OBJECTIVE: To compare the effects of bilateral vertebral puncture guided by an angle-adjustable linear laser auxiliary device versus free-hand bilateral vertebral puncture. METHODS: A retrospective analysis was conducted on the clinical data of 47 patients who underwent thoracolumbar percutaneous kyphoplasty(PKP) from July 2022 to July 2023. All patients received bilateral percutaneous kyphoplasty, among whom 27 cases underwent conventional free-hand puncture (conventional puncture group) and 20 cases underwent puncture guided by a laser auxiliary device (auxiliary puncture group). In the conventional puncture group, there were 11 males and 16 females, with an average age of (69.6±5.1) years and a disease duration of (6.5±3.8) days;the fractured vertebrae were T₁₁-T₁₂ in 13 cases and L₁-L₂ in 14 cases. In the auxiliary puncture group, there were 7 males and 13 females, with an average age of (70.8±5.6) years and a disease duration of (6.4±3.8) days;the fractured vertebrae were T₁₁-T₁₂ in 7 cases and L₁-L₂ in 13 cases. The operation time, total blood loss, intraoperative fluoroscopy times, fluoroscopy duration, radiation dose, puncture success rate, and surgical complications were compared between the two groups. The visual analogue scale (VAS) was used to evaluate low back pain before surgery, 2 days after surgery, and 1 year after surgery. RESULTS: All patients achieved successful puncture, with good postoperative wound healing and no complications. The operation time of the auxiliary puncture group was (12.1±2.6) minutes, which was shorter than that of the conventional puncture group (14.1±2.8) minutes. The total blood loss of the auxiliary puncture group was (228.5±35.8) ml, less than that of the conventional puncture group (257.0±48.3) ml. The fluoroscopy times, fluoroscopy duration, and radiation dose of the auxiliary puncture group were (5.4±1.3) times, (15.9±3.3) seconds, and (159.4±37.4) μSv, respectively, all lower than those of the conventional puncture group (6.4±1.6) times, (18.8±4.6) seconds, (192.2±48.5) μSv, with statistically significant differences(P<0.05). There were no statistically significant differences in low back VAS scores between the two groups before surgery, 2 days after surgery, or 1 year after surgery(P>0.05). CONCLUSION Both laser auxiliary device-guided vertebral puncture and free-hand vertebral puncture have high success rates and similar postoperative curative effects. However, the laser auxiliary device-guided puncture has shorter operation time, less blood loss, and lower radiation hazard.
Humans ; Male ; Female ; Aged ; Retrospective Studies ; Middle Aged ; Punctures/methods* ; Kyphoplasty/instrumentation* ; Spinal Fractures/surgery* ; Lasers ; Thoracic Vertebrae/injuries* ; Lumbar Vertebrae/injuries*

OBJECTIVETo research the effects of Qubi Zhentong Recipe (QZR) on the expressions of interleukin-1beta (IL-1beta), interleukin-8 (IL-8), and vascular endothelial growth factor (VEGF) in the synovial of rats with collagen-inducing arthritis (CIA), and to discuss its mechanisms of action.

METHODSHealthy male Wistar rats were recruited and randomly divided into the model group ( n = 50) and the normal control group (n = 10). Rats of the model group were injected with type II collagen of bovine (BC II) emulsion in the tail and nape to establish the CIA model. After successful modeling, 30 successfully modeled rats were selected and randomly divided into three groups, i.e., the model group (n = 10), the QZR group (n = 10), and the methotrexate (MTX) group (n = 10). Rats in the normal control group and the model group were administered with physiological saline by gastrogavage, while those in the QZR group were administered with QZR at 22.9 g/kg by gastrogavage. All medication was performed once daily. The rats in the MTX group were administered with MTX suspension at 0.78 mg/kg by gastrogavage, once per week. After 30-day treatment, the levels of IL-1beta, IL-8, and VEGF in the synovial were detected by immunohistochemical method. The arthritis index (AI) was scored before and after medication.

RESULTSAfter treatment the AL score of the QZR group and the MTX group was obviously lower than that of the model group (P < 0.01). The AI score of the two drug groups were lower than that before treatment (P < 0.01). Compared with the normal control group, the expression levels of IL-1beta, IL-8, and VEGF obviously increased in the model group (P < 0.01). Compared with the model group, the expression levels of IL-1beta, IL-8, and VEGF were significantly lower in the two drug groups (P < 0.01). But there was no statistical difference between the QZR group and the MTX group (P > 0.05).

CONCLUSIONDecreasing the expression levels of IL-1beta, IL-8, and VEGF in the synovial of CIA rats may be one of the mechanisms for treating CIA by QZR.

Animals ; Arthritis, Experimental ; drug therapy ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Interleukin-1beta ; metabolism ; Interleukin-8 ; metabolism ; Male ; Rats ; Rats, Wistar ; Synovial Membrane ; drug effects ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo investigate the effect of the Chinese medical formula Qubi Zhentong Recipe(, QZR) on the synovial gene expression profile in collagen-induced arthritis (CIA) rats.

METHODSTen rats were randomly chosen from 60 rats as the control group, and the other 50 rats were used for the CIA models. The CIA model group was constructed by bovine injection of type II collagen through the rats' neck and tail. Twenty rats were randomly chosen from 34 successful CIA models and randomly assigned into two groups: the model group (n =10) and the QZR group (n=10). The QZR group was fed intragastrically with QZR 22.9 g/(kg·d) (10 times the clinical adult dose), and the CIA model group was given the same dose of normal saline. Both model and QZR groups were administered treatment once a day. Total RNA was collected from the knee joint synovium after 30 days. The change in gene expression profile was analyzed by a whole gene chip.

RESULTSA total of 76 genes showed a difference in expression between CIA model group and the control group; 35 genes were down-regulated and 41 were up-regulated. A total of 67 genes showed a difference in expression between the model group and the QZR group; 48 genes were down-regulated and 19 were upregulated.

CONCLUSIONSQZR may affect CIA by stimulating multiple genes and targets, which are related to oncogenes, apoptosis, metabolism, the immune system, ion channels, and transport proteins.

Animals ; Arthritis, Experimental ; genetics ; Cattle ; Disease Models, Animal ; Down-Regulation ; drug effects ; genetics ; Drugs, Chinese Herbal ; pharmacology ; Electrophoresis, Agar Gel ; Extremities ; pathology ; Gene Expression Regulation ; drug effects ; Male ; Rats ; Rats, Wistar ; Synovial Membrane ; drug effects ; metabolism ; pathology ; Transcriptome ; Up-Regulation ; drug effects ; genetics