well as numbness in his right upper and lower limbs for 2 months. The patient reported a history of neck trauma 10 years ago. He received a posterior laminectomy without reconstruction later, and the symptoms improved immediately. During a 32 month follow-up, there was no recurrence of the osteochondroma. Novel techniques for the treatment of this case were applied: simulated surgical resection using 3-Matic 9.0 software, 3D printed model, 3D Digital Image Microscopy, and piezoelectric surgery. These novel techniques provided significant benefits to the patients, the surgeon, and medical education.

Comparison of Unilateral and Bilateral Percutaneous Kyphoplasty for Bone Cement Distribution and Clinical Efficacy: An Analysis Using Three-Dimensional Computed Tomography Images.

BACKGROUND: Percutaneous kyphoplasty (PKP) is an effective treatment for osteoporotic vertebral compression fractures (OVCF). Comparisons of different approaches have previously focused primarily on x-rays. Three-dimensional (3D) computed tomography (CT) enables better imaging evaluation of bone cement distribution. OBJECTIVES: To compare the CT imaging parameters and clinical efficacies of unilateral and bilateral PKP. STUDY DESIGN: This was a prospective, nonrandomized controlled study. SETTING: Department of Orthopedics from an affiliated hospital. METHODS: Seventy-two single-level OVCF patients who underwent 3D CT between 2018 and 2020 were evaluated prospectively. All patients underwent PKP and were assigned to 2 groups: unilateral PKP and bilateral PKP. Imaging outcomes were assessed by determining the cement volume, leakage, dispersion index, vertebral height (VH) and the cement volume of the noninjected and injected sides. Clinical outcomes were evaluated using the Visual Analog Scale (VAS). The correlations between the bone cement volume or dispersion index and the VAS, VH improvement rate (VHIR), or bone cement leakage were also evaluated. RESULTS: The mean follow-up time was 17.1 months. The postoperative VH and VAS in both groups were significantly improved (P < 0.05). However, there were no statistically significant differences in the cement volume, leakage or dispersion index, VH, or VAS between the 2 groups. No statistically significant differences in the cement volume or VH were found between the noninjected and injected sides within the unilateral group. The operative time was significantly shorter in the patients who underwent unilateral PKP. Unilateral PKP in which the bone cement did not cross the midline had a higher VAS compared with bilateral PKP. Both the bone cement volume and dispersion index displayed a positive correlation with the VHIR, but no correlation with the VAS or bone cement leakage. LIMITATIONS: This study was limited by the nonrandomized design, small sample size, and short follow-up period. CONCLUSIONS: While unilateral PKP was as effective as bilateral PKP, it had a shorter operation time. However, the bilateral PKP approach might be followed when bone cement is distributed in only one side following the unilateral PKP procedure.

Network meta-analysis on efficacy and safety of different anti-CGRP monoclonal antibody regimens for prophylaxis and treatment of episodic migraine.

BACKGROUND: Currently, studies have shown that anti-CGRP monoclonal antibodies are effective drugs for the prophylaxis and treatment of episodic migraine. Therefore, for the first time, we classified and concluded 10 treatment regimens according to the different doses, drugs, routes of administration, and courses of treatment, so as to provide a reference for further clinical studies. METHODS: We studied relevant randomized controlled trials (RCTs) published before August 2020 on PubMed, Embase, Ovid MEDLINE, Web of Science, and the Cochrane Central Register of Controlled Trials. RESULTS: Eleven RCTs involving 6397 patients were included in our analysis. Network meta-analysis results suggested that in the comparison of the average migraine days per month, Erenumab  (140 mg), Galcanezumab (120 mg, 240 mg), Fremanezumab (225 mg, 675 mg) were superior to placebo, Erenumab(7 mg), and the difference was statistically significant; Fremanezumab (225 mg, 675 mg) was superior to Erenumab (21 mg, 70 mg), and the difference was statistically significant; in the comparison of average medication days of acute migraine-specific drug per month, Erenumab (70 mg, 140 mg), Galcanezumab (120 mg, 240 mg), Fremanezumab (225 mg, 675 mg) was superior to placebo, and Erenumab (140 mg) and Galcanezumab (120 mg, 240 mg) were superior to Erenumab (70 mg), and the difference was statistically significant; there was no statistically significant difference in the average migraine days in the last month or in the medication days of acute migraine-specific drug. CONCLUSION: Fremanezumab (225 mg) and Galcanezumab (120 mg) may be the best clinical protocol after a comprehensive assessment.

One-stage posterior en-bloc spondylectomy following reconstruction with individualized 3D printed artificial vertebrae for multi-segment thoracolumbar metastases: case report and literature review.

In thoracolumbar vertebral tumors, reconstruction of complex multi-segment thoracolumbar vertebrae after total en-bloc spondylectomy (TES) is still challenging. In recent years, with the development of 3D printing technology, individualized 3D printed artificial vertebrae have been attempted to reconstruct complex multi-segment thoracolumbar spine. Compared with traditional titanium mesh or bone transplantation, it helps reduce long-term complications, bringing a new dawn for reconstructing multi-segment thoracolumbar spine. A 69-year-old female complained of low back pain with limited motion for 1 month. More than 2 months ago, she underwent radical mastectomy due to breast cancer (Luminal A subtype). Imageology examination revealed an osteolytic lesion involving the T11-L1 vertebra. She was performed one-stage 3-segment (T11-L1) en-bloc spondylectomy via posterior approach, and then an artificial vertebrae produced by a novel individualized 3D printing technology was used for reconstruction. The patient was follow-up for 2 years, and she recovered well, with no tumor recurrence, and no complications after spinal reconstruction. The application of individualized 3D printed artificial vertebrae in multi-segment thoracolumbar spine reconstruction can not only reconstruct the bone defect more accurately through the individualized design, but the porous design is able to achieve biomechanical performance comparable to that of cancellous bone, and it is conducive to inducing bone growth, all of which help reduce long-term mechanical complications. Furthermore, the application of artificial vertebrae in surgery can significantly shorten the operation time, reduce intraoperative blood loss and reduce the risk of perioperative complications. Therefore, individualized 3D printed artificial vertebrae is a good choice for complex multi-segment thoracolumbar spine reconstruction.

Novel Approach for Efficient Recovery for Spinal Cord Injury Repair via Biofabricated Nano-Cerium Oxide Loaded PCL With Resveratrol to Improve in Vitro Biocompatibility and Autorecovery Abilities.

It is more difficult to develop the low-cost spinal cord injury repair materials with high stability and biocompatibility for the biomedical applications. Herein, for the first time, we demonstrated the functional restoration of an injured spinal cord by the nano CeO2 particles assembled onto poly (∊-caprolactone) (PCL)/resveratrol (RVL) were synthesized using the biocompatible ionic liquid. The as-prepared biocompatible nanomaterials were characterized and confirmed by using different instruments such as Fourier transform infra-red spectroscopy for functional groups identification, X-ray diffraction for crystalline nature, Scanning electron microscopy, transmission electron microscopy for morphological structure, Dynamic light scattering for size distribution of the nanoparticles and thermogravimetric analysis for thermal properties. The synergetic effect between the uniform distributions of nano-sized CeO2 particles onto the PCL polymer with RVL can remarkably enhance the catalytic performance. Biofabricated nano-cerium oxide loaded PCL with RVL revealed that treatment significantly preserved hydrogen peroxide and also good catalytic performance. This study presents a nano-sized cerium oxide particles loaded PCL with RVL biocompatible materials have been providing highly efficient regenerative activity and biocompatibility in spinal card regeneration.

Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression.

BACKGROUND: Many doctors ignored the possibility that there is still a spinal cord compression (SCC) need for decompression after atlantoaxial reduction. Reduction can be achieved on kinematic magnetic resonance imaging (MRI); thus, we want to analyze the role of kinematic MRI in reducible atlantoaxial dislocation and make a preoperative decision whether to perform decompression. METHODS: 36 patients with atlantoaxial reduction on preoperative kinematic MRI in extension postures were enrolled retrospectively. Grouping was based on the condition of SCC after atlantoaxial reduction preoperatively. Group A: patients with SCC after atlantoaxial reduction on dynamic cervical MRI were treated with C1 laminectomy for decompression and atlantoaxial fixation. Group B: patients with no significant SCC, according to dynamic MRI, underwent only atlantoaxial fixation. Clinical outcomes were evaluated using JOA score for spinal cord function. Radiological outcomes were assessed by measuring spinal cord diameter on MRI. RESULTS: The mean follow-up time was 17.1 months. Postoperative JOA score and percentage of SCC in both groups were significantly better than its preoperative score. There were no significant statistical differences in the JOA score at 12 months after surgery and the JOA improvement rate between two groups. All patients in the two groups had a lower percentage of SCC on preoperative extension MRI, compared with neutral MRI. No significant statistical differences in the spinal decompression improvement rate were observed between the two groups. CONCLUSIONS: Decompression should be performed in patients who still have significant SCC on preoperative kinematic MRI. Kinematic MRI could be used to assess SCC and decide whether to perform decompression preoperatively.

Biomechanical effects of direction-changeable cage positions on lumbar spine: a finite element study.

This finite element (FE) study of lumbar biomechanics aims to predict how the parameters like range of motion (ROM), intervertebral disc pressure (IDP), cage stress and screw stress are affected by different direction-changeable cage positions. Firstly, the three-dimensional FE model of L3-L5 segment was developed, and the model was adjusted to adapt different direction-changeable cage positions at the L4-L5 level though transforaminal lumbar interbody fusion (TLIF) with pedicle screws. The effects of Type A (the lateral region), Type B (the lateralcentral region) and Type C (the anteriocentral region) on ROM, IDP, cage stress and screw stress were examined. The results showed that after implantation of interbody cages at different positions, the ROM at surgical level L4-L5 decreased substantially in all motion modes. The maximal stress in cage decreased with Type A, B and C in all motion modes except flexion and extension. The maximal cage stress was observed in Type A with 720.5 MPa in left rotation, in Type B with 707 MPa in flexion, in Type C with 397.3 MPa in left rotation, respectively. The maximal IDP was similar in three types, with 1.6 MPa in left lateral bending in Type A, 1.5 MPa in flexion in Type B, and 1.4 MPa in flexion in Type C. The range of screw peak stress was 16.4 to 61.1 MPa in Type A, 15.9 to 50.9 MPa in Type B, and 14.6 to 46.1 MPa Type C. In conclusion, comparing the cages with different positions, anteriocentral position cage has more advantages like lower cage stress, ODL and screw stress.

Effect of Vicenin-2 on ovariectomy-induced osteoporosis in rats.

In worldwide, osteoporosis has become one of the severe public health distress and over 200 million people get affected by tenderness and fissure during their life period. Vicenin-2 is a naturally occurring flavonoid glycoside present in Moringa oleifera, Peperomia blanda and Ocimum sanctum Linn with numerous biological activities. The present study aims to assess the effect of Vicenin-2 on ovariectomy-induced postmenopausal osteoporosis in female rats. Surgical removal of ovaries was achieved to institute the ovariectomy animal model. The ovariectomized (OVX) animals were alienated into four groups: Control, OVX alone (model), OVX with Vicenin-2 (5 mg/kg b.w), and OVX with Vicenin-2 (10 mg/kg b.w). Also, their consistent conduct remained managed intragastrically for about 12 weeks. OVX rats treated with Vicenin-2 effectually improved body mass, uterus index, lipid profiles, inflammatory markers, bone turnover markers and amplified the presence of calcium in the OVX rat serum. Vicenin-2 was found to suppress the actions of ACP, E2, and BGP in OVX rats. Besides, Vicenin-2 showed some adverse effects over histomorphometric percentage and histological studies, in which tabular thickness and area were restored in the control and Vicenin-2 managed OVX rats. PCR results of Alp, Runx 2, Osx showed diminished expressions in OVX rats whereas treatment with Vicenin-2 displays up-regulated expression of these genes. Through our study, we established that Vicenin-2 did not wield a detrimental upshot on the skeletal organization of OVX rats. Besides, we put forward that Vicenin-2 could be an excellent candidate to treat and manage bone related disease or disorders.

Effect of Huatan Jieyu granules in treatment of Parkinson's disease patients with sleep disorder identified as symptom pattern of phlegma-heat-stirring wind.

OBJECTIVE: To investigate the safety and efficacy of Huatan Jieyu granules in treatment of Parkinson's disease (PD) patients with sleep disorder identified as symptom pattern of phlegma-heat-stirring wind in terms of the theory of Traditional Chinese Medicine. METHODS: In total, 107 Parkinson's disease patients with sleep disorders identified as symptom pattern of phlegma-heat-stirring wind were selected and randomly divided into the experimental group (55 cases) and the control group (52 cases). Both groups were given basic treatment with prednisone. The experimental group of patients was treated with Huatan Jieyu granules and the control group of patents was treated with only the basic treatment. Treatment lasted for 4 weeks. Sleep polygraph were recorded before the study as well as 3 months and 6 months after treatment. RESULTS: After treated with Huatan Jieyu granules, the total sleep time, and the percentage of non rapid eye movement 2 (NREM 2), non rapid eye movement 3 (NREM 3) and rapid eye movement (REM) sleep period increased significantly, while the percentage of NREM1 sleep period decreased significantly compared with before treatment (P < 0.05). CONCLUSION: The treatment of PD patients with sleep disorder by Huatan Jieyu granules can improve their sleep structure and their sleep quality.