Arthroplasty, Replacement ; methods ; Diskectomy ; methods ; Humans ; Spinal Diseases ; surgery ; Spine ; surgery

Humanism ; Humans ; Orthopedics

Humans ; Orthopedics ; trends

Adolescent ; Humans ; Scoliosis ; classification ; surgery ; Spinal Fusion ; methods

Background: Current treatments for scoliosis have some defects and complications. To study spinal deformities and test novel scoliosis treatments, many animal models of scoliosis have been developed. These models applied a single load to the spine and could not precisely modulate the spinal growth in different dimensions. In this study, we applied posterior tethering in various directions with the application of nickel?titanium (NT) coil springs in dog's spine to modulate spinal growth in the coronal, sagittal, and transverse planes and create a scoliosis model possess curves that mimic adolescent idiopathic scoliosis (AIS) three dimensionally. Methods: Scoliosis was surgically induced in eight 8?week?old female dogs (weight: 1.95–2.30 kg) using bone screws and NT coil springs. The deformity was induced through the placement of posterior NT coil springs that tethered the spine by bone screw fixation. All dogs were monitored with serial radiographs to document changes in deformities. Results: All experimental animals developed scoliotic curves convex to the left in the lumbar segment. The mean coronal Cobb angle was 18.0° immediately postoperatively and 54.5° at 22 weeks. The mean lordosis increased from 6.2° postoperatively to 35.0° at final follow?up. Apical axial rotation increased from 4.5° postoperatively to 31.2° at 22 weeks. Conclusions: With the application of NT springs in dogs that allowed posterior tethering in various directions, lumbar spinal deformity was achieved in three planes: coronal, sagittal, and transverse planes. Notably, the lumbar spine in surgically treated dogs developed lordoscoliosis with obvious rotation and the curves mimic AIS three dimensionally well. This method allows lumbar scoliosis to develop without deep dissection of muscle and maintains the essential anatomical elements along the spinal curve. Moreover, the spinal growth modulation technique could yield information that would provide a basis for developing novel early?stage treatments for children with scoliosis.

Etiology of adolescent idiopathic scoliosis (MS),a complicated three-dimensional spinal deformity with early-onset,receives continuous attention but remains unclear.To gain an insight into AIS pathogenesis,this review searched PubMed database up to June 2019,using key words or medical subject headings terms including "adolescent idiopathic scoliosis," "scoliosis," "pathogenesis,etiology," "generics,mesenchymal stem cells," and their combinations,summarized existing literatures and categorized the theories or hypothesis into nine aspects.These aspects include bone marrow mesenchymal stem cell studies,genetic studies,tissue analysis,spine biomechanics measurements,neurologic analysis,hormone studies,biochemical analysis,environmental factor analysis,and lifestyle explorations.These categories could be a guidance for further etiology or treatment researches to gain inspiration.

This study is to investigate if madecassoside can protect against myocardial reperfusion injury in rabbit heart in vivo. The ischemia reperfusion model was established. Left ventricular function and ECG were monitored at the ischemia and reperfusion period. The infarct areas were expressed as percentage. The levels of LDH, CK, MDA and SOD were measured and C-reactive protein (CRP) in serum was measured by ELISA kit. Cardiomyocyte apoptosis were measured by TUNEL staining. A monoclonal rabbit anti-goat Bcl-2 proteins as primary antibody was used for Bcl-2 immunohistochemical staining. Treatment with madecassoside (3.2, 1.6 and 0.8 mg x kg(-1)) i.v. during ischemia reperfusion injury attenuated myocardial damage, that is, characteristic of decreasing infarct size, decreasing LDH and CK release. Activities of SOD were diminished and MDA level increased obviously in control group whereas pretreatment with madecassoside significantly blunted the decrease of SOD activity, markedly reduced the levels of MDA, CRP and cardiomyocyte apoptosis, and upregulated the expression of Bcl-2. Madecassoside has the protective effect against myocardial ischemia reperfusion injury, and effects of anti-lipid peroxidation, enhancement of SOD activity, anti-inflammation and anti-apoptosis.
Animals ; Apoptosis ; drug effects ; C-Reactive Protein ; metabolism ; Cardiotonic Agents ; isolation & purification ; pharmacology ; Centella ; chemistry ; Creatine Kinase ; blood ; Electrocardiography ; L-Lactate Dehydrogenase ; blood ; Lipid Peroxidation ; drug effects ; Male ; Malondialdehyde ; blood ; Myocardial Reperfusion Injury ; metabolism ; pathology ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; pathology ; Plants, Medicinal ; chemistry ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rabbits ; Random Allocation ; Superoxide Dismutase ; blood ; Triterpenes ; isolation & purification ; pharmacology

OBJECTIVETo investigate the perioperative and early-term efficacy of bilateral total knee arthroplasty (BTKA) in one-stage procedure.

METHODSTotally 93 patients operated with BTKA in one-stage procedure from 2003 June to 2005 June were followed up and the curative effect was determined with Hospital for Special Surgery knee-rating system (HSS). The complications were then analyzed.

RESULTSThe mean postoperative HSS score was 89. 6 (55 approximately 96 scores) and the excellence/good rate reached 95. 7% (excellent in 74 cases, good in 15 cases, moderate in 2 cases, and poor in 2 cases). Except for the muscle power, the pain, joint function, range of joint movement (ROM) , deformity, and stability were significantly improved after operation (P < 0. 05). The average ROM of knee was improved to 99. 8 (75-135 ) degrees after operation from 88.9 (25-110) degrees before operation (P < 0. 01). Complications included deep vein thrombosis (n = 2) , incision fat liquidation (n = 2) , deep infection ( n = 1) , urinary infection ( n = 1) , and peroneal nerve palsy (n = 1). No death was documented.

CONCLUSIONBilateral total knee arthroplasty in one-stage procedure under secure conditions can be performed with good outcomes in selected patients without a definite increase in perioperative risk.

Adult ; Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Knee Prosthesis ; Male ; Middle Aged ; Treatment Outcome

The traditional treatment of scoliosis is mainly based on open surgeries that use the anterior approach, the posterior approach, or both. These surgical procedures often lead to complications including massive blood loss, infections, and pain of incision.The minimally invasive spine surgery (MISS) was introduced in the 1990s and has shown many advantages including less blood loss, less pain, and lower infection incidences.Today MISS is mainly used in the treatment of adolescent idiopathic scoliosis and adult scoliosis. However, due to some inevitable complications, it still can not be routinely applied.This review will briefly summarize the advances in the application of MISS in surgical treatment of adolescent idiopathic scoliosis and adult scoliosis.
Adolescent ; Adult ; Humans ; Minimally Invasive Surgical Procedures ; adverse effects ; methods ; Postoperative Complications ; epidemiology ; Scoliosis ; surgery ; Spine ; surgery

OBJECTIVETo explore the possible mechanism of the erector spinal muscles in idiopathic scoliosis by comparing the expression and localization of neuronal nitric oxide synthase (nNOS) and inducible nitric oxide synthase (iNOS) of the thoracic erector spinal muscles on convex side and concave side.

METHODSThe patient group comprised 8 females and 2 males who were scheduled for spinal surgery. The apex of scoliotic curve in these patients arose between T6 and T11. The mean age was 14.3 (range 12-17) years, and the mean Cobb angle was 57.7 degrees (range 45 degrees-85 degrees). Muscle biopsies were taken bilaterally during surgery from the superficial multifidus muscle at the apex of the curve between the 6th and 11th thoracic vertebral levels. Part of the tissue was fixed in formalin and stained with hematoxylin and eosin; the remaining tissue was snap frozen and processed for immunohistochemistry and Western blot. Immunocytochemistry for nNOS and iNOS were performed using the EnVision two-step method. Western blot was done with antibodys to nNOS and iNOS. Immunoreactive bands were visualized by enhanced chemiluminescence according to the manufacturer's specifications (Amersham Corp).

RESULTSnNOS protein in the erector spinal muscles was localized at the sarcolemma. Western blot demonstrated that nNOS protein expression in the concave side of erector spinal muscles is more than that in the convex side. A significant decrease in nNOS protein and activity was found on the convex side of erector spinal muscles from idiopathic scoliosis patients; There was a little immunoreactivity to iNOS in erector spinal muscles. There was little difference in iNOS protein expression between both sides of the curve. Western blot detected the same results.

CONCLUSIONThere is a greater expression of nNOS and iNOS on the concave side than on the convex side, suggesting nNOS and iNOS may play a role in the pathogenesis of idiopathic scoliosis.

Adolescent ; Child ; Female ; Humans ; Immunohistochemistry ; Male ; Muscle, Skeletal ; cytology ; enzymology ; Nitric Oxide Synthase ; analysis ; metabolism ; Nitric Oxide Synthase Type I ; Nitric Oxide Synthase Type II ; Scoliosis ; enzymology