Objective To investigate the feasibility to execute percutaneous kyphoplasty(PKP) in the field comprehensive surgical shelter during kinds of natural disasters. Methods Five experimental pigs underwent PKP in a comprehensive surgical shelter during simulated natural disasters, and were observed for operating time, intraoperative blood loss, complications and postoperative survival rate. Results All the 5 pigs had the operations completed successfully with high postoperative performances in extremities motion and survival rate, and the mean operating time was(43±5.7)min and the mean intraoperative blood loss was (42±3.6)ml.Cement penetrated into the intervertebral space of one pig with satisfactory extremities motion,while no complications occurred in the other pigs.Conclusion The comprehensive surgical shelter proves to enable PKP,and thus extends emergency treatment to the frontier during simulated natural disasters.

Objective To evaluate the accuracy and safety of screw placement position through second sacral alar -iliac(S2AI)with in-teroperative cone beam CT(CBCT)scan.Methods Collected 22 patients who underwent second sacral alar-iliac screw implant surgery in our hospital from June 2015 to June 2017.All the patients had intraoperative CBCT scan and conventional CT scan after operation.Regard the postoperative CT scan imageing as gold standard to assess the accuracy and safety of S 2AI screws position.The S2AI tract parameters were measured with intraoperative CBCT images and postoperative CT images respectively.Results There was no significant difference between the S2AI tract parameters which were measured with intraoperative CBCT images and postoperative CT images(P>0.05).Conclusion The intraoperative CBCT scan could accurately evaluate the position of S 2AI screws,as well as clarify the damage of the inner and outer plate of the iliac bone in the process of fixation.Compared with postoperative conventional CT scan,the intraoperative CBCT scan can potentially re-duce the reoperation rate.

Objective To evaluate the accuracy and safety of pedicle screw placement for spinal deformity under intraoperative CT-as-sisted.Methods The clinical data of 28 patients with spinal deformity,who underwent intraoperative CT-assisted placement of pedicle screws in our hospital from March 2014 to March 2017,were analyzed retrospectively.Intraoperative CT-assisted placement of pedicle screws was to observe the position of pedicle screws and adjust the screw position.The safety of pedicle screw fixation was assessed by the postoperative complications.Results All 28 patients of scoliosis were successfully performed surgery.A total of 402 pedicle screws were placed in the spines and the placements of 64 screws of them were adjusted according to intraoperative CT findings.Of 402 screws,377 were placed in the pedicles,13 by grade 1 pedicle breach,8 by grade 2 pedicle breach and 4 by grade 3 pedicle breach according to Gertzbein-Robbins classifi-cation of pedicle screw placement accuracy.No complication was directly related to the screws placement.No patient required reoperation due to the misplacement of the pedicle screws.Conclusion Intraoperative cone-beam CT scan can help the surgeon improve the accuracy and safety of pedicle screw placement for spinal deformity with less complication.

Objective To evaluate the safety and effectiveness of percutaneous alcohol embolization(PAE) combined with percutaneous vertebroplasty(PVP) for aggressive vertebral haemangiomas (AVHs) with epidural extension.Methods The data of 26 consecutive patients underwent PAE combined with PVP for the treatment of AVHs with epidural extension from October 2013 to November 2015 were analyzed retrospectively.The average follow-up time was (12.21 ± 1.34) months.The pain symptom before and after surgery were evaluated with a visual analogue scale (VAS).Results Pre-procedure mean VAS score was (7.23 ± 1.3) and the postoperative VAS score was (3.11 ± 1.9) at last follow-up.Ten patients (38.5％) remained asymptomatic.Eighty-eight percent of the patients with neurosensory disorders had complete regression of these symptoms.Two of the three patients with motor deficit did not show any improvement.No major complication was recorded.Conclusion PAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural extension.This technique appears mainly effective for pain and neurosensory symptoms,but seems less effective for motor deficit relief.

OBJECTIVEIn order to investigate Hantavirus (HV) infection of captured rodents and to understand the genotypes and the molecular characteristic of Hantaviruses in Shenzhen.

METHODSThe captured rodents were classified and the density of distribution was calculated. A total of 472 animals were captured, among which Rattus norvegicus was the dominant group. The total viral RNA was extracted from the lung tissues positive with HV antigens by immunofluorescent assay and gene sequence of M fragment was amplified with RT-nested-PCR by using the Hantavirus genotype specific primers. The amplified genes were then sequenced, and subjected to genotyping and homology analysis.

RESULTSThe results of genotype analysis showed that the Hantaviruses taken from twenty-one lung specimens in Rattus norvegicus in Shenzhen city belonged to the Hantavirus type II (SEOV). Results in homology analysis suggested that the homology among twenty-one samples should be rather high with 95.4% of nucleotide sequence identity and they belonged to the same subtype. Phylogenetic tree analysis showed that they were branched into at least six different lineages, and were highly homologized with SZ2083. We also found that these virus strains had not shown more highly homology of nucleotide sequence in nearest district, whereas revealed consistency in farther district.

CONCLUSIONThe major hosts of Hantaviruses in Shenzhen city were Rattus norvegicus and the epidemic strains were genotyped as SEO-type. Nucleotide sequence and deduced amino acid sequence from different rodents were highly homologous, while nucleotide mutation had also been observed. Further studies are required to explore the possible viruses' sequence mutation.

Animals ; China ; epidemiology ; DNA Primers ; DNA, Viral ; Genotype ; Hantavirus ; classification ; genetics ; Hantavirus Infections ; epidemiology ; veterinary ; virology ; Polymerase Chain Reaction ; RNA, Viral ; Rats ; Rodent Diseases ; epidemiology ; virology ; Sequence Homology

Objective To investigate the value of intraoperative X-ray guided and CT guided percutaneous biopsy in the diagnosis of thoracic and lumbar space occupying lesions.Methods A total of 97 patients with thoracic and lumbar space occupying lesions who were not diagnosed clinically in our hospital from May 2011 to July 2016 were retrospectively analyzed.All patients underwent percutaneous vertebral biopsy under the guidance of Artis-Zeego robot in the Artis-Zeego complex operating room of our hospital.Thoracic vertebral body biopsy in patients with a total of 46 cases were divided into T group,in which X-ray guided percutaneous biopsy in 25 cases were divided into T-x group,CT guided percutaneous biopsy in 21 cases were divided into T-ct group.Lumbar puncture biopsy in patients with a total of 51 cases were divided into L group,in which X-ray guided percutaneous live review of 24 cases were divided into L-x group,CT guided percutaneous biopsy in 27 cases were divided into L-ct group.According to the packet respectively in X-ray or CT monitoring,the use of bone biopsy needle under local anesthesia,transpedicular approach for spinal lesions of bone amount,by changing the working path or direction bone biopsy needle of different diameter to save drilling samples which were immediately placed in 10％ formalin,specimens were sent for pathological examination and corresponding pathological and cytological examination.The success rate,diagnostic accuracy and complications of percutaneous biopsy were compared between the two groups in X-ray and CT guided percutaneous vertebral biopsy.Results T-x group of 25 patients,5 patients with puncture failure for intraoperative X-ray monitoring difficulties were transferred to puncture under the guidance of CT,the success rate of puncture was 80％ (20/25).Of the patients with success puncture,6 cases were unidentified by pathological examination,the total diagnostic accuracy rate of biopsy in T-x group was 70％ (14/20).The success rate of puncture in T-ct group was 100％,significantly higher than that of T-x group(P ＜ 0.05).In T-ct group,3 cases were unidentified by pathological examination,the total diagnostic accuracy rate of biopsy was 88.5 ％ (23/26),which was significantly higher than that of T-x group (P ＜ 0.05).In the L-x group,1 case with puncture failure for pain during the operation,the success rate of puncture was 95.8％ (23/24),patients of L-ct group were successfully punctured,the success rate was 100％,the difference between the two groups was not significant(P ＞ 0.05).In the L-x group,2 patients failed to confirm the diagnosis,the diagnostic total accuracy rate of L-x group was 87.5％ (21/23);of the L-ct group,1 cases failed to confirm the diagnosis,the diagnosis total accuracy rate of L-ct group was 96.3％ (26/27),the difference between two groups was not significant (P ＞ 0.05).Complications:In the T-x group,1 cases received additional local anesthetic after puncture for pain;1 patients had transient lower extremity paresthesia,and the symptoms were improved 1 weeks later;1 case with intraoperation puncture site paining was not alleviated and had to stop the puncture.All patients with CT guided biopsy had no complications.Conclusion CT and X-ray guided percutaneous biopsy has important significance in diagnosis and treatment of spinal lesions,and CT guided percutaneous biopsy is safer for thoracic lesions with higher diagnostic rate,while for lumbar lesions fluoroscopy,X-ray or CT guided percutaneous biopsy has the same security and diagnostic rate.

OBJECTIVETo explore the incidence, pathogenesis, risk factors and effective treatment of pulmonary complications after allogeneic peripheral blood stem cell transplantation (allo-PBSCT).

METHODSPulmonary complications in 70 patients received allo-PBSCT were analyzed.

RESULTSThirty one episodes were observed in 26 patients. Among them episodes were infectious complications, including bacteria pneumonia, pulmonary fungus disease, CMV interstitial pneumonia and tuberculosis, some cases were caused by two pathogens, and 11 episodes were noninfectious complications, including late-onset noninfectious pulmonary complications (LONIPCs) (n=9), pulmonary edema (n=1) and interstitial pneumonia (n=1). The overall mortality was 12.9%. Graft-versus-host disease (GVHD) prophylaxis without MTX, severe acute GVHD and extensive chronic GVHD were high risk factors for pulmonary complications and advanced disease at transplantation, extensive chronic GVHD were significantly associated with the incidence of LONIPCs.

CONCLUSIONPulmonary disease is the main complication occurred in patients undergoing allo-PBSCT. It is of greatly importance to treat pathogens specifically and diagnose LONIPCs in its early stage.

Adolescent ; Adult ; Female ; Graft vs Host Disease ; prevention & control ; Hematologic Diseases ; surgery ; Humans ; Lung Diseases ; etiology ; Male ; Middle Aged ; Peripheral Blood Stem Cell Transplantation ; adverse effects

The aim of study was to explore the incidence, risk factors, outcome and efficacious treatment of late-onset noninfectious pulmonary complications (LNIPC) after allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Seventy patients received allo-PBSCT were analyzed retrospectively. The results showed that 9 out of 63 patients surviving more than 3 months occurred late-onset noninfectious pulmonary complications (14.3%). Five out of the 9 patients developed secondary pulmonary infections. In 4 patients, LNIPC caused death directly. Advanced stage of disease at transplantation and extensive chronic graft-versus-host disease (GVHD) happened in association with LNIPC. However, other transplantation-related factors including age at transplantation, gender of patient, conditioning regimen, HLA matching and GVHD prophylaxis were not significantly correlated with the incidence of LNIPC. It is concluded that performing pulmonary function test (PFT) and thoracic computer tomography should be taken routinely after transplantation. Most patients who get correct and early diagnosis for LNIPC will show a positive response to prednisone with or without CsA.
Adolescent ; Adult ; Cyclosporine ; therapeutic use ; Female ; Graft vs Host Disease ; prevention & control ; Humans ; Incidence ; Leukemia ; therapy ; Lung Diseases, Interstitial ; classification ; drug therapy ; etiology ; Male ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Prednisone ; therapeutic use ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous

To compare the clinical outcome of autologous peripheral blood stem cell transplantation (APBSCT) and autologous bone marrow transplantation (ABMT) in treatment of patients with acute leukemia in first remission, 41 patients received APBSCT, 17 patients received unpurged ABMT and 30 patients received purged ABMT. The results showed that hematopoietic recovery was significantly earlier after APBSCT than that after purged or unpurged ABMT. The 3-year disease-free survival (DFS), relapse rate (RR) and transplant-related mortality (TRM) for all patients of 3 groups were 51.7%, 41.7% and 6.8%, respectively. DFS and RR were significantly influenced by disease types (ALL or AML) and intervals between diagnosis and CR(1) or CR(1) and transplant. The main causes of transplant-related death were infection and hemorrhage. After APBSCT, DFS, RR and TRM were 48.4%, 43.9% and 4.9%, respectively, and did not differ significantly from those found in unpurged ABMT (47.1%, 45.6% and 11.8%) or purged ABMT (66.5%, 29.6% and 6.7%). It is concluded that the clinical outcome of APBSCT is similar to unpurged or purged ABMT but APBSCT allows faster recovery of hematopoiesis and needs less transfusion support.
Acute Disease ; Adolescent ; Adult ; Bacterial Infections ; etiology ; mortality ; Bone Marrow Purging ; Bone Marrow Transplantation ; adverse effects ; Child ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hemorrhage ; etiology ; mortality ; Humans ; Leukemia ; pathology ; therapy ; Leukemia, Erythroblastic, Acute ; pathology ; therapy ; Leukemia, Monocytic, Acute ; pathology ; therapy ; Leukemia, Myeloid, Acute ; pathology ; therapy ; Leukemia, Myelomonocytic, Acute ; pathology ; therapy ; Leukemia, Promyelocytic, Acute ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Peripheral Blood Stem Cell Transplantation ; adverse effects ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; pathology ; therapy ; Remission Induction ; Survival Rate ; Transplantation, Autologous

OBJECTIVE: To establise the bank of platelet donors with the human platelet antigen (HPA) 1-6, 15 genes so as to provide the HPA-matched platelets for the patients. METHODS: The HPA genotyping of platelets donors and patients with platelet antibody positive confirmed by sercening was performed by using the SSP-PCR; the efficacy of transfusing the HPA-matched platelets for 37 cases platelet antibody positive was analyzed. RESULTS: The most common genotype in platelet donors were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b, followed by HPA-1a/1a-2a/2a-3a/3a-4a/4a-5a/5a-6a/6a-15a/15b; the most common genotype in 53 cases of platelet antibody positive confirened by screening were HPA-1a/1a-2a/2a-3a/3b-4a/4a-5a/5a-6a/6a-15a/15b. Among 37 patients with platelet antibody positive confirened by screeming, 28 showed that the transfusion of HPA-matched platelets was effective with statistically significant difference in comparison with random transfusion group. The HPA-3, HPA-15 were the main factors leading to polymorphisms. CONCLUSION HPA-3 and HPA-15 are polymorphic, which should be focused on. HPA-matched platelets can improve the efficiency of platelet transfusion, and avoid the waste of blood resources. The genotypes of platelet donors can basically meet the requirements for common genotype transfusion.