Objective To investigate the short-term clinical efficacy of Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation in the treatment of thoracolumbar fracture.Methods A retrospective case series analysis was made on 34 patients with thoracolumbar fracture treated by minimally invasive transpedicular bone grafting and fixation in the injury vertebrae with Jack vertebral dilator from December 2014 to December 2015.There were 20 males and 14 females,and their age was 25-27 years (mean,46.7 years).According to the AO classification,there were 16 cases of type A1 and 18 type A3.The injured levels were at T11 in one case,at T12 in 6,at L1 in 15,at L2 in 9 and at L3 in 3.The operation time,blood loss,fluoroscopy frequency,incision length,and postoperative hospital stay duration were recorded.The visual analogue scale (VAS),Oswestry disability index (ODI),height ratio of vertebrae,Cobb angle,and complications were evaluated at follow-up.Results The operation time was (91.2 ±9.8) minutes,blood loss was (42.4 ±4.3) ml,incision length was (7.2 ± 0.4) cm,intraoperative fluoroscopy frequency were five,postoperative hospital stay was (3.9 ± 0.5) days,and follow-up time was (13.8 ± 1.7) months.All the patients showed complete healing in the injury vertebra.The VAS was (6.4 ± 0.9) points preoperatively,(4.1 ± 0.8) points,(1.2 ± 0.4) points,and (1.2 ± 0.5) points at 7 days,3 months and 12 months postoperatively.The ODI was (39.2 ± 2.3) points preoperatively,(24.5 ± 1.9) points,(13.0 ± 3.0) points,and (12.3 ± 2.0) points at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the VAS and ODI were significantly decreased compared with those preoperatively (P ＜ 0.05) and further declined at postoperative 3 months (P ＜ 0.05),while there was no significant difference between 3 months and 12 months postoperatively (P ＞ 0.05).The height ratio of vertebrae was 47.8 ± 12.2 preoperatively,83.6 ±4.9,82.5 ±4.8,and 81.7 ±4.7 at 7 days,3 months and 12 months postoperatively.The Cobb angle was respective (22.4 ± 4.7) °preoperatively,(3.6 ± 2.4) °,(4.6 ± 2.6) °,and (5.0 ± 2.8) ° at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the height ratio of vertebrae was increased and Cobb angle was decreased significantly compared to those preoperatively (P ＜ 0.05),while there was no significant difference in the indicators at 3 days,3 months and 12 months postoperatively (P ＞ 0.05).No looseness or breakage of internal fixation was found at follow-up and all patients had fracture union at the last follow-up.Conclusion Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation is safe and effective for treatment of thoracolumbar fractures,as the procedure can quickly relieve the pain,improve the function disability,effectively maintain the height of the vertebral body and restore the sagittal balance of spine.

Objective To study the regulation of microRNA - 22(miR - 22)on glycometabolism of hemato-poietic stem cell TF - 1 and its molecular mechanism. Methods TF - 1 cells were cultured for 2 h under hypoxic con-ditions. The expression levels of Glut4 and miR - 22 was detected by quantitative real-time PCR(qRT - PCR). The sgRNA vector of the miR - 22 gene was constructed and miR - 22 gene of TK - 1 cells was knocked out by the CRISPR/ Cas9 technique. Overexpression vectors were constructed,and miR - 22 knocked - out cells were introduced to overexpress miR - 22,the expression of miR - 22 was detected by qRT - PCR and the expression levels of Glut4 and PPAR - γ were detected by qRT - PCR and Western blot. Results Compared with the control group,the expression of miR - 22 in TF - 1 cells decreased (0. 015 ± 0. 000 vs. 0. 056 ± 0. 001)and the expression of Glut4 (0. 351 ± 0. 038 vs. 0. 152 ± 0. 005)and PPAR - γ (0. 421 ± 0. 017 vs. 0. 248 ± 0. 008)increased,when TF - 1 cells were cultured for 2 h under hypoxic conditions,and the differences were statistically significant (all P < 0. 05). Compared with the control group,the expression levels of Glut4 (0. 019 ± 0. 00 vs. 0. 008 ± 0. 000)and PPAR - γ (0. 038 ± 0. 001 vs. 0. 019 ± 0. 000)were significantly increased after miR - 22 gene silencing,and they were significantly decreased (Glut4:0. 005 ± 0. 000 vs. 0. 008 ± 0. 000;PPAR - γ:0. 137 ± 0. 000 vs. 0. 019 ± 0. 000)after overexpression of miR - 22,and the differences were statistically significant (all P < 0. 05). Conclusions It suggests that miR - 22 ex-erts a negative regulation on glycometabolism of hematopoietic stem cell TF - 1 by downregulating the expression of PPAR - γ. A new regulatory factor of TF - 1 glycometabolism and the mechanisms are identified,which has provided new ideas for the targeted medication of diseases induced by hematopoietic stem cell dysfunction.

BACKGROUND: There is little published evidence about the role of non-alcoholic fatty liver disease (NAFLD) in the progression from prehypertension to hypertension. This study was conducted to investigate the association of NAFLD and its severity with the risk of hypertension developing from prehypertension. METHODS: The study cohort comprised 25,433 participants from the Kailuan study with prehypertension at baseline; those with excessive alcohol consumption and other liver diseases were excluded. NAFLD was diagnosed by ultrasonography and stratified as mild, moderate, or severe. Univariable and multivariable Cox proportional hazard regression was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident hypertension according to the presence and 3 categories of severity of NAFLD. RESULTS: During a median of 12.6 years of follow-up, 10,638 participants progressed to hypertension from prehypertension. After adjusting for multiple risk factors, patients with prehypertension and NAFLD had a 15% higher risk of incident hypertension than those without NAFLD (HR = 1.15, 95% CI 1.10-1.21). Moreover, the severity of NAFLD was associated with the incidence of hypertension, which was higher in patients with more severe NAFLD (HR = 1.15 [95% CI 1.10-1.21] in the mild NAFLD group; HR = 1.15 [95% CI 1.07-1.24] in the moderate NAFLD group; and HR = 1.20 [95% CI 1.03-1.41] in the severe NAFLD group). Subgroup analysis indicated that age and baseline systolic blood pressure may modify this association. CONCLUSIONS NAFLD is an independent risk factor for hypertension in patients with prehypertension. The risk of incident hypertension increases with the severity of NAFLD.
Humans ; Non-alcoholic Fatty Liver Disease/complications* ; Prehypertension/diagnosis* ; Risk Factors ; Hypertension ; Incidence