Vertical split fracture of the vertebral body following oblique lumbar interbody fusion: A case report

Rationale:Oblique lumbar interbody fusion (OLIF) is an effective and safe surgical technique widely used for treating spondylolisthesis; however, its use is controversial because of several associated complications, including endplate injury. We report a rare vertebral body fracture following OLIF in a patient with poor bone quality.Patient concerns:A 72-year-old male patient visited our clinic for 2 years with lower back pain, leg radiating pain, and intermittent neurogenic claudication.Diagnoses:Lumbar magnetic resonance imaging revealed L4-5 stenosis.Intervention:We performed OLIF with percutaneous pedicle screw fixation and L4 subtotal decompressive laminectomy. We resected the anterior longitudinal ligament partially for anterior column release and inserted a huge cage to maximize segmental lordosis. No complications during and after the operation were observed. Further, the radiating pain and back pain improved, and the patient was discharged. Two weeks after the operation, the patient visited the outpatient department complaining of sudden recurred pain, which occurred while going to the bathroom. Radiography and computed tomography revealed a split fracture of the L5 body and an anterior cage displacement. In revision of OLIF, we removed the dislocated cage and filled the bone cement between the anterior longitudinal ligament and empty disc space. Further, we performed posterior lumbar interbody fusion L4-5, and the screw was extended to S1.Outcomes:After the second surgery, back pain and radiating pain in the left leg improved, and he was discharged without complications.Lesson:In this case, owing to insufficient intervertebral space during L4-5 OLIF, a huge cage was used to achieve sufficient segmental lordosis after anterior column release, but a vertebral body coronal fracture occurred. In patients with poor bone quality and less flexibility, a huge cage and over-distraction could cause a vertebral fracture; hence, selecting an appropriate cage or considering a posterior approach is recommended.     

基因重组毕赤酵母表达瑞替普酶过程中的酶活性分析

目的 研究毕赤酵母诱导表达瑞替普酶过程中的关键酶活性.方法 以摇瓶培养为研究对象,在用甲醇诱导后,连续取样,破碎菌体制成无细胞悬液,检测乙醇氧化酶、甲醛脱氢酶、PDC、G-6-PD、ID、α-KGD和SD的活性.结果 乙醇氧化酶比活在0～6 h逐渐增加,在第6h达到最大44.5 U/mg蛋白.随后迅速下降.在第24～48 h有所回升,然后又逐渐降低.FAD比活在第0～48h逐渐增加.在第48h达到最大值6.72U/mg蛋白,随后逐渐降低.直至放瓶.G-6-PD比活在第2h～6h逐渐增加,在第6～24h逐渐降低,在第24～48h逐渐升高,48h后又逐渐降低直至放瓶.PDC比活在第0～6h逐渐降低,随后略有升高的趋势.ID、α-KGD、SD的活性变化有相似趋势.在前6 h酶活均迅速下降,在第6～24 h缓慢下降,随后ID活性继续缓慢下降,而α-KGD和SD活性在第2～48 h逐渐升高,在第48 h均达到最高值,然后又逐渐降低,直至放瓶.结论 根据酶活变化规律,可将整个诱导期分为4个阶段:第1阶段为诱导0～6 h,是甲醇适应期;第Ⅱ阶段为诱导6～24h,是快速生长期;第Ⅲ阶段为诱导24～48h,是产物积累期;第Ⅳ阶段为诱导48～72h,是代谢缓慢期.在甲醇适应期,甲醇完全氧化代谢流占主导地位.在快速生长期和产物积累期,代谢流逐渐向糖酵解途径和TCA循环途径迁移.     

P253R突变型FGFR2Ⅲc胞外段的表达、复性及活性研究(英文)

成纤维细胞生长因子(Fibroblast growth factor,FGF)具有促进细胞增殖,诱导新生血管形成等重要生理作用,与肿瘤的发生及发展也有十分密切的关系。P253R是Apert综合症中发现的一种突变,可使FGFR2IIIc与FGF2亲和力大大增加,从而导致过度自分泌和旁分泌活性,引起骨骼发育异常。从人胎盘组织提取总RNA,通过RT-PCR扩增得到野生型FGFR2IIIc胞外段基因片段(wsFGFR2);再利用重叠延伸法以wsFGFR2基因片段为模板扩增得到P253R突变型FGFR2IIIc胞外段基因片段(msFGFR2,P253R是Apert综合征中发现的一种突变,可使FGFR2与FGF2亲和力大大增加)。msFGFR2基因克隆到pET3c载体,并在大肠杆菌BL21(DE3)中以包涵体的形式表达。经凝胶层析复性和肝素亲和层析纯化得到复性成功的活性蛋白,复性率为12%,纯度大于95%。MTT结果表明,msFGFR2能显著抑制FGF2促NIH3T3细胞增殖能力,并抑制前列腺癌DU145细胞的增殖,提示msFGFR2能有效阻断FGFs的细胞内信号通路,具有很好的产业化和临床应用前景。     

白内障超声乳化术后应用非甾体抗炎药滴眼剂的疗效分析

目的 观察0.1%吲哚美辛滴眼剂、0.03%欧可芬滴眼剂和0.025%地塞米松滴眼剂对白内障超声乳化联合人工晶状体植入术后炎症的疗效。方法 随机将72例老年性白内障患者分为3组，分别于术前术后滴用0．1％吲哚美辛滴眼剂、0.03%欧可芬滴眼剂和0.025%地塞米松滴眼剂，三组均合并使用抗生素滴眼剂，术后询问症状，进行视力、裂隙灯、眼底镜、眼压检查。结果 术后第1、3、7、14天天三组症状、体征评分差异无显著性。不同时间三组眼压值差异无显著性。结论 非甾体抗炎药滴眼剂与糖皮质激素滴眼剂在控制白内障亏声乳化联合人工晶状体植入术后炎症反应具有相同疗效。     

A Case of Linear Exacerbation of Atopic Dermatitis with Secondary Prurigo Nodularis

Inflammatory acquired Blaschko-linear dermatoses (IABLD) are a continuous concept involving diseases such as lichen striatus, blaschkitis, and atopic dermatitis. However, atopic dermatitis that showed increase in severity along Blaschko lines is rarely reported on its own. Herein, we report a rare case of atopic dermatitis with secondary prurigo nodularis along Blaschko lines, which may be valuable in broadening the concept of IABLD. A 28-year-old male presented with multiple, pruritic, brownish nodules on the left lower extremity along Blaschko lines for 3 to 4 years. The patient had atopic dermatitis since childhood. Histopathologic findings revealed compact orthohyperkeratosis, hypergranulosis, spongiosis, and irregular acanthosis in the epidermis. Fibrosis with vertically arranged collagen fibers and perivascular lymphohistiocytic infiltration were shown in the upper dermis. We diagnosed the case as secondary prurigo nodularis along Blaschko lines, accompanied by the preceding atopic dermatitis. We hypothesized that the patient’s underlying atopic dermatitis increased in severity along Blaschko lines, and prurigo nodularis occurred due to frequent scratching. The lesions improved with topical methylprednisolone cream, oral antihistamines and intralesional triamcinolone injection.     

二氢卟吩P6-6-(N-乙基)酰胺-7,γ-二甲酯锌的合成及对吲哚美辛诱发大鼠胃溃疡的保护作用

目的：研究二氢卟吩P6－6-(N-乙基）酰胺－7，γ－二甲酯锌（I）的合成及抗胃溃疡活性。方法：蚕沙糊状叶绿素经酸，碱降解反应制得紫红素－18（Ⅲ），Ⅲ经乙胺解后重氮甲烷甲基化制得二氢卟吩P6－6－（N－乙基）酰胺－7，γ－二甲酯（II），II与醋酸锌络合制得1，以0．2％吲美辛(20mg/kg)ip大鼠制备胃溃疡模型，并测定溃疡指数和溃疡个数。结果：I的结构经UV，IR，1HNMR，FAB－MS及元素发射光谱确证，ip I 80mg/kg有极显著降低吲哚美辛诱发的大鼠溃疡指数（P＜0．01）和溃疡个数（P＜0．01），结论：I为新化合物，II的波谱数系 首次报道，I对吲哚美辛诱发的大鼠胃溃疡具有显著的保护作用。提示I是一种有开发前景的抗溃疡候选化合物，值得深入研究。     

自分泌一氧化氮在氟尿嘧啶诱导人肝癌细胞凋亡中的作用研究

目的 :观察肝细胞Bel74 0 2自分泌一氧化氮 (NO)在 5 -氟尿嘧啶 (5 FU)诱导人肝癌细胞凋亡过程中的作用 ,进一步揭示 5 FU的作用机理 ,同时寻找提高 5 FU的临床疗效的辅剂。方法 :人肝癌细胞Bel74 0 2按常规条件培养于含 10 %小牛血清的无L 精氨酸 (L Arg)的DMEM (dulbecco’smodifiedeagle’smedium)培养液中。在 5 FU作用下 ,采用免疫组化法观察诱生型一氧化氮合酶 (iNOS)的表达情况 ,并在其底物L Arg存在的前提下 ,采用酶法测定硝酸盐 /亚硝酸盐 ,反映NO的生成 ,并证明其作用。用电镜观察凋亡细胞的形态 ,流式细胞仪进行凋亡细胞的定量。用L Arg的竞争性拮抗剂L NAME(Nω nitro l argininemethylester)对研究结果进行验证。应用病理彩色图文分析系统对免疫组化结果进行光密度定量分析。采用方差分析和t检验进行统计学分析。结果 :在 5 FU的作用下 ,iNOS表达增强 ,5 FU组 (0 1687± 0 0 1968) ,对照组 (0 10 4 9± 0 0 12 66) ,P <0 0 5 ,在其底物L Arg存在的前提下 ,内源性NO的浓度为 (73 0± 10 2 ) μmol/L(P <0 0 5 ) ,有显著性提高 ;人肝癌Bel74 0 2细胞株的凋亡率显著性增高为 (17 85± 0 78) % ,细胞坏死率和残渣率显著减少分别为 (32 99± 0 83) %、(3 18± 1 0 1) %。L NAME