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2.
Chin J Integr Med ; 28(11): 963-970, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35840851

RESUMO

OBJECTIVE: To assess the efficacy and safety of Bushen Huoxue Formula (BSHXF) for the treatment of discogenic low-back pain (DLBP). METHODS: This was a parallel, double-blind, randomized, clinical trial performed between May 2019 and June 2020. Seventy patients were assigned by computerized random number table to the treatment group (lumbar traction and BSHXF, 35 cases) or the control group (lumbar traction and placebo, 35 cases). The patients received intervention for 3 weeks. Assessment was conducted before treatment and at week 1, 2, 3 during treatment. Primary outcome was the self-reported score of Oswestry Disability Index (ODI). Secondary outcomes included Visual Analog Scale (VAS), clinical efficacy rate by minimal clinically important difference (MCID) as well as lumbar tenderness, muscle tone and lumbar spine mobility. Adverse reactions were recorded. Follow-up was performed at 1 and 3 months after the end of treatment. RESULTS: In the treatment group, ODI score was significantly decreased compared with baseline (P<0.05) and the control group at 2- and 3- week treatment. Similarly, VAS score decreased compared with the baseline (P<0.05) and was lower than that in the control group at 2- and 3- week treatment (P<0.05). The clinical efficacy rate of the treatment group was higher than that of the control group after treatment [32.35% (11/34) vs. 3.13% (1/32), P<0.05). Moreover, the tenderness, and muscle tone, as well as the back extension and left flexion in lumbar spine mobility in the treatment group at 3-week treatment were significantly improved compared with the control group (P<0.05). Follow-up showed that at 1-month after treatment, the treatment group had better outcomes than the control group with regard to a total score of ODI and VAS scores, as well as clinical efficacy rate (all P<0.05). Moreover, VAS score was still significantly lower than the control group at 3-month follow-up (P<0.05). No adverse reactions were reported during the study. CONCLUSION: BSXHF combined with lumbar traction can significantly improve the clinical symptoms including pain intensity, functionality, muscle tone, and lumbar spine mobility in DLBP patients. (Registration No. ChiCTR1900027777).


Assuntos
Degeneração do Disco Intervertebral , Dor Lombar , Humanos , Degeneração do Disco Intervertebral/terapia , Dor Lombar/tratamento farmacológico , Vértebras Lombares , Medição da Dor , Resultado do Tratamento
3.
Zhongguo Gu Shang ; 34(10): 928-3, 2021 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-34726021

RESUMO

OBJECTIVE: To evaluate the effect of degenerative scoliosis on the difficulty and efficacy of minimally invasive transforaminal lumbar interbody fusion(MIS-TLIF) in the treatment of lumbar spinal stenosis. METHODS: From September 2016 to September 2019, 52 patients with lumbar spinal stenosis treated by MIS-TLIF were retrospectively analyzed, including 16 males and 36 females, aged from 42 to 71(63.44±5.96) years old, the course of disease from 1.5 to 6.5 years, with an average of (3.69±1.10) years. All patients had lower extremity root pain or numbness, 41 patients had intermittent claudication. There were 31 cases of L4, 5 and 21 cases of L5S1. There were 18 cases in scoliosis group, lumbar spinal stenosis combined withdegenerative scoliosis, and 34 cases in stenosis group, lumbar spinal stenosis alone. The perioperative data and postoperative complications were recorded, the postoperative interbody fusion was evaluated by CT, and the clinical outcomes were evaluated by VAS score, Oswestry Disability Index (ODI). RESULTS: All patients were followed up for 12 to 36 months, with an average of (19.58±5.33) months. The operation time and intraoperative bleeding in stenosis group were better than those in scoliosis group (P<0.05). There were no significant differences in postoperative drainage volume, postoperative Hb, CRP, postoperative landing time, discharge time, VAS score at discharge and follow-up, ODI score at 3 months and follow up, postoperative complications and interbody fusion rate between two groups (P>0.05). CONCLUSION: For patients with lumbar spinal stenosis undergoing MIS-TLIF, degenerative scoliosis can lead to prolonged operation time and increased bleeding. However, it has no significant effect on therelief of postoperative symptoms, postoperative complications and the recovery of lumbar function.


Assuntos
Escoliose , Fusão Vertebral , Estenose Espinal , Adulto , Idoso , Feminino , Humanos , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Retrospectivos , Escoliose/cirurgia , Estenose Espinal/cirurgia , Resultado do Tratamento
4.
Spine (Phila Pa 1976) ; 46(7): 421-432, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33186278

RESUMO

STUDY DESIGN: An ex vivo study of the rabbit's vertebral endplate. OBJECTIVE: The aim of this study was to assess the effect of axial compression and distraction on vascular buds and vascular endothelial growth factor (VEGFA) expression of the vertebral endplate (VEP). SUMMARY OF BACKGROUND DATA: The abnormal load can lead to intervertebral disc degeneration (IDD), whereas axial distraction can delay this process. The effects of different mechanical loads on the intervertebral disc (IVD) have been hypothesized to be related to changes in the vascular buds of the VEP; moreover, the process that might involve the vascular endothelial growth factor (VEGF) within the VEP. METHODS: Rabbit spinal segments (n = 40) were harvested and randomly classified into four groups: Control group, no stress was applied; Group A, a constant compressive load applied; Group B, compression load removed for a fixed time daily on a continuous basis, and substituted with a distraction load for 30 minutes; and Group C, compression removed for 30 minutes for a fixed period daily on a continuous basis. Tissue specimens were collected before the culture (day 0) and on day 14 post-culture of each group for analysis of IVDs' morphology, and protein and mRNA expression of Aggrecan, COL2al, VEGFA, and vascular endothelial growth factor receptor 2 of the VEPs. RESULTS: Application of axial distraction and dynamic load compression significantly delayed time- and constant compression-mediated VEP changes and IDD. Moreover, the degree of degeneration was associated with loss of vascular buds, as well as the downregulation of VEGFA and its receptor. CONCLUSION: The regulation of vascular buds and VEGF expression in the VEP represents one of the mechanisms of axial distraction and dynamic loading.Level of Evidence: N/A.


Assuntos
Deslocamento do Disco Intervertebral/metabolismo , Disco Intervertebral/metabolismo , Vértebras Lombares/metabolismo , Amplitude de Movimento Articular/fisiologia , Compressão da Medula Espinal/metabolismo , Fator A de Crescimento do Endotélio Vascular/biossíntese , Animais , Degeneração do Disco Intervertebral/genética , Degeneração do Disco Intervertebral/metabolismo , Deslocamento do Disco Intervertebral/genética , Masculino , Pressão/efeitos adversos , Coelhos , Compressão da Medula Espinal/genética , Fator A de Crescimento do Endotélio Vascular/genética , Suporte de Carga/fisiologia
5.
PLoS One ; 15(6): e0234747, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584845

RESUMO

SUMMARY OF BACKGROUND DATA: The vascular buds in the vertebral endplate (VEP) are the structural foundation of nutrient exchange in the intervertebral disc (IVD). VEGF is closely related to angiogenesis in the endplate and intervertebral disc degeneration (IDD). OBJECTIVE: To investigate the effects of static load on vascular buds and VEGF expression in the VEP and to further clarify the relation between IDD and VEGF. METHODS: IVD motion segments were harvested from rabbit lumbar spines and cultured under no-loading conditions (controls) or in custom-made apparatuses under a constant compressive load (0.5 MPa) for up to 14 days. Tissue integrity and the number of vascular buds were determined, and the concentrations and expression of Aggrecan, COL2a1, and VEGFA in the VEPs were assessed after 3, 7, and 14 days of culturing and then compared with those of fresh tissues. RESULTS: Under the constant compression, the morphological integrity of the VEPs was gradually disrupted, and immunohistochemistry results showed a significant decrease in the levels of Agg and COL2a1. During the static load, the number of vascular buds in the VEPs was gradually reduced from the early stage of culture, and ELISA showed that the constant compressive load caused a significant decrease in the VEGFA and VEGFR2 protein concentrations, which were consistent with the immunohistochemistry results. Western blot and RT-PCR results also showed that the loading state caused a significant decrease in VEGFA expression compared with that of fresh and control samples. CONCLUSIONS: Constant compression caused degeneration of the VEP as well as a decreased number of vascular buds, thereby accelerating disc degeneration. VEGFA is involved in this process. We anticipate that regulating the expression of VEGFA may improve the condition of the lesions to the vascular buds in the endplates, thus enhancing the nutritional supply function in IVD and providing new therapeutic targets and strategies for the effective prevention and treatment of IDD.


Assuntos
Vasos Sanguíneos/fisiologia , Regulação da Expressão Gênica , Disco Intervertebral/irrigação sanguínea , Disco Intervertebral/metabolismo , Estresse Mecânico , Fator A de Crescimento do Endotélio Vascular/metabolismo , Animais , Técnicas de Cultura , Masculino , Coelhos
6.
Zhongguo Zhong Yao Za Zhi ; 45(5): 1159-1166, 2020 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-32237460

RESUMO

To evaluate the clinical efficacy and safety of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation, in order to provide evidence for its clinical application. PubMed, Cochrane Library, EMbase, CNKI, WanFang, VIP, CBM and Clinical Trials.gov databases were sysmatically retrieved. Two researchers independently searched, screened and extracted data. Randomized controlled trials in line with the inclusion criteria were included in the study. The article quality was assessed with the bias risk tool in the Cochrane Handbook. Meta-analysis was performed using RevMan 5.3. A total of 604 articles were obtained from the retrieval, and 824 patients in 9 studies were finally selected through screening. The course of treatment was about 1 month, and all of the studies were completed in China. Meta-analysis showed that the efficacy of Shentong Zhuyu Decoction in the treatment of lumbar disc herniation was better than that of the control group(RR=1.19, 95%CI[1.12, 1.26], P<0.000 01), including the comparison with Yaotongning Capsules(RR=1.10, 95%CI[1.02, 1.19], P=0.01) and diclofenac sodium tablets(RR=1.26, 95%CI[1.11, 1.44], P=0.000 4). In VAS pain score, Shentong Zhuyu Decoction had also obvious advantages(MD=-3.70, 95%CI[-6.31,-1.09], P=0.005). In addition, the number of adverse events in the Shentong Zhuyu Decoction group was lower than that in the control group. Shentong Zhuyu Decoction can effectively alleviate discomfort symptoms of patients with LDH. It has an obvious clinical efficacy and less adverse reactions. However, restricted by the quality of the included literatures, prospective, multi-center, large-sample-size randomized controlled trials are still needed to further improve the clinical evidence of the effect of Shentong Zhuyu Decoction in the treatment of LDH.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Deslocamento do Disco Intervertebral/tratamento farmacológico , China , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Zhongguo Gu Shang ; 32(9): 802-806, 2019 Sep 25.
Artigo em Chinês | MEDLINE | ID: mdl-31615174

RESUMO

OBJECTIVE: To explore the influence of individual characteristics of patients on the kinematics parameters of sitting lumbar spine manipulation. METHODS: From January 2016 to December 2016, 30 patients with degenerative lumbar spondylolisthesis were treatede, including 18 males and 12 females, aged from 45 to 61(52.33±2.34) years old, with a course of 2 to 72(29.13±3.23) months. Motion capture technique was used to measure the kinematics parameters of the same manipulator in sitting lumbar spine manipulation for 30 patients, including rotation time, maximum speed and maximum acceleration. The parameters of the left and right hands of the operator were different. The effects of individual characteristics on the kinematics parameters of sitting lumbar spine manipulation were analyzed. RESULTS: The kinematic and mechanical parameters of manipulation were as follows:spin time, maximum speed, maximum acceleration, the manipulation done by right or left hand showed the similar parameters(P>0.05). According to multivariate linear regression, there was a significant correlation between the age of the patient and the rotation time of the operator(P<0.01); the height of patient had a significant correlation with the maximum speed and maximum acceleration of the operator(P<0.01). CONCLUSIONS: There is no difference between the manipulation of left and right hand in clinical application. Age and height are important influencing factors of sitting lumbar rotation manipulation.


Assuntos
Manipulação da Coluna , Postura Sentada , Fenômenos Biomecânicos , Feminino , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular
8.
Orthop Surg ; 11(3): 500-509, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31243925

RESUMO

OBJECTIVES: To establish a dynamic three-dimensional (3D) model of upper cervical spine instability and to analyze its biomechanical characteristics. METHODS: A 3D geometrical model was established after CT scanning of the upper cervical spine specimen. The ligament of the specimen was fatigued to establish the upper cervical spine-instability model. A 100-N preloaded stress was applied to the upper surface of the occipital bone, and then a 1.5-Nm moment was applied in the occipital-sagittal direction to simulate upper cervical spine flexion and extension. Subsequently, the 3D dynamic model was established based on trajectory data that were measured using a motion-capture system. The stress on the main ligament and the relative motion angle of the joint were analyzed. RESULTS: The shape of the model grid was regular and the total number of its units was 627 000. After finite-element analysis was conducted, results of the ligament stress and relative movement angle were obtained. After the upper cervical spine instability, the pressure of the alar ligament during the upper cervical spine extension was increased from 2.85 to 8.12 MPa. The pressure of the flavum ligament was increased during the upper-cervical spine flexion, from 0.90 to 1.21 MPa. The pressure of the odontoid ligament was reduced during the upper cervical spine flexion and extension, from 10.46 to 6.67 MPa and 25.66 to 16.35 MPa, respectively. The pressure of the anterior longitudinal ligament and cruciate ligament was increased to a certain degree during upper cervical spine flexion and extension. The pressure of the anterior longitudinal ligament was increased during flexion and extension, from 7.70 to 10.10 MPa and 10.45 to 13.75 MPa, respectively. The pressure of the cruciate ligament was increased during flexion and extension, from 2.29 to 4.34 MPa and 2.32 to 4.40 MPa, respectively. In addition, after upper cervical spine instability, the articular-surface relative-movement angle of the atlanto-occipital joint and atlanto-axial joint had also changed. During upper cervical spine flexion, the angle of the atlanto-occipital joint was increased from 3.49° to 5.51°, and the angle of the atlanto-axial joint was increased from 8.84° to 13.70°. During upper cervical spine extension, the angle of the atlanto-occipital joint was increased from 11.16° to 12.96°, and the angle of the atlanto-axial joint was increased from 14.20° to 17.20°. Therefore, the movement angle of the atlanto-axial joint was most obvious after induction of instability. CONCLUSION: The 3D dynamic finite-element model of the upper cervical spine can be used to analyze and summarize the relationship between the change of ligament stress and the degree of instability in cervical instability. Frequent or prolonged flexion activities are more likely to lead to instability of the upper cervical spine.


Assuntos
Vértebras Cervicais/fisiopatologia , Análise de Elementos Finitos , Imageamento Tridimensional , Instabilidade Articular/fisiopatologia , Modelos Anatômicos , Tomografia Computadorizada por Raios X , Fenômenos Biomecânicos , Vértebras Cervicais/diagnóstico por imagem , Humanos , Instabilidade Articular/diagnóstico por imagem
9.
Zhongguo Gu Shang ; 31(7): 627-634, 2018 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-30103586

RESUMO

OBJECTIVE: To compare effect of serum of Bushen Huoxue prescription on rabbit with intervertebral disc motion segments in vitro culture. METHODS: Twenty-four New Zealand white rabbits aged from 4 to 6 months and weighted from 2.5 to 3 kg were divided into medicated group and control group, 7 in each group. Rabbits were excuted under condition of asepsis, 28 spinal motion segments were taken out in each group, and segments were loaded in spinal motion segments in vitro and cultured in culture apparatus. Nutrient solution of medicated group contain 10% serum of Bushen Huoxue prescription, and 10% blank serum in control group. Seven discs between two groups were taken out and observed by histomorphology, proteoglycan PAS/AB stining, collagen II immunohistochemical staining, AGG, Col2aI by PCR test before culture and on the 3th, 7th and 14th day after culture. RESULTS: Histomorphology results showed the formation of medicated group was better than that of control group at 1 week after culture. PAB/AB test results showed content of poteoglycan between two groups were decreased. Imunohistochemical results showed content of collagen II in medicated group were obviously increased than that of control group at 3 days, but decreased obviously at 1 week than that of control group. PCR results showed expression of Agg in medicated group was obviously decreased than that of control group, but no statistical significance between two groups on the 7 th and 14 th day. Expression of Col2aI between two groups at 3 days were increased, and medicated group increased obviously more, while there were no significant difference between two groups. CONCLUSIONS: Serum of Bushen Huoxue prescription could delay intervertebral disc degeneration at short time for it is relate with improving circulation, inhibiting inflammatory, regulating extracellular matrix, so the prescription plays an important role in early prevention and treatment for intervertebral disc degeneration.


Assuntos
Degeneração do Disco Intervertebral , Disco Intervertebral , Animais , Medicamentos de Ervas Chinesas , Matriz Extracelular , Coelhos
10.
Zhongguo Gu Shang ; 30(3): 241-246, 2017 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-29349963

RESUMO

OBJECTIVE: To evaluate the stability of teaching robot of rotation-traction manipulation. METHODS: Operators were required to get the hang of rotation-traction manipulation and had clinical experience for over 5 years. The examination and data processing of the ten operators in our research were collected by the teaching robot of rotation-traction manipulation. Traction, pulling force, maximum force, pulling time, rotational amplitude and pitch range were recorded and compared for five times(G1, G2, G3, G4 and G5). The qualification rates were analyzed to evaluate the stability of teaching robot of rotation-traction manipulation. RESULTS: Nonconforming items were found in G1 and G2, for instance, pulling force(P=0.074), maximum force(P=0.264) and rotational amplitude (P=0.531). There was no statistically difference. None nonconforming item was found in G3, G4 and G5. All data were processed by SPSS and One-way ANOVA was used to analysis. Pulling force was found statistically different in G1, compared with G4 and G5(P=0.015, P=0.006). Maximum force was found statistically different in G1, compared with G4 and G5 (P=0.021, P=0.012). None differences were found in other comparisons (P>0.05). CONCLUSIONS: The teaching robot of rotation-traction manipulation used in our research could provide objective and quantitative indices and was considered to be an effective tool of assessing the rotation-traction manipulation.


Assuntos
Manipulações Musculoesqueléticas/métodos , Robótica , Rotação , Tração , Manipulações Musculoesqueléticas/instrumentação , Pesquisa
11.
Biomed Res Int ; 2016: 2481712, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27872846

RESUMO

The development of mechanically active culture systems helps in understanding of the role of mechanical stress in intervertebral disc (IVD) degeneration. Motion segment cultures facilitate the application and control of mechanical loads. The purpose of this study was to establish a culturing method for rabbit IVD motion segments to observe the effect of static load on the whole disc organ. Segments were cultured in custom-made apparatuses under a constant, compressive load (3 kg) for 2 weeks. Tissue integrity, matrix synthesis, and matrix gene expression profile were assessed and compared with fresh one. The results showed ex vivo culturing of samples gradually destroyed the morphology. Proteoglycan contents and gene expression were decreased and downregulated obviously. However, immunohistochemical staining intensity and collagen type II gene expression were significantly enhanced and upregulated. In contrast, these trends were reversed under constant compression. These results indicated short-term static load stimulated the synthesis of type II collagen; however, constant compression led to progressive degeneration and specifically to proteoglycan. Through this study a loading and organ-culturing system for ex vivo rabbit IVD motion segments was developed, which can be used to study the effects of mechanical stimulation on the biology of IVDs and the pathomechanics of IVD degeneration.


Assuntos
Colágeno Tipo II/biossíntese , Matriz Extracelular/metabolismo , Regulação da Expressão Gênica , Degeneração do Disco Intervertebral/metabolismo , Disco Intervertebral/metabolismo , Estresse Mecânico , Animais , Modelos Animais de Doenças , Matriz Extracelular/patologia , Disco Intervertebral/patologia , Disco Intervertebral/fisiopatologia , Degeneração do Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/fisiopatologia , Coelhos , Suporte de Carga
12.
Chin Med J (Engl) ; 129(19): 2338-46, 2016 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-27647194

RESUMO

BACKGROUND: The development of mechanically active culture systems helps increase the understanding of the role of mechanical stress in intervertebral disc (IVD) degeneration. Motion segment cultures allow for preservation of the native IVD structure, and adjacent vertebral bodies facilitate the application and control of mechanical loads. The purpose of this study was to establish loading and organ culture methods for rabbit IVD motion segments to study the effect of static load on the whole disc organ. METHODS: IVD motion segments were harvested from rabbit lumbar spines and cultured in no-loading 6-well plates (control conditions) or custom-made apparatuses under a constant, compressive load (3 kg, 0.5 MPa) for up to 14 days. Tissue integrity, matrix synthesis, and the matrix gene expression profile were assessed after 3, 7, and 14 days of culturing and compared with those of fresh tissues. RESULTS: The results showed that ex vivo culturing of motion segments preserved tissue integrity under no-loading conditions for 14 days whereas the static load gradually destroyed the morphology after 3 days. Proteoglycan contents were decreased under both conditions, with a more obvious decrease under static load, and proteoglycan gene expression was also downregulated. However, under static load, immunohistochemical staining intensity and collagen Type II alpha 1 (COL2A1) gene expression were significantly enhanced (61.54 ± 5.91, P = 0.035) and upregulated (1.195 ± 0.040, P = 0.000), respectively, compared with those in the controls (P < 0.05). In contrast, under constant compression, these trends were reversed. Our initial results indicated that short-term static load stimulated the synthesis of collagen Type II alpha 1; however, sustained constant compression led to progressive degeneration and specifically to a decreased proteoglycan content. CONCLUSIONS: A loading and organ culture system for ex vivo rabbit IVD motion segments was developed. Using this system, we were able to study the effects of mechanical stimulation on the biology of IVDs, as well as the pathomechanics of IVD degeneration.


Assuntos
Disco Intervertebral/metabolismo , Disco Intervertebral/fisiologia , Núcleo Pulposo/metabolismo , Núcleo Pulposo/fisiologia , Técnicas de Cultura de Órgãos/métodos , Estresse Mecânico , Animais , Regulação da Expressão Gênica , Imuno-Histoquímica , Degeneração do Disco Intervertebral/metabolismo , Degeneração do Disco Intervertebral/fisiopatologia , Masculino , Coelhos
13.
Zhongguo Gu Shang ; 28(9): 824-31, 2015 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-26647565

RESUMO

OBJECTIVE: To compare the changes of nucleus pulposus after in vitro culture of rabbit whole intervertebral disc and spinal motion segment. METHODS: Twenty-one New Zealand white rabbits which were randomly divided into organ group with 8 rabbits and segment group with 13 rabbits. Fifty intervertebral discs and 50 spinal motion segments were harvested respectively under aseptic conditions from two groups. These specimens were maintained in organ culture with hyperosmotic media (410 mOsm/kg), then 10 discs of the two groups were observed respectively by HE staining, immunohistochemistry of collagen type III, proteoglycan content and cells viability of nucleus pulposus before culture and at 3, 7, 14, 21 days after culture. RESULTS: HE staining showed the intervertebral disc tissue structure remained intact after culture of 21 days organ group and 14 days segment group,but there was severely degenerated of 21 days segment group. The intensity value of type II collagen immunohistochemical staining in the nucleus pulposus were not changed significantly between 21 days organ group and 14 days segment group (P > 0.05), but the staining of segment group at 21 days became shallower, there was significant difference compared with before each time points and organ group at 21 days (P < 0.05). PAS/AB staining of proteoglycan of nucleus pulposus showed that there were not decrease of tinting strength of two groups within 7 days, but the strength weakened slightly of two groups at 14 days, and the tinting strength became weaker at 21 days segment group, the change is more obvious than the organ group. The intensity value of fluorescence staining of nucleus pulposus cells was not changed significantly within 7 days of two groups (P > 0.05), the intensity value decreased slightly at 21 days organ group and 14 days segment group, but there were no significant difference compared with before time points (P > 0.05) however at 21 days segment group the intensity decreased as cells viability of nucleus pulposus decreased,and there was a significant difference compared with before each time points and organ group at 21 days (P < 0.05). CONCLUSION: It is not obviously degenerated of the discs of organ group cultured within 21 days and segment group cultured within 14 days, but there was significant degeneration of the intervertebral disc of segment group after cultured 21 days, so the rabbit spinal motion segment can be used on research about the biomechanics of intervertebral disc as a vitro experimental model within 14 days.


Assuntos
Disco Intervertebral/patologia , Animais , Colágeno Tipo II/análise , Feminino , Imuno-Histoquímica , Disco Intervertebral/química , Masculino , Técnicas de Cultura de Órgãos , Coelhos
14.
Zhongguo Gu Shang ; 28(4): 330-4, 2015 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-26072615

RESUMO

OBJECTIVE: To improve the X-ray diagnosis of cervical spondylosis of vertebral artery type (VCS). METHODS: A blinded design research. The X-ray signs both 60 patients with VCS and 60 patients with cervical spondylotic radiculopathy were collected from January 2011 to November 2012. There were 36 males and 84 females, aged from 25 to 65 years old with an average of (48.4 ± 12.3) years old. Cervical curvature, atlanto-occipital joint angle, atlanto-axial joint angle, C2/C3 joint angle and lower cervical instability condition and segmental distribution were measured and recorded by X-rays. These data were analyzed and compared between the two groups after unblended. Combined with clinical manifestations,the X-ray imaging features of VCS were further analyzed. RESULTS: There was significant difference in cervical curvature between two groups in anteflexion X-ray films (P < 0.05). There was significant difference in extension degree of atlanto-occipital joint angle between two groups (P < 0.01). There was significant difference in atlanto-axial joint angle between two groups in lateral X-ray films (P< 0.05). There was significant.difference in anteflexion degree of atlanto-axial joint angle between two groups (P < 0.05). There was no significant difference in C2/C3 joint angle between two groups. There was no significant difference in the lower cervical instability condition and segmental distribution between two groups. In VCS group, the mild and moderate dizziness was main symptom, flexion and extension activities of neck was most common cause in the dizziness; and always accompanied with headache; tenderness mostly concentrated in the upper cervical area. CONCLUSION: Both X-ray signs and clinical manifestations can prompt the abnormalities of the upper cervical structure or function in patients with VCS. Anteflexion activities of neck observed by functional position of X-ray films should be emphasized in diagnosis of VCS.


Assuntos
Radiculopatia/diagnóstico por imagem , Espondilose/diagnóstico por imagem , Artéria Vertebral , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Raios X
15.
Zhongguo Gu Shang ; 27(6): 513-7, 2014 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-25241474

RESUMO

OBJECTIVE: To evaluate clinical significance of waist soft tissue tension detection in treating chronic nonspecific low back pain. METHODS: From August 2011 to March 2012,60 patients with chronic nonspecific low back pain were divided into two groups (sliver needle group and TCM fumigation group) according to propotion of 1:1. In sliver needle group, there were 17 males and 13 females aged from 28 to 55 years old with an average age of (45.70 +/- 4.15), treated with sliver needle; In TCM fumigation group,there were 19 males and 11 females aged from 27 to 55 years old with an average age of (43.03 +/- 5.86), treated with TCM fumigation. Changes of force-displacement distance (FDD), specific absorption rate (S) of two groups were observed before treatment, 1 week and 3 months after treatment respectively, VAS scoring and Roland-Morris disability questionnaire (RMDQ) were used to access clinical effects. RESULTS: (1) VAS score of silver needle group was 4.77 +/- 0.78, 1.99 +/- 1.08 and 2.55 +/- 0.94, respectively before treatment, at 1 week and 3 months after treatment,while VAS score in TCM fumigation group were 4.43 +/- 0.61, 2.48 +/- 0.71 and 3.05 +/- 0.86, respectively. VAS score of two groups after treatment were sigificant decrease than that of before treatment (P < 0.05). There was no sigificant differences between two groups before treatment, but sliver needle group performed well in analgesia than TCM fumigation group, and had obvious differences (P < 0.05). RMDQ score of silver needle group was 13.63 +/- 1.96, 5.87 +/- 2.33 and 6.53 +/- 2.89, respectively before treatment, at 1 week and 3 months after treatment, while RMDQ score in TCM fumigation group were 13.40 +/- 2.01, 6.90 +/- 2.31, 9.23 +/- 2.87, respectively. There was no significant differences between two groups before treatment and 1 week after treatment (P > 0.05), and had obvious differences between two groups at 3 months after treatment (P < 0.01). Both groups could obvious improve dysfunction caused by chronic low back pain, and curative effect of sliver needle groups was more endurable. (2) Following-up at 3 months after treatment, FDD of multifidus, erector spinae of effected side and multifidus of healthy in sliver needle group were obvious increased (P < 0.05); In TCM fumigation group, FDD of multifidus and erector spinae on both side were increased at 1 week after treatment (P < 0.05), but had no significant meaning at 3 months after treatment on health side (P>0.05). There was no significant meaning before treatment (P > 0.05), FDD of multifidus, erector spinae of effected side in sliver needle group were obvious increased at 1 week after treatment (P < 0.05); but no obvious meaning on health side. FDD of both side in sliver needle group were obvious increased at 3 months after treatment. (3) There was correlation among differences of FDD in multifidus and erector spinae, VAS score and differences of RMDQ, and Spearman correlation coefficient R was 0.517, 0.811, 0.746 and 0.625; There was correlation between items of soft tissue tension and sympotoms, function and life quality. Conclusion:Soft tissue tension detection can effectively manifest degree of pain and dysfunction of low back, and improve objectivity of therapeutic evaluation for chronic low back pain.


Assuntos
Terapia por Acupuntura , Medicamentos de Ervas Chinesas/administração & dosagem , Dor Lombar/terapia , Terapia por Acupuntura/instrumentação , Adulto , Idoso , Medicamentos de Ervas Chinesas/química , Feminino , Humanos , Dor Lombar/tratamento farmacológico , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tono Muscular/efeitos dos fármacos , Agulhas , Músculos Paraespinais/efeitos dos fármacos , Músculos Paraespinais/fisiopatologia
17.
Zhongguo Gu Shang ; 24(4): 327-31, 2011 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-21604534

RESUMO

OBJECTIVE: To explore the effects of removing dampness and promoting diuresis method on autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats, in order to provide the basis for the treatment of lumbar disc herniation with Chinese medical immunotherapy. METHODS: Forty male Wistar rats were divided into 4 groups randomly according to body weight layer:sham operation group (group A), model contrast group (group B), colchicine tablets group (group C), modified Qingyao decoction group (group D). There were 10 rats in each group. Nucleus pulposus of coccygeal vertebra was transplanted to the gluteal muscle by operation in groups B, C, D, which can lead to autoimmune and immuno-inflammatory response of rats; the rats of group A were only treated with sham operation. At the 3rd day after operation, the rats were fed through intragastric administration, the group A and B with distilled water (10 ml/kg), the group C and D respectively with suspension of colchicine tablets (10 ml/kg, 0.01 mg/ml) and water-decocted liquid of modified Qingyao decoction (10 ml/kg,1.035 g/ml), once a day and continuous medication for 18 days. All rats were killed at the 21th day after operation. The immunoglobulin G (IgG), immunoglobulin M (IgM) and interleukin-1beta (IL-1beta), interleukin-8 (IL-8) level in serum of different groups were detected by ELISA method. At the same time, surrounding tissues of the transplanted nucleus pulposus were observed by pathological section. RESULTS: The level of IgG, IgM, IL-1beta, IL-8 in serum of group B was significantly higher than that of group A (P < 0.01), while the level of IgG, IgM, IL-1beta, IL-8 in serum of group C, D was significantly lower than that of group B (P < 0.05 or P < 0.01). Moreover, pathological section indicated that immuno-inflammatory response was hardly found in surgical site of group A, while local immuno-inflammatory response of surrounding tissues of the transplanted nucleus pulposus of group C and D was much lighter than that of group B. CONCLUSION: Removing dampness and promoting diuresis method could inhibit autoimmune and immuno-inflammatory response caused by nucleus pulposus of rats.


Assuntos
Autoimunidade , Deslocamento do Disco Intervertebral/imunologia , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Medicina Tradicional Chinesa , Animais , Modelos Animais de Doenças , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Interleucina-1beta/sangue , Interleucina-8/sangue , Deslocamento do Disco Intervertebral/patologia , Masculino , Ratos , Ratos Wistar
18.
Zhongguo Gu Shang ; 23(10): 750-3, 2010 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-21137285

RESUMO

OBJECTIVE: To observe the effects of two different therapies on patients whose cervical function were restricted due to cervical spondylotic radiculopathy. METHODS: Form April 2008 to October 2009, 71 cases with cervical spondylotic radiculopathy were divided into group A (36 cases) and group B (35 cases). Among them, 22 cases were male and 49 cases were female, ranging in age form 45 to 65 years with an average of 52.27 years, course of disease was from 3 days to 5 years. The patients in group A were treated with rotation-traction manipulation, neck pain particles and cervical rehabilitation exercises; and the patients in group B were treated with cervical traction, Diclofenac sodium sustained release tablets and wearing neck collar. Theapeutic time was two weeks. The cervical anteflexion, extension, left and right lateral bending, left and right rotative activity were measured by helmet-style activities instrument before and after treatment (at the 1, 3, 5, 7, 9, 11, 13 days and 1 month after treatment respectively). RESULTS: There were no difference between two groups in cervical activity in all directions before treatment (P > 0.05). Compared with the beginning, cervical anteflexion and extension showed significant difference at the 5th day after treatment in group A (P < 0.01). In group B, cervical anteflexion showed significant difference at the 13th day after treatment (P < 0.05), but at the 1 month after treatment, the significant difference disappeared (P > 0.05); cervical extension showed significant difference at the 7th day after treatment compared with the beginning (P < 0.05). Compared with the beginning,left lateral bending showed significant difference at the 1st day after treatment in group A (P < 0.05) and at the 5th day after treatment in group B (P < 0.01). Both in group A or B, right lateral bending, left and right rotative activity showed significant difference at the same time after treatment, either the 3rd day (P < 0.05) or the 5th day (P < 0.05). Compared between groups, cervical anteflexion, left and right lateral bending, left and right rotative activity showed significant difference at the 1 month after treatment (P < 0.05). CONCLUSION: The rotation-traction manipulation and neck pain particles and cervical rehabilitation exercises in treating cervicalspondylotic radiculopathy have quick effect to improve the activities of cervical anteflexion, extension, left lateral bending, and have durable effect to improve the activities of cervical spine in all directions.


Assuntos
Terapia por Exercício , Cervicalgia/terapia , Pescoço/patologia , Radiculopatia/terapia , Espondilose/terapia , Idoso , Vértebras Cervicais/fisiopatologia , Feminino , Humanos , Masculino , Manipulação da Coluna/métodos , Pessoa de Meia-Idade , Movimento (Física) , Cervicalgia/fisiopatologia , Medição da Dor , Postura , Radiculopatia/fisiopatologia , Rotação , Tração/métodos
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