1.The distribution of Schmorl's nodes in patients with low back pain or radiculopathy and their correlation with degeneration of lumbar intervertebral discs
Yilei CHEN ; Zhijie ZHOU ; Shunwu FAN ; Fengdong ZHAO ; Xiangqian FANG
Chinese Journal of Orthopaedics 2013;33(11):1078-1083
Objective To evaluate the distribution of Schmorl's nodes (SN) in patients with low back pain or radiculopathy,and to analyze the correlation between SN and degeneration of lumbar intervertebral discs.Methods In 2012,1024 patients with low back pain or sciatica were examined by magnetic resonance (MR) scan and plain film.There were 448 males and 576 females,with an average age of (54.3 ± 12.7) years (range,22-90).The features distribution of SN in lumbar endplate on age,sex,segment and the type and grade of intervertebral disc degeneration were analyzed retrospectively.Results Among 5120 lumbar intervertebral segments of the 1024 patients,295 (28.8%) cases and 532 (5.2%) endplates were involved with SN,302 located in the cranial and 230 in the caudal endplate.According to percent prevalence per lumbar segment,L1,2 was the most common level (29.1%),followed by L3,4 (23.7%) and L2,3 (21.1%).The incidence of SN was positively correlated with elder age,but not with sex,body weight,height,or body mass index.SN occurred more often in bulging,extrusion,Modic changes,spondylolisthesis and osteophyte comparing with normal disc or protrusion or high intensity zone.The distributions of the grade of intervertebral disc degeneration were significantly different between groups with and without adjacent SN.Intervertebral discs with adjacent SN were more degenerated than those without adjacent SN.The number,size and volume of SN were associated with the degrade of intervertebral discs degeneration.SN was divided into two types,i.e.,acute edematous SN and non-acuteSN,according to the signal type on T1-and T2-weighted MR images,and the degeneration of the corresponding intervertebral discs was more severe in the latter than the former group.Conclusion SN occurred more often in the upper lumbar spine and cranial endplate in patients with low back pain or radiculopathy.SN were correlated with elder age and the degeneration of lumbar intervertebral discs.The number,size,volume and signal type on MR images of SN impacted on its correlation with lumbar intervertebral disc degeneration.
2.STUDY ON THE STERILIZATION EFFECTS OF FUNGI BY THE TREATMENT OF OZONE
Dongping SUN ; Ping LU ; Aijuan ZHANG ; Zhijie FANG ; Hongzhao LI
Microbiology 2001;(1):29-31
In this paper, the lethal effect on Rhizopus, Aspergillus niger, Penicillium by ozone was studied. The mortality rate against the time of the treatment of ozone and the variation of ozone concentration was measured. The changes of cell form were also observed. The Experiment results indicate that fungi could be destroyed completely by ozone and the mortality rate obviously increase with the prolonging of treatment time. When ozone was absorbed by KI,the mortality rate declines.
3.Study of hepatic cellular injury due to hepatic ischemia in dogs
Jiling JIANG ; Wenjun YANG ; Guozuo XIONG ; Zhijie XU ; Kui HE ; Desong JIANG ; Yong FANG
Chinese Journal of General Surgery 2001;0(07):-
Objective To investigate the ischemic injury of hepatic cell caused by hepatic artery occlusion.Methods The hepatic artery was occluded in 20 dogs via operation,while the portal vein remained patent.Specimens were gained from the right liver at four time points:before occlusion of the hepatic artery,20(minutes),40 minutes and 60 minutes after artery occlusion.Each specimen was examined by HE and BCL-2 by immunohistochemistry.The gray scale of BCL-2 in HE sections was detected.Results Hepatic cellular injury was obvious 20 minutes after occlusion of the hepatic artery.Irreversible hepatic cellular injury was(observed) 60 minutes after hepatic artery occlusion.The results showed that the gray scale of BCL-2 at every time point after hepatic artery occlusion were significantly different from that before hepatic artery occlusion(P
4.Comparison of adjacent segment degeneration following one-level mini-open or conventional open posterior lumbar interbody fusion
Zhijie ZHOU ; Shunwu FAN ; Xiangqian FANG ; Xing ZHAO ; Zhijun HU ; Fengdong ZHAO
Chinese Journal of Orthopaedics 2013;(2):136-141
Objective To compare the difference of adjacent segment degeneration (ASD) following one-level mini-open or conventional open posterior lumbar interbody fusion (PLIF).Methods From October 2005 to September 2008,108 patients underwent one-level instrumented PLIF using two different approaches: mini-open approach in 56 patients including 32 males and 23 females,aged from 32 to 68 years (average,53.8 years) and conventional open approach in 52 patients including 24 males and 28 females,aged from 27 to 69 years (average,52.6 years).The follow-up rates of the mini-open and conventional open groups were 91.1% and 88.5%,respectively.The visual analog scale (VAS),Oswestry disability index (ODI),multifidus muscle injury and ASD were evaluated.Results There were no significant differences in VAS and ODI scores between two groups preoperatively,but the two scores in the mini-open group were significantly lower than those in conventional open group after surgery.Compared with the conventional open approach,less decrease of cross sectional area and less severe fatty degeneration of the multifidus muscle were observed in mini-open group.There were 4 cases of radiographic ASD in the mini-open group including two symptomatic cases,and 11 cases in the conventional open group including 4 symptomatic cases among them 2 required surgical intervention.Both radiographic and symptomatic ASD were correlated with the decrease of cross sectional area and degree of fatty degeneration of the multifidus muscle,but only symptomatic ASD was associated with the clinical results.Conclusion Compared with the conventional open approach,the mini-open PLIF has many advantages,such as better clinical outcomes,lower incidence of multifidus muscle atrophy,and lower incidence of radiographic ASD.
5.Integration: a method for evaluating voltage-dependent transient outward potassium currents in pharmacology
Deli DONG ; Zhijie SUN ; Jundong JIAO ; Peng YUE ; Qinghui WANG ; Zhiwei FANG ; Baofeng YANG
Chinese Journal of Pharmacology and Toxicology 2005;19(1):64-69
AIM To evaluate the integration method for analysis of voltage-dependent Ca2+-independent transient outward K+ currents (Ito) in pharmacology. METHODSThe inactivation phases of Ito were best fitted by the sum of two or three exponentials equations. The area under the raw current curves (AUC) was obtained by the integration of exponential equations. The AUC normalized to the cell capacitance represented the net K+ charge flow during any depolarized duration and was as the index for comparison. Calcineurin overexpression transgenic (TG) mice showed downregulation of Ito. These data were tested by the integration method. RESULTS AUC obtained from three or two exponentials fittings was calculated as: AUC=A1τ1+A2τ2+A3τ3+A0t-A1τ1e-t/τ1-A2τ2e-t/τ2-A3τ3e-t/τ3 or AUC=A1τ1+A2τ2+A0t-A1τ1e-t/τ1-A2τ2e-t/τ2. The 50% and 90% action potential duration (APD50, APD90) in ventricular myocytes of mice are about 10 ms and 30 ms, respectively. AUC at 10 ms (AUC50, AUC of 50% APD) and 30 ms (AUC90, AUC of 90% APD) in left ventricle cardiomyocytes of wild type (WT) and TG mice were normalized to the cell capacitance. The normalized AUC50 and AUC90 of WT group were significantly more than those of TG group, which was consistent to the prolongation of APD in TG mice and the previous published results(downregulation of components of Ito in TG mice). CONCLUSION The integration method was an ideal way for analysis of transient outward K+ currents in pharmacology.
6.Disruption of circadian rhythms inhibits wound healing of corneal epithe-lium in mice
Peng LIU ; Jun LIU ; Yunxia XUE ; Fang SONG ; Hanqing WANG ; Ting FU ; Chaoyong XIA ; Zhijie LI
Chinese Journal of Pathophysiology 2015;(3):499-504
[ ABSTRACT] AIM: To observe the effect of circadian rhythms on wound healing of mouse corneal epithelium. METHODS:The C57BL/6 male mice were used in the study.A part of corneal epithelium (2 mm in diameter) was struck off by a golf-like knife to form a round wound area.The dynamics of epithelial healing in the wound area were ob-served under microscope with fluorescein staining.In addition, with related antibodies and DAPI, the dynamic changes of the neutrophils, platelets and dividing cells were also investigated.RESULTS:The healing rates in LL group (12 h light/12 h light) and DD group (12 h dark/12 h dark) were obviously slower than that in LD group (12 h light/12 h dark), mainly showing delayed re-epithelialization, decreased epithelial cells, increased diameter of blood vessel, and delayed re-cruitment of neutrophils and platelets, but more cell number.CONCLUSION:Disruption of circadian rhythms significant-ly inhibits the wound healing of corneal epithelium, mainly through delaying the inflammation and re-epithelialization, but aggravating the inflammatory responses.
7.Exploration of Variety of Matrix Metalloproteinase 9 and Blood Brain Barrier in Cardiopulmonary Resuscitation Rats
Zhijie HE ; Zijun ZOU ; Yun ZHANG ; Minggen ZHOU ; Zuyong LI ; Xiangshao FANG ; Zitong HUANG
Journal of Sun Yat-sen University(Medical Sciences) 2009;30(4):418-421,427
[Objective] To explore the variety of matrix metalloproteinase 9 (MMP9) and blood brain barrier (BBB) in cardiopulmonary resuscitation rats.[Methods] Eighty rats were randomly divided into 2 groups:the sham-operated group (n = 40) and the resuscitation group (n = 40).The two groups were anaesthetized and endotracheally intubated,the resuscitation group was also induced to cardiac arrest by aphysia.Then the rats were put to death and samples were taken at immediate,3 h,9 h,24 h,and 48 h.After that,the expression of MMP9,MMP9 mRNA,water content and Evans blue content in brain tissue were detected.Ultramicrostructure of brain tissue was observed with electron microscope.[Results] Compared to the sham-operated group,at 3 h,9 h,24 h and 48 h,the expression of MMP9 of resuscitation group was significantly changed.MMP9mRNA significantly increased.Water content statistically increased and so was Evans blue content.The change of ultramicrostructure in the resuscitation group at 3 h,9 h,24 h,and 48 h was obvious.[Conclusion] The expression of MMP9 and MMP9mRNA obviously increased in the cerebral ischemia model with CPR rats,and got to peak at 24 h.Water content and Evans blue content in brain tissue obviously increased in the cerebral ischemia model with CPR rats,BBB was destroyed,and the peak was 24 h.The injury of ultramicrostructure of brain tissue with electron microscope was obvious,and the peak was 24 h.
8.Myocardial protection study of histidine-tryptophan-ketoglutarate cardioplegic solution on infants with tetralogy
Jiancheng HUANG ; Fang YAN ; Xiaozheng CUI ; Jun WANG ; Huijun ZHANG ; Zhijie LI ; Yanbo DONG
Clinical Medicine of China 2015;31(5):451-454
Objective To evaluate the myocardial protective effects of Histidine-TryptophanKetoglutarate (HTK) solution on infants with tetralogy of fallot in cardiac operation through comparison with St.Thomas Ⅱ cardioplegia(STH) and HTK cardioplegia in the operation of tetralogy of fallot.Methods Forty infants with tetralogy of fallot(TOF) were enrolled in this study.Their age ranged from 7 to 35 months,and body mass from 5.3 to 9.5 kg.The infants were randomly divided into HTK (n =20) group and STH (n =20) group who received HTK or STH solution respectively.Then 3 ml blood sample were got at 1,2,4,8,24 and 48 h after the opening of ascending aorta.The serum levels of cardiac troponin Ⅰ(cTnI),creatine kinase(CK) and creatine kinase MB(CK-MB) were measured.Results There was significant difference between two groups in terms of the level of cTnI at different time (F(inner group)=49.94,P<0.001;F(between group) =10.23,P<0.001;F (across group) =28.49,P<0.001),and the level of cTnI in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P<0.05).There was significant difference between two groups in terms of the level of CK at different time (F(inner group) =58.85,P<0.001;F(between group) =16.43,P<0.001;F(across group)=18.32,P<0.001),and the level of CK in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P<0.05).There was significant difference between two groups in terms of the level of CK-MB at different time (F(inner group)=34.51,P <0.001;F(between group)=11.03,P<0.001;F(across group)=10.28,P<0.001),and the level of CK-MB in HTK group was lower than that of STH group at 1,2,4,8,24 and 48 h after the opening of ascending aorta (P <0.05).Conclusion HTK is more valid than STK for improving the ability of anti ischemia of myocardium and cardiac function,reducing arrhythmia and ischemia reperfusion injury on infants with TOF in cardiopulmonary bypass.
9. Clinical research progress in stroke-associated pneumonia
Fang FANG ; Yi SHU ; Zhijie XIAO
Chinese Critical Care Medicine 2019;31(11):1429-1434
Stroke-associated pneumonia (SAP) is a spectrum of pulmonary infections in non-mechanical ventilation patients within 7 days of stroke. SAP is one of the most common complications after stroke, with an incidence of 7%-38%, which is significantly associated with poor prognosis of stroke. Stroke-induced immune-depression syndrome (SIDS) is one of the main pathogenesis of SAP, which is closely related to autoimmune, sympathetic nervous system (SNS), hypothalamic-pituitary-adrenalin axis (HPA axis), parasympathetic nervous system (PNS), and damage-related molecular patterns (DAMPs). It is unclear how the lungs and brain interact during the development of SAP. Some clinical studies have found that some clinical indicators such as monocyte human leukocyte antigen-DR (mHLA-DR), neutrophil to lymphocyte ratio (NLR) and heart rate variability (HRV) can be used to predict SAP occurrence. Old age, male, and diabetes are currently considered risk factors for SAP. Furthermore, a variety of SAP risk scales such as A2DS2 scale (age, atrial fibrillation, dysphagia, gender and stroke severity), preventive antibacterial therapy in acute ischemic stroke (PANTHERIS) scale, acute ischemic stroke-associated pneumonia scale (AIS-APS), and ISAN scale (pre-stroke independence, gender, age, and stroke severity) have been developed. According to the opinion of Pneumonia in Stroke Consensus in 2015, it is recommended to use the modified Centers for Disease Control and Prevention (CDC) pneumonia clinical diagnostic criteria for the diagnosis of SAP. Prevention of SAP is the most important part of clinical practice. Preventive antibiotics are not recommended, and once SAP is diagnosed, the antibiotic strategies should be followed. Neuroprotective and anti-inflammatory treatments are still being studied.
10.Early complications associated with oblique lateral interbody fusion in the treatment of degenerative lumbar diseases
Jiying WANG ; Zhijie ZHOU ; Shunwu FAN ; Xiangqian FANG ; Fengdong ZHAO ; Jianfeng ZHANG ; Xing ZHAO ; Zhijun HU ; Junhui LIU ; Yanyan WANG
Chinese Journal of Orthopaedics 2017;37(16):1006-1013
Objective To evaluate the early clinical outcomes and complications of oblique lateral interbody fusion (OLIF) in the treatment of degenerative lumbar diseases.Methods All of 83 patients,29 males and 54 females with ages from 32 to 83 (average 60.8± 13.7 y),underwent OLIF with or without posterior pedicle screw-rod instrumentations from October 2014 to February 2017.The index diagnosis was discogenic back pain in 17 cases,spondylolisthesis in 23,lumbar spinal canal stenosis in 25,and degenerative lumbar spinal kyphoscoliosis in 18 cases.The distribution of operative level was 5 at L1,2,13 at L2,3,38 at L3,4,and 69 at L4,5.The mean number of fusion level for each case was 1.5 segments.The operative duration,blood loss during operation,intra-operative and post-operative complications,the length of post-operative hospital stay were recorded.Clinical outcomes were evaluated using visual analogue scale (VAS) and Oswestry disability index (ODI).All patients were followed up for at least 3 months.Lumbar X-ray and CT scans were taken and the clinical outcomes were re-assessed during follow-up.Results Fifty-one in the 83 patients underwent supplementary posterior pedicle screw-rod instrumentation with OLIF procedures.The operation lasted for 43-295 min,with a mean duration of (153 ± 72) min.Mean operation time for each OLIF segment was 43± 12 min.Blood loss during the operation was 30-800 ml,with a mean of 125±74 ml.Mean blood loss for each OLIF segment was 27±13 min.Average length of stay was 5.6 ± 3.2 d,ranging from 3-15 d.The VAS for back pain and leg pain and ODI scores were decreased apparently for each patient.The total incidence of complications was 22.9% (19/83),including 6.0% (5/83) of intra-operative complications (4 cases of cage subsidence,1 case of segmental artery injury) and 16.9% (14/83) of post-operative ones.The latter consisted of ipsilateral hip flexor weakness in 6,ipsilateral anterolateral thigh pain in 2,ipsilateral lateral thigh numbness in 1,contralateral pain in flexion of hip in 1,ipsilateral sympathetic chain injury in 2,and pain in area of iliac bone donor site in 2.All symptoms were released or disappeared during follow-up.Conclusion OLIF as a novel minimally invasive technique can act as a safe and effective treatment for degenerative lumbar diseases,which can also reduce approach-related complications.