1.Lateral fusion after oblique lateral lumbar interbody fusion: incidence, imaging characteristics, and contributing factors
Yongjun TONG ; Chudi FU ; Junhui LIU ; Bao HUANG ; Yilei CHEN ; Zhi SHAN ; Xuyang ZHANG ; Shunwu FAN ; Fengdong ZHAO
Chinese Journal of Orthopaedics 2025;45(7):420-428
Objective:To evaluate the characteristic manifestations of lumbar fusion following oblique lateral interbody fusion (OLIF), determine the specific incidence of these patterns, and the identify factors associated with fusion characteristics.Methods:This retrospective study analyzed 209 patients who underwent OLIF surgery at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2017 and September 2023. The cohort had a mean age of 64.2±9.8 years and included 125 males and 84 females. A total of 338 lumbar segments were assessed, comprising 159 segments treated with stand-alone OLIF (OLIF-SA) and 179 segments treated with OLIF combined with posterior pedicle screw fixation (OLIF-PSF). Inclusion criteria were: patients aged 18-80 years who underwent OLIF with complete radiographic records. Surgical parameters, including fixation method, number of fused segments, surgical approach, and cage dimensions (height and width), were obtained from operative records. Radiographic evaluation included preoperative osteophytes, Hounsfield unit (HU) values of endplates, and cage positioning. Fusion rate, fusion pattern (lateral vs. central), cage subsidence, and related influencing factors were assessed. Clinical outcomes were measured via the Oswestry disability index (ODI) and visual analog scale (VAS) preoperatively, immediately postoperatively, and at 1-year follow-up. Results:The overall fusion rate was 98.2% (332/338), with a non-union rate of 1.8% (6/338). The incidence of lateral fusion was 40.2% (136/338). In the OLIF-SA group, lateral and central fusion rates were 50.3% (80/159) and 49.7% (79/159), respectively, with no cases of non-union. In the OLIF-PSF group, lateral fusion occurred in 31.3% (56/179), central fusion in 65.4% (117/179), and non-union in 3.3% (6/179), with statistically significant differences between groups ( P<0.05). Preoperative osteophytes and higher endplate HU values were significantly associated with lateral fusion ( P<0.05). However, cage dimensions and cage position (anterior-posterior and lateral placement) were not significantly associated with fusion pattern ( P>0.05). Overall, 61.5% (208/338) of segments showed no cage subsidence; 24.5% (83/338) had settling, and 14.0% (47/338) had grade 1 or higher subsidence. Among lateral fusion cases, the rates of no subsidence, anchoring, grade 1, grade 2, and grade 3 subsidence were 67.6%, 21.3%, 7.4%, 3.9%, and 0.7%, respectively. In the central fusion group, these rates were 59.2%, 27.6%, 9.2%, 2.5%, and 1.3%, respectively. In the non-union group, grade 2 and 3 subsidence occurred in 50% (3/6) each, significantly higher than in the other fusion groups ( P<0.05). Post hoc analysis confirmed that grade 2 and 3 subsidence rates were significantly elevated in the non-union group compared to the lateral and central fusion groups, while other subsidence categories showed no significant differences across groups. Clinically, patients showed significant improvements in ODI and VAS scores following surgery ( P<0.05). Conclusions:Lateral fusion occurred in 40.2% of OLIF cases. The OLIF-SA technique, preoperative osteophytes, and elevated preoperative HU values were significantly associated with lateral fusion. In contrast, surgical approach, number of fused segments, cage height, width, and cage positioning did not significantly influence the occurrence of lateral fusion.
2.Stem cell therapy for amyotrophic lateral sclerosis:cell source,number,modification,and administration route
Wen ZHAO ; Yulin BI ; Xuyang FU ; Hongmei DUAN ; Zhaoyang YANG ; Xiaoguang LI
Chinese Journal of Tissue Engineering Research 2025;29(19):4083-4090
BACKGROUND:With the continuous advancement of medical technology,stem cell therapy has been used to treat a variety of diseases,including amyotrophic lateral sclerosis. OBJECTIVE:To review the research progress of stem cell therapy for amyotrophic lateral sclerosis,and prospect the development trend of this field. METHODS:PubMed,China National Knowledge Infrastructure(CNKI),and WanFang Data were searched for articles published from 1995 to 2024 using the key words"amyotrophic lateral sclerosis,mesenchymal stem cells,neural stem/progenitor cells,pluripotent stem cells."A total of more than 1 700 articles were retrieved,and 58 articles were finally included in this review. RESULTS AND CONCLUSION:Amyotrophic lateral sclerosis is a neurodegenerative disease that affects lower motor neurons in the brainstem and spinal cord and upper motor neurons in the motor cortex.The related research of stem cells in the treatment of amyotrophic lateral sclerosis has become a research hotspot.In this review,we summarize the application of different types of stem cells in amyotrophic lateral sclerosis research,including mesenchymal stem cells,neural stem progenitor cells,and induced pluripotent stem cells,and evaluate the key points of preclinical research such as stem cell source,cell volume,stem cell modification methods,and drug delivery routes,which lays the foundation for the future application of stem cell therapy.
3.High-risk factors for significant liver histopathological damage in patients with indeterminate phase of chronic HBV infection
Wenchang WANG ; Xuyang LI ; Chunyan WANG ; Mengwen HE ; Yifan GUO ; Yiming FU ; Miao LIU ; Dong JI
Journal of Clinical Hepatology 2025;41(11):2258-2264
ObjectiveTo investigate the features of liver histopathological damage in patients with indeterminate phase of chronic HBV infection, as well as the timing for initiating antiviral therapy in such patients. MethodsA retrospective screening was performed for the patients with chronic HBV infection who were hospitalized in The Fifth Medical Center of Chinese PLA General Hospital and underwent liver biopsy from March 2018 to April 2022, among whom the patients who met the criteria for indeterminate phase defined in Chinese guidelines for chronic hepatitis B prevention and treatment (2022 edition) were enrolled, and their clinical data were collected. Liver histopathological stage was determined using the Scheuer scoring system, with stages 0 — 4 for inflammation grade (G) and stages 0 — 4 for fibrosis degree (S), and the patients were divided into groups based on the presence of significant necroinflammation (≥G2) and significant liver fibrosis (≥S2). The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. A Spearman’s rank correlation analysis was used to investigate the correlation between liver histopathology and clinical factors, and the Logistic regression model was used to identify the independent influencing factors for significant necroinflammation and liver fibrosis. ResultsA total of 271 patients with indeterminate phase of chronic HBV infection were enrolled, among whom 61 (22.5%) had significant necroinflammation (≥G2) and 124 (45.8%) had significant liver fibrosis (≥S2). The Logistic regression analysis showed that alanine aminotransferase ≥30 U/L (for male patients) or ≥19 U/L (for female patients) (odds ratio [OR]=2.69, 95% confidence interval [CI]: 1.39 — 5.21, P=0.003), HBV DNA ≥2 000 IU/mL (OR=2.75, 95%CI: 1.38 — 5.48, P=0.004), and liver stiffness measurement (LSM) ≥6.0 kPa (OR=4.57, 95%CI: 2.17 — 9.62, P<0.001) were independent risk factors for significant inflammation. HBV DNA ≥2 000 IU/mL (OR=1.82, 95%CI: 1.01 — 3.32, P=0.049) and LSM ≥6.0 kPa (OR=2.06, 95%CI: 1.23 — 3.43, P=0.006) were independent influencing factors for significant liver fibrosis. ConclusionAmong the patients with indeterminate phase of chronic HBV infection, a substantial proportion of patients have significant liver histopathological damage. Antiviral therapy should be initiated in a timely manner for patients with high-risk factors.
4.Lateral fusion after oblique lateral lumbar interbody fusion: incidence, imaging characteristics, and contributing factors
Yongjun TONG ; Chudi FU ; Junhui LIU ; Bao HUANG ; Yilei CHEN ; Zhi SHAN ; Xuyang ZHANG ; Shunwu FAN ; Fengdong ZHAO
Chinese Journal of Orthopaedics 2025;45(7):420-428
Objective:To evaluate the characteristic manifestations of lumbar fusion following oblique lateral interbody fusion (OLIF), determine the specific incidence of these patterns, and the identify factors associated with fusion characteristics.Methods:This retrospective study analyzed 209 patients who underwent OLIF surgery at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between July 2017 and September 2023. The cohort had a mean age of 64.2±9.8 years and included 125 males and 84 females. A total of 338 lumbar segments were assessed, comprising 159 segments treated with stand-alone OLIF (OLIF-SA) and 179 segments treated with OLIF combined with posterior pedicle screw fixation (OLIF-PSF). Inclusion criteria were: patients aged 18-80 years who underwent OLIF with complete radiographic records. Surgical parameters, including fixation method, number of fused segments, surgical approach, and cage dimensions (height and width), were obtained from operative records. Radiographic evaluation included preoperative osteophytes, Hounsfield unit (HU) values of endplates, and cage positioning. Fusion rate, fusion pattern (lateral vs. central), cage subsidence, and related influencing factors were assessed. Clinical outcomes were measured via the Oswestry disability index (ODI) and visual analog scale (VAS) preoperatively, immediately postoperatively, and at 1-year follow-up. Results:The overall fusion rate was 98.2% (332/338), with a non-union rate of 1.8% (6/338). The incidence of lateral fusion was 40.2% (136/338). In the OLIF-SA group, lateral and central fusion rates were 50.3% (80/159) and 49.7% (79/159), respectively, with no cases of non-union. In the OLIF-PSF group, lateral fusion occurred in 31.3% (56/179), central fusion in 65.4% (117/179), and non-union in 3.3% (6/179), with statistically significant differences between groups ( P<0.05). Preoperative osteophytes and higher endplate HU values were significantly associated with lateral fusion ( P<0.05). However, cage dimensions and cage position (anterior-posterior and lateral placement) were not significantly associated with fusion pattern ( P>0.05). Overall, 61.5% (208/338) of segments showed no cage subsidence; 24.5% (83/338) had settling, and 14.0% (47/338) had grade 1 or higher subsidence. Among lateral fusion cases, the rates of no subsidence, anchoring, grade 1, grade 2, and grade 3 subsidence were 67.6%, 21.3%, 7.4%, 3.9%, and 0.7%, respectively. In the central fusion group, these rates were 59.2%, 27.6%, 9.2%, 2.5%, and 1.3%, respectively. In the non-union group, grade 2 and 3 subsidence occurred in 50% (3/6) each, significantly higher than in the other fusion groups ( P<0.05). Post hoc analysis confirmed that grade 2 and 3 subsidence rates were significantly elevated in the non-union group compared to the lateral and central fusion groups, while other subsidence categories showed no significant differences across groups. Clinically, patients showed significant improvements in ODI and VAS scores following surgery ( P<0.05). Conclusions:Lateral fusion occurred in 40.2% of OLIF cases. The OLIF-SA technique, preoperative osteophytes, and elevated preoperative HU values were significantly associated with lateral fusion. In contrast, surgical approach, number of fused segments, cage height, width, and cage positioning did not significantly influence the occurrence of lateral fusion.
5.Components analysis and anti-psoriatic effect of standard decoction of Lithospermum
Wenjing ZHANG ; Jing FU ; Lu ZHANG ; Tianyuan WANG ; Xuyang HAN ; Ping LI ; Zuping ZENG
International Journal of Traditional Chinese Medicine 2019;41(3):273-278
Objective To analyze the main ingredients and investigate the anti-psoriasis effect in the standard decoction of Lithospermum. Methods The extraction rate was determined by extract determination method, and the content of total polysaccharide and total phenolic acid was evaluated by spectrophotometry. Moreover, the effects of different concentrations of the standard decoction of Lithospermum on skin lesions induced by imiquimod (IMQ) in psoriatic mice were observed. Results The extracting rate was 4.65 %, the total polysaccharide content was 1.182 mg/ml and the total phenolic acid content was 3.506 mg/ml. The different concentrations of the standard decoction of Lithospermum could ameliorate the scales, erythema and psoriasis-like mice skin and reduce the thickness of epidermis. Conclusions The standard decoction of Lithospermum could improve the psoriasis-like lesions induced by imiquimod in mice and possess the anti-psoriasis effect.
6.Stereotactic hematoma aspiration for supratentorial hypertensive intracerebral hemorrhage:comparison with conservative treatment
Xinjun WANG ; Xuyang ZHANG ; Xudong FU ; Shaolong ZHOU ; Zhuo YANG
International Journal of Cerebrovascular Diseases 2018;26(6):434-438
Objective To compare the effectiveness of stereotactic hematoma aspiration and conservative treatment for supratentorial hypertensive intracerebral hemorrhage (HICH) with hematoma volume 25-40 ml. Methods Patients with supratentorial HICH admitted to the Department of Neurosurgery, the Fifth Affiliated Hospital of Zhengzhou University from January 2014 to January 2017 were retrospectively enrolled. The incidence of rebleeding, good outcome (defined as the modified Rankin Scale score 0-2 at 3 months after onset) rate, and mortality were compared between the stereotactic hematoma aspiration group and the conservative treatment group. Results A total of 204 patients were enrolled. Their mean age was 61. 3 ±9. 2 years, 114 were males, and their median hematoma volume was 32 ml (interquartile range 25- 39 ml), median baseline Glasgow Coma Scale score was 11 (interquartile range 9-14), and there was no patient with brain herniation. One hundred and twenty patients (58. 8%) underwent stereotactic hematoma aspiration and 84 (41. 2%) received conservative treatment. Compared with the conservative treatment group, the incidence of rebleeding in the stereotactic hematoma aspiration group was significantly lower (2. 5% vs. 22. 6%, χ2 =20. 788, P < 0. 001), and the rate of good outcome was significantly higher at 3 months after onset (85. 0% vs. 70. 2%; χ2 = 8. 305, P = 0. 004 ), but there was no significant difference in mortality (5. 0% vs. 11. 9%, χ2 =3. 259, P =0. 071). Multivariable logistic regression analysis showed that advanced age (odds ratio [OR] 1. 77, 95% confidence interval [CI] 1. 25-2. 46; P = 0. 006), previous stroke history (OR 1. 36, 95% CI 1. 12-1. 64; P =0. 032), and conservative treatment (OR 1. 42, 95% CI 1. 25-1. 78; P = 0. 021) were the independent risk factors for poor outcomes. Conclusions Stereotactic hematoma aspiration can significantly reduce the incidences of rebleeding and risk of the poor outcome in the supratentorial HICH patients with hematoma volume 25-40 ml. Therefore, early active surgical treatment should be considered.

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