Objective To investigate the short-term clinical outcome of one-level degenerative diseases for a single surgeon during his initial phase of performing a minimally invasive surgery oblique lumbar interbody fusion (OLIF) on the basis of perioperative parameters and follow-up data.Methods A prospective analysis of 49 consecutive patients that underwent a OLIF between November 2014 and March 2016 by corresponding author was performed.Only those patients that were single level,index surgeries were included.Every patient had a diagnosis of degenerative lumbar diseases including lumbar spondylolisthesis (25 cases),discogenic low back pain (14 cases) or segmental instability (10 cases).Patients underwent an indirect decompression and fusion using an expandable tubular retractor and single intervertebral cage with bilateral percutaneous pedicle screw fixation.49 patients were divided into the A group (the first 24 patients) and the B group (25 patients after the initial 24 patients).The following data were compared between the two groups:surgical time for Skin-Skin (minutes),estimated blood loss (ml),radiograph exposure time (seconds),the clinical and radiographic results,and intra-/postoperative complications.All intraoperative parameters only included the measurement and findings related with the OLIF procedure.The short-term clinical outcome of single level degenerative lumbar diseases treated by OLIF was assessed on the basis of follow-up data.The learning curve was measured using a logarithmic curve-fit regression analysis.Results Average operative time was significantly longer in the A group 47.1±10.6 min compared with the B group 37.2± 10.0 min.In comparison with the B group,the A group had significantly more X-ray exposure time (25.3±6.1 s versus 17.1±6.9 s).The operative and X-ray exposure time gradually decreased as the series progressed,and an asymptote was reached after about 20 cases.There was no statistically significant difference in intraoperative blood loss between the A group (28.1± 18.2) ml and the B group 24.4± 10.9 ml.The most observed complication was donor site pain (11 cases,45.8％),followed by thigh numbness/pain (5 cases,20.8％) and psoas/quadriceps weakness (2cases,8.3％),paralytic ileus (one case,4.2％) and sympathetic nerve injury (one case,4.2％) in the A group.Donor site pain occurred in four patients (16.0％),thigh numbness/ pain in three patients (12.0％),psoas/quadrieeps weakness in one patient (4.0％) and sympathetic nerve injury in one patient (4.0％) in the B group.All complications were transient and resolved within 3 months.The incidence of complications excluding donor site pain in the early period (A group) and the later period (B group) was 37.5％ and 20.0％,respectively,although there were no significant differences in perioperative complications between both groups.Forty nine patients were followed up for more than 1 year,and the average follow-up period was 18.5±3.9 months.The back pain VAS and ODI scores decreased respectively from 6.4±2.3 before surgery to 1.5±0.9 in final follow-up and from 37.1 ±9.4 before surgery to 11.8±3.9 in the last follow-up time.Total fusion rate was 89.8％ (44/49 cases)in final follow-up.Radiographic evaluation showed similar bony fusion in the A group (22 of 24 cases) with the B group (22 of 25 cases) in the last follow-up time.Conclusion Single level degenerative lumbar diseases can safely and effectively be treated by using OLIF with a good short-term clinical outcome.The procedure presents a learning curve to the practicing spine surgeon with regards to operative time,X-ray exposure time and intra-/postoperative complications.Intraoperative parameters improved with understanding the minimally invasive technique.Close attention to details can minimize complications that may be associated with the learning curve.

To investigate such physical indexes as hygroscopicity, angle of repose, bulk density, fillibility of compression of mixed powder of directly compressed auxiliary materials and fermented cordyceps powder by using micromeritic study methods. The results showed that spray-dried lactose Flowlac100 and microcrystalline cellulose Avicel PH102 had better effect in liquidity and compressibility on fermented cordyceps powder than pregelatinized starch. The study on the impact of directly compressed auxiliary materials on the powder property of fermented cordyceps powder had guiding significant to the research of fermented cordyceps powder tablets, and could provide basis for the development of fermented cordyceps powder tablets.
Cellulose ; chemistry ; Cordyceps ; chemistry ; Drug Compounding ; methods ; Fermentation ; Lactose ; chemistry ; Powders ; chemistry ; Tablets ; chemistry ; Technology, Pharmaceutical ; methods

Based on ninety three acetylcholinesterase inhibitors (AChEIs) which have the same mechanism of action but are different in structural characteristics, the pharmacophore model for acetylcholinesterase inhibitor was constructed by the CATALYST system. The optimal pharmacophore model with three hydrophobic units, a ring aromatic unit and a hydrogen-bond acceptor unit were confirmed (Weight = 3.29, RMS = 0.53, total cost-null cost = 62.75, Correl = 0.93, Config = 19.05). This pharmacophore model will act on the double active site of acetylcholinesterase and is able to predict the activity of known acetylcholinesterase inhibitors that are used for clinical treatment of Alzheimer's disease (AD), and can be further used to identify structurally diverse compounds that have higher activity treating with Alzheimer's disease (AD) by virtual screening.
Acetylcholinesterase ; chemistry ; metabolism ; Alzheimer Disease ; enzymology ; prevention & control ; Cholinesterase Inhibitors ; chemistry ; classification ; therapeutic use ; Drug Design ; Humans ; Models, Chemical ; Models, Molecular ; Molecular Structure ; Quantitative Structure-Activity Relationship ; Structure-Activity Relationship

OBJECTIVETo investigate the change of serum levels of interleukin-6 (IL-6), C-reactive protein (CRP) and creatine kinase (CK) in patients undergoing microendoscopic discectomy (MED) and open discectomy.

METHODSForty-four patients with single level lumbar disk herniation were treated, either by MED (Group A, n equal to 22) or open discectomy (Group B, n equal to 22). Peripheral venous blood samples were taken before surgery and at 24 and 48 hours postoperatively. The operating time, intraoperative blood loss, postoperative hospital stay were recorded. The pain severity of incision was evaluated by visual analog scale after operation and the clinical outcome was evaluated by Oswestry disability index. Statistical comparison was performed by the analysis of variance and Student's t test.

RESULTSThe data showed that patients in Group A had a less intraoperative blood loss (P < 0.05), shorter operating length (P < 0.05), shorter postoperative hospital stay (P < 0.05) and less postoperative pain of incision than those in Group B. Serum levels of IL-6 (mean, 31.60 ng/L +/- 9.88 ng/L vs 39.16 ng/L +/- 11.14 ng/L, P < 0.05) and CK (mean, 167.91 U/L +/- 51.85 U/L vs 401.55 U/L +/- 108.86 U/L, P < 0.05) all get to the peak at 24 hours after operation and Group A with the response statistically less than Group B. Serum level of CRP peaked at 24 hours in Group A (mean, 12.68 mg/L +/- 7.10 mg/L vs 20.82 mg/L +/- 8.79 mg/L, P less than 0.05)and peaked at 48 hours after surgery in Group B (mean, 10.77 mg/L +/- 5.25 mg/L vs 29.95 mg/L +/- 14.85 mg/L, P < 0.05). The clinical outcomes of both groups were the same at 6 months after surgery.

CONCLUSIONSBoth MED and open discectomy have made good clinical outcomes, however, the less change of IL-6, CRP and CK after operation proves that MED procedure is less traumatic to patients than open discectomy.

Adult ; C-Reactive Protein ; analysis ; Creatine Kinase ; blood ; Diskectomy ; methods ; Endoscopy ; Female ; Humans ; Interleukin-6 ; blood ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Minimally Invasive Surgical Procedures ; methods

OBJECTIVETo observe the correlation between the decline of cognitive function and the level of plasma homocysteine in patients with Alzheimer's disease (AD).

METHODSThirty six AD patients were selected from hospitals in Tianjin. The enrolled patients were in accord with the diagnosis criteria. Thirty two control subjects were corresponding patients without AD in the period. Blood samples were extracted from each subject to determine the levels of homocysteine (Hcy) and folate. Cognitive status was evaluated by the mini- mental state examination (MMSE) and clinical dementia rating scale (CDR).

RESULTSThe mean value of serum Hcy concentration [(17.51 +/- 5.62) micromol/L] of AD group was higher than that of control group [(12.38 +/- 4.25)micromol/L]. The serum [(5.17 +/- 1.76) microg/L] and diet folate [(206.94 +/- 44.51) microg/d] concentration of AD group were lower than those of control group [(7.92 +/- 2.22) microg/L, (259.74 +/- 41.92) microg/ d]. The incidence of hyperhomocysteinemia in AD group (64%) was higher than that in control group (22%). A significant relation between Hcy concentrations and the CDR was observed. With the increase of Hcy concentrations the CDR raised, and with the increase of Hcy concentrations the MMSE decreased.

CONCLUSIONHyperhomocysteinemia is one of the risk factors inducing the onset of AD. There is a significant negative correlation between Hcy levels and cognitive levels in AD group. Folate deficiency is an important reason to cause elevated Hcy levels in AD.

Alzheimer Disease ; blood ; etiology ; Case-Control Studies ; Folic Acid ; blood ; Homocysteine ; blood ; Humans ; Hyperhomocysteinemia ; blood ; complications

OBJECTIVETo explore the satisfactory rate in patients with body dysmorphic disorder (BDD) after cosmetic surgery.

METHODSWe designed a questionnaire to investigate the postoperative satisfactory rate in patients with BDD and without BDD.

RESULTSThere was significant difference in postoperative satisfactory rate between patients with BDD and without BDD.

CONCLUSIONThe patients with BDD have a lower satisfactory rate, which is even worse after repeated surgery.

Adult ; Body Dysmorphic Disorders ; psychology ; Body Image ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Surgery, Plastic ; Surveys and Questionnaires

OBJECTIVETo investigate the biomechanical effect of different volume, distribution and leakage to adjacent disc of bone cement on the adjacent vertebral body by three-dimensional osteoporosis finite element model of lumbar.

METHODSL(4)-L(5) motion segment data of the cadaver of an old man who had no abnormal findings on roentgenograms were obtained from computed tomography (CT) scans. Three-dimensional model of L(4)-L(5) was established with Mimics software, and finite element model of L(4)-L(5) functional spinal unit (FSU) was established by Ansys 7.0 software. The effect of different loading conditions and distribution of bone cement after vertebroplasty on the adjacent vertebral body was investigated.

RESULTSThis study presented a validated finite element model of L(4)-L(5) FSU with a simulated vertebroplasty augmentation to predict stresses and strains of adjacent untreated vertebral bodies. The findings from this FSU study suggested the endplate and disc stress of the adjacent vertebral body was not influenced by filling volume of bone cement but unipedicle injection and leakage to the disc of bone cement could concentrate the stress of adjacent endplate.

CONCLUSIONSAsymmetric distributions and leakage of cement into intervertebral disc can improve the stress of endplate in adjacent vertebral body. These results suggest that optimal biomechanical configuration should have symmetric placement and avoid leakage of cement in operation.

Bone Cements ; adverse effects ; pharmacology ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Lumbar Vertebrae ; surgery ; Male ; Polymethyl Methacrylate ; adverse effects ; pharmacology ; Stress, Mechanical

Female ; Humans ; Manipulation, Orthopedic ; Middle Aged ; Radius Fractures ; surgery ; Ulna Fractures ; surgery ; Ulnar Nerve Compression Syndromes ; surgery

OBJECTIVETo study the cytotoxic T lymphocyte (CTL) response induced by dendritic cells (DC) transduced with recombinant adenovirus vector bearing hepatitis B virus surface antigen (HBsAg) gene in hepatocellular carcinoma HepG2. 2. 15 cells in vitro.

METHODSFull length HBsAg cDNAs were subcloned into pIND vector, followed by being cloned into pShuttle vector. The HBsAg gene fragments resulted from the pShuttle-S digested with PI-Sce and I-Ceu were linked to the linear adeno-X virus DNA. After packaged with HEK293 cells, the adenovirus expression vector was obtained. Then the recombinant adenovirus expression plasmid AdVHBsAg was transfected into human monocyte-derived dendritic cells, to construct AdVHBsAg hepatocarcinoma tumor vaccine. The effectiveness of transfection was detected by Western blot. Surface molecules of AdVHBsAg-DC were detected by FACS. Autologous T cell proliferation stimulated by AdVHBsAg-DC was detected by 3H-TdR assay. Cytotoxic CTL activity induced by AdVHBsAg-DC in vitro was detected by LDH assay.

RESULTSHBsAg gene in the inserted DNA of AdVHBsAg was confirmed by PCR, and predictive fragments proved by restriction enzyme digestion analysis were exhibited. Cell pathological changes appear after 10 days HEK293 cells transfected AdVHBsAg. Western blot analysis showed that HBV surface antigen gene was expressed in transfected DC, indicating that the transfection was effective. AdVHBsAg-DC was able to upregulate CD1a, CD11c, CD80, CD86 and HLA-DR. Autologus T cell proliferation induced by AdVHBsAg-DCs was significantly higher than that in DC control group and LacZ-DC group (P < 0.05). AdVHBsAg-DC activated CTL presented the specific killer ability to the hepatocellular carcinoma cells expressing HBsAg.

CONCLUSIONDC transduced with recombinant adenovirus HBsAg can express HBV-related hepatocellular carcinoma antigen (HBsAg), and AdVHBsAg-DC can induce potent immune response against HBsAg-positive hepatocellular carcinoma cells in vitro.

Adenoviridae ; genetics ; Antigens, CD1 ; metabolism ; CD11c Antigen ; metabolism ; Cancer Vaccines ; immunology ; Carcinoma, Hepatocellular ; immunology ; pathology ; virology ; Cell Line, Tumor ; Cell Proliferation ; Cytotoxicity, Immunologic ; immunology ; Dendritic Cells ; cytology ; immunology ; metabolism ; Genetic Vectors ; Hepatitis B Surface Antigens ; genetics ; metabolism ; Humans ; Liver Neoplasms ; immunology ; pathology ; virology ; Plasmids ; Recombinant Proteins ; genetics ; metabolism ; T-Lymphocytes, Cytotoxic ; cytology ; immunology ; Transfection

Objective To investigate the diagnostic value of assisting stress ultrasound elastographic quantitative parameter in determination of the thrombus age in an ex-vivo model of venous thrombi.MethodsAfter 1,3,6 and 9 days,9 saphenous vein samples with venous thrombosis were scanned by both tissue touch elasticity image and acoustic radiation force impulse (ARFI) respectively.For each group of thrombus age,a mean sheer strain was calculated in all thrombosis samples of the respective age.Furthermore,correlation of two sample data was analysed.Results The stiffness of thrombus age group of 1,3,6 and 9 days by tissue touch elasticity image were (49.23±14.91)%,(68.75±10.03)%,(80.82±10.29)% and (91.98±4.10)% respectively with significant differences among the parameters (P<0.05).Quantitative data of thrombus age groups correlated positively by two kinds of these elasticity image significantly (r=0.702,P=0.000).Conclusions The assisting stress ultrasound elastographic method with HM% in this experiment setting of venous thrombosis is proved to be helpful in determination of the age of venous thrombi.The present results obtained in our experiment might provide a potential application in evaluation of deep vein thrombosis by the elastographic technology clinically.