1.Clinical study of enlarged anterior cervical intervertebral cone-shape decompression and fusion in the treatment of degenerative cervical kyphosis
Xiaolong SHEN ; Huajian ZHONG ; Chen XU ; Leixin WEI ; Huajiang CHEN ; Wen YUAN
Chinese Journal of Surgery 2025;63(5):422-428
Objective:To examine the clinical effect of the enlarged anterior cervical intervertebral cone-shape decompression and fusion(EACDF) for treating degenerative cervical kyphosis (DCK).Methods:This study is a retrospective case series research. From September 2018 to September 2023, the data of 51 patients with DCK who underwent EACDF at Department of Orthopaedics, the Second Affiliated Hospital, Naval Medical University were analyzed retrospectively. Among the 51 patients, there were 28 males and 23 females, with an age of (61.6±9.8) years old (range:39 to 74 years), and an body mass index of (25.9±2.7) kg/m 2 (range:20.7 to 31.7 kg/m 2). Patients underwent EACDF with expanded decompression by distracted intervertebral space, partial resections of posterior edge of vertebral body and uncinate vertebral joint. The operation duration, blood loss and length of hospital stay were recorded. The visual analog scale (VAS) of neck pain and arm pain, cervical disability index (NDI), and modified Japanese Orthopaedic Association (mJOA) score were recorded in patients before and immediately after surgery, as well as at follow-up. Imaging parameters such as C 2-7 Cobb angle of cervical global curvature, Cobb angle at the operative segment, C 2-7 sagittal vertical axis (C 2-7 SVA), T 1 slope and the height of operative segment were measured. The fusion rate and surgical complications of two groups were recorded. Fourty-five patients who underwent anterior cervical corpectomy with fusion (ACCF) during the same period were included to compare the effectiveness of deformity correction between the two groups. Repeated measures ANOVA was used for intra group data comparison and Dunnett- t test was used for pairwise comparison, and mixed design ANOVA was used for inter group data comparison. Results:All patients were successfully completed the operation. The follow-up period after surgery was (40.4±13.4) months (range:12 to 72 months). The neck pain and arm pain VAS, NDI and JOA in the two groups immediately after surgery, at 2 months, 12 months after surgery, and the final follow-up were significantly improved compared with those before operation (all P<0.05). In both groups, postoperative the C 2-7 Cobb angle, Cobb angle at the operative segment, C 2-7 SVA, T 1 slope, and height of operative segment were significantly improved immediately after surgery, at 2 months, 12 months, and the final follow-up (all P<0.05). The C 2-7 Cobb angle, Cobb angle at the operative segment, and height of operative segment immediately after surgery, at 2 months, 12 months, and the final follow-up in the EACDF group were significantly higher than those in the ACCF group (all P<0.05). There were no significant differences in C 2-7 SVA and T 1 slope between the two groups(all P>0.05). At the final follow-up, the angle of every intervertebral space correction in the EACDF group was (9.3±1.6) °(range:6.5° to 12.3°), while in the ACCF group was (3.1±1.8) °(range:1.2° to 5.6°), with a significant difference between the two groups ( P<0.05). Patients at the both groups got bone graft fusion at the final follow-up. Conclusions:The clinical effect of EACDF for treating DCK is satisfactory. EACDF maybe superior to ACCF in restoring intervertebral height, correcting and maintaining cervical curvature.
2.Applications and prospects of artificial intelligence in cervical spine surgery
Chinese Journal of Surgery 2025;63(5):383-388
Artificial intelligence(AI) is increasingly being utilized in the research of cervical spine diseases, encompassing areas such as image analysis, assisted diagnosis, clinical treatment decision support, surgical assistance, and postoperative rehabilitation, thereby demonstrating significant clinical value. However, many existing studies primarily focus on evaluating model performance and often lack clear indicators of clinical utility. Additionally, these studies face challenges such as heterogeneity in research design and reporting, low transparency of algorithms and dataset quality. As AI continues to advance rapidly, future efforts should prioritize the establishment of standardized databases, the enhancement of algorithm reliability, the minimization of data bias, and the achievement of comprehensive AI assistant management throughout the cervical spine surgery process.
3.Clinical study of enlarged anterior cervical intervertebral cone-shape decompression and fusion in the treatment of degenerative cervical kyphosis
Xiaolong SHEN ; Huajian ZHONG ; Chen XU ; Leixin WEI ; Huajiang CHEN ; Wen YUAN
Chinese Journal of Surgery 2025;63(5):422-428
Objective:To examine the clinical effect of the enlarged anterior cervical intervertebral cone-shape decompression and fusion(EACDF) for treating degenerative cervical kyphosis (DCK).Methods:This study is a retrospective case series research. From September 2018 to September 2023, the data of 51 patients with DCK who underwent EACDF at Department of Orthopaedics, the Second Affiliated Hospital, Naval Medical University were analyzed retrospectively. Among the 51 patients, there were 28 males and 23 females, with an age of (61.6±9.8) years old (range:39 to 74 years), and an body mass index of (25.9±2.7) kg/m 2 (range:20.7 to 31.7 kg/m 2). Patients underwent EACDF with expanded decompression by distracted intervertebral space, partial resections of posterior edge of vertebral body and uncinate vertebral joint. The operation duration, blood loss and length of hospital stay were recorded. The visual analog scale (VAS) of neck pain and arm pain, cervical disability index (NDI), and modified Japanese Orthopaedic Association (mJOA) score were recorded in patients before and immediately after surgery, as well as at follow-up. Imaging parameters such as C 2-7 Cobb angle of cervical global curvature, Cobb angle at the operative segment, C 2-7 sagittal vertical axis (C 2-7 SVA), T 1 slope and the height of operative segment were measured. The fusion rate and surgical complications of two groups were recorded. Fourty-five patients who underwent anterior cervical corpectomy with fusion (ACCF) during the same period were included to compare the effectiveness of deformity correction between the two groups. Repeated measures ANOVA was used for intra group data comparison and Dunnett- t test was used for pairwise comparison, and mixed design ANOVA was used for inter group data comparison. Results:All patients were successfully completed the operation. The follow-up period after surgery was (40.4±13.4) months (range:12 to 72 months). The neck pain and arm pain VAS, NDI and JOA in the two groups immediately after surgery, at 2 months, 12 months after surgery, and the final follow-up were significantly improved compared with those before operation (all P<0.05). In both groups, postoperative the C 2-7 Cobb angle, Cobb angle at the operative segment, C 2-7 SVA, T 1 slope, and height of operative segment were significantly improved immediately after surgery, at 2 months, 12 months, and the final follow-up (all P<0.05). The C 2-7 Cobb angle, Cobb angle at the operative segment, and height of operative segment immediately after surgery, at 2 months, 12 months, and the final follow-up in the EACDF group were significantly higher than those in the ACCF group (all P<0.05). There were no significant differences in C 2-7 SVA and T 1 slope between the two groups(all P>0.05). At the final follow-up, the angle of every intervertebral space correction in the EACDF group was (9.3±1.6) °(range:6.5° to 12.3°), while in the ACCF group was (3.1±1.8) °(range:1.2° to 5.6°), with a significant difference between the two groups ( P<0.05). Patients at the both groups got bone graft fusion at the final follow-up. Conclusions:The clinical effect of EACDF for treating DCK is satisfactory. EACDF maybe superior to ACCF in restoring intervertebral height, correcting and maintaining cervical curvature.
4.Applications and prospects of artificial intelligence in cervical spine surgery
Chinese Journal of Surgery 2025;63(5):383-388
Artificial intelligence(AI) is increasingly being utilized in the research of cervical spine diseases, encompassing areas such as image analysis, assisted diagnosis, clinical treatment decision support, surgical assistance, and postoperative rehabilitation, thereby demonstrating significant clinical value. However, many existing studies primarily focus on evaluating model performance and often lack clear indicators of clinical utility. Additionally, these studies face challenges such as heterogeneity in research design and reporting, low transparency of algorithms and dataset quality. As AI continues to advance rapidly, future efforts should prioritize the establishment of standardized databases, the enhancement of algorithm reliability, the minimization of data bias, and the achievement of comprehensive AI assistant management throughout the cervical spine surgery process.
5.Research progress in the biological characteristics of matrix metalloproteinase-19 in tumor
Liming CHEN ; Danlin WANG ; Chunze ZHANG ; Huajiang DONG ; Zhihui TAI ; Aidong LIU
International Journal of Biomedical Engineering 2023;46(3):264-269
The matrix metalloproteinases family (MMPs) are proteins related to tumor formation and metastasis that have attracted the attention of scholars in recent years. Tumor cells can secrete MMPs during malignant transformation, and the expression of MMPs in different malignant tumors is diverse, and different members of MMPs do not have exactly the same biological properties. Matrix metalloproteinase-19 (MMP-19) is a new member of MMPs whose secretion increases rapidly during the malignant transformation of cells and is released into the extracellular space to participate in biological processes such as proliferation, adhesion, invasion, migration, and angiogenesis of tumor cells. In this paper, the progress of research on the biological properties of MMP-19 in tumors was reviewed to provide a theoretical basis for exploring the development of tumors, especially for studying the invasion and metastasis of tumor cells.
6.Clinical characteristics of serious interstitial lung diseases
Xiuwen LIU ; Liying WU ; Hongxin ZANG ; Huajiang DONG ; Xuefen CHEN ; Xueren LI
International Journal of Biomedical Engineering 2021;44(6):474-478
Objective:To analyze the clinical characteristics and treatment of patients with serious interstitial lung diseases (SILD).Methods:The clinical data of 43 patients with SILD hospitalized in the respiratory intensive care unit of the Characteristic Medical Center of The Chinese People's Armed Police Force from January 2010 to December 2020 were retrospectively reviewed. According to the prognosis, the patients were divided into the death group and non-death group.Results:The included 43 patients include 31 cases of acute exacerbation of idiopathic interstitial pneumonia (AE-IIP), 18 cases of usual interstitial pneumonia (UIP) and 16 cases of nonspecific interstitial pneumonia (NSIP), in which 40% were aggravated due to co-infection and 33 patients were dead. The results showed that there was no significant difference between death and non-death patients in age, gender, smoking, hospitalization time, duration, clinical symptoms and signs, blood T lymphocyte subsets, co-infection, mechanical ventilation and glucocorticoid dose (all P>0.05), and there were significant differences in arterial partial pressure of oxygen to the fraction of inspired oxygen (PaO 2/FiO 2) and arterial partial pressure of carbon dioxide (PaCO 2) (all P<0.05). The PaO 2/FiO 2 level in the dead patients was lower, who often accompanied by type Ⅱ respiratory failure. Conclusions:AE-IIP was more common in patients with SILD, and most of their chest images were consistent with UIP and NSIP. Pulmonary infection is a common cause of acute exacerbation of SILD, and type II respiratory failure in the progress of the disease is a sign of poor prognosis.
7. Comparison of three different posterior cervical approaches for treating cervical spine trauma with ossification of posterior longitudinal ligament
Min QI ; Huajiang CHEN ; Chen XU ; Wen YUAN
Chinese Journal of Surgery 2019;57(3):176-181
Objective:
To investigate the clinical application value of using laminoplasty combine with short-segment pedicle screw fixation in the treatment of cervical spine trauma patients with ossification of posterior longitudinal ligament (OPLL).
Methods:
Fifty-four cervical spine trauma patients with OPLL from June 2014 to June 2016 were retrospectively analyzed of Department of Spine Surgery, Changzheng Hospital, Naval Military Medical University. There were 31 males and 23 females, aging (68.4±4.3) years (rang: 46 to 82 years). All patients had a history of cervical spine trauma, confirmed by imaging examination of OPLL, and there are signs and symptoms related to cervical spinal cord compression. Eighteen patients underwent one-stage laminoplasty combine with short-segment pedicle screw fixation(group A), and 15 patients underwent posterior cervical laminectomy and pedicle screw fixation (group B). Twenty-one patients underwent posterior laminoplasty (C group). According to the range of OPLL and the compression of the spinal cord, the range of laminoplasty was selected. MRI scan was used to evaluated the compression condition of cervical spine and the injury condition of anterior longitudinal ligament injury and other factors that can cause local instability of the cervical spine. Posterior unilateral pedicle screw fixation (two pedicles) were performed in the instability segment. The neurological function of the patients was assessed by the Japanese Orthopedic Association (JOA) Score before surgery, the second day after surgery, 3 months, 1 year and the last follow-up. The cervical spine X-ray films were used to evaluate cervical curvature, cervical spine activity and internal fixation-related complications.
Results:
The average follow-up time was 18 months (6-30 months). Satisfactory neurological improvement was achieved in all three groups, and no internal fixation-related complications occurred during follow-up. The range of laminoplasty was 22 cases in 4 segments (C3-C6, C4-C7) and 17 cases in 5 segments (C3-C7). Unilateral pedicle screw fixation was performed in 11 patients with C3-4 fixation and 7 patients with C4-5 fixation. Cervical curvature was basically the same in the three groups after operation and at the last follow-up. No significant changes in cervical curvature and kyphosis were observed during the follow-up period. The overall cervical mobility (C2-C7) in group A and group C had no significant difference compared with preoperative (
8.A study of cervical sagittal parameters change after two modus of anterior cervicalsurgery in cervical myelopathy
Wenchao YU ; Wen YUAN ; Huajiang CHEN ; Peng CAO ; Chen XU ; Chen YANG
Chinese Journal of Orthopaedics 2018;38(21):1285-1292
Objective To analyze cervical sagittal parameters change after anterior cervical discectomy fusion (ACDF) and anterior cervical corpectomy fusion (ACCF) in cervical myelopathy.Methods 80 patients with cervical myelopathy who underwent anterior cervical surgery between March 2013 and October 2014 were analyzed in this study.44 patients (24 males,20 females) were operated by ACDF,with an average age of 59.5±4.26 years old and 36 patients (20 males,16 females) were operated by ACCF,with an average age of 62.5±3.85 years old.Japanese Orthopaedic Association (JOA) scores,visual analogue scale (VAS) and neck disability index (NDI) were obtained in all patients preoperatively,6 months after surgery and at the latest follow-up.Standing radiographs of cervical spine,CT (3D) and MR were obtained preoperatively,6 months after surgery and at the latest follow-up.Cervical sagittal parameters were assessed with the following 3 parameters:C2-7 Cobb angle,C2-7 sagittal vertical axis (C2-7 SVA) and T1-Slope.Results All the patients were followed up from 18 to 26 months,with the average time of 22 months.The group of ACDF:JOA scores,VAS scores and NDI scores changed from 8.1±1.4,5.8±1.2,22.2±5.9 to 13.2±1.8,1.5±1.4,10.5± 4.8.The group of ACCF:JOA scores,VAS scores and NDI scores changed from 7.3±1.6,4.9±1.5,24.2±4.3 to 13.9±1.1,1.7±1.2,11.3±4.2.There was no significant difference of JOA scores,VAS scores and NDI scoresbetween two group (t=1.544,0.887,1.666;P=0.134,0.382,0.107).The group of ACDF:C2-7 Cobb angle,C2-7 SVA and T1-Slope angle changed from 17.5°±4.7°,20.3±9.3 mm,35.2°±8.6° to 29.5°±5.2°,11.2±8.6 mm,28.7°±8.2°.The group of ACCF:C2-7 Cobb angle,C2-7 SVA and T1-Slope angle changed from 16.8°±5.1°,19.5±8.6 mm,34.6°±9.1° to 25.3°±4.2°,15.7±9.2 mm,30.3°±7.9°,with significant difference between the two group (t=2.75,2.45,2.34;P=0.039,0.045,0.043).The changes of T1-Slope angle in ACDF group were more significantly (P< 0.05).In each group,compared with patients who had low T1-Slope (< 25°) preoperatively,the C2-7 SVA in the patients with high T1-Slope (>25°) was decreased significantly.Compared with patients who had high T1-Slope preoperatively,the C2-7 Cobb in the patients with low T1-Slope was increased significantly.Conclusion Good curative effect could be achieved by ACDF and ACCF in cervical myelopathy.Both surgical methods can maintain the curvature of the cervical alignment and improve the sagittal balance parameters of the cervical alignment.Consideringthe cervical sagittal balance,the ACDF is more suitable for the patient with high T1-Slope angle preoperatively.
9.Cross-sectional survey on adaptation of graduate students with current management mode in a military medical university
Fei ZHONG ; Long QING ; Huajiang CHEN
Chinese Journal of Medical Education Research 2017;16(12):1227-1232
Objective To research the current problems in graduate education administration of military medical university, a questionnaire survey was made. Aimed at the actual needs of students, coun-termeasures and suggestions were put forward. Methods Using self-compiled questionnaire, we investigated the physical and mental state of postgraduate students and the attitude to graduate advisor, scientific re-search and management system in a military medical university during from October 2016 to January 2017. Data processing and statistical analysis were used by SPSS 23.0, and the data of different categories of students were compared by chi square test. Results 320 questionnaires were distributed and 309 valid questionnaires were collected. The recovery rate was 96.5%. 95.8% of graduate students (315 people) gen-erally recognized the patterns and manage effectiveness of graduate advisor and management unit. 70.9%(219 people) were satisfied with current graduate life. 73.5% (227 people) were also able to maintain a good mood and mentality. 78.7% (243 people) felt the high pressure of research and 91.2% (282 people) were satisfied with their mentor. There was a statistically significant difference in the overall evaluation of student team management among students of different source categories (P=0.002), and there was a statistically significant difference in frequency of monthly communication with tutors among different majors ( P=0.002). Conclusion The graduate students in the university are currently able to adapt to the overall man-agement system. However, we should strengthen the targeted management according to the categories of students, strengthen students' psychological counseling work, deepen their life and find unstable factors in time, and coordinate the management of tutors and student teams, so that scientific research and organiza-tional management complement each other.
10.Effect of umbilical cord mesenchymal stem cells on VEGF and MCP-1 of acute myocardial ischemia-reperfusion injury in rats
Shijin CHEN ; Yufang SHI ; Bo ZHANG ; Jun LIU ; Song HAN ; Wei LI ; Huajiang DONG ; Chongzhi SHANG ; Huipeng MENG ; Hongjun DING ; Mingliang ZHAO
International Journal of Biomedical Engineering 2017;40(6):453-456
Objective To investigate the effects of human umbilical cord mesenchymal stem cells (UC-MSCs ) on vascular endothelial growth factor ( VEGF ) and monocyte chemoattractant protein-1 ( MCP-1 ) of acute myocardial ischemia-reperfusion (AMI-R) injury in rats. Methods 24 Sprague-Dawley rats were randomly divided into sham group, AMI-R group and UCMSCs treatment groups on average. The rats were sacrificed on the 10th day after UCMSCs transplantation, and the myocardial tissues below the ligature were taken. The mRNA and protein expressions of MCP-1 of the tissue were detected by RT-PCR and Western Blot respectively, and the expression of VEGF protein was detected by immunohistochemistry. Results The relative expression levels of MCP-1 mRNA and the protein in UCMSCs group were significantly lower than those in sham group and AMI-R group (all P<0.05). The expression of VEGF protein in UCMSCs group was significantly higher than that in sham group and AMI-R group, the differences were statistically significant(all P<0.05). Conclusion UCMSCs transplantation can promote the angiogenesis and decrease the inflammation reaction in the treatment of acute myocardial ischemia-reperfusion injury.

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