OBJECTIVE: To evaluate the short-and medium-term efficacy of posterior medial branch block in the treatment of persistent pain after percutaneous vertebral augmentation. METHODS: From January 2018 to January 2023, a total of 1, 062 patients with osteoporotic vertebral compression fractures underwent percutaneous vertebral augmentation. Among them, 32 elderly patients who experienced persistent low back pain after surgery and subsequently received posterior medial branch block and cryoablation were included. Six patients died during follow-up, leaving 26 patients for final analysis (1 male, 25 females). The mean age was (82.96±5.66) years (ranged, 76 to 94 years). The mean body mass index was (23.76±3.08) kg·m^-2(ranged 18.1 to 27.2 kg·m^-2). The bone mineral density T-value ranged from -2.5 to -4.3 with a mean of (-3.09±0.56). The mean volume of bone cement injected was 6.00 (5.38, 7.00) ml. Fracture locations were T₁₁ (2 cases), T₁₂ (7 cases), L₁ (10 cases), L₂ (6 cases), and L₃ (1 case). The mean interval from vertebral augmentation to block treatment was (7.12±2.22) months (rangd 6 to 12 months). The vertebral augmentation procedures were percutaneous kyphoplasty(PKP) in 12 cases and percutaneous vertebroplasty (PVP) in 14 cases. At the 2nd week, 3rd month, and 6th month after the block, the numerical rating scale(NRS), Oswestry disability index(ODI), patient satisfaction, and pain relief rate at the 6th month were evaluated. Relationships between pain relief rate at the 6th month after the last treatment and possible influencing factors were analyzed. RESULTS: Compared with X-ray films after percutaneous vertebral augmentation, the X-ray films before block showed an increase in kyphotic angle and vertebral compression rate, with statistically significant differences(P<0.05). At the 2nd week, 3rd month, and 6th month after posterior medial branch block and cryoablation, NRS and ODI scores were significantly lower than before the block(P<0.05). Among the 26 patients, 5 received additional cryoablation. At the 6th month after the last treatment, 19 patients reported excellent or good satisfaction. Univariate binary Logistic analysis showed all P>0.05, and no independent factor affecting final satisfaction or pain relief at 6 months after the last treatment was identified. CONCLUSION Posterior medial branch block(with cryoablation) can effectively improve short-and medium-term symptoms and function in patients with persistent axial low back pain after percutaneous vertebral augmentation for osteoporotic vertebral fractures.
Humans ; Male ; Female ; Aged ; Spinal Fractures/surgery* ; Aged, 80 and over ; Osteoporotic Fractures/surgery* ; Vertebroplasty/adverse effects* ; Nerve Block/methods*

Objective To investigate the effect of POSTN protein on the proliferation of chondrocytes of tibial plateau in old rats.Methods Cartilage cells collected from the tibial plateau of old rats were cultured in vitro to the third generation.Then the cells were divided into 3 groups:POSTN group,PBS group and POSTN antibody group.The proliferations of the three groups at 24 h,48 h and 72 h were determined by EDU method.The expression of Notch1 protein was detected by immunohistochemistry in all groups at the same time.Female 20-month-old Sprague-Dawley rats were randomly divided into 3 groups:POSTN protein injection group,Phosphate Buffered Saline (PBS) injection group and POSTN antibody injection group.Twelve weeks after the operation,related reagents were injected 3 times consecutively at day 1,day 3,day 5 and EDU was injected into joints at day 1.At 2 weeks after injection,the rats were killed and the knee tibial plateau was taken to observe the proliferation of the cartilage cells.Results At 24 h,there were differences between the three groups O(F=27.32,P=0.017).The proliferation rates of POSTN group [(23±8)％] and PBS group [(21±10)％] were higher than that of POSTN antibody group (16±5)(P=0.003,P=0.011).At 48 h,there were differences between the three groups (F=35.34,P＜0.01).The proliferation rate of POSTN group [(36±11)％] was higher than that of the other groups [(22±6)％],(18±6)％(P=0.021,P＜0.01).At 72h,there were differences between the three groups (F=52.62,P=0.000).The proliferation rate of POSTN group [(56±17)％] was the highest one,the proliferation rate of PBS group [(31±8)％] was the medium,and the POSTN antibody group [(26±7)％] was the lowest one (all P＜0.05).As for Notch1 protein expression in chondrocytes,there were differences between the three groups (F=26.72,P＜0.01).The Notch1 protein was the most frequently expressed in POSTN protein-injection group and the least in the anti-POSTN group.In rats,the proliferation rate of the chondrocytes in the medial tibia plateau of the knee of POSTN protein injection group [(36±14)％],which was the highest,and that of the POSTN antibody injection group [(10 ±4)％] was the lowest (all P＜0.05).Conclusion POSTN protein can promote the proliferation of chondrocytes knee OA rats.POSTN antibody injection has been shown to induce the proliferation of chondrocytes.The POSTN protein may promote the proliferation of chondrocytes by activating the Notch signaling pathway.

Objective We performed comprehensive proteomic analyses of synovial fluid by using the isobaric tags for relative and absolute quantitation (iTRAQ) method and LC-MS/MS, and searched for candidate biomarkers for osteoarthritis. Methods Synovial fluid was collected from patients with late-stage OA, earlystage OA and the control group. Molecular variations were detected by the iTRAQ method. T test was used for statistical analysis. Results Using the iTRAQ method, we identified 1 283 proteins from synovial fluid of patients with osteoarthritis, of which 268 proteins were not reported previously. There were 72 proteins upregulated and 249 proteins down-regulated between moderate OA group and controls. One hundred and twentyeight proteins were up-regulated and 141 proteins were down-regulated between severe OA group and controls.One hundred and ninety-two proteins were up-regulated and 76 proteins were down-regulated between severe OA group and moderate OA group. Eight proteins were found to be up-regulated in the three groups.Conclusion This is an in-depth analysis of the synovial fluid proteome from patients with osteoarthritis by iTRAQ method. The catalog of proteins generated in this study will further expand our knowledge regarding the pathophysiology of osteoarthritis and help us in identifying good biomarkers for early diagnosis.

OBJECTIVETo summarize the results of endoscopic screening of esophageal, gastric cardiac and gastric cancers in the high-risk population, and analyze the influencing factors such as age, gender and biopsy rate on their detection and early diagnosis rates.

METHODSNine high incidence cities and counties of esophageal cancer in Henan province were included in this study. People aged 40-69 years were set to the target population. Excluding contraindications for gastroscopy, in accordance with the national technical scheme of early cancer diagnosis and treatment, gastroscopic screening and biopsy pathology for human esophageal, cardiac and gastric cancers were carried out.

RESULTSDuring the 3-year period, a total of 40 156 subjects were screened. Among them, 18 459 cases of various precancerous lesions (46.0%) were detected. The cancer detection rate was 2.3% (916 cases), including 763 cases of early cancers. The diagnosis rate of early cancers was 83.3%. Precancerous lesions were detected in 9297 cases (23.2%) for esophagus and 9162 cases (22.8%) for gastric cardia as well as stomach, respectively.

CONCLUSIONSThe results of this study demonstrate that endoscopic screening is feasible for early detection, diagnosis and treatment of esophageal, gastric cardia and gastric cancers among high risk population in high incidence area. Exploration analysis of relevant affecting factors may help to further improve the screening project for early diagnosis and treatment of those cancers.

Adult ; Age Distribution ; Aged ; Biopsy ; Cardia ; China ; Early Detection of Cancer ; Esophageal Neoplasms ; diagnosis ; Female ; Gastroscopy ; Humans ; Male ; Mass Screening ; Middle Aged ; Precancerous Conditions ; diagnosis ; Stomach Neoplasms ; diagnosis

Objective Objective To evaluate the biomechanical effects of using a new injectable calcium phosphate cement to consolidate the fixation of osteoporotic intertrochanteric fracture. Method Five matched pairs of human cadaver femora were used to produce the model of intertrochanteric fracture. All fractures were fixed with dynamic hip screws(DHS),and divided into two groups. In the CPC consolidation group of each pair, CPC was used to grout the hip screw and to fill the posteromedial defect. All femora were subjected to biomechanical test. Result Under the loading of 500 N, in the CPC consolidation group, the mean axial stiffness was (691.93±18.90) N/mm and the horizontal shear stiffness was (5553.84±27.47) N/mm. The mean lateral and medial strength was 5.15±0.35 MPa and (4.13±0.24) MPa. The torsion stiffness was 0.41 and the ultimate loading was (3580±286)N. In the control group, the mean axial stiffness was (453.45±19.75) N/mm, the horizontal shear stiffness was (3848.87±22.63) N/mm, the mean lateral and medial strength was (3.12±0.37) MPa and (1.80±0.21) MPa, and, the torsion stiffness was 0.35 and the ultimate loading was (2512±189)N. Consolidation fixation with CPC increased each of the biomechanical efficiency（P<0.05）. Conclusion CPC consolidation of osteoprotic femoral head and the medial defect of intertrochanteric fracture could significantly improve the overall stability and decrease the rate of postoperative complication.

Estrogen Receptor (ERalpha) is a member of superfamily of ligand-activated transcription factors which play critical roles in many biological processes. To screen novel modulators of ERalpha for drug development and biological function research, we developed a mammalian one-hybrid-based high-throughput screening model for ERalpha modulator. We cloned the ERalpha LBD gene from the total mRNA of fat tissue by RT-PCR and fused it with the GAL4 DNA binding domain of pBIND-GAL4 plasmid to construct a chimara expression plasmid pBIND-GAL4-Eralpha(LBD). The L02 cells was cotransfected with pBIND-GAL4-ERalpha(LBD) and a GAL4-responsive luciferase reporter plasmid pGL3-GAL4, and following treatment with test compounds for 24 h, the activities of luciferase were detected to evaluate the transactivities of ERalpha modulators. After manner optimizations of transfection conditions, Estradiol, an agonist control, induced the expression of luciferase in a dose-dependent with EC50 of 0.17 micromol/L, the maximum folds of induction was about 28.1. Tamoxifen, an antagonist control, efficiently suppressed the estradiol-mediated luciferase induction with EC50 of 0.10 micromol/L. Using this screening model, we discovered four ERalpha agonists from 2000 natural and synthetic compounds.
3T3-L1 Cells ; Animals ; Chimera ; metabolism ; DNA-Binding Proteins ; biosynthesis ; genetics ; Estrogen Receptor Modulators ; chemistry ; isolation & purification ; Estrogen Receptor alpha ; agonists ; Genes, Reporter ; genetics ; Genistein ; chemistry ; isolation & purification ; HeLa Cells ; Humans ; Luciferases ; genetics ; metabolism ; Mice ; Models, Chemical ; Saccharomyces cerevisiae Proteins ; biosynthesis ; genetics ; Transcription Factors ; biosynthesis ; genetics ; Transfection