Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patie...Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.展开更多
Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resecti...Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from the cervical vertebrae Mechanical instability in the cervical spine elicited by this surgical intervention accelerated the process of intervertebral disc degeneration The extent of intervertebral disc degeneration was graded in morphologically, and the thicknesses of the calcified layer and the uncalcified layer of the cartilage end plate were measured in each degenerated cervical disc Results In less severely degenerative cervical discs, the morphology of the cartilage end plate showed nearly normal construction, and the tidemark was clear In severely degenerative discs, the matrix and cells showed fibrosis, the tidemark advanced, and the calcified cartilage thickened There exists a positive correlation between the thickness of the calcified layer of the cartilage end plate and the degree of cervical disc degeneration Conclusion The calcification of the cartilage end plate is the key factor that initiates and promotes cervical disc degeneration展开更多
Background Far lateral lumbar disc herniation （FLLDH） accounts for 2.6% to 11.7% of all lumbar herniated discs. Numerous surgical approaches have been described for treating this condition. The purpose of this study...Background Far lateral lumbar disc herniation （FLLDH） accounts for 2.6% to 11.7% of all lumbar herniated discs. Numerous surgical approaches have been described for treating this condition. The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH. Methods From June 2000 to March 2006, 52 patients with FLLDH were treated with minimally invasive procedures. All patients were assessed by anteroposterior and lateral roentgenography and computed tomography （CT）. Some patients underwent myelography, discography, and magnetic resonance imaging. Procedures performed included Yeung Endoscopy Spine System （YESS） （n=25）, METRx MicroDiscectomy System （n=13）, and X-tube （n=14）. Patients were followed up for a mean of 13.5 months. Clinical outcomes were assessed using a visual analog scale （VAS） and Nakai criteria. Results All 3 procedures significantly improved radiating leg symptoms （P 〈0.005）. After surgery, 84.0%, 84.6%, and 92.8% of patients in the YESS, METRx, and X-tube groups had excellent or good outcomes. There were no statistically significant differences of VAS scores between the groups. The YESS procedure was associated with the shortest operation time, simplest anesthesia, and least trauma compared with the other 2 procedures, especially for type I herniations. The METRx procedure was the most suitable for type Ⅱ herniations and posterior endoscopic facetectomy. Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability （type Ⅲ）. Conclusion Minimally invasive strategies and options should be determined with reference to the type of FLLDH.展开更多
AIM:To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation.METHODS:Fifty-eight patients with large ...AIM:To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation.METHODS:Fifty-eight patients with large lumbar disc herniation were treated with percutaneous injection of ozone via the posterior-lateral route and inner margin of the facet joint under digital subtraction angiography.Second injections were performed 5 d after the initial injection.All patients were followed up for 6-18 mo.A modified Macnab method was used for assessing clinical outcomes after oxygen-ozone therapy.RESULTS:Successful puncture was obtained in all patients.The overall efficacy was 91.4;the outcome was the excellent in 37 cases(63.8),good in 16 cases(27.6) and fair/poor in 5 cases(8.6) according to the Macnab criteria.No severe complications were found throughout this study.CONCLUSION:Percutaneous intradiscal ozone injection via the posterior-lateral route and inner margin of the facet joint is effective and safe for treatment of large lumbar disc herniation.展开更多
Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis an...Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.展开更多
OBJECTIVE： A systematic review of the literature was conducted to evaluate the curative effect and safety of Duhuojisheng Tang on prolapse of the lumbar intervertebral disc. METHODS： The databases of PubMed, China N...OBJECTIVE： A systematic review of the literature was conducted to evaluate the curative effect and safety of Duhuojisheng Tang on prolapse of the lumbar intervertebral disc. METHODS： The databases of PubMed, China Na- tional Knowledge Infrastructure （CNKI）, Chinese Sci- entific Journals Database （VlP）, Chinese Biomedical Literature Database （CBM） and Chinese Medical Ci- tation Index （CMCl） were searched up to January 30, 2012. Randomized controlled trials were select- ed to compare Duhuojisheng Tang with one ormore of the following treatments： traction, acu- puncture, massage, cupping and Western medical treatment. The quality-evaluating standard and the software RevMan 5.1 in Cochrane coordinative net were used to analyze the data. The effective index- es of the results were clinical curative rate, effective- ness of alleviating clinical symptoms and adverse reaction. RESULTS： Thirty-one randomized controlled trials of low quality, involving 3915 patients were system- atically evaluated. Statistical analyses showed that good curative effect was achieved in both the group using Duhuojisheng Tang alone and with combined therapies. CONCLUSION： Using Duhuojisheng Tang alone or combined with other therapies can effectively im- prove pain, leg-raising height and other clinical symptoms of patients with prolapse of lumbar in- tervertebral disc. Due to low methodological quali- ty of the articles, no exact recommendations can be made.展开更多
At present, the inner cutters of a full face rock tunnel boring machine (TBM) and transition cutter edge angles are designed on the basis of indentation test or linear grooving test. The inner and outer edge angles of...At present, the inner cutters of a full face rock tunnel boring machine (TBM) and transition cutter edge angles are designed on the basis of indentation test or linear grooving test. The inner and outer edge angles of disc cutters are characterized as symmetric to each other with respect to the cutter edge plane. This design has some practical defects, such as severe eccentric wear and tipping, etc. In this paper, the current design theory of disc cutter edge angle is analyzed, and the characteristics of the rock-breaking movement of disc cutters are studied. The researching results show that the rotational motion of disc cutters with the cutterhead gives rise to the difference between the interactions of inner rock and outer rock with the contact area of disc cutters, with shearing and extrusion on the inner rock and attrition on the outer rock. The wear of disc cutters at the contact area is unbalanced, among which the wear in the largest normal stress area is most apparent. Therefore, a three-dimensional model theory of rock breaking and an edge angle design theory of transition disc cutter are proposed to overcome the flaws of the currently used TBM cutter heads, such as short life span, camber wearing, tipping. And a corresponding equation is established. With reference to a specific construction case, the edge angle of the transition disc cutter has been designed based on the theory. The application of TBM in some practical project proves that the theory has obvious advantages in enhancing disc cutter life, decreasing replacement frequency, and making economic benefits. The proposed research provides a theoretical basis for the design of TBM three-dimensional disc cutters whose rock-breaking operation time can be effectively increased.展开更多
To study the rock deformation with three- dimensional model under rolling forces of disc cutter, by car- rying out the circular-grooving test with disc cutter rolling around on the rock, the rock mechanical behavior u...To study the rock deformation with three- dimensional model under rolling forces of disc cutter, by car- rying out the circular-grooving test with disc cutter rolling around on the rock, the rock mechanical behavior under rolling disc cutter is studied, the mechanical model of disc cutter rolling around the groove is established, and the the- ory of single-point and double-angle variables is proposed. Based on this theory, the physics equations and geometric equations of rock mechanical behavior under disc cutters of tunnel boring machine （TBM） are studied, and then the bal- ance equations of interactive forces between disc cutter and rock are established. Accordingly, formulas about normal force, rolling force and side force of a disc cutter are de- rived, and their validity is studied by tests. Therefore, a new method and theory is proposed to study rock- breaking mech- anism of disc cutters.展开更多
Objective To identify the antimicrobial resistance of commercial lactic acid bacteria present in microbial foods and drug additives by analyzing their isolated strains used for fermentation and probiotics. Methods Ant...Objective To identify the antimicrobial resistance of commercial lactic acid bacteria present in microbial foods and drug additives by analyzing their isolated strains used for fermentation and probiotics. Methods Antimicrobial susceptibility of 41 screened isolates was tested with disc diffusion and E-test methods after species-level identification. Resistant strains were selected and examined for the presence of resistance genes by PCR. Results Distribution of resistance was found in different species. All isolates were susceptible to chloramphenicol, tetracycline, ampicillin, amoxicillin/clavulanic acid, cephalothin, and imipenem. In addition, isolates resistant to vancomycin, rifampicin, streptomycin, bacitracin, and erythromycin were detected, although the incidence of resistance to these antibiotics was relatively low. In contrast, most strains were resistant to ciprofloxacin, amikacin, trimethoprim/sulphamethoxazole, and gentamycin. The genes msrC, vanX, and dfrA were detected in strains of Enterococcus faecium, Lactobacillus plantarum, Streptococcus thermophilus, and Lactococcus lactis. Conclusion Antibiotic resistance is present in different species of probiotic strains, which poses a threat to food safety. Evaluation of the safety of lactic acid bacteria for human consumption should be guided by established criteria, guidelines and regulations.展开更多
Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantati...Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 （AAV2）-mediated connective tissue growth factor （CTGF） and tissue inhibitor of metalloproteinases 1 （TIMP1） genes in vitro. Methods Computer tomography （CT）-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits, rAAV2-CTGF-IRES-TIMPI-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs （transplantation group）, phosphate-buffered saline （PBS） was injected into degenerative lumbar intervertebral discs （degeneration control group） and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index （DHI） and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging （MRI） analysis The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type II collagen and proteoglycan was detected by RT-PCR. Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture. Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen II mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the degeneration 展开更多
Background Microendoscopic discectomy （MED） is a minimally invasive operation that allows rapid recovery from surgery for lumbar disc herniation, but has replaced traditional open surgery in few hospitals because mo...Background Microendoscopic discectomy （MED） is a minimally invasive operation that allows rapid recovery from surgery for lumbar disc herniation, but has replaced traditional open surgery in few hospitals because most surgeons avoid its long learning curve. We evaluated the effectiveness and safety of lumbar MED at stages of spinal surgeons＇ learning curve. Methods Fifty patients receiving MED from June 2002 to February 2003 were divided into chronological groups of ten each： A-E. The control group F was ten MED patients treated later by the same medical team （September-October 2006）. All operations were performed by the same team of spinal surgeons with no MED experience before June 2002. We compared groups by operation time, blood loss, complications and need for open surgery after MED failure. Results Operation times by group were： A, （107±14） minutes; B, （85±13） minutes; C, （55±19） minutes; D, （52±12） minutes; E, （51±13） minutes; and F, （49±15） minutes. Blood loss were： A, （131±73） ml; B, （75±20） ml; C, （48±16） ml; D, （44±17） ml; E, （45±18） ml; and F, （45±16） ml. Both operation time and blood loss in groups C, D, E and F were smaller and more stable compared with groups A and B. Japanese Orthopedic Association assessment （JOA） score of each group in improvement rate immediately and one year after operation were as follows （in percentage）： A, （79.8±8.8）/（89.8±7.7）; B, （78.6±8.5）/（88.5±7.8）; C, （80.8±11.3）/（90.8±6.7）; D, （77.7±11.4）/（88.9±9.3）; E, （84.0±8.7）/（89.6±9.0）; and F, （77.8±11.6）/ （86.9±8.4）. Groups showed no statistical difference in improvement rates. Complications developed in three patients in group A, two in group B, and none in the other groups. Conclusions Spinal surgeons performing MED become proficient after 10-20 operations, when their skill becomes fairly sophisticated. Patients＇ improvement rate is the same regardless of surgeons＇ phase of lea展开更多
Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic...Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years （range from 29 to 73）. The median follow-up was 41.85months （range from 36.00-55.63 months）. Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association （JOA） score was 14.0 before surgery, and 16.5 at the most recent follow-up （P 〈0.01）. The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion （ROM） at the indexed level was （10.40±4.97）°, which has significantly correlated with the most recent follow-up ROM which was （8.56±4.76）° （P 〈0.05, r=0.33）. The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of （7.52±3.37）° （P 〈0.05）. The preoperative functional spinal unit （FSU） angulation was （-0.96±6.52）°, which was not significantly correlated with that of the most recent follow-up value of （-2.65±7.95）° （P 〈0.01, r=0.53）. The preoperative endplate angulation was （2.61±4.85）°, which had no significant correlation with that of the most recent follow-up value of （0.71±6.41）° （p 〉0.05）.Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical 展开更多
According to the cutting characteristics of progressive spiral movement by rotary cutting of the disc cutter, using the broken theory of interaction of compression and shearing, the three-axis force rotary cutting mec...According to the cutting characteristics of progressive spiral movement by rotary cutting of the disc cutter, using the broken theory of interaction of compression and shearing, the three-axis force rotary cutting mechanical model of disc cutter was established and the influence of installation radius, the phase difference and the cutter space on the mechanics of disc cutter were analyzed. The results show that on the same radial line of tunneling interface, the boring distance of cutting tools installed on a different radius is not equal. The cutting radial line of tunneling interface is a polyline and its height is determined by phase angle and penetration of cutting tools. Both phase difference and the installation radius between adjacent disc cutters have little effect on the vertical force and rolling force, but increase with the increase in cutter spacing. In addition, when increasing phase difference and cutter space bilaterally, and reducing installation radius simultaneously, the lateral force would be improved. Related results have been verified onl O0 t rotary tool cutting test platform.展开更多
OBJECTIVE: To compare the efficacy of electroacupuncture(deep needling) and general orthopedics in treatment of lumbar disc herniation(LDH), and to evaluate its long-term efficacy.METHODS: This trial is a prospective ...OBJECTIVE: To compare the efficacy of electroacupuncture(deep needling) and general orthopedics in treatment of lumbar disc herniation(LDH), and to evaluate its long-term efficacy.METHODS: This trial is a prospective cohort study.A total of 175 participants will be observed. The exposure group is obtained from department of acupuncture and moxibustion and the control group is from orthopedic department in hospital. Patients in exposed group will receive electroacupuncture in Dachangshu(BL 25), Guanyuanshu(BL 26), L4 Jiaji points(EX-B2 L4), L5 Jiaji points(EX-B2 L5) and S1 Jiaji points(EX-B2 S1) in the affected side once a day, 6 times as a treatment course for two courses(12 times). Patients in control group will receive orthopedic conventional therapy. In acute period,the treatment is mannitol injection(250 mL∶50 g) 200 mL, i.v., q.d.; 0.9% sodium chloride injection250 mL, vitamin C injection 2 g, Dexamethasone sodium phosphate injection 10 mg, i.v., q.d.; sterile water for injection 2 mL, adenosine cobalt amine injection 1 mg, i.m., q.d., 12 d. In remission period,the treatment is Voltaren(Diclofenac diethyl lamine emulsion) external, q.d., 12 d. The researchers do not give any other intervention and record the relevant information only.RESULTS: Modified Japanese Orthopaedic Association Scores, Visual Analogue Scale/Score, the Short Form-36 Quality-of-Life Questionnaire and Oswestry Disability Questionnaire and the second outcome measures(Adverse Event Questionnaire and Relapse Questionnaire) are measured before treatment, after the sixth treatment, and after the twelfth treatment. The follow-up periods are3 months after the twelfth treatment, 6 months after the twelfth treatment, 1 year after the twelfth treatment.CONCLUSION: This study will provide clinical researchers with the evidence on the safety and longterm efficacy of electroacupuncture in patients with Lumbar disc herniation.展开更多
文摘Discogenic low back pain is a serious medical and social problem, and accounts for 26%-42% of the patients with chronic low back pain. Recent studies found that the pathologic features of discs obtained from the patients with discogenic low back pain were the formation of the zones of vascularized granulation tissue, with extensive innervation in fissures extending from the outer part of the annulus into the nucleus pulposus. Studies suggested that the degeneration of the painful disc might originate from the injury and subsequent repair of annulus fibrosus. Growth factors such as basic fibroblast growth factor, transforming growth factor β1, and connective tissue growth factor, macrophages and mast cells might play a key role in the repair of the injured annulus fibrosus and subsequent disc degeneration. Although there exist controversies about the role of discography as a diagnostic test, provocation discography still is the only available means by which to identify a painful disc. A recent study has classified discogenic low back pain into two types that were annular disruption-induced low back pain and internal endplate disruption-induced low back pain, which have been fully supported by clinical and theoretical bases. Current treatment options for discogenic back pain range from medicinal anti-inflammation strategy to invasive procedures including spine fusion and recently spinal arthroplasty. However, these treatments are limited to relieving symptoms, with no attempt to restore the disc's structure. Recently, there has been a growing interest in developing strategies that aim to repair or regenerate the degenerated disc biologically.
文摘Objective To study the relationship between cartilage end plate calcification and intervertebral disc degeneration Methods An experimental model of cervical disc degeneration in rabbits was established by resection of the cervical supraspinous and interspinous ligaments and detachment of the posterior paravertebral muscles from the cervical vertebrae Mechanical instability in the cervical spine elicited by this surgical intervention accelerated the process of intervertebral disc degeneration The extent of intervertebral disc degeneration was graded in morphologically, and the thicknesses of the calcified layer and the uncalcified layer of the cartilage end plate were measured in each degenerated cervical disc Results In less severely degenerative cervical discs, the morphology of the cartilage end plate showed nearly normal construction, and the tidemark was clear In severely degenerative discs, the matrix and cells showed fibrosis, the tidemark advanced, and the calcified cartilage thickened There exists a positive correlation between the thickness of the calcified layer of the cartilage end plate and the degree of cervical disc degeneration Conclusion The calcification of the cartilage end plate is the key factor that initiates and promotes cervical disc degeneration
文摘Background Far lateral lumbar disc herniation （FLLDH） accounts for 2.6% to 11.7% of all lumbar herniated discs. Numerous surgical approaches have been described for treating this condition. The purpose of this study was to evaluate minimally invasive surgical techniques for the treatment of FLLDH. Methods From June 2000 to March 2006, 52 patients with FLLDH were treated with minimally invasive procedures. All patients were assessed by anteroposterior and lateral roentgenography and computed tomography （CT）. Some patients underwent myelography, discography, and magnetic resonance imaging. Procedures performed included Yeung Endoscopy Spine System （YESS） （n=25）, METRx MicroDiscectomy System （n=13）, and X-tube （n=14）. Patients were followed up for a mean of 13.5 months. Clinical outcomes were assessed using a visual analog scale （VAS） and Nakai criteria. Results All 3 procedures significantly improved radiating leg symptoms （P 〈0.005）. After surgery, 84.0%, 84.6%, and 92.8% of patients in the YESS, METRx, and X-tube groups had excellent or good outcomes. There were no statistically significant differences of VAS scores between the groups. The YESS procedure was associated with the shortest operation time, simplest anesthesia, and least trauma compared with the other 2 procedures, especially for type I herniations. The METRx procedure was the most suitable for type Ⅱ herniations and posterior endoscopic facetectomy. Posterior lumbar interbody fusion and unilateral pedicle screw instrumentation with X-tube was the most suitable for herniations combined with degenerative lumbar instability （type Ⅲ）. Conclusion Minimally invasive strategies and options should be determined with reference to the type of FLLDH.
基金Supported by The National Natural Science Foundation of China,No. 30670612
文摘AIM:To evaluate the effects of percutaneous ozone injection via the posterior-lateral route and inner margin of the facet joint in the treatment of large lumbar disc herniation.METHODS:Fifty-eight patients with large lumbar disc herniation were treated with percutaneous injection of ozone via the posterior-lateral route and inner margin of the facet joint under digital subtraction angiography.Second injections were performed 5 d after the initial injection.All patients were followed up for 6-18 mo.A modified Macnab method was used for assessing clinical outcomes after oxygen-ozone therapy.RESULTS:Successful puncture was obtained in all patients.The overall efficacy was 91.4;the outcome was the excellent in 37 cases(63.8),good in 16 cases(27.6) and fair/poor in 5 cases(8.6) according to the Macnab criteria.No severe complications were found throughout this study.CONCLUSION:Percutaneous intradiscal ozone injection via the posterior-lateral route and inner margin of the facet joint is effective and safe for treatment of large lumbar disc herniation.
文摘Lumbar disc herniation is a common disease in the clinical context and does great harm to either the physical or mental health of patients suffering from this disease.Many guidelines and consensus for the diagnosis and treatment of lumbar disc herniation have been published domestically and internationally.According to the expert consensus,clinicians could adopt tailored and personalized diagnosis and treatment management strategies for lumbar disc herniation patients.
基金Supported by Capital Application Project on Clinical Characteristics of Science and Technology Commission of Beijing Municipalit (No. Z111107058811056)Planned Project on Beijing Traditional Chinese Medicine "inheritance of 3 + 3 programme" of Beijing Chinese Medicine Administration Bureau (2011-SZ-C-34)
文摘OBJECTIVE： A systematic review of the literature was conducted to evaluate the curative effect and safety of Duhuojisheng Tang on prolapse of the lumbar intervertebral disc. METHODS： The databases of PubMed, China Na- tional Knowledge Infrastructure （CNKI）, Chinese Sci- entific Journals Database （VlP）, Chinese Biomedical Literature Database （CBM） and Chinese Medical Ci- tation Index （CMCl） were searched up to January 30, 2012. Randomized controlled trials were select- ed to compare Duhuojisheng Tang with one ormore of the following treatments： traction, acu- puncture, massage, cupping and Western medical treatment. The quality-evaluating standard and the software RevMan 5.1 in Cochrane coordinative net were used to analyze the data. The effective index- es of the results were clinical curative rate, effective- ness of alleviating clinical symptoms and adverse reaction. RESULTS： Thirty-one randomized controlled trials of low quality, involving 3915 patients were system- atically evaluated. Statistical analyses showed that good curative effect was achieved in both the group using Duhuojisheng Tang alone and with combined therapies. CONCLUSION： Using Duhuojisheng Tang alone or combined with other therapies can effectively im- prove pain, leg-raising height and other clinical symptoms of patients with prolapse of lumbar in- tervertebral disc. Due to low methodological quali- ty of the articles, no exact recommendations can be made.
基金supported by National Natural Science Foundation of China (Grant No. 51075147)
文摘At present, the inner cutters of a full face rock tunnel boring machine (TBM) and transition cutter edge angles are designed on the basis of indentation test or linear grooving test. The inner and outer edge angles of disc cutters are characterized as symmetric to each other with respect to the cutter edge plane. This design has some practical defects, such as severe eccentric wear and tipping, etc. In this paper, the current design theory of disc cutter edge angle is analyzed, and the characteristics of the rock-breaking movement of disc cutters are studied. The researching results show that the rotational motion of disc cutters with the cutterhead gives rise to the difference between the interactions of inner rock and outer rock with the contact area of disc cutters, with shearing and extrusion on the inner rock and attrition on the outer rock. The wear of disc cutters at the contact area is unbalanced, among which the wear in the largest normal stress area is most apparent. Therefore, a three-dimensional model theory of rock breaking and an edge angle design theory of transition disc cutter are proposed to overcome the flaws of the currently used TBM cutter heads, such as short life span, camber wearing, tipping. And a corresponding equation is established. With reference to a specific construction case, the edge angle of the transition disc cutter has been designed based on the theory. The application of TBM in some practical project proves that the theory has obvious advantages in enhancing disc cutter life, decreasing replacement frequency, and making economic benefits. The proposed research provides a theoretical basis for the design of TBM three-dimensional disc cutters whose rock-breaking operation time can be effectively increased.
基金supported by the National Natural Science Foundation of China (51075147)
文摘To study the rock deformation with three- dimensional model under rolling forces of disc cutter, by car- rying out the circular-grooving test with disc cutter rolling around on the rock, the rock mechanical behavior under rolling disc cutter is studied, the mechanical model of disc cutter rolling around the groove is established, and the the- ory of single-point and double-angle variables is proposed. Based on this theory, the physics equations and geometric equations of rock mechanical behavior under disc cutters of tunnel boring machine （TBM） are studied, and then the bal- ance equations of interactive forces between disc cutter and rock are established. Accordingly, formulas about normal force, rolling force and side force of a disc cutter are de- rived, and their validity is studied by tests. Therefore, a new method and theory is proposed to study rock- breaking mech- anism of disc cutters.
文摘Objective To identify the antimicrobial resistance of commercial lactic acid bacteria present in microbial foods and drug additives by analyzing their isolated strains used for fermentation and probiotics. Methods Antimicrobial susceptibility of 41 screened isolates was tested with disc diffusion and E-test methods after species-level identification. Resistant strains were selected and examined for the presence of resistance genes by PCR. Results Distribution of resistance was found in different species. All isolates were susceptible to chloramphenicol, tetracycline, ampicillin, amoxicillin/clavulanic acid, cephalothin, and imipenem. In addition, isolates resistant to vancomycin, rifampicin, streptomycin, bacitracin, and erythromycin were detected, although the incidence of resistance to these antibiotics was relatively low. In contrast, most strains were resistant to ciprofloxacin, amikacin, trimethoprim/sulphamethoxazole, and gentamycin. The genes msrC, vanX, and dfrA were detected in strains of Enterococcus faecium, Lactobacillus plantarum, Streptococcus thermophilus, and Lactococcus lactis. Conclusion Antibiotic resistance is present in different species of probiotic strains, which poses a threat to food safety. Evaluation of the safety of lactic acid bacteria for human consumption should be guided by established criteria, guidelines and regulations.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30471750）.
文摘Background Intervertebral disc degeneration is the main cause of low back pain. The purpose of this study was to explore potential methods for reversing the degeneration of lumbar intervertebral discs by transplantation of gene-modified nucleus pulposus cells into rabbit degenerative lumbar intervertebral discs after transfecting rabbit nucleus pulposus cells with adeno-associated virus 2 （AAV2）-mediated connective tissue growth factor （CTGF） and tissue inhibitor of metalloproteinases 1 （TIMP1） genes in vitro. Methods Computer tomography （CT）-guided percutaneous annulus fibrosus injury was performed to build degenerative lumbar intervertebral disc models in 60 New Zealand white rabbits, rAAV2-CTGF-IRES-TIMPI-transfected rabbit nucleus pulposus cells were transplanted into degenerative lumbar intervertebral discs （transplantation group）, phosphate-buffered saline （PBS） was injected into degenerative lumbar intervertebral discs （degeneration control group） and normal lumbar intervertebral discs served as a blank control group. After 6, 10 and 14 weeks, the disc height index （DHI） and signal intensity in intervertebral discs were observed by X-ray and magnetic resonance imaging （MRI） analysis The expression of CTGF and TIMP1 in nucleus pulposus tissue was determined by Western blotting analysis, the synthesis efficiency of proteoglycan was determined by a 35S-sulfate incorporation assay, and the mRNA expression of type II collagen and proteoglycan was detected by RT-PCR. Results MRI confirmed that degenerative intervertebral discs appeared two weeks after percutaneous puncture. Transgenic nucleus pulposus cell transplantation could retard the rapid deterioration of the DHI. MRI indicated that degenerative intervertebral discs were relieved in the transplantation group compared with the degeneration control group. The expression of collagen II mRNA and proteoglycan mRNA was significantly higher in the transplantation group and the blank control group compared with the degeneration
文摘Background Microendoscopic discectomy （MED） is a minimally invasive operation that allows rapid recovery from surgery for lumbar disc herniation, but has replaced traditional open surgery in few hospitals because most surgeons avoid its long learning curve. We evaluated the effectiveness and safety of lumbar MED at stages of spinal surgeons＇ learning curve. Methods Fifty patients receiving MED from June 2002 to February 2003 were divided into chronological groups of ten each： A-E. The control group F was ten MED patients treated later by the same medical team （September-October 2006）. All operations were performed by the same team of spinal surgeons with no MED experience before June 2002. We compared groups by operation time, blood loss, complications and need for open surgery after MED failure. Results Operation times by group were： A, （107±14） minutes; B, （85±13） minutes; C, （55±19） minutes; D, （52±12） minutes; E, （51±13） minutes; and F, （49±15） minutes. Blood loss were： A, （131±73） ml; B, （75±20） ml; C, （48±16） ml; D, （44±17） ml; E, （45±18） ml; and F, （45±16） ml. Both operation time and blood loss in groups C, D, E and F were smaller and more stable compared with groups A and B. Japanese Orthopedic Association assessment （JOA） score of each group in improvement rate immediately and one year after operation were as follows （in percentage）： A, （79.8±8.8）/（89.8±7.7）; B, （78.6±8.5）/（88.5±7.8）; C, （80.8±11.3）/（90.8±6.7）; D, （77.7±11.4）/（88.9±9.3）; E, （84.0±8.7）/（89.6±9.0）; and F, （77.8±11.6）/ （86.9±8.4）. Groups showed no statistical difference in improvement rates. Complications developed in three patients in group A, two in group B, and none in the other groups. Conclusions Spinal surgeons performing MED become proficient after 10-20 operations, when their skill becomes fairly sophisticated. Patients＇ improvement rate is the same regardless of surgeons＇ phase of lea
文摘Background Theoretic advantages of cervical disc arthroplasty include preservation of normal motion and biomechanics in the cervical spine, and reduction of adjacent-segment degeneration. The clinical and radiographic effects of cervical disc arthroplasty in short term have been ascertained. The aim of this study is to research the data of mid-term results.Methods In this prospective cohort study, 50 patients who underwent cervical disc arthroplasty from December 2003 to January 2006 were enrolled. There were 39 patients who received 1-level disc arthroplasty, and 11 patients received 2-level disc arthroplasty, with an average age of 50.9 years （range from 29 to 73）. The median follow-up was 41.85months （range from 36.00-55.63 months）. Patients were followed prospectively with respect to their symptoms,neurologic signs, and radiographic results.Results The median value of Japanese Orthopaedic Association （JOA） score was 14.0 before surgery, and 16.5 at the most recent follow-up （P 〈0.01）. The median value of the recovery rate of the JOA score was 92.2%. The preoperative range of motion （ROM） at the indexed level was （10.40±4.97）°, which has significantly correlated with the most recent follow-up ROM which was （8.56±4.76）° （P 〈0.05, r=0.33）. The ROM at the operative level at the most recent follow-upwas greater than the value at the 3-month follow-up of （7.52±3.37）° （P 〈0.05）. The preoperative functional spinal unit （FSU） angulation was （-0.96±6.52）°, which was not significantly correlated with that of the most recent follow-up value of （-2.65±7.95）° （P 〈0.01, r=0.53）. The preoperative endplate angulation was （2.61±4.85）°, which had no significant correlation with that of the most recent follow-up value of （0.71±6.41）° （p 〉0.05）.Conclusions The clinical and radiographic results of cervical disc arthroplasty are good in mid-term follow-up. The normal range of motion of the operated level and the biomechanics in the cervical
基金Project(2007CB714002) supported by the National Basic Research Program of ChinaProject(51074180) supported by the National Natural Science Foundation of ChinaProject(2010FJ1002) supported by Hunan Municipal Science and Technology Program,China
文摘According to the cutting characteristics of progressive spiral movement by rotary cutting of the disc cutter, using the broken theory of interaction of compression and shearing, the three-axis force rotary cutting mechanical model of disc cutter was established and the influence of installation radius, the phase difference and the cutter space on the mechanics of disc cutter were analyzed. The results show that on the same radial line of tunneling interface, the boring distance of cutting tools installed on a different radius is not equal. The cutting radial line of tunneling interface is a polyline and its height is determined by phase angle and penetration of cutting tools. Both phase difference and the installation radius between adjacent disc cutters have little effect on the vertical force and rolling force, but increase with the increase in cutter spacing. In addition, when increasing phase difference and cutter space bilaterally, and reducing installation radius simultaneously, the lateral force would be improved. Related results have been verified onl O0 t rotary tool cutting test platform.
基金the 2016 Capital Clinical Application Research and Achievement Promotion Project:Capital Characteristics-A Prospective Cohort Study of electroacupuncture at Deep Acupuncture at Five Points to Treat Lumbar Disc Herniation(No.Z161100000516137)
文摘OBJECTIVE: To compare the efficacy of electroacupuncture(deep needling) and general orthopedics in treatment of lumbar disc herniation(LDH), and to evaluate its long-term efficacy.METHODS: This trial is a prospective cohort study.A total of 175 participants will be observed. The exposure group is obtained from department of acupuncture and moxibustion and the control group is from orthopedic department in hospital. Patients in exposed group will receive electroacupuncture in Dachangshu(BL 25), Guanyuanshu(BL 26), L4 Jiaji points(EX-B2 L4), L5 Jiaji points(EX-B2 L5) and S1 Jiaji points(EX-B2 S1) in the affected side once a day, 6 times as a treatment course for two courses(12 times). Patients in control group will receive orthopedic conventional therapy. In acute period,the treatment is mannitol injection(250 mL∶50 g) 200 mL, i.v., q.d.; 0.9% sodium chloride injection250 mL, vitamin C injection 2 g, Dexamethasone sodium phosphate injection 10 mg, i.v., q.d.; sterile water for injection 2 mL, adenosine cobalt amine injection 1 mg, i.m., q.d., 12 d. In remission period,the treatment is Voltaren(Diclofenac diethyl lamine emulsion) external, q.d., 12 d. The researchers do not give any other intervention and record the relevant information only.RESULTS: Modified Japanese Orthopaedic Association Scores, Visual Analogue Scale/Score, the Short Form-36 Quality-of-Life Questionnaire and Oswestry Disability Questionnaire and the second outcome measures(Adverse Event Questionnaire and Relapse Questionnaire) are measured before treatment, after the sixth treatment, and after the twelfth treatment. The follow-up periods are3 months after the twelfth treatment, 6 months after the twelfth treatment, 1 year after the twelfth treatment.CONCLUSION: This study will provide clinical researchers with the evidence on the safety and longterm efficacy of electroacupuncture in patients with Lumbar disc herniation.
