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The authors asked for the change of the figure 1. They wanted to send the figure that was 200 times bigger under the microscope as described in Figure 1 caption, however, they mistakenly uploaded the wrong picture. Reference: 1. Tao Wang, Si-Dong Yang, Sen Liu, Hui Wang, Huan Liu, Wen Yuan Ding: 17ß-Estradiol Inhibites Tumor Necrosis Factor-alpha Induced Apoptosis of Human Nucleus Pulposus Cells via the PI3K/Akt Pathway. Med Sci Monit, 2016; 22: 4312-4322. DOI: 10.12659/MSM.900310.
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BACKGROUND The aim of this study was to evaluate the clinical efficacy of modified posterior vertebral column resection (MPVCR) in treating osteoporotic Kummell disease. MATERIAL AND METHODS Between January 2013 and January 2015, 10 patients who were diagnosed with Kummell disease underwent MPVCR treatment, and their medical records were retrospectively collected. Every patient had follow-up for at least one year, with an average of 15 months. Clinical efficacy of MPVCR treatment was evaluated by kyphotic Cobb's angle, Oswestry disability index (ODI) and visual analogue scale (VAS) score. RESULTS Data analyses showed that operation time was 188.39±30.8 minutes, and blood loss was 860±130 mL with 600±200 mL of blood transfusions. VAS score decreased significantly after MPVCR surgery (p<0.001, Mann-Whitney U test). In addition, data analyses showed that postoperative ODI was less than preoperative ODI, which was a statistically significant difference (p<0.001, Mann-Whitney U test). X-ray radiograph showed that kyphotic Cobb's angle was 45°±12° preoperatively, 10°±4° two weeks after surgery, and 15°±6° at last follow-up, indicating that Cobb's angle after MPVCR surgery was significantly improved, compared to the preoperative scores (p<0.05, SNK-q test). CONCLUSIONS MPVCR surgery was an effective and safe surgical method to treat Kummell disease, especially for patients with kyphotic deformity and obvious nerve-oppressed symptoms. However, the long-term clinical effect still needs further studies.
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Procedimentos Neurocirúrgicos/métodos , Fraturas por Osteoporose/cirurgia , Fraturas da Coluna Vertebral/cirurgia , Idoso , Feminino , Seguimentos , Humanos , Cifose/cirurgia , Vértebras Lombares/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoporose/cirurgia , Estudos Retrospectivos , Vértebras Torácicas/cirurgiaRESUMO
BACKGROUND Clinically, percutaneous vertebroplasty (PVP) is frequently applied to treat osteoporotic vertebral compression fracture (OVCF). It is believed that new compression fractures are more likely to occur adjacent to the PVP-treated segment, typically within 1 month after PVP. The purpose of this study was to investigate risk factors for adjacent vertebral compression fractures (AVCF) after PVP in patients with OVCF after menopause. MATERIAL AND METHODS Between Jun 2012 and Dec 2016, 412 patients were initially identified. We enrolled 390 patients in this study, and 22 were lost to follow-up. The medical records of the patients were retrospectively collected. Patients were followed up for at least 6 months, with an average follow-up period of 18 months. The potential risk factors investigated in this study included age, duration of menopause (DoM), preoperative vertebral compression, number of preoperative vertebral fractures (NPVF), bone mineral density (BMD), surgical approach (unilateral or bilateral), anesthesia methods, bone cement dose, complications (including COPD), and anti-osteoporosis treatment. Logistic regression analysis was used to determine the risk factors. RESULTS Sixty-eight patients were observed to have suffered from AVCF after PVP at the last follow-up. Univariate analysis showed that age, DoM, NPVF, BMD, COPD, and anti-osteoporosis treatment were the potential variables associated with the onset of AVCF (all P<0.05). Binary logistic regression analysis showed that the logistic regression equation was as follows: logit P=-3.10-1.07×X2+0.99×X3+2.15×X4 (where X2=BMD; X3=DoM; X4=NPVF), and "logit P" stands for the likelihood of developing an AVCF following PVP. CONCLUSIONS A long duration of menopause and preoperative multi-level vertebral fractures were the risk factors for AVCF in patients following PVP after menopause, while a high-level BMD acted in a protective role for AVCF development.
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Fraturas por Compressão/etiologia , Menopausa/fisiologia , Fraturas da Coluna Vertebral/etiologia , Vertebroplastia/efeitos adversos , Idoso , Densidade Óssea , Feminino , Humanos , Modelos Logísticos , Fraturas por Osteoporose/cirurgia , Doença Pulmonar Obstrutiva Crônica/complicações , Estudos Retrospectivos , Fatores de RiscoRESUMO
BACKGROUND Tumor necrosis factor-α (TNF-α) has been widely known to induce degeneration of nucleus pulposus cells (NPCs). 17ß-estradiol (17ß-E2) has been broadly proven for its function of suppressing cell apoptosis. The aim of this study is to explore whether 17ß-E2 protects apoptosis of human NPCs induced by TNF-α via the PI3K/AKT pathway. MATERIAL AND METHODS NPCs were divided into four groups: control, TNF-α (100 ng/mL), TNF-α (100 ng/mL) with pretreated 17ß-E2 (10 um/L), TNF-α (100 ng/mL) with pretreated 17ß-E2 (10 um/L) and MK2206 (10 um/L, inhibitor of the PI3K/AKT pathway). Flow cytometry was used to measure the apoptotic incidence. Inverted phase-contrast microscopy was used to accomplish the morphological observation for apoptosis of treated cells. Additionally, Cell Counting Kit 8 (CCK-8) assay was used to detected cell proliferation. Western blot and quantitative real-time PCR (qRT-PCR) were applied to explore the expression of pro-caspase-3, caspase-3/p17, cleaved PARP, PARP, Akt, and phospho-Akt (p-Akt). RESULTS First, inverted phase-contrast microscopy, CCK-8, and flow cytometry showed that TNF-α induced marked apoptosis, which was abolished by 17ß-E2. Furthermore, Western blot and qRT-PCR showed that 17ß-E2 protects TNF-α which can induced apoptosis by upregulating p-Akt, whereas Akt was essentially constant. Our data revealed that p-Akt expression peaked at 24 hours in a time-dependent manner (0-48 hours) after treating with TNF-α; and the p-Akt expression generally increased in a time-dependent manner (0-48 hours) after treating with TNF-α and 17ß-E2. CONCLUSIONS 17ß-E2 is shown to protect NPCs against TNF-α induced apoptosis by upregulating p-Akt in the PI3K/AKT pathway. 17ß-E2 generally increases expression of p-Akt.
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Estradiol/farmacologia , Núcleo Pulposo/citologia , Núcleo Pulposo/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Apoptose/efeitos dos fármacos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Humanos , Núcleo Pulposo/metabolismo , Fosforilação , Substâncias Protetoras/farmacologia , Transdução de Sinais/efeitos dos fármacos , Regulação para Cima/efeitos dos fármacosRESUMO
BACKGROUND: The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC). MATERIAL/METHODS: Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score. RESULTS: Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (p<0.05). Medical expenses were far lower in the UPSFB group (p<0.001). There were no significant differences among the 3 groups in postoperative complications, interbody fusion rate, reoperation rate, JOA score, and patient satisfaction (all p>0.05). CONCLUSIONS: As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive.
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Transplante Ósseo , Procedimentos Ortopédicos/métodos , Parafusos Pediculares , Perda Sanguínea Cirúrgica , Transfusão de Sangue , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/cirurgia , Tempo de Internação , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Procedimentos Ortopédicos/efeitos adversos , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Reoperação , Fusão VertebralRESUMO
PURPOSE: To analyse the incidence and risk factors associated with proximal junctional kyphosis (PJK) following spinal fusion, we collect relative statistics from the articles on PJK and perform a meta-analysis. METHODS: An extensive search of literature was performed in PubMed, Embase, and The Cochrane Library (up to April 2015). The following risk factors were extracted: age at surgery, gender, combined anterior-posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation, thoracoplasty, fusion to sacrum (S1), preoperative thoracic kyphosis angle (T5-T12) >40°, bone mineral density (BMD) and preoperative to postoperative sagittal vertical axis (SVA difference) >5 cm. Data analysis was conducted with RevMan 5.3 and STATA 12.0. RESULTS: A total of 14 unique studies including 2215 patients were included in the final analyses. The pooled analysis showed that there were significant difference in age at surgery >55 years old (OR 2.19, 95 % CI 1.36-3.53, p = 0.001), fusion to S1 (OR 2.12, 95 % CI 1.57-2.87, p < 0.001), T5-T12 >40° (OR 2.68, 95 % CI 1.73-4.13, p < 0.001), low BMD (OR 2.37, 95 % CI 1.45-3.87, p < 0.001) and SVA difference >5 cm (OR 2.53, 95 % CI 1.24-5.18, p = 0.01). However, there was no significant difference in gender (OR 0.98, 95 % CI 0.74-1.30, p = 0.87), combined anterior-posterior surgery (OR 1.55, 95 % CI 0.98-2.46, p = 0.06), use of pedicle screw at top of construct (OR 1.55, 95 % CI 0.67-3.59, p = 0.30), hybrid instrumentation (OR 1.31, 95 % CI 0.92-1.87, p = 0.13) and thoracoplasty (OR 1.55, 95 % CI 0.89-2.72, p = 0.13). The incidence of PJK following spinal fusion was 30 % (ranged from 17 to 62 %) based on the 14 studies. CONCLUSIONS: The results of our meta-analysis suggest that age at surgery >55 years, fusion to S1, T5-T12 >40°, low BMD and SVA difference >5 cm are risk factors for PJK. However, gender, combined anterior-posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation and thoracoplasty are not associated with PJK.
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Cifose/epidemiologia , Parafusos Pediculares , Complicações Pós-Operatórias/epidemiologia , Sacro/cirurgia , Fusão Vertebral , Toracoplastia , Humanos , Incidência , Estudos Retrospectivos , Fatores de RiscoRESUMO
In our previous study, 17ß-estradiol was proved to protect rat annulus fibrosus cells against apoptosis induced by interleukin-1ß (IL-1ß). However, whether 17ß-estradiol has protective effect on rat nucleus pulposus cells remains unclear. The purpose of this study was to further explore the effects of 17ß-estradiol on rat nucleus pulposus cells based on IL-1ß-induced apoptosis. TUNEL assay and Annexin V/PI double staining were used to detect apoptosis and revealed that IL-1ß induced notable apoptosis, which was reversed by 17ß-estradiol. Meanwhile, cell viability and binding ability were decreased by IL-1ß, but activated caspase-3 was increased. However, all of the detected effects of IL-1ß were eliminated by 17ß-estradiol. Furthermore, real-time quantitative RT-PCR was used to further find that IL-1ß downregulated expression level of type II collagen, aggrecan, tissue inhibitor of matrix metalloproteinase (TIMP)-1, while upregulated matrix metalloproteinase (MMP)-3, MMP-13 and Bcl-2, which was further confirmed by western blot. Finally, 17ß-estradiol was proved to abolish the above negative effects of IL-1ß. In summary, this work presented that IL-1ß maybe induced apoptosis of rat nucleus pulposus cells, which was resisted by 17ß-estradiol by down-regulating MMP-3 and MMP-13 via a mitochondrial pathway. This research provides a novel insight into the anti-apoptotic effect of 17ß-estradiol on IL-1ß-induced cytotoxicity, and may potentially lead to a better understanding of the clinical effects of 17ß-estradiol, especially in terms of intervertebral disc degeneration.
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Estradiol/farmacologia , Interleucina-1beta/antagonistas & inibidores , Metaloproteinase 13 da Matriz/genética , Metaloproteinase 3 da Matriz/genética , Substâncias Protetoras/farmacologia , Agrecanas/genética , Agrecanas/metabolismo , Animais , Apoptose/efeitos dos fármacos , Caspase 3/genética , Caspase 3/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Condrócitos/citologia , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Colágeno Tipo II/genética , Colágeno Tipo II/metabolismo , Regulação da Expressão Gênica , Interleucina-1beta/farmacologia , Disco Intervertebral/citologia , Disco Intervertebral/efeitos dos fármacos , Disco Intervertebral/metabolismo , Masculino , Metaloproteinase 13 da Matriz/metabolismo , Metaloproteinase 3 da Matriz/metabolismo , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Cultura Primária de Células , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais , Inibidor Tecidual de Metaloproteinase-1/genética , Inibidor Tecidual de Metaloproteinase-1/metabolismoRESUMO
Levofloxacin has been reported to have cytotoxicity to chondrocytes in vitro. And 17ß-estradiol has been widely studied for its protective effects against cell apoptosis. Based on apoptotic cell model induced by levofloxacin, the purpose of this study was to explore the mechanism by which 17ß-estradiol protects rat nucleus pulposus cells from apoptosis. Inverted phase-contrast microscopy, flow cytometry, and caspase-3 activity assay were used to find that levofloxacin induced marked apoptosis, which was abolished by 17ß-estradiol. Interestingly, estrogen receptor antagonist, ICI182780, and functional blocking antibody to α2ß1 integrin, both prohibited the effect of 17ß-estradiol. Simultaneously, levofloxacin decreased cellular binding ability to type II collagen, which was also reversed by 17ß-estradiol. Furthermore, western blot and real-time quantitative PCR were used to find that integrin α2ß1 was responsible for estrogen-dependent anti-apoptosis, which was time-response and dose-response effect. 17ß-estradiol was proved for the first time to protect rat nucleus pulposus cells against levofloxacin-induced apoptosis by upregulating integrin α2ß1 signal pathway.
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Antibacterianos/efeitos adversos , Apoptose/efeitos dos fármacos , Condrócitos/efeitos dos fármacos , Estradiol/farmacologia , Integrina alfa2beta1/metabolismo , Disco Intervertebral/citologia , Levofloxacino/efeitos adversos , Animais , Caspase 3/metabolismo , Células Cultivadas , Condrócitos/citologia , Condrócitos/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley , Regulação para CimaRESUMO
BACKGROUND: Fluoroquinolones are in wide clinical use as safe and effective antibiotics. Articular cartilage, tendons, and epiphyseal growth plates have been recognized as targets of fluoroquinolone-induced connective tissue toxicity. However, the effects of fluoroquinolones on annulus fibrosus (AF) cells are still unknown. MATERIAL/METHODS: The main objective of this study was to investigate the effects of levofloxacin, a typical fluoroquinolone antibiotic drug, on rat AF cells in vitro. Rat annulus fibrosus (RAF) cells were treated with levofloxacin at different concentrations (0, 10, 20, 30, 40, 60, 80, and 90 µg/ml) and were assessed to determine the possible cytotoxic effects of levofloxacin. Inverted phase-contrast microscopy was used to accomplish the morphological observation of apoptosis of treated cells. Western blot and real-time quantitative RT-PCR (qPCR) was used to explore the expression of active caspase-3 and MMP-3. Flow cytometry was used to measure the apoptotic incidences. RESULTS: Our study showed that levofloxacin, with concentrations at 30, 60, and 90 µg/ml, induced dose-dependent RAF cell apoptosis and higher expression of caspase-3 and MMP-3. More apoptotic cells were observed by inverted phase-contrast microscopy. Moreover, levofloxacin increased the activity of caspase-3, and it also reduced cell viability with different concentrations ranging from 10 to 80 µg/ml. CONCLUSIONS: Our study results suggest that levofloxacin has cytotoxic effects on RAF cells, characterized by enhancing apoptosis and reducing cell viability, and indicate a potential toxic effect of fluoroquinolones on RAF cells.
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Disco Intervertebral/efeitos dos fármacos , Disco Intervertebral/patologia , Levofloxacino/toxicidade , Animais , Anexina A5/metabolismo , Western Blotting , Caspase 3/metabolismo , Forma Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Fluoresceína-5-Isotiocianato/metabolismo , Disco Intervertebral/enzimologia , Metaloproteinase 3 da Matriz/metabolismo , Reação em Cadeia da Polimerase , Propídio/metabolismo , Ratos Sprague-DawleyRESUMO
Levofloxacin, a fluoroquinolone, is a widely-used and effective antibiotic. However, various adverse side effects are associated with levofloxacin. The purpose of this study was to further explore the effects of levofloxacin on rat nucleus pulposus cells (NPCs). Inverted phase-contrast microscopy, flow cytometry and caspase-3 activity assays were used and revealed that serum deprivation induced apoptosis, which was markedly increased by levofloxacin in a dose-dependent manner. Simultaneously, levofloxacin decreased cell binding to type II collagen (COL2). Thus, levofloxacin-induced apoptosis exhibits characteristics of anoikis, the process by which cell death is triggered by separation from the extracellular matrix, which contains COL2. Furthermore, real-time quantitative RT-PCR was used to further confirm that levofloxacin downregulates COL2 expression in a dose-dependent manner. At last, western blot was used to find that levofloxacin increased the ratio of Bax/Bcl-2 and active caspase-3 in a dose-dependent manner. Levofloxacin therefore increases the effects of serum deprivation on anoikis by downregulating COL2 in rat NPCs in vitro via Bax/Bcl-2/caspase-3 pathway. This research provides a novel insight into the mechanisms of levofloxacin-induced toxicity and may potentially lead to a better understanding of the clinical effects of levofloxacin, especially in terms of intervertebral disc degeneration.
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Anoikis/efeitos dos fármacos , Caspase 3/metabolismo , Levofloxacino/farmacologia , Proteína X Associada a bcl-2/metabolismo , Animais , Sequência de Bases , Meios de Cultura Livres de Soro , Primers do DNA , Ativação Enzimática , Masculino , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Parkinson's disease (PD) is a significantly progressive neurodegenerative disease characterised by both motor and nonmotor disorders. The main pathological characteristics of PD consist of the loss of dopaminergic neurons and the formation of alpha-synuclein-containing Lewy bodies in the substantia nigra. Currently, the main therapeutic method for PD is anti-Parkinson medications, including levodopa, madopar, sirelin, and so on. However, the effect of pharmacological treatment has its own limitations, the most significant of which is that the therapeutic effect of dopaminergic treatments gradually diminishes with time. Exercise training, as an adjunctive treatment and complementary therapy, can improve the plasticity of cortical striatum and increase the release of dopamine. Exercise training has been proven to effectively improve motor disorders (including balance, gait, risk of falls and physical function) and nonmotor disorders (such as sleep impairments, cognitive function and quality of life) in PD patients. In recent years, various types of exercise training have been used to treat PD. In this review, we summarise the exercise therapy mechanisms and the protective effects of different types of exercise training on PD patients.
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Terapia por Exercício , Doença de Parkinson/terapia , Humanos , Doença de Parkinson/fisiopatologia , Resultado do TratamentoRESUMO
Worldwide, elderly people have a higher prevalence of myocardial infarction (MI), which is associated with body function aging and a sedentary lifestyle. In addition to medication, exercise training is a well-established supplementary method to prevent and treat cardiovascular diseases (CVDs). Substantial evidence has shown the value of different intensity exercise programs in the prevention and treatment of MI, and exercise rehabilitation programs are also applicable to elderly patients with MI. Although exercise rehabilitation programs could significantly improve function, quality of life (QoL), and lower mortality and morbidity for people with MI, such programs are underused because their mechanisms are not accurately elucidated. To promote the application of exercise therapy for MI, this review summarizes the benefits and mechanisms of exercise rehabilitation for post-MI patients and provides rationalized proposals for outpatient cardiac rehabilitation.
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OBJECTIVES: This study aimed to investigate the effect factors associated with the postoperative dissatisfaction of patients undergoing open-door laminoplasty for cervical OPLL. METHODS: In this study, 194 patients, who underwent open-door laminoplasty for cervical OPLL from January 2009 to January 2016, were retrospectively reviewed. The Patient Satisfaction Index (PSI) was collected at discharge, 6 months, 1 year, and the last follow-up. According to the PSI, patients were divided into satisfied group and dissatisfied group. The possible effect factors included demographic variables and surgery-related variables. RESULTS: At discharge, 42 (21.6%) patients were in the dissatisfied group, as compared to the satisfied group, the hospitalization cost, hospital stay, postoperative depression, the axial neck pain, delayed wound healing, and VAS-neck had significant statistical differences. At 6-month follow-up, 25 (12.9%) patients were in the dissatisfied group. The axial neck pain and JOA score had significant statistical differences between the two groups, and no significant differences were found between the two groups in other items. At 1 year with 18 (9.3%) dissatisfied patients and last follow-up with 14 (7.2%) dissatisfied patients, the JOA score and symptom recurrence had significant statistical differences. For further analysis, the dissatisfied patients with axial neck pain at 6 months were significantly higher than that at other terms and the JOA score of the two groups increased gradually with prolonging of restoration years but compared with the dissatisfied group, the JOA scores were obviously better in the satisfied group at the last follow-up. CONCLUSIONS: Overall, to patients undergoing open-door laminoplasty for cervical OPLL, hospitalization cost and neck pain might be mainly associated with patient dissatisfaction at the early and middle recovery. Patient dissatisfaction at the long-term treatment outcome might be mainly associated with the low improvement rate of JOA score and symptom recurrence.
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Vértebras Cervicais/cirurgia , Laminoplastia/tendências , Ossificação do Ligamento Longitudinal Posterior/cirurgia , Satisfação do Paciente , Complicações Pós-Operatórias/etiologia , Idoso , Vértebras Cervicais/diagnóstico por imagem , Estudos de Coortes , Feminino , Seguimentos , Humanos , Laminoplastia/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ossificação do Ligamento Longitudinal Posterior/diagnóstico por imagem , Complicações Pós-Operatórias/diagnóstico por imagem , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Autophagy, a catabolic degradation system, is utilized for destroying and recycling the damaged or unnecessary cellular components. Brain plasticity refers to the remarkable characteristics of brain neurons that change their structure and function according to previous experience. This review was performed by searching the relevant articles in databases of SCIENCEDIRECT, PUBMED, and Web of Science, from respective inception to January 2019. Here, we review the neuroprotective effect of autophagy in neurological diseases and the mechanism of autophagy in brain plasticity. Moreover, the mechanism of autophagy in the process of brain plasticity can provide the possibility for the development of new treatment methods in the future, thus benefiting patients with neurological diseases. In summary, autophagy and brain plasticity play important roles in neurological diseases.
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Intervertebral disc degeneration (IVDD) is the main pathological basis of spinal degenerative diseases, and aberrant apoptosis of nucleus pulposus cells (NPCs) is the main cellular process that causes IVDD. In our previous studies, 17ßestradiol (E2) was demonstrated to protect rat NPCs from interleukin1ß (IL1ß)induced apoptosis via the PI3K/Akt signaling pathway. However, the downstream signaling pathway of PI3K/Akt is currently unclear. The present study aimed to explore the signaling pathways that are downstream of the PI3K/Akt pathway, including mTOR, NFκB and glycogen synthase kinase3ß (GSK3ß). Annexin V/propidium iodide double staining was used to determine the incidence of apoptosis. Cell Counting kit8 and MTS assays were used to determine the proliferation and viability of NPCs, respectively. Cellular binding was evaluated using a cellcollagen binding assay. Western blotting was used to determine the protein expression levels of mTOR, NFκB and GSK3ß, and their phosphorylation levels, as well as the expression levels of active caspase3. The results revealed that IL1ß induced NPC apoptosis and increased the early apoptotic rate of NPCs. However, E2 reduced the early apoptosis of NPCs induced by IL1ß. In addition, E2 suppressed the decrease in cell viability and binding ability caused by IL1ß cytotoxicity. Western blotting revealed that E2 also reduced the expression of activated caspase3, and increased the expression of activated mTOR. As a specific inhibitor of mTOR, rapamycin effectively attenuated the effects of E2. These findings indicated that E2 protected NPCs against apoptosis via activation of the mTOR/caspase3 pathway.
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Apoptose/efeitos dos fármacos , Caspase 3/genética , Condrócitos/efeitos dos fármacos , Estradiol/farmacologia , Interleucina-1beta/antagonistas & inibidores , Serina-Treonina Quinases TOR/genética , Animais , Apoptose/genética , Caspase 3/metabolismo , Condrócitos/citologia , Condrócitos/metabolismo , Regulação da Expressão Gênica , Glicogênio Sintase Quinase 3 beta/genética , Glicogênio Sintase Quinase 3 beta/metabolismo , Interleucina-1beta/farmacologia , Masculino , Núcleo Pulposo/citologia , Núcleo Pulposo/efeitos dos fármacos , Núcleo Pulposo/metabolismo , Fosfatidilinositol 3-Quinases/genética , Fosfatidilinositol 3-Quinases/metabolismo , Cultura Primária de Células , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais , Sirolimo/farmacologia , Serina-Treonina Quinases TOR/antagonistas & inibidores , Serina-Treonina Quinases TOR/metabolismoRESUMO
Autophagy is a conservative catabolism process, participating in delivering the cytosol and cytosolic components to the lysosome. Abnormal autophagy is related to human pathologies, for instance diabetes, neurodegeneration, cardiovascular, macular degeneration, pulmonary, and cancer. Enormous evidences indicate that autophagy may mediate the cellular pathological condition in the process of neurological diseases. Exercise as a form of physiological stress may cause an adaptation, and autophagy is a necessary process for adaptational response to exercise. Autophagy during exercise may improve neurological function, control tissue maintain tissue integrity, and activate different signals pathway for adaptation. In this review, we summarize the possible mechanisms of exercise training via autophagy in neurological diseases.
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Autofagia/fisiologia , Exercício Físico/fisiologia , Doenças do Sistema Nervoso/fisiopatologia , Aclimatação , Adaptação Fisiológica , Animais , Humanos , Lisossomos , Modelos Biológicos , Condicionamento Físico Animal/métodos , Condicionamento Físico Animal/fisiologia , Transdução de Sinais , Estresse FisiológicoRESUMO
OBJECTIVES: The aim of this study was to explore the prevalence and risk factors for axial neck pain in patients undergoing multilevel anterior cervical decompression with fusion surgery. METHODS: In this study, 88 patients, who underwent multilevel anterior cervical decompression with fusion surgery from January 2012 to January 2017, were retrospectively reviewed. Based on the postoperative axial neck pain, the patients were classified into two groups: axial pain group and no axial pain group. The patients were followed up 3 weeks, 3 months, and 1 year after cervical anterior surgery for the early- and long-term clinical evaluation. The possible effect factors included demographic variables (age, sex, BMI, smoking, drinking, heart disease, hypertension, diabetes, preoperative kyphosis, preoperative axial neck pain, preoperative JOA scores, and ODI) and surgery-related variables (surgical option, vertebral lesions, spinal canal stenosis rate, superior fusion segment, presence of intramedullary high signal intensity). RESULTS: The prevalence of axial neck pain was 27.3% (24 cases of 88). Our results showed that preoperative axial neck pain (62% vs 23%, P < 0.001) and preoperative kyphosis (42% vs 21.9%, P < 0.001) were risk factors for axial pain after multilevel anterior cervical surgery. Additionally, for patients with preoperative cervical kyphosis, compared to no axial pain group, the axial neck group was significantly more likely to exist a higher preoperative angle of C2-7 (13.31 ± 2.33 vs 7.33 ± 2.56, P < 0.001) and a higher correction range for kyphosis (20.24 ± 4.12 vs 12.34 ± 3.12, P < 0.001). However, for all the patients with postoperative axial symptoms, the improvement rate of axial pain was significantly higher for patients without cervical kyphosis at the early-term follow-up (3 weeks) (P = 0.032), no significant differences were found at the medium-term (P = 0.554) and long-term follow-up (P = 0.902), and improvements of clinical symptom have no obvious difference at the last follow-up. CONCLUSIONS: Overall, preoperative axial neck pain and kyphosis could predict axial neck pain for patients undergoing multilevel anterior cervical decompression with fusion surgery, and recovery of cervical kyphosis may contribute to the long-term recovery of neural function, but may also suffer from risk of short-term axial pain, which could be reduced through moderate cervical curvature recovery.
Assuntos
Vértebras Cervicais/cirurgia , Descompressão Cirúrgica/efeitos adversos , Cervicalgia/etiologia , Dor Pós-Operatória/etiologia , Fusão Vertebral/efeitos adversos , Idoso , Vértebras Cervicais/diagnóstico por imagem , Descompressão Cirúrgica/métodos , Feminino , Seguimentos , Humanos , Cifose/complicações , Masculino , Pessoa de Meia-Idade , Cervicalgia/diagnóstico por imagem , Medição da Dor/métodos , Dor Pós-Operatória/diagnóstico por imagem , Radiografia , Estudos Retrospectivos , Fatores de Risco , Fusão Vertebral/métodos , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/cirurgiaRESUMO
Cauda equina syndrome (CES) resulting from acute lumbar disc herniation due to spinal massage is extremely rare. We present a case of CES caused by the acute worsening of a lumbar disc herniation after a vigorous back massage that included spinal manipulation. After vigorous back massage with spinal manipulation performed by a massage therapist, a 38-yr-old male patient experienced CES with severe numbness in both lower limbs, inability to walk due to weakness of bilateral lower limbs, and incontinence of urine and feces. The magnetic resonance imaging and computer tomography scan results showed that the L4-5 disc herniated down into the spinal canal, extensively compressing the ventral dural sac. The patient was successfully treated with an emergency operation including laminectomy, spinal canal decompression, discectomy, interbody fusion, and pedicle screw fixation. The muscle power in both lower limbs of the patient recovered rapidly to support standing only 1 wk later. Moreover, he regained continence of urine and feces. In conclusion, this case brings us novel knowledge that spinal massage or manipulation may worsen pre-existing disc herniation causing CES, and a timely emergency surgery is necessary and effective for treatment of CES-related symptoms.
Assuntos
Síndrome da Cauda Equina/etiologia , Deslocamento do Disco Intervertebral/terapia , Vértebras Lombares/patologia , Manipulação da Coluna/efeitos adversos , Massagem/efeitos adversos , Adulto , Dorso , Incontinência Fecal/etiologia , Humanos , Masculino , Manipulação da Coluna/métodos , Massagem/métodos , Incontinência Urinária/etiologiaRESUMO
Exercise training is a regular therapy for stroke patients in clinic. However, whether the early exercise is beneficial for stroke patients is still controversial. The review was performed in databases of OVID, PUBMED, and ISI Web of Science, from respective inception to December 2017. In this review, we summarize the effect of different exercise intensity, initiation time, and style on ischemic stroke. Moreover, the possible mechanism is also discussed. The conclusion is that the voluntary exercise is better in promoting the functional recovery following stroke compared to forced exercise; too early initiated exercise might play a harmful role following stroke, while early initiated exercise might exert benefits after stroke; mild and moderate intensity exercise training could generate better neuroprotection in comparison with high intensity exercise training; early excise training could regulate the process of brain edema, cell apoptosis, oxidative damage, stem cells and other mechanisms in order to exert neuroprotection for brain.
Assuntos
Terapia por Exercício/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Animais , Encéfalo/fisiopatologia , Edema Encefálico , Isquemia Encefálica/fisiopatologia , Modelos Animais de Doenças , Exercício Físico , Humanos , Neuroproteção , Condicionamento Físico Animal , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/fisiopatologiaRESUMO
Lower limb deep vein thrombosis (DVT) is not an uncommon postoperative complication of spinal fusion surgery. However, the related risk factors identified in previous studies remain controversial. This study aimed to investigate risk factors for lower limb DVT in patients with single-level lumbar fusion surgery. Between January 2010 and December 2016, a total of 710 patients undergoing lumbar fusion were recruited for this study, including 172 males and 538 females (aged 18-75 years). Deep vein thrombosis was detected by ultrasonography. Accordingly, patients were divided into the DVT group and the non-DVT group and compared in terms of operative data, underlying diseases, and biochemical data. Additionally, logistic regression analysis was performed to identify risk factors for lower limb DVT. The incidence of lower limb DVT was 11.8% (84 of 710 cases). Five patients were symptomatic, with lower limb pain and swelling. Two patients developed pulmonary embolism and 1 died. Binary logistic regression indicated that advanced age (P = .001, odds ratio [OR] = 2.86, 95% CI: 1.85-5.12), hypertension (P = .006, OR = 4.10, 95% CI: 1.09-2.30), and increased d-dimer (P < .001, OR = 3.49, 95% CI: 2.05-6.36) were risk factors for postoperative DVT. In conclusion, for patients with single-level lumbar fusion, advanced age, increased d-dimer, and hypertension may contribute to DVT development after spinal fusion surgery. Therefore, patients with these risk factors should be protected during the perioperative period.