1.Femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint trasplantation
Clinical Medicine of China 2013;(4):343-344
Objective To study far femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint transplantation and the use of GSH nail Methods Eleven cases with far femoral malignant bone tumor were administered tumor resection,transplanted with allogeneic heterotoeic bone half-joint,and fixed with GSH nail Results Nine out of the 11 cases were followed up.None of them had infection,rejection or heterotopic bone fracture.All of them can move with walking after 6 months.The effects of surgery was rated as excellent for 3 cases,fine for 4 cases andbad for 2 cases according to Mankin's rating criteria.Conclusion Salvage limb treatment for bone tumor can improve patients' quality of life.Allogeneic heterotopic bone,with rich source and acceptable joint surface,is a good graft for the treatment of bone defect after bone tumor resection.
2.The role of magnetic resonance imaging in predicting the efficacy of depression
Peng ZHAO ; Jiabo SHI ; Zhijian YAO
Chinese Journal of Behavioral Medicine and Brain Science 2017;26(7):661-665
Depression is a common mental disorder with high incidence rate and low remission rate.The prediction of therapeutic effect in depression is limited to clinical features and neuroimaging.Reviewed the Results of magnetic resonance imaging for predicting the treatment response in depression and explored the Objective image markers for predicting the therapeutic effect in depression.It showed that the studies mainly focused on emotion regulation neural circuitry and few on reward neural circuitry.Prefrontal cortex,cingulate cortex,amygdala and hippocampus play important roles on predicting therapeutic effect.The study of magnetic resonance imaging for predicting therapeutic effect in depression is a feasible research field.More researches of finding the role of reward neural circuits in predicting the effect of antidepressants are needed.The brain structure and function of the neural circuits involved in depression and predicting the effect of anti-depression need to be studied by multimodal MRI method.
3.Clinical effect of open reduction and internal fixation with bone graft on tibial pilon fracture
Zhijian ZHAO ; Kunfeng CHEN ; Tianfeng BAI
Clinical Medicine of China 2014;30(2):206-207
Objective To evaluate the clinical application of open reduction and internal fixation and bone grafting on treatment of pilon fractures of tibia.Methods Forty cases with Pilon fractures of Ⅱ,Ⅲ tibia who underwent open reduction and intemalfixation and bone grafting treatment were selected as our subjects.Those 40 cases were performed follow-up for 8.0-60.0 months,and average was 31.5 months.The ankle joint symptoms and functional Mazur scoring system were used to evaluate the function of ankle joint.Results Of the 40 patients,15 cases were with excellent ankle function,and 19 cases were good,4 cases were poor and 2 cases were worse.The excellent and good rate was 85% (34/40).Conclusion Open reduction and internal fixation and bone grafting is proved as the effective treatment on Ⅱ,Ⅲ tibia pilon fractures.
4.Management of urinary tract obstruction in patients with kidney transplantation
Wen ZHONG ; He LAI ; Zhijian ZHAO ; Wenzhong CHEN ; Guohua ZENG
China Journal of Endoscopy 2016;22(9):43-46
Objective To investigate the treatment of urinary tract obstruction after kidney transplantation, and to introduce the novel ‘antegrade percutaneous urinary tract throughout guidance technique’ with guide wire in selected patients. Methods 43 cases of renal transplantation patients due to urinary tract obstruction (ureteral stenosis and hydronephrosis in 24 cases, urinary calculi with or not ureteral stenosis in 19 cases) received endourological treatment. Retrograde pathway was tried firstly, if failed, antegrade pathway was adopted with‘antegrade percutaneous urinary tract throughout guidance technique’, 18 Fr percutaneous tract was established if necessary, endoscopy was needed in antegrade or combine with retrograde pathway. Results Of the 43 patients, 9 (20.9 %) patients were managed directly through the retrograde ureteroscopy, 28 (65.1 %) patients were managed with anterograde percutaneous technique in 18 Fr tract, 6 (14.0 %) patients were treated with ‘antegrade percutaneous urinary tract throughout guidance technique’. Operation time was (72.0 ± 16.0) (45 ~ 95) minutes. Postoperative stone clearance rate of 89.5 % (17/19). Of 32 cases with ureteral stricture, 6 (6/32, 18.8 %) cases were cured after one time of dilation and JJ stent indwelling for 2 months, 18 (56.3%) cases with stable hydronephrosis after 2-3 times of dilation and JJ stent indwelling, 5 cases (15.6 %) needed long-term repeated stent indwelling for drainage, 3 (9.4%) cases required nephrostomy tube drainage. Conclusion Minimally invasive treatment of urinary tract obstruction after renal transplantation is effective. Antegrade percutaneous urinary tract throughout guidance technique provided a powerful guarantee for retrograde operation and avoided the bleeding risk following percutaneous renal surgery, when combined with flexible ureteroscopy, urinary calculi in patients with kidney transplantation can be effectively managed with little trauma.
5.Effect of low-concentration ozone on calcium channels in fetal rat spinal cord neurons in vitro
Xiaowen LIN ; Zhijian FU ; Xuli ZHAO ; Juntian XIE
Chinese Journal of Anesthesiology 2010;30(10):1189-1191
Objective To investigete the effect of low-concentration ozone (O3) on voltage-gated calcium channels in fetal rat spinal cord neurons in vitro. Methods The spinal cord neurons were cultured in vitro and identified by immunohistochemistry staining. Then the cells were seeded into the culture dish and randomly divided into 3 groups: control group (group C, n = 5), O3 15 μg/ml (group O3-15, n = 4) and O3 20 μg/ml group (group O3-20, n = 8). The cells were exposed to O3 15 and 20 μg/ml in group O3-15 and O3-20 respectively, while the cells were exposed to air in group C. After 20 min incubation, the electrophysiological activity of calcium channels in neurons was recorded using whole-cell patch-clamp technique. Results Peak calcium current density was significantly increased in group O3-15 and O3-20 compared with group C ( P < 0.05). Half-activation voltage was significantly lower in group O3-15 and O3-20 than in group C ( P < 0.05). Peak calcium current density was significantly higher in group O3 -20 than in group O3-15 ( P < 0.05) . There was no significant difference in half-inactivation voltage among the three groups ( P > 0.05). Conclusion Low concentration of O3 can make the activation of the calcium ion channel easy in fetal rat spinal cord neurons in vitro.
6.Clinical significance of lymph node micrometastasis of colorectal cancer detected by immunohistochemistry
Mingrong CHENG ; Zhijian CHENG ; Yuankun CAI ; Jiaying ZHAO ; Hongzhi XU
Fudan University Journal of Medical Sciences 2010;37(1):29-33
Objective To evaluate the prognostic impact of a wide spectrum of pathologic parameters in a consecutive series of homogenously treated and well-characterized patients with stage Ⅰ and Ⅱ colorectal cancer, and to investigate the prognostic value of lymph node occult disease (micrometastasis) in disease-free survival rate detected by immunohistochemistry with epithelial membrane antigen and carcinoembryonic antigen. Methods The study included 126 patients operated on by a single surgeon for stage Ⅰ and Ⅱ colorectal tumors. The postoperative follow-up was performed for 64 to 106 months. At least 10 lymph nodes were harvested and examined in all the specimens. The prognostic value of 10 pathologic parameters, including lymph node occult disease (micrometastasis) detected by immunohistochemistry was investigated. Results Multivariate analysis identified lymphatic vessel invasion (absent or present;P=0.009) in lymph node positive and negative by immunohistochemistry. The five-year disease-free survival rates were 78.7%, 65.5% and 43.8% for the lymph node negative, isolated tumor cells and micrometastasis groups, respectively. There was significant difference between the lymph node negative and micrometastasis groups (P=0.005). However, the difference between the lymph node negative and isolated tumor cells groups was not statistically significant (P=0.144). Conclusions We propose that for patients found micrometastasis in lymph node with high-risk stage Ⅰ and Ⅱ colorectal cancer, adjuvant therapies are justified and effective.
7.Clinical efficacy of Sky Bone Expander System in the treatment of osteoporotic vertebral body compression fractures in the elderly
Zhijian ZHAO ; Kunfeng CHEN ; Wei MEI ; Chunli WANG
Clinical Medicine of China 2012;28(11):1208-1209
Objective To investigate the therapeutic effect of Sky Bone Expander System in the treatment of osteoporotic vertebral body compression fractures in the elderly.MethodsTwenty-five cases (26 vertabrals)with osteoporotic vertebral body compression fractures were treated by Sky Bone Expander System.ResultsAll the 25 cases completed the surgery successfully,with an average operation duration of 35 min (range:30 -60 min).We injected 2.7 -4.5 ml bone cement to each vertebrae with an average of 3.5 ml.No blood vessels and nerves damage or other complications were found.The height of vertebral was restored.ConclusionSky Bone Expander System could effectively treat osteoporotic vertebral body compression fractures in the elderly.The height of vertebral could rebound and kyphosis could be improved.Furthermore,Sky Bone Expander System could relieve pain and reduce the leakage of bone cement
8.Comparison of MPCNL and ESWL for monotherapy of renal calculi in infants
Zhijian ZHAO ; Guohua ZENG ; Jianye JIA ; Wenqi WU ; Wen ZHONG
Chinese Journal of Urology 2013;(1):20-23
Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0% (21/25) after first session and 96.0% (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0%) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8% (7/22) after first session and 86.3% (19/22) after second session for 11 infants (50.0%).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5%)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P < 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).
9.Treatment of complex renal stones in solitary kidneys under percutaneous nephrolithotomy combined with retrograde intrarenal surgery
Guohua ZENG ; Zhijian ZHAO ; Wen ZHONG ; Wenzhong CHEN ; Wenqi WU
Chinese Journal of Urology 2013;(4):268-271
Objective To evaluate the efficacy and advantages of the technique by combined PCNL and retrograde intrarenal surgery (RIRS) in a second stage to treat the complex renal stones in solitary kidney cases.Methods PCNL most with a single 18-24 F tract was performed first and RIRS was carried out at a second stage in solitary kidneys of 21 patients,of which congenital in 14.3% (3 cases),contralateral nephrectomy in 42.8% (9 cases),and functional solitry kidneys in 42.8% (9 cases).Of the 21 patients,the average age was 45 years with 15 males and 6 females.The stones were 8 multiple,6 partial staghorn,and 7 complete staghorn with a mean size of 4.6 (3.8-6.8) cm.Results Of the 21 PCNL cases,a single tract,double,triple tracts were established in 18 (85.7%),2 (9.5%),1 (4.8%) cases,respectively.Mean operation time of PCNL was 95 (45-175) min.After 1 day of PCNL,all case had residual stones with a mean size of 1.9 (1.0-3.5) cm.Two case occurred fever after PCNL and one case presented bleeding resolved by selective renal artery embolization.The mean operation time of RIRS was 72 (35-95) min.Stone-free rate after RIRS was 85.7% (18/21).The final stone free rate increased to 95.2% (20/21) after one case received a second-look PCNL and two cases accepted ESWL.Two cases occurred fever and steinstrasses after RIRS resolved by rigid ureteroscopy.At the 3 months follow-up,renal function became stable,improved and worse in 71.4% (n=15),23.8% (n=5),and 4.8% (n=l) of patients.Conclusions PCNL combined with RIRS could be an effective and safe option for complex stones in solitary kidneys with less bleeding,reduced tracts,minor complications and good renal function preservation.
10.Clinical application of thoracoscopic surgery for esophageal neoplasms in lateral prone position
Yulong HOU ; Wei GUO ; Zhijian YANG ; Jianqiang ZHAO
Chinese Journal of General Practitioners 2013;12(10):837-838
Thirty-three patients with esophageal carcinoma (T3N1M0 or less) underwent thoracoscopic surgery in lateral prone position for esophagectomy from February 2010 to November 2012.Their postoperative outcomes and survivals were retrospectively analyzed.The results confirmed the feasibility and safety of this mini-invasive thoracoscopic procedure in lateral prone position for patients with esophageal carcinoma.A possible advantage of lateral prone technique is that in case of an emergency switch to open surgery,precious time may be saved in changing body position.