1.Degeneration of paraspinal muscles in degenerative lumbar spinal stenosis with or without spondylolisthesis and its correlation with degeneration of lumbar facet joints
Zexiang ZHONG ; Xinhua ZHOU ; Yafeng JI ; Xinxing FAN ; Xiongfeng LI ; Xuesheng JIANG ; Qian LU
Chinese Journal of Orthopaedics 2024;44(20):1331-1338
		                        		
		                        			
		                        			Objective:To analyze the differences in paraspinal muscles between patients with degenerative lumbar spinal stenosis (DLSS) with or without spondylolisthesis and to assess the correlation between these differences and lumbar facet joint degeneration.Methods:The data of 68 patients with DLSS who underwent surgical treatment in our hospital from January 2021 to April 2023 was retrospectively analyzed. Of these, 22 were male (32.4%) and 46 were female (67.6%), with an average age of 69.7±5.9 years (range: 56-80 years). The DLSS group included 35 patients without spondylolisthesis [13 males (37.1%) and 22 females (62.9%)], average age 68.5±5.9 years (range: 56-80 years), while the DLSS+degenerative spondylolisthesis (DS) group included 33 patients with spondylolisthesis [9 males (27.3%) and 24 females (72.7%)], average age 70.9±5.7 years (range: 58-80 years). Magnetic resonance imaging (MRI) scans of the L 3-S 1 intervertebral disc levels were collected from all patients. Using ImageJ software, the cross-sectional area (CSA) and percentage of fat infiltration area (FIA%) of the erector spinae and multifidus muscles were measured. Additionally, the facet joint angle (FJA), facet overhang (FO), and facet effusion (FE) were evaluated using Surgimap software, and their correlation with CSA and FIA% of the paraspinal muscles was analyzed. Results:The FJA and FO in the DLSS+DS group (50.16°±11.08° and 7.67±2.25 mm) were significantly larger than those in the DLSS group (43.51°± 7.75° and 3.88±1.98 mm) ( P<0.05). However, differences in FE between the two groups were not statistically significant. The cross-sectional areas of the multifidus muscles at L 3, 4, L 4, 5, and L 5S 1 in the DLSS+DS group (576.66±112.70 mm 2,, 782.72±141.49 mm 2, and 817.88±185.22 mm 2,, respectively) were significantly smaller than those in the DLSS group (647.37±165.44 mm 2,, 881.20±202.10 mm 2,, and 995.06±211.25 mm 2,, respectively) ( P<0.05). The FIA% of the erector spinae at L 3, 4, L 4, 5, and L 5S 1 in the DLSS+DS group (11.47%±5.14%, 14.84%±6.15%, 20.82%±7.41%) were significantly higher than those in the DLSS group (6.27%±2.83%, 10.81%±4.84%, 16.17%±5.88%) ( P<0.05). Similarly, the FIA% of the multifidus muscles at L 3, 4, L 4, 5, and L 5S 1 in the DLSS+DS group (18.04%±5.88%, 19.67%±5.78%, 19.31%±8.61%) were significantly higher than those in the DLSS group (9.85%±4.39%, 12.27%±3.70%, 14.65%±3.82%) ( P<0.05). No statistically significant differences were found in the CSA of the erector spinae at these levels between the two groups. The CSA of the multifidus muscles at L 3, 4, L 4, 5, and L 5S 1 in both groups were negatively correlated with FJA and FO ( r=-0.318, P=0.008; r=-0.381, P=0.001; r=-0.439, P<0.001; r=-0.290, P=0.016; r=-0.315, P=0.009; r=-0.479, P<0.001). The FIA% of the erector spinae at L 3, 4, L 4, 5, and the multifidus muscles at L 4, 5 and L 5S 1 were positively correlated with FJA ( r=0.352, P=0.003; r=0.344, P=0.004; r=0.300, P=0.013; r=0.359, P=0.003). Additionally, the FIA% of the erector spinae at L 3, 4, L 4, 5, and L 5S 1, and the multifidus muscles at L 3, 4 and L 4, 5 were positively correlated with FO ( r=0.409, P=0.001; r=0.248, P=0.042; r=0.277, P=0.022; r=0.500, P<0.001; r=0.447, P<0.001). There was no correlation between FE and CSA or FIA% of the erector spinae and multifidus muscles at L 3, 4, L 4, 5, and L 5S 1 in either group. Furthermore, FJA was positively correlated with FO ( r=0.369, P=0.002), but no correlation was observed between FE and FJA or FO. Conclusion:Compared to patients with lumbar spinal stenosis, those with degenerative lumbar spinal stenosis with spondylolisthesis exhibit more severe paraspinal muscle atrophy, a more sagittal orientation of the facet joints, and a higher degree of facet joint osteoarthritis. Patients with larger FJA and FO show more severe paraspinal muscle atrophy.
		                        		
		                        		
		                        		
		                        	
2.Pinoresinol diglucoside activates Nrf2 pathway to improve osteoporosis in mice
Zhanfeng MO ; Qian LU ; Yafeng JI ; Chengdong CHEN ; Pan TANG ; Xuesheng JIANG
Chinese Journal of Endocrine Surgery 2023;17(3):353-358
		                        		
		                        			
		                        			Objective:Rosin alcohol two glycosidase (pinores inoldiglucoside, PDG) effect on the improvement of the osteoporosis in mice and the possible mechanism of action.Methods:A mouse model of osteoporosis was established by removing bilateral ovaries. According to the random number table method, 50 mice were divided into model (MOD) group (equal volume of normal saline), positive control (PC) group (0.2 mg/kg estradiol), PDG-low dose (L) group (5 mg/kg) PDG), PDG-high dose (H) group (10 mg/kg PDG by gavage) and PDG-H+ML385 group (10 mg/kg PDG by gavage after intramuscular injection of 30 mg·kg-1 ML385), 10 mice in each group; Another 10 mice without any ovarian treatment were selected as sham group (intragastric administration of the same amount of normal saline). After 3 weeks of drug intervention, the serum alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRAP), interleukin-6 (IL-6) and tumor necrosis factor were detected by enzyme-linked immunosorbent assay (ELISA) -α (TNF-α). The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) were measured by dual energy X-ray. The mRNA and protein expression levels of nuclear factor related factor 2 (Nrf2), oxidase heme oxygenase 1 (HO-1), quinone oxidoreductase 1 (NQO1) were detected by real-time fluorescence quantitative PCR (qRT-PCR) and Western blot, respectively.Results:The serum ALP levels in Sham, MOD, PC, PDG-L, PDG-H and PDG-H + ML385 groups were (25.88±3.42), (47.42±5.32), (36.20±3.37), (38.95±3.24), (29.66±2.64), (39.57±2.06) U/dL, respectively; The serum trap levels were (2.18±0.40), (4.69±0.83), (3.58±0.38), (3.67± 0.48), (2.93±0.26), (3.81±0.49) U/L, respectively; BMD (153.04±12.96), (86.25±6.71), (126.53±8.99), (119.77±8.84), (139.18±15.94), (92.09±4.17) mg/cm 2; The expression levels of Nrf2 mRNA were 1.00±0.00, 0.35±0.04, 0.67±0.05, 0.54±0.03, 0.82±0.08 and 0.48±0.04, respectively; The expression levels of HO-1 mRNA were 1.00±0.00, 0.25±0.03, 0.56±0.03, 0.47± 0.03, 0.71±0.04 and 0.37±0.04, respectively; The expression levels of nqo1mrna were 1.00±0.00, 0.38± 0.02, 0.63±0.03, 0.58±0.04, 0.79±0.05 and 0.44±0.03, respectively; Nrf2 protein expression levels were 0.98±0.08, 0.26±0.04, 0.52 ±0.06, 0.46±0.03, 0.86±0.07, 0.45±0.05. HO-1 protein expression levels were 0.39±0.02, 0.09±0.01, 0.15 ±0.03, 0.17±0.03, 0.26±0.03, 0.12±0.02. NQO1 protein expression levels were 0.53±0.03, 0.21±0.02, 0.38±0.04, 0.29±0.02, 0.55±0.03, 0.24±0.04, respectively; The levels of serum IL-6 were (104.25±11.35), (515.38±74.48), (351.78± 65.12), (364.73±36.64), (246.18±17.52), (408.93±32.56) pg/ml, respectively; The levels of serum TNF-α were (33.79±3.55), (170.11±19.24), (76.09±8.99), (84.95±6.12), (66.98±3.73), (119.04±9.75) pg/mL, respectively; The serum SOD levels were (258.47±19.25), (72.15±8.12), (187.60±14.63), (152.61±12.36), (204.22±19.65), (138.01±13.62) U/mL, respectively; The serum MDA levels were (2.02±0.27), (4.75±0.73), (3.19±0.46), (3.7±0.49), (2.91±0.42), (4.10 ±0.25) μmol/L respectively. There were significant differences between MOD group and Sham group, or PC, PDG-L, PDG-H, PDG-H+ML385 group and MOD group,or PDG-H+ML385 group and PDG-H ( P<0.05) . Conclusion:PDG can reduce bone inflammation and oxidative stress by activating Nrf2 pathway and improve the state of osteoporosis.
		                        		
		                        		
		                        		
		                        	
3.Impact of interleukin-6 gene polymorphisms and its interaction with obesity on osteoporosis risk in Chinese postmenopausal women.
Ya-Feng JI ; Xuesheng JIANG ; Wei LI ; Xingtao GE
Environmental Health and Preventive Medicine 2019;24(1):48-48
		                        		
		                        			AIMS:
		                        			To investigate the association of four single-nucleotide polymorphisms (SNPs) of the IL-6 gene with osteoporosis (OST) susceptibility.
		                        		
		                        			METHODS:
		                        			PCR restriction fragment length polymorphism (PCR-RFLP) was carried out for SNPs detection. Generalized multifactor dimensionality reduction (GMDR) model and logistic regression model were used to examine the interaction between SNP and obesity on OST.
		                        		
		                        			RESULTS:
		                        			Logistic regression model revealed that G allele of rs1800796 and the T allele of rs2069849 were associated with increased OST risk, compared to those with wild genotype. However, no significant correlations were found when analyzing the association of rs1800795 and rs1554606 with OST risk. GMDR analysis suggested that the interaction model composed of the rs1800796 and obesity was the best model with statistical significance (P value from sign test [P] = 0.012), indicating a potential gene-environment interaction between rs1800796 and obesity. Overall, the two-locus models had a cross-validation consistency of 10/10 and had the testing accuracy of 0.641. We also conducted stratified analysis for rs1800796 genotype and obesity, and found that obese subjects with CG or GG genotype have the highest OST risk, compared to subjects with CC genotype, and normal BMI OR (95% CI) = 2.21 (1.52-3.49), after adjustment for age, smoke, and alcohol consumption status.
		                        		
		                        			CONCLUSIONS
		                        			Our results suggested that the C allele of rs1800796 and the C allele of rs2069849 of IL-6 gene interaction between rs1800796 and abdominal obesity were all associated with increased OST risk.
		                        		
		                        		
		                        		
		                        			Aged
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		                        			Aged, 80 and over
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		                        			China
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		                        			Female
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		                        			Gene-Environment Interaction
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		                        			Humans
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		                        			Interleukin-6
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		                        			genetics
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		                        			metabolism
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		                        			Middle Aged
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		                        			Obesity
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		                        			epidemiology
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		                        			etiology
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		                        			genetics
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		                        			Osteoporosis
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		                        			epidemiology
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		                        			etiology
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		                        			genetics
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		                        			Polymorphism, Single Nucleotide
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		                        			Postmenopause
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		                        			genetics
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		                        			physiology
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		                        			Risk Factors
		                        			
		                        		
		                        	
4.Effect of sevoflurane on cognitive function of mice with Alzheimer's disease
Zhen JIANG ; Wei DAI ; Pengcheng GENG ; Xiaoyu HAN ; Qingqing DAI ; Zhilai YANG ; Jiqian ZHANG ; Xuesheng LIU
Chinese Journal of Anesthesiology 2017;37(4):423-425
		                        		
		                        			
		                        			Objective To evaluate the effect of sevoflurane on cognitive function of mice with Alzheimer's disease.Methods Twenty male mice carrying mnutations in amyloid precusor protein (APP) and presenilin 1 genes,weighing 30-40 g,aged 7 months,were divided into either sevoflurane group (group Sev) or control group (group C),with 20 mice in each group.Mice inhaled 3% sevoflurane for 4 h in group Sev,and mice inhaled 30% oxygen for 4 h in group C.At 1 month after inhaling sevoflurane or oxygen,the mice underwent continuous multiple-trail inhibitory avoidance training.The mice were then sacrificed and hippocampi were isolated for determination of the number of Aβ plaques (by immunohistochemistry) and expression of APP and Tau (S396) phosphorylation (by Western blot).Results Compared with group C,the memory lateucy was significantly shortened,the number of Aβ plaques was increased,the phosphorylation of Tau (S396) was increased,and the expression of APP was up-regulated in group Sev (P<0.05).Conclusion Sevoflurane can decrease the cognitive function of mice with Alzheimer's disease.
		                        		
		                        		
		                        		
		                        	
5.Study on the therapeutic effects of hyperbaric oxygen on human umbilical cord Wharton jelly mesenchyme cells on myocardial infarction rats
Hong ZHANG ; Xuesheng LUO ; Gongda JIANG ; Xiao CHEN
Journal of Chinese Physician 2015;17(7):1013-1016
		                        		
		                        			
		                        			Objective To explore whether hyperbaric oxygen could enhance the effects of the transplanted stem cell on treating myocardial infarction rats.Methods A total of 70 Sprague-Dawley (SD) Rats was randomly divided into four groups,sham operated,acute myocardial infarction (AMI),mesenchymal stem cells (MSCs) (Stem Cell Transplanting),and hyperbaric oxygen (HBO) + MSCs group,respectively.Myocardial infarction rat model was established,hyperbaric oxygen treatment was carried out every day at the first to 30 day after AMI.Human umbilical cord Wharton jelly mesenchyme cell was transplanted at the third day after AMI.The densities of polymorphonuclear neutrophils and macrophages in the infracted border zones and in the infarcted area of heart were determined with hematoxylin and eosin (HE) staining.The cardiac function was assessed with M-mode transthoracic echocardiography,in vivo.Results (1)Compared to MSCs group,the stem cell proliferation and survival rates were increased significantly at the forth week (276.6 ±73.8 versus 20.5 ± 12.3,P <0.01).(2)Compared to the AMI and MSCs groups,the infracted area and the number of inflammatory cell infiltration were significantly reduced in HBO alone and MSCs + HBO groups.(3) Compared to the AMI group,the cardiac function was significantly improved at the different degree in the other three groups;among these groups,cardiac function was significantly improved in the MSCs + HBO group (P <0.01),except for the volume of end-dilation (P >0.05).Conclusions Hyperbaric oxygenation could significantly promote the proliferation and survival rate of stem cells,and improve the cardiac function.Thus further enhance the effect of the transplanted stem cell on treating the infarcted heart.
		                        		
		                        		
		                        		
		                        	
6.Bacillus anthracis isolates analysis by multiple-locus variable-numbers of tandem repeats analysis,Liaoning,China
Lingling MAO ; Jiang TIAN ; Lu LEI ; Xuesheng LIU ; Wei ZHANG ; Meimei ZHANG ; Yue HAN ; Wenqing YAO
Chinese Journal of Zoonoses 2015;(3):232-234
		                        		
		                        			
		                        			The epidemic characteristics and genotype of Bacillus anthracis strains in Liaoning Province ,China was analyze in this study .Six Bacillus anthracis strains from 2001 to 2011 were studied with multiple‐locus variable‐number tandem repeat analysis (MLVA) .BioNumerics4 .0 software was used to analyze the DNA fingerprint of statistics ,and cluster analysis results were obtained .Clustering analysis found that the 6 strains could be divided into two genotypes .For anthrax outbreaks ,the ge‐netic markers of multiple‐locus variable‐number tandem repeat were highly similar .It's suggested that MLVA is quite useful for investigation of strain relatedness in regions of outbreaks .
		                        		
		                        		
		                        		
		                        	
7.Role of PPARα/PGC-1αin doxorubicin induced mouse dilated cardio-myopathy
Xuesheng WANG ; Yongyao YANG ; Tianhe YANG ; Qingan JIANG
Chinese Journal of Pathophysiology 2015;(7):1160-1165
		                        		
		                        			
		                        			[ ABSTRACT] AIM:To investigate the changes of peroxisome proliferator-activated receptors ( PPAR)α/peroxi-some proliferator activated receptor coactivator 1 alpha ( PGC-1α) in doxorubicin ( DOX) induced dilated cardiomyopathy ( DCM) and its effect on the energy metabolism and myocardial function in mice .METHODS:Forty mice were randomly divided into 4 groups:control group, DOX group, PPARαinhibitor group and PPARαagonist group.The DCM model was established by injection of DOX.The protein levels of PPARα/PGC-1αwere detected.The PPARαinhibitor and PPARαagonist were used 2 weeks beforeinjection of DOX.The contents of adenine acid and phosphocreatine ( Pcr) in the mito-chondria were measured by high-performance liquid chromatography ( HPLC) .The ANT activity was analyzed by the atrac-tyloside-inhibitor stop technique.The changes of the echocardiography and hemodynamics were also observed.RESULTS:DOX induced DCM model was successfully established.The protein levels of PPARαand PGC-1αin control group were significantly higher than those in DOX group (P<0.05).Both of the high-energy phosphate contents and the transport ac-tivity of ANT were decreased in DOX group (P<0.05), and the hemodynamic parameters were disordered (P<0.01). Compared with DOX group, PPARαinhibitor pre-treatment significantly reduced the PPARα/PGC-1αexpression.Mean-while, high-energy phosphate contents in the mitochondria and the ANT transport activity of the mitochondria decreased, as well as the left ventricular function ( P<0.05) .On the other hand, PPARαagonist significantly increased the expression of PPARαand PGC-1α, and improved the transport activity of ANT.In addition, the hemodynamic parameters were amel-iorated, but the high-energy phosphate contents of the mitochondria did not significantly change.CONCLUSION:PPARα/PGC-1αplays an important role in the regulation of ANT transport activity in dilated cardiomyopathy induced by DOX, and the activation of PPARα/PGC-1αhas protective effects on the DCM induced by DOX.
		                        		
		                        		
		                        		
		                        	
8.Preoperative Evaluation on Calot’s Triangle Adhesion by Magnetic Resonance Cholangiopancreatography
Rongxun SUN ; Jiang CHEN ; Xuesheng JI ; Jingtian LIU ; Dawei ZHANG ; Guangbin WU ; Xiaoyan LI ; Peilong SUN
Chinese Journal of Clinical Medicine 2014;(5):570-571
		                        		
		                        			
		                        			Objective:To investigate the value of magnetic resonance cholangiopancreatography(MRCP)in the evaluation on Calot’s triangle adhesion before laparoscopic cholecystectomy(LC).Methods:A total of 254 patients received MRCP before LC,and the type of Calot’s triangle adhesion was evaluated,which included whether or not the cystic duct had been displayed, adjacent relations between the cystic duct and the gallbladder ampulla,and the open position of the cystic duct in the gallbladder ampulla.The type of Calot’s triangle adhesion by preoperative evaluation was compared with that by intraoperative findings. The relation between the type by preoperative evaluation and the difficulty of operation was analyzed.Results:The type of Cal-ot’s triangle adhesion by preoperative MRCP corresponded with that by intraoperative findings.The rabbit tail type of adjacent relation between the cystic duct and the gallbladder ampulla,the cystic duct starting at the middle portion of the gallbladder am-pulla and the absent imaging of cystic duct could indicate difficult LC procedures.Conclusions:MRCP could be used in preoper-ative evaluation on Calot’s triangle adhesion,to predict the difficulty degree of the LC procedure.
		                        		
		                        		
		                        		
		                        	
9.Cervical laminoplasty using titanium miniplate for multisegmental cervical spondylotic myelopathy
Bishui ZHAN ; Guoshwn ZHOU ; Chengdong CHEN ; Xuesheng JIANG ; Wei LI ; Qian LU
Journal of Chinese Physician 2012;14(3):329-331,335
		                        		
		                        			
		                        			Objective To evaluate the clinical outcome of cervical laminoplasty using titanium miniplate ( AO arch) for the treatment of multisegmental cervical spondylotic myelopathy (MCSM).Methods 21 patients with MCSM were operated by cervical posterior unilateral open-door laminoplasty combined with titanium miniplate internal fixation.The JOA score,sagittal diameter of the spinal canal in the midline (SD) and cervical curvature index according to the measurement of Penning method before surgery and at postoperative follow-up intervals were measured and compared by one-way analysis of variance.Results All patients were followed up for 9 ~48 months.There were no severe adverse events.CT sean showed bony fusion at hinge side since six months after operation.According to the JOA score evaluation system,al final follow-up period,9 cases were excellent,7 good,3 ordinary and 2 cases bad.Recovery rate was 62.5 % at final follow-up interval.Cervical SD before surgery and in posloperative one month were (9.2 ± 1.1 )mm,(13.5 ± 1.4) mm,respectively.The difference was significant between them( t =3.02,P < 0.01 ),but there was no improvement since one month postoperatively ( P > 0.05 ).Cervical curvature index was ( 12.6 ± 14.7 ) ° preoperatively,it was ( 17.1 ± 12.4 ) ° at final follow-up interval,indicating that cervical curvature index made obvious progress at final follow-up interval ( t =8.26,P < 0.01 ),but there was no significant change within six months postoperatively ( P > 0.05 ).Conclusions Cervical laminoplasty combined with titanium miniplate can enlarge and maintain cervical SD,ameliorate cervical curvature and neurological function,and it is an ideal alternative treatment for MCSM.
		                        		
		                        		
		                        		
		                        	
10.Application of perforator flaps to repair chronic osteomyelitis with soft tissue defect in the distal lower extremity
Zhaohui PAN ; Jianli WANG ; Pingping JIANG ; Shan XUE ; Xuesheng LIU
Chinese Journal of Microsurgery 2010;33(5):353-356
		                        		
		                        			
		                        			Objective To evaluate free or pedicled perforator flaps for repairing chronic osteemylitis with soft-tissue defect in the distal lower extremity. Methods From May of 2006 to October of 2007, 28 consecutive patients of chronic osteomylitis with soft-tissue defect in the distal lower extremity underwent surgical debridement and reconstruction with free or pedicled perforator flaps. There were 13 free flaps. The free anterolateral thigh flaps were used in 2 cases to repair the soft defects in the front of leg, 3 cases in the front of the malleolus, 2 cases in the dorsum of foot, 2 cases in the heel. The free lateral crural flaps nourished by perone al artery were used in 4 cases to repair the soft defects in the dorsum of foot. There were 15 pedicled flaps. Posterior tibial artery perforator flaps were used in 4 cases to repair the soft defects in the front of leg, and 2 cases in the medial malleolus. Lateral retromalleolar perforator flaps nourished by peroneal artery were used in 6 cases to repair the soft-defects in the heel, 1 case in the lateral malleolus and 1 case in the dorsum of foot, the first dorsal metatarsal artery perforator flap was used to repair the proximal dorsum of hallux. The wound was closed with irrigation-suction in 7 cases and with vancomycin-impregnated gelatin in 8 cases. Results All 27 flaps were successfully survived except insuffcient vein refluence in 1 posterior tibial artery perforator flap, which resulted in a superficial necrosis and healed spontaneously. The follow-up period from 6 months to 2 years revealed that recurrence developed in two diffuse type patients and both were treated once and twice with success, respectively. The others healed without any signs of recurrences. No debulking procedure was necessary in any case. Secondary bone graft was performed in 3 cases. All patients were ambulatory and fully weight-bearing with normal clinical parameters at the time of last review. According to the evaluating criteria for the treatment of foot disease, the mean score was 84.5. Conclusion Free or pedicled perforator flap has been shown to be well vascularised, and it is feasible for the treatment of chronic osteomyelitis with soft-tissue defect in the distal lower extremity.
		                        		
		                        		
		                        		
		                        	
            
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