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ABSTRACT: To detect the expression of telomerase in glial scar and its correlation with glial scar.
There were 120 Sprague Dawley rats were randomly divided into non-interference group of telomerase, interference group of telomerase and control group. Non-interference group and interference group were for spinal cord injury, which adopted Allen's Weight Dropping to make molding; control group was for sham operation to open the vertebral plate and expose spinal marrow, in which spinal cord injury would not be caused. The expression of telomerase and glial fibrillary acidic profein (GFAP) was detected by PCR-ELISA and Western blot, and the formation of glial scar was observed by immunofluorescence on the 1st, 3rd, 5th, 7th, 14th, 28th, 42th and 56th day after the spinal injury, and analyzed its relativity.
The expression of telomerase in non-interference group was (0.180 ± 0.004 - 1.217 ± 0.072), which was significantly higher than those in interference group (0.028 ± 0.007 - 0.092 ± 0.004, χ(2) = 28.753 - 37.518, P < 0.05) and control group (0.072 ± 0.007 - 0.075 ± 0.004, χ(2) = 18.618 - 41.093, P < 0.05) at all the time, with statistical significance. The expression of GFAP in non-interference group was (1.98 ± 0.15 - 19.40 ± 0.55) which was significantly higher than those in interference group (1.10 ± 0.13 - 16.64 ± 1.02, χ(2) = 14.538 - 37.366, P < 0.05) and control group (0.44 ± 0.05 - 0.48 ± 0.04, χ(2) = 16.733 - 34.041, P < 0.05) at all the time, with statistical significance. The expression of GFAP showed a linear correlation with that of telomerase in non-interference group, and with statistical differences (r = 0.755, P < 0.01). The expression of telomerase in interference group and control group were always negative. Glial scar observed by immunofluorescence in non-interference group was heavier than that in interference group, and control group showed no formation of glial scar.
Telomerase shows a dynamic expression in glial scar and has positive correlational linear relationship with GFAP which shows the formation of glial scar. And the telomerase may be an important factor in promoting the formation of glial scar.
Zhonghua wai ke za zhi [Chinese journal of surgery] 12/2012; 50(12):1113-8.
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The spine journal: official journal of the North American Spine Society 11/2011; 11(11):1076-7. · 2.90 Impact Factor
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Wei-bin Sheng,
Hai-long Guo,
Er-dan Mai,
La-Ti Pu,
Yu-Lin Zhan,
Ge-le Jin,
Qiang Deng,
Xin-feng Zheng,
Chuan-hui Xun,
Tao Xu,
Juan Tian
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ABSTRACT: To investigate whether annular tears is a cause of low back and radiating leg pain and explore the clinical characteristics and treatment for patients with this condition.
A total of 34 patients with low back and radiating leg pain, but without lumbar disc herniation on CT (computed tomography) or MRI (magnetic resonance imaging), were examined by electrophysiological studies and discography to identify whether there were or not annular tears and nerve root injury and decipher the relations between them. The series included 15 males and 19 females with an average age of 45.6 years old and the average duration of symptoms was 25.8 months. All patients with annular tears and positive pain provocation test were treated by local windowing decompression and debridement of nucleus pulposus after failed conservative treatment. The pre- and post-operative functions and pain were evaluated by JOA (Japanese Orthopedic Association) and VAS (visual analog scale) scores respectively. The average follow-up was 17.4 months.
The clinical manifestations included low back and radiating leg pain, intermittent claudication and nerve root injury. No significant abnormalities were discovered on X-ray and CT scan. T2W images of magnetic resonance demonstrated a low intensity or black disc in all patients and high-intensity zone (HIZ) (n = 21). Electromyography showed nerve root injury (n = 27). Abnormality of conduction velocities of common peroneal nerve (n = 7) and tibial nerve (n = 3) were found. Thirty-four patients with 38 discs displayed pain reproduction on contrast injection during discography and the sites of annular tears were confirmed on CT scan after discography. Pre- and post-operative average JOA scale score was 8.7 points and 13.5 points, the recovery ratio 76.2% and the excellent and good outcomes 88.2%. Pre- and post-operative average VAS score was 8.6 points and 2.8 points. And the recovery rate was 80.5%.
The annular tears result in low back and radiating leg pain. And the typical characteristics are low back and radiating leg pain, intermittent claudication and nerve root injury. MRI and electrophysiological studies play an important role in diagnosing this condition. Lumbar discography is the decisive method and prerequisite of selecting surgery. Local windowing decompression and debridement of nucleus pulposus is a simple and effective method.
Zhonghua yi xue za zhi 12/2010; 90(45):3198-202.
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ABSTRACT: To evaluate the intraobserver and interobserver reliability and main influencing factors of the King, Lenke, and PUMC classification systems for idiopathic scoliosis (IS) using radiographs that had not been premeasured.
Fifty-six patients with IS, 9 male and 47 female, aged 15.4 (11 - 18), underwent preoperative X-ray photography of spine standing full-length posteroanterior and lateral films and left and right supine side-bending radiographs. The films were read by four orthopedic surgeons independently to do measurement and typing according to the King, Lenke, and PUMC classification systems respectively. Two weeks later, the sequence of the X-ray films was re-ordered and the 4 surgeons read them and did measurement and typing once more. The average percentage of intraobserver and interobserver agreement was calculated. Kappa coefficients were used to determine the intraobserver and interobserver reliability.
King classification demonstrated fair interobserver reliability and excellent intraobserver reliability. The mean interobserver reliability was 65.8% (Kappa coefficient = 0.542), while the intraobserver reliability was 82.6% (Kappa coefficient = 0.767). The main reason of disagreement was distinguishment of the King type II and type III. Another reason was assessment of King type V. The complete Lenke classification demonstrated poor reliability. The mean interobserver reliability was 50.0% (Kappa coefficient = 0.438), and the intraobserver reliability was 47.0% (Kappa coefficient = 0.402). The 3 components of Lenke classification had fair interobserver and intraobserver reliability when they were examined separately. The main reasons for disagreement arose from judging whether there was a structural upper thoracic curve and assigning sagittal thoracic modifier. The PUMC type demonstrated excellent intraobserver and interobserver reliability with a mean interobserver reliability of 87.8% (Kappa coefficient = 0.757), and a mean intraobserver reliability of 92.9% (Kappa coefficient = 0.958). Its subtypes demonstrated fair agreement with the mean interobserver reliability of 70.2% (Kappa coefficient = 0.629), and a mean intraobserver reliability of 74.1% (Kappa coefficient = 0.674). The main reasons for disagreement were definition of a curvature and Cobb angle measurement.
King and PUMC classification systems have higher interobserver and intraobserver reliability than Lenke classification. The reliability levels of the 3 classification systems are all influenced by many factors. Judgment of an upper thoracic curve, variable of Cobb angle measurement, and relationship of the central vertical sagittal line to apex of curve are the common reasons for disagreement in these 3 classifications.
Zhonghua yi xue za zhi 05/2009; 89(15):1047-52.
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ABSTRACT: To investigate the feasibility, clinical indications and significance of one-stage radical eradication, wedged vertebral osteotomy and instrumentation in the treatment of tuberculosis of thoracic and lumbar spine associated with kyphosis or scoliokyphosis through a purely posterior procedure.
Sixteen cases with tuberculosis of thoracic and lumbar spine associated with kyphosis or scoliokyphosis were treated by one-stage radical eradication, wedged vertebral osteotomy and instrumentation fixation through posterior procedure. All patients included 12 males and 4 females, and the average age was 37.1 years (from 17 to 53 years). The preoperative average Cobb angle of kyphosis was 78.3 degrees (range from 54 degrees to 138 degrees ). There were 2 cases associated with scoliosis (the Cobb angle of scoliosis was 31 degrees and 24 degrees), and 1 case with lateral transition. Spinal cord compression were found in 7 cases. According to the Frankel's classification, 2 cases belonged to C degree, and 5 cases to D degree. There were 2 cases with caudal equina or nerve root lesions.
The average blood loss during the operation was 1100 ml (range from 450 to 2200 ml), and the average operation time was 265 min (range from 215 to 325 min). The postoperative results were satisfactory, 14 cases were excellent and 2 cases were good. Obvious improvement was obtained in 9 cases with neurological dysfunction. The postoperative average Cobb' angle was 28.5 degrees (range from 0 degrees to 67 degrees), and the corrective rate was 63.6%. The followed-up was ranged from 14 to 52 months with an average of 26.3 months. There were no major complications related to the fixations, loss of correction and the fusion were achieved in all patients.
One-stage radical eradication, wedged vertebral osteotomy and instrumentation is a feasible and an effective procedure in the treatment of spinal tuberculosis associated with kyphosis or scoliokyphosis. Compared with combined anterior and posterior procedure, the surgical technique may decrease injuries and has better result.
Zhonghua wai ke za zhi [Chinese journal of surgery] 03/2005; 43(4):205-9.
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ABSTRACT: To evaluate the efficacy of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression in cervical myelopathy.
Thirty-five patients with cervical myelopathy were treated by the procedure of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression. The preoperative average JOA scale score was 8.7 point (Range 4-15).
Sixty-nine vertebral were corpectomized and 104 levels were decompressed and fused with an average of 3 levels. Among the cases, 1 vertebrae was corpectomized in 7 cases, 2 vertebra in 22 cases, 3 vertebra in 6 cases. There were no surgery-related complications. The patients were followed up from 11-37 months, with an average of 17.4 months. No plate breakage, screw loose, graft infection, lysis and absorption was discovered. The fusion rate was 100%, the average time of fusion was 9.3 months (range from 6-15 months). The postoperative average JOA scale score was 14.8 point (range 7-17), the recovery ratio was 73.5% and the excellent and good results was 82.8%.
The use of allogenic strut bone graft and instrumentation for anterior cervical fusion following subtotal corpectomy and decompression in cervical myelopathy may not only simplify surgical procedure and decrease injuries and complications, but also the fusion is satisfactory and reliable.
Zhonghua wai ke za zhi [Chinese journal of surgery] 11/2004; 42(19):1174-7.
