1.Ilizarov bone transport assisted by a 3D printed patient-specific guide plate for treatment of tibial bone defects
Hao ZHENG ; Lili WANG ; Yong LIU ; Jianli WANG ; Xuejian GAO
Chinese Journal of Orthopaedic Trauma 2023;25(7):617-623
Objective:To evaluate the efficacy of 3D printed patients-specific guide plates in assisting Ilizarov bone transport in the treatment of tibial bone defects.Methods:A retrospective study was conducted to analyze the clinical data of 24 patients with tibial bone defects who had been admitted to Institute of Trauma Orthopedics, The 80th Army Group Hospital of PLA from January 2018 to March 2022. There were 9 males and 15 females with an age of (49.8±6.5) years, and 4 upper tibial defects, 5 middle tibial defects, and 15 lower tibial defects. According to the methods of repairing bone defects, the patients were divided into 2 groups: a 3D printing group of 10 cases where a 3D printed patient-specific guide plate was used to assist Ilizarov bone transport in the treatment of tibial bone defects, and a traditional group of 14 cases where Ilizarov bone transport was performed in a traditional manner. The 2 groups were compared in terms of operation time, frequency of intraoperative fluoroscopy, axial angulation of the tibia at postoperation and the last follow-up, external fixation time (EFT) and external fixation index (EFI). At the last follow-up, healing of bone defects was evaluated according to the criteria of The Association for the Study and Application of the Method of Ilizarov (ASAMI), functional outcomes were evaluated according to the Paley criteria, and needle infection was recorded according to the Paley classification for complications.Results:There was no statistically significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (11.3±2.0) months on average after operation. The 3D printing group had significantly shorter operation time [(19.9±2.6) min] and significantly lower frequency of intraoperative fluoroscopy [(3.0±0.8) times] than the traditional group [(38.1±2.2) min and (8.9±1.3) times] (P<0.05), and had significantly better axial angulation of the tibia at postoperation and the last follow-up than the traditional group ( P<0.05). There was no significant difference in EFT or EFI between the 2 groups ( P>0.05), and the last follow-up revealed no significant difference either in bone healing, functional outcomes, or needle infection between the 2 groups ( P>0.05). Conclusion:In the treatment of tibial bone defects, compared with conventional Ilizarov bone transport, the Ilizarov bone transport assisted by a 3D printed patient-specific guide plate demonstrates advantages of shorter operation time, lower intraoperative fluoroscopy, and higher reduction accuracy.
2.No-touch technique for harvesting saphenous vein in coronary artery bypass grafting and research progress
Wei LI ; Xuejian HOU ; Zhuhui HUANG ; Kui ZHANG ; Ran DONG ; Jubing ZHENG
Chinese Journal of Thoracic and Cardiovascular Surgery 2023;39(7):436-440
The saphenous vein has been one of the most commonly used vascular materials for coronary artery bypass grafting(CABG), but the low long-term patency of the vein grafts limits the surgical benefits of CABG. The traditional method of saphenous vein harvesting is more damaging to the venous structures, which has led to the development of no-touch saphenous vein harvesting techniques. In this paper, we review the clinical progress of no-touch saphenous vein in CABG and the potential mechanisms of this technique, to improve the patency of vein grafts by analyzing the latest literature and research progress at the domestic and international level.
3.Treatment of traumatic fibrous stiffness of the knee with a combination of arthrolysis and Ilizarov tech-nique
Jiancheng ZANG ; Lei SHI ; Xuejian ZHENG ; Sihe QIN
Chinese Journal of Orthopaedic Trauma 2022;24(6):464-470
Objective:To investigate the clinical efficacy and indications of arthrolysis plus Ilizarov technique in the treatment of traumatic fibrous stiffness of the knee.Methods:The clinical data were analyzed retrospectively of the 9 patients (10 knees) with traumatic fibrous stiffness who had been treated by arthrolysis plus Ilizarov technique from January 2012 to December 2020 at Department of Orthopaedics, Rehabilitation Hospital of National Research Center for Rehabilitation Technique Aids. There were 8 males and one female, aged from 15 to 42 years (average, 30.2 years). The left side was affected in 2 cases, the right side in 6 ones and bilateral sides in one. Their knee stiffness was all caused by injury around the knee. The time from injury to treatment ranged from 12 months to 38 years (average, 16.5 years). The admission examination revealed that the knee extension ranged from -40° to 0° and the knee flexion from -10° to 40°. Wearing time for the external fixator and incidence of complications were recorded; the ranges of knee motion were compared before and after treatment; the Qin Sihe criteria for postoperative limb deformity correction were used at the last follow-up to evaluate the curative efficacy.Results:The 9 patients were followed up for 20 to 78 months with an average of 35 months. The external fixators were worn for 14 to 200 days with an average of 78.4 days. During the traction period, pin tract reaction (3 holes) occurred in 2 patients with 3 knees, pin tract infection (2 holes) in 2 patients with 2 knees, the incision healed poorly in one patient, and no other complications occurred. The functional recovery of the knee was good at the last follow-up. The knee extension was 0°, insignificantly different from the preoperative value (-6.5°±12.9°) ( t=-1.591, P=0.146); the flexion angle was 70.0°±17.6°, significantly better than the preoperative value (15.0°±17.2°) ( t=-6.822, P< 0.001). According to the Qin Sihe postoperative criteria, the curative efficacy at the last follow-up was excellent in 7 knees and good in 3. Conclusion:In the treatment of traumatic fibrous stiffness of the knee, when the efficacy of simple arthrolysis is not good enough, a combination with Ilizarov technique can help improve the postoperative knee function and prevent severe complications.
4.Thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children
Hao ZHENG ; Yong LIU ; Lili WANG ; Jianli WANG ; Xuejian GAO
Chinese Journal of Microsurgery 2022;45(5):528-533
Objective:To investigate the clinical effect of thoracoumbilical flap combined with random abdominal flap in repair of large-area soft tissue defects of calf in children.Methods:The clinical data of 16 children with large-area soft tissue defects of calf treated with thoracoumbilical flap combined with abdominal random flap from January 2004 to December 2007 in PLA Trauma Orthopaedic Research Institute, 80th Group Military Hospital of the PLA were retrospectively analysed. There were 7 boys and 9 girls aged 8 to 14(11.3 in average) years old. Six cases were crushed by heavy objects, 6 crushed by wheels, 3 by thermal press and 1 by machine strangulation. After thorough debridement, the wound area ranged from 16.0 cm×9.0 cm to 38.0 cm×15.0 cm. Four cases were treated after 3-10 hours of injury by emergency surgery. Twelve cases received surgeries 0-11 days after hospital admission and wound being stabilised. Doppler ultrasound was used to locate the perforating vessels according to the location, size and shape of the wound. Thoracoumbilical flap combined with abdominal random flap were designed and harvested to repair the wound. The sizes of flaps were 18.0 cm×11.0 cm-40.0 cm×16.0 cm. All patients entered follow-up at the outpatient clinic or through WeChat interviews. The appearance, texture of the flap and limb recovery were checked and recorded.Results:After surgery, all of 16 flaps survived, of which 12 flaps had phase-one healing, 3 flaps had small area of necrosis at the edge, which healed after repeated dressing changes and 1 flap developed vascular comproise, and survived after surgical exploration. The donor sites healed in phase-one. All 16 children had 6 months to16 years of follow-up, with an average of 20.7 months. The colour of the flaps was normal with soft texture. The motor function of calf was satisfactory. According to Punor functional evaluation criteria, 12 cases were in excellent and 4 in good.Conclusion:The thoracoumbilical flap combined with abdominal random flap features a reasonable design, strong blood supply and repair of a large area. It is a reliable method for repairing large area soft tissue defects in the calf of children.
5.Effect of lncRNA loc730101 on the biological characteristics of osteosarcoma U2OS cells through Wnt/β-catenin signal pathway
Yawei CAO ; Peng XIAO ; Jinpeng SUN ; Xiaodong SONG ; Fei ZHENG ; Xuejian WU
Chinese Journal of Microsurgery 2020;43(2):161-166
Objective:To investigate the effect of long-chain non coding RNA (lncrna) loc730101 in the proliferation, invasion and migration of U2OS cells, and its mechanism.Methods:From February, 2019 to October, 2019, U2OS cells cultured in vitro were divided into control group (normal culture), negative group (transfection nega- tive control), and interference group (transfection of interference sequences targeting LOC730101). The expression of LOC730101 in cells was detected by reverse transcription-polymerase chain reaction (RT-PCR). Cell proliferation ac tivity was tested by methylthiazolyldiphenyl-tetrazolium bromide (MTT) method. Cell clone formation rate was mearused by plate clone formation test. Cell cycle distribution was tested by flow cytometry. Cell invasion and migra- tion were examed by Transwell chamber. The expression levels of epithelial-mesenchymal transition-related proteins Vimentin, N-cadherin, E-cadherin, and Wnt/β-catenin signaling pathway related proteins in cells β-catenin, c-Myc, cyclin D1(CyclinD1) and matrix metalloproteinase-7(MMP-7) proteins were detected by Western blotting method. The date was statistical analysed and considered as statistically significant when P<0.05. Results:Compared with the control group, the expression level of LOC730101 (0.25±0.03 and 1.00±0.06) in interference group and control group, respectively. The same below), cell survival rate [(57.65±3.26)% and (100.00±7.39)%], clone formation rate [(13.03± 2.12)% and (25.35±3.58)%], number of invasive cells(51.36±3.48 and 92.85±6.62), number of migrating cells (77.15± 5.05 and 136.92±15.35), the percentage of cells in S phase [(20.54±2.15)% and (28.15±2.38)%] and G 2/M phase [(16.87±2.12)% and (23.36±3.12)%], as well as the expression level of Vimentin (0.52±0.04 and 1.17±0.13), N-cadherin (0.31±0.03 and 0.65±0.04), β-catenin (0.42±0.03 and 0.73±0.04), c-Myc (0.29±0.03 and 0.65±0.03), CyclinD1 (0.26± 0.02 and 0.58±0.04), MMP-7 protein (0.55±0.03 and 0.86±0.06) was decreased significantly ( P<0.05), while the per- centage of cells in G 0/G 1 phase [(62.62±5.15)% and (48.46±3.65)%] and the expression level of E-cadherin protein(0.82± 0.06 and 0.38±0.03) were increased significantly in the interference group ( P<0.05). But there was no significant differ- ence in each index in the negative group ( P>0.05). Conclusion:Reduce the regulation of LOC730101 can inhibit the proliferation, invasion and migration of U2OS cells, and its mechanism may be related to the inhibition of Wnt/β-catenin signaling pathway.
6.Clinical trial of levocarnitine on patients with continuous blood purification
Yilan LOU ; Meng JIANG ; Xuejian ZHENG
Chinese Journal of Biochemical Pharmaceutics 2017;37(4):201-203
Objective To evaluate the clinical effect of levocarnitine in the treatment of continuous blood purification and its effect on matrix metalloproteinase-2(MMP-2),interleukin-18(IL-18)and heart function.Methods 118 patients with continuous blood purification were randomly divided into the control group(n=59)and treatment group group(n=59).Two groups were treated with hemodialysis treatment.Control group was given folic acid,vitamin B and alpha keto acid,treatment group intravenous given levocarnitine injection 20mg/kg+0.9%NaCl 20mL on the basis of control group.A cycle of treatment was 28 days,and treated for 3 cycles.Serum levels of MMP-2 and IL-18,heart function,clinical effect and adverse drug reaction were compared between the two groups.Results After treatment,the total effective rate in control group was 84.74%,lower than 94.92%in treatment group(P<0.05).After treatment,serum MMP-2,IL-18,left atrial diameter(LAD),left ventricular end diastolic diameter(LVDd),left ventricular posterior wall thickness(LVPWT),ventricular septal thickness(IVST),left ventricular volume index(LVMI)in two groups were lower than pre-treatment(P<0.05),and the indexes in treatment group were more lower than control group(P<0.05).The E/A and left ventricular ejection fraction(LVEF)in two groups were all increased after treatment,and those in treatment group were higher than control group,the differences were significant(P<0.05).There was no significant in the incidence rate of adverse drug reactions between two groups.Conclusion Levocarnitine in the treatment of continuous blood purification was effective,and significantly reduce the serum MMP-2,IL-18 level and improve the heart function.
7. Domestic external fixator application in the treatment of limb deformities: 7 289 cases application report
Sihe QIN ; Baofeng GUO ; Xuejian ZHENG ; Shaofeng JIAO ; Hetao XIA ; Aimin PENG ; Qi PAN ; Jiancheng ZANG ; Zhenjun WANG
Chinese Journal of Surgery 2017;55(9):678-683
Objective:
To discuss the clinical application and effects of domestic external fixator in the treatment of patients with malformations of limbs.
Methods:
A total of 7 289 patients with malformation of limbs who had been operated in Qin Sihe orthopedic surgery team from January 1989 to June 2016 were retrospective analyzed. The patients were treated with domestic external fixator, including 4 033 males and 3 256 females, aging from 2 to 82 years with a mean age of 23.4 years. There were 2 732 patients using Ilizarov external fixator, 4 713 patients using hybrid external fixator, 57 patients using monobrachial external fixator, 232 patients using Ilizarov external fixator and hybrid external fixator. The Ilizarov, hybrid and monobrachial external fixator were used in 67, 65 and 0 patients on the upper limbs and in 2 665, 4 616 and 57 patients on the lower limbs. There were 3 028 patients operated on the left limbs, 3 260 patients operated on the right limbs and 1 001 patients operated on the bilateral limbs. The top three types of diseases were sequelae of poliomyelitis, cerebral palsy and post-traumatic stress disorder peromely. Deformity types inclued talipes equinovarus, knee flexion deformity, cavus foot and so on.
Results:
All the patients were followed up for a period of 2.5 months to 22.4 years, with an average follow-up time of 5.4 years. All of the external fixators were used for single once, and there was no substitute for external fixator quality problem. All the patients were completed surgery goal until removing external fixation except 1 patient gave up treatment and 1 removed the fixator because of metal allergy. The common complications included wire or pin infection and joint movement limitation and so on.
Conclusions
The domestic external fixator developed and produced based on the characteristics of Chinese limb deformity disability. The domestic external fixator can be used to treat kinds of limb deformities with the advantages of practical, economical, adjustable, universal and portable. The domestic external fixator could meet the clinical demand for fixation of the osteotomy end of the limbs, the correction of the deformity, the repair of the defects and the limb lengthening.
8.Clinical characteristic and therapy analysis of testicular germ cell tumour:45 cases report
Qifei WANG ; Wei ZHENG ; Xuejian WANG
Chinese Journal of Postgraduates of Medicine 2014;37(3):38-40
Objective To investigate the diagnosis and therapy of testicular germ cell tumour.Methods The clinical data of 45 cases that were confirmed by pathology testicular germ cell tumour were retrospectively analyzed.Results All 45 cases were resected successfully.Among of them,28 cases seminoma,3 cases teratoma,2 cases embryoma,2 cases choriocarcinoma,4 cases mixed testicular germ cell tumour,5 cases yolk sac tumor,1 case spermatocytic seminoma.The treatment method was selected by pathology results.Eleven cases were lost,34 cases were followed up for 3 month to 5 years,25 cases seminoma,9 cases non-seminoma,5 cases were died.Conclusion Surgical resection and adjuvant chemotherapy are important factors for testicula disease.
9.The modified Ilizarov device combined with minimally invasive osteotomy in the treatment of genu varum deformity
Sihe QIN ; Xuejian ZHENG ; Hetao XIA ; Yilian HAN ; Longxi REN
Chinese Journal of Orthopaedics 2012;32(3):199-204
Objective To evaluate the effect of modified Ilizarov device combined with minimally invasive osteotomy in the treatment of genu varum deformity.Methods From February 2002 to May 2010,a total of 31 patients with genu varum deformity who had underwent corrections by using modified Ilizarov device combined with minimally invasive osteotomy were retrospectively analyzed,including 8 males and 23 females with an average age of 35.6 years (range,18-69 years).Fifty-six knees were involved in the 31 patients.Preoperative angle of genu varum was 17.0° ±8.8°.According to the American knee society score (KSS),preoperative score was about 34-100 point with an average of 86.2±18.5.After determining the center of rotation angulation,osteotomy was performed in the site of tibial deformity and below the fibular head with minimally invasive device respectively.Prepared modified Ilizarov device was assembled and fixed with kirschner wire.Then genu varum deformity was progressively corrected by adjusting the length of bilateral bolts.X-ray film,KSS score,subjective sensation,and occurrence of complication were used to evaluate the therapeutic effects.Results Modified Ilizarov devices were used in 56 knees for 9-20 weeks,all patients were followed up for 14-50.4 months,with an average of 30.5 months.The angle of genu varum deformity was 1.7°±0.9°,the KSS was 96.1±7.7.According to KSS,the results were excellent in 49 knees,good in 6,fair in 1,with the excellent and good rate was 98.2% (55/56).The complications included pin site infection in 11 patients and pin loosening in 3 ones; they were healed through routine dressing change and replacing pin site respectively.Conclusion Modified Iilizarov device combined with minimally invasive osteotomy for the treatment of genu varum deformity can achieve a satisfactory therapeutic effect.
10.Severe Tick Infestation in a Hare and Potential Risk for Transmitting Pathogens to Humans.
Weiqing ZHENG ; Haiying CHEN ; Xiaoqing LIU ; Xuejian GUO ; Renlong FU
The Korean Journal of Parasitology 2011;49(4):419-422
Severe tick infestation was found in a hare in a suburban area of Nanchang, Jiangxi Province, China. We sampled ticks and identified them based on their morphologic characteristics. Three species, Ixodes sinensis, which is commonly found in China and can experimentally transmit Borrelia burgdorferi, Rhipicephalus haemaphysaloides, and Haemaphysalis longicornis which can transmit Lyme disease were detected with an optical microscope and a stereomicroscope. Risk of spreading ticks from suburban to urban areas exists due to human transportation and travel between the infested and non-infested areas around Nanchang.
Animals
;
Arachnid Vectors/*classification/microbiology
;
Borrelia burgdorferi/physiology
;
China
;
Fatal Outcome
;
Female
;
Hares/*parasitology
;
Humans
;
Ixodidae/*classification/microbiology
;
Lyme Disease/microbiology/*transmission
;
Male
;
Risk
;
Tick Infestations/parasitology/transmission/*veterinary

Result Analysis
Print
Save
E-mail