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Yin Q.-D.,Peoples Hospital of Jiangsu Province | Tian X.-W.,Wuxi Traditional Chinese Medicine Hospital | Zheng Z.-G.,Soochow University of China
Chinese Journal of Tissue Engineering Research

BACKGROUND: Screw loosening and loss of correction are main complications in patients with osteoporosis receiving pedicle screw implantation. Therefore, osteoporosis is considered as a relative contraindication for pedicle screws. OBJECTIVE: To study the clinical results of methods for improving stability of pedicle screw in patients with osteoporosis. METHODS: Thirty-four patients with osteoporosis were treated with pedicle screw internal fixation, and the methods of improving stability of pedicle screw were applied during the operation. There were 14 cases of fractures (fracture group) and 20 cases of osteopathy. Spinal posterolateral or intervertebral body graft fusion was performed in the 20 cases of osteopathy and five cases of fractures (fusion group). According to Jikei grading scale for osteoporosis, eight cases were in early stage, 11 cases I stage, eight cases II stage and seven cases III stage. For 19 cases inearly stage and I stage osteoporosis, longer and large size of pedicle screws were used, combined with rod system with ankylosing connection between screws and connecting rods using two cross-link devices, placement of pedicle screw with large angles in the horizontal and the sagittal planes were applied to improve the relative stability of screw. For 15 cases of II stage and III stage osteoporosis, bone cement was used to fill the screw path to improve the absolute stability of screw. RESULTS AND CONCLUSION: There was no breakage of screw during the follow-up with the mean period of 14 months (ranged 9-26 months), only two cases in fracture group with Jikei I stage osteoporosis had screw loosening at 5 to 6 months after fixation, as well as partial loss of correction of reduction, but no other adverse effects. The loss of correction of reduction in the fracture group was 5% in average, and the fusion rate was 100% in the fusion group. Different methods of improving the stability of pedicle screw applied in patients with osteoporosis according to different situations may reduce the occurrence of complications, such as screw loosening and loss of correction. Source

Cao Y.-J.,Soochow University of China | Zhang X.,Soochow University of China | Wang W.-H.,Kunshan No.1 Peoples Hospital | Zhai W.-Q.,Taicang No.1 Peoples Hospital | And 10 more authors.
Chinese Medical Journal

Background Elevated fibrinogen (Fg) level is a known risk factor for ischemic stroke. There are few clinical trials on oral fibrinogen-depleting therapies for secondary ischemic stroke prevention. We aimed to assess the effects of one-year therapy with oral lumbrokinase enteric-coated capsules on secondary ischemic stroke prevention. Methods This is a multicenter, randomized, parallel group and controlled study that began treatment in hospitalized patients with ischemic stroke and continued for 12 months. Patients were randomized to either the control group that received the standard stroke treatment or the fibrinogen-depleting group that received the standard stroke treatment plus enteric-coated lumbrokinase capsules. The NIH Stroke Scale scores (NIHSSs) and plasma Fg level were recorded. The carotid artery intima-media thickness (IMT) and status of plaques were examined through carotid ultrasound examination. Primary outcomes included all-cause mortality, any event of recurrent ischemic stroke/transient ischemic attack (TIA), hemorrhagic stroke, myocardial infarction and angina, and other noncerebral ischemia or hemorrhage. Kaplan-Meier survival analysis and the Long-rank test were used to compare total vascular end point incidence between the two groups. Comparison of median values between two groups was done by the Student t test, one-way analysis of variance (ANOVA), or non-parametric rank sum test. Results A total of 310 patients were enrolled, 192 patients in the treatment group and 118 patients in the control group. Compared to the control group, the treatment group showed favorable outcomes in the Fg level, carotid IMT, the detection rate of vulnerable plaques, the volume of carotid plaques, NIHSS scores, and incidence of total vascular (6.78% and 2.08%, respectively) and cerebral vascular events (5.93% and 1.04%, respectively) (P <0.05). In the treatment group, the volume of carotid plaques was significantly related to the carotid IMT, the plaque diameter, width and number (P=0.000, 0.000, 0.000, 0.022; F=13.51, 2.52, 11.33, -3.29, but there was a weak correlation with the Fg level (P=0.056). After 1-year therapy, the incidence of overall vascular end points was reduced by 4.7%. Conclusion Long-term oral fibrinogen-depleting therapy may be beneficial for secondary ischemic stroke prevention. Source

Zhang A.,Wuxi Peoples Hospital | Zhang X.,Wuxi Traditional Chinese Medicine Hospital | Tan X.,Nantong University | Cai B.,Guangxi Medical University | And 3 more authors.
International Immunopharmacology

Resveratrol, trans-3,4′-trihydroxystilbene, is a natural phytoalexin. Its anti-inflammatory activity has attracted more and more attention in clinic over the years for the treatment of inflammatory diseases. However, its effect on bone repair and new bone formation in an inflammatory microenvironment is quite little understood, especially when bone-marrow derived mesenchymal stem cells (MSCs) are used in stem cell therapy for the treatment of inflammatory bone diseases. In the present study, we investigated the effect of resveratrol on osteogenic differentiation of primary mouse bone marrow derived MSCs and potential mechanism involved when cells were exposed to TNF-α treatment. We found that resveratrol reversed the apoptotic effect of TNF-α and abrogated its inhibitory effect on osteogenic differentiation of bone marrow derived MSCs. Mechanistic studies demonstrated that resveratrol rescued the TNF-α-induced impairments of osteogenesis, and inhibited TNF-α-activated NF-κB signaling. Our study may help understand the mechanism involved in the inhibitory effect of inflammatory cytokines on osteogenic differentiation, and highlights the role of resveratrol as a potential therapeutic agent for bone repair and especially in MSC-based cell therapy for the treatment of inflammation-associated bone diseases. © 2015 Elsevier B.V. All rights reserved. Source

Cao H.,Nanjing University | Cao H.,Nantong University | Jin C.,Wuxi Traditional Chinese Medicine Hospital | Huang D.,Nantong University | And 5 more authors.
Molecular Medicine Reports

The present study aimed to observe the growth of transplanted tumors in mice with colorectal cancer (CRC) under hyperglycemic conditions and to detect the expression of vascular endothelial growth factor (VEGF) in these tumors. The study also aimed to observe the changes in serum insulin-like growth factor-1 (IGF-1) levels and to determine whether type 2 diabetes mellitus (T2DM) was a risk factor for the progression and development of CRC. A mouse model of a transplanted colorectal tumor with T2DM was established to observe the changes in volume and size of the transplanted tumor. Mice were sacrificed at the end of the 5th week to determine the serum IGF-1 level and VEGF expression in the tumor tissues. The tumor volume (1628.5±882 mm3) in the CRC-DM group was larger than that in the CRC group (1950.2±726 mm3; P<0.05). The serum IGF-1 level (105.33±32.32 ng/ml) was higher than that in the normal (69.83±25.57 ng/ml) and CRC groups (70.17±25.27 ng/ml; P<0.05). The VEGF expression in the tumor tissues of the CRC-DM group(70.0±11.5%) was higher than that in the CRC group (42.9±7.5%; P<0.05). T2DM may be one of the causes for the promotion of CRC growth and its mechanism may be correlated with the increased IGF-1 action observed in the blood that induces VEGF gene transcription, upregulates VEGF expression, causes tumor angiogenesis and thus leads to the occurrence and metastasis of tumors. Copyright © 2013 Spandidos Publications Ltd. Source

Zhu L.,Wuxi Traditional Chinese Medicine Hospital | You J.,Wuxi Traditional Chinese Medicine Hospital | Hu P.,Wuxi Traditional Chinese Medicine Hospital | Mao C.,Jiangsu University | Chen D.,Jiangsu University
Cancer Research and Clinic

Objective: To study the expression and clinical significance of miR-183-5p, TβR I and TβR II in esophageal squamous cell carcinoma (ESCC). Methods: The mRNA and protein expression of miR-183-5p, TβR I and TβR II were examined in ESCC cell lines ECA-109, TE-1, normal esophageal epithelial cells, tumor tissues and tumor-free tissues from 72 ESCC patients. Their clinical significance and the relationship between miR-183-5p and the latter two were analyzed. The effects of miR-183-5p on the expression of TβR I and TβR II in ECA-109 cells and the cell functions of ECA-109 were also investigated. Results: Compared with the normal esophageal epithelia cells, ESCC cell lines TE-1 and ECA-109 were statistically characterized by a high expression of miR-183-5p (all P < 0.05) and low expression of TβR I and TβR II (all P< 0.05). The expression of miR-183-5p in ESCC tissues was higher than that in adjacent normal tissues, while the expressions of TβR I and TβR II were lower (all P < 0.05). The expression of miR-183-5p was closely related to sex, tumor differentiation, tumor staging, distant metastasis, lymphatic metastasis, and tumor location (all P < 0.05). TβR I level was associated with sex, lymph node metastasis and tumor size (all P< 0.05). Experimental data showed the negative correlation between the expression of miR-183-5p and TβR I in ESCC tissues (r = -0.521, P < 0.05). Over expression of miR-183-5p significantly inhibited the expression of TβR I in ECA-109 cells (P < 0.05) and promoted the growth, invasion and metastasis of ECA-109 cells (P < 0.05). Low expression of miR-183-5p significantly promoted the expression of TβR I in ECA-109 cells (P < 0.05), and suppressed the growth, invasion and metastasis of ECA-109 cells (P < 0.05). There was no significant change in the expression of TβR II in the transfection experiments. Conclusion: MiR-183-5p is closely related to the abnormal expression of TβR I , which may exert an important role in the progression of lymphatic metastasis. © Copyright 2016 by the Chinese Medical Association. Source

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