Ginkgetin attenuates bone loss in OVX mice by inhibiting the NF-κB/IκBα signaling pathway.

Background: Osteoporosis is a disease associated with bone resorption, characterized primarily by the excessive activation of osteoclasts. Ginkgetin is a compound purified from natural ginkgo leaves which has various biological properties, including anti-inflammation, antioxidant, and anti-tumor effects. This study investigated the bone-protective effects of ginkgetin in ovariectomized (OVX) mice and explored their potential signaling pathway in inhibiting osteoclastogenesis in a mouse model of osteoporosis. Methods: Biochemical assays were performed to assess the levels of Ca, ALP, and P in the blood. Micro CT scanning was used to evaluate the impact of ginkgetin on bone loss in mice. RT-PCR was employed to detect the expression of osteoclast-related genes (ctsk, c-fos, trap) in their femoral tissue. Hematoxylin and eosin (H&E) staining was utilized to assess the histopathological changes in femoral tissue due to ginkgetin. The TRAP staining was used to evaluate the impact of ginkgetin osteoclast generation in vivo. Western blot analysis was conducted to investigate the effect of ginkgetin on the expression of p-NF-κB p65 and IκBα proteins in mice. Results: Our findings indicate that ginkgetin may increase the serum levels of ALP and P, while decreasing the serum level of Ca in OVX mice. H&E staining and micro CT scanning results suggest that ginkgetin can inhibit bone loss in OVX mice. The TRAP staining results showed ginkgetin suppresses the generation of osteoclasts in OVX mice. RT-PCR results demonstrate that ginkgetin downregulate the expression of osteoclast-related genes (ctsk, c-fos, trap) in the femoral tissue of mice, and this effect is dose-dependent. Western blot analysis results reveal that ginkgetin can inhibit the expression of p-NF-κB p65 and IκBα proteins in mice. Conclusion: Ginkgetin can impact osteoclast formation and activation in OVX mice by inhibiting the NF-κB/IκBα signaling pathway, thereby attenuating bone loss in mice.

TREATMENT OF THORACOLUMBAR FRACTURES BY CLOSED REDUCTION VIA A PERCUTANEOUS SOLID PEDICLE SCREW.

Objectives: Investigate the effect of closed reduction and per- cutaneous pedicle screw fixation in treating thoracolumbar fractures. Methods: This retrospective study analyzed 12 cases of single-segment thoracolumbar spine fractures without spinal cord and nerve injury at our department from March 2016 to September 2017. Patients were treated with closed reduction, percutaneous reduction, and internal fixation with solid pedicle screws. The operation time, intraoperative blood loss, anterior vertebral body height ratio (AVHR), Cobb angle (CA) of sagittal kyphosis, and VAS of back pain were determined and statistically compared. Results: The average operation time was 147.2 ± 45.6 min, and the average intraoperative bleeding was 67.8 ± 34.2 mL. All fractured vertebrae were completely reduced, their height was restored, and kyphosis was corrected. The average follow-up period was 10.6 ± 2.7 months, with significant improvements seen in the AVHR, CA of sagittal kyphosis, and VAS score (P < 0.01). One case had a broken rod after three months, and another had a postoperative infection. All the patients achieved bony healing. Conclusion: The treatment of thoracolumbar fractures by closed reduction and internal fixation with a percutaneous solid pedicle screw is simple, effective, and economical. Level of Evidence VI; Therapeutic Study, Case Series .

Objetivo: Investigar o efeito da redução incruenta e da fixação com parafuso de pedículo percutâneo no tratamento das fraturas toraco- lombares. Métodos: Este estudo retrospectivo analisou 12 casos de fraturas toracolombares com segmento único sem lesão medular ou neural, encontrados no departamento dentro do período de março de 2016 a setembro de 2017. Os pacientes foram tratados com redução fechada e fixação interna com parafusos de pedículo percutâneo. O tempo de operação, a perda sanguínea intra-operatória, a relação da altura do corpo vertebral anterior (AVHR), o ângulo de Cobb (CA) da cifose sagital e a EVA relativa à dor nas costas foram determinados e comparados estatisticamente. Resultados: O tempo médio da operação foi de 147,2±45,6 min, com sangramento intraoperatório médio de 67,8±34,2 mL. Todas as vértebras fraturadas foram com- pletamente reduzidas, suas alturas foram restauradas e a cifose foi corrigida. O período médio de acompanhamento foi de 10,6±2,7 meses, apresentando melhorias significativas observadas no AVHR, CA da cifose sagital e pontuação VAS (P <0,01). Um caso teve uma haste quebrada após 3 meses, e outro paciente apresentou uma infecção pós-operatória. Todos os pacientes alcançaram a recuperação óssea. Conclusão: O tratamento das fraturas toracolombares por redução fechada com fixação interna pelo parafuso de pedículo percutâneo é simples, eficaz e econômico. Nível de Evidência IV; Estudos Terapêuticos, Série de Casos.

Treatment of thoracolumbar fractures by closed reduction via a percutaneous solid pedicle screw / Tratamento de fraturas toracolombares por redução fechada com parafuso de pedículo percutâneo

ABSTRACT Objectives: Investigate the effect of closed reduction and per- cutaneous pedicle screw fixation in treating thoracolumbar fractures. Methods: This retrospective study analyzed 12 cases of single-segment thoracolumbar spine fractures without spinal cord and nerve injury at our department from March 2016 to September 2017. Patients were treated with closed reduction, percutaneous reduction, and internal fixation with solid pedicle screws. The operation time, intraoperative blood loss, anterior vertebral body height ratio (AVHR), Cobb angle (CA) of sagittal kyphosis, and VAS of back pain were determined and statistically compared. Results: The average operation time was 147.2 ± 45.6 min, and the average intraoperative bleeding was 67.8 ± 34.2 mL. All fractured vertebrae were completely reduced, their height was restored, and kyphosis was corrected. The average follow-up period was 10.6 ± 2.7 months, with significant improvements seen in the AVHR, CA of sagittal kyphosis, and VAS score (P < 0.01). One case had a broken rod after three months, and another had a postoperative infection. All the patients achieved bony healing. Conclusion: The treatment of thoracolumbar fractures by closed reduction and internal fixation with a percutaneous solid pedicle screw is simple, effective, and economical. Level of Evidence VI; Therapeutic Study, Case Series.

RESUMO Objetivo: Investigar o efeito da redução incruenta e da fixação com parafuso de pedículo percutâneo no tratamento das fraturas toraco- lombares. Métodos: Este estudo retrospectivo analisou 12 casos de fraturas toracolombares com segmento único sem lesão medular ou neural, encontrados no departamento dentro do período de março de 2016 a setembro de 2017. Os pacientes foram tratados com redução fechada e fixação interna com parafusos de pedículo percutâneo. O tempo de operação, a perda sanguínea intra-operatória, a relação da altura do corpo vertebral anterior (AVHR), o ângulo de Cobb (CA) da cifose sagital e a EVA relativa à dor nas costas foram determinados e comparados estatisticamente. Resultados: O tempo médio da operação foi de 147,2±45,6 min, com sangramento intraoperatório médio de 67,8±34,2 mL. Todas as vértebras fraturadas foram com- pletamente reduzidas, suas alturas foram restauradas e a cifose foi corrigida. O período médio de acompanhamento foi de 10,6±2,7 meses, apresentando melhorias significativas observadas no AVHR, CA da cifose sagital e pontuação VAS (P <0,01). Um caso teve uma haste quebrada após 3 meses, e outro paciente apresentou uma infecção pós-operatória. Todos os pacientes alcançaram a recuperação óssea. Conclusão: O tratamento das fraturas toracolombares por redução fechada com fixação interna pelo parafuso de pedículo percutâneo é simples, eficaz e econômico. Nível de Evidência IV; Estudos Terapêuticos, Série de Casos

Comparison of the technique of anterior cervical distraction and screw elevating-pulling reduction and conventional anterior cervical reduction technique for traumatic cervical spine fractures and dislocations.

INTRODUCTION: To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations. MATERIALS AND METHODS: A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015. They were 54 males and 32 females with an age ranging from 20 to 73 years (average age, 40.1 ± 5.6 years). These patients were distributed into group A and group B in the sequence of visits, with 44 cases of conventional anterior cervical reduction (group A) and 42 cases of anterior cervical distraction and screw elevating-pulling reduction (group B). Comparison of intraoperative blood loss, operation duration and vertebral reduction rate was made between the two groups. The follow-up time was 12-18 months, and the clinical outcomes of surgery were evaluated according to ASIA score, VAS score and JOA score. RESULTS: Statistically significant difference was revealed between group A and group B in the surgical time and the correction rate of cervical spine dislocation (p < 0.05), with the results of group B better than those of group A. For the two groups, statistically significant difference was shown between the ASIA score, VAS score and JOA score before and after operation (p < 0.05), with the results better after operation, while no statistically significant difference was revealed in such scores between the two groups (p > 0.05), with the therapeutic effect of group A the same with that of group B. CONCLUSIONS: Anterior cervical distraction and screw elevating-pulling reduction is simple with low risk, short operation duration, good effect of intraoperative vertebral reduction and well-recovered function after the operation. Meanwhile, as a safe and effective operation method for cervical spine fractures and dislocations, it can reduce postoperative complications and the risk of the iatrogenic cervical spinal cord injury caused by prying or facet joint springing during conventional reduction, having more obvious advantages compared to the conventional surgical reduction adopted by group A, with good cervical spine stability as shown in long-term follow-up. Therefore, it is suitable for clinical promotion and application.

[The causes of death and risk factors in patients of war wound and trauma of extremities by logistic regression model].

OBJECTIVE: To explore the causes of death and risk factors in patients of war wound and trauma of extremities. METHODS: This retrospective study involved 352 patients of war wound and trauma of extremities admitted to 303rd Hospital of People's Liberation Army during the period between 1968 to 2002. All the data were reviewed and the causes of death of 15 patients were analyzed by autopsy, and a computer's logistic regression model analysis was performed to approach the risk factors of death. RESULTS: Fifteen of the three hundred and fifty-two patients were died (4.3 %). The causes of death included acute renal failure (ARF) (46.7%, 7/15), lung embolism (20.0%, 3/15), clostridial myonecrosis (20.0%, 3/15) and multiple organ system failure (MOSF) (13.3%, 2/15). In the univariate analysis, the risk of death increased by shock, time admitted to hospital, amputation, time of tourniquet, associated injury of head, thoracic region, abdomen or blood vessel (P < 0. 05). In the logistic regression model analysis, shock and amputation were the two factors most strongly associated with the death of patients of war wound and trauma. (P < 0. 05). CONCLUSION: Acute renal failure (ARF) was the main cause of death of patients of war wound and trauma of extremities. Its should be helpful for minimize the mortality of patients of war wound and trauma to manage the shock in time and have a correct choice of amputation promptly.

[Serial thin cross-sectional anatomy and computerized three-dimensional reconstruction of metacarpal fascial spaces of hand].

OBJECTIVE: To build three-dimensional (3-D) visible model for surgical treatment of infection of fascial spaces of hand. METHODS: Serial thin cross-sections (0.2 mm) of hand were made by cryomicrotome, and the thin cross-sections of metacarpal parts were observed. A personal computer was employed to reconstruct 3-D model of metacarpal fascial space. RESULTS: The shapes, locations and adjacent relations of the mid-palmar space, thenar space and metacarpal bones were displayed clearly from computerized 3-D model, which could be the cross-reference of the cross-sections expediently. CONCLUSION: The computerized 3-D reconstruction of metacarpal fascial spaces can provide some guidance for surgical treatment of infection and other diseases of metacarpal fascial spaces.