1.Protective effect and mechanism of Icariin on oxidative stress injury in neurons
Yu-Meng DU ; Si-Min YANG ; Xiao-Tong QIN ; Yan LI ; Rui-Jun JU ; Xiao-Ming PENG ; Xiao-Qiang YAN ; Jie GUAN ; Ling-Yue MA
The Chinese Journal of Clinical Pharmacology 2024;40(13):1869-1873
Objective To explore the protective mechanism of icariin on neuronal oxidative damage,providing a basic pharmacological basis for the treatment of cognitive impairment.Methods Glutamate was used to induce oxidative stress injury in HT22 cells.HT22 cells were divided into control group(normal cultured cells),model group(glutamate injury model)and experimental-L,-M,-H groups(5,10 and 20 μmol·L-1 icariin pretreatment for modeling,respectively).Cell proliferation was detected by cell counting kit-8(CCK-8)method;cytotoxicity was detected by lactate dehydrogenase(LDH)method;reactive oxygen species(ROS)levels were detected by flow cytometry;superoxide dismutase(SOD)levels were detected by biochemical kits;the expression levels of Kelch-like epichlorohydrin-related protein-1(Keap1),nuclear factor E2-related factor 2(Nrf2)were detected by Western blotting;the corresponding mRNA expression was detected by real-time fluorescence quantification polymerose chain reaction.Results The cell viability of control group,model group and experimental-L,-M,-H groups were(100.00±1.31)%,(66.38±2.44)%,(72.07±4.95)%,(82.41±3.57)%and(87.97±4.98)%;LDH release were(0.48±0.52)%,(18.82±2.09)%,(15.32±1.17)%,(10.37±1.39)%and(6.51±0.87)%;ROS level were(14.23±1.13)%,(41.74±1.60)%,(35.69±1.08)%,(33.28±1.69)%and(30.32±2.03)%;SOD levels were(54.84±1.17),(37.95±1.13),(48.02±1.28),(50.56±1.34)and(52.55±1.04)U·mg-1;Keap1 protein levels were 0.36±0.01,0.52±0.03,0.46±0.04,0.39±0.09 and 0.35±0.12;Nrf2 protein levels were 0.29±0.02,0.13±0.08,0.18±0.03,0.21±0.11 and 0.26±0.04;catalase(CAT)mRNA levels were 1.01±0.08,0.81±0.06,0.90±0.04,1.05±0.15 and 1.33±0.26;SOD mRNA levels were 1.09±0.12,0.83±0.03,0.86±0.08,0.94±0.08 and 1.09±0.16.Among the above indicators,the differences between the model group and the control group were statistically significant(all P<0.01);the differences between the experimental-M,-H groups and the model group were statistically significant(P<0.01,P<0.05).Conclusion Icariin may activate the Keap1/Nrf2/antioxidant response element(ARE)signaling pathway,regulate the expression of related proteins,and reduce the level of ROS to effectively alleviate oxidative stress injury in neuronal cells.
2.Design of self-aid pressurized heating tourniquet
Chu-Lan XIAO ; Fu-Qiang LI ; Si-Ping LU ; Jun-Hui LI
Chinese Medical Equipment Journal 2024;45(3):111-114
Objective To design a self-aid pressurized heating tourniquet to decrease the mortality and morbidity of post-traumatic hemorrhage of limbs in highland cold regions.Methods The tourniquet was in the form of long strip and consisted of a gas generating heating mechanism,an inflatable cuff,a decompression mechanism and a micro timer.The gas generating heating mechanism was composed of an inner cylinder and an outer cylinder,which were fixed with screws;the inflatable cuff had two variations for the upper limb and lower limb respectively,with fabric for fixing on the outer side and an airbag set on the inner side;the decompression mechanism had a pressurized valve as its main component;the electronic micro timer was secured to the slot on the gas generating heating mechanism by an insertion clasp.Results The tourniquet developed enabled self-aid hemostasis in 1 to 2 s for post-traumatic hemorrhage of limbs in highland cold regions,and could effectively prevent the affected limb from losing temperature.Conclusion The tourniquet developed gains advantages in easy operation,hemostasis,heat preservation and adjustable pressure,which is of significance for enhancing the self-aid ability for post-traumatic hemorrhage of limbs in highland cold regions.[Chinese Medical Equipment Journal,2024,45(3):111-114]
3.On-line Measurement of Styrene Secondary Organic Aerosol Using Synchrotron Radiation Vacuum Ultraviolet Photoionization Aerosol Mass Spectrometer
Ming-Qiang HUANG ; Xiao-Bin SHAN ; Liu-Si SHENG ; Zhen-Ya WANG ; Chang-Jin HU ; Xue-Jun GU ; Wei-Jun ZHANG
Chinese Journal of Analytical Chemistry 2024;52(8):1200-1210
Secondary organic aerosol(SOA)produced by photooxidation of styrene and other aromatic compounds is a major part of fine particles in urban atmosphere.In this study,the measurement of component and content of SOA formed from photooxidation of styrene in smog chamber using synchronous radiation vacuum-ultraviolet photoionization aerosol mass spectrometer(VUV-PIAMS)was conducted.Photoionization mass spectra of styrene SOA was detected by synchrotron radiation photon with 10.5 eV,and the proportion of main components was quantified based on the peak area of each ion peak.The photoionization efficiency curve of ion peak was obtained under synchrotron radiation photons in the range from 7.5 to 11.5 eV,and then the ionization potential was acquired for qualitative analysis of the component structure.The results showed that the photoionization mass spectra of styrene SOA mainly contained ion peaks at m/z 106,108,120 and 122,and the ionization potentials of each peak were(9.41±0.03)eV,(8.93±0.03)eV,(9.24±0.03)eV and(9.25±0.03)eV,respectively.Combined with quantum chemistry calculation and off-line measurement verification of infrared absorption spectra and electrospray ionization mass spectra,it was determined that benzaldehyde,benzyl alcohol,4-vinylphenol and benzoic acid were main components of styrene SOA,accounting for 32.5%,17.5%,25%and 15%of the measured components,respectively,and the generated quantity ratio was 13∶7∶10∶6.VUV-PIAMS could overcome the disadvantages of off-line method,and could on-line detect component and content of SOA,proving a useful tool to measure the chemical components and reveal the formation process of SOA particles.
4.Prediction, analysis and application of learning curve of tooth preparation for all ceramic crowns of maxillary central incisors.
Si Yu WU ; Ya Ning LI ; Xiao ZHANG ; Long Wei LV ; Yun Song LIU ; Hong Qiang YE ; Yong Sheng ZHOU
Journal of Peking University(Health Sciences) 2023;55(1):108-113
OBJECTIVE:
To predict the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training based on the modified Wright learning curve model, then to analyze and applicate the learning curve.
METHODS:
Twelve graduate students participating in standardized dental resident training were selected to prepare the resin maxillary central incisors on phantom head simulators for all ceramic crowns 4 times. The results of preparation were evaluated by 3 prosthetic experts with at least 10 years' experience focusing on the reduction, contour, taper, shoulder, finish line, margin placement, adjacent tooth injury, and preparation time for tooth preparation. The learning rate of tooth preparation was calculated by scores of tooth preparation of 4 times. The learning curve of tooth preparation was predicted based on the modified Wright learning curve model. According to the criteria of standardized training skill examinations for dental residents in Beijing, 80 was taken as the qualified standard score. The minimum training times for tooth preparation to satisfy the qualified standard score (80) was calculated, to analyze the characteristics of learning curve and evaluate the effectiveness of tooth preparation.
RESULTS:
The scores of 4 tooth preparation were 64.03±7.80, 71.40±6.13, 74.33±5.96, and 75.98±4.52, respectively. The learning rate was (106±4)%, which showed the learning curve an upward trend. There were no significant differences between the qualified standard score and the predicted scores of tooth preparation from the 5th preparation to the 13th preparation (P > 0.05). The predicted score of the 14th preparation was higher than the qualified standard score (P < 0.05).
CONCLUSION
The trend of the learning curve of tooth preparation for all ceramic crowns of maxillary central incisors on phantom head simulators for graduate students participating in standardized dental resident training is upward, which predicts the minimum training times higher than the qualified standard score is 14 times.
Humans
;
Tooth Preparation, Prosthodontic/methods*
;
Incisor
;
Learning Curve
;
Crowns
;
Tooth Preparation
;
Ceramics
;
Dental Porcelain
;
Dental Prosthesis Design
5.Amygdalin Ameliorates Liver Fibrosis through Inhibiting Activation of TGF-β/Smad Signaling.
Zhun XIAO ; Qiang JI ; Ya-Dong FU ; Si-Qi GAO ; Yong-Hong HU ; Wei LIU ; Gao-Feng CHEN ; Yong-Ping MU ; Jia-Mei CHEN ; Ping LIU
Chinese journal of integrative medicine 2023;29(4):316-324
OBJECTIVE:
To observe the effect of amygdalin on liver fibrosis in a liver fibrosis mouse model, and the underlying mechanisms were partly dissected in vivo and in vitro.
METHODS:
Thirty-two male mice were randomly divided into 4 groups, including control, model, low- and high-dose amygdalin-treated groups, 8 mice in each group. Except the control group, mice in the other groups were injected intraperitoneally with 10% carbon tetrachloride (CCl4)-olive oil solution 3 times a week for 6 weeks to induce liver fibrosis. At the first 3 weeks, amygdalin (1.35 and 2.7 mg/kg body weight) were administered by gavage once a day. Mice in the control group received equal quantities of subcutaneous olive oil and intragastric water from the fourth week. At the end of 6 weeks, liver tissue samples were harvested to detect the content of hydroxyproline (Hyp). Hematoxylin and eosin and Sirius red staining were used to observe the inflammation and fibrosis of liver tissue. The expressions of collagen I (Col-I), alpha-smooth muscle actin (α-SMA), CD31 and transforming growth factor β (TGF-β)/Smad signaling pathway were observed by immunohistochemistry, quantitative real-time polymerase chain reaction and Western blot, respectively. The activation models of hepatic stellate cells, JS-1 and LX-2 cells induced by TGF-β1 were used in vitro with or without different concentrations of amygdalin (0.1, 1, 10 µmol/L). LSECs. The effect of different concentrations of amygdalin on the expressions of liver sinusoidal endothelial cells (LSECs) dedifferentiation markers CD31 and CD44 were observed.
RESULTS:
High-dose of amygdalin significantly reduced the Hyp content and percentage of collagen positive area, and decreased the mRNA and protein expressions of Col-I, α-SMA, CD31 and p-Smad2/3 in liver tissues of mice compared to the model group (P<0.01). Amygdalin down-regulated the expressions of Col-I and α-SMA in JS-1 and LX-2 cells, and TGFβ R1, TGFβ R2 and p-Smad2/3 in LX-2 cells compared to the model group (P<0.05 or P<0.01). Moreover, 1 and 10 µmol/L amygdalin inhibited the mRNA and protein expressions of CD31 in LSECs and increased CD44 expression compared to the model group (P<0.05 or P<0.01).
CONCLUSIONS
Amygdalin can dramatically alleviate liver fibrosis induced by CCl4 in mice and inhibit TGF-β/Smad signaling pathway, consequently suppressing HSCs activation and LSECs dedifferentiation to improve angiogenesis.
Rats
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Male
;
Mice
;
Animals
;
Transforming Growth Factor beta/metabolism*
;
Amygdalin/therapeutic use*
;
Endothelial Cells/metabolism*
;
Olive Oil/therapeutic use*
;
Rats, Wistar
;
Smad Proteins/metabolism*
;
Liver Cirrhosis/metabolism*
;
Liver
;
Transforming Growth Factor beta1/metabolism*
;
Signal Transduction
;
Collagen Type I/metabolism*
;
Carbon Tetrachloride
;
Hepatic Stellate Cells
6.Clinical study of 19 cases of steroid-refractory gastrointestinal acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation with fecal microbiota transplantation.
Yu Yu ZHENG ; Xiao Tian YANG ; Guo Qiang LIN ; Mei Ru BIAN ; Ye Jun SI ; Xing Xia ZHANG ; Yan Ming ZHANG ; De Pei WU
Chinese Journal of Hematology 2023;44(5):401-407
Objective: To investigate the clinical efficacy of fecal microbiota transplantation (FMT) for treating steroid-refractory gastrointestinal acute graft-versus-host disease (GI-aGVHD) . Methods: This analysis included 29 patients with hematology who developed steroid-refractory GI-aGVHD after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in Huaian Hospital Affiliated to Xuzhou Medical University from March 2017 to March 2022. Among them, 19 patients underwent FMT treatment (the FMT group) and 10 patients did not (the control group). The efficacy and safety of FMT were assessed, as well as the changes in intestinal microbiota abundance, lymphocyte subpopulation ratio, peripheral blood inflammatory cytokines, and GVHD biomarkers before and after FMT treatment. Results: ① Complete remission of clinical symptoms after FMT was achieved by 13 (68.4%) patients and 2 (20.0%) controls, with a statistically significant difference (P<0.05). Intestinal microbiota diversity increased and gradually recovered to normal levels after FMT and FMT-related infections did not occur. ②The proportion of CD3(+) and CD8(+) cells in the FMT group after treatment decreased compared with the control group, and the ratio of CD4(+), regulatory T cells (Treg), and CD4(+)/CD8(+) cells increased (all P< 0.05). The interleukin (IL) -6 concentration in the FMT group was lower than that in the control group [4.15 (1.91-5.71) ng/L vs 6.82 (2.40-8.91) ng/L, P=0.040], and the IL-10 concentration in the FMT group was higher than that in the control group [12.11 (5.69-20.36) ng/L vs 7.51 (4.10-9.58) ng/L, P=0.024]. Islet-derived protein 3α (REG3α) was significantly increased in patients with GI-aGVHD, and the REG3α level in the FMT group was lower than that in the control group after treatment [30.70 (10.50-105.00) μg/L vs 74.35 (33.50-139.50) μg/L, P=0.021]. Conclusion: FMT is a safe and effective method for the treatment of steroid-refractory GI-aGVHD by restoring intestinal microbiota diversity, regulating inflammatory cytokines, and upregulating Treg cells.
Humans
;
Fecal Microbiota Transplantation/methods*
;
Treatment Outcome
;
Graft vs Host Disease/etiology*
;
Hematopoietic Stem Cell Transplantation/adverse effects*
;
Steroids
7.Analysis of distribution characteristics of specific immunoglobulin E in 8 092 children with eczema and urticaria in a hospital of pediatric in Tianjin City.
Ren NA ; Yong Ming SHEN ; Ping SI ; Hui Qiang LI ; Jia Yi ZHANG ; Wen Wei GUO ; Xin TAN ; Xiao Hui YANG ; Bei ZHANG ; Li Sheng ZHENG
Chinese Journal of Preventive Medicine 2023;57(9):1385-1390
To investigate the common specific immunoglobulin E(sIgE) in children with eczema and urticaria, compare the allergies in children with different diseases, genders and ages, and provide the scientific basis for the prevention, diagnosis and treatment. A retrospective study was conducted to analyze the children who were suspected of eczema and urticaria and tested for serum sIgE in the Tianjin Children's Hospital from December 2019 to August 2021. A total of 8 092 serum samples were tested for ten food allergens and ten inhaled allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children's characteristics and factors such as different sexes and ages and by the mass data. The results showed that the positive rate of eczema was 64.42%(5 213/8 092), and the urticaria was 35.58%(2 879/8 092). The positive rate of specific IgE was 66.65%(5 393/8 092), the food allergens was 61.74%(4 996/8 092), and the inhaled allergens was 34.85%(2 820/8 092). The top three positive rates of food allergens were egg 46.65%(3 775/8 092), milk 32.64%(2 641/8 092) and wheat flour 15.08%(1 220/8 092). The top three positive rates of inhaled allergens were house dust 21.40%(1 732/8 092), Alternaria 11.78%(953/8 092) and Dermatophagoides farinae 7.33%(593/8 092). The positivity of food allergens and inhaled allergens was significantly different in different age groups. The positive rates of food allergens in different age groups were 48.92%(947/1 936) in<1 year old, 72.28%(2 680/3 708) in 1-3 years old, 64.58%(919/1 423) in 4-6 years old and 43.90%(450/1 025) in>6 years old. The positive rates of inhaled allergens in different age groups were 17.67%(342/1 936) in<1 year old, 36.35%(1 348/3 708) in 1-3 years old, 46.38%(660/1 423) in 4-6 years old and 45.85%(470/1 025) in>6 years old. The top six positive rates of allergens of eczema were the same with urticaria, which were egg, milk, house dust, wheat flour, Alternaria and Dermatophagoides farinae. The allergens (greater than or equal to grade 4) differed in children with eczema and urticaria. Moreover, there were significant differences in the positive rates of Alternaria, egg, wheat flour, crab and shrimp. In conclusion, this study can reflect the epidemic characteristics of allergens in children with eczema and urticaria to a certain extent. There were significant differences in the positive rates of allergens between different age groups. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of allergic diseases.
Infant
;
Child
;
Humans
;
Female
;
Male
;
Child, Preschool
;
Flour
;
Retrospective Studies
;
Triticum
;
Urticaria/epidemiology*
;
Eczema/epidemiology*
;
Hospitals
;
Immunoglobulin E
;
Allergens
;
Dust
8.Analysis of distribution characteristics of specific immunoglobulin E in 8 092 children with eczema and urticaria in a hospital of pediatric in Tianjin City.
Ren NA ; Yong Ming SHEN ; Ping SI ; Hui Qiang LI ; Jia Yi ZHANG ; Wen Wei GUO ; Xin TAN ; Xiao Hui YANG ; Bei ZHANG ; Li Sheng ZHENG
Chinese Journal of Preventive Medicine 2023;57(9):1385-1390
To investigate the common specific immunoglobulin E(sIgE) in children with eczema and urticaria, compare the allergies in children with different diseases, genders and ages, and provide the scientific basis for the prevention, diagnosis and treatment. A retrospective study was conducted to analyze the children who were suspected of eczema and urticaria and tested for serum sIgE in the Tianjin Children's Hospital from December 2019 to August 2021. A total of 8 092 serum samples were tested for ten food allergens and ten inhaled allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children's characteristics and factors such as different sexes and ages and by the mass data. The results showed that the positive rate of eczema was 64.42%(5 213/8 092), and the urticaria was 35.58%(2 879/8 092). The positive rate of specific IgE was 66.65%(5 393/8 092), the food allergens was 61.74%(4 996/8 092), and the inhaled allergens was 34.85%(2 820/8 092). The top three positive rates of food allergens were egg 46.65%(3 775/8 092), milk 32.64%(2 641/8 092) and wheat flour 15.08%(1 220/8 092). The top three positive rates of inhaled allergens were house dust 21.40%(1 732/8 092), Alternaria 11.78%(953/8 092) and Dermatophagoides farinae 7.33%(593/8 092). The positivity of food allergens and inhaled allergens was significantly different in different age groups. The positive rates of food allergens in different age groups were 48.92%(947/1 936) in<1 year old, 72.28%(2 680/3 708) in 1-3 years old, 64.58%(919/1 423) in 4-6 years old and 43.90%(450/1 025) in>6 years old. The positive rates of inhaled allergens in different age groups were 17.67%(342/1 936) in<1 year old, 36.35%(1 348/3 708) in 1-3 years old, 46.38%(660/1 423) in 4-6 years old and 45.85%(470/1 025) in>6 years old. The top six positive rates of allergens of eczema were the same with urticaria, which were egg, milk, house dust, wheat flour, Alternaria and Dermatophagoides farinae. The allergens (greater than or equal to grade 4) differed in children with eczema and urticaria. Moreover, there were significant differences in the positive rates of Alternaria, egg, wheat flour, crab and shrimp. In conclusion, this study can reflect the epidemic characteristics of allergens in children with eczema and urticaria to a certain extent. There were significant differences in the positive rates of allergens between different age groups. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of allergic diseases.
Infant
;
Child
;
Humans
;
Female
;
Male
;
Child, Preschool
;
Flour
;
Retrospective Studies
;
Triticum
;
Urticaria/epidemiology*
;
Eczema/epidemiology*
;
Hospitals
;
Immunoglobulin E
;
Allergens
;
Dust
9.Connotation and Clinical Application of Tong (Dredging) Method in Treatment of Coronary Heart Disease
Jie WANG ; Si-yuan ZHOU ; Chao LIU ; Xiao-shan HUI ; Hao-qiang HE
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(1):1-6
Tong (dredging) method in traditional Chinese medicine (TCM) emphasizes soothing the stagnated Qi, blood, and body fluid in zang-fu organs, meridians, and collaterals to remove pathogens, reinforce vital Qi, and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore, attack pathogenic Qi, harmonize Yin and Yang, as well as tonify deficiency, and resolve stagnation. It has been proved effective in treating coronary heart disease (CHD), which falls into the category of "chest impediment and heart pain" in TCM, with the key pathogenesis lying in blood vessel obstruction. Therefore, dredging blood vessels is the primary therapeutic principle for CHD. Specifically, there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold, which makes Yang-qi undissipated, Cinnamomi Ramulus, Piperis Longi Fructus, Alpiniae Officinarum Rhizoma, and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body, which hinders Qi and blood to nourish the myocardium, resulting in chest pain, Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation, heat-clearing, toxin-removing, and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma, Chuanxiong Rhizoma, Notoginseng Radix et Rhizoma, etc. can be prescribed for blood stasis, Trichosanthis Fructus, Allii Macrostemonis Bulbus, Pinelliae Rhizoma, etc. for phlegm, and Aquilariae Lignum Resinatum, Euodiae Fructus, etc. for pathogenic cold. Since the chronic disease can affect collaterals, Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus, Coptidis Rhizoma, Cinnamomi Cortex, etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome, the methods of nourishing the mind and calming the nerves through tranquilizing the mind, calming down the mind, and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen, Polygalae Radix, and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration, Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence, Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying, kidney and heart must be strengthened simultaneously, and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi, and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi, which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.
10.Clinical efficacy of oblique lumbar interbody fusion combined with unilateral pedicle screw fixation via Wiltse approach in the treatment of lumbar spinal stenosis.
Zhi-Qiang WANG ; Jian-Qun ZHANG ; Si-Min LIANG ; Xiao-Yin LIU ; Wei GUO ; Qiang MA ; Zhao-Hui GE
China Journal of Orthopaedics and Traumatology 2022;35(10):943-950
OBJECTIVE:
To evaluate the efficacy of oblique lumbar interbody fusion combined with unilateral pedicle screw fixation via Wiltse approach in the treatment of lumbar spinal stenosis.
METHODS:
From July 2017 to January 2019, 90 patients with lumbar spinal stenosis, including 38 males and 52 females, aged from 43 to 75 years old with an average of(59.9±8.8) years old, and were treated with oblique lumbar interbody fusion(OLIF) combined with Wiltse unilateral pedicle screw fixation. Surgical decompression and fixation was performed in 50 cases of single segment, 32 cases of double segments and 8 cases of three segments. The distribution of responsible segments included 8 cases of L2-L3, 12 cases of L3-L4 and 30 cases of L4-L5 on single segment, 10 cases of L2-L4 and 22 cases of L3-L5 on double segments, and 8 cases of L2-L5 on three segments. The operation time, blood loss and occurrence of complications were recorded, Visual analogue scale(VAS), Oswestry Disability Index(ODI) and SF-36 scale were used to evaluate clinical efficacy. Lumbar X-ray and MRI were taken at three days after operation, interverterbral space height, intervertebral foraminal height, interverterbral foraminal area, and spinal canal area were measured, and interbody fusion was evaluated according to CT at half a year after operation.
RESULTS:
All patients were followed up from 12 to 33 months, with an average of (20.2±6.6) months. Mean operation time was (103.3±35.9) min, and mean intraoperative blood loss was (70.4±17.8) ml. VAS of low back pain leg pain, and ODI decreased from 6.2±1.1, 6.1±0.9 and (59.9±4.2)% to 2.7±0.5, 2.5±0.5 and (31.3±8.8)%. SF-36 scale significantly increased from (37.2±3.1) to (54.9±6.1) at the six months postoperation(P<0.05). The intervertebral space height, intervertebral foraminal height, intervertebral foraminal area, and spinal canal area were significantly improved at 3 days after operation(P<0.05). Six months after operation, CT scan showed well fusion in 87 cases, but 3 cases with poor fusion, including 1 case of single segment, 2 cases of multi-segments. The total fusion rate was 96.7% (87/90), the single segment fusion rate was 98.0% (49/50), and the multi-segments fusion rate was 95.0%(38/40). The overall incidence of complications was 17.8%(16/90), including transient iliopsoas muscle weakness in 5 cases (5.6%), endplate fracture in 2 cases (2.2%), peritoneal injury in 1 case (1.1%), postoperative hematoma in 1 case (1.1%), adjacent segment disease in 1 case(1.1%), and fusion cage subsidence in 6 cases (6.7%). Three patients was followed up for recurrent nerve root pain and the symptoms were relieved after revision operation. All complications were relieved or disappeared in varying degrees during the follow-up period, and there were no complications such as cage displacement and screw fracture.
CONCLUSION
OLIF combined with unilateral pedicle screw fixation via Wiltse approach is effective in treating lumbar spinal stenosis with minimally invasive advantages such as less trauma and less complications. Under the premise of strictly grasping the indications, this method could also achieve satisfactory clinical results in multi-segments oprations.
Male
;
Female
;
Humans
;
Adult
;
Middle Aged
;
Aged
;
Spinal Stenosis/surgery*
;
Pedicle Screws
;
Spinal Fusion/methods*
;
Lumbar Vertebrae/surgery*
;
Treatment Outcome
;
Low Back Pain

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