Objective To introduce the mini-open anterior correction under video assisted thoracosco- py for thoracic idiopathic scoliosis and report its clinical results.Methods From July 2001 to 2006,37 ca- ses of right thoracic idiopathic seoliosis were surgically corrected with mini-open anterior instrumentation. There were 4 males and 33 females with average age of 14.1 years and average Cobb angle of 56?.Fourteen cases with Lenke I A 14 cases,IB ++-++++ 14 cases,IC 9 cases.The Risser sign was ++-++++. The operative time,blood loss,instrumented levels,correction rate and loss of correction were analyzed. Results The operative time averaged 220 miu.The intraoperative blood loss averaged 320 ml.The average number of instrumented levels was 7.8.The postoperative Cobb angle was 16.8?on average with correction rate of 70%.With a follow-up of 18-36 months,the loss of correction averaged 4.6%,but no hardware complications.Conclusion The clinical results of mini-open anterior correction under thoracoscopy for tho- racic idiopathic scoliosis were satisfactory.It may minimize the complications of classical thoracotomic anterior correcion and mav reduce the high requirement for anesthesia,long operative time and high cost of thoraco- scopic anterior instrumentation.

OBJECTIVETo compare the early clinical results of thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis.

METHODSTwenty-three cases with idiopathic right thoracic scoliosis were divided into 2 groups. Group A includes 8 females with average age of 14.8 years and average Cobb angle of 54 degrees . The Risser sign was +++ approximately ++++. These patients were operated on with thoracoscopic Eclipse instrumentation. Group B covers 2 males and 13 females with average age of 13.8 years and average Cobb angle of 57 degrees . The Risser sign was ++ approximately ++++. These patients were operated on with mini-open thoracotomic anterior instrumentation. The operative time, blood loss, postoperative drainage, instrumented levels, curve correction and early loss of correction of both groups were analyzed.

RESULTSThe patients of group A had average operative time of (360 +/- 72) min, (629 +/- 145) ml of intra-operative blood loss, (7.4 +/- 1.1) of instrumented levels, (500 +/- 150) ml of post operative drainage, 74 +/- 14% of curve correction rate and (8.6 +/- 2.7)% of early loss of correction after 6 approximately 18 m follow-up. The patients of group B had average operative time of (246 +/- 64) min, (300 +/- 110) ml of intra-operative blood loss, (7.8 +/- 0.9) of instrumented levels, (210 +/- 90) ml of post operative drainage, (70 +/- 12)% of curve correction rate and (4.6 +/- 1.9)% of early loss of correction. The curve correction rates of thoracoscopic and mini-open thoracoscopic anterior correction were not significantly different (P >0.05). But the operative time, blood loss, postoperative drainage, and early loss of correction showed significant difference (P <0.05).

CONCLUSIONSThoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis have their own indications. Both techniques are safe and effective to correct the idiopathic thoracic scoliosis with satisfied early results. But the early loss of correction of mini-open thoracotomic anterior correction is significantly less than that of thoracoscopic anterior correction.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Scoliosis ; surgery ; Spinal Fusion ; methods ; Thoracic Vertebrae ; surgery ; Thoracoscopy ; Thoracotomy ; methods ; Treatment Outcome

OBJECTIVETo explore the clinical features and treatment results of brachial plexus palsy caused by halo traction before posterior correction in patients with severe scoliosis.

METHODSA total of 300 cases of severe scoliosis received halo traction before posterior correction in our department from July 1997 to November 2004. Among them, 7 cases were complicated with brachial plexus palsy. The average Cobb angle was 110 degree (range, 90 degree-135 degree). Diagnoses were made as idiopathic scoliosis in 1 case, congenital scoliosis in 3 cases, and neuromuscular scoliosis in 3 cases. Additionally, diastematomyelia and tethered cord syndrome were found in 3 cases and thoracolumbar kyphosis in 2 cases. Weight of traction was immediately reduced when the patient developed any abnormal neurological symptoms in the upper extremity, and rehabilitation training was undertaken. Simultaneously, neurotrophic pharmacotherapy was applied, and the neurological function restoration of the upper limbs and the recovery time were documented.

RESULTSTraction was used for an average of 3.5 weeks (range, 2-6 weeks) before spinal fusion for these 7 patients. The average traction weight was 8 kg, which was 19% on average (range, 13%-26%) of the average body weight (40.2 kg). These 7 patients had long and thin body configuration with a mean height of 175 cm. The duration between symptoms of brachial plexus paralysis and the diagnosis was 1-3 hours. All of these 7 patients presented various degrees of numbness in the ulnar side of the hand and forearm. Median nerve paresis was found in 3 cases and ulnar nerve paresis in 4 cases. Complete recovery of the neurological function had been achieved by the end of three months.

CONCLUSIONSThe clinical features of brachial plexus palsy caused by halo traction include median nerve paresis, ulnar nerve paralysis, and numbness in the ulnar side of the hand and forearm, which may be due to the injury of the inferior part of the brachial plexus, i.e., damage of C8 and T1 nerve roots. Complete recovery of neurological function can be expected when the patient is kept under careful observation for recognizing this complication as soon as possible, then immediately reducing or removing the traction weight, and adopting rehabilitation training and neurotrophic pharmaceutical treatment.

Adolescent ; Adult ; Brachial Plexus Neuropathies ; etiology ; therapy ; Child ; Female ; Humans ; Male ; Paralysis ; etiology ; therapy ; Prognosis ; Scoliosis ; therapy ; Traction ; adverse effects

OBJECTIVETo evaluate the efficacy and significance of posterolateral fusion in preventing failure of short-segment stabilization for the treatment of thoracolumbar burst fractures.

METHODSSixty patients with thoracolumbar burst fractures were included in the study. The patients were classified into two groups (n equal to 30 in each group). In Group A, patients were treated in our hospital with short-segment instrumentation via posterolateral fusion with iliac bone. In Group B, patients were treated in other hospital with short-segment fixation without fusion. All cases came to our hospital for reexamination. There were 18 males and 12 females in Group A with a mean age of 42.3 years (range, 24 to 52 years) and 16 males and 14 females in Group B with a mean age of 41.5 years (range, 19 to 54 years). Radiographic (Cobb angle, kyphosis of the vertebral body, and sagittal index) and clinical outcomes (Low Back Outcome Score ) were analyzed after an average follow-up of 16 months.

RESULTSAfter operation, Cobb angle was reduced from 19.3 degrees to 3.1 degrees in Group A and from 19.1 degrees to 3.3 degrees in Group B (P>0.05). It was 5.9 degrees in Group A and 11. 9 degrees in Group B at the final follow-up (P<0.01). Its average loss of correction was 2.8 degree in Group A and 8.6 degrees in Group B. Average kyphosis of the vertebral body was reduced from 21.3 degrees to 6.2 degrees in Group A and from 21.7 degrees to 7.4 degrees in Group B (P>0.05). It was decreased to 7.9 degrees in Group A and 13.5 degrees in Group B at the final follow-up (P<0.01). Its average loss of correction was 1.7 degrees in Group A and 6.1 degrees in Group B. Sagittal index was reduced from 21.3 degrees to 3.6 degrees in Group A and from 20.5 degrees to 3.8 degrees in Group B (P<0.05). It was decreased to 5.1 degrees in Group A and 9.8 degrees in Group B at the final follow-up (P<0.01). Its average loss was 1.5 degrees in Group A and 6.0 degrees in Group B. In Group A, 73.3% of patients had an excellent result based on Low Back Outcome Score system, while that in Group B was only 43.3%.

CONCLUSIONSPosterolateral fusion is an effective measure to prevent implant failure, and decrease loss of correction, posttraumatic kyphosis and neurological deficit during the treatment of thoracolumbar burst fractures. Short-segment fixation of thoracolumbar burst fractures without fusion obviously increases failure rate and it is not an optional procedure.

Adult ; Bone Screws ; Female ; Fracture Fixation ; adverse effects ; Fractures, Bone ; diagnostic imaging ; surgery ; Humans ; Lumbar Vertebrae ; diagnostic imaging ; injuries ; Male ; Middle Aged ; Radiography ; Spinal Fusion ; adverse effects ; methods ; Thoracic Vertebrae ; diagnostic imaging ; injuries

OBJECTIVETo investigate the correlation between blood concentrations of tacrolimus (FK506) and cystatin C (Cys C) and the effect of FK506 on glycolipid metabolism in renal transplant recipients.

METHODSA total of 325 patients receiving renal transplantation between August, 2014 and September, 2015 in Nanfang Hospital were divided into 4 groups according to the postoperative time (1 month group, 1-3 months group, 4-6 months group, and 7-12 months group). FK506 blood trough concentration was measured at the time of postoperative follow-up, and creatinine (Scr) and Cys C levels were also detected. Results Plasma FK506 concentration decreased with age in the recipients and showed a positive correlation with Cys C (r=0.985, P=0.015) but no obvious correlation with Scr (r=0.259, P=0.741). FK506 had no effect on blood glucose (5.53-5.59 mmol

CONCLUSIONFK506 does not affect the level of glycolipid metabolism in patients after renal transplantation. Cys C is positively related to blood concentration of FK506 in the renal transplantation recipients. The rational use of FK506 can improve the effectiveness and safety of the treatment in the recipients.

OBJECTIVETo evaluate the clinical importance of titanium mesh cage (TMC) in anterior instrumentation for scoliosis.

METHODSThirty-six consecutive patients with thoracolumbar/lumbar adolescent idiopathic scoliosis were treated with anterior derotation and instrumentation using autologous bone grafting and TMC for interbody fusion. The average age of patients was 17 years (ranged from 14 to 22 years), in which 5 cases were male and 31 cases were female.

RESULTSThe coronal Cobb angle before surgery, 2 weeks after surgery, and 13 months at the follow-up was measured as 56 degrees , 15 degrees , and 18 degrees respectively, while the thoracic kyphosis from T(5) to T(12) was 30 degrees , 33 degrees , and 37 degrees respectively, and the lumbar lordosis from L(1) to S(1) was 46 degrees , 56 degrees , 51 degrees . There were no death, infection, implant failures or collapse of intervertebral space. Intraoperative injury of lacteal occurred in one patient, but no postoperative complications happened. One of two patients who had pleural effusion was managed with close drainage. Exudative pleurisy occurred in one patient, the sympathectomy effect occurred in three patients who presented asymmetry of skin temperature and resolved in short term.

CONCLUSIONSCoronal and sagittal alignment can be well corrected and maintained with TMC in anterior scoliosis surgery, collapse of intervertebral space and lumbar kyphosis can be prevented.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Orthopedic Fixation Devices ; Retrospective Studies ; Scoliosis ; surgery ; Spinal Fusion ; instrumentation ; methods ; Thoracic Vertebrae ; surgery ; Titanium

OBJECTIVETo analyze thoracic complications related to the convex thoracoplasty for the treatment of rib hump deformity in patients with thoracic scoliosis.

METHODSBetween December 2003 and September 2007, 548 patients with thoracic scoliosis underwent posterior spinal correction and the convex thoracoplasty. There were 167 male and 381 female, with an average age of 16.1 years (range, 12 to 38 years). The mean preoperative rib prominence was 35 degrees (range, 16 degrees to 50 degrees).

RESULTSThe mean number of resected ribs was 4.1. The mean rib prominence was 7 degrees (range 2 degrees to 17 degrees) after operation. No death happened. Thoracic complications related to the thoracoplasty consisted of respiratory insufficiency in 1 (0.2%) patient,intraoperative tear of parietal pleura in 29 (5.3%), with a subsequent pleural effusion in 6 and pneumothorax in 3. In the other patients, no obvious tear of parietal pleura was found during operation. However, 6 (1.1%) patients had pleural effusion after operati on.

CONCLUSIONThe thoracic complications related to convex thoracoplasty can be decreased by improving the surgical skill and using respiratory function monitoring.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Postoperative Complications ; prevention & control ; Scoliosis ; surgery ; Thoracic Vertebrae ; surgery ; Thoracoplasty ; adverse effects

OBJECTIVETo explore the correlation between the polymorphism in the DNA methyltransferase-3B (DNMT3B) gene promoter single nucleotide polymorphism (SNP)-149C→T (rs2424913) and-579G→T(rs1569686) and the genetic susceptibility to colorectal cancer in Jiangsu population.

METHODSGenomic DNA was extracted from the leukocyte cell of blood samples collected from 544 colorectal cancer (CRC) patients (including 280 cases of colon cancer and 264 cases of rectal cancer) since January 2009 and July 2010, in a hospital, Jiangsu Province. The same samples were collected from the other 533 control subjects. Polymerase chain reaction with restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing analysis were employed to assess the polymorphism of DNMT3B gene promoter-149C→T and-579G→T.

RESULTSFor DNMT3B-149C→T, no significant deviation was observed in the genotype distributions of polymorphisms between CRC cases (TT: 98.90% (538/544); CT: 1.10% (6/544)) and controls (TT: 97.75% (521/533); CT: 2.25% (12/533)) (χ(2) = 2.07, P = 0.15). The CC genotype was not detected in either patients or control subjects. The DNMT3B-149CT genotype was not associated with the risk of CRC (adjusted OR = 0.48, 95%CI: 0.18 - 1.30). For DNMT3B-579G→T, the genotype distributions of polymorphisms in CRC patients (TT: 90.07% (490/544); GT: 9.19% (50/544); GG: 0.74% (4/544)) were significantly different from those in control group (TT: 81.80% (436/533); GT: 17.82% (95/533); GG: 0.38% (2/533)) (χ(2) = 15.49, P < 0.05). The results showed that the-579 G allele could significantly decrease the risk of CRC (adjusted OR = 0.50, 95%CI: 0.35 - 0.72) in comparison with the -579 TT genotype. In addition, stratification analysis showed that for DNMT3B-579G→T, the genotype distributions of polymorphisms in colon cancer (TT: 92.50% (259/280); GT: 7.50% (21/280)) were significantly different from those in the controls (TT: 81.80% (436/533); GT: 17.82% (95/533); GG: 0.38% (2/533)) (χ(2) = 13.53, P < 0.05); and similar result was found in rectal cancer (TT: 87.50% (231/264); GT: 10.98% (29/264); GG: 1.52% (4/264)) and controls (TT: 81.80% (436/533); GT: 17.82% (95/533); GG: 0.38% (2/533)) (χ(2) = 5.64, P = 0.018). G allele carriers could decrease the risk of colon cancer (adjusted OR = 0.38, 95%CI: 0.23 - 0.63), and the risk of rectal cancer (adjusted OR = 0.65, 95%CI: 0.42 - 0.99). However, for DNMT3B-149C→T , there were no significant deviation in the genotype distributions of polymorphisms between colon cancer (TT: 98.57% (276/280); CT: 1.43% (4/280)) and controls (TT: 97.75% (521/533); CT: 2.25% (12/533)) (χ(2) = 0.82, P = 0.366); and there was no significant deviation between rectal cancer (TT: 99.24% (262/264); CT: 0.76% (2/264)) and controls (TT: 97.75% (521/533); CT: 2.25% (12/533)) either (χ(2) = 1.89, P = 0.169).

CONCLUSIONOur research demonstrates that the-579 G allele is a potential protective factor for the occurrence of CRC, however, the polymorphism of DNMT3B-149 gene shows no close correlation with the occurrence and development of CRC among Chinese population.

Aged ; Alleles ; Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Colorectal Neoplasms ; genetics ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide

Objective To develop a new mPCR method for rapid diagnosis of six types of encephalitis causing viruses of HS-VI,HSVII,VZV,EBV,EV71 and CMV.Methods Six pairs of specific primers for CMV,EV71,HSV I,VZV,EBV and HSV II were designed.The mPCR detection method was established and the sensitivity was detected.In order to verify the clinical application value of their multiplex PCR system,fifteen cerebrospinal fluid specimens of clinically suspected VE from the First Affiliated Hospital of Soochow University from 2014 to 2015 were examined by the mPCR method.Results The 6 pairs of primers did not interfere with each other,and the sensitivity of the mPCR system was over 103copies/μl.Among 15 cerebrospinal fluid specimens from patients with suspected viral encephalitis,six specimens(6/15,40%)were tested positive by the mPCR.Among them,HSV I was 5 and CMV was 1.Conclusion The mPCR method for detecting six types of en-cephalitis-associated virus at same time was established with high specificity,sensitivity and stability.

OBJECTIVETo investigate whether initial bone mineral status acts as a predictor factor in evaluating the early outcome of brace treatment in adolescent idiopathic scoliosis (AIS) girls.

METHODSSeventy-seven girls with AIS, aged 10 - 15 years old, were included in this study. A standardized bracing protocol was performed in these girls, and the early outcomes of brace treatment were evaluated at over-1-year follow-up. Girls with a progressed scoliosis and those with a non-progressed scoliosis were identified. The associations between the outcome and the indices before bracing, including age, menstrual status, Risser grade, bone mineral density (BMD) status, curve magnitude and curve pattern were assessed using univariate analysis. A multiple Logistic stepwise regression was used to determine the risk factors in curve progression in AIS girls treated with brace treatment.

RESULTSThere were 16 girls (21%) with a progressed scoliosis and 61 girls (79%) with a non-progressed scoliosis, respectively. In the girls with a progressed scoliosis, higher ratios of subjects were found with pre-menarchal status (chi(2) = 9.628, P = 0.004), lower Risser grade (chi(2) = 4.565, P = 0.037), main thoracic scoliosis (chi(2) = 4.009, P = 0.045), a larger curve (chi(2) = 1.685, P = 0.194), as well as osteopenia (chi(2) = 3.828, P = 0.050), as compared with those with a non-progressed scoliosis. During brace treatment, besides pre-menarchal status, a larger Cobb angle, and a main thoracic scoliosis, osteopenia (OR = 5.362, P = 0.022) was identified as the risk factor in curve progression in AIS girls, as revealed by the multiple Logistic regression analysis.

CONCLUSIONSOsteopenia might be an independent risk factor in the curve progression during brace treatment. The analysis of initial BMD status before bracing may help to predict the outcome of brace treatment.

Adolescent ; Bone Density ; Braces ; Child ; Female ; Humans ; Prognosis ; Retrospective Studies ; Scoliosis ; physiopathology ; therapy ; Treatment Outcome