[Digital and anatomical study of posterior atlantooccipital joint-occipital condyle-clivus screw technique]

Objective: To investigate the screw placement parameters, feasibility and safety of posterior atlantooccipital joint-occipital condyle-clivus screw technique in Chinese people. Methods: Upper cervical spine CT images of 46 patients, including 24 males and 22 females, were collected with random number table from June 2019 to May 2020 in Ningbo No.6 Hospital. The patients aged 20-55 years, with a mean age of (39±9) years. Total of 92 sides of upper cervical spine models were obtained by Mimics 19.0 digital three-dimensional reconstruction, and screw placement was conducted simulately. The midpoint of transition zone between the posterior arch of atlas and the inferior articular process of lateral mass was selected as the screw entry point. The diameter and length of screws was 3.5 mm and 50 mm, respectively. Detailed morphometric measurements of the 92 atlantooccipital joint-occipital condyle-clivus screws were conducted. The distance between the screw and its surrounding important structures, screw inside and upper tilting angles, the length of screw trajectory in atlas and the length of screw trajectory on occipital side (occipital condyle-clivus) were all measured. Paired t test was performed on the parameters of left and right screw placement to confirm whether there was difference between the two sides. Results: In the 46 cases of upper cervical spine digital three-dimensional models, 92 posterior atlantooccipital joint-occipital condyle-clivus screws were implanted. All the screws were completely fixed in the clivus, without breaking through the upper sphenoid sinus, entering into the canalis spinalis and foramen magnum, and damaging the surrounding structures such as hypoglossal canal. The screw trajectory parameters between the left and right sides were slightly different, but there was no statistical differences between the two sides (P>0.05). The vertical distance between the screw entry point and the upper edge of atlas was (12.6±1.0) mm, the vertical distance between the screw entry point and the lower edge of atlas was (6.5±0.6) mm, the distance between the screw and the medial border of atlas vertebral artery foramen was (6.7±0.6) mm, the distance between the screw entry point and the medial wall of atlas was (6.6±0.7) mm, the distance between the screw outer margin and the hypoglossal canal was (5.5±0.6) mm, screw inside tilting angle was 21.2°±2.5°, screw upper tilting angle was 52.0°±3.4°, the length of screw trajectory in atlas was (12.1±0.9) mm, the length of screw trajectory on occipital side (occipital condyle-clivus) was (37.9±0.9) mm. Conclusion: The posterior atlantooccipital joint-occipital condyle-clivus screw technique can serve as a feasible and safe treatment for instability of the occipitocervical junction, which can be used as a new posterior occipitocervical fusion technique.

Pseudoginsenoside-F11 attenuates morphine-induced signalling in Chinese hamster ovary-mu cells

Pseudoginsenoside-F11 (PF11), an ocotillol type saponin isolated from Panax quinquefolium L., has been shown to antagonize the behavioral actions of morphine. Biochemical experiments revealed that PF11 could inhibit diprenorphine (DIP) binding with an IC50 of approximately 6.1 microM and reduced the binding potency of morphine in Chinese hamster ovary (CHO)-mu cells. Furthermore, PF11 significantly attenuated morphine-stimulated [35S]GTPgammaS binding in a dose dependent manner, and strongly decreased the efficacy of morphine to inhibit intracellular cAMP production. In addition, PF11 pretreatment could also significantly inhibit naloxone induced cAMP overshoot in the morphine-pretreated cells. However, PF11 per se had no effect on either [35S]GTPgammaS binding or intracellular cAMP accumulation. These data suggested that PF11 antagonized the morphine stimulated opioid receptor signalling directly at the cellular level.

Reversal of morphine-induced memory impairment in mice by withdrawal in Morris water maze: possible involvement of cholinergic system

The effects of morphine and morphine withdrawal on memory performance were examined in mice by using Morris water maze task. Morphine-induced memory impairment at the doses of 5 and 10 mg/kg recovered after repeated administration. Oxotremorine, a muscarinic receptor agonist, at the dose of 0.1 mg/kg ip, and physostigmine, a cholinesterase inhibitor, at the dose of 0.1 mg/kg ip, significantly antagonized morphine (10 mg/kg sc)-induced memory impairment in mice. Furthermore, repeated naloxone (0.5 mg/kg ip) attenuated scopolamine (0.2 mg/kg ip)-induced memory impairment. By using escalating doses of morphine for 13 days, morphine-induced memory impairment was continuously maintained. When withdrawal was precipitated by naloxone (5 mg/kg ip), or administration of oxotremorine (0.1 and 0.2 mg/kg ip) or physostigmine (0.05 and 0.1 mg/kg ip), the impairment was completely reversed. These results suggest that morphine-induced memory impairment could be partially due to the inhibition of the central cholinergic activity.