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Huzhou, China

Fengbin Y.,No. 98 Hospital of PLA | Xinwei W.,Changzheng Hospital | Haisong Y.,Changzheng Hospital | Yu C.,Changzheng Hospital | And 2 more authors.
European Spine Journal | Year: 2013

Background: The Smith-Robinson approach is commonly used to expose the vertebrae in anterior cervical discectomy and fusion (ACDF). Postoperative dysphagia has been frequently reported following this procedure. In this approach, surgical dissection can be carried out either lateral (LEO) or medial (MEO) to the omohyoid muscle. The purpose of this study was to compare the degree of dysphagia between the LEO and MEO groups. Methods: In this randomized, prospective study, 80 patients were enrolled and evenly divided into the MEO and LEO groups. Patients underwent two-level ACDF using a right-sided Smith-Robinson approach. Follow-up was obtained 1, 3, 6, 12 week and 6 months after surgery. The degree of dysphagia was assessed using a 14-item questionnaire from the SWAL-QOL survey. Results: There were no differences between the MEO and LEO groups with respect to age, gender, body mass index, or length of surgery. Overall, the SWAL-QOL scores were not different between the two groups at any of the follow-up time points. However, when the level of surgery was taken into consideration, the early postoperative SWAL-QOL scores were significantly lower in the C3-C4 subgroup when the MEO approach was used. Conversely, the SWAL-QOL scores were significantly lower in the C6-C7 subgroup when the LEO approach was used. Two patients with C6-C7 surgery in the MEO group also developed dysphonia that resolved spontaneously within 3 months. Conclusion: The findings from this study suggest that the LEO approach should be selected if the level of surgery involves C3-C4. For C6-C7 surgery, however, a left-sided MEO approach should be used. Depending on surgeon's preference, either approach can be used if both cervical levels are involved. © 2012 Springer-Verlag Berlin Heidelberg. Source

Yu F.,No. 98 Hospital of PLA | Liao X.,Changzheng Hospital | Liu X.,Changzheng Hospital | Wang X.,Changzheng Hospital | Chen D.,Changzheng Hospital
Journal of Spinal Disorders and Techniques | Year: 2015

Study Design: A retrospective clinical study. Objective: To analyze and evaluate the clinical outcomes of cerebrospinal fluid (CSF) leak after anterior decompression for cervical ossification of the posterior longitudinal ligament (OPLL) with or without dural ossification (DO). Summary of Background Data: Anterior decompression can be highly efficacious in the treatment of OPLL. However, in some cases of OPLL, there often exists DO and fusion with the posterior longitudinal ligament, which may increase the chance for CSF leak during an anterior decompression surgery. Materials and Methods: A retrospective analysis was performed on 126 OPLL patients (89 men and 37 women) treated with anterior decompression surgery between January 2008 and January 2012. The mean age at operation was 61 years (ranging from 46 to 72 y) and the average duration of diagnosis was 4.2 years (ranging from 3 d to 7 y). DO was present in 11 patients, of whom 7 developed dural tear or defect. Among the 115 patients without DO, only 4 developed dural tear. Intraoperative dural repair was performed with gelatin foam onlay and fibrin glue seal. Postoperative care for CSF leak involved bed rest, CSF drainage, nutritional support, and antibiotics. Results: A total of 11 cases associated with dural tear or defect developed postoperative CSF leak (an overall incidence of 8.7%). There was a statistically significant difference (P< 0.001) in the incidence of CSF leak between the DO group (63.6%) and the non- DO group (3.5%). While leakage in 3 patients resolved spontaneously within 5 days of surgery, intermittent CSF cysts developed in 8 patients. These were treated with circular pressure bandages, repeated aspiration, and lumbar drainage. All 8 cases resolved 14-30 days after surgery. These 11 patients were followed up for an average of 12.8 months (range of 1 to 36mo) with an average Japanese Orthopedic Association score of 51.2% and no significant neurological deficit or persistent headaches were recorded. Conclusions: Patients with DO are at increased risk for dural injury while undergoing anterior decompression for the treatment of OPLL. This is associated with a high incidence of CSF leak. However, the majority of patients with CSF leak could be managed conservatively. © 2015 Wolters Kluwer Health, Inc. All rights reserved. Source

Miao J.-H.,Shanghai University of Traditional Chinese Medicine | Wang S.-Q.,Shanghai University of Traditional Chinese Medicine | Zhang M.-H.,Harbin Medical University | Yu F.-B.,No. 98 Hospital of PLA | And 3 more authors.
Oncology Reports | Year: 2014

Galectin-1 (GAL1), a widely expressed βgalacto-side-binding protein, exerts pleiotropic biological functions. GAL1 has been found to be upregulated in many malignancies; yet the role of GAL1 in the pathophysiology of human osteosarcoma (OS) remains uncertain. The present study was carried out to investigate the expression of GAL1 in human OS tissues and to explore its effects on the growth and invasion of OS cells. OS and corresponding adjacent non-cancerous tissues (ANCT) were collected from 30 consecutive cases. The expression of GAL1 was detected by immunohistochemical assay through tissue microarray procedure. Using small hairpin RNA (shRNA)-mediated GAL1 knockdown (Lv-shGAL1) in OS (MG-63 and U-2 OS) cells, we observed the changes in the malignant phenotype in OS cells in vitro and in vivo. As a consequence, the positive expression of GAL1 was significantly higher in OS tissues than that in the ANCT (63.3 vs. 36.7%, P=0.029), and was positively correlated with distant metastasis in the OS patients (P=0.022). Knockdown of GAL1 suppressed cell proliferative activities and invasive potential and induced apoptosis in OS cells with decreased expression of p38MAPK, p-ERK, Ki-67 and matrix metallopeptidase-9 (MMP-9) and increased expression of caspase-3. In addition, the tumor volume in the MG-63 subcutaneous tumor models treated with Lv-shGAL1 was significantly smaller than that in the negative control (NC) group (P<0.01). Altogether, our findings indicate that high expression of GAL1 is associated with distant metastasis of OS patients, and knockdown of GAL1 inhibits growth and invasion of OS cells possibly through inhibition of the MAPK/ERK pathway, suggesting that GAL1 may represent a potential target for the treatment of cancer. Source

Miao J.,Shanghai University of Traditional Chinese Medicine | Yu F.,No. 98 Hospital of PLA | Shen Y.,University of Georgia | He N.,University of Georgia | And 3 more authors.
Spine Journal | Year: 2014

Background context Anterior cervical discectomy and interbody fusion was a classical treatment for cervical degenerative disc disease (CDDD). However, the rigid fusion also leads to a reduction in normal cervical spine motion and to increased biomechanical stress at adjacent levels, which in turn accelerates degenerative changes of the discs at these levels. Cervical disc replacement (CDR) is a new technology with the aim of addressing the limitations of fusion procession and preserving motion at the treated level. Discover prosthesis (DePuy Spine, Raynham, MA, USA) is a new type artificial disc and there are few reports about it. Purpose The purpose of this study was to analyze the primary clinical and radiographic outcomes of CDR with Discover prosthesis to treat mono- or bi-segment CDDD in a Chinese population. Study design The study design was prospective and single-center clinical trial of the Discover prosthesis in the treatment of patients with mono- or bi-segment CDDD. Patients sample Seventy-nine patients with 102 Discover prosthesis arthroplasty performed (56 mono-segment and 23 bi-segment) were evaluated. Outcome measures Clinical outcomes based on Japanese Orthopaedic Association (JOA), visual analog scale (VAS) pain score, and Odom's scale and radiographic outcomes including the anterior disc heights (ADH), posterior disc heights (PDH), range of motion, and performance of heterotopic ossification (HO) of the operative segment were assessed. Methods Clinical and radiographic follow-up was performed. Preoperative and postoperative ADH, PDH, and range of motion were measured from lateral and flexion-extension radiographs. The paired t test was used to assess the difference of clinical and radiographic outcomes before and after operation. The performance of HO was observed by two independent MD. Results The mean follow-up time for all the patients was 31.6 months, ranging from 24 to 43 months. Mean preoperative JOA score was 9.5, and VAS overall pain score was 7.2. At 2-, 6-, 12-, and 24-month follow-up, the mean JOA score was 14.1, 14.7, 15.3, and 14.9, whereas the mean VAS overall pain score was 1.9, 1.7, 1.8, and 1.4, respectively. Mean JOA and VAS scores showed statistical improvements in the postoperative period. Seven patients had mild dysphagia within the first month after operation. According to Odom's scale, 52 patients had excellent outcomes, 25 patients had good outcomes, and 2 patients had fair outcomes at 2-year follow-up. The Mean preoperative ADH and PDH of the operative segment were 4.9 mm and 3.1 mm. Compared with preoperative, there were significantly increased and maintenance well at 2- (7.5 mm, 5.1 mm), 6- (7.5 mm, 5.0 mm), 12- (7.4 mm, 4.9 mm) and 24-month (7.2 mm, 5.0 mm) follow-up. Range of motion of the operative segment in the postoperative follow-up was slightly increased than the preoperative follow-up but not statistically significant. Heterotopic ossification was presented in six replaced levels at 1-year follow-up including 4 Grade I and 2 Grade II and 18 replaced levels at the follow-up more than 2 years including 8 grade I and 10 grade II No prosthesis subsidence or excursion was identified. Conclusions The use of Discover prostheses in our study resulted in satisfactory clinical and radiographic outcomes. The prostheses can restore and maintain interbody height, while preserve the motion of the treated segment. Although the results of this study demonstrate initial safety and effectiveness in a Chinese population, we need further studies to know more about the impact of CDR with Discover prosthesis, especially on HO and adjacent segment degeneration. © 2014 Elsevier Inc. All rights reserved. Source

Yang B.,Shanghai University | Ni W.-P.,No. 98 Hospital of PLA | Guo F.,Shanghai University | Lu X.,Shanghai University | And 4 more authors.
Academic Journal of Second Military Medical University | Year: 2014

Objective Explore the techniques of urethral separation in Robotic-assisted radical prostatectomy. Methods Through the study of the anatomy of urethra and surround structures and the review of surgical video of Robotic-assisted radical prostatectomy, we summarize the techniques of urethral separation with “double sandwich” as following six operative points: identify the golden eye, ligation the deep dorsal penile vein, the approach of slope road, sustained tension, divided the lateral attachment of urethra and passing through the plane between the urethral and D’S fascia. The surgeon have performed 20 cases of Robotic-assisted radical prostatectomy between 6 to 9 in 2013, including 2 cases of T2N0M014, 3 cases of T3N0M0, 3 cases of T4N0M0(with 3 month of neoadjuvant therapy). Results All cases were successfully completed without conversion to open, the average operative time 138 ±47. 8min, bleeding150 ± 67.4 ml, bladder-urethra anastomosis time 13 ± 6.5 min. We used the way of “double sandwich” to successfully separate 17 cases of urethra anatomic, 3 cases are failed, among 2 cases are based tip adhesions and 1 case is bleeding affect the vision. The rate of urinary control is 64.7% and positive margin is 11.8% in the 17 case. The further follow-up is still in progress. Conclusion Using the techniques of “double sandwich”, we can dissect the urethral anatomic and reduce the difficulty of bladder-urethra anastomosis. © 2014, Second Military Medical University Press. All rights reserved. Source

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