OBJECTIVETo analyze the clinical characteristics of elderly patients with spinal tuberculosis and explore its clinical effects with anti-TB drugs alone.

METHODSFrom January 2008 to July 2010, the data of 36 patients with spinal tuberculosis underwent conservative treatment of anti-TB drugs alone were analyzed. There were 19 males and 17 females with an average age of 73.5 years (ranged, 60 to 85). All patients were in the active phase with high ESR and CRP levels and were treated with 3HRZE/6-9HRE (course from 9 to 12 months). According to clinical symptoms, chemical examination, radiological image to adjust drug and depending on VAS score to evaluate pain.

RESULTSAll the patients were followed up from 8 to 24 months with an average of 15 months. Tuberculose of 31 patients healed after chemotherapy from 9 to 12 months and ESR and CRP recovered normally. Levofloxacin and para-amino salicylic acid were used in 4 cases because of 4 cases occurred drug fast for RFP or INH, after 15 months, their obtained healing. Symptom of 1 case got worse during chemotherapy, and surgical treatment were performed, after 3 months, ESR and CRP recovered normally, X-ray and CT showed spinal osteosclerosis and fusion without significant kyphosis and internal fixation loosening. Cobb angle was respectively(17.6+/-2.3) degrees, (18.1+/-2.7) degrees before treatment and last follow-up (P>0.05). MRI showed abscess was absorbed and spinal inflammation subsidised. VAS score was respectively 6.5+/-1.7, 1.4+/-0.5 before treatment and last follow-up (P<0.05). Seven patients had complications relating with drug adverse reaction,after discontinuation and treated with clinical symptom,the patients recovered normally.

CONCLUSIONAnti-TB drugs alone can obtain satisfactory effects in treating early senile spinal tuberculosis, but strict supervision and individual administration should not be disregardful.

Aged ; Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Tuberculosis, Spinal ; diagnosis ; drug therapy

Adult ; Aged ; Antigens, CD20 ; metabolism ; Diagnosis, Differential ; Female ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, B-Cell ; genetics ; metabolism ; pathology ; surgery ; Lymphoma, Extranodal NK-T-Cell ; pathology ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Tonsillar Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Tonsillectomy ; Tonsillitis ; pathology ; Young Adult

Decompression, Surgical ; Humans ; Lumbar Vertebrae ; surgery ; Spinal Fusion ; Spondylolisthesis ; diagnosis ; physiopathology ; surgery

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Large Cell ; metabolism ; pathology ; Diagnosis, Differential ; Histiocytic Sarcoma ; metabolism ; pathology ; surgery ; Hodgkin Disease ; metabolism ; pathology ; Humans ; Lymphoma, Large B-Cell, Diffuse ; metabolism ; pathology ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Male ; Melanoma ; metabolism ; pathology ; Receptors, Cell Surface ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Actins ; analysis ; Antigens, CD34 ; analysis ; Carcinoma, Papillary ; classification ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Keratin-19 ; analysis ; Keratin-20 ; analysis ; Muscle, Smooth ; chemistry ; Pancreatic Neoplasms ; classification ; metabolism ; pathology ; Proto-Oncogene Proteins c-kit ; analysis ; Receptors, Estrogen ; analysis ; Receptors, Progesterone ; analysis

Abdominal Pain ; etiology ; Child ; Child, Preschool ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Purpura, Schoenlein-Henoch ; complications ; pathology

OBJECTIVETo probe into clinical therapeutic effect of acupuncture on infertility of ovulatory disturbance and the mechanism.

METHODSThe patients were randomly divided into an acup-moxibustion group and a medication group in the order of visiting, 60 cases in each group. The acup-moxibustion group were treated with acupuncture at Zhongji (CV 3), Guanyuan (CV 4), Zigong (EX-CA 1), Zusanli (ST 36), Sanyinjiao (SP 6) and suspended moxibustion over Shenque (CV 8), Sanyinjiao (SP 6), and the medication group with oral administration of 50 mg Clomiphene. After treatment for 3 menstrual cycles, pregnancy rate, basal body temperature, B-ultrasonic examination and ovulation were assessed.

RESULTSAcup-moxibustion and oral administration of Clomiphene had higher ovulating effect, with no significant difference between them (P > 0.05); the pregnancy rate in the acup-moxibustion group was significantly higher than that in the medication group (P < 0.05).

CONCLUSIONAcup-moxibustion and Clomiphene have a same ovulating effect, and the pregnancy rate is higher and the abortion rate is lower for the patient of acup-moxibustion treatment than that for oral administration of Clomiphene.

Acupuncture Therapy ; Adult ; Female ; Humans ; Infertility, Female ; therapy ; Medicine, Chinese Traditional ; Ovulation

OBJECTIVETo construct Epithelia Membrane Protein 1 gene-deficient in human fetal nucleus pulposus model by lentivirus-mediated RNA interference for building a platform for illustrating the biomechanisms role of EMP-1 during human intervertebral disc degeneration.

METHODSThe lentivirus vector with shRNA targeting EMP-1 mRNA was transected into 293FT cells by liposome. Then the lentivirus supernatant was obtained and used for infecting human fetal nucleus pulposus. The expression of GFP was observed under fluorescence microscope after 48 h. The viral particles were collected at 72 h after transfection. The efficacy of gene interference was tested by Western blot and Real-time RT-PCR. Analysis the results of the fluorescent microscope scenes and get the average values of EMP-1/GAPDH by detected the interference efficiency of various interference DNA sequences with western blot and semi quantitative RT-PCR methods.

RESULTSThe lentivirns with high titer were obtained and the EMP-1 gene deficient cell strains were obtained. Semi quantitative RT-PCR and Western blot proved the average values of EMP-1/GAPDH decreased from 0.46 to 0.32 and 0.5 to 0.25 (P < 0.01).

CONCLUSIONLentivirus packaging technology can be mastered skillfully. EMP-1 gene-deficient cell models are successfully established.

Fetus ; HEK293 Cells ; Humans ; Intervertebral Disc ; metabolism ; Lentivirus ; genetics ; Neoplasm Proteins ; genetics ; RNA Interference ; Receptors, Cell Surface ; genetics ; Transfection

OBJECTIVETo investigate clinical outcome of short-course chemotherapy in retreating spinal tuberculosis after radical operation.

METHODSForty-six retreating patients with spinal tuberculosis were included in this series, 29 males, 17 females with the age from 27 to 61 years (average of 43.7 years). All patients were treated with radical operation and short-course anti-tuberculous chemotherapy from March 2005 to March 2008. The tuberculous focus located thoracic spine in 17 cases, thoracic-lumbar in 13 and lumbosacral vertebrae in 16 cases. Of them, 5 cases had sinuses of tuberculosis and 7 cases had incomplete palsy in lower limbs (Frankel C-D). CT or MRI showed obvious sequestra, cold abscess within spinal focus. Surgical procedures including debridement, auto-bone grafting, and one-stage internal fixation, was performed at the 4 to 6 weeks after chemotherapy. Chemotherapy regimes were 3HRZ/6-9HRE in majority of patients. Clinical effect and focus healing were evaluated at follow-up period.

RESULTSTuberculous symptoms and local pain of vertebral volume were obvious in all patients before chemotherapy,with average ESR 65.3 mm/h and average CRP 37.4 mg/L. After 4-6 weeks chemotherapy, tuberculosis symptoms and vertebral pain improved in all patients, and the average ESR decreased to 38.3 mm/1h, the average CRP decreased to 17.2 mg/L. Two to three months after operation, tuberculous symptoms and local pain relived in all patients,ESR and CRP became normal in 37 cases. Six to twelve months after operation, bonegraft complex in each patient became stable and there were no instrument loosening or deformity correction loss. Six patients with incomplete palsy recovered and 1 case improved from Frankel C to D grade. Focus healing was achieved in 44 cases (95.7%) after short-course chemotherapy (3HRZ/6-9HRE), and there were no resurgence in 2 to 4 years follow-up period. Drug fast 2 cases for RFP+INH cured at the 15 months after chemotherapy.

CONCLUSIONSRemoved tubercular focus for the treatment of retreating spinal tuberculosis can improve clinical effect and shorten chemotherapy course.

Adult ; Antitubercular Agents ; therapeutic use ; Combined Modality Therapy ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Thoracic Vertebrae ; surgery ; Treatment Outcome ; Tuberculosis, Spinal ; drug therapy ; surgery

OBJECTIVETo study the curative effect of surgical treatment of drug-resistant spinal tuberculosis.

METHODSFrom March 2005 and April 2009, the clinical data of 60 patients with drug-resistant spinal tuberculosis were retrospectively analyzed. Including 36 males and 24 females; aged from 5 to 79 years with an average of 47.3 years. Thirty-four patients had neurological deficits, among them, 2 cases were grade A, 5 cases were grade B, 13 cases were grade C, 14 cases were grade D according to ASIA standard. According to the severity and location of the infection, the patients underwent anterior, posterolateral costotransversectomy or posterior debridement and bone grafting and internal fixation. The antituberculous chemotherapy for a total of 12 to 18 months was guided by conventional and genotypic drug susceptibility testing. Tubercular relapse, neurological function, spinal fusion were observed by ASIA grade, X-ray and CT scan.

RESULTSAll cases were followed up from 1 to 5 years with an average of 3.1 years. Recurrence was found in 2 cases who were cured after second operation. 34 cases with neurological deficits recovered totally or partially. X-ray or CT films showed spinal fusion in 57 patients.

CONCLUSIONThe therapeutic effect of individuall operative options is good in treating drug-resistant spinal tuberculosis after antituberculous chemotherapy based on conventional and genotypic drug susceptibility testing.

Adolescent ; Adult ; Aged ; Antitubercular Agents ; therapeutic use ; Child ; Child, Preschool ; Drug Resistance, Bacterial ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium ; drug effects ; genetics ; Radiography ; Retrospective Studies ; Spine ; Tuberculosis, Multidrug-Resistant ; diagnostic imaging ; drug therapy ; microbiology ; surgery ; Tuberculosis, Spinal ; diagnostic imaging ; drug therapy ; microbiology ; surgery ; Young Adult