1.Impact of spinal sagittal balance on reinforced vertebral recompression fractures following percutaneous kyphoplasty
Lide TAO ; Huajian SHAN ; Jun DAI ; Jinyu BAI ; Wentao ZHONG ; Chaowen BAI ; Xueli QIU ; Xiaozhong ZHOU ; Bingchen SHAN
Chinese Journal of Orthopaedics 2025;45(15):977-983
Objective:To investigate the correlation between postoperative spinal sagittal parameters and reinforced vertebral recompression fractures in patients with osteoporotic vertebral compression fractures (OVCFs) who have undergone percutaneous kyphoplasty (PKP).Methods:Data on patients with OVCFs treated with PKP at the Department of Orthopaedics, Second Affiliated Hospital of Soochow University, from August 2020 to August 2024, were collected. Among these, 31 patients who underwent single-segment PKP experienced postoperative reinforced vertebral recompression fractures (recompression fracture group), comprising 8 males and 23 females, with a mean age of 73.74±8.76 years, a body mass index (BMI) of 23.83±1.87 kg/m 2, and a bone mineral density T-value of -2.29±0.55. The remission rate of the visual analogue scale (VAS) after surgery was 80.14%±4.86%, with a mean volume of bone cement used at 5.37±0.69 ml. The surgical segments involved included T 5 (1 case), T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (9 cases), L 1 (7 cases), L 2 (4 cases), L 3 (2 cases), and L 4 (2 cases). Following a 1∶1 matching principle, 31 patients whose vertebrae did not experience reinforced recompression fractures during the same period (non-recompression fracture group) were included. This group also comprised 8 males and 23 females, with a mean age of 74.88±8.31 years, a BMI of 23.15±2.04 kg/m 2, a bone mineral density T-value of -2.76±0.64, and a VAS remission rate of 79.75%±5.01%. The mean volume of bone cement used in this group was 5.41±0.72 ml. The surgical segments involved included T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (8 cases), L 1 (7 cases), L 2 (5 cases), L 3 (2 cases), L 4 (2 cases), and L 5 (1 case). There were no statistically significant differences in the aforementioned indicators between the two patient groups ( P>0.05). A comparison of the postoperative spinal sagittal parameters between the two groups was conducted, focusing on the local kyphosis angle (LKA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and the lumbar-pelvic matching value (PI-LL). Indicators that exhibited statistically significant differences were included in the binary logistic regression analysis to evaluate the impact of spinal sagittal parameters following PKP on the recompression of the reinforced vertebral. Results:The time to reinforced vertebral recompression fractures after PKP ranged from 35 to 184 d, with a median of 69 d. The TK in the recompression fracture group (46.56°±7.02°) was significantly greater than that in the non-recompression fracture group (41.95°±5.76°). Additionally, the LKA, PI and SS were all smaller in the recompression fracture group (9.84°±2.13°, 41.36°±4.27°, 22.69°±5.53°, respectively) compared to the non-recompression fracture group (12.37°±2.64°, 48.09°±6.33°, 28.41°±7.64°), with all differences being statistically significant ( P<0.05). However, no significant differences were observed between the LL, PT, and PI-LL values ( P>0.05). TK, LKA, PI, and SS were included in the binary logistic regression analysis, which indicated that TK [ OR=1.533, 95% CI(1.47, 1.59)] after PKP was positively correlated with the occurrence of reinforced vertebral recompression fractures. Conversely, LKA [ OR=0.882, 95% CI(0.80, 0.96)], PI [ OR=0.815, 95% CI(0.71, 0.91)], and SS [ OR=0.833, 95% CI(0.73, 0.93)] were negatively correlated. Conclusions:The incidence of reinforced vertebral recompression fractures following PKP is associated with spinal sagittal parameters, including TK, LKA, PI, and SS. Specifically, a larger TK and smaller values of LKA, PI, and SS are correlated with an elevated risk of reinforced vertebral recompression fractures.
2.Impact of spinal sagittal balance on reinforced vertebral recompression fractures following percutaneous kyphoplasty
Lide TAO ; Huajian SHAN ; Jun DAI ; Jinyu BAI ; Wentao ZHONG ; Chaowen BAI ; Xueli QIU ; Xiaozhong ZHOU ; Bingchen SHAN
Chinese Journal of Orthopaedics 2025;45(15):977-983
Objective:To investigate the correlation between postoperative spinal sagittal parameters and reinforced vertebral recompression fractures in patients with osteoporotic vertebral compression fractures (OVCFs) who have undergone percutaneous kyphoplasty (PKP).Methods:Data on patients with OVCFs treated with PKP at the Department of Orthopaedics, Second Affiliated Hospital of Soochow University, from August 2020 to August 2024, were collected. Among these, 31 patients who underwent single-segment PKP experienced postoperative reinforced vertebral recompression fractures (recompression fracture group), comprising 8 males and 23 females, with a mean age of 73.74±8.76 years, a body mass index (BMI) of 23.83±1.87 kg/m 2, and a bone mineral density T-value of -2.29±0.55. The remission rate of the visual analogue scale (VAS) after surgery was 80.14%±4.86%, with a mean volume of bone cement used at 5.37±0.69 ml. The surgical segments involved included T 5 (1 case), T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (9 cases), L 1 (7 cases), L 2 (4 cases), L 3 (2 cases), and L 4 (2 cases). Following a 1∶1 matching principle, 31 patients whose vertebrae did not experience reinforced recompression fractures during the same period (non-recompression fracture group) were included. This group also comprised 8 males and 23 females, with a mean age of 74.88±8.31 years, a BMI of 23.15±2.04 kg/m 2, a bone mineral density T-value of -2.76±0.64, and a VAS remission rate of 79.75%±5.01%. The mean volume of bone cement used in this group was 5.41±0.72 ml. The surgical segments involved included T 8 (1 case), T 10 (1 case), T 11 (4 cases), T 12 (8 cases), L 1 (7 cases), L 2 (5 cases), L 3 (2 cases), L 4 (2 cases), and L 5 (1 case). There were no statistically significant differences in the aforementioned indicators between the two patient groups ( P>0.05). A comparison of the postoperative spinal sagittal parameters between the two groups was conducted, focusing on the local kyphosis angle (LKA), lumbar lordosis (LL), thoracic kyphosis (TK), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), and the lumbar-pelvic matching value (PI-LL). Indicators that exhibited statistically significant differences were included in the binary logistic regression analysis to evaluate the impact of spinal sagittal parameters following PKP on the recompression of the reinforced vertebral. Results:The time to reinforced vertebral recompression fractures after PKP ranged from 35 to 184 d, with a median of 69 d. The TK in the recompression fracture group (46.56°±7.02°) was significantly greater than that in the non-recompression fracture group (41.95°±5.76°). Additionally, the LKA, PI and SS were all smaller in the recompression fracture group (9.84°±2.13°, 41.36°±4.27°, 22.69°±5.53°, respectively) compared to the non-recompression fracture group (12.37°±2.64°, 48.09°±6.33°, 28.41°±7.64°), with all differences being statistically significant ( P<0.05). However, no significant differences were observed between the LL, PT, and PI-LL values ( P>0.05). TK, LKA, PI, and SS were included in the binary logistic regression analysis, which indicated that TK [ OR=1.533, 95% CI(1.47, 1.59)] after PKP was positively correlated with the occurrence of reinforced vertebral recompression fractures. Conversely, LKA [ OR=0.882, 95% CI(0.80, 0.96)], PI [ OR=0.815, 95% CI(0.71, 0.91)], and SS [ OR=0.833, 95% CI(0.73, 0.93)] were negatively correlated. Conclusions:The incidence of reinforced vertebral recompression fractures following PKP is associated with spinal sagittal parameters, including TK, LKA, PI, and SS. Specifically, a larger TK and smaller values of LKA, PI, and SS are correlated with an elevated risk of reinforced vertebral recompression fractures.
3.20()-Protopanaxatriol promotes the binding of P53 and DNA to regulate the antitumor network multiomic analysis.
Zhihua WANG ; Wenbo WU ; Xiangchen GUAN ; Shuang GUO ; Chaowen LI ; Ruixue NIU ; Jie GAO ; Min JIANG ; Liping BAI ; Elaine Laihan LEUNG ; Yuanyuan HOU ; Zhihong JIANG ; Gang BAI
Acta Pharmaceutica Sinica B 2020;10(6):1020-1035
Although the tumor suppressor P53 is known to regulate a broad network of signaling pathways, it is still unclear how certain drugs influence these P53 signaling networks. Here, we used a comprehensive single-cell multiomics view of the effects of ginsenosides on cancer cells. Transcriptome and proteome profiling revealed that the antitumor activity of ginsenosides is closely associated with P53 protein. A miRNA-proteome interaction network revealed that P53 controlled the transcription of at least 38 proteins, and proteome-metabolome profiling analysis revealed that P53 regulated proteins involved in nucleotide metabolism, amino acid metabolism and "Warburg effect". The results of integrative multiomics analysis revealed P53 protein as a potential key target that influences the anti-tumor activity of ginsenosides. Furthermore, by applying affinity mass spectrometry (MS) screening and surface plasmon resonance fragment library screening, we confirmed that 20()-protopanaxatriol directly targeted adjacent regions of the P53 DNA-binding pocket and promoted the stability of P53-DNA interactions, which further induced a series of omics changes.

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