Objective To compare the cl inical effects of indirect decompression versus open decompression to vertebral canal in treatment of thoracolumbar burst fractures without neurologic deficit. Methods From April 2004 to June 2008, 52 cases of thoracolumbar burst fracture without neurologic deficit underwent posterior exposition, reduction and fixation with Atlas Fixator (AF) instrumentation. There were 34 males and 18 females with an average age of 43.1 years (range, 31-63 years). The affectd locations were T11 in 5 cases, T12 in 24 cases, L1 in 16 cases, and L2 in 7 cases. The time from injury to operation was 3-8 days (4.4 days on average). All cases were devided into indirect decompression group (group A) and open decompression group (group B). There were no statistically significant differences (P gt; 0.05) in sex, age, affect site, and disease course between two groups. The operative time, blood loss were recoded. Preoperatively, immediately postoperstively and at last follow-up, the height of the fracture vertebra and the Cobb angle were obtained from X-ray pictures and were statistically analysed. Radiographic parameters on computed tomography (CT) pictures were used to get the encroachment rate of vertebral canal. Results The operative time was (87.3 ± 7.9) minutes and (125.3 ± 13.6) minutes, and the blood loss was (273.7 ± 23.4) mL and (512.6 ± 37.7) mL in groups A and B, respectively; showing statistically significant differences (P lt; 0.05). The average follow-up time was 17.4 months (range, 11-31 months) in group A and 19.9 months (range, 12-33 months) in group B. All wounds achieved primary heal ing postoperatively without deaths and spinal cord injuries. Postoperative compl ications in group B included 3 cases of screws loosening, 1 case of screw breakage, and 3 cases of low back pain, and were given symptomatic management. There were no statistically significant differences (P gt; 0.05) in the height of the fracture vertebra, the Cobb angle andthe encroachment rate of vertebral canal preoperatively or postoperstively between two groups. There were statistically significant differences (P lt; 0.05) in the above three parameters between preoperation and postoperation in two groups, but there were no statistically significant differences (P gt; 0.05) in the spinal correction between two groups. The losing-rate of spinal correction of the height of the fracture vertebra and the Cobb angle of group A was lower than group B, showing statistically significant differences (P lt; 0.05). Conclusion The short-term results of two decompression styles in treatment of thoracolumbar burst fractures without neurologic deficit were satisfactory, but indirect decompression has more merits than open decompression: shorter operative time, less blood loss, lower losing-rate of spinal correction, and better stabil ization of vertebral column.
ObjectiveTo explore the effects of silencing the expression of ubiquitin-conjugating enzyme E2T (UBE2T) gene on proliferation, apoptosis, migration and invasion abilities of A549 cells.MethodsA549 cells were cultured in vitro. Three sets of shRNA-UBE2T plasmid vectors (UBE2T-shRNA1 group, UBE2T-shRNA2 group, UBE2T-shRNA3 group) and shRNA-NC (shRNA-NC group) were constructed, respectively. A549 cells were transfected with lipofection transfection. The cells transfected with empty vector were enrolled as control (control group). The transfection efficiency was detected by RT-PCR. The effects of silencing the expression of UBE2T gene on biological behaviors (proliferation, apoptosis, migration, and invasion) of lung cancer A549 cells were detected by clone formation assay, flow cytometry, Transwell assay and scratch test. The expression of proliferation and apoptosis related proteins, and expression of PI3K/AKT signaling pathway proteins were detected by Western blot. ResultsAfter transfection, expression level of UBE2T mRNA in UBE2T-shRNA1 group, UBE2T-shRNA2 group and UBE2T-shRNA3 group was significantly down-regulated (all P<0.05), whose down-regulation was the most significant in UBE2T-shRNA3 group (P<0.05). Compared with control group and shRNA-NC group, clone formation rate, number of invasion A549 cells, scratch healing rate, Ki67 expression, PCNA expression, p-PI3K/PI3K ratio and p-AKT/AKT ratio were significantly decreased in UBE2T-shRNA3 group (P<0.05), while A549 apoptosis rate, Bax/Bcl-2 ratio and cleaved caspase-3/caspase-3 ratio were significantly increased (P<0.05). There were no significant differences in the above indexes between control group and shRNA-NC group (P>0.05). ConclusionsThe shRNA interfering with UBE2T is reliable to construct the model of A549 cells with stable low-expression UBE2T. Down-regulation of UBE2T expression can promote apoptosis of A549 cells, inhibit their proliferation, invasion and migration abilities. The mechanism may be related to inhibiting the activation of PI3K/AKT signaling pathway.