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Objective To evaluate the clinical effects of transforaminal lumbar interbody fusion (TLIF) versus posterior lumbar interbody fusion (PLIF) on lumbar spondylolisthesis and lumbar instability in Chinese patients.Methods Literatures about clinical effects of TLIF and PLIT on lumbar spondylolisthesis and lumbar instability were collected from Chinese academic literature database (CNKI),Chinese biomedical literature database (CMBdisc),Wanfang database and Chinese journals of orthopedics.Data from those literatures including operation time,bleeding volume,surgical complications,postoperative interspace height,visual analog scale (VAS) score,Oswestry Disability Index (ODI) and improvement rate of Japanese Orthopedic Association (JOA) score were analyzed by Stata SE 11.2 software.Results A total of 12 literatures met the inclusion criteria and 1041 cases were included (PLIF group,n=520; PLIF group,n=521).The operation time was longer in PLIF group than in TLIF group [standardized mean difference (SMD)=1.26,95％CI:0.58-1.94,P＜0.001].The bleeding volume was more in PLIF group than in TLIF group SMD=1.70,95％CI:0.94 2.46,P＜0.001).The surgical complications were more in PLIF group than in TLIF group (SMD=4.50,95％CI:2.65-7.64,P＜0.001).There were no statistical differences in postoperative interspace height,VAS score,ODI score,improvement rate of JOA score and fusion rate between the two groups [SMD=-0.07,-0.07,0.15,1.43,95％CI:-0.44-0.30,-0.27-0.13,-0.06-0.35,0.75-2.73,0.63-2.15,respectively,all P＞0.05].Conclusions TLIF has significant advantages on decreasing operation time,bleeding volume and risk of surgical complications as compared with PLIF.TLIF and PLIF have the same clinical efficacy on restoring and maintaining postoperative interspace height.

Objective To compare the cell-killing and sensitization effect of 6-gingerol on human hepatoma carcinoma (HepG-2) cell in normal mode versus hypoxia-hypoglycemia mode in chemotherapy.Methods The HepG-2 cells was cultured to logarithmic phase and treated with adriamyein doxorubicin hydrochloride (ADM) (5,10,15,20,40,60 mg/L) and 6-gingerol(25,50,100,200 μmol/L)in different concentrations.Then the cell counting kit (CCK-8) assay kit was used to determine the proliferation inhibition of HepG-2 cells.Cell apoptosis was detected by combining flow cytometry and AnnexinV-FITC PI double staining after treated with different drugs.The expressions of bcl-2,bax and birc-5 mRNA in HepG-2 cells was detected by real time fluorescence quantitative polymerase chain reaction(RT-PCR)assay.Results 6-gingerol and ADM had a certain degree of growth inhibition on HepG-2 cells.In two modes,the inhibition ratios of the 6-gingerol and ADM were both increased along with the increase of the concentration,which showed a dose-dependent manner.Flow cytometry analysis demonstrated that the apoptosis rate in the control group,6-gingerol group,ADM group and the 6-gingerol+ADM group in the normal mode was (7.98±0.76)％,(9.63 ± 1.00) ％,(12.70 ± 2.13) ％ and (19.92 ± 1.41) ％ respectively.The apoptosis rate in the control group,6-gingerol group,ADM group and the 6-gingerol+ ADM group in the hypoxia-hypoglycemia mode was (13.92 ± 2.02)％,(19.36 ±-1.22)％,(27.87 ± 0.99)％ and (38.63 ± 2.25)％ respectively.It demonstrated that the apoptosis rate was increased in the experimental groups as compared to the control group under the two culture conditions(the normal mode and the hypoxiahypoglycemia mode)(t=7.250,5.259,12.185,8.140,15.000,47.576,respectively,all P＜0.05,0.01 or 0.001).The combination group had the highest number of apoptosis cells,and the number of apoptosis cells was higher in hypoxia-hypoglycemia group than in normal culture group.Real-time PCR analysis showed that,compared with the control group,the expressions of bcl-2 and birc-5 mRNA were decreased and the expression of bax mRNA had no significant changes in experimental group under the normal culture conditions.The expressions of bcl-2 and birc-5 mRNA were significantly decreased and the expression of bax mRNA was increased in experimental group as compared with the control group under the hypoxia-hypoglycemia conditions.Under the hypoxiahypoglycemia environment,the expression of bcl-2 mRNA was significantly increased,the expressions of bax and birc-5 mRNA was significantly reduced,and the ratio of bcl-2 and bax was significantly increased as compared with the normal culture conditions.Conclusions 6 gingerol may decrease the inhibitory effect of survivin protein on tumor cells apoptosis by reduced the expression of birc-5,which generates the cell-killing and sensitizing effect on HepG-2 cell in chemotherapy.This performance is more obvious in the hypoxia-hypoglycemia environment.