Objective To investigate the biomechanical influence ofvertebroplasty using autosolidification calcium phosphate cement (CPC) on thoracolumbar osteoporotic fractures. Methods Four cadaver specimens with osteoporosiswere applied to make spine unit. There were 2 females and 2 males, whose average age was 69 years.All underwent flexion-axial loading to result in vertebral body fracture. Following reduction, the middle fractured vertebral body were strengthened by the method of vertebroplasty, using CPC. Before fracture and after vertebroplasty, all were conducted biomechanical test. Results After being packed- CPC to the space in the fractured vertebral body, the strength andstiffness in vertebroplastic group (2 285±34 N，427±10 N/mm) were significantly higher than that in osteoporotic group (1 954±46 N，349±18 N/mm) (Plt;0.05). The vertebral height changing in vertebroplastic group(5.35±0.60 mm) were significantly lower than that in osteoporotic group (5.60±0.70 mm) (Plt;0.05). And the fractured body increases its strength and stiffnessby 16.92% and 22.31% respectively in comparison with its initial situation. Conclusion After being injected CPC into bone trabecular interspaces, the fractured vertebral bodies can restore its strength and stiffness markedly.
ObjectiveTo evaluate the security of intravitreal injection with ciproflaxacin to retina.MethodsTweenty-four rabbits were randomly divided into 4 groups with 6 rabbits in each group. 0.1 ml ciproflaxacin in doses of 2 500,5 000,and 10 000 μg was intravitreally injected into the rabbits eyes, retrospectively. And 0.1 ml saline solution was injected into the vitreous body of the rats in the control group. Indirect microscope, light microscope and electroretinogram (ERG) were used to observe the changes of ocular fundus.ResultsNormal results of light microscopy and ultrastructure were found in 250 μg and 500 μg groups; irregularly arranged outer and inner nuclear layers, dropsical or even lost ganglion cells, and ultrastructural changes were in 1 000 μg group. There was no apparent difference of ERG′s a and b amplitudes before and after intravitreal injection with ciproflaxacin in each group.ConclusionIntravitreal injection with ciproflaxacin is safe, and 500 μg or less is the secure dosage in rabbits' eyes. (Chin J Ocul Fundus Dis, 2005,21:180-182)
Objective To investigate the effectiveness of pretreatment with mixture of lidocaine and flurbiprofen axetil in reducing injection pain of propofol. Methods One hundred and sixty ASI I–II patients undergoing general anaesthesia were randomly allocated into four groups (40 cases in each group): the control group, the lidocaine (Lc) group, the flurbiprofen axetil (FA) group and the mixture of lidocaine and flurbiprofen axetil (hereafter termed as “mixture”) group. After the occlusion of venous drainage, patients were pretreated with 7 mL of 0.9% saline in the control group, 5 mL (50 mg) of flurbiprofen axetil and 2 mL of 0.9% saline in the FA group, 2 mL (40 mg) of 2% lidocaine and 5 mL of 0.9% saline in the Lc group, and 5 mL (50 mg) of flurbiprofen axetil and 2 mL (40 mg) of 2% lidocaine in the mixture group, respectively. The occlusion was released 2 min later and then 0.5 mg/kg propofol was injected into the vein within 5 s. During injecting propofol, the patients were asked by another anesthetist to assess and record their pain through using VSR. Results No significant differences in the demographic characteristics were found among the four groups. In comparison with the control group, the incidence rates of propofol injection pain were obviously lower in the mixture group, the FA group and the Lc group (Plt;0.05); there was a significant reduction in the incidence rate of pain in the mixture group compared with the other three groups. The median pain score was significantly lower in the mixture group and the Lc group than that in the control group. During the 24 hour follow-up after operation, neither the adverse events such as red-swelling in injection site, phlebitis or drug eruption, nor the gastrointestinal stimulating signs were found. Conclusion The mixture of flurbiprofen axetil and lidocaine is found to be more effective in reducing injection pain of propofol.
To review the advance in the experimental studies and evaluate the potential therapeutic appl ication of the growth differentiation factor 5(GDF-5) and osteogenic protein 1 (OP-1) in intervertebral disc degeneration.Methods Relevant l iterature at home and abroad publ ished in recent years was searched and analyzedcomprehensively. Results The growth factor was one of the most potential proteins in curing the intervertebral discdegeneration. In vitro, exogenous GDF-5 or OP-1 increased the deoxyribonucleic acid and proteoglycan contents ofboth nucleus pulposus and annlus fibrosis cells types significantly. GDF-5 at 200 ng/mL or OP-1 significantly stimulatedproteoglycan synthesis and collagen synthesis. In vivo, the injection of GDF-5(100 μg) or OP-1(100 μg in 10 μL 5% lactose) resulted in a restoration of disc height, improvement of magnetic resonance imaging scores, and histologic grading scores had statistical significance. Conclusion A single injection of GDF-5 or OP-1 has a reparative capacity on intervertebral discs, presumably based on its effect to stimulate matrix metabol ism of intervertebral disc cells and enhance extracellular matrix production. A single injection of exogenous GDF-5 or OP-1 in the degenerated disc shows a good prospect.
Objective To evaluate the safety and efficacy of botulinum toxin type A injection around internal anal sphincter and sector resection combined with epluchage and drainage by a small incision in treatment for stage Ⅱ and Ⅲ anal fissure，explore its surgical procedures and key points，and introduce a new surgical treatment for anal fissure. Methods The patients according to the inclusive criteria were divided into trial group and control group in randomized，parallel，controlled clinical trial method．The botulinum toxin type A injection around internal anal sphincter and sector resection combined with epluchage and drainage by a small incision was performed in the trial group, the anal fissure resection and part internal anal sphinctor latero-resection was perfermed in the control group. The safety index （including anal stenosis，incontinence，acute urinary retention，postoperative pain，and rectal anal tube pressure） and validity indicators （including cure rate，operation time，wound healing，wound healing grade，and scar size） were compared before and after operation between two groups．Results No anal stenosis and acute urinary retention occurred in the two groups. The anal incontinence score was not significantly different between two groups （P＞0.05）．The postoperative pain score in the trial group was significantly lower than that in the control group （24 h，the first defecation，and on week one after operation，all P＜0.01）．The difference of rectal anal canal pressure was not statistically significant between two groups （P＞0.05）．The cure rate was higher （P＜0.05），operation time and wound healing time were shorter （P＜0.01），wound healing was better （P＜0.05），scar area was smaller （P＜0.01） in the trial group as compared with the control group．Conclusions Comparing with the control group，high cure rate，short wound healing time，small size of scar，short operation time and minimal invasion are seen in the trial group．The shape and function of the anus are better reserved than that of the control group，this technique has a good clinical efficacy and safety．
ObjectiveTo observe the effects of bulbar subconjunctival and periocular injection of dexamethasonone on blood glucose levels of type 1 diabetic mellitus (T1DM)rats.
Methods80 healthy adult male Sprague-Dawley rats were randomly divided into GroupⅠ(n=40) and GroupⅡ(n=40). GroupⅠrats received intraperitoneal (IP) injection of streptozotocin to induce T1DM model, while GroupⅡrats received IP injection of citrate buffer solution and was the control group.GroupⅠrats and GroupⅡrats were further divided into four subgroups:A (n=10), a (n=10), B (n=10), and b (n=10). Subgroup-A rats received bulbar subconjunctival injection of dexamethasone, subgroup-a rats received bulbar subconjunctival injection of saline, subgroup-B rats received periocular injection of dexamethasone, subgroup-b rats received periocular injection of saline. After the injection, rats were fasted but could drink water. Tail vein blood samples were collected and the blood glucose level was measured by glucose monitor.
ResultsAfter modeling, the blood glucose level of GroupⅠand GroupⅡrats was(9.31±1.79) mmol/L and (5.72±0.80) mmol/L respectively, the difference was statistically significant (P < 0.05). The blood glucose level of GroupⅠrats reached the peak in 3h after injection. In 6-24 h after injection, the blood glucose level of GroupⅠA rats was obviously increased than that of the blood glucose level of Group Ia rats and the difference was statistically significant (P < 0.05). In 3-24 hours after injection, the blood glucose level of GroupⅠB rats was obviously increased than that of the blood glucose level of GroupⅠb rats and the difference was statistically significant (P < 0.05). Comparing the blood glucose level during different injection time between GroupⅠA rats and GroupⅠB rats, between GroupⅠa rats and GroupⅠb rats, the difference was not statistically significant (P > 0.05). In 3-24 hours after injection, the blood glucose level of GroupⅡA rats was obviously increased than that of the blood glucose level of GroupⅡa rats and the difference was statistically significant (P < 0.05); the blood glucose level of GroupⅡB rats was obviously increased than that of the blood glucose level of GroupⅡb rats and the difference was statistically significant (P < 0.05). Comparing the blood glucose level during different injection time between GroupⅡA rats and GroupⅡB rats, between GroupⅡa rats and GroupⅡb rats, the difference was not statistically significant (P > 0.05).
ConclusionBulbar subconjunctival injection and periocular injection of dexamethasone could both increase the blood glucose of TIDM rats, but these two injection methods had no differences on the blood glucose level.
ObjectivesTo systematically review the prophylactic efficacy of lidocaine administrated intravenously in advance on rocuronium associated injection pain/withdrawal movement in patients under general anesthesia.MethodsPubMed, The Cochrane Library, Web of Science, EMbase, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant randomized controlled trials (RCTs) on pretreatment with lidocaine intravenously to prevent injection pain /withdraw movement from rocuronium from inception to September 30th, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 30 RCTs involving 2 518 patients were included. The results of meta-analysis showed that, compared to the control group, pretreating with intravenous lidocaine could significantly reduced the occurrence of total pain/withdrawal movement associated with rocuronium injection (RR=0.43, 95%CI 0.36 to 0.51, P<0.000 01), and whether with (RR=0.39, 95%CI 0.29 to 0.52, P<0.000 01) or without (RR=0.45, 95%CI 0.36 to 0.57, P<0.000 01) occluding the vein, intravenous lidocaine could prevent pain/withdrawal movement associated with rocuronium injection. In addition, the incidence of lidocaine group igniting moderate (RR=0.38, 95%CI 0.31 to 0.46, P<0.000 01) or severe (RR=0.23, 95%CI 0.18 to 0.30, P<0.000 01) pain/ withdrawal movement were less likely to occur. However, there was no difference between the lidocaine and control group in the incidence of mild injection pain/withdrawal movement induced by rocuronium (RR=0.89, 95%CI 0.75 to 1.06, P=0.19).ConclusionsCurrent evidence shows that pre-intravenous lidocaine can reduce the occurrence of injection pain/withdrawal movement associated with rocuronium injection patients, especially in the prevention of moderate and severe injection pain/withdrawal movement.
Objective To explore the facilitative effects of different allogenic cells injected into the denervated muscles on the nerve regeneration, the protection of the myoceptor degeneration, and the promotion for rehabilitation of the muscular function. Methods Schwann cells, myoblast cells, and renal endothelial cells were prepared from 400 SD rats aged 7 days and weighing 20.0±2.3 g. Thirty-six adult female SD rats weighing 120-150 g were randomly divided into 4 groups(n=9). Under the asepsis condition, the left ischiadic nerves of all the SD rats were cut off, and the primary suture of the epineurium was performed. After operation, the different corresponding cells were injected into the triceps muscles of the rat calf in each group once per week for 4 times in all. One ml of Schwann cells (1×106/ml) was injected into the rats in Group A; 1 ml of the mixed cells of Schwann cells and myoblast cells (1×106/ml) was injected into the rats in Group B; 1 ml of the extract from the mixed cells of Schwann cells, myoblast cells, and renal endothelial cells (1×106/ml) was injected into the rats in Group C; 1 ml of the culture medium without any serum was injected into the rats in Group D as a control. After operation, observation was made for the general condition of the rats; 3 months after operation, enzymohistochemistry and the CJun expression were performedin the ventricornual motor neuron. At the proximal and the distal ends of the nerve suture, the density of neurilemma cells in the unit area and the area size of the regenerated nerve fibers were observed and measured. Results The affected limbs of the rats in Groups A, B and C improved 13 months after operation. The ulcers and swelling at the ankles gradually relieved and the rats could move normally 3 months after operation. However, the affected limbsof the rats in Group D still had ulcers and swelling, with an obvious contracture of the toes and a difficult movement. Three months after operation, the number of the target muscle myoceptor, the number of the Actin positive cells, the activity of the various enzymes in the denervated muscles, and the histological changes of the regenerated nerves were better in Group C than in Groups A and B (P＜0.01); and they were all better in Groups A, B and C than in Group D（Plt;0.01）. Conclusion Schwann cells, the mixture of Schwann cells and myoblast cells, and the extract from the mixture of Schwann cells, myoblast cells and renal endothelial cells can all promote neurotization and rehabilitation of the muscular function, and protect against the myoceptor degeneration. However, the effect of the extract is superior to that of Schwann cells or the mixed cells.
