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1.
Front Public Health ; 12: 1327844, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38841657

RESUMO

Objective: This study explored the impact of a family intervention on the relapse rate of Chinese patients with alcohol dependence. Methods: A total of 151 male patients with alcohol dependence who were discharged from the Substance Dependence Department of the Wenzhou Seventh People's Hospital from January to December 2020 were selected. They were divided into the control (n = 73) and experimental (n = 78) groups. Patients in both groups received routine alcohol cessation treatment. Moreover, patients in the experimental group were followed up by a professional psychiatrist to carry out individual family intervention. The Family Function Rating Scale (FAD), a Self-made general information questionnaire, and the Chinese version of the Family Intimacy and Adaptability Scale (FACESI-CV) were performed. Re-drinking rate and readmission rate were assessed. Results: Family intervention could reduce relapse rate (31, 39.74%) and rehospitalization (27, 34.62%) compared with the control group. After family training, FAD factor scores were improved in the experiment group in comparison with the control group. Family training improved communication (18.2 ± 3.7), role (20.8 ± 2.5), emotional response (10.8 ± 1.8), emotional involvement (13.7 ± 1.2), behavioral control (19.8 ± 1.2), and overall functionality (23.5 ± 2.1) in the experiment group in comparison with the control group. After family training, intimacy (70.5 ± 8.7) and adaptability (64.1 ± 6.9) in the experiment group was higher than in the control group. After family intervention, Michigan Alcohol Dependence Scale (MAST) (9.21 ± 0.68) and Short-Form 36 (SF-36) (80.32 ± 4.47) in the experiment group were higher than the control group. Conclusion: Family intervention for families of patients with alcohol dependence can improve their family function, increase their family intimacy and adaptability, and reduce the rate of relapse.


Assuntos
Alcoolismo , Recidiva , Humanos , Masculino , Alcoolismo/psicologia , Adulto , China , Pessoa de Meia-Idade , Inquéritos e Questionários , Terapia Familiar/métodos , Família/psicologia
2.
J Orthop Surg Res ; 17(1): 107, 2022 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-35183219

RESUMO

BACKGROUND: Osteoporosis (OP) is a systemic bone disease manifested as low bone mass, destruction of bone microstructure, increased bone fragility and fracture risk. The purpose of this study was to explore the role and mechanism of PDX1 for osteogenic differentiation of adipose derived stem cells (ADSCs). METHODS: GSE37329 dataset was retrieved from NCBI Gene Expression Omnibus (GEO) database and performed bioinformatic analyses. ADSCs were incubated with normal medium, osteogenic induction medium (OIM) and OIM+si-PDX1. Then, alkaline phosphatase (ALP) staining and Alizarin Red Staining (ARS) were performed to assess the role of PDX1 for osteogenesis of ADSCs. PI3K inhibitor, LY294002 was then added to further explore the mechanism of PDX1 for osteogenic differentiation of ADSCs. Western blot assay was used to assess the osteogenic-related markers. Graphpad software was used to perform statistically analysis. RESULTS: A total of 285 DEGs were obtained from analysis of the dataset GSE37329, of which 145 were upregulated and 140 were downregulated genes. These differentially expressed genes mainly enriched in cell differentiation and PI3K/Akt signaling pathway. Moreover, PDX1 was decreased in osteogenic induced ADSCs. Knockdown of PDX1 significantly increased osteogenic differentiation capacity and p-PI3K and p-Akt protein levels. Administration with LY294002 could partially reversed the promotion effects of si-PDX1. CONCLUSION: In conclusion, knockdown of PDX1 promotes osteogenic differentiation of ADSCs through the PI3K/Akt signaling pathway.


Assuntos
Osteogênese/genética , Fosfatidilinositol 3-Quinases , Proteínas Proto-Oncogênicas c-akt/genética , Transdução de Sinais/genética , Diferenciação Celular/efeitos dos fármacos , Células Cultivadas , Proteínas de Homeodomínio , Humanos , Células-Tronco Mesenquimais , Osteogênese/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Células-Tronco/fisiologia , Transativadores
3.
J Orthop Surg Res ; 16(1): 10, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407691

RESUMO

BACKGROUND: Osteoporosis (OP) is an age-related systemic bone disease. MicroRNAs (miRNAs) are involved in the regulation of osteogenic differentiation. The purpose of this study was to explore the role and mechanism of miR-1249-5p for promoting osteogenic differentiation of adipose-derived stem cells (ADSCs). METHODS: GSE74209 dataset was retrieved from NCBI Gene Expression Omnibus (GEO) database and performed bioinformatic analyses. OP tissue and healthy control tissues were obtained and used for RT-PCR analyses. ADSCs were incubated with miR-1249-5p mimic, inhibitor and corresponding negative control (NC), alkaline phosphatase (ALP) staining, and Alizarin Red Staining (ARS) were then performed to assess the role of miR-1249-5p for osteogenesis of ADSCs. Targetscan online website and dual-luciferase reporter assay were performed to verify that the 3'-UTR of PDX1 mRNA is a direct target of miR-1249-5p. RT-PCR and western blot were also performed to identify the mechanism of miR-1249-5p for osteogenesis of ADSCs. RESULTS: A total of 170 differentially expressed miRNAs were selected, among which, 75 miRNAs were downregulated and 95 miRNAs were upregulated. Moreover, miR-1249-5p was decreased in OP patients, while showed a gradual increase with the extension of induction time. miR-1249-5p mimic significantly increased osteogenic differentiation capacity and p-PI3K and p-Akt protein levels. Luciferase activity in ADSCs co-transfected of miR-1249-5p mimic with PDX1-WT reporter plasmids was remarkably decreased, but there was no obvious change in miR-1249-5p mimic with PDX1-MUT reporter plasmids co-transfection group. Overexpression PDX1 could partially reverse the promotion effects of miR-1249-5p on osteogenesis of ADSCs. CONCLUSION: In conclusion, miR-1249-5p promotes osteogenic differentiation of ADSCs by targeting PDX1 through the PI3K/Akt signaling pathway.


Assuntos
Adipócitos/fisiologia , Tecido Adiposo/citologia , Diferenciação Celular/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Expressão Gênica/genética , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , MicroRNAs/fisiologia , Osteogênese/genética , Células-Tronco/fisiologia , Transativadores/genética , Transativadores/metabolismo , Regiões 3' não Traduzidas , Células Cultivadas , Humanos , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Transdução de Sinais/genética , Transdução de Sinais/fisiologia
4.
Biosci Rep ; 40(9)2020 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-32803252

RESUMO

OBJECTIVES: In the treatment of osteoarthritis (OA), tramadol, a common weak opioid, has become popular due to its effectiveness in inhibition of pain. In the present study, we aimed to explore the effect of tramadol on subchondral bone, especially changes in the microstructure and mechanical properties. METHODS: A mouse model of OA was established in the present study by destabilization of the medial meniscus (DMM). A vehicle or drug was administered for 4 weeks. Specimens were harvested and analyzed radiologically and histologically using micro-computed tomography (micro-CT), scanning electron microscopy (SEM), atomic force microscopy (AFM) and histological staining to evaluate the knee joints of mice undergoing different forms of intervention. RESULTS: In the early stages of OA induced by DMM, the subchondral bone volume fraction in the OA group was significantly higher than in the sham+vehicle (sham+veh) group, while the volume in the treatment groups was lower than in the DMM+vehicle (DMM+veh) and sham+veh groups. In addition, the elastic moduli in the treatment groups clearly decreased compared with the DMM+veh and sham+veh groups. Observations of the subchondral bone surface by SEM indicated serious destruction, principally manifesting as a decrease in lacunae and more numerous and scattered cracks. Histological staining demonstrated that there was no difference in the degeneration of either the articular cartilage or synovial cells whether tramadol was used or not. CONCLUSION: Although tramadol is effective in inhibiting pain in early OA, it negatively regulates the microstructure and mechanical properties of subchondral bone in joints.


Assuntos
Osso e Ossos/efeitos dos fármacos , Osteoartrite do Joelho/tratamento farmacológico , Osteoartrite do Joelho/fisiopatologia , Tramadol/efeitos adversos , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/farmacologia , Animais , Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/ultraestrutura , Cartilagem/efeitos dos fármacos , Cartilagem/patologia , Modelos Animais de Doenças , Módulo de Elasticidade/efeitos dos fármacos , Masculino , Meniscos Tibiais/fisiopatologia , Camundongos Endogâmicos C57BL , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Osteoartrite do Joelho/diagnóstico por imagem , Sinovite/induzido quimicamente , Sinovite/patologia , Tramadol/farmacologia , Microtomografia por Raio-X
5.
Chin Med J (Engl) ; 131(19): 2297-2301, 2018 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-30246715

RESUMO

BACKGROUND: Risperidone and paliperidone have been the mainstay treatment for schizophrenia and their potential role in neuroprotection could be associated with brain-derived neurotrophic factor (BDNF) and N400 (an event-related brain potential component). So far, different effects on both BDNF and N400 were reported in relation to various antipsychotic treatments. However, few studies have been conducted on the mechanism of risperidone and paliperidone on BDNF and N400. This study aimed to compare the effects of risperidone and paliperidone on BDNF and the N400 component of the event-related brain potential in patients with first-episode schizophrenia. METHODS: Ninety-eight patients with first-episode schizophrenia were randomly divided into the risperidone and paliperidone groups and treated with risperidone and paliperidone, respectively, for 12 weeks. Serum BDNF level, the latency, and amplitude of the N400 event-related potential before and after the treatment and Positive and Negative Syndrome Scale (PANSS) scores were compared between the two groups. RESULTS: A total of 94 patients were included in the final analysis (47 patients in each group). After the treatment, the serum BDNF levels in both groups increased (all P < 0.01), while no significant difference in serum BDNF level was found between the groups before and after the treatment (all P > 0.05). After the treatment, N400 amplitudes were increased (from 4.73 ± 2.86 µv and 4.51 ± 4.63 µv to 5.35 ± 4.18 µv and 5.52 ± 3.08 µv, respectively) under congruent condition in both risperidone and paliperidone groups (all P < 0.01). Under incongruent conditions, the N400 latencies were shortened in the paliperidone group (from 424.13 ± 110.42 ms to 4.7.41 ± 154.59 ms, P < 0.05), and the N400 amplitudes were increased in the risperidone group (from 5.80 ± 3.50 µv to 7.17 ± 5.51 µv, P < 0.01). After treatment, the total PANSS score in both groups decreased significantly (all P < 0.01), but the difference between the groups was not significant (P > 0.05). A negative correlation between the reduction rate of the PANSS score and the increase in serum BDNF level after the treatment was found in the paliperidone group but not in the risperidone group. CONCLUSIONS: Both risperidone and paliperidone could increase the serum BDNF levels in patients with first-episode schizophrenia and improve their cognitive function (N400 latency and amplitude), but their antipsychotic mechanisms might differ.


Assuntos
Antipsicóticos/farmacologia , Fator Neurotrófico Derivado do Encéfalo/efeitos dos fármacos , Palmitato de Paliperidona/farmacologia , Risperidona/farmacologia , Esquizofrenia/tratamento farmacológico , China , Eletroencefalografia , Potenciais Evocados/efeitos dos fármacos , Feminino , Humanos , Masculino
6.
Zhongguo Gu Shang ; 31(4): 354-360, 2018 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-29772862

RESUMO

OBJECTIVE: To evaluate the efficacy and safety of different operation time for acute spinal cord injury(SCI) based on systematic review. METHODS: PubMed database, EMBASE database, Cochrane Library, ISI Web of knowledge, CBM database, VIP database, CNKI database and Wanfang database were searched from their start year up to February 2017 for relevant randomized clinical trials on the treatment of acute spinal cord injury with different intervention times. RESULTS: Four randomized clinical trials of total 156 cases were included. Early surgical intervention for the patients with incomplete spinal cord injury can improve the ASIA motor function score [MD=3.29, 95%CI(-7.90, 14.49), P=0.56] and overall Frankel score[OR=7.65, 95%CI(2.69, 21.74), P=0.000 1]. There was no significant difference in the improvement of the overall Frankel score[OR=4.88, 95%CI(0.74, 32.09), P=0.10] for the patients with complete spinal cord injury between the early surgery and delayed surgery group. There was no significant difference in hospitalization time[MD=-3.4, 95%CI(-8.12, 1.32), P=0.16], death rate [OR=1.07, 95%CI(0.21, 5.56), P=0.93]and incidence of decubitus[OR=1.07, 95%CI(0.17, 6.69), P=0.94] between the early surgery and delayed surgery group. CONCLUSIONS: Early surgical intervention can promote the nerve function recovery after spinal cord injury, whithout further incidence of complications, but random control trails with higher quality are still required for this conclusion.


Assuntos
Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/cirurgia , Fatores de Tempo , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Chin Med J (Engl) ; 131(3): 301-306, 2018 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-29363645

RESUMO

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) and event-related potentials (ERPs) are a noninvasive technique that widely used in neurophysiological field. Although rTMS has shown clinical utility for a number of neurological conditions, Recently,there was little understanding of the the efficacy of rTMS on Schizophrenia(SZ) and the change of ERP between before and after rTMS treatment. The objective of this study was to investigate the characteristics of N400, mismatch negativity (MMN), and P300 before and after treatment with rTMS in SZ. METHODS: One hundred and twenty-seven SZ patients hospitalized in Shanghai Mental Health Center from March 2015 to July 2017, divided into two groups (85 patients were recruited as rTMS group and 42 were recruited as sham rTMS [ShrTMS] group) and 76 normal controls (NCs) who were the staff and refresher staff in our hospital were recruited at the same time. A Chinese-made rTMS and a Runjie WJ-1 ERPs instrument were used in the present experiment. N400 was elicited by congruent and noncongruent Chinese idioms. After rTMS treatment, N400, P300, and MMN characteristics were compared with those before treatment and NC group. RESULTS: Compared with NC, the SZ patients exhibited delays in N400, P300, and MMN latency and decreased N400, P300, and MMN amplitudes in their frontal area (P < 0.05). After 25 rTMS treatments, N400 amplitudes in the frontal area (elicited by idioms with same phonic and different shape and meaning and with different phonic, shape, and meaning) were increased in the SZ patients (P < 0.05). However, there was no significant change in N400 before and after treatment with ShrTMS in SZ patients (P > 0.05). Amplitudes for MMN and target P300 also increased in SZ patients after rTMS treatment (P < 0.05). CONCLUSIONS: Based on our preliminary findings, we believe that the combined usage of N400, MMN, and P300 could be a valuable index and an electrophysiological reference in evaluating the effects of rTMS treatment in SZ patients.


Assuntos
Eletroencefalografia/métodos , Potenciais Evocados , Esquizofrenia/terapia , Estimulação Magnética Transcraniana/métodos , Adulto , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Esquizofrenia/fisiopatologia , Resultado do Tratamento , Adulto Jovem
8.
Chin Med J (Engl) ; 130(4): 414-419, 2017 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-28218214

RESUMO

BACKGROUND: Electroconvulsive therapy (ECT) can alleviate the symptoms of treatment-resistant depression (TRD). Functional network connectivity (FNC) is a newly developed method to investigate the brain's functional connectivity patterns. The first aim of this study was to investigate FNC alterations between TRD patients and healthy controls. The second aim was to explore the relationship between the ECT treatment response and pre-ECT treatment FNC alterations in individual TRD patients. METHODS: This study included 82 TRD patients and 41 controls. Patients were screened at baseline and after 2 weeks of treatment with a combination of ECT and antidepressants. Group information guided-independent component analysis (GIG-ICA) was used to compute subject-specific functional networks (FNs). Grassmann manifold and step-wise forward component selection using support vector machines were adopted to perform the FNC measure and extract the functional networks' connectivity patterns (FCP). Pearson's correlation analysis was used to calculate the correlations between the FCP and ECT response. RESULTS: A total of 82 TRD patients in the ECT group were successfully treated. On an average, 8.50 ± 2.00 ECT sessions were conducted. After ECT treatment, only 42 TRD patients had an improved response to ECT (the Hamilton scores reduction rate was more than 50%), response rate 51%. 8 FNs (anterior and posterior default mode network, bilateral frontoparietal network, audio network, visual network, dorsal attention network, and sensorimotor network) were obtained using GIG-ICA. We did not found that FCPs were significantly different between TRD patients and healthy controls. Moreover, the baseline FCP was unrelated to the ECT treatment response. CONCLUSIONS: The FNC was not significantly different between the TRD patients and healthy controls, and the baseline FCP was unrelated to the ECT treatment response. These findings will necessitate that we modify the experimental scheme to explore the mechanisms underlying ECT's effects on depression and explore the specific predictors of the effects of ECT based on the pre-ECT treatment magnetic resonance imaging.


Assuntos
Encéfalo/fisiopatologia , Depressão/terapia , Eletroconvulsoterapia/métodos , Adulto , Encéfalo/patologia , Depressão/fisiopatologia , Transtorno Depressivo Resistente a Tratamento/fisiopatologia , Transtorno Depressivo Resistente a Tratamento/terapia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
9.
Clin Spine Surg ; 30(2): 80-84, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28207616

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the feasibility, efficacy, and safety of percutaneous kyphoplasty (PKP) for the treatment of painful osteoblastic-related spinal metastases unresponsive to conservative treatments. SUMMARY OF BACKGROUND DATA: PKP represents a powerful tool in the management of oncology patients who suffer from painful osteolytic spinal lesions. However, to our knowledge, there have been no reports on the role of PKP in the treatment of osteoblastic metastatic spinal lesions. In this study, we evaluate the potential efficacy of kyphoplasty for the treatment of painful osteoblastic spinal metastases unresponsive to conservative treatments. METHODS: A retrospective study was performed on 13 patients managed with PKP for painful osteoblastic-related spinal metastases. Visual analog scale pain score and Oswestry disability index questionnaire were used to assess back pain and functional status, respectively. RESULTS: The average visual analog scale pain score before the treatment was 8.5±0.5 compared with 2.0±0.8 at 3 days after the procedure (P<0.001), and remained largely unchanged from 1.6±0.5 at 1 month, 1.5±0.5 at 3 months to 2.2±0.7 at the last follow-up. The Oswestry disability index scores decreased from 77.2±8.2 before the surgery to 34.6±7.4 at 3 days after the operation (P<0.001), 32.2±6.1 at 1 month, 30.2±5.9 at 3 months, and 34.5±6.7 at the last follow-up. No symptomatic cement leakage and PKP-related complications were found after operation. CONCLUSIONS: PKP is an effective, safe, and minimally invasive procedure to treat painful osteoblastic spinal metastases, leading to a significant reduction of pain and improvement of functional status.


Assuntos
Neoplasias Ósseas/secundário , Neoplasias Ósseas/cirurgia , Cifoplastia/métodos , Osteoblastoma/cirurgia , Neoplasias da Coluna Vertebral/patologia , Adulto , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoblastoma/diagnóstico por imagem , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Escala Visual Analógica , Raios X
10.
Spine (Phila Pa 1976) ; 41(5): 378-83, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26926162

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of this study was to evaluate the efficacy of laminoplasty for the treatment of patients with an occupying ratio greater than 50% and to determine possible factors related to surgical outcome of posterior decompression. SUMMARY OF BACKGROUND DATA: Little data are available about effect and prognostic factors of laminoplasty for cervical myelopathy with an occupying ratio greater than 50%. METHODS: Fifty-five consecutive patients with an occupying ratio greater than 50% who underwent cervical laminoplasty between January 2005 and December 2010 were reviewed in this study. Patients with cervical kyphosis were excluded. Clinical and radiologic outcomes were assessed. Univariate analysis was used to investigate the relationship between recovery rate and the age, duration of symptoms, preoperative Japan Orthopedic Association (JOA) score, posterior shift of the spinal cord, preoperative cervical lordosis, spinal cord compression ratio, and follow-up period. Multivariate linear regression analysis was used to determine the best surgical outcome predictor. RESULTS: All patients maintained cervical lordosis. Average JOA score improved from 10.7 ±â€Š1.7 points preoperatively to 14.0 ±â€Š1.4 points at the last follow-up. The mean rate of recovery was 51.4 ±â€Š25.7%. Final recovery rates showed 6 excellent results, 29 good results, 18 fair results, and 2 poor results. Univariate analysis showed significant correlation between the recovery rate and the spinal cord compression ratio, duration of symptoms, and posterior movement of the spinal cord. The multivariate linear regression analysis showed that the best surgical outcome predictor was the spinal cord compression ratio (ß = 0.698, P < 0.001). R-square of the final multiple linear regression model was 0.509. CONCLUSION: Laminoplasty can still be considered as a decompressive pattern for patients with a high occupying ratio greater than 50%. The spinal cord compression ratio, duration of symptoms, and posterior movement of the spinal cord play important roles in recovery rate. The best surgical outcome predictor is the spinal cord compression ratio. LEVEL OF EVIDENCE: 4.


Assuntos
Vértebras Cervicais/cirurgia , Laminoplastia/métodos , Doenças da Medula Espinal/diagnóstico por imagem , Doenças da Medula Espinal/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios X , Resultado do Tratamento
11.
Pain Physician ; 18(6): E1021-8, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26606016

RESUMO

BACKGROUND: Percutaneous kyphoplasty (PKP) has been proven as an effective, minimally invasive procedure for the treatment of Kummell's disease in the early stages. However, a risk of cement leakage and further neurological damage remains during and after PKP, especially in chronic osteoporotic stage III Kummell's disease with severe spinal canal stenosis. OBJECTIVE: To evaluate the feasibility and efficacy of PKP for the treatment of chronic osteoporotic stage III Kummell's disease with severe spinal canal stenosis. STUDY DESIGN: A retrospective evaluation of postoperative radiographs. SETTING: Pain management clinic. METHODS: A retrospective study was performed on 9 patients with 11 levels managed with PKP for chronic osteoporotic stage III Kummell's disease with severe spinal canal stenosis. Clinical and radiological outcomes were assessed. RESULTS: Substantial pain relief was attained in all the patients. Both visual analogue scale (VAS) and Oswestry Disability Index (ODI) scores improved significantly from pre- to post-operation (P < 0.05), and remained unchanged at every follow-up. No neurological deterioration was found. Postoperatively, the anterior and midline vertebral body heights were significantly corrected (P < 0.05), and were sustained at the final follow-up. Similar results were seen in the correction of kyphotic angle. Neither cement leakage into the spinal canal nor further dislodging of the posterior vertebral fragments occurred. Two cases experienced subsequent fractures with one having a second PKP and the other being treated conservatively. LIMITATIONS: Retrospective study of 9 cases with 11 levels due partly to the rarity of the disorder. CONCLUSIONS: PKP is an effective, minimally invasive procedure for the treatment of chronic osteoporotic stage III Kummell's disease with severe spinal stenosis, leading to a significant relief of symptoms and improvement of functional status. INSTITUTIONAL REVIEW: This study was approved by the Institutional Review Board.


Assuntos
Cifoplastia/métodos , Índice de Gravidade de Doença , Canal Medular/lesões , Canal Medular/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Estenose Espinal/cirurgia , Idoso , Cimentos Ósseos , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/lesões , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Medição da Dor/métodos , Radiografia , Estudos Retrospectivos , Canal Medular/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/epidemiologia , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/epidemiologia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/lesões , Vértebras Torácicas/cirurgia
12.
Indian J Orthop ; 48(6): 582-6, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25404770

RESUMO

BACKGROUND: Expansive open door laminoplasty with the use of titanium miniplate is becoming popular. Usually, the plate is applied at each level to prevent re-closure of the opened lamina. However, it is also used at alternating levels (i.e., C3, C5 and C7) in clinical settings in order to reduce the cost. Whether they have any difference in clinical efficacy? There is a lack of comparative data between the two kinds of plate fixation in the literature. MATERIALS AND METHODS: 83 patients who underwent cervical laminoplasty with alternating levels plate fixation (51 patients in Group A) or all levels plate fixation (32 patients in Group B) between January 2008 and October 2012 were evaluated in our institute retrospectively. Clinical and radiologic outcomes were assessed. RESULTS: No statistical difference was found in the mean operation time, blood loss, incidence of significant axial symptoms and C5 palsy, preoperative anteroposterior diameter (APD) and preoperative Japanese Orthopedic Association score between the two groups. However, Group B showed a higher rate of neurologic recovery after surgery. Postoperative increased APD and open angle in Group B were significantly larger than Group A. The mean cost for Group B (12801 ± 460.6 USD) was higher than Group A (8906 ± 566.7 USD). CONCLUSIONS: Despite the higher cost of all level fixation, it is more effective in maintaining the expansion of the spinal canal and can obtain better clinical improvement compared to alternating levels fixation.

13.
Orthopedics ; 36(4): e489-93, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23590791

RESUMO

Currently, bilateral pedicle screw fixation is the standard of instrumentation, providing rigid fixation and an increased fusion rate. However, due to the excessive rigidity of the system, this instrumentation has been suspected to cause degeneration of adjacent segments. Alternatively, less rigid unilateral pedicle fixation is considered to be as effective as bilateral constructs. Few studies have compared unilateral and bilateral constructs in the treatment of lumbar degenerative disease. The purpose of this retrospective study was to evaluate possible differences between unilateral and bilateral pedicle screw fixation for single-level lumbar degenerative disease.Between October 2006 and October 2010, sixty consecutive patients were treated with unilateral pedicle screw fixation (28 patients) or bilateral pedicle screw fixation (32 patients) at the authors' institution. Oswestry Disability Index and visual analog scale scores showed a statistical difference between preoperative values and 3- and 6-month postoperative values (P<.05). Unilateral fixation resulted in shorter operative times and less intraoperative blood loss. No significant difference was found between the 2 fixation methods in terms of fusion rate and complication rate (P>.05).Lumbar interbody fusion with unilateral pedicle screw fixation was an effective and convenient method of treatment of single-level lumbar degenerative disease, with little surgical trauma.


Assuntos
Parafusos Ósseos , Vértebras Lombares/cirurgia , Osteoartrite/cirurgia , Fusão Vertebral/instrumentação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
J Spinal Disord Tech ; 26(1): E13-8, 2013 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23075860

RESUMO

STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the feasibility, efficacy, and safety of laminoplasty with plate fixation at alternating levels through radiologic analysis of the enlarged spinal canal and clinical follow-up. SUMMARY OF BACKGROUND DATA: Laminoplasty is commonly used to manage cervical myelopathy. Because of the absence of rigid fixation, traditional laminoplasty commonly results in complications, including secondary narrowing of the spinal canal and neurological deterioration. At present, miniplate fixation is promising to prevent reclosure of the opened lamina efficiently by applying plates at each level. However, plates are also used at alternating levels (ie, C3, C5, C7) in clinical settings to reduce the cost of patients. To date, no thorough studies on plates used at alternating levels have been published. METHODS: Forty-two consecutive patients who underwent cervical laminoplasty for the treatment of cervical spondylotic myelopathy with plate fixation at alternating levels between January 2008 and April 2011 were reviewed for this study. Clinical and radiologic outcomes were assessed. RESULTS: Lateral cervical spine x-rays showed improvements in anteroposterior diameter (APD) of the spinal canal in all levels. No difference of APD was found between alternating fixed levels and unfixed levels preoperatively. Postoperative increased APD in alternating fixed levels was larger than unfixed levels. The mean increased APD in C6 level was smaller than C3, C5, and C7 level (P<0.05). However, there was no difference of the mean increased APD between C4 and C6 levels. Similar results were seen for the mean open angle from computed tomography scan. The mean Japanese Orthopaedic Association (JOA) improvement rate was 58.9%±17.8% on follow-up. However, the available JOA data from all 4 patients with insufficient open angle in unfixed levels exhibited limited improvement of neurological deficit. CONCLUSIONS: Laminoplasty with plate fixation at alternating levels is a safe, relatively fast, and cost-effective surgical method for most patients with cervical myelopathy. However, unfixed levels (C4 and C6) still have the risk of closure of open angle, which could be associated with remaining spinal cord compression. C6 is a much higher risk level compared with C4.


Assuntos
Placas Ósseas , Laminectomia/instrumentação , Laminectomia/métodos , Fusão Vertebral/instrumentação , Fusão Vertebral/métodos , Espondilose/diagnóstico por imagem , Espondilose/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Vértebras Cervicais/cirurgia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Resultado do Tratamento
15.
Ying Yong Sheng Tai Xue Bao ; 23(6): 1629-34, 2012 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-22937653

RESUMO

The 3 'cDNA fragment of KsNHX1 in Kochia sieversiana was obtained by RACE. The phylogenetic analysis of antiporters from different plant species indicated that the KsNHX1 was a gene encoding vacuolar Na+/H+ antiporter. By using semi-quantitative RT-PCR, the expression profiles of the KsNHX1 under different saline-alkali stresses were examined. It was observed that the transcript of KsNHX1 in leaves under the stress of 200 mmol x L(-1) for 2-24 h increased gradually with increasing duration, and the expression of KsNHX1 in roots, stems, leaves, and flowers under the stress of 200 mmol x L(-1) for 10 h was up-regulated. Under various NaCl concentrations, the expression of KsNHX1 in leaves was up-regulated, with the maximum under 160 mmol x L(-1) of NaCl. The expression of KsNHX1 in roots was also up-regulated under the stress of < 400 mmol x L(-1). Under various concentrations of Na2CO3, the expression of KsNHX1 in roots appeared the similar change patterns with those under corresponding concentrations of NaCl, but the expression of KsNHX1 in leaves was down-regulated except under 160 mmol x L(-1). The changes of the expression patterns implied that KsNHX1 played roles in maintaining the homeostasis of K+/Na+, which probably contributed to the saline-alkali tolerance of Kochia sieversiana.


Assuntos
Chenopodiaceae/genética , Proteínas de Plantas/metabolismo , Plantas Tolerantes a Sal/genética , Trocadores de Sódio-Hidrogênio/metabolismo , Estresse Fisiológico/genética , Sequência de Bases , Chenopodiaceae/metabolismo , Dados de Sequência Molecular , Proteínas de Plantas/genética , Plantas Geneticamente Modificadas , Tolerância ao Sal/genética , Bicarbonato de Sódio/metabolismo , Cloreto de Sódio/metabolismo , Trocadores de Sódio-Hidrogênio/genética , Vacúolos/genética , Vacúolos/metabolismo
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