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Shi Z.,Shanghai University | Wu Y.,Peoples Liberation Army 457 Hospital | Huang J.,Pudong Hospital of Shanghai City | Zhang Y.,Peoples Liberation Army 161 Hospital | And 5 more authors.
International Journal of Surgery | Year: 2013

Objective: To study the effect of the thoracoplasty on the pulmonary function after the posterior scoliosis correction operation. Methods: From June 2001 to June 2010, 60 thoracic scoliosis patients (24 males, 36 females) were collected. Their average age was 17.6±5.0 years. All patients underwent posterior 3-dimensional operation and thoracoplasty. The pulmonary function was examined preoperatively, 3 months, and 24 months after the operation. The correlation between the postoperative decrease ratio of pulmonary function parameters and postoperative recovery time was analyzed by Pearson correlations. Results: The average Cobb's angle in the coronal plane was corrected from 99.1°±17.6° preoperatively to 49.8°±11.8° postoperatively, with the average correction ratio of (44.3±12.6) %. There were significant decrease in the pulmonary function parameters 3 months after the operation [vital capacity (VC), 14.4%; percentage of the VC with measured/predicted value (VC%), 14.7%; forced vital capacity (FVC), 15.7%; percentage of the FVC with measured/predicted value (FVC%), 16.6%; the first second forced expiratory volume (FEV1), 13.2%; the percentage of FEV1 with measured/predicted value (FEV1%), 12.9%] (P<0.05). The pulmonary function parameters at the last follow-up were slightly higher than the preoperative parameters, but the statistical difference was not significant (P>0.05). The decrease ratio of postoperative pulmonary function parameters and the postoperative recovery time was positively correlated. Conclusion: The pulmonary function will be decreased obviously after the thoracoplasty and the posterior scoliosis correction operation in the short time, but returns to the normal level after 2 years. © 2013 Surgical Associates Ltd. Source


Shi Z.,Shanghai University | Chen J.,Shanghai University | Chen J.,Xuzhou Medical College | Wang C.,Shanghai University | And 9 more authors.
Journal of Spinal Disorders and Techniques | Year: 2015

Objective: To compare the effect of thoracoscopic anterior release combined with posterior spinal fusion and posterior-only approach with an all-pedicle screw construct in the treatment of rigid thoracic adolescent idiopathic scoliosis. Methods: From June 2001 to June 2010, 63 patients who were admitted to our hospital with thoracic Cobb angle ≥80 degrees and the flexibility r40% were enrolled in our study. They were treated with either a combined anterior/posterior spinal fusion with hooks and screws (group A, n=25) or a posterior spinal fusion alone with an all-pedicle screw construct (group B, n=38). The thoracic Cobb angle in the standing whole-spine anteroposterior x-ray, thoracic kyphosis (T5-T12) Cobb angle, imaging examination parameters, fixation segments, implant density, and complications between the 2 groups were compared. Results: There were no significant differences in operation time, bleeding volume, length of hospital stay, preoperative coronal, sagittal Cobb, coronal curve flexibility, or postoperative coronal Cobb correction ratio between the 2 groups. Moreover, no significant difference in the Scoliosis Research Society-22 score at the last follow-up was present in the 2 groups, although it had been improved compared with that presented during the pre-operative period. The implant density of group A (44 ±4%) was significantly lower than that of group B (55 ±5%) (P < 0.001). In group A, the main complication was chylothorax (n=2) and hemopneumothorax (n=2). In group B, acute intestinal obstruction was observed in 2 patients and pleural effusion was observed in 1 patient. In addition, 12 screws were misplaced (12/403, 3.0%) in group B. Conclusions: In patients with rigid thoracic adolescent idiopathic scoliosis, posterior-only approach with an all-pedicle screw construct could achieve the same curve correction as a combined anterior/posterior spinal fusion by increasing the implant density. However, for scoliosis patients with a high risk of implant complications, anterior release combined with posterior spinal fusion is still recommended. Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved. Source


Fan H.-B.,Peoples Liberation Army 161 Hospital | Wang A.-J.,Peoples Liberation Army 161 Hospital | Yang D.-L.,Huazhong University of Science and Technology | Xiao J.,Peoples Liberation Army 161 Hospital | And 8 more authors.
Chinese Journal of Cancer Research | Year: 2013

Objective: Ascites in patients with hepatic cirrhosis is caused by cirrhosis in most cases. For most malignant ascites, the primary malignancy could be readily identified using conventional imaging methods, e.g., computed tomography (CT) and magnetic resonance imaging (MRI). However, in a small fraction of the patients, the primary malignancy remains occult even with these examinations. In this retrospective study, we assessed the usefulness of 18F-FDG PET/CT in patients with hepatic cirrhosis and malignant ascites of otherwise unknown origin. Methods: Twenty-eight patients with malignant ascites of unknown primary sites after CT, MRI and ultrasound during the period of five years between January 2008 and December 2012 had received 18F-FDG PET/CT. Medical records of these patients were reviewed and analyzed. Results: Elevated 18F-FDG absorption was found in 23 of 28 cases in the following sites: gastrointestinal tract (n=10, 43.5%), prostate (n=5, 21.7%), peritoneum (n=4, 13.3%), and ovary (n=4, 13.3%). Cancer was confirmed by pathology in 20 cases after open or laparoscopic surgeries. Five patients were found to have benign ascites, among which, 3 were found to be false positive due to tuberculosis. SUV values were significantly higher for tumors than for benign lesions (mean values, 6.95 vs. 2.94; P=0.005). Conclusions: The 18F-FDG PET/CT can be as a powerful imaging tool in identifying tissue origin in liver cirrhosis patients suspected of cancers or with cancers of unknown primary sites. © Chinese Journal of Cancer Research. All rights reserved. Source


Fan H.-B.,Peoples Liberation Army 161 Hospital | Yang D.-L.,Huazhong University of Science and Technology | Chen A.-S.,Peoples Liberation Army 161 Hospital | Li Z.,Peoples Liberation Army 161 Hospital | And 6 more authors.
American Journal of the Medical Sciences | Year: 2013

BACKGROUND:: Sepsis-associated cholestasis is a common problem in neonatal patients. However, there are limited data related to sepsis-associated cholestasis in adults. In this study, the authors assessed the clinical characteristics, risk factors and outcome of adult patients with sepsis-associated cholestasis. METHODS:: An observational prospective single-center study was conducted. A total of 608 patients with sepsis (66 patients with cholestasis and 542 without evidence of cholestasis) from January 1, 2005, to December 31, 2011, were included from the infectious disease unit. Demographic, clinical and laboratory information were recorded on admission for all patients. Additional data were also collected on the day of the 1st episode of bacteremia for patients who developed cholestasis. Accordingly, the organ dysfunction scores (Acute Physiology and Chronic Health Evaluation [APACHE] II and Sequential Organ Failure Assessment [SOFA]) were assessed on the same day. RESULTS:: The mean age of the 608 patients was 49.3 ± 11.4 years (range, 22-83 years); 312 (51.3%) patients were men, 296 (48.7%) were women. The mean APACHE II and SOFA score were 15.2 ± 6 and 5.6 ± 2.3, respectively. Sepsis-associated cholestasis was strongly associated with older age, biomarkers of organ dysfunction and clinical composite scores (APACHE II and SOFA). Mortality was higher in patients with sepsis-associated cholestasis (10.6%) compared with subjects with sepsis without cholestasis (1.5%) (P < 0.05). CONCLUSIONS:: The authors found that sepsis-associated cholestasis affects the outcome of patients with sepsis in the infectious disease unit. Additional clinical studies are necessary to elucidate the pathology and pathophysiology of sepsis-associated cholestasis. © 2013 Lippincott Williams & Wilkins. Source

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