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1.
ACS Nano ; 17(11): 10033-10040, 2023 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-37216376

RESUMO

Fabricating micro/nanostructures of oxide semiconductors with oxygen vacancies (OVs) is crucial for advancing miniaturized functional devices. However, traditional methods for the synthesis of semiconductor metal oxides (SMOs) with OVs usually involve thermal treatment, such as annealing or sintering, under anaerobic conditions. Herein, a multiphoton-induced femtosecond laser (fs) additive manufacturing method is reported for directly writing micropatterns with high resolution (∼1 µm) and abundant OVs in an atmospheric environment at room temperature (25 °C). The interdigitated functional devices fabricated by these micropatterns exhibit both photosensitivity and gas sensitivity. Additionally, this method can be applied to flexible and rigid substrates. The proposed method realizes the high-precision fabrication of SMOs with OVs, enabling the future heterogeneous integration of oxide semiconductors on various substrates, especially flexible substrates, for various device applications, such as soft and wearable electronics/optoelectronics.

2.
Acta Biochim Biophys Sin (Shanghai) ; 54(11): 1720 - 1730, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36514221

RESUMO

Intervertebral disc degeneration (IVDD) is a general disorder that results in low back pain and disability among many affected individuals. However, the current treatments for IVDD are limited to relieving the symptoms but do not solve the fundamental issue. In this study, the role of USP14 in mediating the activation of the NLRP3 inflammasome and the pyroptosis of AF cells from IVDD patients is determined in vitro, and gain- and loss-of-function assays of USP14 and the NLRP3 inflammasome are conducted. Pyroptosis of AF cells is detected by flow cytometry. The inflammatory cytokines (IL-1ß and IL-18) and protein levels of NLRP3, active Caspase-1, Aggrecan, MMP3 and ADAMTS-5 are determined by ELISA and western blot analysis, respectively. The correlation between USP14 and NLRP3 is measured by coimmunoprecipitation and ubiquitination analysis. Upregulation of USP14 is accompanied by increased level of the NLRP3 inflammasome in AF cells from IVDD patients; furthermore, a positive correlation between them is observed. USP14 knockdown inhibits pyroptosis in AF cells by inducing ubiquitination of NLRP3, while overexpression of USP14 has the opposite effect, which is inhibited by the NLRP3 inflammasome inhibitor INF39. USP14 exerts its positive regulatory effect on AF cell pyroptosis by modulating the NLRP3/Caspase-1/IL-1ß and IL-18 signaling axes.


Assuntos
Anel Fibroso , Degeneração do Disco Intervertebral , Humanos , Caspase 1/metabolismo , Inflamassomos/metabolismo , Interleucina-18 , Interleucina-1beta/metabolismo , Degeneração do Disco Intervertebral/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Piroptose , Ubiquitina Tiolesterase/genética
3.
Mol Genet Genomics ; 297(5): 1229-1242, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35767190

RESUMO

We sought to identify novel biomarkers and related mechanisms that might shape the immune infiltration in IDD, thereby providing novel perspective for IDD diagnosis and therapies. Gene expression data sets GSE124272 (for initial analysis) and GSE56081 (for validation analysis) involving samples from IDD patients and healthy controls were retrieved from the Gene Expression Omnibus (GEO) database. Immune genes associated with IDD were identified by GSEA; module genes that exhibited coordinated expression patterns and the strongest positive or negative correlation with IDD were identified by WGCNA. The intersection between immune genes and module genes was used for LASSO variable selection, whereby we obtained pivotal genes that were highly representative of IDD. We then correlated (Pearson correlation) the expression of pivotal genes with immune cell proportion inferred by CIBERSORT algorithm, and revealed the potential immune-regulatory roles of pivotal genes on the pathogenesis of IDD. We discovered several immune-associated pathways in which IDD-associated immune genes were highly clustered, and identified two gene modules that might promote or inhibit the pathogenesis of IDD. These candidate genes were further narrowed down to 8 pivotal genes, namely, MSH2, LY96, ADAM8, HEBP2, ANXA3, RAB24, ZBTB16 and PIK3CD, among which ANXA3, MSH2, ZBTB16, LY96, PIK3CD, ZBTB16, and ADAM8 were revealed to be correlated with the proportion of CD8 T cells and resting memory CD4 T cells. This work identified 8 pivotal genes that might be involved in the pathogenesis of IDD through triggering various immune-associated pathways and altering the composition of immune and myeloid cells in IDD patients, which provides novel perspectives on IDD diagnosis and treatment.


Assuntos
Degeneração do Disco Intervertebral , Proteínas da Gravidez , Proteínas ADAM , Biomarcadores , Biologia Computacional , Redes Reguladoras de Genes , Proteínas Ligantes de Grupo Heme , Humanos , Proteínas de Membrana , Proteína 2 Homóloga a MutS
4.
Oxid Med Cell Longev ; 2022: 8245614, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35116094

RESUMO

Osteosarcoma (OS) is the most common malignancy of bone. Liensinine exerts antitumor effects on cancers of the colon, breast, and gallbladder. However, its antitumor activity in OS remains unclear. This study is aimed at investigating the efficacy of liensinine against OS and the underlying mechanism of action. Cell proliferation, apoptosis, and cycle arrest in OS were detected using the Cell Counting Kit-8 (CCK-8), colony formation, and flow cytometry assays, respectively. The production of reactive oxygen species (ROS), glutathione (GSH) and glutathione disulfide (GSSG) concentrations, and mitochondrial membrane potential (MMP) of OS cells were measured by flow cytometry, colorimetry, and JC-1 staining. The expressions of factors related to apoptosis, cell cycle, and activation of the JAK2/STAT3 pathway were determined by Western blotting. To examine the potential role of ROS, an antioxidant (N-acetyl cysteine, NAC) was used in combination with liensinine. In vivo, we generated a xenograft mouse model to assess its antitumor efficacy. Tissue level expressions of factors related to apoptosis and activation of the JAK2/STAT3 pathway were assessed by immunohistochemistry or Western blotting. Liensinine inhibited the proliferation and induced G0/G1 phase arrest and apoptosis of OS cells in a dose-dependent manner. Additionally, liensinine promoted intracellular ROS production, enhanced the GSSG/GSH ratio, and induced MMP loss and ROS-mediated suppression of the JAK2/STAT3 pathway. NAC significantly attenuated the liensinine-induced antitumor activities and activated the JAK2/STAT3 pathway. In vivo, liensinine effectively inhibited the OS growth and promoted apoptosis; however, it had no negative effect on the internal organs. In conclusion, liensinine-induced ROS production could suppress the activation of the JAK2/STAT3 pathway and inhibit the OS growth both in vivo and in vitro. Our findings provided a new rationale for subsequent academic and clinical research on OS treatment.


Assuntos
Proliferação de Células/efeitos dos fármacos , Isoquinolinas/farmacologia , Fenóis/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Linhagem Celular Tumoral , Feminino , Pontos de Checagem da Fase G1 do Ciclo Celular/efeitos dos fármacos , Glutationa/metabolismo , Humanos , Isoquinolinas/uso terapêutico , Janus Quinase 2/metabolismo , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Camundongos , Camundongos Nus , Osteossarcoma/tratamento farmacológico , Osteossarcoma/metabolismo , Osteossarcoma/patologia , Fenóis/uso terapêutico , Fator de Transcrição STAT3/metabolismo , Transplante Heterólogo
5.
JOR Spine ; 5(4): e1229, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36601380

RESUMO

Objectives: To observe histological and inflammatory characteristics of epidural fat (EF) adjacent to the ossification area in patients with ossification of the thoracic ligament flavum (TOLF) and provide a preliminary research basis for investigating the impact of the EF on OLF. Methods: Samples of EF and autologous subcutaneous adipose tissue (SCAT) from TOLF patients (n = 26) and non-TOLF patients (n = 23) were harvested during posterior thoracic spine surgery. Adipocyte size and fibrosis were measured by histology. Vascularization and inflammatory cell infiltration were evaluated by immunohistochemical staining. Adipogenesis-related genes were assessed by real-time quantitative PCR. Conditioned media from cultured EF were evaluated via enzyme-linked immunosorbent assay to detect the secretion of inflammatory cytokines, including interleukin-6 (IL-6), tumor necrosis factor (TNF-α), and leptin. The phosphorylated STAT3 protein level in ligament flavum (LF) was examined using Western blot. Results: Adipocytes size in EF was similar between in the TOLF and non-TOLF groups, but significantly smaller than that from autologous SCAT. Adipogenesis-related mRNA expression in EF was lower than that in SCAT. More fibrosis and vascularization were found in TOLF than in non-TOLF. EF in the TOLF group exhibited more macrophages and B lymphocytes infiltrated. The levels of cytokines such as IL-6, TNF-α, and leptin secreted by EF were significantly higher in the TOLF group than non-TOLF. The level of phosphorylated STAT3 in LF was significantly upregulated in the TOLF group. Conclusions: Morphologically, EF adjacent to the ossification area is smaller and more uniform than autologous SCAT, exhibiting a characteristic similarity to visceral fat. EF in the TOLF group shows a more fibrotic, vascularized, and inflammatory phenotype, which secretes multiple cytokines. The phosphorylated STAT3 protein was significantly upregulated in the TOLF group. Whether these properties of EF directly affect the process of OLF needs to be further explored.

6.
J Mater Chem B ; 9(11): 2641-2655, 2021 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-33683276

RESUMO

In our previous study, zinc oxide nanoparticles (ZnO NPs) presented satisfying therapeutic effects with cancer cell selectivity in osteosarcoma cells and, thus, have been considered as a potential nanomedicine for human osteosarcoma treatment. However, the poorly investigated internalization process, including their endocytic pathway into tumor cells and intracellular fate, limits the clinical application. Here, we further clarified these aspects. First, ZnO NPs were rapidly internalized by osteosarcoma cells and accumulated in mitochondria, before being entrapped into lysosomes. Second, dynasore (a dynamin inhibitor) was demonstrated to be the most effective in blocking ZnO NP uptake and rescuing ZnO NP-induced osteosarcoma cell autophagic death and apoptosis. Third, we confirmed the key role of dynamin 2 in ZnO NP endocytosis and subsequent autophagic cell death in vitro and in vivo. Furthermore, we proved that VPS34 transferred from cell cytoplasm to cell membrane to interact with dynamin under ZnO NP treatment. Altogether, combined with our previous study, the current research further revealed that ZnO NPs entered human osteosarcoma cells through the VPS34/dynamin 2-dependent endocytic pathway, directly targeting and damaging the mitochondria before being entrapped into the lysosomes, thereby initiating mitophagy-Zn2+-reactive oxygen species-mitophagy axis mediated cell apoptosis.


Assuntos
Classe III de Fosfatidilinositol 3-Quinases/metabolismo , Dinamina II/metabolismo , Mitocôndrias/efeitos dos fármacos , Nanopartículas/química , Osteossarcoma/tratamento farmacológico , Óxido de Zinco/farmacologia , Apoptose/efeitos dos fármacos , Autofagia/efeitos dos fármacos , Endocitose/efeitos dos fármacos , Humanos , Mitocôndrias/metabolismo , Osteossarcoma/metabolismo , Osteossarcoma/patologia , Óxido de Zinco/química
7.
Med Hypotheses ; 143: 110130, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32759009

RESUMO

In order to preserve paravertebral muscles and posterior ligaments complex (PLC), this paper proposes a new lumbar laminoplasty surgery for lumbar spinal stenosis (LSS). According to the anatomy of back muscles insertions, building block osteotomy (BBO) which aimed to achieve precise osteotomy and reconstruction based on modular design theory was firstly put forward, and supposed to be achieved by an ultrasound bone scalpel (UBS). In details, lumbar spinous processes are longitudinally split, then supraspinous and interspinous ligaments are sharply cut off longitudinally. After converting to lumbar flexion, lamina osteotomy is innovatively finished by an UBS through interspinous space. After decompression, hollow screws are firstly suggested to be used on each side to fix lamina and spinous processes, and PLC is reconstructed by interrupted suture. Feasibility of this method is evaluated in details. Challenges, advantages and disadvantages are also discussed.


Assuntos
Músculos do Dorso , Laminoplastia , Estenose Espinal , Descompressão Cirúrgica , Humanos , Vértebras Lombares/cirurgia , Osteotomia , Estenose Espinal/cirurgia
8.
Med Hypotheses ; 144: 110007, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32592920

RESUMO

Concerning the damage to back muscles and posterior ligament complex (PLC) by posterior open approach for lumbar spinal stenosis (LSS), the oblique lateral intervertebral fusion (OLIF) is pretty popular nowadays. However, oblique lateral approach has obvious drawbacks, which are limited vision and operative scope for achieving spinal canal decompression. Herein, we present a hypothesis that lumbar canal decompression can be well achieved by OLIF combined with spinal endoscope operative system. Nerval decompression and spinal reconstruction are achieved in a minimal invasive way, which may play an instructive role for the treatment of serious LSS.


Assuntos
Fusão Vertebral , Estenose Espinal , Descompressão Cirúrgica , Humanos , Vértebras Lombares/cirurgia , Estenose Espinal/cirurgia , Resultado do Tratamento
9.
Onco Targets Ther ; 13: 4755-4765, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547104

RESUMO

INTRODUCTION: Chordoma is a malignant primary bone tumor that is found in the spine and skull. X-inactive specific transcript (XIST) is a long non-coding RNA (lncRNA) is known to be involved in the development of various cancers, but its precise function and mechanism in human chordoma have not been elucidated. Here, we investigated the role of lncRNA XIST in chordoma progression. METHODS: Quantitative real time-polymerase chain reaction (qRT-PCR) was performed to determine lncRNA XIST expression in human chordoma tissues and matched-noncancerous tissues. Western blot was used to determine protein expression. Silencing and overexpression of lncRNA XIST were carried out by RNA interference (RNAi) and lentiviral transduction, respectively. Cell Counting Kit-8 (CCK-8) assay and flow cytometry were employed to examine the effects of lncRNA XIST on growth of human chordoma cells. Lastly, the role of lncRNA XIST in vivo was explored using a xenograft model. RESULTS: We found that lncRNA XIST expression was upregulated in chordoma and strongly correlated with poor patient prognosis. Moreover, lncRNA XIST promoted proliferation and inhibited apoptosis of chordoma cells. Mechanistically, upregulation of lncRNA XIST led to a decrease in miR-124-3p expression, thereby promoting the expression of the miR-124-3p target gene, inhibitor of apoptosis-stimulating protein of p53 (iASPP). Addition of miR-124-3p inhibitor or mimic reversed the effects induced by lncRNA XIST silencing or overexpression on chordoma cell proliferation. Lastly, using a xenograft mouse model, we found that silencing of lncRNA XIST decreased tumorigenicity in vivo, as shown by increased tumor cell apoptosis. CONCLUSION: Our findings demonstrate a key role for lncRNA XIST in chordoma progression by regulating miR124-3p/iAPSS pathway.

10.
Ann Palliat Med ; 9(4): 1497-1505, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32576014

RESUMO

BACKGROUND: Osteonecrosis of the femoral head (ONFH) is difficult to treat, and leads to an impaired microcirculation of the femoral head and activation of a repair response. The type H vessels have been proved to mediate the growth of the bone vasculature and couple angiogenesis to osteogenesis. The aim of the study is to investigate the experimental verification of H subtype vascular endothelial cells (HSVECs) in the human femoral head. METHODS: Vascular endothelial cells were isolated from femoral heads of patients who underwent hip replacement. Cells were isolated by the methods of enzymic digestion and density gradient centrifugation, purified by differential adhesion and selective medium. The HSVECs were characterized for localization of endothelial cell markers such as von Willebrand factor (vWF), vascular cell adhesion molecule-1 (VCAM1), CD31 and Endomucin (Emcn) by immunofluorescence staining. Cell morphology was observed by microscopy. RESULTS: The HSVECs expressing vWF, VCAM-1, CD31 and Emcn were identified by immunofluorescence. After 3-4 days of culture, adherent cells were observed evenly distributed in the culture flasks, and inconsistent in size and shape. Following 7-8 days of culture, the cells formed a monolayer after fusion, arranged in fascicular, whorled, and the growth was attachment-inhibited. Most of the cells appeared short spindle, polygon and cobblestone-like morphologic characteristics. CONCLUSIONS: Here we make an effective experimental verification of HSVECs in the human femoral heads, which will facilitate the study of ONFH, hip osteoporosis and other bone diseases in vitro.


Assuntos
Células Endoteliais , Cabeça do Fêmur , Artroplastia de Quadril , Glucocorticoides , Humanos , Osteogênese
11.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 34(2): 206-212, 2020 Feb 15.
Artigo em Chinês | MEDLINE | ID: mdl-32030953

RESUMO

OBJECTIVE: To explore the effect of icariin on early steroid-induced osteonecrosis of the femoral head in rabbits. METHODS: Fifty mature New Zealand rabbits (weighing, 2.5-3.0 kg) were randomly divided into control group ( n=10), model group ( n=20), and experimental group ( n=20). The rabbits of model and experimental groups were injected with lipopolysaccharide and methylprednisolone to establish the animal model of early steroid-induced osteonecrosis of the femoral head. The rabbits of experimental group were feeded with icariin solution once a day for 6 weeks since the first injection of methylprednisolone, whereas the rabbits of control and model groups were given normal saline at the same time points. The left femoral heads were removed after 6 weeks and gross morphological features were evaluated. Micro-CT scan was performed to analyze the trabecular microstructure with the following parameters: trabecular bone volume to total volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Tn), and trabecular separation (Tb.Sp). The Micro-CT scan was also converted to three-dimensional reconstruction images for observation. HE staining was applied to observe the trabecular structure and morphological changes of osteocytes and marrow adipocytes. It was also used to determine whether the samples of femoral heads occurred osteonecrosis based on the criteria for pathological diagnosis, and calculate the rate of empty lacunae. RESULTS: Seven rabbits died during the study, and 9, 16, and 18 rabbits in the control, model, and experimental groups, respectively, enrolled the final analysis. Compared with control group, the femoral head collapse and trabecular breaks were more obvious, and the trabeculae were sparse with irregular arrangement in the model group according to the results of gross observation, Micro-CT scan, and three-dimensional reconstruction images. But in the experimental group, the surface of femoral head was slight shrinking without obvious collapse, and the degeneration of trabecular structure was mild. According to bone microstructures analysis, the Tb.N, Tb.Tn, and BV/TV of femoral head in model and experimental groups were lower than those in control group, while the Tb.Sp in the model and experimental groups were significantly higher. The Tb.N, Tb.Tn, and BV/TV of femoral head in experimental group were higher than those in model group, while the Tb.Sp in the experimental group was significantly lower. The differences between groups were all significant ( P<0.05). In the model group, HE staining showed that the number of osteocytes reduced, the number of empty lacunae increased, and the marrow adipocytes piled up in the space between femoral trabeculae, some even mashed together like a cyst. In the experimental group, the trabecular structure was still relatively complete compared with model group, no obvious apoptosis of osteocytes was observed, the size and number of adipocytes were basically normal. None of the animals in control group occurred osteonecrosis of the femoral head based on the criteria for pathological diagnosis, and the incidence of osteonecrosis were 81.3% (13/16) in the model group and 66.7% (12/18) in the experimental group, and the difference was not significant ( P=0.448). The rate of empty lacunae of osteonecrotic femoral heads in the model group was 33.1%±1.4%, which was higher than that in experimental group (18.9%±0.8%) and in control group (12.7%±1.5%), and the differences between groups were significant ( P<0.05). CONCLUSION: The icariin has a protective effect on the early steroid-induced osteonecrosis of the femoral head in rabbits, which can decrease osteocytes apoptosis, improve the bone microstructure, and delay such disease processes.


Assuntos
Cabeça do Fêmur , Animais , Modelos Animais de Doenças , Necrose da Cabeça do Fêmur , Flavonoides , Metilprednisolona , Coelhos
12.
Skeletal Radiol ; 47(12): 1587-1593, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29725712

RESUMO

OBJECTIVE: Dual-energy CT (DECT) is being widely used in suspected gout patients in recent years. Many clinicians tend to use DECT instead of aspiration biopsy in the diagnosis of gout, but its accuracy has shown controversial results. In this systematic review and meta-analysis, we sought to evaluate the accuracy of DECT in the diagnosis of gout. MATERIALS AND METHODS: We performed a systematic review of the literature published in Medline, Embase, PubMed, and Cochrane databases. Studies included are all clinical trials of DECT in the diagnosis of gout. Quality assessment of bias and applicability was conducted using the Quality of Diagnostic Accuracy Studies-2 (QUADAS-2). We recorded sensitivity and specificity of algorithms and calculated positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odd ratio (DOR), and respective confidence intervals (CI). The summary receiver operating characteristic curve (sROC) was drawn to get the Cochran Q-index and the area under the curve (AUC). RESULTS: Seven studies were included in this review and showed high homogeneity. The analysis results presented the pooled sensitivity was 88% (95% CI 84-90%) and specificity was 90% (95% CI 85-93%). Then, we figured out that the pooled PLR was 8.48 (95% CI 5.89-12.22) and NLR was 0.10 (95% CI 0.04-0.24) respectively. In addition, Cochran-Q was 0.90 and AUC was 0.9565 in sROC curve. CONCLUSIONS: DECT showed relatively high sensitivity and specificity in the diagnosis of gout. Synthetically considering these DECT abnormalities could improve the diagnostic sensitivity. More rigorous and standardized studies are still needed to support these findings.


Assuntos
Gota/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Humanos
13.
Medicine (Baltimore) ; 97(5): e9796, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29384878

RESUMO

Bone marrow edema (BME) represents a reversible but highly painful finding in magnetic resonance imaging (MRI) of patients with knee osteoarthritis. The aim of this retrospective study was to evaluate the efficacy of extracorporeal shock wave treatment (ESWT) on painful BME in osteoarthritis of the knee.This study focuses on people who had early-to-mid stage osteoarthritis with knee pain and MRI findings of BME. Patients who underwent ESWT treatment or prescribed alendronate treatment in our department were analyzed. Knee pain and function were measured using the visual analog scale (VAS) for pain and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), respectively. The degree of BME was measured with MRI scans.A total of 126 patients who received ESWT treatment (Group A, n = 82) or alendronate treatment (Group B, n = 44) were included. All patients were followed up clinically and radiographically for a minimum of 12 months. The mean follow-up was 23.5 months (range, 12-38 months). The VAS and WOMAC score decreased more significantly after treatment in Group A than that in Group B (P <.01) within 3 months. In 6-month MRI follow-ups, there was higher incidence of distinct reduction and complete regression of BME of the affected knee in Group A than that in Group B (P <.01).ESWT is an effective, reliable, and noninvasive treatment in patients with painful BME in osteoarthritis of the knee followed by a rapid normalization of the MRI appearance. It has the potential to shorten the natural course of this disease.


Assuntos
Doenças da Medula Óssea/terapia , Edema/terapia , Tratamento por Ondas de Choque Extracorpóreas , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/terapia , Adulto , Idoso , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/etiologia , Edema/diagnóstico por imagem , Edema/etiologia , Feminino , Estudo Historicamente Controlado , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/diagnóstico por imagem , Medição da Dor , Estudos Retrospectivos , Resultado do Tratamento
14.
Medicine (Baltimore) ; 96(25): e7326, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28640148

RESUMO

BACKGROUND: Red blood cell (RBC) transfusions are commonly used in surgical patients, but accompanied by many risks such as metabolic derangement, and allergic and febrile reactions. Indications for transfusion in patients after hip or knee surgery have not been definitively evaluated and remain controversial. We performed a meta-analysis to compare the benefits and harms of restrictive versus liberal transfusion strategies in patients after hip or knee surgery. METHODS: The PubMed, EMBASE, and Cochrane Library databases were searched for relevant studies through September 2015. The main clinical outcomes reported in randomized controlled trials (RCTs) included 30-day mortality, infection rate, cardiogenic complications, and length of hospital stay. The meta-analysis program of the Cochrane Collaboration (RevMan version 5.3.0) was used for data analysis. Statistical heterogeneity was assessed by both Cochran chi-squared test (Q test) and I test. Begg and Egger test were used to assess potential publication bias. RESULTS: We identified 10 eligible RCTs, involving 3788 patients in total. In patients undergoing hip or knee surgery, we found no differences in mortality, or the incidence rates of pneumonia, wound infection, myocardial infarction, or congestive heart failure, between restrictive and liberal thresholds for RBC transfusion (P > .05). CONCLUSION: Restrictive transfusion has no advantage over the liberal strategy. However, considerably less patients received blood transfusion via the restrictive strategy than with the liberal counterpart. Due to variations in the included studies, additional larger scale and well-designed studies are required to validate these conclusions.


Assuntos
Transfusão de Eritrócitos/métodos , Quadril/cirurgia , Joelho/cirurgia , Procedimentos Ortopédicos , Transfusão de Eritrócitos/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Spine (Phila Pa 1976) ; 42(2): E128-E129, 2017 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-28072638
16.
Spine (Phila Pa 1976) ; 41(11): E700-E701, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27054456
17.
Spine (Phila Pa 1976) ; 40(23): 1816-23, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26571063

RESUMO

STUDY DESIGN: A meta-analysis of published randomized controlled Trials (RCTs). OBJECTIVE: The aim of this study was to compare the efficacy and safety of cervical disc arthroplasty (CDA) with anterior cervical discectomy and fusion (ACDF) for the treatment of one-level cervical degenerative disc disease (CDDD). SUMMARY OF BACKGROUND DATA: ACDF has been widely performed for the treatment of CDDD. However, the loss of motion at the operated level has been hypothesized to accelerated adjacent-level disc degeneration. CDA is designed to avoid the side effect of fusion. However, it is still uncertain whether CDA is more effective and safer than ACDF. METHODS: We performed a meta-analysis of published RCTs to examine whether there was a superior clinical effects of CDA than ACDF. A PubMed database search through October 2014 was performed for relevant studies. We included RCTs that reported relevant data in the treatment of one-level CDDD, which were suitable for detailed extraction of data. RESULTS: We identified 18 RCTs eligible for analysis. The results of the meta-analysis indicated longer operative times, more blood loss, lower neck and arm pain scores reported on a visual analog scale (VAS), better neurological success, greater motion at the operated level, fewer secondary surgical procedures in the CDA group than in the ACDF group (P < 0.05). The 2 groups had similar lengths of hospital stay, Neck Disability Index scores, and rates of adverse events (P > 0.05). CONCLUSIONS: Findings of the present meta-analysis indicated that CDA was an effective and safe surgical procedure for the treatment of one-level CDDD, and CDA was found to be more superior than ACDF in terms of VAS neck and arm pain, neurological success, range of motion at the operated level, and secondary surgical procedures. LEVEL OF EVIDENCE: 1.


Assuntos
Artroplastia , Vértebras Cervicais/cirurgia , Discotomia , Degeneração do Disco Intervertebral/cirurgia , Artroplastia/efeitos adversos , Artroplastia/métodos , Artroplastia/estatística & dados numéricos , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Discotomia/efeitos adversos , Discotomia/métodos , Discotomia/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Cervicalgia , Duração da Cirurgia , Medição da Dor
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