Antiamnesic effect of acyl-prolyl-containing dipeptide (GVS-111) in compression-induced damage to frontal cortex

Antiamnestic effect of acyl-prolyl-containing dipeptide GVS-111 was demonstrated in rats with bilateral compression-induced damage to the frontal cortex. Both intraperitoneal and oral administration of the dipeptide improved retrieval of passive avoidance responses in rats with compression-induced cerebral ischemia compared to untreated controls. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 130, No. 9, pp. 272–274, September, 2000     

Diffraction ellipsometry studies of osmotically compressed muscle fibers

Microstructural features of relaxed, skinned muscle fibers compressed with polyvinylpyrollidone were examined by optical diffraction ellipsometry. This technique is sensitive to the optical anisotropy within the muscle, including that due to intrinsic properties of the protein molecules as well as that due to the regular arrangement of proteins in the surrounding medium. The change in polarization state of light after interacting with the muscle is described by the differential field ratio (DFR) and birefringence (n). Compression of single fibers (sarcomere length = 2.6 m) with 0%–21% polyvinylpyrrolidone caused an increase of up to 23% and 31% for DFR and n, respectively. The largest increase in both parameters occurred at intermediate sarcomere lengths. Theoretical modelling of the results suggest that the average S-1 tilt angle may be reduced upon compression of the filament lattice. This is supported by experiments in which S-1 was enzymatically cleaved with -chymotrypsin. Separate experiments comparing fibers with intact membranes and skinned fibers compressed to an equivalent lattice spacing showed little difference in DFR or n.     

网格定位器在腰椎椎体成形术中的应用

目的比较网格优化椎体成形术(percutaneous vertebroplasty,PVP)与传统PVP治疗骨质疏松性椎体压缩骨折的疗效。方法回顾性分析2016年5月至2019年5月北部战区总医院脊柱外科收治196例腰椎单节段行PVP治疗患者的临床资料,根据手术方法不同分为网格优化组(102例)和传统PVP组(94例)。网格优化组:男38例、女64例,年龄(67.3±8.5)岁,病程(2.3±1.2)d,L1椎体59例、L2椎体31例、L3椎体8例、L4椎体3例、L5椎体1例。传统PVP组:男26例、女68例,年龄(71.5±5.6)岁,病程(2.1±1.1)d,L1椎体52例、L2椎体33例、L3椎体7例、L4椎体2例。术前按两组不同方法选择最佳穿刺点及穿刺角度,完成穿刺后置入导丝及工作通道,推入骨水泥,术毕。主要观察指标为手术时间、术中X线透视次数、骨水泥注入量、骨水泥渗漏情况,以及疼痛视觉模拟评分(visual analogue scale,VAS)、伤椎前缘和伤椎中缘高度。结果两组患者术前一般资料的差异均无统计学意义(P>0.05),证明两组患者的基线资料具有可比性。所有患者均顺利完成手术,术中、术后均未出现脊髓神经损伤、切口感染、肺栓塞、死亡等严重并发症。网格优化组患者手术时间(34.8±6.5)min、透视次数(29.5±5.5)次、骨水泥注入量(5.3±2.1)ml、骨水泥渗透率3.9%(4/98)均优于传统PVP组,差异均有统计学意义(P<0.05)。网格优化组术后第3天、3个月及末次随访时VAS评分分别为(1.1±0.6)分、(1.0±0.3)分和(0.9±0.2)分,均优于传统PVP组(P<0.05)。两组患者术后第3天伤椎前缘及中缘高度的差异均无统计学意义(P>0.05),但网格优化组术后3个月伤椎前缘和中缘高度分别为(1.8±0.4)mm、(1.8±0.3)mm,末次随访时分别为(1.7±0.3)mm、(1.7±0.3)mm,均优于传统PVP组,差异均有统计学意义(P<0.05)。结论相比传统PVP手术,术前应用网格定位器进行网格优化PVP手术治疗骨质疏松性椎体压缩骨折更安全、有效。     

A systematic review of MIS and open decompression surgery for spinal metastases in the last two decades

ObjectiveThe primary intention of this review being to produce an updated systematic review of the literature on published outcomes of decompressive surgery for metastatic spinal disease including metastatic spinal cord compression, using techniques of MIS and open decompressive surgery.MethodsThe authors conducted database searches of OVID MEDLINE and EMBASE identifying those studies that reported clinical outcomes, surgical techniques used along with associated complications when decompressive surgery was employed for metastatic spinal tumors. Both retrospective and prospective studies were analysed. Articles were assessed to ensure the required inclusion criteria was met. Articles were then categorised and tabulated based on the following reported outcomes: predictors of survival, predictors of ambulation or motor function, surgical technique, neurological function, and miscellaneous outcomes.Results2654 citations were retrieved from databases, of these 31 met the inclusion criteria. 5 studies were prospective, the remaining 26 were retrospective. Publication years ranged from 2000 to 2020. Study size ranged from 30 to 914 patients. The most common primary tumors identified were lungs, breast, prostate and renal cancers. One study ( Lo and Yang, 2017)¹³ reported that in those patients with motor deficit, survival was significantly improved when surgery was performed within 7 days of the development of motor deficit compared to situations when surgery was carried out 7 days after onset. This was the only study that showed that the timing of surgery plays a significant role w.r.t. survival following the onset of spinal cord compression symptoms. Four articles identified that a pre-operative intact motor function and or ambulatory status conferred a higher likelihood of a better post-operative outcome, not just in relation to survival but also in relation to post-operative ambulation as well as a greater tendency towards suitability for adjuvant treatment. Even for the same scoring system e.g. tokuhashi and its effectiveness in predicting survival, results from different studies varied in their outcome. The Karnofsky Performance Status (KPS) being the most commonly used tool to assess functional impairment, the Eastern Cooperative Oncology Group (ECOG) performance status being used in two studies. 23 studies identified an improvement in neurological function following surgery. The most common functional scale used to assess neurological outcome was the Frankel scale, 3 studies used the American Spinal Injury Association (ASIA) impairment scale for this purpose. Wound problems including infection and dehiscence appeared to be the most commonly reported surgical complication. (25 studies). The most commonly used surgical technique involved a posterior approach with decompression, with or without stabilisation. Less commonly employed techniques included percutaneous pedicle screw fixation associated with or without mini-decompression as well as anterior approaches involving corpectomy and instrumentation. 9 studies included in their data, the effect of radiation therapy in combination with surgery or as a comparison used as an alternative to surgery in spinal metastases.ConclusionsWe provide a systematic literature review on the outcomes of decompressive surgery for spinal metastases. We analyse survival data, motor function, neurological function, as well as the techniques of surgery used. Where appropriate complications of surgery are also highlighted. It is the authors’ intention to provide the reader with a reference text where this information is ready to hand, allowing for the consideration of means and methods to improve and optimise the standard of care in patients undergoing surgical intervention for metastatic spinal disease.     

饮片细粉对肠炎宁半浸膏片压缩成型的影响研究

目的 研究半浸膏颗粒中饮片细粉含量对其物理性质和压缩性能的影响。方法 以肠炎宁片为模型药物,测定含不同饮片细粉比例的肠炎宁颗粒的粉体学性质、压缩过程参数、抗张强度等指标,采用不同压缩方程对片剂抗张强度-压力、孔隙率-压力、抗张强度-孔隙率的变化规律进行拟合,阐明肠炎宁半浸膏片的成型机制,并用主成分分析对粉体学性质、压缩过程参数及拟合系数之间的相关性进行分析。结果 当肠炎宁颗粒中的饮片细粉含量小于6%时,随着饮片细粉含量的增加,粒子间的结合力增强,粉体的成型性增强;当含量超过6%后,饮片细粉弹性作用增强,粒子间结合力减弱,抑制成型。结论 从压缩成型角度说明了肠炎宁半浸膏片中饮片细粉含量的临界值为6%,可为半浸膏片的处方工艺优化提供较好的理论和实验依据。     

杂交分离手术治疗伴有脊髓压迫症状的胸腰椎转移瘤的疗效观察

目的:评估杂交分离手术治疗伴有脊髓压迫症状的胸腰椎转移瘤的临床疗效。方法 :回顾性分析2013年6月～2018年6月我院收治的28例因伴有脊髓压迫症状的胸腰椎转移瘤行手术治疗患者的临床资料,其中男18例,女10例,年龄57.0±10.8岁(41～77岁)。原发肿瘤类型:肺腺癌12例,肺鳞癌2例,肺神经内分泌癌1例,直肠腺癌6例,肾透明细胞癌3例,乳腺癌2例,肝细胞癌1例,前列腺癌1例。肿瘤侵犯脊柱部位:单发胸椎转移13例、腰椎转移11例,多发胸椎转移2例、腰椎转移1例,胸腰椎转移1例。术前Frankel分级A级1例,B级5例,C级6例,D级16例;疼痛视觉模拟评分(visual analogue scale,VAS)为7.3±0.8分;Tomita评分5.9±0.9分(4～7分);硬膜外脊髓压迫(epidural spinal cord compression,ESCC)评分1b级3例,1c级9例,2级8例,3级8例。均行杂交分离手术,具体方法包括后入路椎体肿瘤部分切除减压、骨水泥钛网支撑、骨水泥填充封闭、椎弓根螺钉内固定术。统计手术时间、术中出血量、术后住院天数,术后即刻及术后3个月时的Frankel分级,术后7d及术后3个月时的VAS评分,美国东部肿瘤协作组(Eastern Cooperative Oncology Group,ECOG)体力状况评分,术中和术后相关并发症情况以及患者生存期。结果 :手术时间为202.0±34.7min(140～285min),术中出血量为819.6±150.0ml(500～1100ml),术后住院日为13.2±3.9d(7～22d)。术中及术后并发症:脑脊液漏3例,切口感染3例,尿路感染1例,肺部感染1例,术后急性神经根刺激症状3例,随访至12个月时发生钛网移位1例。术后7d、3个月VAS评分及ECOG评分与术前比较均有显著性改善(P0.05)。中位随访时间为20.5个月(6～42个月),平均随访时间为21.3±10.0个月,至末次随访有6例存活,其中1例于术后30个月时出现椎体新发转移,行二次手术后仍带瘤生存,至末次随访时存活时间为38个月。结论:杂交分离手术治疗伴有脊髓压迫症状的胸腰椎转移瘤能够明显减轻脊髓压迫,改善患者神经功能,缓解疼痛,提高生活质量。     

经椎体后上缘入路椎体后凸成形术治疗腰椎骨质疏松性椎体压缩骨折的临床疗效

【摘要】 目的：分析经椎体后上缘入路椎体后凸成形术（percutaneous kyphoplasty,PKP）的手术设计,并与经双侧椎弓根入路PKP治疗骨质疏松性腰椎椎体压缩性骨折（osteoporotic vertebral compression fracture,OVCF）进行临床疗效对比。方法：回顾性分析符合纳入标准并行PKP治疗的患者67例,共74个椎体,按照患者接受PKP的不同入路手术分为经椎体后上缘入路组（观察组）与经双侧椎弓根入路组（对照组）。其中观察组男6例,女23例,平均年龄76.8±8.8岁;对照组男9例,女29例,平均年龄77.7±10.2岁。对两组患者的椎体高度改善率、骨水泥分布及渗漏情况、穿刺角度、手术时间、术中放射暴露、骨水泥注射量、VAS评分和ODI评分进行对比分析。结果：所有患者均顺利完成手术,术中未发生穿刺相关神经损伤、节段动脉损伤等。两组患者椎体高度改善率[（47.68±23.76）％ vs （48.70±22.10）％]、骨水泥注射量（4.35±1.00ml vs 4.63±0.75ml）、骨水泥单侧分布率（6.1％ vs 0）、椎管内骨水泥渗漏率（27.3％ vs 14.6％）、椎间盘骨水泥渗漏率（12.1％ vs 9.8％）、椎间孔骨水泥渗漏率（3.0％ vs 0）及术后VAS（2.10±0.90 vs 1.92±0.67）相比,差异均无统计学意义（P>0.05）。两组椎旁骨水泥渗漏率（30.3％ vs 61.0%）、放射暴露、手术时间（39.2±4.7min vs 44.8±5.5min）及穿刺角度相比,差异有统计学意义（P＜0.05）。结论：经椎体后上缘入路单侧穿刺即可达到椎体中心实现骨水泥双侧弥散,可减少手术时间与放射暴露,降低骨水泥椎旁渗漏率,可获得与经双侧椎弓根入路PKP相同的椎体复位率及临床疗效。     

绝经后骨质疏松性椎体压缩性骨折患者血清雌激素、前脂肪因子-1水平与骨代谢和骨密度相关性研究

目的 研究绝经后骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture,OVCF）患者血清雌激素、前脂肪因子-1（preadipose factor-1,Pref-1）水平与骨代谢和骨密度的相关性。方法 纳入湛江中心人民医院2019年1月至2020年11月期间确诊的64例绝经OVCF患者为OVCF组,同时纳入绝经后的健康女性45名为对照组,比较OVCF组和对照组血清中雌二醇、Pref-1水平,并根据OVCF患者血清中雌二醇、Pref-1的水平分为高低亚组,进行患者骨代谢、骨密度等一系列指标的比较,通过Preason相关性分析雌二醇、Pref-1的水平与骨代谢、骨密度指标的相关性。结果 OVCF患者血清中雌二醇水平较对照组显著降低（t=13.275,P<0.05）,Pref-1水平显著上升（t=10.360,P<0.05）;雌二醇高表达组较低表达组患者血清中25-（OH）VitD、N-MID的水平以及腰椎骨密度、髋部骨密度均显著上升（t=7.378,5.472,10.290,9.774,P<0.05）,PINP、β-CTX水平均显著降低（t=6.447,9.103,P<0.05）;Pref-1高表达组较低表达组患者血清中25-（OH）VitD、N-MID的水平以及腰椎骨密度、髋部骨密度均显著下降（t=8.350,7.426,12.376,10.450,P<0.05）,PINP、β-CTX水平均显著升高（t=8.266,11.205,P<0.05）;OVCF患者血清雌二醇水平与25-（OH）VitD、N-MID以及腰椎骨密度、髋部骨密度均呈正相关（r>0,P<0.05）,与PINP、β-CTX水平呈负相关（r<0,P<0.05）;Pref-1与25-（OH）VitD、N-MID的水平及腰椎骨密度、髋部骨密度均呈负相关（r<0,P<0.05）,与PINP、β-CTX水平呈正相关（r>0,P<0.05）。结论 绝经后OVCF患者血清雌激素显著下调,Pref-1水平明显上调,且二者与骨代谢和骨密度指标之间存在密切相关性,对二者水平的医学干预或能为OVCF的临床治疗带来新的契机。