Percutaneous pedicle screw fixation (PPSF) has been a popular approach for treating thoracolumbar and lumbar fracture, and its relevant complications have been gradually recognized. This study aimed to summarize the complications of PPSF in treating thoracolumbar and lumbar fracture as well as the management and outcomes of the complications.We retrospectively analyzed the patients with thoracolumbar and lumbar fracture who were admitted to our department from February 2011 to February 2015 and underwent posterior PPSF. Information on demographics, medical comorbidities, radiographs, and treatment was obtained from hospital medical records and follow-up records. Main outcome indexes included adverse clinical and radiological outcomes during and after surgery.A total of 781 patients were included in this study. Forty-six patients (5.9%) presented with complications during or after surgery. The complications included intraoperative guide wire breakage, abdominal artery injury, spinal dura mater injury, postoperative pedicle screw misplacement, screw breakage, plug screw falling off, connecting rod loosening, poor reduction, and late infection. Among the 39 cases with postoperative complications, 14 underwent revision surgery, and the remaining patients underwent conservative treatment and presented good outcomes.PPSF is associated with the following complications: guide wire rupture, blood vessel injury, cerebrospinal fluid leakage, screw misplacement, poor reduction, failed internal fixation, and infection. A thorough preoperative evaluation, accurate operation, and timely and correct management of complications are critical to achieving satisfactory surgical outcomes.
Herbal medicine has
been used to countermine various diseases for
centuries. However, most of the therapeutic targets underlying herbal
therapy remain unclear, which largely slow down the novel drug discovery
process from natural products. In this study, we developed a novel
computational pipeline for assisting de novo identification of protein
targets for herbal ingredients. The pipeline involves pharmacophore
comparison and reverse ligand–protein docking simulation in
a high throughput manner. We evaluated the pipeline using three traditional
Chinese medicine ingredients such as acteoside, quercetin, and epigallocatechin
gallate as examples. A majority of current known targets of these
ingredients were successfully identified by the pipeline. Structural
comparative analyses confirmed that the predicted ligand–target
interactions used the same binding pockets and binding modes as those
of known ligand–target interactions. Furthermore, we illustrated
the mechanism of actions of the ingredients by constructing the pharmacological
networks on the basis of the predicted target profiles. In summary,
we proposed an efficient and economic option for large-scale target
exploration in the herb study. This pipeline will be particularly
valuable in aiding precise drug discovery and drug repurposing from
natural products.
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