Objective:To investigate the correlation between certain unhealthy lifestyles and the incidence of gastroesophageal reflux disease (GERD),thus to provide the lifestyle guidelines for GERD patients.Methods:Retrospective study were conducted for 402 GERD and 276 non-GERD out-patients in Department of Gastroenterology,Third Xiangya Hospital,Central South University from August,2014 to August,2015 based on questionnaire survey,then the correlation of unhealthy lifestyles with GERD were analyzed.Results:The top 10 common symptoms for GERD were as follows:reflux,acid regurgitation,postprandial fullness,heartburn,swallow obstruction or pain,epigastric burning sensation,paraesthesia pharynges,poststernal pain,chronic laryngopharyngitis,and chronic cough.The top 8 unhealthy habits closely related to GERD were as follows:fast-eating,over-eating,spicy preferred diet,sweets preferred diet,anxious,soup preferred diet,high-fat diet,and hot eating.Single-factor analysis showed that GERD was markedly correlated to gender (male),age (≥ 60 years),BMI,smoking,alcohol fast-eating,over-eating,hot-eating,spicy preferred diet,high-fat diet,acid preferred diet,sweets preferred diet,hard food preference,strong tea preference,coffee preference,immediately on bed after meal,difficult defecation,dyscoimesis,anxious,and too tight belt,respectively (P＜0.05).Logistic multiple regression analysis indicated that the largest risk factor for GERD was the fast-eating (OR=3.214,95％ CI 2.171 to 4.759,P＜0.001) followed by the overeating (OR=2.936,95％ CI 1.981 to 4.350,P＜0.001),elderly population (OR=2.047,95％ CI 1.291 to 3.244,P=0.002),too tight belt (OR=2.003,95％ CI 1.013 to 3.961,P=0.046),and hot-eating (OR=1.570,95％ CI 1.044 to 2.362,P=0.030).Conclusion:The elderly people are at high risk for GERD,and unhealthy habits like fast-eating,over-eating,too tight belt,and hot-eating is closely related to GERD.The lifestyles such as chewing food thoroughly,splitting the meals up,warm and cool diet,keeping patients out of the too tight belt are necessary for GERD patients.

OBJECTIVE: To compare the biomechanical differences among the atlantoaxial transarticular screw fixation (Magerl) and other posterior fixation techniques. METHODS: Seven preserved atlantoaxial-complex specimens were harvested and fixated with Magerl, Magerl plus Gallie wiring, Magerl plus Brooks wiring, pure Brooks, pure Gallie, and Halifax interlaminar clamping fixation, respectively. The torque for every fixation technique was measured at the point of five-degree rotation of the atlantoaxial joint. RESULTS: The torque for Magerl was 6.59 Nmplus minus1.14 Nm, which was significantly higher than any other pure posterior techniques including Gallie (1.74 Nmplus minus0.31 Nm). Brooks (4.06 Nmplus minus0.48 Nm) and Halifax (3.44 Nmplus minus0.87 Nm) (P<0.01), but less than Magerl plus brooks (9.94 Nmplus minus1.45 Nm) (P<0.01). No statistically significant difference was found between Magerl and Magerl plus Gallie wiring (7.61 Nmplus minus1.10 Nm) or between Brooks and Halifax. CONCLUSIONS: Compared with other pure posterior fixation techniques the atlantoaxial transarticular screw fixation technique provides more torsion-resistance capacity. It is also suggested that combined Gallie wiring do not add any biomechanical superiority to this technique.

OBJECTIVETo investigate the long-term efficacy of anterior approach surgery on cervical spondylotic myelopathy and factors affecting prognosis.

METHODSThe data in 116 patients suffered from cervical spondylosis from January 1992 to December 2000 were reviewed, including 80 male cases and 36 female cases, whose age ranged from 36 to 76 years (mean, 51 years). The preoperative course of disease was 2 months to 20 years (mean, 19 months). There were 65 cases (56.0%) with single segments involved, 44 cases (37.9%) with two segments, 7 cases (6.0%) with three segments. Ninety-eight cases were onset slowly, 18 cases with no remote cause and aggravating quickly. Three kinds of surgeries were performed: anterior cervical decompression and autoiliac bone interbody fusion, anterior cervical decompression and fusion with threaded fusion cage, anterior cervical decompression and autoiliac bone interbody fusion with anterior screw-plate system. Improvement in spinal cord function was assessed using the Japanese Orthopaedic Association (JOA) scoring system, the long-term efficacy and influential factors were also analyzed.

RESULTSThe mean follow-up time was 7 years and three months (5 - 12 years). The mean preoperative JOA score was 9.34 +/- 1.81. The mean postoperative JOA score was 10.35 +/- 1.85. At the final follow-up, the JOA score was 14.09 +/- 1.90 and the recovery rate was 63.2%. Among the total patients, 27 cases were excellent, 47 cases were fine, 23 cases were good, 19 cases were poor, the fineness rate was 63.8%. The long-term efficacy of anterior approach surgery has close correlations with time of course, age of onset, preoperative spinal cord function and the number of affected segments, but has no correlations with modes of fusion and internal fixation.

CONCLUSIONSThe patients will be attentively observed while having a definite diagnosis of cervical spondylotic myelopathy. The good long-term results will be obtained after early anterior cervical decompression and fusion.

Adult ; Aged ; Cervical Vertebrae ; pathology ; surgery ; Decompression, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Spinal Fusion ; methods ; Spinal Osteophytosis ; surgery ; Time Factors ; Treatment Outcome

OBJECTIVETo determine the stress distribution on endplate after lumbar prosthetic disc nucleus (PDN) replacement.

METHODSSix fresh lumbar vertebrae with normal Modic classification were harvested. The specimens were used to establish L4-5 intact, nucleotomy, prosthetic nucleus pulposus replacement models. Vertical compression tests were performed with MTS machine at the rate 50 N per second to maximum load of 1300 N. The stress under the endplate were measured directly with accurate pressure sensors.

RESULTSFor intact specimens, the stress on the endplate maintained higher in the central zone of the endplate, and decreased gradually to the periphery, and was well-distributed. After nucleotomy, the stress on the central zone of endplate was significantly decreased, and increased stress occurred in the periphery of endplate. After PDN replacement, the stress on the central zone of endplate was found more 15.1% higher than that in intact disc (P < 0.05), and the neighboring zone also showed higher stress measurements.

CONCLUSIONSAfter lumbar prosthetic disc nucleus replacement, the stress concentration on endplate may occur in the central zone of prosthetic disc nucleus insertion. Therefore, the prosthetic nucleus pulposus with suitable shape, proper biomechanical functions and updated materials need further study.

Adult ; Arthroplasty, Replacement ; Cartilage, Articular ; physiology ; Humans ; Intervertebral Disc ; surgery ; Joint Prosthesis ; Lumbar Vertebrae ; surgery ; Middle Aged ; Stress, Mechanical

OBJECTIVETo evaluate the structural characteristics and biocompatibility of a novel nano-Ta-Ti alloy rod for its potential application in internal fixation.

METHODSTa coating of a Ti alloy rod with nano-Ta (tantalum) powder was performed using laser melting with symmetrical grooves repleted with nano-Ta powder along the whole length. The microstructure of the cross section of Ta-Ti alloy rod, pore diameter and components of the coating were analyzed using scanning electron microscopy. The influence of this nano-Ta-Ti alloy on proliferation and differentiation of MC3T3-E1 cells was evaluated by MTT cytotoxicity test and ALP activity test.

RESULTSUnder scanning electron microscope, the Ta-coating surface presented with a gross porous (200-300 µm) structure with dense fusion between Ta particles, and no new element was produced after laser melting. Biocompatibility evaluation showed that Ti alloys with and without Ta coating both promoted the proliferation of MC3T3-E1 cells, but the coated alloy showed better performance and obviously promoted the differentiation of the osteoblasts.

CONCLUSIONAlloying between Ta and Ti can be accomplished successfully by laser melting technique, and the alloy obtained has ideal surface structure and good biocompatibility.

3T3 Cells ; Alloys ; Animals ; Biocompatible Materials ; Cell Differentiation ; Cell Proliferation ; Materials Testing ; Mice ; Microscopy, Electron, Scanning ; Osteoblasts ; cytology ; Porosity ; Tantalum ; Titanium

OBJECTIVETo study the effect of anti-CD25 monoclonal antibody (mAb) combined with antithymocytic globulin (ATG) in the treatment of severe steroid-resistant acute graft-versus-host disease (aGVHD) after unrelated donor hematopoietic stem cell transplantation (UD-HSCT).

METHODSTen leukemic patients who developed severe steroid-resistant aGVHD during UD-HSCT received a standard dose of anti-CD25 mAb and a medium or low dose of ATG. The effect on aGVHD control, patients' survival, infection and relapse after the therapy were analyzed.

RESULTSEight of the 10 patients had complete remission and 2 had partial remission after the combined therapy. In the 8 patients with complete remission, 2 developed third degree aGVHD 3-3.5 months after the transplantation, and were managed with a second combined therapy to successfully achieve complete remission. In the total of 12 combined treatments, the median time of therapeutic effect was 5 days (3-10 days); the median complete relief time was 12 days (8-30 days) in the 10 cases. Among the 8 patients who survived for more than 3 months, 7 were diagnosed to have chronic GVHD including 4 with extensive chronic GVHD. No relapse of leukemia was found in these patients. Five patients survived the 2-year-long follow-up after the transplantation with survival time over 2 years; of the 5 patients who died within 2 years after the transplantation, 1 survived for more than one year, and 4 for less than 6 months. Two patients died from invasive fungal infection, two from aGVHD and one from cGVHD-induced multiple organ failure.

CONCLUSIONAnti-CD25 mAb combined with ATG has good therapeutic effect on steroid-resistant sever aGVHD and may help achieve high complete remission rate and long-term survival in leukemic patients after UD-HSCT.

Acute Disease ; Adult ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antilymphocyte Serum ; administration & dosage ; therapeutic use ; Drug Resistance ; Drug Therapy, Combination ; Female ; Graft vs Host Disease ; drug therapy ; prevention & control ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Interleukin-2 Receptor alpha Subunit ; immunology ; Male ; Prednisone ; therapeutic use ; Young Adult

Alcoholism ; physiopathology ; Animals ; Dose-Response Relationship, Drug ; Evoked Potentials, Auditory ; drug effects ; Female ; Fetus ; drug effects ; Pregnancy ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the clinical effect of a self-designed posterior STB thoracolumbar transpedicular screw-plate system in the treatment of spondylolysis and spondylolisthesis.

METHODSThis STB screw-plate system is developed with titanium alloy (TC4, Ti6Al4V). During December, 1999 and January, 2001, this system was applied in 51 cases, including lumbar spondylolysis and spondylolisthesis (36 cases), degenerative lumbar instability (15 cases). The patients were aged 22 - 78 years, mean age: 47.5 - years; among them there were 14 male cases, 37 female cases; There were 15 cases degenerative spondylolisthesis with grade I-II slip, 36 cases of spondylolysis and spondylolisthesis, including 34 cases with grade I-II slips and 2 cases with grade III slips; single level of 33 cases, two levels 3 cases. Decompression was performed for the 43 cases with interbody fusion using iliac crest or bilateral-lateral fusion using demineralized bone matrix and 8 cases were fixed with demineralized bone matrix fusion without decompression.

RESULTSAll the operations heeded about 60 - 120 minutes, and during the operations bleeding amounts were 200 - 500 ml. The cases completely recovered to work or normal action after 3 months of surgeries. 46 of all cases were achieved to satisfactorily reduction and clinical effect, 5 cases of grade II-III remained incomplete reduction (grade I slip).

CONCLUSIONThis STB system has advantages of biomechanical stability and reduction capability and its effect in clinical application is undoubtedly positive.

Adult ; Biomechanical Phenomena ; Bone Plates ; Bone Screws ; Humans ; Joint Dislocations ; surgery ; Lumbar Vertebrae ; Male ; Spinal Fusion ; instrumentation ; methods ; Spondylolisthesis ; physiopathology ; surgery ; Spondylolysis ; physiopathology ; surgery ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the biocompatibility of pectin/poly vinyl alcohol composite (CoPP) hydrogel for use as a prosthetic nucleus pulposus material.

METHODSThe in vitro cytotoxicity of CoPP hydrogel was tested in NCTC L929 cells, which were divided into normal control group, negative control group [treated with poly (vinyl alcohol) hydrogel, PVA], experimental group (treated with CoPP) and positive control group (0.64% phenol). The optical density of the cells on days 2, 4, and 7 of the corresponding treatments was determined and the relative growth rate calculated. For in vivo biocompatibility evaluation, dehydrated CoPP and PVA hydrogel were respectively implanted into the left and right gluteus of SD rats, and the wound healing and general status were observed. The muscular tissues containing the implants were taken 1, 4, and 12 weeks after the implantation for gross observation and microscopic observation of the inflammatory cell infiltration (ICI) and formation of the fibrous capsulation around the implants.

RESULTSThe L929 cells incubated with PVA and CoPP group both grew well, with relative growth rate over 80% and 75%, respectively. The cytotoxicity of PVA and CoPP was both lower than grade 1. In contrast, the relative growth rate in the positive control group was below 24%, with cytotoxicity over grade 4. In the SD rats, ICI of grade IV occurred in the muscular tissues around the PVA and CoPP implants at 1 week without formation of complete capsule, and at 4 weeks, ICI was lowered to grade 1 with grade 4 capsular reaction. Till week 12, the ICI and capsular reaction were both first grade.

CONCLUSIONCoPP hydrogel has in vitro grade 0 or 1 cytotoxicity and causes only mild inflammation after implantation in rats, suggesting good biocompatibility of the material.

Animals ; Biocompatible Materials ; Hydrogel, Polyethylene Glycol Dimethacrylate ; Implants, Experimental ; Intervertebral Disc ; surgery ; Materials Testing ; methods ; Pectins ; chemistry ; Polyvinyl Alcohol ; chemistry ; Rats

OBJECTIVETo study the effect of ozonized saline on the activation of the Keap1-Nrf2-ARE signaling pathway in rat liver cells.

METHODSTwenty male Sprague-Dawley rats were randomly divided into ozonized saline (OS) group, model group, ozonized saline control (OSC) group and normal control (NC) group. The rats in OS group and model group were intravenously administered with OS or oxygen saline (5 ml/kg) respectively, once a day for 15 days, and then intraperitoneally injected with CCl4 dissolved in oliver oil. The rats in OSC group were pretreated with OS for 15 days. The rats in NC group were fed normally for 15 days. On the 16th day, the rats in OSC group and NC group were intraperitoneally injected with oliver oil (2 ml/kg) without CCl4. After 24 hours of CCl4 or olive oil intraperitoneal injection, the serum levels of alanine transaminase (ALT) and aspertate aminotransferase (AST) were measured. The liver tissues were also collected for detection of total anti-oxygen capability (TAOC), glutathione (GSH), catalase (CAT), Glutathione peroxidase (GPx). Western Blot was used to detect Nrf2 and immunofluorescence staining assay to display intracelluar distribution of Nrf2.

RESULTSCompared with the rats in model group,the serum ALT and AST levels of rats in OS group were significantly lower (P < 0.01) ,which were (1240.4 ± 188.2) U/L and (1245.4 ± 176.9) U/L vs (539.8 ± 175.3) U/L and (546.0 ± 130.2) U/L, and the TAOC, CAT, GPx and GSH activity of rats in OS group were significantly higher, which were (0.72 ± 0.24) U/mg, (1.05 ± 0.21) mg/g, (676.9 ± 115.1) U/mg and (45.2 ± 14.3) U/mg vs (1.37 ± 0.19) U/mg, (2.23 ± 0.55) mg/g, (1024.6 ± 162.9) U/mg and (68.2 ± 9.9) U/mg, respectively. In contrast with NC group, pretreatment of OS in OSC group elevated TAOC, CAT, GPx and GSH activity (P < 0.01 or P < 0.05). Ozonized saline can strengthen the Nrf2 expression in liver cells.

CONCLUSIONPreconditioning injection of ozonized saline can reduce rat's liver injury induced by CCl4. The ozonized saline, as a novel Nrf2 activator, can reduce the oxidative damage of radical oxygen species (ROS) and the deleterious substance by activating the Keap1-Nrf2-ARE signaling pathway and its downstream genes expression.

Alanine Transaminase ; metabolism ; Animals ; Glutathione ; metabolism ; Glutathione Peroxidase ; metabolism ; Hepatocytes ; drug effects ; metabolism ; Intracellular Signaling Peptides and Proteins ; Kelch-Like ECH-Associated Protein 1 ; Liver ; metabolism ; Male ; Malondialdehyde ; metabolism ; NF-E2-Related Factor 2 ; metabolism ; Oxidative Stress ; Ozone ; pharmacology ; Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Superoxide Dismutase ; metabolism