1.Effect of intensive vertebral therapy on osteoporotic vertebral compression fracture in elderly patients: A randomized controlled clinical trial
Qiang WANG ; Liangyuan WEN ; Quan JI ; Yudian QIU ; Junchuan LIU ; Lin WANG
Chinese Journal of Geriatrics 2022;41(7):767-771
Objective:To evaluate the effects of percutaneous kyphoplasty(PKP)and percutaneous vertebroplasty(PVP)operation in elderly patients with osteoporotic vertebral compression fracture(OVCF).Methods:From June 2019 to June 2020, a total of 58 patients with OVCF aged over 60 and under 80 years who had a loss of more than one-third of the anterior margin height of vertebral and agreed to participate in the study were randomly divided into PKP group and PVP group.The visual analogue pain scale(VAS)score, SF-36 quality of life score, anterior height of fractured vertebral body, leakage of bone cement, refracture and cost of high-value consumables were observed at the time point before operation, 1 day, 1 month, 3 month, 6 month, 12 month after operation.Results:VAS scores in PKP and PVP groups were decreased after operation as compared with preoperation( F=115.380, 175.010, both P<0.001). VAS score was lower in the PKP group than in the PVP group at 6 months after operation with statistically significant difference( t=2.219, P=0.031), and no statistically significant difference at other time points between the two groups(all P>0.05). In the PKP and PVP groups, the height of the anterior edge of the vertebral body recovered significantly on the first day after operation, and there was a significant difference in the height compared with that before operation( F=43.020, 51.010, both P<0.001). The SF-36 scores at the latter time point in PKP and PVP groups were increased as compared with the previous time point.The increment of the SF-36 scores was statistically significant at 1 month after operation than pre-operation, and also at 3 months after operation than at 1 month after operation.The leakage rate of bone cement was 37.0%(10/27)in PKP group and 25.0%(7/28)in PVP group, with no significant difference between the two groups( χ2=0.930, P=0.391). The refracture rate was 3.7%(1/27)in PKP group and 7.1%(2/28)in PVP group, with no significant difference between the two groups( χ2=0.000, P=1.000). The cost of high-value consumables for single segment fracture was 46 490 yuan in PKP group, and 36 700 yuan in PVP group.The cost of PKP group was higher than that of PVP group. Conclusions:PKP and PVP operation in the treatment of osteoporotic vertebral compression fractures have good effects in aspect of analgesia, restoring vertebral height and improving patients' quality of life.The analgesic effect is slightly better in PKP group than in PVP group.PVP group has more advantages in health economics.
2.Traditional Chinese Medicine in Prevention and Treatment of Renal Fibrosis in Diabetic Nephropathy by Targeting Notch Signaling Pathway: A Review
Yudian WANG ; Rong ZHOU ; Kaixuan DONG ; Xi CHEN ; Xiaoyong YU
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(17):221-227
Diabetic nephropathy (DN) is one of the common chronic kidney diseases (CKD) worldwide and a major cause of end-stage renal disease (ESRD), seriously threatening and affecting the life and health of the global population. Currently, the pathogenesis of DN is considered to be closely related to factors such as glucose metabolism disorders, abnormal lipid metabolism, oxidative stress, activation of inflammatory factors, autophagy, and cell apoptosis in the continuous high-glucose environment of the body. Renal fibrosis is an important pathological feature and ultimate pathological outcome of DN. Timely intervention in renal fibrosis is of significant clinical and practical importance for the prevention and treatment of DN. Due to the limitations of western medicine in treating DN, traditional Chinese medicine (TCM) intervention in the process of renal fibrosis in DN has been widely used as a routine and potential treatment method due to its multi-component, multi-effect, and multi-target effects, effectively delaying the progression of the disease. It has been found that the Notch signaling pathway plays an important role in the development and maintenance of homeostasis in the body, and abnormal activation of the Notch signaling pathway is associated with DN. Activation of this signaling pathway plays a key role in the process of renal fibrosis. This article reviewed the regulatory mechanism of the Notch signaling pathway in renal fibrosis in DN, focusing on the relationship between targeting Notch signaling pathway by Chinese medicinal monomers and prescriptions and renal fibrosis in DN in order to provide a theoretical basis for the development of new drugs, basic research, and clinical application of TCM in the prevention and treatment of DN.