2011 Vol. 2, No. 1

Display Method:
Original Contributions
Abstract:
  Objective  To observe the expression of S100A8, heat shock protein(HSP)90, and calmodulin(CaM)in the discs endplate cartilage of patients with idiopathic scoliosis(IS)and congenital scoliosis(CS).  Methods  The discs of 4 IS patients(diagnosed by clinical and radiological data)and 4 CS patients who had undergone anterior-route surgeries were collected.Total protein was extracted from endplate cartilage with TRIzol method.The expressions of S100A8, HSP90, and CaM genes in the cartilages were analyzed using Western blot.  Results  The expressions of HSP90 and CaM in the cartilages were not significantly different between CS patients and IS patients, while the expression of S100A8 was significantly higher in IS patients than that in CS patients.  Conclusion  S100A8 may play a role in the occurrence and development of IS.
Abstract:
  Objective  To screen the risk factors associated with breast cancer among Chinese women, with an attempt to provide evidence for the evaluation of breast cancer risks among Chinese women on an individual level.  Methods  A case-control study on 416 breast cancer patients and 1156 age-and region-matched controls was conducted in 14 hospitals in 8 provinces/municipalities of China.Conditional logistic regression was applied to analyze the association between risk factors and breast cancer.  Results  The risk factors of breast cancer among Chinese women included higher body mass index(BMI ≥ 24)(OR=4.07, 95%CI:2.98-5.55), history of benign breast disease biopsy(OR=1.68, 95%CI:1.19-2.38), age of menarche ≥ 14 years(OR=1.41, 95%CI:1.07-1.87), psychological depression(for grade 1-4, OR=2.15, 95% CI:1.26-3.66;for grade 5-9, OR=3.48, 95% CI:2.03-5.95), menostasia(OR=2.22, 95% CI:1.50-3.28), family history of breast cancer(OR=1.72, 95%CI:1.15-2.58), and family history of cancer other than breast cancer(OR=1.55, 95%CI:1.22~1.98)(all P < 0.05 when compared between the 416 breast cancer patients and 1156 controls).Although use of oral contraceptives(OC)(OR=1.59, 95% CI:0.83-3.05)was associated with an increased risk of breast cancer, the difference was not statistically significant(P > 0.05).  Conclusions  Many risk factors including BMI ≥ 24, history of benign breast disease biopsy, age of menarche ≥ 14 years, psychological depression, menostasia, family history of breast cancer, and family history of cancer other than breast cancer may contribute to breast cancer among Chinese women.This research provides a basis for the individualized evaluation of risks of breast cancer and the population-based interventions in China.
Abstract:
  Objective  To evaluate the value of the dual-tracer positron emission tomography(PET)in the pre-operative diagnosis of liver masses.  Methods  Totally 40 patients whose liver masses could not be positioned by routine examination were enrolled in this study from October 2004 to August 2010.All patients received PET examination using 18F-fluorodeoxyglucose(18F-FDG)and 11C-Acetate as tracer.  Results  Of these 40 patients, the masses were pathologically confirmed to be malignant in 33 patients, precancerous changes in 2 patients, and benign in 5 patients.On the contrary, dual-tracer PET found malignant lesions in 34 patients, with a sensitivity of 97.1% and a positive predictive value of 91.9%.18F-FDG PET identified 20 malignant masses(57.1%)and 11C-Acetate PET identified 29(82.9%).For atypical hyperplasia, well differentiated lesions, and moderately well-differentiated lesions, the sensitivity of 11C-acetate(100%)was significantly higher than 18F-FDG(28.6%)(P < 0.01).However, for poorly differentiated lesions and moderately poor-differentiated lesions, the sensitivity of 18F-FDG was a bit higher but without statistical significance.  Conclusion  The combined application of these two tracers in PET can increase the diagnostic accuracy for liver masses preoperatively and may indicate the differentiation levels of tumors, and thus provides useful information for surgical decision-making.
Abstract:
  Objective  To investigate the apoptosis of neurons in the penumbra of cerebral ischemic rats transplanted with bone marrow derived-mesenchymal stem cells(BMSCs).  Methods  Bone marrow of a healthy adult volunteer was collected, and BMSCs were cultivated and harvested.Adult rats subjected to 2 h middle cerebral artery occlusion(MCAO)were randomly assigned to the BMSCs-treated group(n=12)and the control group(n=12), in which rats were transplanted with 5×105 BMSCs or saline, respectively, into the ipsilateral brain parenchyma on the 3rd post-MCAO day.The modified neurological severity scores(mNSS)was used to measure functional recovery.On the 14th post-MCAO day, apoptotic cells in the penumbra were detected by TUNEL analysis.On the 28th post-MCAO day, neurons were stained by immunoflu-orescence, and hematoxylin-eosin staining was used to evaluate the relative ischemic volume.  Results  TUNEL-positive cells were significantly reduced(P=0.017), and in contrast, neuronal nuclei antigen(NeuN)-positive cells were significantly increased(P=0.015)in the penumbra in BMSCs-treated group compared with control group.The relative ischemic volume was decreased in the BMSCs-treated group(28.3±4.5)% compared with the control group(36.8±5.6)%(P=0.041).The mNSS was significantly decreased in BMSCs-treated group at each time point starting on the 14th post-MCAO day compared with control group(P < 0.05).  Conclusion  BMSCs treatment can decrease ischemic volume and improve functional recovery after cerebral ischemia, which may, at least partially, attribute to the reduced apoptosis of neurons in the penumbra.
Abstract:
  Objective  To evaluate the effectiveness and complications of prostate brachytherapy.  Methods  We enrolled 27 prostate cancer patients aged 63 to 81 years(mean:75 years)in our study, with 16 at the clinical stage of T1cN0M0, 11 at T2aN0M0, and 14 with Gleason score of 5, 13 with Gleason score of 6. Their serum prostate specific antigen(PSA)levels ranged 2.8-18.6 μg/L(mean:8.5 μg/L). All of them underwent 125I seed implantation with the D90 of 140-155 Gy and had the serum PSA levels routinely determined after the procedure.Effectiveness and complications were also observed. None of the 27 patients were treated with hormone therapy.  Results  Follow-up ranged from 12 to 74 months(mean:44 months). The median nadir PSA was 0.18 μg/L, with only 2 above 1.0 μg/L. One year after brachytherapy, the median level of serum PSA was 0.71 μg/L(mean:0.92 μg/L), and 17 with the level under 1.0 μg/L. Two patients(7%)experienced biochemical failure at the 30 month and 48 month after the procedure. Two patients(7%)developed acute urinary retention, which was released after catheterization for 1 week. Low urinary tract symptoms were observed in 24 patients, which were improved 6-12 months later. No prostate-rectal fistula was observed. Seventeen patients erected efficiently before brachytherapy, while 10 preserved erection in different levels after brachytherapy. The incidence of erectile dysfunction was 41%(7/17).  Conclusion  Prostate brachytherapy is an effective treatment for low- and intermediate-risk patients with acceptable complications. Most patients can preserve sexual function after this procedure.
Abstract:
  Objective  To analyze the short- and long-term outcomes of surgical treatment of active infective endocarditis(IE).  Methods  Surgeries were performed for 71 patients with active IE from January 2001 to July 2010. Patients with prosthetic valve or healed IE were excluded.  Results  Of these 71 patients, the mean age was 44.6±14.4 years, and 55(77.5%) were men. Streptococcus was the most common causative microorganism. Two patients (2.8%) died during post-surgical hospital stay. Survivors were followed up for 42.4±32.4 months. The actuarial 1-, 5-, and 10-year survival rates were (98.5±1.5)%, (92.6±4.5)%, and (79.4±12.8)%, respectively.  Conclusion  Surgery can achieve satisfactory short- and long-term effectiveness for active IE.
Abstract:
  Objective  To investigate the effectiveness of transanal endoscopic microsurgery(TEM) in treating rectal neoplasms.  Methods  The clinical data of 120 patients with rectal neoplasms which were treated using TEM between April 2006 and November 2009 were summarized and analyzed retrospectively. The mean diameter of rectal lesions was(1.8±0.8)cm(range:0.5-5.5 cm). The average distance of lesions from the anal verge was(7.5±2.6)cm(range, 4-20 cm). The orientations of the lesions at the rectal wall were as follows:43 at the anterior wall, 30 at the posterior wall, 26 at the left wall, and 21 at the right wall.  Results  Surgical procedures included the transmural excision(n=106)and the submucosal excision with partial muscular layer excision(n=14). The average operating time was(73.4±31.1)min(range, 25-180 min). The mean intra-operative blood loss was(10.7±7.8)ml(range, 3-60 ml). The postoperative pathological examination identified 43 retcal adenomas, 39 rectal adenocarcinomas or carcinomatous changes of adenomas(22 Tis, 8 T1, and 9 T2 cases), 15 rectal carcinoids, 2 stromal tumor, 1 leiomyoma, and 20 inflammatory polyps or others. Surgical margins of all specimens were negative. Postoperative complications included anal hemorrhage(n=2), pulmonary infection(n=1), and urinary infection(n=1), making a postoperative morbidity of 3.3%. The average postoperative hospital stay was(3.4±1.3)d(range, 2-8 d). With a mean follow-up of 13.5 months(range, 3-4 months), no tumor recurrence or metastasis was observed.  Conclusions   TEM is a minimally invasive surgery and has advantages of low intra-operative blood loss, better therapeutic effectiveness, and faster recovery. It has became a preferred procedure for local excision of rectal neoplasms.
Abstract:
  Objective  To compare the effectiveness of three new analgesia methods for early post-thoracotomy pain control.  Methods  Totally 81 patients randomly accepted one of three new methods for post-thoracotomy analgesia: patient controlled intravenous analgesia(PCIA), patient controlled epidural analgesia(PCEA), and intercostal nerve cryoanalgesia(INC). The effects were evaluated by visual analogue scales(VAS)from the day of thoracotomy to 3 days after operation.  Results  The dosage was not significantly different between PCEA and PCIA groups(P>0.05), but PCEA group had significantly less administration frequency(P < 0.05). The VAS score was significantly superior in PCEA group than in the other two groups(P < 0.01). The expectoration ability was significantly better in PCEA group than in INC groups(P < 0.01), and was significantly better in PCIA group than in INC group(P < 0.05)in the second and the third post-thoracotomy days. The incidence of side effects was significantly higher in PCIA group than in PCEA and INC groups(P < 0.01), and was significantly lower in INC group than in the other two groups(P < 0.01). The integrated evaluations showed that PCEA group was significantly better than the other two groups(P < 0.01).  Conclusions  PCEA has better analgesic effect than PCIA and INC for post-thoracotomy pain control, lower incidence of side effects, and better expectoration ability. Thus, PCEA is the most suitable method for controlling the early post-thoracotomy pain.
Abstract:
  Objective  To study the compatibility of two different scaffolds with chondrogenic-like cells in vitro.  Methods  Chondrogenic-like cells were derived from bone marrow mesenchymal stem cells. Chondrogenic-like cells and two different scaffolds(PGA scaffold and PGA\collagen composite scaffold) were cocultured in vitro. Morphological features were observed by HE staining and electron microscopy. Cell adhesion and proliferation were detected with MTT assay and compared to the control group.  Results  Histological and ultrastructural observations showed the cells grew well on the surface of the PGA\collagen composite scaffold. The cells were not adhered on the surface of the PGA scaffold. The MTT assay showed that both two scaffolds did not inhibit the proliferation of chondrogenic-like cells.  Conclusion  The PGA\collagen composite scaffold has good biocompatibility with chondrogenic-like cells and can be used as a vehicle for trachea tissue engineering.
Abstract:
  Objective  To evaluate the clinical results of open reduction and internal fixation(ORIF) and external fixation(EF)for the treatment of unstable fractures in distal radius.  Methods  From September 2005 to February 2008, 44 patients(average age:61.5 years) with unstable distal radial fractures were treated in our department by the same surgeon with either ORIF or EF. According to AO Muller classification, there were 11 cases of type A, 9 cases of type B, and 24 cases of type C. Twenty-one cases were treated with EF, while 23 cases with ORIF. The duration of operation and intra-operative blood loss were recorded. The patients were followed up 3 months, 1 year, and 2 years after surgery. Clinical and radiological outcomes, including Gartland-Wertley(GW) scores, range of motion of wrist joint, and grip strength, were measured. Complications were observed and recorded.  Results  EF took shorter time and less blood loss than ORIF. At the 3-month follow-up, ORIF cases showed superior GW scores, volar flexion, dorsiflexion and grip strength than EF. At the 1-year follow-up, better volar flexion and grip strength were found in ORIF cases. At the 2-year follow-up, ORIF cases still showed better volar flexion than EF.  Conclusion  In the treatment of unstable distal radial fractures, ORIF can achieve better clinical outcomes in the first 2 years, while EF offers shorter operation time and less blood loss.
Abstract:
  Objective  To summarize the surgical treatment results and discuss the surgical strategy of congenital scoliosis due to lumbosacral hemivertebrae.  Methods  Totally 877 patients with congenital scoliosis were treated in our hospital between January 2001 and January 2010. Among them, there were 8 cases of lumbosacral hemivertebrae(3 males and 5 females, with the average age at surgery of 11 years old). The clinical data including the anatomic data of hemivertebrae, coronal and saggital Cobb angle, coronal and sagittal trunk shift, surgical approach, and fusion area were retrospectively analyzed for these 8 patients.  Results  There were 5 full-segmented hemivertebrae and 3 semi-segmented hemivertebrae. Seven patients underwent hemivertebrae resection with posterior approach only, 1 patients underwent hemivertebrae resection with one-stage anterior and posterior approach. The intra-operative blood loss ranged 200-2300 ml(mean:692 ml). The average operation time was 6.5 h. Six patients had short segment fixation and 2 patients had long segment fixation. The mean coronal Cobb angle of lumbosacral curve was 33.1° before surgery, 9.8° after surgery, and 14.0° at latest follow-up. The mean coronal Cobb angle of proximal lumbar curve was 32.5° before surgery, 12.6° after surgery, and 14.2° at latest follow-up. Four patients had coronal trunk imbalance before surgery. The complications included wound dehiscence(n=1) and nerve root injury(n=1). Two patients had malpostion of pedicle screw. One revision surgery was performed. All patients were followed up from 12 to 82 months, with an average follow-up duration of 30.9 months. Coronal trunk shift was improved in 7 patients after surgery, 1 patient had coronal trunk decompensation at final follow-up, and no saggital trunk decompensation was noted.  Conclusions  Lumbosacral hemivertebrae may cause scoliosis with obvious coronal trunk imbalance, which needs early intervention. The early surgery with hemivertebrae resection and short segment fixation is able to avert severe local deformity and prevent secondary deformity. If the compensatory lumbar curve is severe, extensive fusion is preferred.
Abstract:
  Objective  To compare the clinical effectiveness and safety between simultaneous and staggered bilateral total knee arthroplasty(TKA) in one hospitalization.  Methods  We retrospectively analyzed 233 patients with primary osteoarthritis of both knee joints who received bilateral TKA in one hospitalization and follow-up for at least 2 years. These patients were grouped into simultaneous group and staggered group based on the procedures they received. The age, body weight index(BWI), years lived with disorder(YLD), pre-operative co-morbidity, pre-operative hospitalization time, total hospitalization time, total operation time, total toniquet time, total drainage volume, total blood transfusion volume, pre-operative Hospital for Special Surgery(HSS)score, post-operative HSS score(2 years), complications, and its ratio were reviewed and analyzed with one tail t test.  Results  The simultaneous group included 191 cases(31 males and 160 females) and the staggered group included 42 cases(5 males and 37 females). The pre-operative co-morbidity rate was significantly higher in the staggered group than in the simultaneous group, while no such significant difference existed in terms of age, BWI, and YLD(P>0.05). The total hospitalization time of staggered group was significantly longer than that in the simultaneous group, while the total blood transfusion volume was significantly less(both P < 0.01). The pre-operative hospitalization time, total operation time, total toniquet time, and total drainage volume were not significantly different between these two groups(P>0.05). The HSS scores before operation and 2 years after operation were also not significantly different(P>0.05). The wound complication rate was higher in the simultaneous group than the staggered group. Thromboembolism events occurred only in calf muscular veins in both groups with similar incidences. No patients suffered from severe complication or died during hospital stay.  Conclusion  With reasonable patient selection and delicated pre-operative preparation, simultaneous bilateral TKA has similar clinical effectiveness and safety as staggered bilateral TKA.
Abstract:
  Objective  To analyze the clinical features of pulmonary sequestration, with an attempt to improve the understanding of this disease and minimize diagnosis and treatment errors.  Methods  The clinical data including the clinical features, diagnostic methods, operative technique, complications, and outcomes of 53 patients with pulmonary sequestration from 1988 to 2009 were retrospectively reviewed.  Results  Of these 53 patients, there were 29 males and 24 females aged 12-68 years(mean:32.7 years). Their disease course ranged from 1 week to 40 years(mean:68 months). Preoperative diagnoses included pulmonary sequestration(n=40), pulmonary cyst(n=7), bronchiectasis(n=3), bullae(n=1), hydrothorax(n=1), and lung cancer(n=1). Thoracotomy was performed in 50 patients and thoracoscopy was performed in 3 patients. Pulmonary sequestration was pathologically confirmed in all 53 patients.Follow-up(mean:8 years)was performed in 46 patients, and no long-term complication was noted.  Conclusions  Pulmonary sequestration is rare pulmonary congenital deformity. Enhanced computed tomography and three-dimensional reconstruction are most helpful for diagnosis. Surgery is preferred, and both thoracotomy and thoracosopy can achieve good outcomes among selected patients.
Abstract:
  Objective  To explore the clinical and financial significance of establishing an optimal protocol for immediate breast reconstruction after mastectomy.  Methods  Totally 28 women who underwent immediate reconstruction(IR) and 52 patients who underwent delayed reconstruction(DR) after mastectomy were enrolled in this study. The clinical outcomes were evaluated by SF-36 health survey. The average health care expenditures, duration of hospital stay, and complications were analyzed.  Results  Within 1-5 years of follow-up, no significant difference was found between these two groups and the healthy control group in all 8 dimensions of SF-36. The average health care expenditures and hospital days were significant lower in IR group than in DR group.  Conclusion  Immediate breast reconstruction has better economic and clinical outcomes than delayed breast reconstruction after mastectomy, and therefore deserves further application.
2011, 2(1): 6-6, 41.
HTML (169) PDF(14)
Abstract:
2011, 2(1): 14-14.
HTML (85) PDF(8)
Abstract:
2011, 2(1): 32-32.
HTML (72) PDF(8)
Abstract:
2011, 2(1): 50-50.
HTML (74) PDF(7)
Abstract:
2011, 2(1): 55-55.
HTML (90) PDF(10)
Abstract:
2011, 2(1): 60-60.
HTML (49) PDF(8)
Abstract:
2011, 2(1): 69-69.
HTML (164) PDF(11)
Abstract:
2011, 2(1): 70-75. doi: 10.3969/j.issn.1674-9081.2011.01.015
HTML (31) PDF(9)
Abstract:
2011, 2(1): 75-75.
HTML (77) PDF(8)
Abstract:
2011, 2(1): 76-78. doi: 10.3969/j.issn.1674-9081.2011.01.016
HTML (29) PDF(5)
Abstract:
2011, 2(1): 79-84. doi: 10.3969/j.issn.1674-9081.2011.01.017
HTML (43) PDF(5)
Abstract:
2011, 2(1): 84-84.
HTML (41) PDF(8)
Abstract:
2011, 2(1): 85-88. doi: 10.3969/j.issn.1674-9081.2011.01.018
HTML (56) PDF(6)
Abstract:
2011, 2(1): 89-92. doi: 10.3969/j.issn.1674-9081.2011.01.019
HTML (48) PDF(8)
Abstract:
2011, 2(1): 92-92.
HTML (47) PDF(4)
Abstract:
2011, 2(1): 93-95. doi: 10.3969/j.issn.1674-9081.2011.01.020
HTML (76) PDF(7)
Abstract:
2011, 2(1): 95-95.
HTML (49) PDF(8)
Abstract:
2011, 2(1): 96-99. doi: 10.3969/j.issn.1674-9081.2011.01.021
HTML (300) PDF(5)
Abstract:
2011, 2(1): 100-102. doi: 10.3969/j.issn.1674-9081.2011.01.022
HTML (46) PDF(5)
Abstract:
2011, 2(1): 103-105. doi: 10.3969/j.issn.1674-9081.2011.01.023
HTML (34) PDF(4)
Abstract:
2011, 2(1): 105-105.
HTML (74) PDF(10)
Abstract:
2011, 2(1): 106-113. doi: 10.3969/j.issn.1674-9081.2011.01.024
HTML (80) PDF(30)
Abstract: