1.Vertebral and inter-vertebral screw fixation for treating thoracolumbar compression fracture:a long-term follow-up of spinal stability
Chinese Journal of Tissue Engineering Research 2016;20(4):522-528
BACKGROUND: Posterior pedicle screw fixation is a common method for treatment of thoracolumbar compression fractures. The fixation method contains long-segment fixation, short-segment fixation and vertebral fixation. Clinical effects of vertebral fixation and inter-vertebral short-segment fixation for treating thoracolumbar fractures remain unclear. OBJECTIVE: To compare the stability of posterior vertebral fixation and inter-vertebral pedicle screw fixation for treating thoracolumbar compression fractures. METHODS: Clinical data of 46 patients with thoracolumbar compression fractures were retrospectively analyzed. According to the fixation methods, they were divided into the vertebral fixation group (n=21) and inter-vertebral fixation group (n=25). The operation time, intraoperative bleeding, intraoperative blood transfusion, the time of lying in bed, vertebral Cobb angle, anterior vertebral height and visual analog scores were evaluated for a long time. RESULTS AND CONCLUSION: (1) During repair, in both groups, operation time, intraoperative bleeding and intraoperative blood transfusion were better in the inter-vertebral fixation group than in the vertebral fixation group (P < 0.05-0.01). The time of lying in bed was better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.01). (2) No significant difference in Cobb angle and anterior vertebral height was detected before and after treatment and during repair in both groups, but final fol ow-up and fol ow-up loss were better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.05-0.01). (3) No significant difference in visual analog scores was detected before and after treatment in both groups. Visual analog scores were better in the vertebral fixation group than in the inter-vertebral fixation group (P <0.01). (4) These results suggested that the two fixation methods obtained satisfactory repair effects in long-term fol ow-up. The dominance in maintaining the height and curvature of the spine was more obvious in the vertebral fixation group than in the inter-vertebral fixation group. The vertebral fixation can be more effective to reconstruct the spinal physiological sequence and restore its stability. After repair, low back pain can also be effectively control ed.
2.Surgical Treatment of Female Stress Urinary Incontinence by Tension-free Vaginal Tap
Qian LIN ; Shaobo JIANG ; Xiande WU ; Junming XIE
Journal of Medical Research 2006;0(12):-
Objective To describe the clinical curative effects of surgical treatment of female stress urinary incontinence by tension-free vaginal tap.Methods Surgical treatment of 17 women suffering from stress urinary incontinence whose average course are11years by tension-free vaginal tap.Then,observe the complications and how symptome improved after operation.In this 17 cases,one had a failure experience of bladder neck ventrofixation,another had an operation of pelvic cavity in the past.Results All operations were successed,the mean operative time was about 30 minutes,the mean amount of bleeding was 40ml.No case had the complication of bladder perforated and dysuria after operation.The urinary incontinence symptomes were disappered within 5 days after operation.During a follow up of 3~12 months,no SUI recurred.Conclusions Our result demonstrates that TVT has the virtues of small trauma、simplely manipulate and less complications.Patients recover well and have a high rate of curing.It can also be use in such patients who had operations of pelvic cavity and failure operation for SUI in the past.
3.Evaluation of ultrasound on peripheral atheral atherosderosis after treatment by folicacid in combination with mecobalamin in uremia patient
Xianghong CHEN ; Shaobo DING ; Yuhuan XIE ; Ziai LIU ; Hao WANG
Chinese Journal of Primary Medicine and Pharmacy 2008;15(8):1278-1279,插1
Objective To evaluate the clinical significance of peripheral atheral atherosclerosis after treatment by folicacid in combination with mecobalarain in uremia patient using vascular ultrasound.Methods 99 cases of uremia patients with carotid atherosclerosis were treated with folie acid tablets and mecobalamin tablets for six months.The carotid intimia-media thiclmess(IMT),total plaque area,numbers and ultrasound types of carotid atherosclerotic before and after treatment were observed.Results After six months,carotid IMT became tinner significantly,and the totsl plaque area decreased(P<0.05).The ultrasound types of carotid atherosclerotic plagues have changed after six montha.and the plaque numbers decreased significantly(P<0.05).Conclusion Threatment by folie acid combination with mecobalamin in uremia patients maybe helpful to the progression of carotid athereaclerotie disease.
4.The clinical analysis of 142 cases of minimally invasive transthoracic device closure of ventricular septal defect
Guoliang LU ; Lunchao MA ; Chao YANG ; Yingyuan ZHANG ; Shaobo XIE
The Journal of Practical Medicine 2015;(8):1294-1295
Objective To summarize the minimally invasive transthoracic ventricular septal defect (VSD) occlusion operation experience in the clinical application. Methods 142 VSD patients (admitted from August, 2013 to October, 2014) were chosen. All patients were treated with minimally invasive transthoracic device closure under the monitoring of transoesophageal echocardiogram. Results 136 cases received successful closure, and 6 cases still need CPB conventional extracorporeal circulation operation. After follow-up for 3 ~ 12 months for 102 patients, 16 cases remain residual shunt. Conclusion The short-term therapeutic effect of minimally invasive transthoracic device closure of VSD is satisfying. However , the long-term follow-up remains to be studied.
5.Effects of Gubi Decoction on serum related inflammatory factors and PI3K/Akt/mTOR signaling pathway in osteoarthritis model rats
Liqing ZHONG ; Shaobo DING ; Runkai HU ; Weichao HAN ; Shufen HE ; Baocheng XIE
International Journal of Traditional Chinese Medicine 2021;43(4):357-362
Objective:To explore the effect of Gubi Decoction on serum related inflammatory factors and PI3K/Akt/mTOR signaling pathway in osteoarthritis model rats. Methods:Seventy SPF rats were randomly divided into the blank group, sham operation group, Glucosamine sulfate group, and the low, medium and high dose Gubi Decoction groups. Except the blank group and sham operation group, knee osteoarthritis animal models were prepared by the modified Hulth method in each group. On the 28th day after successful model preparation, the high, medium and low dose Gubi Decoction groups were given Gubi Decoction 24, 12 and 6 g/kg by gavage respectively; glucosamine sulfate group was given glucosamine sulfate tablet suspension 3 g/L by gavage, once a day for 28 days. The levels of TNF-α and IL-1β in serum were detected by ELISA. The gene expressions of PI3K, Akt and mTOR in cartilage tissue were detected by Real-PCR. The protein expressions of PI3K, Akt, p-PI3K, p-Akt and mTOR were detected by Western blot. Results:Compared with the model group, the knee joint diameter[(11.17 ± 1.81) mm, (11.60 ± 1.38) mm, (10.80 ± 1.17) mm vs. (12.57 ± 0.98) mm] of the rats in the glucosamine sulfate group and the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05). The content of TNF-α [(111.43 ± 21.98) ng/L, (53.42 ± 13.25) ng/L vs. (157.89 ± 23.60) ng/L], IL-1β [(67.50 ± 18.44) ng/L, (48.22 ± 9.63) ng/L vs. (96.11 ± 14.85) ng/L] in the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05), and the expression of PI3K (1.87 ± 0.17, 1.24 ± 0.49 vs. 2.19 ± 0.47), Akt (1.50 ± 0.51, 1.10 ± 0.32 vs. 2.68 ± 0.63), and mTOR (1.32 ± 0.54, 1.10 ± 0.33 vs. 2.94 ± 0.55) mRNA in the medium and high dose Gubi Decoction groups significantly decreased ( P<0.05). The expression of PI3K, Akt, p-PI3K, p-Akt in the low, medium and high dose Gubi Decoction groups significantly decreased ( P<0.05), and the expression of mTOR in the medium dose Gubi Decoction group significantly decreased ( P<0.05). Conclusion:Gubi Decoction can significantly reduce the level of inflammatory factors in the serum of osteoarthritis model rats, and its anti-inflammatory and analgesic effects may be related to PI3K/Akt/mTOR signaling pathway.
6.Implantation of 125I seeds under CT direction combined with percutaneous vertebroplasty in the treatment of vertebral metastatic tumors
Shaobo HU ; Haojun YANG ; Xiaoxi XIE
China Modern Doctor 2015;(19):109-112,116
Objective To study the clinical efficacy and prognosis of implantation of 125I seeds under CT direction com-bined with percutaneous vertebroplasty (PVP)in the treatment of vertebral metastatic tumors. Methods All 48 patients with vertebral metastatic tumors who were treated in our hospital from January 2012 to December 2013 were selected. They were assigned to observation group and control group according to random number table,with 24 patients in each group. Patients in the control group were given conventional surgical incision, and patients in the observation group were given the treatment of 125I seeds under CT direction combined with PVP. General data such as age, gender, pri-mary type, and pain degree in both groups were collected, efficacy and complications after the treatment in both groups were statistically collected, and statistical analysis was carried out for the collected data. Results Effective rate of treatment was 79.2% in the observation group, and effective rate of treatment was 50.0% in the control group. The difference of both groups was statistically significant(P<0.05). Incidence of postoperative complications was 16.7%in the observation group, significantly lower than 79.1% in the control group. The difference of both groups was statistically significant (P<0.05). A total of 34 centrums in 24 patients in the observation group all successfully completed the treatment of 125I seeds combined with PVP,and the successful rate of surgery was 100%. 1,2 and 3 seed needles were used to be implanted into 12,14 and 8 centrums respectively. Sleeping quality of patients in the observation group was generally better than that in the control group, and their depression degree was also lower. The comparison between both groups was significant (P<0.01); NIHSS scores of 24 hours and 14 days after the treatment were measured,and the scores between both groups were compared. Results showed that the scores in the observation group were lower(P<0.05). Conclusion Implantation of 125I seeds under CT direction combined with percutaneous vertebroplasty in the treatment of vertebral metastatic tumors has a favorable efficacy, and is able to effectively alleviate patients' pain; the treatment has a low incidence of complications and is able to control the development of tumors, which is worthy of clinical promotion.
7.Application of muscular flap and induced membrane technique in the emergency treatment for limb salvage for Gustilo type Ⅲ B and Ⅲ C open fracture of lower leg
Li YU ; Yong ZHAO ; Zhe XIE ; Bing WANG ; Ling-Long DENG ; Chi WEI ; Kai DENG ; Guorong YU ; Shaobo ZHU
Chinese Journal of Microsurgery 2018;41(6):538-543
Objective To investigate the clinical effectivity of the muscular flap transposition and induced membrane technique in the emergency treatment for the limb salvage of Gustilo type Ⅲ B/C open fracture of lower leg. Methods From July, 2015 to December, 2017, 10 cases of Gustilo type Ⅲ B/C fracture of lower leg with bone defects were performed limb salvage surgery. Induced membrane technique was used to fill the bone defects in the emergency room.The gastrocnemius and/or soleus muscular flaps were transposed to cover the bone cement or ex-posed bone simultaneously in emergence treatment. After the wound healed completely, traditional bone grafting was used to repair the bone defects. There were 4 cases of Gustilo type Ⅲ B and 6 cases of Gustilo type Ⅲ C. The aver-age length of bone defect was (5.25±1.70) cm ranging from 3.0 cm to 11.0 cm. The gastrocnemius medial head flaps were performed in 5 cases, the combined application with the gastrocnemius medial head flaps and the medial hemimuscular flaps of soleus were performed in 2 cases, and medial hemimuscular flaps of soleus were transposed in 3 cases. Results The wounds in 6 cases were healed at one stage, but 2 cases healed by dressing because the exudate after skin grafting.In 1 case, the cross-leg flap was used to cover the exposed bone cement due to the necro-sis of soleus flap. The other 1 was performed the transposition of the lateral gastrocnemius flaps because the exposure of bone cement after the necrosis of the upper and lateral muscles in lower leg. In the second-stage, the bone defects were reconstructed by traditional bone grafting. The average healed time of bone was 7.2 months ranging from 5 months to 9 months. At the last followed-up time, all patients recovered their function of weight-bearing. The Paley's score of the adjacent joints: excellent in 8 cases and good in 2 cases. Conclusion The combination with induced membrane technique and local muscular flap transposition in emergency surgery is an effective method to limb salvage for the Gustilo type Ⅲ B/C open fracture of lower leg.
8.Application of three-stage Masquelet technique for infective bone defects of foot and ankle
Li YU ; Bing WANG ; Zhe XIE ; Linglong DENG ; Chi WEI ; Kai DENG ; GuoRong YU ; Shaobo ZHU
Chinese Journal of Trauma 2018;34(11):1007-1013
Objective To investigate the clinical efficacy of three-stage Masquelet technique in the treatment of infective bone defects of foot and ankle.Methods A retrospective case series study was conducted on the clinical data of 19 patients with infective bone defects of foot and ankle admitted to Zhongnan Hospital of Wuhan University from December 2014 to October 2017.There were 15 males and four females,aged 18-68 years [(39.6 ± 12.3)years].Among the patients,16 patients were infected with bacteria and three patients were infected with Mycobacterium tuberculosis.The infection involved humeral end,talus and surrounding joints in 14 patients,internal hemorrhoids in two patients,midfoot and interphalangeal joints in one patient,and humerus and metatarsophalangeal joints in two.The operation included three stages:the first stage was thorough debridement,supplemented with negative pressure closed drainage (VSD) and continuous washing to clarify the pathogenic bacteria;the second stage was to fill the bone defect with targeted antibiotic bone cement to prevent or treat infection;in the third stage,after filling the antibiotic bone cement for 3 months with no sign of local wound infection,the bone cement was taken out,and the bone reconstruction operation was performed by means of internal fixation and bone grafting.The flap survival and wound healing were observed,and the time of fracture healing was recorded.The American Orthopaedic Foot and Ankle Society (AOFAS) score and the Visual Analogue Score (VAS) were used to evaluate the improvement of the function of the foot and ankle before operation and at the last follow-up,and the bone healing was evaluated according to the radiographic union scale in tibial (RUST) fractures.Results The patients were followed up for 9-12 months [(11.1 ±1.0) months].Two patients with soft tissue defects caused by preoperative infection and necrosis received posterior tibial artery perforator flap and anterolateral thigh flap repair in the second stage,and the flaps all survived.The postoperative bone healing time was 3 7 months [(3.5 ± 1.4)months].Nineteen patients underwent three-stage surgery,and the ankle and foot wound or sinus tract were all healed,with no infection recurrence during follow-up.At the last follow-up,the AOFAS score was improved significantly from preoperative (36.3 s-12.1) points to (71.4 ± 5.7) points (P < 0.05).The VAS was decreased significantly from preoperative (5.3 ± 1.2) points to (1.4 ± 0.9) points (P < 0.05).The RUST bone healing score at the last follow-up was 8-12 points [(10.2 ± 1.1) points].Conclusion In treating the infective bone defects of foot and ankle,the three-stage Masquelet technique can effectively control infection,facilitate wound healing,promote bone union,and improve foot and ankle function.
9.Application of scenario simulation teaching in cardiopulmonary resuscitation training for junior surgical residents
Suhua KUANG ; Shaobo XIE ; Lifang WENG ; Xiaoshan REN ; Rong LIU ; Qing LIANG
Chinese Journal of Medical Education Research 2019;18(6):636-640
Objective To explore the effect of scenario simulation teaching method in the training of cardiopulmonary resuscitation (CPR) for junior surgical residents. Methods 133 junior residents (working life<3 years) in the author's hospital rotating Cardiac Surgery department were selected and divided into control group (n=65) and observation group (n=68), in which the control group adopted traditional classroom teaching: teacher explanation-demonstration-student practice-teacher counseling; the observation group adopted scenario simulation teaching: teacher explanation-demonstration-student practice-teacher counseling scenario simulation. Before and after training, two groups both received the CPR theory and double operation assessment , comparing the difference of assessment scores between groups before and after training . Results There was no statistically significant difference in the demographic characteristics between the two groups. The assessment scores of CPR theory and operation were improved in both groups after training, and there were significant differences (P=0.000). There were no statistically significant differences in the CPR theory and operation assessment scores between the two groups before training (P>0.05);compared with the scores of CPR operation between the two groups after training, the observation group [(84.62±3.94)] was significantly higher than that of the control group [(79.68±5.45)] and there were significant statistical differences (P=0.000), while there was no statistically significant difference in CPR theory assessment scores between the two groups (P>0.05). Conclusions Both traditional classroom teaching and scenario simulation teaching methods could improve the CPR theory and skill level of the surgical junior resident, but situa tional simulation teaching method is better than traditional classroom teaching method in improving students' CPR performance.
10.One-stage repair of ankle fracture combined with grade Ⅲ injury to lateral ligament
Li YU ; Bing WANG ; Zhe XIE ; Linglong DENG ; Chong ZHANG ; Chi WEI ; Kai DENG ; Guorong YU ; Shaobo ZHU
Chinese Journal of Orthopaedic Trauma 2019;21(7):581-585
Objective To investigate the surgical outcomes of one-stage repair of the ankle fracture combined with grade Ⅲ injury to the lateral ligament.Methods From April 2015 to December 2017,23 patients with ankle fracture and lateral ligament injury were treated at Department of Traumatic Reconstruction Surgery/Foot and Ankle Surgery,Zhongnan Hospital.There were 15 males and 8 females,aged from 18 to 65 years (average,37.8 years).After intraoperative treatment of their fractures,22 ruptures of the ligamentous insertion were repaired with suture anchor and one rupture of the middle ligament with Internal Brace.Routine postoperative X-rays,physical examination and Sefton grading system were used to evaluate the stability of the ankle joint and the subtalar joint.The Karlsson-Peterson and American Orthopedic Foot and Ankle Society (AOFAS) scores were used to evaluate the function and pain of the ankle.Results The follow-up for this cohort ranged from 12 to 24 months (average,13.9 months).The bone union time ranged from 6 to 24 weeks,averaging 10.1 weeks.There was no chronic instability of lateral ankle or subtalar joint in all the cases.Two cases developed osteochondral lesion of the medial talus which was treated with micro-fracture surgery one year after injury;one case suffered subtalar arthritis which was treated by subtalar arthrodesis 14 months after injury.Their Karlsson-Peterson scores averaged 84.6 points and AOFAS ankle-hindfoot scores 93.7 points with 19 excellent and 4 good cases.The Sefton grading system gave 9 cases of grade Ⅰ and 14 ones of grade Ⅱ.Conclusion One-stage repair of the ankle fracture combined with grade Ⅲ injury to the lateral ligament can lead to the stability of the ankle joint and the subtalar joint and improved function of the ankle.