OBJECTIVETo summarize the clinical manifestation and diagnosis of ganglioneuroma in spine and investigate the clinical effect of surgical treatment.

METHODSThe clinical data of 6 patients underwent a surgery for ganglioneuroma in spine from January 2008 to January 2015 were retrospectively analyzed. There were 4 males and 2 females, aged from 2 to 63 years old with an average of 34.6 years. The courses of disease were from 3 days to 17 years. Five patients complicated with superficial hypesthesia in correlative level of tumor, and the muscle strength under tumor plane had decreased at different levels, with the strength of grade II-IV. Two cases complicated with hypermyotonia and positive bilateral Hoffmann's and Babinski sign. Five cases were sporadic lesion in correlative spinal canal and one case complicated with the giant occupying lesion in thoracic cavity.

RESULTSSix operations had been performed including 5 en bloc and 1 subtotal resection. Postoperative pathological results showed tumor cells scattered or fasciculated inserted into Schwann cells in the stroma. In 2 patients complicated with radiculalgia before operation, 1 case was relieved and 1 was invariant after operation. All 4 patients with preoperative dyscinesia in the limbs obtained improvement after operation. All the patients were followed up from 0.3 to 6.8 years with an average of 2.5 years. At the final follow-up, according to ASIA grade, 5 cases were good and 1 case was invariant. During the follow-up, only 1 patient experienced chemoradiation because of merging ganglioneuroblastoma and receiving subtotal resection. No recurrence in other 5 cases.

CONCLUSIONGanglioneuroma is a benign and rare tumors in spine. Clinically, radicular pain and sensory-motor disorders are the main manifestations. Its diagnosis depends on pathological examination. Prognosis of surgical treatment is good.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Ganglioneuroma ; diagnosis ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Spinal Neoplasms ; diagnosis ; surgery

OBJECTIVETo compare clinical efficacy of Zero-profile implant for anterior cervical discectomy and fusion and conventional titanium plate with cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation.

METHODSFrom August 2011 to March 2014, clinical data of 139 patients with single cervical disc herniation treated with anterior cervical discectomy and interbody fusion with internal fixation were retrospectively analyzed. The patients were divided into two groups according to its operation method. There were 63 patients in group A which performed anterior discectomy and interbody fusion with Zero-profile;76 patients in group B which performed anterior cervical discectomy and cage plate internal fixation. JOA score and Odom functional rating between two groups were compared before and after operation. Videofluorographic swallowing study (VFSS) were used to evaluate thickness of prevertebral soft tissue. Bazaz dysphagia score were used to assess incidence of dysphagia. Postoperative AP X-ray and CT of cervical vertebra at 12 months were applied for evaluating bone graft fusion. Postoperative MRI was applied for evaluating the incidence of adjacent segment degeneration. Blood loss,operative time, preoperative and postoperative JOA score, Odom functional rating and VFSS score, Bazaz score, fusion rate between vertebral bodies and incidence of adjacent segment degeneration were compared between two groups.

RESULTSThere were no statistical meaning between two groups in JOA score, Odom functional rating before and after operation (P > 0.05); and no significant meaning in VFSS score between two groups before operation (P > 0.05); There were no significant difference in operative time and blood loss. There was statistical meaning in VFSS, Bazaz dysphagia score at 2 days, and 6 months after operation (P < 0.05). All patients obtained bone union at 1 year after operation, and no obvious meaning in fusion rate (P > 0.05). Eight patients (12.7%) in group A occurred adjacent segment degeneration and 19 patients (25%) in group B occurred adjacent segment degeneration, and there was significant meaning between two groups (P < 0.05).

CONCLUSIONBoth of Zero-profile implant for anterior cervical discectomy and fusion and conventional cage internal fixation for the treatment of single segmental cervical intervertebral disc herniation could obtain satisfied clinical results. While Zero-profile implant for anterior cervical discectomy and fusion has advantages of lower incidence of adjacent segment degeneration, and its mid and long term following-up results still further observation.

Adult ; Aged ; Bone Plates ; Case-Control Studies ; Cervical Vertebrae ; surgery ; Diskectomy ; Female ; Fracture Fixation, Internal ; Humans ; Intervertebral Disc ; surgery ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; Treatment Outcome

Child, Preschool ; Diagnosis, Differential ; Female ; Humans ; Lead Poisoning, Nervous System, Childhood ; diagnosis ; therapy ; Male

Objective To investigate the relationship of omentin-1 with adiponectin and inflammatory cytokines in type 2 diabetes (T2DM) patients with nonalcoholic fatty liver disease (NAFLD). Methods The serum levels of omentin-1 and adiponectin were assayed by enzyme-linked immunosorbent assay (ELISA) in patients of T2DM with NAFLD (group A, n=63), T2DM without NAFLD (group B, n=63)and normal control group (group C, n=70). At the same time the biochemical markers and inflammatory marker, such as tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hs-CRP) and interleukin 6(IL-6) were detected in three groups. The correlation analysis and multiple regression analysis were used to de-tect the association of omentin-1 with adiponectin and inflammatory markers. The logistic regression was used to analyze fac-tors influencing NAFLD in patients with T2DM. Results The serum levels of omentin-1 and adiponectin were significant-ly lower in group A [ (27.02±2.82)μg/L and (11.98±3.63) mg/L] than those of group B [(31.52±2.81)μg/L and (15.85±3.28) mg/L] and group C [(35.92±2.80)μg/L and (19.88±3.44) mg/L], and there were significantly lower levels of them in group B than those of group C (P<0.01). The plasma omentin-1 level was positively correlated with adiponectin and high density li-poprotein (HDL-C) in group A. Also the plasma omentin-1 level was negatively correlated with TNF-α, IL-6, fasting blood glucose (FBG), homeostasis model assessment of insulin resistance (HOMA-IR), visceral adipose tissue, waist, waist-to-hip ratio (WHR) and free fatty acid in group A (P<0.05 or P<0.01). Multiple stepwise regression analysis showed that adipo-nectin, TNF-αand IL-6 were independent factors influencing the level of plasma omentin-1. Logistic regression analysis showed that omentin-1 was one of independent factors influencing T2DM combined with NAFLD (P<0.01). Conclusion The incident of NAFLD in T2DM patients is related to the lower level of omentin-1, which may be influenced by adiponectin and inflammatory factors.

Objective To investigate the relationship between plasma levels of chromogranin A (CHGA) and adi-pose triglyceride lipase (ATGL) in patients with type 2 diabetes (T2DM) combined non-alcoholic fatty liver disease (NAFLD). Methods The plasma levels of CHGA and ATGL were assayed by enzyme-linked immunosorbent assay (ELISA) in T2DM patients with NAFLD (group A, n=74), T2DM without NAFLD (group B, n=76), and normal group (group NC, n=75). The correlation between CHGA, ATGL and other metabolic index was analyzed. Results The plasma level of CHGA was significantly higher in group A (83.15±9.46) and group B (70.90±2.75) than that of group NC (46.74±8.15, P<0.01), and the level of CHGA was significantly higher in group A than that of group B (P<0.01). The plasma level of ATGL was sig-nificantly lower in group A (21.36±13.42) and group B (40.29±22.83) than that of group NC (72.30±26.41, P<0.01), and the level was lower in group A than that of group B (P<0.01). There was a negative correlation between the plasma CHGA, AT-GL and carbohydrate oxidation rate in group A. There was a positive correlation between fasting insulin (FINS), insulin resis-tance index (HOMA-IR), free fatty acid (FFA) and fat oxidation rate in group A. There was a negative correlation between plasma level ATGL and body mass index (BMI), FINS, cholesterol (TC), triglyceride (TG) and HOMA-IR, meanwhile, it was positively correlated with FFA. The multiple stepwise regression analysis showed that FINS, ATGL and FFA were indepen-dent variables for CHGA. The Logistic regression analysis showed that plasma levels of CHGA, ATGL and FFA were the in-dependent predictors of T2DM with NAFLD. Conclusion The plasma levels of CHGA and ATGL are closely correlated with substance and energy metabolism, and the interaction between them may play an important role in the pathogenesis of T2DM with NAFLD .

OBJECTIVETo observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension.

METHODSEighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment.

RESULTSAs for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group.

CONCLUSIONEGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Acupuncture Points ; Anesthesia ; methods ; Anesthesia, General ; Animals ; Arteries ; Dogs ; Gastrins ; Hypotension, Controlled ; Male ; Motilin ; Nitroprusside ; Transcutaneous Electric Nerve Stimulation

OBJECTIVETo explore the efficacy and safety of zero-profile implant for anterior cervical discectomy and fusion (ACDF) in treating single cervical disc herniation.

METHODSFrom August 2011 to June 2012,30 patients with single cervical disc herniation were treated with ACDF using zero-profile implant in one motion segment. There were 18 males and 12 females with a mean age of 55.3 years old (ranged, 36 to 68). Incidence of dysphagia, height of intervertebral space and condition of bone fusion were observed after operation. Spinal nerves function and clinical results were assessed according to Japanese Orthopaedic Association (JOA) score, Odom criteria.

RESULTSAll patients were followed up from 12 to 24 months with an average of 15.9 months. The mean intraoperative blood loss was (85.3 +/- 14.2) ml (70 to 120 ml) and operative time was (90.0 +/- 12.8) min (70 to 120 ml). Preoperative, postoperative at 3 months and 1 year, JOA score was 8.72 +/- 2.36 (5.0 to 13.0), 14.72 +/- 1.66 (11.5 to 17.0) and 15.65 +/- 1.03 (13.5 to 17.0), respectively. One year after operation, according Odom criteria to assess, 22 cases got excellent results, 7 good, 1 fair. All dysphagiaes vanished completely at 3 months after operation. The lost height of intervertebral space was (0.34 +/- 0.13) mm (0.1 to 0.6 mm) and (0.39 +/- 0.15) mm (0.2 to 0.7 mm) at 3, 12 months after operation, respectively. All patients obtained bone fusion at 1 year after operation.

CONCLUSIONThe zero-profile implant is a valid alternative to anterior cervical plate in treating single cervical disc herniation with ACDF, it has advantages of convenient procedure, satisfactory effect, lower incidence of postoperative dysphagia, reliable stability and less implant-related complications.

Adult ; Aged ; Cervical Vertebrae ; surgery ; Diskectomy ; adverse effects ; methods ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Displacement ; surgery ; Male ; Middle Aged ; Prostheses and Implants ; Safety ; Spinal Fusion ; adverse effects ; Treatment Outcome

BACKGROUNDInflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA.

METHODSBetween 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared.

RESULTSThe two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711).

CONCLUSIONSDespite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.

Adult ; Aged ; Aortic Aneurysm, Abdominal ; mortality ; pathology ; surgery ; Atherosclerosis ; complications ; pathology ; Case-Control Studies ; Female ; Humans ; Inflammation ; complications ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Tuberculous aortic aneurysm (TBAA) is an extremely rare clinical event with life-threatening implication. Management for this condition is challenging and its therapeutic option has not been yet established. A few recent reports described endovascular repair rather than open surgery as the method for treatment. Although this remains controversial, endovascular exclusion has been gaining acceptance for some surgeons. We present a case of TBAA who was treated by endovascular stent grafting for a descending thoracic aortic aneurysm with simultaneous anti-tuberculous medication. The outcome was favorable.
Adult ; Aneurysm, Infected ; drug therapy ; microbiology ; surgery ; Antitubercular Agents ; therapeutic use ; Aortic Aneurysm, Thoracic ; drug therapy ; microbiology ; surgery ; Humans ; Male