Objective To explore the efficiency of indocyanine green (ICG) fluorescence imaging-guided hepatectomy and its short-term prognosis in patients with primary liver carcinoma. Methods Retrospective analysis was conducted on 166 patients diagnosed with primary liver carcinoma and admitted to the Department of Hepatobiliary Surgery of Shanghai General Hospital affiliated to Shanghai Jiao Tong University School of Medicine from June 2018 to June 2021. Patients were categorized into ICG group (n=72) and non-ICG group (n=94) based on the utilization of ICG during surgery. Moreover, the clinical information of preoperation, intraoperation, and postoperation were collected and compared between the two groups. ICG fluorescence images of the lesions in the ICG group were recorded for analysis. Results ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis. Hepatocellular carcinoma lesions predominantly displayed partial fluorescence, while intrahepatic cholangiocarcinoma lesions showed circular fluorescence. Well differentiated tumors exhibited complete fluorescence (7/11), moderately differentiated tumors demonstrated partial fluorescence (28/51), and poorly differentiated tumors displayed circular fluorescence (7/10). Most patients with liver cirrhosis exhibited partial fluorescence (18/35) or complete fluorescence (13/35).Compared to the non-ICG group, the ICG group demonstrated higher serum albumin levels on the first (34.6 g/L vs. 31.4 g/L) and the third postoperative days (32.4 g/L vs. 31.2 g/L)(P<0.001). Conversely, the ICG group showed shorter operation time (170 min vs. 210 min), lower rate of intraoperative hepatic portal blockade (9.7% vs. 33.0%), less intraoperative blood loss (400 mL vs. 430 mL), shorter postoperative hospital stay (10 d vs. 14 d), and lower incidence of short-term postoperative complications (4.2% vs. 20.2%) (P<0.05) compared to the non-ICG group. Conclusions ICG fluorescence intensity is associated with the histopathology, differentiation grade of primary liver cancer, and the presence of liver cirrhosis.The judicious application of ICG fluorescence imaging technology alongside surgical techniques holds promise for improving short-term prognosis and expediting the postoperative recovery.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective To investigate the surgery outcomes between patients with different recovery states measured by visual analog scores (VAS),explore the relationships among surgery outcomes,bone cement,and degrees of pain relief,and to find out the best combination of cement volume and cement distribution for Percutaneous kyphoplasty (PKP).Methods There were 220 patients with 220 vertebra,from January 2012 to January 2014,who received PKP in our hospital.Patients were divided into two groups,on the basis of different VAS.The epidemiological data,operative effect,and surgical complications were compared between two groups.Characteristic curve (ROC) was used to analyze the effect of bone cement dosage and distribution on the diagnosis of patients with different recovery state.The correlation was analyzed between the dose and distribution of bone cement and surgery outcomes.Moreover,logistic regression analysis was used to assess the safety of cement implantation.Results A total of 77 recuperators and 143 non-recuperators were included in the study.Two groups of patients in epidemiological data showed no significant difference.The surgery duration,bone cement injection dose,cement distribution,vertebral height restoration rate and improvement of kyphotic angle in the recuperator group were all significantly higher than those in the non-recuperator group.Whether small dose and large dose of bone cement volume and expanded the bone cement distribution area could significantly improve the patient of operation after the recovery rate and bone cement dose with extensive bone cement distribution area and large bone cement dose with limited bone cement distribution area had the same operation after the recovery effect (x2 =2.880,P =0.090).When the cement volume was constant,cement distribution was positively correlated with the restoration rate of vertebral height and improvement of the kyphotic angle (r2 =0.207,P ＜ 0.01;r2 =0.159,P =0.02).Conclusions The value of cement distribution is better than cement volume in relieving patient pain for diagnostic.For PKP,cement distribution above 0.49 with small cement should be suggested.

Objective To investigate the anatomy of upper cervical vertebrae's stable reconstruction by poster arch of atlas screw by anatomic study. Methods To collect the anatomical data of 39 dry atlas with the average inner diameter of vessel of atlas, the average high and wide of the screw point of poster arch of atlas, the average high and wide of poster arch of atlas beneath the groove for vertebral artery, the tract length of poster arch screw, the tract length of lateral mass screw, the direction and angle of poster arch screw, and the direction and angle of lateral mass. Statistical comparison were performed with Student test between the tract length of poster arch screw and the tract length of lateral mass screw. Results The average inner diameter of vessel of atlas was (26.8±2.58) mm(21.7-31.0 mm). The screw point high and wide of poster arch of atlas were (6.83±1.97) mm and (6.40±1.36) mm respectively. The average high and wide of poster arch of atlas beneath the groove for vertebral artery were (4.37±1.11) mm and (8.05±1.33) mm respectively. The tract length of poster arch screw were (30.54±1.705) mm. The direction and angle of poster arch screw was 15°-20° incline laterally and 0°-5°incline cephalo. 25.6%(10 cases) patients with the diameter less than 3.5mm beneath the groove for vertebral artery. The direction and angle of lateral mass screw was 32.05°±6.03° incline medially and 5° incline cephalo. There were significant differences between the tract length of poster arch screw and the tract length of lateral mass screw(t=59.528, P＜0.001 ). Conclusion About 74.4% patients can reconstruct the upper cervical stable by poster arch of atlas screw. The technique can gain instant upper cervical stable, and reduce the risk of injury of blood vessel by over explore the atlas arch compare with the technique of lateral mass screw fixation of atlas. The technique is worth to promoting with its character of safe, easy perform and rigid fixation.

0.05).There were no pseudoarthrosis and internal fixation failure.The incidence of proximal junction kyphosis was higher in group B(P

[Objective]To review the therapeutic effect of TSRH in correction of coronal plane,sagittal plane and horizontal plane malformation of the idiopathic scoliosis,and to evaluate the result of screw-rod and screw-crook-rod system.[Method]A total of 79 idiopathic scoliosis patients who were corrected with TSRH were analyzed.There were 48 males and 31 females with an average age of 15.5 years.Only pedicle screws system was used in 56 cases,pedicle crook or vertebral plate crook in thoracic vertebra,pedicle screws system in lumbar vertebrae were used in 23 cases,then the results of two groups were compared.[Result]Cobb's angel in coronal plane was corrected from 18 to 31 after operation,the correction rate was from 56 percent to 87 percent,with an average of 68 percent;while Cobb's angel in sagittal plane was corrected from 21 to 33 after operation,with an average of 25.Rotation was corrected by I degree,heights were increased by 3 cm in average.The mean followed-up duration of 63 cases was two years and a half year.There was significant difference between the two groups in correction rate in coronal plane and sagittal plane,also in loss of correction in coronal plane.[Conclusion]TSRH could make satisfying results in correction of idiopathic scoliosis,and the result would be better if pedicle screws system is used.

[Objective]To discuss the methods of insertion the pedicle screws of thoracic vertebrae and sum the results of correction of idiopathic scoliosis.[Method]Bone of entrance was removed with rongeur forceps.According to the depth and rotation preoperative,to drill using 1.5 mm and 2.5 mm Kirschner wire.If the resistance was increasing and Kirschner wire was bending,it needs to adjust the direction.Stop to drill whenachieve the depth,after checking the hole using special probe then strike awl in the hole.Checking the hole using specillum again then insert the screws.[Result]97% were successful inserted by one time.There were no patients with spinal cord injury and leakage of cerebrospinal fluid and no infection of incisionsl wound.The correction rate in coronal plane was 73% after surgery.The Cobb's angle in sagittal plane was from 6? to 30?,with average of 23?.Rotation deformity was corrected Ⅰ to Ⅱ degree.There were 103 patients.Follow-up duration was with average 4.9 years.Trunk balance was good and no flat back was happen.Bone graft fused well.The correction lost 3.7% in coronal plane at final follow up.One case was with late infection and 2 patients were with screws broken.The internal fixations were removed out.[Conclusion]Using Kirschner wire to made screw hole is a good way to insert thoracic vertebrace pedicle screw.Screw-rod system had favourable three diamensions correct control force.Fully pedicle screw to correct idiopathic scoliosis has good results.

Objective To summarize the experiences of the diagnosis and treatment of the intraspinal tumors. Methods One hundredand twenty-three cases of the intraspinal tumors were analyzed retrospectively. Results The intraspinal tumors in those patients included meningiomas/neurofibroma in 32 cases (19.5%), neurinoma in 32 cases (26.0%), ependymoma in 8 cases (6.5%), astrocytoma in 13 cases (10.6%), lipoma in 10 cases (8.1%), metastatic tumors and hemangioma each in 5 cases (4.1%), arachnoid cyst in 9 cases (7.3%), and others in 17 cases (13.8%). The extramedullary subdural, epidural and intramedullary tumors accounted for 56.9%, 21.1% and 22.8%. According to the locations, 30.1% tumors located at cervical region, 37.4% at thoracic region, 19.5% at lumbar region and 13.0% at sacral segments. The total removal rates of tumors were 69.1% (the total removal rates of extramedullary tumors were 70.1%, and the removal rates of intramedullary tumors were 60.7%).The improvement rates of different degree of movement, sense and sphincter function were 75.2%, 73.8% and 77.8%. Conclusion Most of the intraspinal tumors are benign, and the surgical outcome is satisfied. The keys of therapeutic efficacy were MRI and microsurgical techniques application. The spinal stability reconstruction is in the extreme need if spinal stability is breached in surgery.

Objective To explore effect of Axis internal fixation system while decompression and fusion for the treatment of timeworn atlantoaxial dislocation with incomplete spinal cord injury.Methods 29 cases of timeworn atlanto-axial dislocation with incomplete spinal cord injury underwent decompression fusion and Axis internal fixation with a 7～46 months (mean 20 months) flowing-up.ResultsAfter treatment, all patients got completed fusion, there was no deterioration of neurofunction, and rate of JOA scores increased was 78.6%.ConclusionAxis internal fixation system can provide immediately a rigid stability and maintain axial correction for the segment ahile decompression and fusion for the treatment of timeworn atlantoaxial deslocation with incomplete spinal cord injury.

Objective To explore the clinical features and operative method of complicated spinal tuberculosis. Methods Totally 562 inpatients suffering from spinal tuberculosis during January 1997 to December 2006 were reviewed retrospectively. A new definition of complicated spinal tuberculosis was made. Complicated spinal tuberculosis was classified into different types. Every type had its special surgical operation approach. Results Among the 87 cases being followed up for 45 months, 75 patients were totally recovered, and 12 patients were obvious improved on the mend according to Dr. Fang Xian-zhi’s standard. The classification of function which above good was 97.1%. The fusion rate was 96.3% during 87 patients who received bone grafting treatment 9 months ago. Posterior convex angle was 24? to 57?, average 35.3?. Conclusion We consider that complicated spinal tuberculosis will not be surgical contraindication. Different types of complicated spinal tuberculosis by different operation approach, and careful preparation before operation will gain good curative outcome.