International journal of clinical and experimental medicine
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Current solutions for treating uncontained lumbar disk herniation include laser assisted endoscopic foraminoplasty and Transforaminal Endoscopic Spine System, both of which have some issues in clinical practice. This study aims to report the design of a new instrument for percutaneous posterolateral foraminoplasty. 148 patients with uncontained lumbar disk herniation were treated with percutaneous foraminoplasty followed by transforaminal endoscopic discectomy. Follow up were obtained for 134 cases. ⋯ Follow-up was up to 5 years postoperatively. There were 75 of excellent, 49 of good and 5 of fair according to MacNab score system, with total successful rate up to 92.5%. 5 cases with L5S1 disc herniation complained about irritation to the dorsal root ganglion. In conclusion, the new transforaminal endoscopic discectomy instrument is safe and effective for percutaneous foraminoplasty.
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High mobility group box-B1 (HMGB1) is upregulated in tumors, inflammations, and other injuries. However, its extracellular role and signaling in wound healing remains unclear. In the present study, we examined the HMGB1 levels in hematoma samples in fractured bones and in human macrophagy U937 cells under hypoxia with enzyme-linked immunosorbent assay (ELISA) and western blotting. ⋯ Moreover, the MG-63 cells incubated with HMGB1 had increased ERK1/2 phosphorylation, whereas such effect was blocked by the TLR-4 knockout with SIRNA-TLR-4 transfection. In conclusion, we found the up regulation HMGB1 in the hematoma of fractured bones and in macrophage U937 cells under hypoxia, and the hypoxia-up regulated HMGB1 promoted the proliferation of osteoblast MG-63 cells and activated the phosphorylation of ERK and JNK. And the proliferation promotion and the activation of ERK/JNK signaling was TLR-4-dependent.
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The aim of this study was to investigate the role of Von Willebrand Factor/thrombospondin type I repeats-13 (VWF/ADAMTS13) balance in aSAH. Fifty eight patients with aSAH at the First Affiliated hospital of Soochow University, Suzhou, China, between January 2012 and January 2014 were eligible for the study. They were divided into delayed cerebral ischemia group (DCI group) and non-delayed cerebral ischemia group (no DCI group), or cerebral vasospasm group (CVS group) and no spasm group (no CVS group), or good outcome group and poor outcome group. ⋯ The balance of VWF/ADAMTS13 could be used to predict the clinical outcome. The deficiency of ADAMTS13 can not only induce DCI but also accelerate inflammatory reaction. Our results reported in this paper may provide new insights into the possible use of ADAMTS13 as a therapeutic agent in aneurysmal subarachnoid hemorrhage.
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Post thoracotomy chronic pain is a severe problem that affects the majority of patients and decreases the quality of life. The purpose of this study is to evaluate the long-term effects of thoracal epidural levobupivacaine and intravenous dexketoprofen analgesia formed pre-emptively on the wound site pain after major thoracotomy operations. This randomised, prospective and double-blind study was performed with 60 patients undergoing thoracic surgery. ⋯ When the scores of Patient Satisfaction Scale (PSS) of the cases were compared, they were found to be higher in Group PED as statistically significant during the discharge period (P<0.001). Scores of PSS were higher in Group PED as statistically significant during the postoperative month 6 (P = 0.008). Combined application of pre-emptive intravenous dexketoprofen and thoracal epidural analgesia reduce the chronic post-thoracotomy pain.
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Sepsis is a systemic inflammatory response to infection and includes severe sepsis, septic shock and death. Platelet endothelial cell adhesion molecule-1 (PECAM-1) is one cell adhesion molecule expressed on platelets and leukocytes. It regulates platelet activation and mediates transendothelial migration of leukocytes, thus maintaining the integrity of the vasculature. ⋯ Among sepsis patients, the serum levels of sPECAM-1 were significantly higher in CG and GG genotype than in CC genotype. In septic shock patients, nonsurvivors (83.7 ± 12.6 ng/ml, n = 69) had a significantly higher serum sPECAM-1 level than the survivors (76.9 ± 12.7 ng/ml, n = 53) (P<0.01). In conclusion, PECAM-1 Leu125Val polymorphism and its sPECAM-1 levels are associated with sepsis severity and susceptibility to septic shock.