1.Effect of Ginkgo biloba extract in post-stroke depression model rats
Si-Min XIE ; You-Qiong WANG ; Miao-Miao MO ; Dong-Yi WANG ; Hai-Lan CHEN ; Bin YANG
The Chinese Journal of Clinical Pharmacology 2024;40(13):1933-1937
Objective To observe the effect of Ginkgo biloba extract(GBE)on depression like behavior in post stroke depression(PSD)model rats,and explore the mechanism of regulating Toll like receptor 4/nuclear factor-κ B(TLR4/NF-κB)pathway to inhibit neuroinflammation.Methods Rats were randomly divided into 6 groups,sham,cerebral ischemia,PSD,paroxetine,low-dose Ginkgo biloba extract(GBE-L)and high-dose Ginkgo biloba extract(GBE-H)groups,10 rats in each group.Except for the sham group,middle cerebral artery occlusion(MCAO)was performed to prepare a left focal cerebral ischemia model.Except for the sham group and cerebral ischemia group,other groups were subjected to chronic unpredictable mild stress(CUMS)to establish PSD rat model for 8 weeks.After 4 weeks of CUMS,the paroxetine group,GBE-L,and GBE-H were treated with paroxetine 5 mg·kg-1,GBE 50 mg·kg-1,and GBE 100 mg·kg-1,respectively.The sham group,cerebral ischemia group,and PSD group were treated with the same volume of 0.9%NaCl and continuously administered by gavage for 28 d.After 4 weeks and 8 weeks of CUMS,the body weight and sugar preference test were measured.Levels of serum tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β)and levels of norepinephrine(NE),serotonin(5-HT),and dopamine(DA)in the cerebral cortex were measured by enzyme-linked immunosorbent assay(ELISA).The mRNA levels of Tlr4,Nfkb1,and nuclear factor κ B-kinase subunit β inhibitory factor(Ikbkb)in the hippocampus of rats were detected by polymerase chain reaction.The protein levels of NF-κB,nuclear factor κB inhibitory protein α(IKBα)and phosphorylation nuclear factor κB inhibitory protein α(p-IKB)in hippocampal tissue were detected by Western blot.Results The body weights of rats in the sham group,cerebral ischemia group,PSD group,paroxetine group,GBE-L group and GBE-H group were(427.10±6.36),(403.10±7.37),(310.10±9.71),(355.00±4.03),(347.90±9.88)and(391.90±5.07)g;sugar preference rate were(93.93±1.78)%,(91.57±1.03)%,(54.72±7.34)%,(88.35±4.36)%,(63.55±12.73)%and(81.04±4.31)%;the levels of NE in the cerebral cortex were(1 951.14±52.86),(1 827.27±23.63),(1 662.12±35.92),(2 033.58±72.28),(1 887.31±33.07)and(2 175.00±42.54)pg·mL-1;the levels of 5-HT in the cerebral cortex were(237.07±8.86),(226.15±10.27),(214.51±3.46),(297.13±5.79),(274.14±7.63)and(285.34±8.72)ng·mL-1;the levels of DA in the cerebral cortex were(1 531.11±47.26),(1 209.89±58.09),(1 143.15±36.31),(1 812.67±51.28),(1 651.56±31.82)and(1 853.33±20.42)pg·mL-1.Compared with the PSD group,GBE significantly increased the body weight of rats(P<0.01)and increased the preference rate of sugar water in rats,showing the antidepressant like behavioral.GBE significantly reduced the levels of serum TNF-α,IL-1 β(all P<0.01),increased the levels of NE,5-HT,and DA in the cerebral cortex(all P<0.01),down regulate the mRNA levels of Tlr4,Nfkb1 and Ikbkb(P<0.05,P<0.01),reduced the expression of NF-κB(P<0.01),and reduced the phosphorylation of IKBα(P<0.01).Conclusion Ginkgo biloba extract can improve depression-like behavior in PSD model rats,and has antidepressant effect.Its mechanism is related to the inhibition of TLR4/NF-κB pathway,thus reducing neuroinflammation.
2.Clinical trial of different doses of remifentanil combined with sevoflurane in the treatment of patients undergoing spinal surgery
Hai-Tao TAN ; Tao CHEN ; Jian LI ; You-Cai LIN
The Chinese Journal of Clinical Pharmacology 2024;40(20):2958-2962
Objective To observe the efficacy and safety of different doses of remifentanil combined with sevoflurane in patients undergoing spinal surgery.Methods Patients undergoing spinal surgery were divided into low dose group,medium dose group and high dose group.Low dose group,medium dose group and high dose group were given 0.2,0.4 and 0.6 μg·kg-1·min-1 remifentanil by intravenous pump,respectively.Pain status[visual analogue score(VAS)],analgesic drug use,quality of recovery,hemodynamic indexes at different times[before surgery(T0),immediately after intubation(T1),intravenous pump injection of remifentanil 5 min(T2),10 min(T3),15 min(T4)]of the 3 groups were compared;and safety was evaluated.Results The low,medium and high dose groups were enrolled in 49,56 and 51 patients,respectively;the VAS scores at 6,12 and 24 h after operation in the low dose group were(2.48±0.51),(2.73±0.63)and(2.61±0.54)points,respectively;the VAS scores in the medium dose group were(2.36±0.54),(2.65±0.59)and(2.51±0.50)points,respectively;the VAS scores in the high dose group were(2.29±0.53),(2.53±0.57)and(2.44±0.52)points,respectively.There was no statistically significant difference between the groups(all P>0.05).The number of patient-controlled analgesia pump compressions in the low,medium and high dose groups were(3.27±0.96),(3.02±0.90)and(2.89±0.71)times,respectively;the number of remedial analgesia cases was 2 cases(4.08%),2 cases(3.57%)and 0 cases(0.00%),respectively.There was no statistically significant difference(all P>0.05).The recovery time of low,medium and high dose groups were(7.05±1.65),(8.24±2.17)and(9.03±2.48)min,respectively;the recovery time of consciousness were(11.26±2.73),(13.85±2.94)and(15.57±3.17)min,respectively;the extubation time were(16.34±3.05),(18.72±3.29)and(20.34±3.58)min,respectively.The differences were statistically significant(all P<0.05).There was no significant difference in blood oxygen saturation(SpO2),mean arterial pressure and heart rate at time points of T0,T1,T2,T3 and T4 among the three groups(all P>0.05).Adverse drug reactions in the 3 groups were mainly hypotension,nausea and vomiting,bradycardia,etc.The total incidence of adverse drug reactions in the high,medium and low dose groups was 11.76%(6 cases/51 cases),7.14%(4 cases/56 cases)and 8.16%(4 cases/49 cases),respectively.There were no statistically significant differences(P>0.05).Conclusion 0.2 μg·kg-1·min-1 remifentanil combined sevoflurane has better recovery quality and high safety in spinal surgery patients.
3.Application of the OmniLogTM microbial identification system in the detection of the host spectrum for wild-type plague phage in Qinghai Plateau
Cun-Xiang LI ; Zhi-Zhen QI ; Qing-Wen ZHANG ; Hai-Hong ZHAO ; Long MA ; Pei-Song YOU ; Jian-Guo YANG ; Hai-Sheng WU ; Jian-Ping FENG
Chinese Journal of Zoonoses 2024;40(1):21-25
The growth of three plague phages from Qinghai Plateau in two Yersinia pestis strains(plague vaccine strains EV76 and 614F)and four non-Yersinia pestis strains(Yersinia pseudotuberculosis PTB3,PTB5,Escherichia coli V517,and Yersinia enterocolitica 52302-2)were detected through a micromethod based on the OmniLogTM microbial identification system and by the drop method,to provide a scientific basis for future ecological studies and classification based on the host range.For plague vaccine strains EV76 and 614F,successful phage infection and subsequent phage growth were observed in the host bacte-rium.Diminished bacterial growth and respiration and a concomitant decrease in color were observed with the OmniLogTM mi-crobial identification system at 33 ℃ for 48 h.Yersinia pseudotuberculosis PTB5 was sensitive to Yersinia pestis phage 476,but Yersinia pseudotuberculosis PST5 was insensitive to phage 087 and 072204.Three strains of non-Yersinia pestis(Yersinia pseudotuberculosis PTB3,Escherichia coli V517,and Yersinia enterocolitica 52302-2)were insensitive to Yersinia pestis pha-ges 087,072204,and 476 showed similar growth curves.The growth of phages 476 and 087,as determined with the drop method,in two Yersinia pestis strains(plague vaccine strains EV76 and 614F)and four non-Yersinia pestis strains(Yersinia pseudotuberculosis PTB3,Escherichia coli V517,and Yersin-ia enterocolitica 52302-2)showed the same results at 37 ℃,on the basis of comparisons with the OmniLogTM microbial i-dentification system;in contrast,phages 072204 did not show plaques on solid medium at 37 ℃ with plague vaccine strains EV76 and 614F.Determination based on the OmniLogTM detection system can be used as an alternative to the traditional determination of the host range,thus providing favorable application val-ue for determining the interaction between the phage and host bacteria.
4.Full-field Anterior Chamber Angle Measurement Based on Optical Reflection Tomography
Bi-Wang LIU ; Jun-Ping ZHONG ; Hai-Na LIN ; Ya-Guang ZENG ; You-Ping YU ; Hong-Yi LI ; Ding-An HAN ; Jin-Ying CHEN
Progress in Biochemistry and Biophysics 2024;51(9):2240-2248
ObjectiveAngle-closure glaucoma (ACG) is one of the major eye-blinding diseases. To diagnose ACG, it is crucial to examine the anterior chamber angle. Current diagnostic tools include slit lamp gonioscopy, water gonioscopy, ultrasound biomicroscopy (UBM), and anterior segment optical coherence tomography (AS-OCT). Slit lamp and water gonioscopy allow convenient observation of the anterior chamber angle, but pose risks of invasive operation and eye infections. UBM can accurately measure the structure of the anterior chamber angle. However, it is complex to operate and unsuitable for patients, who have undergone trauma or ocular surgery. Although AS-OCT provides detailed images, it is costly. The aim of this study is to explore a non-invasive, non-destructive optical reflection tomography (ORT) technique. This technique can achieve low-cost three-dimensional imaging and full-field anterior chamber angle measurement of the porcine eye. MethodsThe experiment involved assembling an optical reflection tomography system, which included a complementary metal oxide semiconductor (CMOS) camera, a telecentric system, a stepper motor, and a white light source, achieving a spatial resolution of approximately 8.5 μm. The process required positioning the porcine eye at the center of the field of the imaging system and rotating it around its central axis using a stepper motor. Reflection projection images were captured at each angle with an exposure time of 1.0 ms and an interval of 2°. The collected reflection-projection data were processed using a filtered reflection tomography algorithm, generating a series of two-dimensional slice data. These slices essentially represented cross-sectional views of the three-dimensional structural image, and were reconstructed into a complete three-dimensional structural image. Based on the reconstructed three-dimensional structural image of the porcine eye, the anterior chamber angles at different positions were measured, and a distribution map of these angles was drawn. Simultaneously, the ORT measurements were compared with the standard results obtained from optical coherence tomography (OCT) to assess the accuracy of ORT measurements. ResultsIn this study, we successfully obtained the reflection projection data of a porcine eye using ORT technology, reconstructed its three-dimensional structural image, and measured the anterior chamber angle, generating the corresponding distribution map. To better distinguish the different structural parts of porcine eye, the three-dimensional structural image was marked with blue, green, and yellow dashed lines from the outer to the inner layers. The area between the blue and green dashed lines corresponded to the sclera. The area between the green and yellow dashed lines corresponded to the iris. The area inside the yellow dashed line corresponded to the pupil. The three-dimensional structural image clearly revealed the key anatomical features of the porcine eye. It was able to measure the anterior chamber angle at different positions. Additionally, the anterior chamber angle measurements of the porcine eye using ORT were compared with the measurements obtained using a TEL320C1 type OCT system, showing an average deviation of 0.51° and a mean square error
5.Construction and characterization of lpxC deletion strain based on CRISPR/Cas9 in Acinetobacter baumannii
Zong-ti SUN ; You-wen ZHANG ; Hai-bin LI ; Xiu-kun WANG ; Jie YU ; Jin-ru XIE ; Peng-bo PANG ; Xin-xin HU ; Tong-ying NIE ; Xi LU ; Jing PANG ; Lei HOU ; Xin-yi YANG ; Cong-ran LI ; Lang SUN ; Xue-fu YOU
Acta Pharmaceutica Sinica 2024;59(5):1286-1294
Lipopolysaccharides (LPS) are major outer membrane components of Gram-negative bacteria. Unlike most Gram-negative bacteria,
6.Mapping Dissolved Gases Distribution in Lake Water Using Shipborne Membrane Inlet Mass Spectrometry
Han WANG ; Chang-Jie LIU ; Hai-Yun SONG ; You-Jiang LIU ; Chi-Lai CHEN
Chinese Journal of Analytical Chemistry 2024;52(7):937-944
As global average carbon dioxide concentrations steadily rise,the frequency,intensity,and duration of cyanobacterial blooms in aquatic ecosystems are increasing annually.This phenomenon presents a significant threat to the overall health of global ecosystems and has garnered worldwide attention.In this study,an online detection of small-molecule dissolved gas concentrations in lake using a home-made membrane inlet mass spectrometer was conducted.Comparative water samples analyses demonstrated that the developed mass spectrometer instrument effectively discriminated between different water samples based on its dissolved gas detection capabilities.Online survey revealed that the concentrations of dissolved O2 and dissolved CO2 were 0.24 mmol/L and 1.31 μmol/L,respectively,in areas without cyanobacterial coverage.In areas with cyanobacterial coverage,their concentrations were 0.21 mmol/L and 0.92 μmol/L,respectively.In areas where cyanobacteria were densely collected,the dissolved CO2 content rose rapidly,while the dissolved O2 content decreased rapidly.This result revealed that large-scale cyanobacterial blooms exacerbated CO2 emissions,and during such blooms,lakes acted as sources of CO2,emitting substantial amounts into the atmosphere,thereby contributing to adverse impacts on global climate change.Furthermore,extensive cyanobacterial blooms led to a rapid decrease in dissolved O2 levels,resulting in O2 depletion and the mortality of fish and benthic invertebrates.The research highlighted the significance of the ratio of content of O2 and CO2 as a crucial indicator for cyanobacterial monitoring,with a smaller ratio indicating higher cyanobacterial content.Moreover,changes in turbidity and variations in the ratio of O2 and CO2 exhibited strong consistency.Large-scale algal blooms increased water turbidity,which posed a threat to the survival of aquatic organisms.This study provided a technological means for online detection of dissolved gases in water,offering essential references for water quality assessment,ecological evaluation,and particularly,for early prevention,mid-term management,and post-treatment effectiveness assessment of cyanobacterial blooms.
7.Analysis of Traditional Chinese Medicine Constitution Types of Nonspecific Low Back Pain and the Influencing Factors for the Thickness of Ligamentum Flavum
Zhou-Hang ZHENG ; Yu ZHANG ; Long CHEN ; Dong-Chun YOU ; Wei-Feng GUO ; Xing-Ming LIU ; Huan CHEN ; Rong-Hai WU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(5):1103-1108
Objective To investigate the distribution of the traditional Chinese medicine(TCM)constitution types in the patients with nonspecific low back pain(NLBP)and to explore the correlation of the thickness of ligamentum flavum with the age,body mass index(BMI),gender,the presence of diabetes mellitus,and the grading of hypertension.Methods Sixty patients with NLBP admitted to Guangdong Second Traditional Chinese Medicine Hospital from January 2023 to June 2023 were selected as the study subjects.The TCM constitution types of the patients were identified,the thickness of the ligamentum flavum at lumbar vertebrae 4/5 segment(L4/5)disc level was measured by computerized tomography(CT)scanning,and the patients'age,genders,TCM constitution types,BMI,the presence or absence of diabetes mellitus,and hypertension grading were recorded.Correlation analysis and linear regression analysis were used for the exploration of the relevant influencing factors for the thickness of the ligamentum flavum of patients with NLBP.Results(1)The average thickness of ligamentum flavum in the 60 patients with NLBP was(2.60±0.72)mm.(2)The TCM constitutions of NLBP patients were classified into four types,of which blood stasis constitution was the most common,accounting for 21 cases(35.0%),followed by 19 cases(31.7%)of damp-heat constitution,12 cases(20.0%)of phlegm-damp constitution,and 8 cases(13.3%)of qi deficiency constitution.(3)The results of correlation analysis showed that BMI,gender,TCM constitution type and the presence or absence of diabetes mellitus had no influence on the thickness of ligamentum flavum in NLBP patients(P>0.05),while the age and hypertension grading had an influence on the thickness of ligamentum flavum(P<0.01).(4)The results of linear regression analysis showed that the age had an influence on the thickness of the ligamentum flavum(b = 0.034,t = 6.282,P<0.01),while the influence of the hypertension grading had no influence on the thickness of the ligamentum flavum(P>0.05).Conclusion The TCM constitution type of NLBP patients is predominated by blood stasis constitution,the thickness of ligamentum flavum is significantly affected by the age,and hypertension may be a potential factor affecting the thickness of ligamentum flavum.
8.Clinical Efficacy of"Triple-posture Positive Bone-setting"Chiropractic Manipulation Combined with Tongluo Huoxue Formula for the Treatment of Lumbar Spinal Stenosis of Qi Deficiency and Blood Stasis Type
Long CHEN ; Zhou-Hang ZHENG ; Yu ZHANG ; Meng-Shu WANG ; Zhao-Yuan ZHANG ; Wei-Feng GUO ; Huan CHEN ; Xing-Ming LIU ; Dong-Chun YOU ; Rong-Hai WU
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(6):1450-1456
Objective To observe the clinical efficacy of"triple-posture positive bone-setting"chiropractic manipulation combined with Tongluo Huoxue Formula for the treatment of lumbar spinal stenosis(LSS)with qi deficiency and blood stasis syndrome.Methods Sixty patients with LSS of qi deficiency and blood stasis type were randomly divided into trial group and control group,with 30 cases in each group.The trial group was treated with"triple-posture positive bone-setting"chiropractic manipulation(a chiropractic manipulation performed under the positive cooperation of the patients at three postures)combined with Tongluo Huoxue Formula,while the control group was treated with"triple-posture positive bone-setting"chiropractic manipulation combined with conventional western medicine.The course of treatment for the two groups covered 4 weeks.Before and after treatment,the patients of the two groups were observed in the changes of pain visual analogue scale(VAS)score,Japanese Orthopedic Association(JOA)score of lumbar function,Oswestry Disability Index(ODI)score,straight-leg raising test results and serum interleukin 6(IL-6)and C-reactive protein(CRP)levels.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the trial group was 96.67%(29/30)and that of the control group was 63.33%(19/30).The intergroup comparison(tested by Fisher's exact test)showed that the clinical efficacy of the trial group was significantly superior to that of the control group(P<0.05).(2)After treatment,the lumbar function indicators of pain VAS scores and ODI scores in the trial group were significantly lower(P<0.05),and the JOA scores were significantly higher than those before treatment(P<0.05),while in the control group,only the ODI scores were significantly lower than those before treatment(P<0.05).The intergroup comparison showed that the decrease of VAS and ODI scores and the increase of JOA scores in the trial group were significantly superior to those in the control group(P<0.05 or P<0.01).(3)After treatment,the Laseque s sign of the trial group was significantly improved compared with that before treatment(P<0.05),while no significant improvement was presented in the control group(P>0.05).The intergroup comparison showed that the improvement of Laseque's sign in the trial group was significantly superior to that in the control group(P<0.01).(4)After treatment,the levels of serum inflammatory factors of IL-6 and CRP in the two groups were lower than those before treatment(P<0.05),and the decrease of serum IL-6 level in the trial group was significantly superior to that in the control group(P<0.05),but CRP level in the two groups after treatment did not differ from that before treatment,no statistically significant difference was shown between the two groups after treatment,either(P>0.05).(5)The incidence of adverse reactions in the trial group was 6.67%(2/30)and that in the control group was 13.33%(4/30),and the intergroup comparison(by Fisher's exact test)showed that there was no significant difference between the two groups(P>0.05).Conclusion The therapeutic effect of"triple-posture positive bone-setting"chiropractic manipulation combined with Tongluo Huoxue Formula exert certain effect for the treatment of LSS patients with qi deficiency and blood stasis syndrome,and it has more obvious advantages in improving the lumbar function,promoting the rehabilitation of the patients,and lowering the level of serum inflammatory factors than"triple-posture positive bone-setting"chiropractic manipulation combined with conventional western medication.
9.Diagnostic value of 3D fast spin-echo sequence scanning combined with multislice spiral CT in knee cruciate ligament injury
You-Qiang LI ; Hai-Jiao WANG ; Bu-Qi ZHU ; Liang WANG ; Hong QIAN ; Chang-Yin WANG
China Journal of Orthopaedics and Traumatology 2024;37(2):153-158
Objective To explore the potential value of three-dimensional fast spin echo(3D-SPACE)combined with multilayer spiral CT(MSCT)in the diagnosis of knee cruciate ligament injury,to provide a new direction for the optimization of subsequent clinical diagnosis.Methods A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021,aged from 21 to 68 with an average of(41.52±4.13)years old.For all patients,separate MSCT scanner scans,3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used.The injury and classifica-tion of the anterior and posterior cruciate ligament of the knee were compared,the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed,the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined.Results There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate(P>0.05).The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone(P<0.05).The 3D-SPACE sequence scan alone and the MSCT detection alone had no signifi-cant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint(P>0.05).3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related mea-surements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone(P<0.05).The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960,which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795.The com-bined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically different(Z=2.236,P<0.05),and MSCT alone and 3D-SPACE sequence scanning combined with MSCT analysis and prediction models were statistically different(Z=2.653,P<0.05).Conclusion The application of 3D-SPACE sequence combined with MSCT scanning for knee cruciate ligament injury can improve the diagnosis rate of patients with knee cruciate ligament injury.It can be used as a diagnostic tool for patients with knee cruciate ligament injury and is worthy of clinical application.
10.Reasons and strategies of reoperation after oblique lateral interbody fusion
Zhong-You ZENG ; Deng-Wei HE ; Wen-Fei NI ; Ping-Quan CHEN ; Wei YU ; Yong-Xing SONG ; Hong-Fei WU ; Shi-Yang FAN ; Guo-Hao SONG ; Hai-Feng WANG ; Fei PEI
China Journal of Orthopaedics and Traumatology 2024;37(8):756-764
Objective To summarize the reasons and management strategies of reoperation after oblique lateral interbody fusion(OLIF),and put forward preventive measures.Methods From October 2015 to December 2019,23 patients who under-went reoperation after OLIF in four spine surgery centers were retrospectively analyzed.There were 9 males and 14 females with an average age of(61.89±8.80)years old ranging from 44 to 81 years old.The index diagnosis was degenerative lumbar intervertebral dics diseases in 3 cases,discogenie low back pain in 1 case,degenerative lumbar spondylolisthesis in 6 cases,lumbar spinal stenosis in 9 cases and degenerative lumbar spinal kyphoscoliosis in 4 cases.Sixteen patients were primarily treated with Stand-alone OLIF procedures and 7 cases were primarily treated with OLIF combined with posterior pedicle screw fixation.There were 17 cases of single fusion segment,2 of 2 fusion segments,4 of 3 fusion segments.All the cases underwent reoperation within 3 months after the initial surgery.The strategies of reoperation included supplementary posterior pedicle screw instrumentation in 16 cases;posterior laminectomy,cage adjustment and neurolysis in 2 cases,arthroplasty and neuroly-sis under endoscope in 1 case,posterior laminectomy and neurolysis in 1 case,pedicle screw adjustment in 1 case,exploration and decompression under percutaneous endoscopic in 1 case,interbody fusion cage and pedicle screw revision in 1 case.Visu-al analogue scale(VAS)and Oswestry disability index(ODI)index were used to evaluate and compare the recovery of low back pain and lumbar function before reoperation and at the last follow-up.During the follow-up process,the phenomenon of fusion cage settlement or re-displacement,as well as the condition of intervertebral fusion,were observed.The changes in in-tervertebral space height before the first operation,after the first operation,before the second operation,3 to 5 days after the second operation,6 months after the second operation,and at the latest follow-up were measured and compared.Results There was no skin necrosis and infection.All patients were followed up from 12 to 48 months with an average of(28.1±7.3)months.Nerve root injury symptoms were relieved within 3 to 6 months.No cage transverse shifting and no dislodgement,loosening or breakage of the instrumentation was observed in any patient during the follow-up period.Though the intervertebral disc height was obviously increased at the first postoperative,there was a rapid loss in the early stage,and still partially lost after reopera-tion.The VAS for back pain recovered from(6.20±1.69)points preoperatively to(1.60±0.71)points postoperatively(P<0.05).The ODI recovered from(40.60±7.01)%preoperatively to(9.14±2.66)%postoperatively(P<0.05).Conclusion There is a risk of reoperation due to failure after OLIF surgery.The reasons for reoperation include preoperative bone loss or osteoporosis the initial surgery was performed by Stand-alone,intraoperative endplate injury,significant subsidence of the fusion cage after surgery,postoperative fusion cage displacement,nerve damage,etc.As long as it is discovered in a timely manner and handled properly,further surgery after OLIF surgery can achieve better clinical results,but prevention still needs to be strengthened.

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