1.Evaluation of the biomechanical stability of lumbar dynamicly fixed by socket track pedicle screws
Gaoxiang LI ; Guitao LI ; Wangyang XU ; Xiaozhong ZHOU ; Junnan LUO
Chinese Journal of Orthopaedics 2016;(2):121-127
Objective To investigate the stability of lumbar single?level dynamicly fixed by socket track pedicle screws after decompression. Methods Socket track pedicle screws are made of titanium?alloy, swing like universal screw within the scope of 18° in the sagittal plane and 8° in the horizontal plane. Motion constraints were due to the hole which the screw goes through. Six pig spines (L1-5) were tested by applying a pure moment of 4.018 Nm in 3 directions of loading. The range of motion (ROM) of the following groups underwent different surgical procedures was measured:(1) intact;(2) dynamic fixation 1 (decompres?sion by total laminectomy and instrumentation with socket track pedicle screws); (3) dynamic fixation 2 (decompression by total laminectomy and bilateral facetectomy while instrumentation with socket track pedicle screws);( 4) instability resulted from decom?pression (decompression by total laminectomy plus bilateral facetectomy without any rod);(5) hybrid fixation (decompression by to?tal laminectomy and bilateral facetectomy while instrumentation with 2 socket track pedicle screws connected with 2 unilateral pedicle screws ). Results Compared with the intact specimens (in flexion, extension, lateral bending and rotation, corresponding angular displacements were 1.84°±0.75°, 1.55°±0.34°, 2.2°±1.07°, 2.06°±0.76° respectively), the ROM of segment L3, 4 of each group were significantly restricted except for axial rotation. In flexion, extension and lateral bending, the ROM was reduced to 0.71°±0.39°, 0.46°±0.18°, 0.85°±0.66° in dynamic fixation 1 group;0.79°±0.43°, 0.71°±0.20°, 1.17°±0.48° in dynamic fixation 2 group and 0.63°±0.50°, 0.37°±0.19°, 0.54°±0.60° in hybrid fixation group. The rotation ROM of dynamic fixation 1 group and hy?brid fixation group were decreased to 1.50°±0.64° and 1.22°±0.36°, whereas the ROM of dynamic fixation 2 had a non?significant reduction to 1.85°±0.67°. The extension and rotation ROM of dynamic fixation 2 increased significantly comparing to dynamic fixa?tion 1 group; the extension, lateral bending and axial rotation ROM of hybrid fixation group were reduced comparing to the state of dynamic fixation 2 group. Conclusion The dynamic instrumentation of single?level lumbar spine with socket track pedicle screws could offer stability in all directions. The flexion, extension, lateral bending and rotation ROM of spine with dynamic instru?mentation after total laminectomy and bilateral facetectomy could be reduced.
2.Treatment and medical follow-up of three cases with acute radiation-induced skin injury
Wangyang PU ; Zhixiang ZHUANG ; Yulong LIU ; Yuan LI ; Yusong ZHANG
Chinese Journal of Radiological Medicine and Protection 2014;34(5):364-366
Objective To discuss diagnosis,treatment and late effects of three patients with acute radiation-induced skin injury after an accident.Methods Medical history collection and physical examination were made in a manner of one or several doctors to one patient.The general health condition was evaluated through laboratory studies,including complete blood count,liver and kidney function,thyroid function and humoral immunity measurement.The genetic analysis of radiation damage was performed by using chromosomal aberrations and micronucleus assay (CB method).The psychological status of the patients was evaluated during medical follow-up.Results Among the three patients,two were diagnosed with degree Ⅲ acute radiation-induced skin injury and one with degree Ⅱ.The medical follow-up showed that two patients had syndrome of neurasthenia.The two cases with degree Ⅲ acute radiation-induced skin injury then became chronic radiation-induced skin damage.Conclusions Acute radiation-induced skin injury could be persistent and become chronic radiation skin damage.It is important for long-term medical follow-up to be taken for patients with acute radiation-induced skin injury.
3.Regulatory effects of taurine up-regulated gene 1 on tumorigenesis
Xingming JIANG ; Zhidong WANG ; Jinglin LI ; Wangyang ZHENG ; Zhenglong LI ; Xinheng LI ; Yunfu CUI
Chinese Journal of Pathophysiology 2017;33(7):1332-1337
It has been estimated that approximately 75% of the human genome is transcribed into RNA, 74% of which would be transcribed into non-coding RNA (ncRNA).The ncRNA can be divided into 2 major groups including small RNA and long non-coding RNA (lncRNA).There is increasing evidence that the dysregulation of lncRNA is closely associated with the occurrence and progression of many tumors.The lncRNA taurine up-regulated gene 1 (TUG1) is originally detected in a genomic screen for genes in response to taurine treatment of developing mouse retinal cells.According to research reports, dysregulation of TUG1 participates in the progression of a variety of tumors.Therefore, the regulatory effects of lncRNA TUG1 on tumorigenesis are summarized in this article.
4.Research of tumor progression locus 2 in tumorigenesis and progression
Jinglin LI ; Wangyang ZHENG ; Xinheng LI ; Zhenglong LI ; Zhidong WANG ; Xingming JIANG ; Yunfu CUI
Journal of Chinese Physician 2017;19(6):946-949
Tumor progression locus 2 (Tpl2) is a crucial three-stage kinase of the mitogen-activited protein kinase (MAPK) family,which plays an important role in MAPK pathway and other signaling pathways.In recent years,a large number of studies have found that aberrant expressing Tpl2 is involved in tumorigenesis and development of various cancers,and is expected to serve as a new biomarker and therapeutic target.Therefore,to reveal the mechanism of Tpl2 will provide a feasible theoretical basis and potential interventional target for the diagnosis and treatment of cancers.
5.Biomechanical features of trabecular metal dental implants
Ling ZHANG ; Kai LI ; Qing PAN ; Junchi CHEN ; Wangyang LI ; Linhu LV ; Yunshui ZHANG ; Ling GUO
Chinese Journal of Tissue Engineering Research 2017;21(26):4137-4142
BACKGROUND: Trabecular metal has been reported to provide enough physiologic support for new bone formation, to induce bone ingrowth and osseointegration so as to achieve the biological synosteosis; therefore, it is available for improving the initial and second stability of the dental implant.OBJECTIVE: To explore the stress distributional differences between porous tantalum trabecular metal (PTTM) dental implant and conventional titanium (TI) dental implant in the zone of mandibular premolar using three-dimensional finite element analysis.METHODS: Three-dimensional finite element models emulating PTTM and TI dental implants were established using Mimics16.0 and CATIA in the zone of mandibular premolar with three types of bone (II, III, IV). Then 100 N force was applied on the abutment at a 45° angle to the vertical axis of the implants in software of MSC Patran2010 and Nastran2010, then the representative von Mises stress nodes were calculated and sampled randomly, and finally the von Mises stress distributional differences between two types of implants were analyzed using SPSS 20.0 statistical software.RESULTS AND CONCLUSION: (1) The Von Mises stresses around the two types of implants both focused on the interface of the cortical bone-abutment-implant region, and the stress was relatively less for the corresponding trabecular bone. (2) If the bone quality was similar, the average von Mises stress of PTTM was higher than that of TI dental implants, but there was no significant difference (P > 0.05). As the bone density lowered (II-IV), the average Von Mises stresses were both increased, and the increasing rate of PTTM was higher than that of TI in bone of II-III, and was lower than that of TI in bone of III-IV. In this experiment, there were no significant stress distributional differences between PTTM and TI dental implant. However, with the bone density reduction, the increasing rate of average Von Mises stress for PTTM was lowered than that for TI dental implants in bone of III-IV, which suggests that PTTM dental implant may be more beneficial for the primary and secondary stability in osteoporosis patients undergoing dental implantation.
6.Study on reconstruction of afferent pathway after repairing transected dorsal root
Xiaojun TANG ; Guitao LI ; Wangyang XU ; Yong QI ; Dixin LUO ; Xunjie JIN
Chinese Journal of Orthopaedics 2011;31(2):175-183
Objective To provide the morphological evidence for sensory pathway by the repair of dorsal root (DR) in which received transected and anastomosed with central processes (DR) and peripheral processes (spinal nerve) respectively. Methods 74 SD rats were divided into three groups randomly. Group A: the distal ending of L6 DR was sutured to the proximal ending of the L4 DR in right side. Group B: the postganglionic spinal nerve of L4 was cut at a point 2 mm to intervertebral foramen and its proximal stump was reconnected to the distal ending of L6 DR in right side. Group C: under the same operative manipulation on group B, but no anastomosis was performed to serve as the sham operation group. The left side was kept intact and served as a normal control in all groups. The repairing results of DR axonal regeneration were evaluated at 3 months after operation by retrograde tracing, the density of positive Calcitonin gene-related peptide (CGRP) axon in dorsal root entry zone (DREZ), survival rate of neurons in DR ganglia and posterior horn, light and transmission electron microscope. Results HRP retrograde tracing demonstrated axonal axoplasmic transport of regenerative nerve recovered well in group B. Regenerative fibers were found. There was no difference between group A or B and normal control with regard to the number of myelinated axons and the thickness of myelin. Regenerating axon stop at the DREZ in group A and the density of positive CGRP were lower than those in group B and normal control. Survival rate of neurons in L6 DR ganglia had no difference among all groups. However, in posterior horn, a significant increase in death was seen in group A and sham group. Conclusion The ability of axonal regeneration was effective and with no disservice to neurons in posterior horn following anastomosis of postganglionic spinal nerve and dorsal root, by which axoplasmic transport across the DREZ into the spinal cord.
7.Selective partial neurotomy of muscular branch of triceps in the treatment Of Spastic talipes equines
Yong QI ; Guitao LI ; Wangyang XU ; Guangqin WU ; Dixin WO ; Xunjie JIN ; Zoohong CHEN ; Xiran CHEN
International Journal of Surgery 2010;37(7):466-468
Objective To summarize and explore the clinical value of selective partial neurotomy of muscular branch of triceps in the treatment of spastic talipes equines.Methods Forty-two cases were included in our study from Aug.2000 to Des.2007,all these cases accepted the operation of selective partial neurotomy muscular branch of triceps.In this study,29 cases were male,13 cases were female.Muscle force of legs,muscular tension,pathologic reflex,gesture and function of legs after operation were compared with that of before operation.Results The mean fallow-up was 18 months.During the fallow-up of this study,muscular tension degraded,the function of ankle joints and the gesture of extremitas inferior were improved obviously.The effective power was about 90% after 12 months follow-up.Conclusions Selective partial neurotomy of muscular branch of triceps is a effective method for the treatment of spastic talipes equines.The operation procedure is simple and effective,and could be generalized in the primary level hospital.
8.Total knee arthroplasty for terminal knee disease:short-term follow-up
Bin LU ; Jinhua WANG ; Jian ZHANG ; Suwan LI ; Wangyang HU ; Xiaoqiang CHEN
Chinese Journal of Tissue Engineering Research 2015;(26):4132-4138
BACKGROUND:In recent decades, total knee arthroplasty is widely used in the treatment of terminal knee joint diseases, such as osteoarthritis, rheumatoid arthritis, traumatic arthritis and other bone diseases. The methods of osteotomy, soft tissue balance and prosthesis rotation positioning have always been debated and discussed in total knee arthroplasty. OBJECTIVE:To explore the repair effect of total knee arthroplasty for terminal knee disease. METHODS:Total knee arthroplasty was performed for treating terminal knee disease in 31 cases (31 knees), including 26 cases of osteoarthritis (26 knees) and 5 cases of rheumatoid arthritis (5 knees). Al cases accompanied flexion contracture deformity to different degrees. The maximum angle of flexion deformity was < 25°. Al patients were scored by hospital for special surgery knee score before and after replacement. Al 31 knees were treated with fixed platform posterior-stabilized prostheses. RESULTS AND CONCLUSION:No complications, such as early infection and prosthesis dislocation, were found after surgery. Joint pain apparently lessened, flexion and varus deformity obviously improved after replacement. Postoperative X-ray films showed good prosthesis position and low limb alignment. Al cases were folowed up for 6-12 months. The hospital for special surgery knee score improved significantly from preoperatively 46.4±5.3 to postoperatively 84.6±10.5 after 6 months of folow-up. Excelent and good rate was 84%. Results indicate that total knee arthroplasty for treating terminal knee disease has a good clinical effect. However, the operation is complex and precise technique is required.
9.Long segment pedicle screw fixation for the thoracolumbar fracture and dislocation
Yong QI ; Hongtao SUN ; Wangyang XU ; Xiaozhong ZHOU ; Dixin LUO ; Chao LI ; Weijian CHEN ; Xunjie JIN
International Journal of Surgery 2011;38(8):543-545,封3
Objective To discuss the value of the posterior long segments pedicle screws fixation in surgical treatment of thoracolumbar fracture-dislocation,and summarize the experience.Method s We reviewed the clinical information of 27 cases of thoracolumbar fracture-dislocation since July 2007 to March 2010; all the cases were treated with the posterior long segments pedicle screws fixation.In these cases,20were male,7 were female.And the age ranged from 18 to 58 years old (average age was 35 years).The posterior approach was used,and the pedicle screws were inserted into the 2 vertebrae above and below the fractured vertebrae.Posterior decompression and bone grafts for fusion were also accomplished during the operation.Results Follow-up ranged from 7 to 25 months,averaging 14 months.Completely restoration of the dislocation was got in 25 cases and the spine sequence resumed to nearly normal.One case with lateral dislocation failed to complete correction; another 1 case operated 20 days after surgery failed to complete correction of forward dislocation.At the last follow-up,the mean Cobb angle loss was 3 degrees,the height of the vertebral had obvious loss compared with that of post-operation.The loosen of screw nut was found during the follow-up,but no dislocation and secondary deformity were observed after fixation.There was no death,no infection.Conclusions The technique of posterior long segments pedicle screw fixation is of great value in the clinical applications,since it has the following advantages:the operation is simple,trauma is small,the fixation is firm,good restoration of fracture and dislocations can be easily got,and most importantly,it can effectively prevent long-term vertebral height loss and the backward protruding deformity.
10.Clinical efficacy of hemivertebra resection for treating congenital kyphoscoliosis
Dixin LUO ; Hongtao SUN ; Xunjie JIN ; Weijian CHEN ; Yong QI ; Wangyang XU ; Chao LI ; Zhousheng LIN ; Xiaozhong ZHOU
Chongqing Medicine 2014;(36):4920-4921
Objective To explore the clinical efficacy and application value of hemivertebra resection for treating congenital ky‐phoscoliosis .Methods 30 cases of congenital kyphoscoliosis and hemivertebral deformity in our hospital from January 2011 to Jan‐uary 2013 were selected as the research subjects .Among them ,12 cases of simple vertebral and non‐structural bending were per‐formed the posterior hemivertebral resection and short segment pedicle screw fixation ;3 cases of complicating lordosis and hemiver‐tebral protruding to the ventral side were performed the anterior hemivertebral resection and bone graft fusion fixation ;15 cases of complicating structural compensatory curve were performed the posterior transpedicle hemivertebral resection and compensatory bend long segment fixation and fusion .The clinical effects of surgical treatment for all patients were performed the comparative a‐nalysis .Results The mean postoperative kyphosis Cobb angle and the average final follow‐up Cobb angle were (8 .6 ± 3 .14) °and (11 .2 ± 7 .23) °respectively .The ultimate orthopedic rate of kyphosis was 58 .6% ;the average postoperative Cobb angle and and the average final follow‐up Cobb angle of scoliosis were (12 .8 ± 5 .47)°and (16 .2 ± 6 .24)°respectively ,the final orthopedic rate of scoliosis was 66 .5% .The mean Cobb angle of kyphosis and scoliosis after operation was significantly less than that before opera‐tion ,the difference was statistically significant(P< 0 .05) .Kyphosis and scoliosis were significantly improved .No significant post‐operative complications occurred .The effects were satisfied by the patients .Conclusion The hemivertebral resection has significant effect for treating congenital kyphoscoliosis with high kyphoscoliosis orthopedic rate and is worthy of further clinical study .