目的 临床观察盐酸氨基葡萄糖和依托芬那酯凝胶治疗膝骨关节炎（KOA）的疗效。 方法 2010年6月－2012年2月，将354例KOA患者随机分为盐酸氨基葡萄糖组（A组）、依托芬那酯凝胶组（B组）和盐酸氨基葡萄糖+依托芬那酯凝胶组（C组）。A组为口服盐酸氨基葡萄糖，750 mg/次，2次/d，疗程6周；B组为依托芬那酯凝胶外用，2次/d，6周为1个疗程；C组为在A组的基础上同时加用B组的方法。 结果 C组在改善行走疼痛、夜间静息痛、晨僵方面优于A、B组，A组优于B组，差异有统计学意义（P＜0.05）。总有效率A组为79.65%，B组67.28%，C组89.38%，差异有统计学意义（P＜0.05）。出现不良反应A组3例，B组3例，C组4例，均较轻微，无严重不良事件发生。 结论 盐酸氨基葡萄糖和依托芬那酯凝胶治疗KOA均安全、有效，联合应用时，疗效进一步增强。
Objective To determine whether fluoxetine, a commonly used selective serotonin reuptake inhibitors (SSRIs), could exacerbate bleeding in a intracerebral hemorrhage (ICH) mouse model. Methods Forty two 12-14 month old female specific pathogen free C57BL/6 mice were selected. Mice were randomly divided into fluoxetine group (fluoxetine pre-treatment) and control group, with 21 mice in each group. After treated with fluoxetine for 7 days, ICH was induced by injecting collagenase Ⅶ-S into the right striatum of middle-aged female mice. Effects of fluoxetine on exacerbating bleeding were evaluated by a combination of histologic, molecular, cellular, and behavioral assessments. Results On the third day after ICH, the hemorrhage volumes of the control group and fluoxetine group were (4.59±1.80) mm3 and (6.09±1.08) mm3, respectively. In middle-aged female mice subjected to collagenase-induced ICH, fluoxetine pre-treatment significantly exacerbated neurological deficit, cerebral hemorrhage volume, myelin damage, hemoglobin and iron deposition, neuronal degeneration, and brain edema (P<0.05). Although there was no significant difference in tail bleeding time between the two groups, fluoxetine pre-treatment might increase tail bleeding time [(276.73±211.06) vs. (438.00±236.79) s; t=−1.686, P=0.055]. Conclusions The use of fluoxetine and more generally of SSRIs, which inhibits platelet aggregation, may exacerbate bleeding after ICH. Thus, patients with depression after ICH may avoid concomitant use of such drugs when choosing an antidepressant.
Objective To compare the effectiveness between unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of Kümmell disease. Methods The clinical data of 45 patients with Kümmell disease that met the criteria between January 2014 and February 2016 were analyzed retrospectively. Among them, 26 cases were treated by unilateral PKP (unilateral group), 19 cases were treated by bilateral PKP (bilateral group). There was no significant difference in gender, age, disease duration, injured vertebral segment, bone mineral density (T value), and the preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI), anterior vertebral height, and kyphosis Cobb angle between 2 groups (P>0.05). The operation time, intraoperative fluoroscopy times, amount of injected bone cement, and hospitalization time were recorded, and the situation of bone cement leakage was observed. The VAS score, ODI, anterior vertebral height, and kyphosis Cobb angle were evaluated before operation, at 1 day after operation, and at last follow-up. Results Bone cement leakage during the operation were found in 4 cases (15.38%) of unilateral group and 3 cases (15.79%) of bilateral group without obvious neurological symptoms; there was no significant difference in the incidence of bone cement leakage between 2 groups (χ2=0.000, P=1.000). The operation time, intraoperative fluoroscopy times, and amount of injected bone cement in the unilateral group were significantly lower than those in the bilateral group (P<0.05); but there was no significant difference in the hospitalization time between 2 groups (P>0.05). The X-ray film examination showed that there was no pulmonary embolism in all patients at 1 day after operation. All the patients were followed up 12-24 months, with an average of 16.4 months. There was no complication such as vertebral re-fracture or cement block displacement in the injured vertebra. The VAS score, ODI, anterior vertebral height, and kyphosis Cobb angle at 1 day after operation and at last follow-up were significantly improved when compared with preoperative values in 2 groups (P<0.05); the VAS score and ODI in 2 groups were further reduced at last follow-up when compared with the value at 1 day after operation (P<0.05), but the anterior vertebral height and kyphosis Cobb angle in 2 groups at last follow-up did not change significantly (P>0.05). There was no significant difference in above indexes at 1 day after operation and at last follow-up between 2 groups (P>0.05). Conclusion Both unilateral and bilateral PKP can achieve good effectiveness in treatment of Kümmell disease. But the unilateral puncture technique possesses advantages such as shorter operation time, less radiation dose, and less amount of injected bone cement.
ObjectiveTo investigate the effectiveness of Vesselplasty and percutaneous kyphoplasty (PKP) in treatment of Kümmell disease.MethodsBetween January 2015 and December 2018, 63 patients with Kümmell disease were treated. Among them, 28 cases were treated with Vesselplasty (Vesselplasty group) and 35 cases were treated with PKP (PKP group). There was no significant difference in gender, age, disease duration, bone mineral density (T value), fracture distribution, and preoperative pain visual analogue scale (VAS) score, Oswestry Disability Index (ODI), anterior height of injured vertebrae, and kyphosis Cobb angle between the two groups (P>0.05). The operation time, intraoperative fluoroscopy time, bone cement injection volume, the leakage rate of bone cement, the diffusion area ratio of bone cement, and the complications of the two groups were recorded. VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle were compared between the two groups before operation and at 1 day after operation and last follow-up.ResultsAll patients of the two groups were followed up 12-36 months, with an average of 24.2 months. The operation time, intraoperative fluoroscopy time, bone cement injection volume, and diffusion area ratio of bone cement were significantly lower in the Vesselplasty group than in the PKP group (P<0.05). The leakage rate of bone cement was significantly lower in the Vesselplasty group (7.14%) than in the PKP group (34.29%) (χ2=5.153, P=0.023). At 1 day after operation and last follow-up, the VAS score, ODI, anterior height of injured vertebrae, and kyphosis Cobb angle of the two groups were superior to those before operation (P<0.05), and no significant difference between the two groups (P>0.05). During the follow-up, there was no re-collapse of vertebrae, and the adjacent vertebrae fracture occurred in 2 cases of the Vesselplasty group and 5 cases of PKP group. There was no significant difference in the incidence of adjacent vertebrae fracture between the Vesselplasty group (7.14%) and the PKP group (14.29%) (χ2=0.243, P=0.622).ConclusionVesselplasty and PKP have similar effectiveness in the treatment of Kümmell disease. They can effectively relieve the pain symptoms, improve the quality of life, partially restore the height of injured vertebrae, and correct kyphosis. But the Vesselplasty has the advantages of shorter operation time, less intraoperative fluoroscopy time, and less bone cement leakage.