AIM: To establish the quality control for Lidanzhitong Tablet (Radix Paeoniae Rubra,Fructus Aurantii,Rhizoma Corydalis,etc.). METHODS:Radix Paeoniae Rubra, Fructus Aurantii and Rhizoma Corydalis were identified by TLC, and the content of paeoniflorin in Radix Paeoniae Rubra was determined by HPLC. RESULTS: Paeoniflorin showed a good linear relationship at a range of 0.597-4.997 ?g, r=0.999 9. The average recovery was 99.06%, and RSD was 3.4%. CONCLUSION: The method is accurate and reliable, and can be used to control the quality of this preparation effectively。

OBJECTIVETo study the causes of failure following surgical treatment of lumbar spondylolisthesis, procedures for redo surgery and the final result of reoperation.

METHODS20 patients who had a repeat operation for lumbar spondylolisthesis were studied retrospectively. On average 24.3 months following the previous surgery, all of these patients had recurrence or progression of back and leg pain. All of 20 patients were reoperated by means of three different procedures.

RESULTSThe causes of failure were post-operative destabilization (6 cases); progressive spondylolithesis (3 cases) implants failure (10 cases) and mistake segment (one case). After reoperation, a mean 34.1 months' follow-up was made. The excellent or good rate was 90%. Incorporation of graft was found in 18 cases with fusion by inter-transverse process and 2 cases by intervertebral space. New bone formation was found in 6 out of 8 cases that had a simultaneous intervertebral cage implant. No implant failure was found in all patients.

CONCLUSIONSSimple laminectomy or discectomy was not indication for lumbar spondylolithesis. No bone graft or union was the main causes of implant failure. Posterior instrumented fusion with laminectomy decompression can be used in the patients who had a prior surgery of simple discectomy or anterior intervertebral bone graft. Except for posterior instrumented fusion with extensive laminectomy decompression, Intervertebral fusion should be considered in the patients who had a prior surgery of laminectomy decompression with instrument, anterior intervertebral fusion (ALIF) was recommended for these cases.

Adult ; Aged ; Bone Transplantation ; methods ; Decompression, Surgical ; Diskectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Reoperation ; Retrospective Studies ; Spinal Fusion ; methods ; Spondylolisthesis ; surgery ; Treatment Outcome

OBJECTIVETo study the treatment of spinal fractures in ankylosing spondylitis.

METHODSNineteen cases of spinal fractures complicating ankylosing spondylitis admitted in our hospital were studied retrospectively.

RESULTSAll of 19 cases were up to the diagnosis standards of ankylosing spondylitis. Eleven patients had cervical fracture and 8 had thoracolumbar fracture. Of the patients with cervical fracture, fractures occurred at C(5 - 7) in 9 patients. Of the patients with thoracolumbar injury, stress fractures were seen in 7 patients and all of seven fractures occurred at T(10)-L(2). Sixteen of the 19 patients sustained fractures through three columns of the spine. Nine patients had spinal cord injures; eight of the 9 cases had cervical fracture. All of the 19 patients were treated operatively. Four different surgical procedures were used in patients with cervical fracture; decompression, fusion and stabilization with instrumentation by anterior approach were performed in 9 patients. Of the patients with thoracolumbar fractures, four different operations were performed; fusion by both anterior and posterior approach plus a long posterior instrument were used in 5 cases. Eighteen patients had an average follow-up period of 46.6 months. Nine patients with preoperative neurological deficits improved in 8 and was stabilized in 1. Radiographic evidence of fusion was observed in all of the 18 patients. Two patients suffered neurological deterioration during surgery. One patient died from cerebrovascular infarction. Two patients had pneumonia after the operative procedure.

CONCLUSIONSSpinal fractures in ankylosing spondylitis are associated with a high rate of neurological injury. Shearing fracture usually occurs at the lower cervical spine (C(5 - 7)) and stress fracture at thoracolumbar spine. Most of the fractures involve three columns of spine. Surgical intervention may be indicated in this injury. Fracture union and neurological improvement can be achieved in most patients treated by operation. We suggest that, fusion and stabilization with instrumentation by anterior approach is indicated in most cervical shearing fracture, and a combined fusion by both sides plus a long posterior instrument is probably beneficial in patients with thoracolumbar stress fracture. Complications is not rare after surgery and appropriate preventive measures are necessary for these patients.

Adult ; Aged ; Cervical Vertebrae ; diagnostic imaging ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; complications ; surgery ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Osteoporosis ; complications ; Postoperative Care ; Postoperative Complications ; prevention & control ; Radiography ; Retrospective Studies ; Spinal Fractures ; etiology ; surgery ; Thoracic Vertebrae ; diagnostic imaging ; pathology ; surgery ; Treatment Outcome

OBJECTIVETo study the effects of epimedium pubescens icariine on the proliferation and differentiation of human osteoblasts.

METHODHuman osteoblasts were obtained by inducting human marrow mesenchymal stem cells (hMSCs) directionally. MTT was used to observe the proliferation and activity of ALP was assayed to observe the differentiation of the third passage human osteoblasts cultured in vitro. The expression of BMP-2 mRNA was checked by RT-PCR.

RESULTEpimedium pubescens icariine at the dose of 20 microg x mL(-1) increased greatly the proliferation and differentiation of human osteoblasts and promoted the expression of BMP-2 mRNA.

CONCLUSIONEpimedium pubescens icariine enhances significantly the proliferation and differentiation of human osteoblasts, which may be mediated by increasing the expression of BMP-2 mRNA.

Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; biosynthesis ; genetics ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Epimedium ; chemistry ; Flavonoids ; isolation & purification ; pharmacology ; Humans ; Osteoblasts ; cytology ; Plants, Medicinal ; chemistry ; RNA, Messenger ; biosynthesis ; genetics ; Transforming Growth Factor beta ; biosynthesis ; genetics

BACKGROUNDIcariine is a flavonoid isolated from a traditional Chinese medicine Epimedium pubescens and is the main active compound of it. Recently, Epimedium pubescens was found to have a therapeutic effect on osteoporosis. But the mechanism is unclear. The aim of the study was to research the effect of Icariine on the proliferation and differentiation of human osteoblasts.

METHODSHuman osteoblasts were obtained by inducing human marrow mesenchymal stem cells (hMSCs) directionally and were cultured in the presence of various concentrations of Icariine. 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) test was used to observe the effect of Icariine on cell proliferation. The activity of alkaline phosphatase (ALP) and the amount of calcified nodules were assayed to observe the effect on cell differentiation. The expression of bone morphogenetic protein 2 (BMP-2) mRNA was detected by reverse transcriptase-polymerase chain reaction (RT-PCR).

RESULTSIcariine (20 microg/ml) increased significantly the proliferation of human osteoblasts. And, Icariine (10 microg/ml and 20 microg/ml) increased the activity of ALP and the amount of calcified nodules of human osteoblasts significantly (P < 0.05). BMP-2 mRNA synthesis was elevated significantly in response to Icariine (20 microg/ml).

CONCLUSIONSIcariine has a direct stimulatory effect on the proliferation and differentiation of cultured human osteoblast cells in vitro, which may be mediated by increasing production of BMP-2 in osteoblasts.

Alkaline Phosphatase ; analysis ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; biosynthesis ; genetics ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drugs, Chinese Herbal ; pharmacology ; Flavonoids ; pharmacology ; Humans ; Osteoblasts ; cytology ; drug effects ; RNA, Messenger ; analysis ; Reverse Transcriptase Polymerase Chain Reaction ; Transforming Growth Factor beta ; biosynthesis ; genetics

OBJECTIVETo determine the effectiveness of surgical correction for post-traumatic kyphosis of thoracolumbar spine.

METHODSFrom 1996 to 2003, 33 consecutive patients with post-traumatic kyphosis of thoracolumbar spine were corrected surgically. The mean age was 40.3 years (range, 13 - 65 years). The mean time between the initial injury and surgical correction was 36.0 months (range, 6 - 220 months). The kyphotic deformity averaged 40.8 degrees (range, 20 degrees - 82 degrees ). All the patients had neurological deficits. Twelve patients had obvious back pain. Seven patients lost sphincter function completely and nineteen patients lost the function partly. Twenty-three patients had ever undergone laminectomy and/or instrumentation. The treatment procedure consisted of anterior release and posterior spinal osteotomy with instrumentation (15 patients), posterior closing wedge osteotomy with instrumentation (12 patients), anterior release and instrumentation (6 patients).

RESULTSKyphosis was corrected from an average of 40.8 degrees to an average of 5.7 degrees, the corrective rate was 86.0% (40.8 degrees - 5.7 degrees /40.8 degrees). There were no severe complications. The average follow-up period was 24.6 months (range, 6 - 84 months). There was no loss of correction at follow-up. Ten of these patients showed an improvement in neural function by one or two levels according to the classification. Sphincter function recovered partly in ten patients. Back pain was relieved significantly in all of twelve patients with back pain preoperatively. Bony fusion was achieved in thirty-two patients. One patient had nonunion and achieved bony fusion after revision.

CONCLUSIONPosterior closing wedge osteotomy was suitable to kyphosis less than 40 degrees. Anterior release and posterior spinal osteotomy was effective, especially to the patients with severe kyphosis deformity or with operation history. Patients with incomplete neurological deficits and/or severe back pain could get benefit from osteotomy of spine, even if their medical history was long.

Adolescent ; Bone Transplantation ; Child ; Female ; Humans ; Kyphosis ; etiology ; surgery ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Osteotomy ; methods ; Retrospective Studies ; Spinal Fractures ; complications ; surgery ; Spinal Fusion ; Thoracic Vertebrae ; injuries ; surgery ; Treatment Outcome

OBJECTIVETo investigate the effect of different dynamic tensional and compressive stress on the mRNA expression of collagen type I and fibronectin in cultured human periodontal ligament fibroblasts (hPDLF), and explore the regularity of functional change in hPDLF.

METHODSA new cyclic strain loading apparatus was used for mechanically loading. Cells cultured in vitro were loaded with three levels (1000 microstrain, 2000 microstrain, 4000 microstrain) of tensional and compressive forces and collected at different time (0 h, 0.5 h, 1 h, 4 h, 8 h,12 h) course after strain loading. The quantity of collagen type I and fibronectin mRNA was analyzed by means of quantitative real-time PCR with special primers of up- and down-regulated genes. Data were analyzed using SPSS version 10.0 software.

RESULTSDifferent magnitude and different kinds of mechanical forces as well as the force application time significantly changed the expression of collagen type I and fibronectin mRNA in hPDLF.

CONCLUSIONSDynamic mechanical forces could regulate the expression of collagen type I and fibronectin mRNA in hPDLF. Collagen type I and fibronectin participated in the mechanical signal transduction in human periodontal ligament fibroblasts.

Cells, Cultured ; Collagen Type I ; metabolism ; Fibroblasts ; metabolism ; Fibronectins ; metabolism ; Humans ; Periodontal Ligament ; cytology ; metabolism ; RNA, Messenger ; genetics ; Stress, Mechanical

OBJECTIVETo investigate the effect of different kinds of mechanical stress on the mRNA expression of integrin beta1 subunit in cultured human periodontal ligament fibroblasts (hPDLF).

METHODSTo scalp and remove the periodontal ligament attached to the mid-third part of the fresh root of young premolars extracted for the cause of orthodontics. Cultured hPDLF by the method of digesting by I-type collagenase combining with tissue adhering. Then hPDLF was isolated and purified by cells passage. The sixth passage's cells were selected to be loaded. A new cyclic strain loading apparatus. Forcel four point bending device was used for mechanically loading. Cells were loaded by three levels (1000, 2000, 4000 microstrain) of tensional and compressive forces and collected at different times (0, 0.5, 1, 4, 8, 12 h) course after strain loading. The quantity of integrin beta1 mRNA in every group was analyzed by means of quantitative real-time PCR with the special primers of up- and down-regulated genes.

RESULTSDynamic mechanical forces down-regulated the expression of integrin beta1 subunit mRNA in hPDLF and the difference in groups by different magnitude, different kinds, and different time of mechanical forces loading were statistically significant. The stronger stimulated forces, the more down-regulated expression. Compression down-regulated the expression of integrin beta1 subunit mRNA more than tension did.

CONCLUSIONDynamic mechanical forces could regulate the expression of integrin beta1 subunit mRNA. The difference among all the groups by different magnitudes, different kinds, and different time of mechanical forces loading were statistically significant.

Cells, Cultured ; Fibroblasts ; Humans ; Integrin beta1 ; Periodontal Ligament ; RNA, Messenger ; Stress, Mechanical

OBJECTIVE:To compare the clinical efficacy,safety and economy of vancomycin and linezolid in the treatment of intracranial infections after neurosurgery operation. METHODS:Clinical data of 53 patients with intracranial infections receivingvancomycin (32 cases) and linezolid (21 cases) after neurosurgery from Jan. 2015 to Nov. 2017 were collected from medical record inquiry system of Xijing Hospital of Air Force Medical University. Pathogen detection,clinical efficacy and cerebrospinal fluid indexes were compared between 2 groups before and after treatment. The occurrence of ADR was observed in 2 groups,and treatment duration of total effective patients and total cost of antibiotics was compared. RESULTS:The bacterial culture of cerebrospinal fluid was positive in 20 patients,with positive rate of 38.46％(20/52). There was no statistical significance in pathogen positive rates and total effective rates between 2 groups (P>0.05). White blood cell count, red blood cell count, neutrophil percentage and the contents of protein in cerebrospinal fluid of 2 groups were lower than before treatment,while the contents of glucose were higher than before treatment,with statistical significance(P<0.05),besides patients with therapy failure. But there was no statistical significance in these indexes between 2 groups after treatment (P>0.05). There was no statistical significance in duration of antibiotics use and incidence of ADR between 2 groups (P>0.05). The total cost of antibiotics in vancomycin group was significantly lower than linezolid group,with statistical significance (P<0.05). CONCLUSIONS:The effectiveness and safety of vancomycin are similar to linezolid in the treatment of Gram-positive bacterial intracranial infection after neurosurgery. Vancomycin is superior to linezolid in terms of economy. If patients do not have obvious liver or kidney insufficiency,or allergies,etc.,vancomycin should still be the first choice for treatment.

Ananas comosus L. leaves,the leaves of pineapple,have a variety of medicinal values. Therefore,they can be used to prevent and treat many diseases. Pineapple leaves are actually safe that few studies have shown the side effects. The chemical composi-tion,medicinal value,toxicity and safety of pineapple leaves were summarized in the article, and the quality research was described simply as well.