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1.
Zhongguo Gu Shang ; 33(5): 414-9, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32452177

RESUMO

OBJECTIVE: To investigate the short-term and mid-term efficacy with non-surgical treatment and to predict the long-term outcomes of ruptured lumbar disc herniation. METHODS: From February 2011 to February 2014, 75 patients with single-segment ruptured lumbar disc herniation treated by non-surgical therapy were selected for prospective study. There were 53 males and 22 females, aged from 18 to 58 (35.62±9.96) years old. The course of disease was from 5 days to 6 months, with an average of (46.45±40.66) days. The lesions were located at L3,4 in 4 cases, at L4,5 in 29 cases, at L5S1 in 42 cases. Radiation pain in 46 cases on the left and 29 cases on the right. The JOA score, straight leg raising test angle and finger-to-ground distance were assessed pretreatment and at 3 months, 6 months, 1 year, 2 years and 5 years after treatment. The improvement rate of JOA at the final follow up (5 years after treatment) was calculated and the curative effect according to JOA score was evaluated;the volume change of protrusion before treatment and at the final follow-up (5 years after treatment) was analyzed, the volume absorption rate of protrusion was calculated and the absorption of protrusion was observed;the relationship between the improvement rate of JOA and the absorption rate of protrusion were analyzed. RESULTS: Seventy one patients were finally followed up at 5 years after non surgical treatment. The JOA score, straight leg raising test angle and finger to ground distance at 3 months, 6 months, 1 year, 2 years and 5 years after treatment were significantly improved (P<0.05). There was no significant difference in JOA scores between 5 years and 6 months after treatment, 5 and 2 years after treatment, and 2 years and 6 months after treatment (P>0.05). There was significant differencein other time points (P<0.05). The results of the straight leg raising test angle and the finger-to-ground distance were similar to the JOA scores. The improvement rate of JOA score was (62.69± 2.47)% at the final follow-up. According to JOA score, the results were excellent in 26 cases, good in 26 cases, fair in 14 cases, poor in 5 cases, and the excellent and good rate was 73.24%. The volume of protrusion decreased from (1 981.73±588.72) mm3 to (1 011.82±395.47) mm3, the total absorption rate was (45.65±2.83)%, the protrusion was obviously absorbed in 24 cases, partially absorbed in 26 cases, not absorbed in 19 cases, and increased in 2 cases. It was found that there was a positive correlation between improvement rate of JOA scores and protrusion absorption rate at 5 years after non surgical treatment (r= 0.679, P<0.001). CONCLUSION: Non-surgical treatment of ruptured lumbar disc herniation can achieve good results, clear the characteristics of the ruptured lumbar disc herniation and prognosis, and some patients have "reabsorption" phenomenon.

2.
Int J Oncol ; 56(2): 606-617, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894296

RESUMO

Abnormal metabolism serves a critical role in the development and progression of different types of malignancies including glioblastoma (GBM), and may therefore serve as a promising target for treatment of cancer. Preclinical studies have indicated that a ketogenic diet (KD) may exhibit beneficial effects in patients with GBM; however, the underlying mechanisms remain incompletely understood. The aim of the present study was to evaluate the effects of a KD on glioma stem­like cells (GSCs), by culturing patient­derived primary GSCs as well as a GSC cell line in glucose­restricted, ß­hydroxybutyrate­containing medium (BHB­Glow) which was used to mimic clinical KD treatment. GSCs cultured in BHB­Glow medium exhibited reduced proliferation and increased apoptosis compared with cells grown in the control medium. Furthermore, decreased expression of stem cell markers, diminished self­renewal in vitro, and reduced tumorigenic capacity in vivo, providing evidence that the stemness of GSCs was compromised. Mechanistically, culturing in BHB­Glow medium reduced glucose uptake and inhibited glycolysis in GSCs. Furthermore, culturing in the BHB­Glow medium resulted in morphological and functional disturbances to the mitochondria of GSCs. These metabolic changes may have reduced ATP production, promoted lactic acid accumulation, and thus, increased the production of reactive oxygen species (ROS) in GSCs. The expression levels and activation of mammalian target of rapamycin, hypoxia­inducible factor 1 and B­cell lymphoma 2 were decreased, consistent with the reduced proliferation of GSCs in BHB­Glow medium. ROS scavenging reversed the inhibitory effects of a KD on GSCs. Taken together, the results demonstrate that treatment with KD inhibited proliferation of GSCs, increased apoptosis and attenuated the stemness in GSCs by increasing ROS production.

3.
Zhongguo Gu Shang ; 32(11): 1003-1007, 2019 Nov 25.
Artigo em Chinês | MEDLINE | ID: mdl-31870047

RESUMO

OBJECTIVE: To observe clinical efficacy of Yishen Huoxue decoction(YSHXD) for the treatment of non-traumatic osteonecrosis of femoral head at early and middle stage. METHODS: From January to June 2016, 69 patients (72 hips) with non-traumatic osteonecrosis of femoral head at early and middle stage were divided into treatment group and control group according to therapeutic methods. In treatment group, there were 35 patients 43 hips, including 15 males and 20 females, aged from 28 to 62 years old with an average of(41.80±11.03) years old, 6 hips were at the stage I, 27 hips were at the stageII, 10 hips were at the stage IIIa according to ARCO classification; and treated by using YSHXD, one dose a day for 12 months. In control group, there were 34 patients 39 hips, including 16 males and 18 females, aged from 31 to 61 years old with an average of (43.35±13.52) years old, 5 hips were at the stage I, 26 hips were at the stageII, 8 hips were at the stage IIIa according to ARCO classification; and treated by using alendronate sodium tablets 70 mg every week for 12 months. Preoperative and postoperative HSS score at 2 weeks were observed and compared, EQ-5D index was used to compare clinical effects. ARCO classification was applied to imaging evaluation, the stage of ARCO over IIIa was considered as end point of observation. The final following-up time and ARCO classification were recorded and performed Kaplan-Meier survival analysis. RESULTS: All patients were followed-up from 26 to 76 months with an average of(43.50±13.26) months. Postoperative Harris score at 2 years in treatment group (84.92±7.56) was higher than that of before treatment (73.58±10.02) (P<0.05), and higher than that of control group(79.61±10.92)(P<0.05), especially the scores of joint function and activity were higher than those of control group(P<0.05). EQ-5D index in treatment group 0.66±0.12 was higher than that of control group 0.59±0.12(P<0.05). Nine hips were collapsed in treatment group at final follow-up, and 10 hips were collapsed in control group, and had no statistical difference between two groups (P>0.05). There was no statistical difference in kaplan-meier survival analysis curves between two groups (P>0.05). There were statistical difference in survival rate between the early, middle ARCO stage and different Harris evaluation. CONCLUSIONS: YSHXD for the treatment of non-traumatic osteonecrosis of femoral head at early and middle stage has obviously clinical effects, could improve hip joint function, and quality of life, and delay the process of femoral head necrosis collapse.


Assuntos
Medicamentos de Ervas Chinesas , Necrose da Cabeça do Fêmur , Adulto , Transplante Ósseo , Feminino , Cabeça do Fêmur , Necrose da Cabeça do Fêmur/tratamento farmacológico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
4.
Chemistry ; 25(46): 10797-10802, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31106453

RESUMO

A novel bifunctionalization of activated methylene was achieved successfully through the base-promoted trifluoromethylthiolation of ß-diketones or ß-ketoesters with trifluoromethanesulfinyl chloride. A series of α-trifluoromethylthiolated α-chloro-ß-diketones and α-chloro-ß-ketoesters were obtained in moderate to good yields under mild conditions. When ß-diketones containing a phenyl group with a hydroxyl or amino substituent at the ortho position were used as substrates, intramolecular trifluoromethylthiolation/cyclization reaction took place to give the corresponding cyclic products. Furthermore, the protocol could be extended to perfluoroalkylthiolation with the sodium perfluoroalkanesulfinate/POCl3 system. On the basis of experimental results, plausible mechanisms are proposed.

5.
Zhongguo Gu Shang ; 32(3): 239-243, 2019 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-30922006

RESUMO

OBJECTIVE: To explore the clinical effect of conservative treatment for giant lumbar intervertebral disc herniation and analyze the factors affecting its resorption. METHODS: From January 2013 to December 2016, the clinical data of 130 patients with giant lumbar intervertebral disc herniation were collected. The patients were classified according to the characteristics of Iwabuchi displacement and "bull eye sign", Xiaosui Huahe decoction of traditional Chinese medicine conservative treatment was used in the patients. There were 93 males and 37 females, aged from 15 to 64 years old with an average of(37.11±13.96) years old; with the disease duration ranging from 1 day to 8 years with an average of(11.82±20.45) months. Rate of intervertebral disc herniation was measured by Futian's method, and clinical effect was evaluated by JOA score. RESULTS: All the patients were followed up from 13 to 48 months with an average of(21.45±11.87) months, and there were no significant differences in follow-up time between different imaging types(P>0.05). The absorption rate 95 patients with persistent conservative treatment was(44.08±35.70)%. The absorption rate of Iwabuchi displacement positive group and "bull eye sign" positive group was significantly higher than the average value(P<0.05). The rate of excellent and good JOA scores in 95 patients was 78.95%, 81.05% and 78.95% at 3, 6 and 12 months after treatment, respectively(P<0.05). Finally 35 patients accepted surgical treatment, the rate of excellent and good JOA scores was 100% at 3, 6, 12 months after treatment(P<0.05). CONCLUSIONS: The clinical effect of Xiaosui Huahe decoction conservative treatment is satisfactory for giant lumbar intervertebral disc herniation. Patients with Iwabuchi displacement and "bull's eye sign" had significant herniation resorption.


Assuntos
Degeneração do Disco Intervertebral , Deslocamento do Disco Intervertebral , Disco Intervertebral , Adolescente , Adulto , Idoso , Feminino , Humanos , Vértebras Lombares , Masculino , Medicina Tradicional Chinesa , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
6.
Zhongguo Gu Shang ; 32(1): 22-27, 2019 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-30813663

RESUMO

OBJECTIVE: To explore clinical efficacy of limited external fixation with plastic paperboard in treating senile proximal comminuted humeral fracture. METHODS: From June 2015 to December 2017, 32 senile patients with proximal comminuted fracture of humerus were treated with plasticized cardboard after manual external fixation. Among them, including 13 males and 19 females aged from 55 to 85 years old with an average of(68.22±8.36) years old; 18 patients on the left side and 14 patients on the right side; all patients were regularly review shoulder X-rays and performed appropriate functional exercises. Constant-Murley shoulder joint scoring was used to evaluate clinical effects. RESULTS: Thirty-two patients were followed up for 3 to 12 months with an average of (4.97±2.39) months. All patients were underwent functional exercise under guidance of physicians. Nine patients were treated with topical Chinese herbal moist heat compresses to promote shoulder function recovery. Thirty-one patients were obtained fracture healing, the time ranged from 5 to 12 weeks with an average of(7.44±1.72)weeks. One patient was not healed due to comminuted fracture of fracture end and the separation was large, the blood supply to humeral head was insufficient for necrosis absorption. Postoperative Constant-Murley shoulder score at 3 months was 87.56±6.93; 15 patients got excellent results, 14 good, 2 fair and 1 poor. CONCLUSIONS: Limited external fixation with plastic paperboard for the treatment of senile proximal comminuted humeral fracture could ensure biomechanical stability of fracture, promote early recovery of shoulder joint function and shorten recovery time.


Assuntos
Fraturas Cominutivas , Fraturas do Úmero , Fraturas do Ombro , Idoso , Idoso de 80 Anos ou mais , Feminino , Fixação Interna de Fraturas , Fraturas Cominutivas/cirurgia , Humanos , Fraturas do Úmero/cirurgia , Masculino , Pessoa de Meia-Idade , Plásticos , Resultado do Tratamento
7.
Neurotherapeutics ; 15(4): 1093-1111, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30112701

RESUMO

Inflammation is implicated in epileptogenesis. Activated microglia and macrophages (MG/MΦ) are found in the brains of patients with epilepsy-related diseases and animal models of epilepsy. It is not yet known how the MG/MΦ activation phenotype affects pathological changes in the brain after a single seizure. In this study, we had 2 main purposes: first, to characterize post-status epilepticus (SE) inflammation by tracking MG/MΦ polarization, and, second, to explore the role of an innate immune receptor adaptor protein, namely, myeloid differentiation primary response gene 88 (MyD88), in the induction of SE in a mouse model. A lithium-pilocarpine model of seizure conditions was generated in C57BL/6 mice. The intensity and distribution of MG/MΦ polarization were tracked by fluorescent immunohistochemistry and Western blotting for the polarization markers inducible nitrogen oxygenized synthase, arginase-1, CD163, and mannose receptor. We observed steadily increasing M1 MG/MΦ along with MyD88 signal upregulation after SE in the hippocampi of mice, whereas the M2 marker arginase-1 was localized mainly in astrocytes rather than in MG/MΦ. Inhibition or gene knockout of MyD88 reduced M1 MG/MΦ and gliosis although increasing M2 MG/MΦ in the hippocampi of SE mice. MyD88 inhibition also augmented glutamate transporter 1 expression and reduced N-methyl-D-aspartate receptor NR1 subunit expression in the hippocampus to protect pyramidal neurons from apoptosis. These data suggest that MG/MΦ polarization after SE impacts the pathological outcome of the hippocampus via MyD88 signaling and point to MyD88 as a potential neuroprotective target for epilepsy therapy.


Assuntos
Apoptose/fisiologia , Hipocampo/metabolismo , Macrófagos/patologia , Microglia/patologia , Fator 88 de Diferenciação Mieloide/antagonistas & inibidores , Neurônios/patologia , Transdução de Sinais/genética , Estado Epiléptico/patologia , Animais , Apoptose/genética , Polaridade Celular/genética , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Regulação da Expressão Gênica em Archaea/efeitos dos fármacos , Regulação da Expressão Gênica em Archaea/genética , Hipocampo/patologia , Marcação In Situ das Extremidades Cortadas , Lítio/toxicidade , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Fator 88 de Diferenciação Mieloide/química , Fator 88 de Diferenciação Mieloide/deficiência , Peptídeos/uso terapêutico , Pilocarpina/toxicidade , Estado Epiléptico/induzido quimicamente , Estado Epiléptico/genética , Receptor 4 Toll-Like/metabolismo
8.
Zhongguo Gu Shang ; 31(6): 522-527, 2018 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-29945407

RESUMO

OBJECTIVE: To investigate the outcome predictive factors of ruptured lumbar disc herniation after conservative treatment. METHODS: From June 2009 to June 2016, 147 patients with ruptured lumbar intervertebral disc herniation were treated with conservative treatment in the orthopedics department of Suzhou Traditional Chinese Medicine Hospital for clinical efficacy and MRI follow-up. Multivariate Logistic regression analysis(Stepwise regression method)was used to analyze the relationship between the 11 categorical variables and absorptivity of protrusions: sex(X1), age(X2), course of disease(X3) , the rate of protrusion(X4), the Komori type(X5), the MSU type(X6), the Iwabuchi type(X7), the Pfirrmann grade(X8), the Modic change on adjacent vertebrae(X9), spinal canal morphology(X10), the Schizas types of cauda equina sedimentation sign(X11). RESULTS: A total of 64 cases of prominent reabsorption among all cases followed-up (absorption rate>=30%), accounting for 43.5%. The reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year(P=0.006), MSU type 3 (P=0.001), Iwabuchi type 1 or 5 (P=0.000), the Schizas type of cauda equina sedimentation sign A or B(P=0.004). Regression equation Y=-10.363+1.916X3+1.446X4-1.445X5+2.070X6+4.679X7+1.125X9+1.023X10+2.223X11. Such factors as age, gender, Pfirrmann classification and spinal canal morphology had no significant effect on reabsorption of protrusions. CONCLUSIONS: Ruptured lumbar disc herniation can be reabsorbed after nonoperative treatment. And the reabsorption of protrusions is more likely to occur in patients with a duration of less than 1 year, MSU type 3, Iwabuchi type 1 or 5, the Schizas type of cauda equina sedimentation sign A or B, which can be used as the key reference factors for predicting the outcome of the projections.


Assuntos
Deslocamento do Disco Intervertebral , Vértebras Lombares , Humanos , Modelos Logísticos , Imagem por Ressonância Magnética , Canal Vertebral , Resultado do Tratamento
9.
Zhongguo Gu Shang ; 31(4): 386-390, 2018 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-29772868

RESUMO

As a self-protective mechanism of cells, autophagy of cells can maintain cell stability by degrading self-aging substances, and it can be highly induced. The ability of autophagy to degraded cells will decrease with age. The resorption phenomenon after lumbar disc herniation is one of the effective mechanisms in conservative treatment of lumbar disc herniation. The degenerative lesion of intervertebral disc is one of the main reasons of lumbar disc herniation. Cell autophagy is extensive participation in the degeneration of lumbar intervertebral disc, delaying the occurrence of degenerative disease. Futhermore, cell autophagy can potentially induce the occurrence of reabsorption. The study of cell autophagy has great significance to the degenerative disease of intervertebral disk and the reabsorption of lumbar disc herniation. And it is also of great significance for the clinical treatment of patients with lumbar disc herniation. For this reason, we should pay more attention to the study of cell autophagy in resorption.


Assuntos
Autofagia , Deslocamento do Disco Intervertebral/patologia , Disco Intervertebral/citologia , Disco Intervertebral/patologia , Vértebras Lombares/patologia , Humanos
10.
Ther Clin Risk Manag ; 14: 409-416, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29520147

RESUMO

Objective: To investigate the alterative spectrum and trends of aeroallergens sensitization in children with allergic rhinitis (AR) in Guangzhou, China in the past 10 years. Participants and methods: In this retrospective study, 4,111 children with complaints of nasal hyper-reactivity who visited the Pediatric Department and/or Otolaryngology Department from January 2007 to November 2016 were enrolled. Serum specific immunoglobulin E was measured and positive detection was made in 3,328 patients, who were, therefore, diagnosed with AR. Positive rates and trends of different aeroallergens sensitization were assessed. The tendency of positive rates changing over the years, and the difference and trends in positive rate of aeroallergen sensitization that occurred in subgroups of gender, age, and season were determined and analyzed with logistic regression. Results: The percentage of detected common aeroallergens in AR children was (from high to low) 81.07%, 34.44%, 14.72%, 11.81%, 6.04%, and 3.70% for house dust mites (HDMs), cat-dog dander, cockroach, mold mixture, tree pollen mixture, and herb pollen mixture, respectively. An ascending trend of aeroallergens sensitization or AR (odds ratio [OR] =1.116, 95% CI: 1.086-1.146) was found. Interestingly, an increasing trend of cat-dog dander and mold sensitization was found in AR children (OR =1.164, 95% CI: 1.133-1.196; OR =1.169, 95% CI: 1.120-1.223) in this retrospective study, while HDMs sensitization held a steady trend (OR =0.983, 95% CI: 0.961-1.007). Conclusion: In the increasing trend of aeroallergens sensitization or AR, HDMs sensitization still held the majority. But emphasis should be made on pet allergy for young children with AR in the context of ascending trend of sensitization to cat-dog dander.

11.
Epilepsy Behav ; 82: 179-188, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29576434

RESUMO

OBJECTIVE: Surgery and drug therapy are the two main treatments for refractory epilepsy. However, to date, there has not been an adequate comparison of the outcomes of these two treatments. This systematic review compared the overall outcome of surgery and medical treatment in patients with drug-resistant epilepsy. METHODS: Articles published in Embase, Medline, Pubmed, and the Cochrane library were searched from their inception until June 2016. RESULTS: Twenty of the eighty-one (24.7%) full-text articles reviewed fulfilled the eligibility criteria and were included in the meta-analysis. Of 1800 patients with drug-resistant epilepsy, 526 of 923 patients (57.0%) in the surgery group were seizure-free compared with 134 of 877 patients (15.3%) in the medical treatment group (19 studies, risk ratio (RR)=3.72, 95% confidence interval (CI) [2.75-5.03]; P<0.00001, I2=53%). In addition, more patients were off antiepileptic drugs (AEDs) in the surgical group (3 studies, n=438, RR=4.76, 95% CI [2.21, 10.28], P<0.0001, I2=0%). Although different studies used different questionnaires to assess patient quality of life (QOL) in both treatment groups, the overall postintervention QOL scores were higher in the surgery than in the medical treatment group, by SMD (6 studies, n=459, SMD=0.61, 95% CI [0.23, 0.98], P=0.002, I2=66%). CONCLUSION: As the complications of interventions, declines in memory, and word recall/naming were not assessed in the meta-analysis, the conclusions are limited to seizure-free, AED use, and QOL. The current evidence indicate that compared with medical treatment, surgery is more likely to achieve seizure-free, off AEDs, and better QOL.


Assuntos
Anticonvulsivantes/uso terapêutico , Encéfalo/cirurgia , Epilepsia Resistente a Medicamentos , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Epilepsia Resistente a Medicamentos/psicologia , Epilepsia Resistente a Medicamentos/cirurgia , Humanos , Qualidade de Vida , Risco
12.
Minerva Med ; 108(4): 334-340, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28248066

RESUMO

BACKGROUND: The serum levels of Dickkopf-1 (DKK1), a secreted Wnt family protein, are different in patients suffering various types of cancers. In the present study, we aim to explore the diagnostic value of DKK1 as a new biomarker in breast cancer. METHODS: Serum was collected from 38 patients with breast cancer and 23 healthy controls. Serological levels of DKK1 were examined by enzyme-linked immunosorbent assay (ELISA). Significance and diagnostic performance including receiver operator characteristic (ROC) and areas under the curve were determined by SPSS software. RESULTS: Serum level of DKK1 was significantly increased in breast cancer patients compared to the healthy controls (P˂0.05). The expression levels of CA15-3 were also evaluated in patients suffering from breast cancer in comparison with healthy controls (P˂0.05). AUC for DKK1 and CA15-3 were 0.81 and 0.64 respectively. Sensitivity and specificity of DKK1 were more than CA15-3 in earlier stage of breast cancer. DKK1 expression in HER-2, estrogen receptor (ER) and progesterone receptor (PR) positive patients was decreased compared with HER-2, ER and PR negative patients. CONCLUSIONS: We found that the expression level of DKK1 in serum was increased in breast cancer patients, suggesting that serum expression level of DKK1 could be a useful biomarker in breast cancer.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Neoplasias da Mama/sangue , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Receptor ErbB-2/sangue , Sensibilidade e Especificidade
13.
Pain Physician ; 20(1): E45-E52, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28072796

RESUMO

BACKGROUND: Lumbar disc herniation (LDH), a common disease, is often treated conservatively, frequently resulting in spontaneous resorption of the herniated disc. The incidence of this phenomenon, however, remains unknown. OBJECTIVE: To analyze the incidence of spontaneous resorption after conservative treatment of LDH using computed tomography and magnetic resonance imaging. STUDY DESIGN: Meta-analysis and systematic review of cohort studies. SETTING: The work was performed at The Suzhou Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine. METHODS: We initiated a search for the period from January 1990 to December 2015 using PubMed, Embase, and the Cochrane Library. Two independent reviewers examined the relevant reports. The references from these reports were also searched for additional trials using the criteria established in the PRISMA statement. RESULTS: Our results represent the pooled results from 11 cohort studies. The overall incidence of spontaneous resorption after LDH was 66.66% (95% CI 51% - 69%). The incidence in the United Kingdom was 82.94% (95% CI 63.77% - 102.11%). The incidence in Japan was 62.58% (95% CI 55.71% - 69.46%). LIMITATIONS: Our study was limited because there were few sources from which to extract data, either in abstracts or published studies. There were no randomized, controlled trials that met our criteria. CONCLUSIONS: The phenomenon of LDH reabsorption is well recognized. Because its overall incidence is now 66.66% according to our results, conservative treatment may become the first choice of treatment for LDH. More large-scale, double-blinded, randomized, controlled trials are necessary to study the phenomenon of spontaneous resorption of LDH.Key words: Lumbar, disc herniation, spontaneous resorption, conservative treatment, incidence, country, meta-analysis, systematic review, observational studies, study designs.


Assuntos
Reabsorção Óssea , Deslocamento do Disco Intervertebral/patologia , Humanos , Incidência , Japão , Remissão Espontânea , Reino Unido
14.
Mol Med Rep ; 13(5): 4001-6, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27035219

RESUMO

The present study was performed to investigate the role of p38 mitogen­activated protein kinase (MAPK) in the resorption of herniated intervertebral discs in 30 rats. In the non­contained and p38 MAPK inhibition (p38i) groups, two coccygeal intervertebral discs (IVDs) were removed and wounded prior to relocation into the subcutaneous space of the skin of the back. In the contained group, the cartilage endplates maintained their integrity. Furthermore, SB203580 was injected intraperitoneally into the p38i group, whereas saline was injected into the other two groups. In the non­contained group, the weight of the relocated IVDs decreased to a greater extent over time when compared with the contained and p38i groups. Phosphorylated p38, tumor necrosis factor­α, and interleukin­1ß were observed to exhibit higher expression levels in the non­contained group compared with the contained and p38i groups, at weeks 1 and 4 post­surgery. The expression level of caspase­3 and the densities of apoptotic disc cells were significantly higher in the non­contained group compared with the contained and p38i groups at 4 weeks post­surgery. In conclusion, p38 MAPK induces apoptosis in IVDs, while also accelerating the resorption of the relocated IVDs. Thus, p38 MAPK may be important in spontaneous resorption of IVDs.


Assuntos
Apoptose/efeitos dos fármacos , Imidazóis/farmacologia , Deslocamento do Disco Intervertebral/tratamento farmacológico , Disco Intervertebral/enzimologia , Piridinas/farmacologia , Proteínas Quinases p38 Ativadas por Mitógeno/antagonistas & inibidores , Animais , Caspase 3/metabolismo , Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/enzimologia , Deslocamento do Disco Intervertebral/patologia , Masculino , Ratos , Ratos Sprague-Dawley , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
15.
Toxicol Lett ; 239(2): 97-107, 2015 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-26386401

RESUMO

Proper proliferation and differentiation of neural stem cells or progenitors in hippocampus is critical to learn and memory functions, which might be disturbed by lead toxicity particularly in young individuals. While astroglial and microglial cells are known to play an important role in regulating neurogenesis of hippocampus, their abnormal response and influence on hippocampal neurogenesis remains unclear. In this study, therefore, glial response including microgliosis, astrogliogenesis and mediating involvement of TLR4-MyD88-NFκB signaling cascades were observed in hippocampus of young mice by animal model with lead (plumbum, Pb) exposure. It revealed that (1) significant microglial activation occurred in hippocampus soon following Pb exposure; (2) increased levels of TLR4, MyD88, NFκB expression were concomitantly detected; (3) BrdU-incorporated progenitor cells were observed in dentate gyrus with significantly-increased numbers at d28 in Pb insult group; (4) obvious astrogliogenesis was observed while these doublecortin-labeled differentiated neurons were not significantly changed in hippocampus; (5) administration of MyD88 inhibitory peptide attenuated or relieved above effects; (6) enhanced expression levels of IL-1ß, TNFα, p38MAPK and ERK1/2 were also detected in hippocampus, indicating potential implication of inflammatory response and MAPK signaling activation in lead-induced microgliosis and astrogliosis. Data of this study overall have indicated that lead exposure could trigger or induce abnormal microgliosis and astrogliogenesis in the hippocampus of young mice through triggering TLR4-MyD88-NFκB signaling cascades, which might possibly thereafter disturb hippocampal neurogenesis and functional plasticity.


Assuntos
Hipocampo/efeitos dos fármacos , Chumbo/toxicidade , Fator 88 de Diferenciação Mieloide/metabolismo , NF-kappa B/metabolismo , Receptor 4 Toll-Like/metabolismo , Envelhecimento , Animais , Astrócitos/efeitos dos fármacos , Bromodesoxiuridina , Regulação da Expressão Gênica , Hipocampo/citologia , Camundongos , Camundongos Endogâmicos C57BL , Microglia/efeitos dos fármacos , Fator 88 de Diferenciação Mieloide/genética , NF-kappa B/genética , Neurônios/efeitos dos fármacos , Neurônios/fisiologia , Receptor 4 Toll-Like/genética
16.
Zhongguo Gu Shang ; 27(8): 668-72, 2014 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-25464593

RESUMO

OBJECTIVE: To investigate the effects of serum containing Gumibao (Chinese character: see text) on the proliferation and differentiation of osteoblast induced by dexamethasone. METHODS: Osteoblasts were extracted from skulls in newly born (within 24 hours) SD rats, and digested with collagenase. The first passage of cells were used for experiments. Cells were cultured in the medium containing different concentrations of dexamethasone (0, 10(-8), 10(-7), 10(-6), 10(-5) ,10(-4) mol/L). Alkaline phosphatase staining were carried out after 1 week and numbers of mineralized nodes with alizarin red staining were observed after 3 weeks. Accordingly, following the treatment of 10(-5) mol/L dexamethasone for 1 week, cells were cultured in the medium with serum containing Gumibao (Chinese character: see text). One week after Cumibao (Chinese character: see text) treatment, cells were stained with Alkaline phosphatase and collagen I and PCNA were examined by Western-blot. However, the observation of numbers of mineralized nodes with alizarin red stain required one more week. RESULTS: High concentration of dexamethasone could inhibit the expression of PCNA, collagen I, alkaline phosphatase and reduce the number of mineralized nodes of osteoblast, while serum containing Gumibao (Chinese character: see text) could reverse the inhibition. CONCLUSION: High concentration of dexamethasone could inhibit the proliferation and differentiation of osteoblastic cells, while serum containing Gumibao (Chinese character: see text) could reverse the inhibition.


Assuntos
Dexametasona/farmacologia , Medicamentos de Ervas Chinesas/farmacologia , Osteoblastos/efeitos dos fármacos , Animais , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Colágeno Tipo I/análise , Relação Dose-Resposta a Droga , Feminino , Osteoblastos/citologia , Osteoblastos/fisiologia , Antígeno Nuclear de Célula em Proliferação/análise , Ratos , Ratos Sprague-Dawley
19.
Chemistry ; 20(47): 15315-9, 2014 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-25308349

RESUMO

A mild and efficient copper-catalyzed intramolecular carbotrifluoromethylation of alkynes has been achieved in the presence of Togni reagent as trifluoromethylating reagent. The reaction tolerates a range of substrates to give a group of trifluoromethylated heterocycles with high selectivities. A plausible mechanism was proposed on the basis of experimental results.

20.
Orthop Surg ; 6(3): 229-35, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25179358

RESUMO

OBJECTIVE: To explore the therapeutic effects of a traditional Chinese medicine (TCM) regimen on patients with ruptured lumbar disc herniation, including assessing its effects on prognosis and protrusion size. METHODS: From June 2008 to December 2011, 102 patients with ruptured lumbar disc herniation who chose conservative treatment with TCM as their first choice were followed up for 2 years to assess their final surgical rate, improvement according to Japanese Orthopaedic Association (JOA) scores, and to calculate the volume and rate of resorption of their protrusions by magnetic resonance imaging (MRI). RESULTS: (i) Eighty-three of the 102 patients (81.37%) experienced partial or complete relief; the remaining 19 (18.63%) eventually needed surgery. (ii) In the 83 patents who underwent conservative treatment, rates of excellent JOA scores at 3 months, 6 months, 1 year and 2 years were 79.52%, 81.93%, 81.93% and 83.13% respectively; differences between these and pretreatment scores are all statistically significant (P < 0.01). (iii) The volume of protrusion in the patients who chose conservative treatment decreased from 1433.89 ± 525.49 mm(3) (mean ± SD) to 1002.01 ± 592.95 mm(3), which is statistically significant (t = 6.854, P < 0.01). The average resorption rate was 27.25% ± 32.97%; in 20 patients (24.10%) the resorption rate was >50%. The remaining 63 patients had no obvious resorption; their excellent rate was 77.77%. The difference in rate of achieving an excellent outcome differed significantly between those who did and did not have resorption of their protrusions (P = 0.018). CONCLUSION: Conservative treatment with a TCM regimen is effective for ruptured lumbar disc herniation and can promote resorption of the protrusion; however, patients who develop specific indications for surgery during such treatment should undergo surgery in a timely manner.


Assuntos
Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares , Medicina Tradicional Chinesa , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/diagnóstico , Deslocamento do Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/cirurgia , Vértebras Lombares/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
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