2.Treatment of high thoracic spine with metastasis by one side extrapedicular approach of percutaneous vertebroplasty and kyphoplasty
Jian WANG ; Yue ZHOU ; Chao CHEN
Orthopedic Journal of China 2006;0(01):-
[Objective]To explore the feasibility and safety of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty(PVP) treating osteolytic lesions of high thoracic vertebra with metastasis by one side extrapedicular approach,and to assess the clinical result of minimally invasive technique. [Methods]In March 2008,one patient(male,59 years old) with T1~3 vertebral metastases of lung cancer diagnozed 8 months ago was selected.The symptoms included extremely severe pain in upper thoracic spine and left should.The analgesic effect was limited for more than 6 months.There was no operative option.Domestic PKP and PVP tool systems were used in local anaesthesia.Under fluoroscopic guidance,T2 and T3 vertebral augmentation were separately completed by single side extrapedicular approach PKP and PVP.Clinical results were followed up and observed.[Results]The procedure was performed smoothly.T3 and T2 vertebrae were differently treated by PKP and PVP.T1 received no treatment because of patient`s intolerance.The operative time of T3 vertebral PKP was 57 minutes.The volume of injected bone cement was 1.9ml.The operative time of T2 vertebral PVP was 49 minutes.The volume of injected bone cement was 1.5ml.Extravertebral leakage of the polymethylmethacrylate(PMMA) into the paravertebral itssue was found without clinical symptom,because osteolysis occurred in the left pedicle of T2 vertebra.There was no other complication.The patient was discharged 5 days after operation.The preoperative,2 days and 3 months postoperative follow-up VAS scores were 10,3 and 6.The patient's markedly pain could be controlled by analgesia.[Conclusion]One side approach percutaneous kyphoplasty is a safe and effective technique for treatment of high thoracic vertebral metastasis with markedly relief of pain.
4.Application of Interventional Treatment in Acute Massive Gastrointestinal Hemorrhage
Min YANG ; Xiaoqiang TONG ; Jian WANG ; Chao WANG ; Yinghua ZOU
Chinese Journal of Medical Imaging 2010;(1):10-12
Purpose To investigate the diagnostic and therapeutic value of vascular interventional technology dealing with acute massive gastrointestinal hemorrhage. Materials and methods 59 patients with acute massive gastrointestinal hemorrhage underwent the arteriography of mesenteric arteries and abdominal arteries. When positive signs of bleeding appeared, super-selective catheterization and embolization with micro-coil and gelfoam was applied immediately. Results Positive signs of bleeding were detected in 28 of 59 patients, among which 25 patients underwent embolization, and successful hemostasis was achieved in 21 cases with an achievement ratio of 84%. And there were 10 cases eventually turning to surgery.Conclusion Vascular interventional technology such as arteriography and embolization played an important role in diagnosis and treatment of acute massive gastrointestinal hemorrhage.
6.Survival analysis of 121 patients with spinal metastases accepted spinal surgery
Xiuxin HAN ; Guowen WANG ; Chao ZHANG ; Jian DUO ; Zhichao LIAO
Chinese Journal of Orthopaedics 2014;34(11):1127-1133
Objective To investigate the safety and efficacy of surgery in 121 patients with spinal metastases.Methotds A retrospective analysis of clinical data from April 2009 to March 2013 was performed in 121 patients with spinal metastases.From 37 to 65 years,69 males and 42 females with mean age of 55.6 years.Primary tumor origin:Lung 35(28.9%),Breast 26(21.4%),Renal 17 (14.0%),Prostate 20 (16.5%),Thyroid 14 (11.6%),Liver 2 (1.7%),Colon 1 (0.8%),other 6 (5.0%).All patients received surgery.Follow-up and survival time were analyzed.In preoperation and postoperative 3 month,pain levels were assessed by visual analogue scale (VAS),neurologic deficit was evaluated by Frankel Grade and functional impairment was classified by Karnofsky Score.The quality of the life was assessed by EORTC QLQ-C30 questionnaire.Survival analysis was evaluated by Kaplan-meier.Results The period of follow-up ranged from 5 to 35 months with the average of 15.9 months.The mean survival was 14.5 months.1-year survival was 53.5%.2-year survival was 36.5%.In patients with lung cancer,the mean survival was 8.5months.1-year survival was 14.3%.2-year survival was 11.4%.In patients with breast cancer,the mean survival was 31 months.1-year survival was 57.7%.2-year survival was 46.2%.In preoperation and postoperative 3 month,the VAS showed statistical significance (t=21.6,P<0.01) ;Post-operatively,80.3% of all patients had functionally useful Frankel Grade D or E compared with 43.5% pre-operatively.KPS score (80-100) percentage was 75.6% postoperatively compared with 33.4% preoperatively.In 1month postoperatively,35 of 75 patients who were sphincteric dysfunction preoperatively were improved.The EORTC QLQ-C30score was 83.39±7.23 in preoperation and 51.34±14.27 in postoperaion.The quality of life was impoved significantly (t=12.6,P<0.01).Conclusion Surgical treatment was effective in improving quality of life by providing better pain control,enabling patients to regain or maintain mobility,and offering improved sphincter control.In all patients,the number of patents with spinal metastases from breast and lung cancer is higher.Compared with spinal metastases from breast cancer,the proportion of lung cancer origin received surgery is higher.
7.PET/CT findings of Langerhans cell histiocytosis in children
Jian ZHANG ; Suyun CHEN ; Hongliang FU ; Chao MA ; Hui WANG
Chinese Journal of Nuclear Medicine and Molecular Imaging 2016;36(4):300-303
Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.
8.The forensic application of Lefort aqua regia digestion method detecting diatom in rabbits′s organs(
Huipin WANG ; Yong CHEN ; Jian ZHAO ; Chao LIU
Chinese Journal of Forensic Medicine 2016;31(5):470-472
Objective The forensic application of Lefort aqua regia digestion method detecting diatom in rabbits’s organs. Methods Using the Lefort aqua regia digestion-membrane ifltrition-SEM observation method and the traditional acid digestion-centrifugation-light microscopy observation method to detect diatom of drowning or postmortem immersion rabbits’s organs(lung,liver,kidney), and make statistical analysis of diatom number, consuming time, digestive capability and ifne structure of diatoms. Results The diatom number of Lefort aqua regia digestion method was superior to conventional acid digestion method, with the difference being statistically signiifcant (P<0.05), as well as consuming time, but have undifferentiated of drowning grounp(P>0.05), and have a better observation effect. Conclusion The Lefort aqua regia digestion method for diatom extraction was helpful for diatom identiifcation., and useful in drowning test by conventional and economicly.
9.STUDIES OF REDUCING WINTERKLILING ON LEAVES OF SCLNDA-PSUS AUREUSM BY SPRAYLLNG THE LEAVES WITH ANTLBLOTLCS
Jian KANG ; Yongshen XIAO ; Haihua WANG ; Chao LIN ;
Microbiology 1992;0(03):-
The leaves of Scindapsus aureum were frozen at\|19℃ for 5 mins after sprayed with 91?g/mL Ampicillin and 91?g/mL streptomycin sulfate mixture solution,After 15 days the results showed that frozen spot number of the leaves treated with water reduced by 75% compared with those of CK,but thethickness unchanged.The frozen spots began with the border of the leaves.The frozen spots of the group treated with antibiotic mixture solution didn't appear until 5 mins later,and the number of the frozen spots reduced by 95% after 8 mins of freezing.They covered the border of the leaves.This indicated that the antibiotic mixture solulion can obviously reduce the freeze injury to the leaves.
10.The characteristics of optical coherence tomography angiography in aquaporin-4 antibody positive neuromyelitis optica spectrum disorders
Jian YU ; Wenghang WONG ; Chao QUAN ; Min WANG
Chinese Journal of Ocular Fundus Diseases 2021;37(3):173-179
Objective:To investigate the alteration of retinal perfusion in aquaporin-4 antibody (AQP4-ab) positive neuromyelitis optica spectrum disorders (NMOSD) patients by optical coherence tomography angiography (OCTA).Methods:A case-control study. Forty-eight AQP4-ab positive NMOSD patients (96 eyes) and 20 age and gender matched healthy controls (40 eyes) were recruited from September 2015 to August 2017 at the Eye & ENT Hospital of Fudan University. Patients of both eyes were included in the groups. The patients were further divided into 4 subgroups (0 ON, 1 ON, 2 ON, 3+ ON group) according to the number of episodes of ON (0, 1, 2, or 3+) with respect to 30、22、31、13 eyes. 0 ON group had no history of ON episodes; 1 ON group, 2 ON group, and 3+ ON group had ON episodes 1, 2, ≥3 times, respectively. All patients underwent complete ophthalmological examinations including BCVA, visual field and OCTA examination. The BCVA was recorded for each eye using metric notation from the Snellen chart, and then converted to the logarithm of the minimum angle of resolution. The central visual field was assessed using a Humphrey Field Analyzer 750 and the mean deviation (MD) was determined. OCTA scans of the optic disc (4.5 mm × 4.5 mm) and macula (6 mm × 6 mm) were acquired. Radial peripapillary capillary (RPC) vessel density, superficial capillary plexus vessel density (SVD), the thickness of ganglion cell and inner plexiform layer (GCIPL) and peripapillary retinal nerve fiber layer (pRNFL) were determined. The generalized estimating equations was performed to compare the difference of BCVA, MD, pRNFL thickness, GCIPL thickness, RPC vessel density and SVD among the groups and the correlations between retinal perfusion and retinal structure, visual function were analyzed.Results:The RPC vessel density and SVD were significant lower in the 0 ON group compared with healthy group (Wald χ2=7.190, 10.134; P<0.01), however, the BCVA, pRNFL and GCIPL thickness were not significant difference between the two groups (Wald χ2=2.308, 1.020, 2.558; P>0.05). The BCVA, visual field MD, RPC vessel density, SVD, pRNFL and GCIPL were significant lower in 1 ON, 2 ON and 3+ ON groups compared with healthy group and 0 ON group (Wald χ2=12.390, 11.346, 38.860, 18.040, 45.418, 26.608; P<0.001 ), but the parameters had no significant difference among the three groups ( P>0.05). The RPC vessel density was significantly correlated with pRNFL thickness ( β=0.372, standard error=0.018, P<0.001), and the SVD was significantly correlated with GCIPL thickness ( β=0.115, standard error=0.204, P<0.001). The MD and BCVA was significantly correlated with peripapillary vessel density after adjustment for other variables (BCVA: β=0.025, standard error=0.005, P=0.000; visual field MD: β=0.737, standard error=0.185, P=0.000). Conclusions:Subclinical primary retinal vasculopathy may occur in NMOSD prior to ON attack, the ON attack may further impair visual function, retinal structure and perfusion, however, the extent of injure is not relevant with the increase of ON attack. The peripapillary vessel density might be a sensitive predictor of visual outcomes in NMOSD patients.