Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in surgical treatment of osteoporotic thoracolumbar vertebral compression fracture in the elderly.Methods From March 2007 to February 2013,210 cases (100 males and 110 females;55-91 years of age,mean 72.5 years) of osteoporotic vertebral compression fracture were treated with PKP.Single-segment fracture was observed in 180 cases,two-segment fracture in 20 cases and three-segment fracture in 10 cases.Lesion involved in 250 vertebrae located in the T6-L5 segment.Bone cement injected into each vertebra was 3-5 ml (mean,4 ml).Treatment effects were assessed with vertebral height,Cobb angle and visual analogue score (VAS).Results At the follow-up of 6-15 months (mean 11 months),thoracic back pain significantly alleviated or disappeared.After operation,improvements were observed in VAS [(8.7 ± 1.2) points vs (2.6 ±0.7) points],anterior vertebral height loss [(11.0 ±3.2) mm vs(5.5 ± 0.8) mm],central vertebral height loss [(8.6 ± 1.1)mm vs (3.3 ± 1.0) mm],and Cobb angle [(29.8 ± 4.5) ° vs (16.7 ± 3.4) °] (P ＜ 0.01).Four patients appeared no pain or numbness in lower limbs although cement leak into disc.Whereas two patients had lower extremity nerve irritation because of cement leak into the spinal canal and recovered after symptomatic treatment.Conclusion PKP is an effective method for treatment of osteoporotic vertebral compression fracture in the elderly,for it can rebuild vertebral height,increase vertebral rigidity as well as stability and relieve thoracic back pain.

We screened a strain NK13 for a certain extent asymmetric hydrolysis the rac-ketoprofen Chloroethyl ester to (S)-Ketoprofen. As identified, NK13 was Bacillus megaterium. Digested NK13 genomic DNA with Sau3AI partially and recovered the fragment from 2 kb to 6 kb, cleaved the plasmid of pUC18 with BamH I, ligated the 2-6 kb fragment of NK13 genomic DNA into pUC18 plasmid, and then transformed an Escherichia coli strain DH5alpha. We created the gene library of NK13 and obtained a positive clone, pUC-NK1 in the library from the tributyrin flat. The result of sequencing showed that there was a whole open read frame (ORF) of 633 bp lipase gene in the plasmid of pUC-NK1. To compare with the genes of GenBank, this lipase gene was reported firstly (GenBank Accession No. EU381317). The lipase gene was amplified by PCR, using pUC-NK1 plasmid as template, and subcloned into the high expression vector pET21b(+) under the control of T7 promoter. The recombinant plasmid, pET-NKest1, was then transformed into an Escherichia coli strain BL21 (DE3) for the production of recombinant lipase protein. After 3 hours of induction by isopropyl-beta-D-thiogalactoside (IPTG), lipase was expressed. SDS-PAGE analysis showed that the relative molecular mass of the lipase protein was about 20 kDa. The result of high performance liquid chromatography (HPLC) showed that the conversion rate of the recombinant strain was fifty times than the wild strain NK13's. The (S)-Ketoprofen enantiomeric excess of the recombinant strain was 75.28%, which indicated that the lipase could hydrolyze (S)-Ketoprofen Chloroethyl ester firstly. If we research the conditions of the hydrolysis rac-ketoprofen Chloroethyl ester of this lipase further, maybe it could offer a foundation to product (S)-Ketoprofen industrially.
Amino Acid Sequence ; Bacillus megaterium ; genetics ; isolation & purification ; metabolism ; Base Sequence ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Ketoprofen ; analogs & derivatives ; chemistry ; isolation & purification ; Lipase ; biosynthesis ; genetics ; Molecular Sequence Data ; Open Reading Frames ; genetics ; Recombinant Proteins ; biosynthesis ; genetics ; Stereoisomerism