1.Clinical efficacy of one-stage transforaminal debridement, interbody fusion and posterior instrumentation for treatment of thoracolumbar spinal tuberculosis
Weibin SHENG ; Tao XU ; Qiang DENG
Chinese Journal of Orthopaedics 2016;36(11):672-680
Objective To discuss the clinical efficacy and surgical indications of one?stage transforaminal debridement, interbody fusion combined with posterior instrumentation for thoracolumbar spinal tuberculosis. Methods All of 34 patients with thoracolumbar spinal tuberculosis were retrospectively analyzed,treated by one?stage transforaminal debridement, interbody fusion and posterior instrumentation from June 2010 to April 2013, including 21 males and 13 females, aged 21 to 64 years old, av?erage 38.2 years. All patients were treated by preoperative quadruple antituberculosis drugs therapy for 2-4 weeks, postoperative regular chemotherapy for 12-18 months. Preoperative and postoperative changes in clinical symptoms, nervous function, the situa?tion of the erythrocyte sedimentation rate (ESR) and C?reactive protein (CRP) with strict follow?up, as well as other related compli?cations were observed. The spinal fusion rate and fusion situation, changing of the physiological curvature, as well as loosening or breaking of the internal fixation device were detected through regular imaging examination. Results The surgery duration time was 60-150 min, average 110 min, and the blood loss was 80-550 ml, average 320 ml. Cerebrospinal fluid leakage occurred in one case. All of the operations were completed successfully without nerve or spinal cord injuries. Postoperative follow?up time was 1 to 4 years, average 2.5 years. Clinical symptoms improved significantly in three months after operation. The visual analogue scale (VAS) improvement rate was about 93%. All patients' ESR and CRP returned to normal levels at the last follow?up. The Kirkaldy?Willis function score showed that the total fine rate was 94%. 12 cases of patients had various degrees of neurological dysfunction before operation, which were back to normal at the final follow?up, except one case of ASIA class B turned to C. Inci?sion fistula formation happened in one case at the third months after surgery, and the wound was healed after debridement. All pa?tients got solid fusion between vertebral body, and there was no graft absorption or collapse, pseudarthrosis, tuberculosis recur?rence, and loosening or breaking of internal fixation devices. Cunclusion One?stage transforaminal debridement, interbody fu?sion and posterior instrumentation is a simple, effective and safety surgical approach, which has great application value for surgi?cal treatment of patients with thoracolumbar spinal tuberculosis.
2.Characteristics and diagnosis of spinal hydatid disease
Weibin SHENG ; Yi LIU ; Xiaoxiong XU
Chinese Journal of Orthopaedics 2001;0(01):-
Objective To study the clinical characteristics of spinal hydatid disease and help to diagnozy and treat the disease. Methods 14 cases with spinal hydatid disease, admitted in our hospital between July 1994 and October 2003, were studied retrospectively. Besides routine examinations, plain X-ray films were performed in all 14 cases, CT in 8 cases and MRI in 13 cases, respectively. 8 cases sufferred serodiagnostic tests for human hydatidosis. All cases underwent operation and the histopathological examination. There were 5 males and 9 females with an average age of 25.8 years(range, 5-53 years) in this series. All 14 cases had the living history in endemic area and the average duration of symptom was 26.7 months(range, 4-120 months). The lesions most frequently involved the thoracic segments, accounting for 35.8%, and then 21.4% in the lumbar, and 28.6% in the lumbosacral segments, cervical segments were the least commonly involved. According to Dew'classification, spinal hydatid cysts located primarily at intradural extramedullary area in 1 case, extradural intraspinal in 2 cases, vertebral in 7 cases, paravertebral in 1 case and combination of various extradural tissues involved in other 3 cases. Results The clinical manifestations were localized back pain or radiating pain, mass and gradually progressive neurological dysfunction. Eight of 14 cases displayed abnormality in X-ray films which showed local, well-defined and irregular erosions with or without surrounding sclerosis or calcifications. CT scans presented multiloculated low density lesions. The MRI characteristics of the lesions were multiloculated cysts, signal intensities of the cyst content were similar to that of CSF. On T1W images the cyst wall appeared iso- or slightly more hypo-intense than the cyst content, T2W images demonstrated a low intensity rim and the hyper-intense cyst content resembling a bunch of grapes. Seven of 8 cases performed the 3-tests serodiagnosis were positive, and 3 cases with positive 3-tests serodiagnosis accepted 8-tests were positive. All the specimens were shown to be Echinococcus Granulosus. Conclusion MRI was the most sensitive diagnostic method and the best method to determinate the site and extent of the cystic lesions. CT and serological examination are useful for diagnosis. The key of avoiding misdiagnosis is to enhance understanding of the disease.
3.Cloning of Plasmodium fiddpmon from Hainan Province in China and Its Characteristics
Di XU ; Weibin GNAN ; Fengyi QU
Academic Journal of Second Military Medical University 1982;0(01):-
Two isolates of Plasmodium jalcipanm from Hainan Province were cloned by limiting dilution method and eight clones were established. Some characteristics including drug sensitivity and antigenicity of these clones were observed. The results showed that the established clones were different from each other in chloroquine sensitivity and antigenicity. The ID50 of chloroquin3e against 6 clones from isolate Fcc-7801 varied between 60.60 and 13.08 nmol/L The ID50 of chloroquine against 2 clones from isolate Fcc-1 were 93.63 and 49.64 nmol/L, respectively. According to the indirect fluorescent antibody (IFA) Teactivity of these clones with a panal of murine anti-gpl95 McAbs, 8 clones could be divided into 5-serotypes, 3 of which were consistent with the Ⅴ , Ⅵ, Ⅶ serotypes devided by J. S. McBride (1985).
4.Clinical significance of accelerated junctional rhythm during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia
Weibin HUANG ; Jihong GUO ; Yuan XU
Chinese Journal of Practical Internal Medicine 2002;0(08):-
Objective Accelerated junctional rhythm (AJR) always occur during slow pathway catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT), the clinical significance of it has not been gotten in agreement. The aim of this study is to search for an association between AJR and ablation target site or tachycardia recurrence.Methods The data of 247 patients with AVNRT who received radiofrequency ablation procedure during April 1995 to October 1999 was analyzed. All these people were divided into two groups (212 patients in the successful ablation group or group 1, 35 patients in the recurrence group or group 2). The AJR was divided into two distinct pattern:type Ⅰ(continuous AJR that persisted until the end of energy delivery) and type Ⅱ (intermit AJR alternated with sinus rhythm during slow pathway ablation, which was eliminated immediately when stopping energy delivery ). Results\ The results showed that patients in group 1 exhibited better AJR response, most of them were seen with type Ⅱ AJR. However most of the people in group 2 had no AJR response throughout energy delivery , few of them had type Ⅰ AJR response. The AJR response of group 1 started relatively earlier than that of group 2(3 2?1 8 vs 5 7?2 5 ,P
5.Construction of targeting short hairpin RNA plasmid vector expressing TERT gene
Yang SONG ; Tao XU ; Mingkun YANG ; Weibin SHENG
Chinese Journal of Tissue Engineering Research 2014;(7):1057-1062
BACKGROUND:Telomerase reverse transcriptase (TERT) plays an important role in telomerase activation.
OBJECTIVE:To construct the targeting short hairpin RNA plasmid vector expressing TERT gene from astrocytes by using pLentilox3.7.U6.
METHODS:By using two sequences from TERT gene, we synthetized sense and antisense strand template sequences of RNA interference molecular in vitro, and then obtained the complementary strands through annealing procedure. We connected the strands with pLentilox3.7.U6 that was sequenced and transfected into the Escherichia coli. In the end, we tested its effect of reducing the TERT gene expressing by using cultured astrocytes from rat spinal cord in vitro through western blot and immunofluorescence technique.
RESULTS AND CONCLUSION:Western blot and immunofluorescence assay showed that, compared with the control group, the interference groups had a lower TERT expression in astrocytes. The targeting short hairpin RNA plasmid vector expressing TERT gene is useful to reduce the TERT gene expression. The targeting short hairpin RNA plasmid vector expressing TERT gene is valid for us to do the further test learning the mechanism of astrocytes in spinal cord injury.
6.Single-cage interbody fusion combined with single-side pedicle screw fixation for single-side lumbar disc herniation
Jifeng CHEN ; Weibin SHENG ; Bo HUANG ; Bo HE ; Tao XU
Chinese Journal of Tissue Engineering Research 2013;(43):7552-7558
BACKGROUND:As for patients with one-side backleg pain who were candidates for surgery treatment of lumbar intervertebral disc herniation, the common treatment includes lumbar vertebral plate opening and decompression, and laminectomy in combination with compression and bilateral pedicle screw fixation. However, these therapeutic approaches are not satisfactory. OBJECTIVE:To explore the feasibility and efficiency of single-side lumbar interbody fusion and unilateral pedicle screw fixation for treatment of lumbar intervertebral disc herniation patients with one-side backleg pain. METHODS:Forty patients with single-side lumbar disc herniation, suffering from unilateral backleg pain, were recruited from Shihezi People’s Hospital, China and were treated with single-side lumbar interbody fusion and unilateral pedicle screw internal fixation. The neurological function of patients was assayed using Japanese Orthopaedic Association score system before and after treatment, the improvement rate and excellent/good rate were calculated. Suk criterion was used to determine fusion status. RESULTS AND CONCLUSION:The mean fol ow-up period for 40 patients was ranging from 6 months to 60 months. Al incisions healed wel , with no infection. The Japanese Orthopaedic Association score after 6 months of treatment was significantly higher than that before treatment (P<0.05), with the excellent and good rate up to 88%. According to Suk criterion, 38 patients achieved bone graft fusion or possible fusion, with interbody fusion rate 95%, as revealed by radiographic and CT evidence. The remaining two patients were detected fusion at 9 months after treatment. Our findings indicate that, single-cage lumbar interbody fusion combined with single-side pedicle screw fixation is the feasible surgical technique and provides satisfactory effects in treating single-side lumbar disc herniation.
7.The expression of macrophage migration inhibition factor in pulmonary tissues of smokers with or without chronic obstructive pulmonary disease
Weibin SHE ; Xiansheng LIU ; Wang NI ; Shixin CHEN ; Yongjian XU
Chinese Journal of Internal Medicine 2012;51(11):863-866
Objective To investigate the expression of macrophage migration inhibition factor (MIF) in pulmonary tissues of the smokers with and without chronic obstructive pulmonary disease (COPD).Methods The subjects were assigned into three groups:non-smokers without COPD (control group,n =12),smokers without COPD (smoker group,n =13) and smokers with COPD (COPD group,n =16).The specimens were obtained from lung tissues as far away from cancer focus as possible (> 5cm).Real-time quantitative PCR and immunohistochemistry were used to investigate the expression and distribution of MIF in pulmonary tissues.The relationship between the severity of airflow obstruction and the differential expressions of MIF in lung tissues of the smokers with or without COPD was analyzed.Results (1) MIF mRNA expression in COPD group (4.87 ± 1.79) was higher than that in the smoker group (2.16 ±0.72;P<0.01),which was higher than that in the control group (1.09 ±0.48;P <0.01).(2)Immunohistochemistry analysis showed that MIF protein expression in lung tissues of the COPD group (0.277±0.025) was higher than that in the smokers group (0.199 ±0.034;P <0.01),which was significantly higher than that in control group (0.130 ±0.021 ;P <0.01).(3) Correlation analysis of MIF mRNA expression in the lung tissues and pulmonary function parameters of forced expired volume in one second (FEV1) percentage of predicted (FEV1 pred) and ratio of FEV1 to forced vital capacity (FEV1/FVC) suggested that MIF mRNA expression in the lung tissues was negatively related with FEV1 pred (r=-0.578,P < 0.01) and FEV1/FVC (r =-0.607,P < 0.01).Conclusions MIF expression significantly increases in the smokers with COPD,and MIF level in the lung is positively correlated with airflow limitation.The results suggest that MIF may play an important role in the pathogenesis of smokinginduced COPD.
8.Effects of panax notoginseng saponins on pneumocyte apoptosis and Fas/FasL expression in rabbits with lung ischemia/reperfusion injury
Zhengjie XU ; Shirong NI ; Wantie WANG ; Weibin ZHOU ; Xiwen CHEN
Chinese Journal of Pathophysiology 1999;0(09):-
AIM: AIM: To explore the relationship between apoptosis in the lung tissues and lung ischemia/reperfusion injury, and observe effects of panax notoginseng saponins (PNS) on apoptosis in lung ischemia/reperfusion injury. METHODS: Single lung in situ ischemia/reperfusion animal model was used. Eighty four Japanese white rabbits were randomly divided into control group (control), ischemia/reperfusion 1 h group (IR1h), IR3h, IR5h, Panax Notoginseng Saponins 1 h group (PNS1h), PNS3h and PNS5h. TUNEL, immunocytochemistry and in situ hybridization techniques were used to observe apoptosis and Fas/FasL expression in various phases of lung ischemia/reperfusion. RESULTS: Cell apoptosis in lung tissues were significantly high, Fas/FasL mRNA and its protein were up-regulated in lung tissues of lung ischemia/reperfusion injury compared with control (all of P
9.Preparation of a femoral fracture model combined with spinal cord injury in Sprague-Dawley rats
Hailong WANG ; Weibin SHENG ; Tao XU ; Hailong GUO
Chinese Journal of Tissue Engineering Research 2014;(18):2818-2823
BACKGROUND:In the animal model of spinal cord injury associated with fractures, the trauma is severe and postoperative survival rate is low. The improved Al en method and open femoral osteotomy method for making animal model has many advantages, such as simple operation, no need of special equipment, quick establishment, shortened operation time and reduced intraoperative bleeding, so they are suitable for preparing a femoral fracture model combined with spinal cord injury.
OBJECTIVE:To design an animal model of femoral fracture combined with spinal cord injury, which can maintain long time survival, meet clinical features, and is simple and easy.
METHODS:Forty-eight male Sprague-Dawley rats were randomly divided into simple femoral fracture group and femoral fracture merging spinal cord injury group. Femoral fracture model was caused by opening osteotomy to cause transverse fracture and implantation of internal fixator in femur. According to the improved Al en method, a self-made blow device was applied to cause acute T 10 segment contusion injury of spinal cord in rats. Thus the femoral fracture model merging spinal cord injury was successful y established. The rats in two groups were grossly observed at different time points after the modeling, and the fracture healing at 4 weeks was detected.
RESULTS AND CONCLUSION:Al the animal models of femoral fracture with spinal cord injury survived, which exhibited the loss of sensory and motor function of the lower limbs, but could slowly creep forward by the upper limbs. In the first 3 days, the rats had poor appetite and few activity, with tail suspension at night there were no ischemia and necrosis of the limb fracture. At 4 weeks, one rat in simple femoral fracture group died, while four rats in femoral fracture merging spinal cord injury group died, with the survival rate of 83.33%, intramedul ary fixation were not prolapsed. In the two groups, continuous bone cal us formation was found in the fracture, and the bone cal us volume in femoral fracture merging spinal cord injury group was significantly higher than those in simple femoral fracture group. The results demonstrated that combining the improved Al en method with smal lateral incision open femoral osteotomy is a simple and feasible method for the establishment of femoral fracture model merging spinal cord injury, and the models survive for 4 weeks.
10.Serum transforming growth factor beta 1 contributes to bone healing in patients with bone fractures combined with spinal cord injuries
Sen YANG ; Hailong WANG ; Weibin SHENG ; Tao XU ; Hailong GUO
Chinese Journal of Tissue Engineering Research 2015;(2):165-169
28 days after injury (P < 0.05). In the fracture+spinal cord injury group, the level of serum transforming growth factor beta 1 had a rapid increase on the 7th day, and reached the peak on the 14th day, and then, this level had no significant decrease until the 28th day. In the simple fracture group, the level of serum transforming growth factor beta 1 began to increase on the 2nd day, reached the peak on the 7th day, and then decreased gradualy. Remarkable changes of serum transforming growth factor beta 1 levels in patients with bone fracture combined with spinal cord injury may be associated with fracture healing in different periods.