OBJECTIVETo explore effectiveness and safety of segmental anterior cervical decompression in treating multi-level cervical myelopathy.

METHODSTwenty-four patients with four levels of cervical myelopathy were treated with segmental anterior cervical decompression (reservation of middle vertebrae, bone graft and plate-screws fixation). Among patients, there were 15 males and 9 females aged from 47 to 75 (averaged 57.9) years old. Preoperative, postoperative at 1 week and the latest following-up AP and lateral X-rays were used to observe bone union, displacement of implant, adjacent segment degeneration, changes of Cobb angle of fusion segment. JOA scoring were applied for evaluate recovery of nerve function.

RESULTSAll operations were completed successfully, 2 cases ocurred hoarseness, and improved after treated symptomatically. Nineteen patients were followed up from 3.1 to 5.3 years with an average of 3.9 years. Bone union time ranged from 3 to 7 (averaged 4.5) months. No screw loosening and displacement occurred. Nine patients occurred titanium mesh subsidence in different degrees, and 4 of them subside >3 mm; four patients ocurred adjacent segment degeneration. Postoperative Cobb angle of fusion segment at 1 week (10.40±2.94)° was improved from preoperative (5.76±4.16)°, but decreased at the latest follow-up (8.57±2.82)°, and had significant meaning compared with preoperative (P<0.01). JOA score at the latest follow-up (14.6±1.1) was higher than that of before operation (8.2±1.9), and had siginificant differences (P<0.01).

CONCLUSIONSegmental anterior cervical decompression for the treatment of multilevel cervical myelopathy has a high clinical operability, and plays an important role in recovering cervical curvature and nerve function based on completely decompression.

Aged ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; methods ; Female ; Humans ; Male ; Middle Aged ; Spinal Fusion ; methods ; Spondylosis ; surgery

OBJECTIVETo investigate the clinical effects and operative options for the treatment of Forestier disease.

METHODSFrom June 2005 to May 2012, 8 patients with progressive dysphagia due to Forestier disease were treated through anterior approach, their clinical data were retrospective analyzed. There were 6 males and 2 females, aged from 65 to 83 years old with an average of 73 years. Among the patients, osteophytes removal was performed in 3 cases, osteophytes removal with discectomy and fusion was performed in 2 cases, osteophytes removal with corpectomy and fusion was performed in 3 cases. According to Bazaz dysphagia score to assess the improvement of the patients' symptoms before and after operation.

RESULTSAll patients were followed up from 12 to 40 months with the mean of 18.5 months. Seven cases were asymptomatic and 1 case had mild symptom in the last follow-up. Radiographs showed the space enlargement between vertebral body and trachea.

CONCLUSIONIt is effective to treat patients with progressive dysphagia due to Forestier disease through surgical method. And the operative options depend on the stability of cervical spine and the neurological symptoms of the patients.

Aged ; Aged, 80 and over ; Female ; Humans ; Hyperostosis, Diffuse Idiopathic Skeletal ; diagnosis ; etiology ; surgery ; Male

In this study, we explored the mechanism of Huganning tablet (HGNP) in the treatment of nonalcoholic fatty liver disease (NAFLD) based on network pharmacology and computer-aided drug design. Firstly, the potential ingredients and targets of HGNP were identified from TCMSP database, Swiss Target Prediction database, Chinese pharmacopoeia (2015) and literatures, and then the targets of HGNP intersected with NAFLD disease targets that obtained in GeneCards database to acquired potential targets. The bioconductor bioinformatics package of R software was used for gene ontology (GO) enrichment and Kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis. The network of “potential ingredient-key target-pathway” was formed in Cytoscape software to study the interactions between potential ingredients of HGNP, key targets, pathways and NAFLD. Based on the results of network pharmacology, the molecular docking analysis of the key targets and potential active ingredients in HGNP tablets with top degree in the network was conducted using Discovery Studio 2020 software, followed by molecular dynamics simulations, binding free energy calculation, drug-likeness properties analysis and ADMET (absorption, distribution, metabolism, excretion and toxicity) properties prediction. In vitro, HepG2 cells were used to establish steatosis model, and the effects of five key compounds on hepatocyte steatosis were analyzed by oil red O staining and triglyceride (TG) content determination. The results showed that 141 ingredients and 151 potential targets were obtained. A total of 2 526 items and 151 pathways were identified by GO and KEGG enrichment analysis. The molecular docking suggested that five components, isorhamnetin, salvianolic acid B, emodin, resveratrol and rhein, exhibited strong binding ability with key targets [retinoic acid receptor RXR-alpha (RXRA), tumor necrosis factor (TNF), glycogen synthase kinase-3 beta (GSK3B), serine/threonine-protein kinase 1 (AKT1)]. It was further verified that isorhamnetin and salvianolic acid B bind to key targets with good structural stability and binding affinity based on molecular dynamics simulations and binding free energy calculations. The drug-likeness properties, pharmacokinetic properties and toxicity of five key compounds were more comprehensively analyzed through drug-likeness properties analysis and ADMET properties prediction. In vitro, all five compounds, isorhamnetin, salvianolic acid B, emodin, resveratrol, and rhein, improved hepatocyte steatosis of HepG2 cells, confirming the reliability of the present study. In conclusion, based on network pharmacology, computer-aided drug design and in vitro validation, this study investigated the mechanism of HGNP for the treatment of NAFLD at multiple levels and provided a basis for its clinical application.

Objective To study the pharmacokinetics profiles of ibupro-fen and pseudo ephedrine with chlorpheniramine suspension after single and multiple dosing in healthy volunteers.Methods Three single and one multiple oral doses of ibuprofen and pseudo ephedrine with chlorphe-niramine suspension were given to healthy volunteers respectively.Ibu-profen concentrations in plasma were determined by HPLC-UV method.Pseudo ephedrine and chlorpheniramine concentrations in plasma were determined by HPLC-MS-MS method.The pharmacokinetic parameters were obtained with statistical analysis by DAS Ver 2.0.Results The main pharmacokinetic parameters of 3 single doses(ibuprofen:200,400,600 mg pseudo ephedrine:30,60,90 mg;chlorpheniramine:2,4,6 mg)and multiple dose(ibuprofe,pseudo ephedrine and chlorphe-niramine 200,30,2 mg,respectively)shown that the concentration-time curves of ibuprofen,pseudo ephedrine and chlorpheniramine were described by one-compartment open model and physiological disposi-tions were assumed by linear kinetics characteristics.Conclusion In multiple dosing study,physiological dispositions of ibuprofen,pseudo e-phedrine and chlorpheniramine all existed no induction and inhibition of drug enzyme phenomenon.

The different components of crude mycelium of the predominant endophytic Colletotrichum gloeosporioides of Artemisa annua have been extracted by the methods of acid hydrolysate. We compared the effect of the isolated components on artemisin biosynthesis in hairy root cultures. Therefore, the oligosaccharide elicitor from C. gloeosporioides has been partially purified by column chromatography of Sephadex G25. The isolated oligosaccharide B II (elicitor, MW < 2500) has been revealed to promote the production of artemisinin in Artemisia annua hairy root cultures. When hairy roots of 23-day old cultures (later growth phase) were exposed to the elicitor at 0.4 mg/mL for 4 days, the maximum production of artemisinin reached to 13.51 mg/L, a 51.63% increase over the control. This is the first report on the stimulation of artemisinin production in hairy roots by the oligosaccharide elicitor from an endophytic fungus of A. annua.
Artemisia annua ; drug effects ; growth & development ; metabolism ; Artemisinins ; metabolism ; Bioreactors ; Colletotrichum ; chemistry ; Mycelium ; chemistry ; Oligosaccharides ; isolation & purification ; pharmacology ; Plant Roots ; drug effects ; growth & development ; metabolism

Objective:To observe the effect of moxibustion on the mRNA and protein expressions of heat-shock protein 70 (HSP70) in gastric cancer-bearing rats. Methods: A total of 40 healthy Sprague-Dawley (SD) rats were adaptively fed for one week. The gastric cancer model was prepared by Walker-256 cancer tissue transplantation. After 7 d, 10 rats were randomly selected to verify the successful modeling, and the remaining 30 rats were divided into a model group, a moxibustion group and an infrared group by the random number table method, with 10 rats in each group. After enrollment, the moxibustion group received suspended moxibustion at Zhongwan (CV 12), Guanyuan (CV 4) and bilateral Zusanli (ST 36), (the first group of acupoints) on the 1st day, and suspended moxibustion at bilateral Pishu (BL 20) and Weishu (BL 21), (the second group of acupoints) on the 2nd day, 20 min each time, once a day. Moxibustion was alternately performed every other day at the two groups of acupoints for 21 d. From the day of enrollment, rats in the infrared group were irradiated with the infrared radiation at the stomach area on the 1st day, and at the T12-T13 interspinous region on the 2nd day, 20 min each time, once a day, and the two locations were alternately irradiated every other day for 21 d. During the treatment, rats in the model group were intervened by grasping and fixation without treatment. At the end of the treatment, blood was collected from the inner eye orbit, and the HSP70 expression in peripheral blood was determined by enzyme linked immunosorbent assay (ELISA). Rats were sacrificed, the tumor volume and growth inhibition rate were measured. The position and changes of HSP70 in gastric cancer were observed by streptavidin-perosidase (SP); HSP70 protein expression was determined by ELISA; HSP70 mRNA expression in cancer tissues was determined by reverse transcription-polymerase chain reaction (RT-PCR) assay. Results: In comparison of the model group, the volume growth of the gastric cancer in the moxibustion group was significantly restricted (P＜0.01); the volume growth inhibition rate in the moxibustion group was 37.93%; the HSP70 expression in peripheral blood and the cancer tissues was significantly increased (both P＜0.01); the expression of HSP70 mRNA and HSP70 content in gastric tumor were both obviously increased in the moxibustion group (P＜0.01); and a large amount of HSP70 was released to the outside of cancer cells in the moxibustion group. In comparison of the model group, the volume growth of the gastric cancer in the infrared group was slightly restricted (P＜0.05) with a volume growth inhibition rate of 15.89%; the HSP70 expression in the infrared group was increased significantly in peripheral blood (P＜0.01) and in the gastric cancer tissues (P＜0.05); more HSP70 was released outside of the cancer cells in the infrared group. In comparison of the infrared group, the volume growth of gastric cancer was more restricted in the moxibustion group (P＜0.05), and the HSP70 expression in the gastric cancer tissues was also higher (P＜0.05); more HSP70 was released outside of the cancer cells in the moxibustion group. Conclusion: Moxibustion and infrared treatment inhibit the gastric cancer growth in the gastric cancer-bearing rats, up-regulate the HSP70 expression in gastric cancer tissues, and promote the production and extracellular release of HSP70, and the effect of moxibustion is more obvious.

Objective: To compare the risk angle and safety angle of needling Yamen (GV 15) between the atlanto-axial dislocation (AAD) patients and healthy subjects. Methods: A total of 177 AAD patients diagnosed and treated at the Center of Upper Cervical Vertebra of Beijing China-Japan Friendship Hospital between January 2010 and January 2018 were included in the AAD group. Another 207 healthy subjects were included in the normal group. There were totally 191 males and 193 females. The MRI scan was performed for the cervical vertebrae to measure the risk angle and safety angle of acupuncture at Yamen (GV 15) on the sagittal image. Results: In the AAD group, the risk angle was (13.14±3.99)° and the relative safety angle was (10.31±3.23)° for the perpendicular needling, while the oblique needling risk angle was (9.09±3.09)° for the male; the risk angle was (12.12±2.74)° and the relative safety angle was (10.56±2.09)° for the perpendicular needling, while the oblique needling risk angle was (9.70±2.95)° for the female. In the normal group, the risk angle was (7.89±1.59)° and the relative safety angle was (10.21±3.55)° for the perpendicular needling, while the oblique needling risk angle was (16.07±1.77)° for the male; the risk angle was (6.93±1.45)° and the relative safety angle was (10.70±2.94)° for the perpendicular needling, while the oblique needling risk angle was (14.89±2.18)° for the female. The perpendicular needling risk angles for the males and females in the AAD group were larger than those in the normal group, and the differences were statistically significant (bothP<0.01); for the inner-group comparison, there was no significant difference in the perpendicular needling risk angle between the male and the female in the AAD group (P>0.05); however, the perpendicular needling risk angle for the male was larger than the female, and the difference was statistically significant in the normal group (P<0.01). There were no significant differences in the relative safety angle for both the male and the female between the AAD group and the normal group (bothP>0.05). For the inner-group comparison, there was no significant difference in the relative safety angle between the male and the female (P>0.05). The oblique needling risk angles for both the males and females were smaller in the AAD group than those in the normal group, and the differences were statistically significant (bothP<0.01); the oblique needling risk angle for the male was not significantly different from that for the female in the AAD group (P>0.05); in the normal group, the oblique needling risk angle for the male was larger than that for the female, and the difference was statistically significant (P<0.01). Conclusion: Under the AAD condition, the risk angle and safety angle of acupuncture at Yamen (GV 15) change significantly, perpendicular needling should be better if performed slightly lower than the horizontal direction, and the oblique needling should be safer across the occipital foramen toward the occipital bone.

OBJECTIVETo investigate the characteristics of human caliciviruses (HuCV) diarrhea among infants and young children with acute diarrhea in Lanzhou, Gansu Province, China by using molecular epidemiologic techniques.

METHODSStool specimens were collected from both outpatients and inpatients with acute diarrhea in Lanzhou. Enzyme-linked immunosorbant assay (ELISA) was used to detect rotavirus antigen (RVA). Reverse transcription-polymerase chain reactions (RT-PCR) were used to detect HuCV in stool specimens of RV ELISA (-).

RESULTSOf the stool specimens collected from 515 cases in Lanzhou from December 2001 to June 2004, 264 were RVA ELISA (+) and 251 were RVA ELISA (-). Among all cases who were RVA ELISA (-), 25 (9.96%) were found positive for HuCV. HuCV was detected in 12 of 133 cases (9.02%) from December 2001 to November 2002, no genotyping was performed for these cases. From July 2003 to June 2004 13 of 118 cases (11.02%) were found positive for HuCV, of whom 11 cases had Norwalk-like virus GII (NLV GII) infection and 2 cases had Sapporo-like virus infection (one case had combined infection with astrovirus) and no NLV GI was found. HuCV infection mainly occurred in children under 2 years of age and no seasonal cluster was found.

CONCLUSIONHuCV is one of the major etiological agents of viral diarrhea among infants and young children in Lanzhou. NLV GII maybe the predominant genotype.

Caliciviridae ; genetics ; Caliciviridae Infections ; epidemiology ; Child, Preschool ; China ; epidemiology ; Diarrhea ; epidemiology ; virology ; Enzyme-Linked Immunosorbent Assay ; Feces ; virology ; Genotype ; Humans ; Infant ; Molecular Epidemiology ; RNA, Viral ; genetics ; Reverse Transcriptase Polymerase Chain Reaction

OBJECTIVETo analyze the clinical outcome of kyphoplasty on costal pain which develops following thoracic osteoporotic compression fractures and evaluate the factors related to costal pain.

METHODSFrom May 2014 to May 2016, a total of 188 patients with thoracic osteoporotic compression fractures undergoing kyphoplasty were reviewed retrospectively. The patients were divided into two groups: the costal pain group included patients who had costal pain after a vertebral fracture and the no costal pain group included patients without costalgia. Visual analogue scale(VAS)and Oswestry Disability Index(ODI)of all patients were measured preoperatively and 3 days, 1 month, 6 months postoperatively respectively. Gender, age, the fracture level, bone mineral density, vertebral body fracture type, and fracture severity were compared between two groups, and the causes of costal pain were analyzed.

RESULTSAmong 188 patients, 38 patients (20.2%) complained of costal pain with back pain. The mean follow-up time was 8.3 months (ranged from 6 to 15 months). The VAS and ODI score of two groups decreased after operation, and there was significant difference between pre-operation and post-operation(<0.05). There was significant difference in VAS score and ODI score between two groups at 3 days and 1 month postoperatively (<0.05). There was no significant difference in VAS score and ODI score between two groups at 6 months postoperatively (<0.05). The incidence of applanation-type deformity and severe fracture in the costal group were higher. The fracture type and fracture severity showed significantly difference between two groups(<0.05).

CONCLUSIONSThe fracture type and fracture severity had significant relation to costal pain of thoracic osteoporotic compression fractures. The kyphoplasty effect on costal pain may not be effective, especially during early post-operation period.

OBJECTIVETo explore clinical effects of multi-segmental cervical spondylosis myelopathy through anterior approach by surgical treatment.

METHODSFrom September 2006 to September 2012, the data of 85 patients with multi segmental cervical spondylosis myelopathy were retrospectively analyzed. Among them, 48 cases were male, 37 cases were female, ranging the age from 34 to 86 years old (mean, 54.5 years old). Surgical procedure included anterior discectomy and fusion (19 cases), anterior secondary discectomy and fusion (45 cases) and anterior discectomy combined with anterior cervical corpectomy with fusion (21 cases). Bone fusion were evaluated by X-ray at the 3rd day after operation and following up. JOA score and improvement rate were compared.

RESULTSAll patients were followed up from 6 to 30 months with an average of 18 months. Decompression were done throughly during operation and good intervertebral space height and cervical curvature were obtained. X-ray showed nonunion in 3 cases, and improvement rate was 96%. JOA score after operation was higher than before operation, and had significant differences (P < 0.05). Fifty-six cases got excellent results, 16 moderate, 9 effective and 4 invalid according to JOA scores.

CONCLUSIONSurgical procedures for cervical spondylosis myelopathy should be chosen reasonably in accordance with sympotoms, signs, imaging data, so as to obtain good results in decompression, recoving intervertebral height and cervical curature, improving fusion rate.

Adult ; Aged ; Aged, 80 and over ; Bone Transplantation ; Cervical Vertebrae ; surgery ; Decompression, Surgical ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spondylosis ; surgery ; Treatment Outcome