Objective To evaluate the effect of percutaneous kyphoplasty (PKP) in the treatment of old osteoporotic vertebral compression fractures with intravertebral clefts.Methods 25 patients (25 vertebrae) suffering from old OVCF with vacuum phenomenon were treated with PKP.There were 8 males and 17 females with an average age of 72.7 years (range,64-84 years) and with an average duration of 7.8 months (range,6-24 months).The height of anterior column and the posterior convex Cobb angle of injured spine were measured on the lateral X-ray film in standing position at pre-operation and post-operation.Clinical symptoms were evaluated by visual analogue scale (VAS).The amount of bleeding and bone cement and complications were recorded.Results All of 25 operations were performed successfully without severe complications.Cement leakage occurred in 5 cases (20％),including 3 cases at the anterior vertebral edge and 2 cases at the lateral vertebra.The surgery time for each vertebra was 35～60 min (mean 42 min),and bone cement volume for each vertebra was 2.0～5.5 ml (mean 3.1 ml).25 patients were followed up for 12 months (range,6-15 months).The VAS score was decreased from (7.44 ± 1.0) preoperatively to (2.36 ± 0.8) day 3 postoperatively and to (2.12 ± 0.7) the last follow-up; the Cobb' s angle was improved from (28.28±3.76) to (23.28±3.76) and (24.32±3.94) respectively; and the anterior vertebral height was increased from (22.48±4.38) mm to (25.80±4.89) mm and (25.24±4.84) mm respectively.There were significant differences in VAS,Cobb's angle,and anterior vertebral height between prre-and post-operation (F=297.84,12.39 and 3.56,P＜0.001 or 0.05),but there were no significant differences in these indicators between day 3 postoperatively and the last follow-up (all P ＞ 0.05).Conclusions PKP is effective in the treatment of old osteoporotic vertebral compression fractures combined with intravertebral clefts.It can relieve pain rapidly and effectively,correct kyphosis,and prevent vertebra collapse.

Objective:To investigate the relationship of osteoporotic vertebral body compression fracture(OVCF)with multifidus muscle and intervertebral disc degeneration in the lower lumbar spine and the lumbar-pelvic parameters in elderly women.Methods:Clinical data of a total of 108 elderly women with osteoporosis were retrospectively analyzed.They were divided into the fracture group(n=56)and the control group(n=52)according to the presence of vertebral body compression fractures.Age, body mass index(BMI)and bone mineral density(BMD)were collected in two groups.The angle of pelvic incidence(PI), angle of pelvic tilt(PT), low lumbar lordosis(LLL)and sacral slope(SS)were measured by the standing lumbar lateral X-ray photography.The degree of degeneration of intervertebral disc L 3-S 1 and multifidus muscle were detected by using the lumbar MRI.These parameters were compared between the two groups. Results:The age, BMI and BMD had no significant difference between the two groups( P>0.05). The degree of intervertebral disc degeneration of L 3-L 4 and L 4-L 5 was statistically significant higher in the fracture group than in the control group( Z=-4.656 and -2.675, P=0.000 and 0.007), while the degree of intervertebral disc degeneration of L 5-S 1 had no statistically significant difference between the two groups( Z=-1.784, P=0.075). There were statistically significant higher multifidus muscle degeneration of L 3-L 4 and L 4-L 5 in the fracture group than in the control group( Z=-3.248 and -4.073, P=0.001 and 0.000), while no significant difference between the two groups in multifidus muscle degeneration of L 5-S 1( Z=-1.096, P=0.282). No statistically significant differences were found in PI, PT, SS and LLL between the two groups( t=1.162, 0.827, -0.082 and -0.677, P=0.248, 0.410, 0.935 and 0.500). Conclusions:The degeneration of intervertebral disc and multifidus muscle of L 3-L 4 and L 4-L 5 is positively correlated with OVCF in elderly women.

ObjectiveTo determine whether glutamate induces the alteration of aquaporin 4 (AQP4) expression in cultured rat astrocytes. MethodsThe secondary cultured astrocytes were treated with 1 mmol/L L-glutamate for 1 h, 3 h, 6 h, 12 h, 24 h and 48 h. The morphologic changes of astrocytes were observed through microscope after GFAP immunostaining and AQP4 mRNA expression were detected with real-time PCR. ResultsThe astrocytes swelled when exposed to glutamate for 1 h and remained with prolonged treatment. Meanwhile, the AQP4 mRNA expression were early down-regulated and subsequently up-regulated, featured with the lowest AQP4 mRNA level at 12 h after treatment (P<0.01) and higher at 48 h (P<0.05). ConclusionAquaporin 4 may be involved in the occurrence and development of astrocyte swelling induced by glutamate.

BACKGROUND:The relationship between the occurrence time and clinical symptoms of bone marrow edema in nontraumatic femoral head necrosis is stil controversial. OBJECTIVE:To evaluate the relationship of bone marrow edema in nontraumatic femoral head necrosis with Association Research Circulation Osseous (ARCO) staging and pain grading. METHODS: Forty-eight patients with nontraumatic femoral head necrosis (58 hips) were confirmed to have bone marrow edema on MRI T1 weighted images and T2 fat suppression images. Then, the patients were graded according to the MRI Classification Method reported by Zhao Pei-rong, the ARCO Staging System and Harris hip score for pain grading. We analyzed the correlation of bone marrow edema with ARCO staging and pain grading. RESULTS AND CONCLUSION:The incidence rate of bone marrow edema in ARCO I-III was increased in sequence, and the difference was statisticaly significant (χ2=27.69,P=0.001); the average rank of bone marrow edema in ARCO I-III was increased significantly (χ2=19.947,P=0.000). The incidence rate of bone marrow edema also increased among different pain grading, and the difference was statisticaly significant (χ2=57.0, P=0.000); the average rank of bone marrow edema among different pain grading was increased significantly (χ2=174.0,P=0.000). The presence and aggravation of bone marrow edema indicate the enlargement of necrosis area and the aggravation of symptoms in patients with nontraumatic femoral head necrosis, which can be used as an auxiliary index for the appraisal of disease progression.

Objective To discuss the feasibility and the effects of percutaneous vertebroplasty (PVP) in the treatment of the osteoporotic compression fracture in theupper and middle thoracic vertebrae.Methods The study included 101 patients.55 cases were treated with PVP (observation group) and 46 cases were treated with conservative treatment (control group).The clinical efficacy of those two different treatment methods was evaluated by the changes of VAS score,ODI score,vertebral height and Cobb angle before versus after treatment.Results VAS and ODI scores at 48 hours and 6 weeks after treatment was significantly lower in observation group than in the control group (all P＜0.05).Although there was no significant difference in VAS and ODI scores between the two groups after 6 months of treatment (both P＞0.05),the anterior and middle vertebral height was decreased and Cobb angle of spine was increased in control group as compared with observation group (both P＜ 0.05).Conclusions PVP is an effective and safe method in the treatment of osteoporotic vertebral compression fractures in upper and middle thoracic vertebrae.The short-and long-term evaluation indexes are better in PVP than in conservative treatment.But the surgery should be proceeded under highly clear perspective equipment by the surgeons with highly level professional technology.Because the surgery is highly risky,surgery should be proceeded with cautions.

Objective To observe the fusion rate by using cage filled with osteophyte in anterior cervical disectomy and fusion.Methods From January 2010 to July 2012,81 patients receiving anterior cervical disectomy and spine fusion underwent treatment with cages containing exclusively autologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space.There were 52 males and 29 females,aged from 55 to 78 years,average 64.1 years in this study.46 patients received one-level fusion,and 35 patients received two-level fusion respectively.Patients were followed up at 3 months,6 months and 1 year after operation.The fusion was evaluated by X-ray film and reconstructive CT.Results The total fusion rate after 3 months of operation was 76.5％ (62/81),the one-level and two-level fusion rate were 78.3％ (36/46) and 74.3％ (26/35),respectively.The total fusion rate after 6 months of operation was 93.8％ (76/81),the one-level and two-level fusion rate were 95.7％ (44/46) and 91.4％ (32/35),respectively.The total fusion rate was 100％ (81/81) after 1 year of operation.No statistically significant difference in fusion rate was found between the two groups.Conclusions The method of using cage filled with osteophyte can acquire ideal fusion rate in one-and two-level anterior cervical disectomy,fusion and plate fixation.

Arthritis, Juvenile ; blood ; Child ; Humans ; Interleukin-15 ; blood

Objective:To investigate the therapeutic efficacy of immunotherapy with dendritic cells-based vaccine against intracranial gliomas in rats.Methods:C6 glioma cells were injected into the brain of Wistar rat under stereotactic monitor to establish an animal model of glioma.The precursors of dendritic cells were isolated from bone marrow of rats,stimulated in vitro with recombinant rat granulocyte-macrophage colony-stimulating factor(rrGM-CSF)and interleukin-4(rrIL-4).Cultured cell populations were confirmed to be functional DCs.These DCs were then pulsed ex vivo with C6 tumor-lysates prepared by three cycles of freezing to -80℃ and thawing to 0℃ and subsequently injected subcutaneously into rats harboring intracranial C6 tumor.Rats from different group were treated with five weekly subcutaneous injections of either control media,unpulsed DCs,or DCs pulsed with tumor-lysates.The animals were followed for survival,the percentage of CD8 +T cells in peripheral blood and cytotoxicity assay in vitro were determined by FACS.The level of cytokine IFN-? and IL-10 were detected by ELISA.Results:The results indicated that C6 glioma model rats treated with tumor-lysate-pulsed DCs led to prolonged survival time,increased the percentage of CD8 + T lymphocyte in peripheral blood in comparing with control group.Cytotoxicity assays suggest that vaccination with these tumor-lysate-pulsed DCs can induce specific cytotoxic T lymphocytes against C6 tumor cells compared with control group.Furthermore,significantly enhanced IFN-? and reduced IL-10 (even undetectable)were observed in rats treated with pulsed-DCs.Conclusion:Data supported the therapeutic efficacy of systemic vaccination with DCs pulsed with tumor-lysates against intracranial glioma.

ObjectiveTo evaluate the diagnostic performance of CTCA in predicting myocardial perfusion defects through comparative analysis between MPI defects and severity of coronary stenosis on CTCA.MethodsFour hundred and seventy-eight patients who underwent CTCA and 99Tcm-MIBI MPI in the same period were analyzed retrospectively.According to the severity of coronary stenosis judged by visual evaluation of the vessel diameter,the patients were divided into five groups:no stenosis,mild stenosis,moderate stenosis,severe stenosis and total occlusion.MPI results were classified as negative or positive for perfusion defects,and the prevalence of perfusion defects in every group was calculated per-patient and per-vessel basis.The cut-off of stenotic severity for predicting myocardial perfusion defects was designated as 50％ or 75％,with MPI as standard reference.True positive,true negative,false positive and false negative statistics were thus determined separately on patient and vessel basis.The diagnostic performance for CTCA were calculated and compared.Pearson Chi-square and its partition tests or Fisher exact test were used to compare ordinal variables.ResultsFifty-eight patients showed myocardial perfusion defects.Either by patientbased or vessel-based analysis,the prevalence of myocardial perfusion defects showed an increasing trend with greater coronary artery stenosis in each group,and there were statistical differences among them (x2 =116.62 and 483.83,both P ＜ 0.05).On patient-based analysis,sensitivity ( SN),specificity ( SP),positive predictive value( PPV),negative predictive value(NPV) and accuracy (AC) for CTCA predicting myocardial perfusion defects were 62.1 ％ ( 36/58 ) and 34.5％ ( 20/58 ) (x2 =8.84,P ＜ 0.05 ),84.5％(355/420) and 97.1％ (408/420) (x2 =40.16,P ＜0.05),35.6％ (30/101) and 62.5％ (20/32) (x2 =7.19,P＜0.05),94.2％ (355/377) and 91.5％ (408/446) (x2 =2.18,P ＞0.05),81.8％ (391/478)and 89.5 ％ (428/478) (x2 =11.66,P ＜ 0.05 ) when the cutoff was set to 50％ and 75％,respectively.On vessel-based analysis,the SN,SP,PPV,NPV and AC for CTCA predicting myocardial perfusion defects were 58.8％ (40/68) and 30.9％ (21/68) (x2 =10.73,P ＜ 0.05),95.9％ (1768/1844) and 99.0％ (1826/1844) (x2 =36.72,P ＜ 0.05 ),34.5％ (40/116) and 53.8％ (21/39) (x2 =4.59,P ＜0.05 ),98.4％ (1768/1796) and 97.5％ ( 1826/1873 ) (x2 =4.14,P ＜ 0.05 ),94.6％ ( 1808/1912 ) and 96.6％ ( 1847/1912 ) (x2 =10.31,P ＜ 0.05 ),respectively.ConclusionsThe prevalence of myocardial perfusion defects correlates positively with the severity of coronary stenosis seen on CTCA.CTCA may predict perfusion defects with high SP and NPV.However,the PPV of CTCA in predicting myocardial perfusion defects is poor when the stenosis cut-off is set at 50％.It is significantly improved when the cutoff value is set at 75 ％.

Objective To construct an expression system to produce the virus-like particles containing a part of the sequence of PSA mRNA, which are ribonuclease-resistant due to the encapsulation of the mRNA by bacteriophage MS2 coat proteins. Methods The PCR products of PSA cDNA fragments were cloned to TA vector pBS-T, then the targeted segments could be obtained when the pBS-T-PSA were digested by restriction endonuclease Hind Ⅲ and cloned to prokaryocytic expression vector pNCCL1. The recombinant plasmids named PNCCL1-PSA were transfected into E. Coli BL21-DE3 and induced to express with IPTG. Results The recombinant plasmids were successfully constructed. The bacteriophage MS2 coat protein which expressed in BL21 can self- assemble to form ribonuclease resistant virus-like particles and the PSA mRNA was encapsulated into virus-like particles. Conclusions The virus-like particle containing PSA mRNA can be expressed in prokaryocyte and it can be used as standard and control in detecting PSA mRNA. It provides a new, stable and ribonuclease-resistant RNA standard in RNA detection.