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Wei H.-K.,Hebei Medical University | Yang S.-D.,Hebei Medical University | Bai Z.-L.,Hebei Medical University | Zhang X.,Hebei Medical University | And 3 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Levofloxacin was previously reported to induce apoptosis of rat annulus fibrosus (AF) cells by upregulating active caspase-3 and matrix metalloproteinase (MMP)-3 expression in vitro. However, the effects of levofloxacin on rat AF cells, as well as the related mechanism, have not been revealed completely. The purpose of this study was to further explore the changes in extracellular matrix and MMPs of rat AF cells based on levofloxacin-induced apoptosis. AF cells isolated from rat AF regions were cultured in monolayers and treated with levofloxacin in a dose- and time-dependent manner. To determine the cytotoxic effects of levofloxacin, inverted phase-contrast microscopy was used to perform morphological observation of apoptotic cells. The mRNA expression levels of MMP-2, -9 and -13 were quantified by reverse transcription and real-time quantitative polymerase chain reaction (RT-qPCR). Protein level of MMP-2 and MMP-13 were determined by western blot. The results showed that levofloxacin induced marked AF cell apoptosis, which was observed by inverted phase-contrast microscopy, and indicated by the increased expression of active caspase-3. Both RT-qPCR and western blot revealed that MMP-2 and MMP-13 expression were upregulated by levofloxacin treatment in a time- and dose-dependent manner. Moreover, cellular binding to type I collagen was found to be decreased by levofloxacin. In conclusion, the results above suggest that the possible cytotoxic effects of levofloxacin on AF cells in vitro may be attributed to the decreased cell binding to type I collagen and up-regulated expression of MMP-2 and MMP-13. © 2015 E-Century Publishing Corporation. All rights reserved.


Liu F.-Y.,Hebei Medical University | Wang T.,Hebei Medical University | Yang S.-D.,Hebei Medical University | Wang H.,Hebei Medical University | And 3 more authors.
European Spine Journal | Year: 2016

Purpose: To analyse the incidence and risk factors associated with proximal junctional kyphosis (PJK) following spinal fusion, we collect relative statistics from the articles on PJK and perform a meta-analysis. Methods: An extensive search of literature was performed in PubMed, Embase, and The Cochrane Library (up to April 2015). The following risk factors were extracted: age at surgery, gender, combined anterior-posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation, thoracoplasty, fusion to sacrum (S1), preoperative thoracic kyphosis angle (T5–T12) >40°, bone mineral density (BMD) and preoperative to postoperative sagittal vertical axis (SVA difference) >5 cm. Data analysis was conducted with RevMan 5.3 and STATA 12.0. Results: A total of 14 unique studies including 2215 patients were included in the final analyses. The pooled analysis showed that there were significant difference in age at surgery >55 years old (OR 2.19, 95 % CI 1.36–3.53, p = 0.001), fusion to S1 (OR 2.12, 95 % CI 1.57–2.87, p < 0.001), T5–T12 >40° (OR 2.68, 95 % CI 1.73–4.13, p < 0.001), low BMD (OR 2.37, 95 % CI 1.45–3.87, p < 0.001) and SVA difference >5 cm (OR 2.53, 95 % CI 1.24–5.18, p = 0.01). However, there was no significant difference in gender (OR 0.98, 95 % CI 0.74–1.30, p = 0.87), combined anterior-posterior surgery (OR 1.55, 95 % CI 0.98–2.46, p = 0.06), use of pedicle screw at top of construct (OR 1.55, 95 % CI 0.67–3.59, p = 0.30), hybrid instrumentation (OR 1.31, 95 % CI 0.92–1.87, p = 0.13) and thoracoplasty (OR 1.55, 95 % CI 0.89–2.72, p = 0.13). The incidence of PJK following spinal fusion was 30 % (ranged from 17 to 62 %) based on the 14 studies. Conclusions: The results of our meta-analysis suggest that age at surgery >55 years, fusion to S1, T5–T12 >40°, low BMD and SVA difference >5 cm are risk factors for PJK. However, gender, combined anterior–posterior surgery, use of pedicle screw at top of construct, hybrid instrumentation and thoracoplasty are not associated with PJK. © 2016 Springer-Verlag Berlin Heidelberg


Bai Z.-L.,Hebei Medical University | Chen Q.,Hebei Medical University | Yang S.-D.,Hebei Medical University | Zhang F.,Hebei Medical University | And 4 more authors.
Medical Science Monitor | Year: 2014

Background: Fluoroquinolones are in wide clinical use as safe and effective antibiotics. Articular cartilage, tendons, and epiphyseal growth plates have been recognized as targets of fluoroquinolone-induced connective tissue toxicity. However, the effects of fluoroquinolones on annulus fibrosus (AF) cells are still unknown.Material/Methods: The main objective of this study was to investigate the effects of levofloxacin, a typical fluoroquinolone antibiotic drug, on rat AF cells in vitro. Rat annulus fibrosus (RAF) cells were treated with levofloxacin at different concentrations (0, 10, 20, 30, 40, 60, 80, and 90 μg/ml) and were assessed to determine the possible cytotoxic effects of levofloxacin. Inverted phase-contrast microscopy was used to accomplish the morphological observation of apoptosis of treated cells. Western blot and real-time quantitative RT-PCR (qPCR) was used to explore the expression of active caspase-3 and MMP-3. Flow cytometry was used to measure the apoptotic incidences.Results: Our study showed that levofloxacin, with concentrations at 30, 60, and 90 μg/ml, induced dose-dependent RAF cell apoptosis and higher expression of caspase-3 and MMP-3. More apoptotic cells were observed by inverted phase-contrast microscopy. Moreover, levofloxacin increased the activity of caspase-3, and it also reduced cell viability with different concentrations ranging from 10 to 80 μg/ml.Conclusions: Our study results suggest that levofloxacin has cytotoxic effects on RAF cells, characterized by enhancing apoptosis and reducing cell viability, and indicate a potential toxic effect of fluoroquinolones on RAF cells. © Med Sci Monit, 2014.


Yang S.-D.,Hebei Medical University | Chen Q.,Hebei Medical University | Wei H.-K.,Hebei Medical University | Zhang F.,Hebei Medical University | And 4 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Objective: Recent studies suggested an increased risk of fractures with interaction between bisphosphonates (BPs) and proton pump inhibitors (PPIs). We performed a meta-analysis of fractures between patients taking BPs/PPIs and those taking BPs only. Methods: We conducted a PubMed database and Ovid database search, as well as Cochrane Library search (up to July 2014) for studies assessing the association between fractures and BPs or/and PPIs. We performed random effects meta-analysis of odds ratios (OR) according to fracture type and conducted subgroup analyses by race and BP subtypes. Heterogeneity was assessed using Q statistics and I2 statistic. Results: After study selection, 4 unique studies (5 comparisons) including 57259 patients were available for this meta-analysis. Pooled analysis of overall fracture risk of BP+PPI group versus BP group showed a significant increase in risk of fractures (OR = 1.52, P = 0.025), with substantial heterogeneity. However, heterogeneity was drastically reduced in subgroup of Asian (I2 = 24% and P = 0.251), and fracture risk showed a significant increase (OR = 1.75, P = 0.026). In contrast, heterogeneity was little eliminated in subgroup of European, and fracture risk was no statistical difference (OR = 1.42, P = 0.068). Three studies including 4 comparisons reported on spine fracture were included in the pooled analysis demonstrating an increased spine fracture risk associated with BP/PPI interaction (OR = 1.60, 95% CI 1.13-2.26, P = 0.008, I2 = 58.6%). Conclusions: This meta-analysis suggests that there is an interaction associated with increased fracture risk (particularly for spine and Asian race) between BP and PPI use. Clinicians should carefully evaluate such risk factors for osteoporosis in patients taking BPs, before routinely prescribing PPIs, and make a careful judgment as to whether PPIs may be safe for patients at high risk of fractures. © 2015, E-Century Publishing Corporation. All rights reserved.


Xu J.-X.,Hebei Medical University | Yang S.-D.,Hebei Medical University | Wang B.-L.,Hebei Medical University | Yang D.-L.,Hebei Medical University | And 4 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Background: Upper lumbar disc herniation (ULDH) is easy to be misdiagnosed due to its special anatomical and atypical clinical features. Few studies have identified the relationship between ULDH and adjacent wedge-shaped vertebrae (WSV). Hypothesis: WSV may have some indicative relations withULDH. Patients and methods: Between January 2003 and October 2013, 47 patients (27 males and 20 females; mean age, 41.2 years) with single-level ULDH (as study group) and 47 sex-and age-matched healthy volunteers (as control group) were studied by radiograph. The two groups were compared with respect to age, sexual proportion, body mass index (BMI), kyphotic angle, and the proportion of WSV. Also, correlative analyses were conducted in the study group to investigate the relation between the kyphotic angle of target vertebrae and other factors including age, BMI, Cobb angle, JOA score and bone mineral density (BMD). Results: The average kyphotic angle in the study group was 11° (4°-22°), while the average kyphotic angle in the control group was 2° (0°-7°). Obviously, the mean kyphotic angle in the study group was statistically larger than that in the control group (t=13.797, P<0.001). The proportion of WSV in the study group was significantly larger than that in the control group (x2=36.380, P<0.0001). The correlations between kyphotic angles and other items (i.e., age, BMI, BMD, Cobb angle and JOA score) in the study group and the control group were low or uncorrelated. Conclusions: WSV are indicatively associated with adjacent ULDH. Thus, ULDH should be alerted when WSV are first found in radiograph and accompanied by clinical symptoms. © 2015, E-Century Publishing Corporation. All rights reserved.

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