1.Thoracolumbar disc herniation and Scheuermann's disease
Zefeng SHI ; Zhongqiang CHEN ; Ning LIU ; Qiang QI
Chinese Journal of Orthopaedics 2011;31(5):436-441
Objective To explore the relationship between thoracolumbar disc herniation (TLDH) and Scheuermann1's disease (SD),as well as the role of SD in the etiology of TLDH.Methods From June 2006 to June 2010,45 patients with TLDH (T10-11-L2-3) underwent surgery in our department.Forty-five patients with lower lumbar disc herniation (LDH,L3-4-L5S1) acted as controls.The incidence of SD and Scheuermann's signs of these patients were examined by reviewing CT,MRI and Ⅹ-ray films.The thoracolumbar kyphotic angles of the two groups were compared.Furthermore,in TLDH group,the incidence of disk herniation within segments with the Scheuermann's signs was compared to that within segments without Scheuermann's signs.Results All except one patient in TLDH group(97.8%) had been associated SD while the incidence of SD in LDH group was only 26.7%.The incidence of all Scheuennann's signs was higher in TLDH group than that in LDH group.The average thoracolumbar kyphotic angle of TLDH group was 15.8°±6.9° while that of LDH group was 4.8°±4.0°.In TLDH group,the incidence of disc herniation within segments with Scheuermann's signs was all higher than that within segments without Scheuermann's signs.Conclusion There is a close relationship between TLDH and SD,suggesting that TLDH is probably a manifestation of SD.Schmorl's node,irregular end plate,wedge-shaped vertebra and especially,posterior bony edge separation,are associated with disc herniation.
2.Arthroscopic Fixation With Double-EndoButton Technique for Avulsion Fracture of Anterior Cruciate Ligament
Chinese Journal of Minimally Invasive Surgery 2018;18(5):440-444
Objective To investigate the clinical outcomes of arthroscopic fixation with double-EndoButton for avulsion fracture of anterior cruciate ligament. Methods In the period from January 2016 to April 2017,a total of 12 patients with avulsion fracture of anterior cruciate ligament received arthroscopic fixation with double -EndoButton technique.Range of motion exercises were allowed from 2 to 4 weeks postoperatively,partial weight bearing walking with brace was allowed from 4 weeks postoperatively,and full weight bearing walking was gradually started from 8 to 12 weeks postoperatively.The X-ray was used for evaluation of fracture reduction and bone union.The knee stability was checked by anterior drawer test, the Lachman test and the pivot-shift test.The knee joint function was accessed by the Lysholm Knee Score system. Results The mean operation time was 55-115 min(mean,79.5 min) and the postoperative length of stay was 4 -7 d(mean, 4.8 d).The 12 patients were followed up for 3 -12 months(mean, 7.8 months).All the patients achieved anatomic reduction and bone union at final follow -up.The results of postoperative anterior drawer test, Lachman test and pivot-shift test were negative.The Lysholm knee score was improved from(44.5 ±2.1)points preoperatively to(92.3 ±1.9)points at final follow-up, with statistically significant difference(t =69.983, P =0.000). Conclusions Arthroscopic fixation with double-EndoButton technique is effective for the treatment of avulsion fracture of anterior cruciate ligament.It is convenient for fracture reduction and fixation,providing sufficient stability for early functional rehabilitation of knee joint postoperatively.
3.Daratumumab combined with chemotherapy bridging to allogeneic hematopoietic stem cell transplantation followed by daratumumab and lenalidomide maintenance therapy for primary plasma cell leukemia: report of one case and review of literature
Zefeng YANG ; Keqian SHI ; Renbin ZHAO ; Peng HU ; Xin GUAN ; Chaoran ZHANG ; Zengzheng LI ; Liqun YU
Journal of Leukemia & Lymphoma 2021;30(8):483-486
Objective:To observe the therapeutic efficacy and prognosis of daratumumab combined with chemotherapy bridging to allogeneic hematopoietic stem cell transplantation (allo-HSCT) followed by daratumumab and lenalidomide maintenance treatment for primary plasma cell leukemia (PCL).Methods:The clinical data of a patient with primary PCL admitted to the First People's Hospital of Yunnan Province in January 2020 were retrospectively analyzed, and relevant literatures were reviewed.Results:The patient was diagnosed with primary PCL and treated with daratumumab combined with BD (bortezomib + dexamethasone) for 1 course and BCDD (bortezomib + cyclophosphamide + liposomaldoxorubicin + dexamethasone) for two courses. The patient was treated with daratumumab combined with allo-HSCT after complete remission. The donor cells were successfully implanted and the chimerism rate of donor cells was 94.36% without acute graft-versus-host disease reaction. And then the patient received intermittent maintenance therapy of daratumumab combined with low dose lenalidomide after transplantation, and the current remission period after transplantation reached 4 months.Conclusions:Daratumumab combined with chemotherapy bridging to allo-HSCT followed by daratumumab and lenalidomide may improve the prognosis of primary PCL and prolong survival time.
4. Gene mutations from 511 myelodysplastic syndromes patients performed by targeted gene sequencing
Bing LI ; Jingya WANG ; Jinqin LIU ; Zhongxun SHI ; Shuailing PENG ; Huijun HUANG ; Tiejun QIN ; Zefeng XU ; Yue ZHANG ; Liwei FANG ; Hongli ZHANG ; Naibo HU ; Lijuan PAN ; Shiqiang QU ; Zhijian XIAO
Chinese Journal of Hematology 2017;38(12):1012-1016
Objective:
To study the characteristics of gene mutations in Chinese myelodysplastic syndromes (MDS) patients.
Methods:
A total of 511 Chinese patients with MDS performed 112-gene targeted sequencing were retrospectively analyzed.
Results:
Eighty-three distinct mutant genes were found in 511 patients with MDS. Amongst these, the most frequent mutations was associated with epigenetics (50%) , followed by spliceosome (37%) , signal transduction (34%) , transcription factors (24%) and cell cycle/apoptosis (17%) . 439 subjects (86%) had at least one gene mutation. The mean number of mutations in refractory anemia with unilineage dysplasia (RCUD) was 1.25, refractory anemia with multilineage dysplasia (RCMD) was 1.73, refractory anemia with ring sideroblasts (RARS) was 2.79, refractory anemia with excess blasts-1 (RAEB-1) was 2.22, RAEB-2 was 2.34, MDS with isolated 5q- was 2.67, MDS, unclassified (MDS-U) was 2.00. U2AF1 mutant subjects were more likely to have isolated+8[
5. A study of clinical characteristics and prognosis of primary myelofibrosis patients with thrombocytopenia in varied degrees
Zefeng XU ; Tiejun QIN ; Hongli ZHANG ; Liwei FANG ; Naibo HU ; Lijuan PAN ; Shiqiang QU ; Bing LI ; Xin YAN ; Zhongxun SHI ; Huijun HUANG ; Dan LIU ; Ya’nan CAI ; Yudi ZHANG ; Peihong ZHANG ; Zhijian XIAO
Chinese Journal of Hematology 2019;40(1):12-16
Objective:
To evaluate clinical characteristics and prognosis of primary myelofibrosis (PMF) patients with thrombocytopenia in varied degrees.
Methods:
Clinical features and survival data of 1 305 Chinese patients with PMF were retrospectively analyzed. The prognostic value of thrombocytopenia in patients with PMF was evaluated.
Results:
320 subjects (47%) presented severe thrombocytopenia (PLT<50×109/L), 198 ones (15.2%) mild thrombocytopenia [PLT (50-99)×109/L] and 787 ones (60.3%) without thrombocytopenia (PLT ≥ 100×109/L). The more severe the thrombocytopenia, the higher the proportions of HGB<100 g/L, WBC<4×109/L, circulating blasts ≥ 3%, abnormal karyotype and unfavourable cytogenetics (
6. Clinical implications and prognostic value of TP53 gene mutation and deletion in patients with myelodysplastic syndromes
Huijun HUANG ; Zhongxun SHI ; Bing LI ; Tiejun QIN ; Zefeng XU ; Hongli ZHANG ; Liwei FANG ; Naibo HU ; Lijuan PAN ; Shiqiang QU ; Dan LIU ; Yanan CAI ; Yudi ZHANG ; Zhijian XIAO
Chinese Journal of Hematology 2019;40(3):215-221
Objective:
To explore the clinical implications and prognostic value of TP53 gene mutation and deletion in patients with myelodysplastic syndromes (MDS) .
Methods:
112-gene targeted sequencing and interphase fluorescence in situ hybridization (FISH) were used to detect TP53 mutation and deletion in 584 patients with newly diagnosed primary MDS who were admitted from October 2009 to December 2017. The association of TP53 mutation and deletion with several clinical features and their prognostic significance were analyzed.
Results:
Alterations in TP53 were found in 42 (7.2%) cases. Of these, 31 (5.3%) cases showed TP53 mutation only, 8 (1.4%) cases in TP53 deletion only, 3 (0.5%) cases harboring both mutation and deletion. A total of 37 mutations were detected in 34 patients, most of them (94.6%) were located in the DNA binding domain (exon5-8) , the remaining 2 were located in exon 10 and splice site respectively. Patients with TP53 alterations harbored significantly more mutations than whom without alterations (
7. Mean corpuscular volume ≤100 fl was an independent prognostic factor in patients with myelodysplastic syndrome and bone marrow blast<5 percent
Zhongxun SHI ; Tiejun QIN ; Zefeng XU ; Huijun HUANG ; Bing LI ; Shiqiang QU ; Naibo HU ; Lijuan PAN ; Dan LIU ; Ya’nan CAI ; Yudi ZHANG ; Zhijian XIAO
Chinese Journal of Hematology 2020;41(1):28-33
Objective:
To explore the prognostic effects of mean corpuscular volume (MCV) in patients with myelodysplastic syndromes (MDS) .
Methods:
321 newly diagnosed, untransfused primary MDS patients who administered from December 2009 to December 2017 were enrolled. The association of MCV with prognosis and several clinical features and genetic mutations were analyzed.
Results:
Patients were divided into MCV≤100 fl (