Second Hospital of Fuzhou

Fuzhou, China

Second Hospital of Fuzhou

Fuzhou, China
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STUDY DESIGN.: Retrospective comparative study OBJECTIVE.: To compare the outcomes of C1–C2 transarticular screw with C1 laminar hook (TAS+ C1H) fixation and C1 trans-arch lateral mass screw with C2 pedicle screw (C1TLMS+ C2PS) fixation in the treatment of reducible atlantoaxial dislocation(AAD). SUMMARY OF BACKGROUND DATA.: TAS+ C1H is comparable to TAS with posterior wiring techniques and superior to C1 lateral mass screw combined with C2 pedicle screw (C1LMS+ C2PS) in biomechanics. However, there were few studies analyzing the differences in outcomes between TAS+ C1H technique and modified C1LMS+ C2PS technique(C1TLMS+ C2PS) for treating AAD. METHODS.: Data of 30 patients with reducible AAD treated by TAS+ C1H fixation and another 30 cases treated by C1TLMS+ C2PS fixation were retrospectively analyzed. Bone fusion time was recorded. The outcomes evaluated by American Spinal Injury Association (ASIA) impairment scale, visual analog scale score for neck pain (VASSNP), neck stiffness (none/mild/severe), patient satisfaction and Neck Disability Index (NDI) were compared between two groups. RESULTS.: There were no complications related to the surgical approach and instrumentation in either group. At the final follow-up, bone graft fusion rates were 100% in both the TAS+ C1H fixation group and the C1TLMS+ C2PS fixation group (P>0.05). The neurological status evaluated by ASIA impairment scale were greatly improved in both screw-hook group (P<0.001) and screw-rod group (P<0.001), but with no significant differences between groups (P>0.05). There were no significant differences between two groups in VASSNP, neck stiffness, patient satisfaction, or NDI (all P>0.05). CONCLUSIONS.: C1TLMS+ C2PS fixation was comparable to TAS+ C1H fixation in fusion rate and functional outcomes for treating reducible AAD. To reduce the risk of vertebral artery injury, CT scan and reconstruction should be done to analyze VA course and C1-C2 anatomic structures before operation.Level of Evidence: 3 Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

Wu J.-J.,Second Hospital of Fuzhou | Chen H.-Z.,Second Hospital of Fuzhou | Zheng C.,Second Hospital of Fuzhou
Pain Physician | Year: 2017

Background: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain. The authors, having limited their practice to endoscopic surgery over the last 10 years, report on their experience gained during that period to relieve pain by transforaminal percutaneous endoscopic revision of lumbar spinal fusions. Objective: To assess the effectiveness of transforaminal percutaneous endoscopic discectomy and foraminoplasty in patients with pain after lumbar spinal fusion. Study Design: Retrospective study. Setting: Inpatient surgery center. Methods: Sixteen consecutive patients with pain after lumbar spinal fusions presenting with back and leg pain that had supporting imaging diagnosis of foraminal stenosis and/or residual/recurrent disc herniation, or whose pain complaint was supported by relief from diagnostic and therapeutic injections, were offered percutaneous transforaminal endoscopic discectomy and foraminoplasty over a repeat open procedure. Each patient sought consultation following a transient successful, partially successful or unsuccessful open lumbar spinal fusions treatment for disc herniation or spinal stenosis. Endoscopic foraminoplasty was also performed to either decompress the bony foramen in the case of foraminal stenosis, or to allow for endoscopic visual examination of the affected traversing and exiting nerve roots in the axilla. The average follow-up time was 30.3 months, minimum 12 months. Outcome data at each visit included MacNab criteria, visual analog scale (VAS), and Oswestry Disability Index (ODI). Results: The average leg VAS improved from 9.1 ± 2.0 to 2.0 ± 0.8 (P < 0.005). Ten patients had excellent outcomes, 5 had good outcomes, one had a fair outcome, and none had poor outcomes, according to the MacNab criteria. Fifteen of 16 patients had excellent or good outcomes, for an overall success rate of 93.7%. No patients required reoperation. There were no incidental durotomies, infections, vascular, or visceral injuries. There was one complication, a case of leg numbness caused by dorsal root ganglion injury. The numbness improved after 2 weeks. After 3 months, physical exam showed that the total area of numbness in the legs had decreased. At last follow-up, the patient had no pain, and only a few areas with numbness remained that did not affect the patient’s activities of daily living. The patient was relieved to be able to avoid open decompression. Limitations: This is a retrospective study. Conclusion: The transforaminal endoscopic approach is effective for patients with back or leg pain after lumbar spinal fusions due to residual/recurrent nucleus pulposus and foraminal stenosis. Failed initial index surgery may involve failure to recognize patho-anatomy in the axilla of the foramen housing the traversing and the exiting nerve. The transforaminal endoscopic approach effectively decompresses the foramen and does not further destabilize the spine needing stabilization. It also avoids going through the previous surgical site. © 2017, American Society of Interventional Pain Physicians. All rights reserved.

Wu J.-J.,Second Hospital of Fuzhou
Chinese Journal of Tissue Engineering Research | Year: 2016

BACKGROUND: Pedicle screw internal fixation is a commonly used method to treat osteoporotic fracture. Internal fixation can effectively reconstruct vertebral body height, restore physiological curvature, and maintain good spinal stability. OBJECTIVE: To investigate the biocompatibility of minimally invasive percutaneous pedicle screw (Sextant) fixation in the treatment of elderly patients with osteoporotic vertebral fractures. METHODS: A total of 71 cases of senile osteoporotic vertebral fractures were given minimally invasive percutaneous pedicle screw (Sextant) fixation for treatment. The C-arm X-ray machine was used to accurately locate the fracture vertebral body in different patients, and the corresponding surface was marked. In order to separate the subcutaneous tissue and fascia layer, the internal fixation with Sextant screw was used. 12 months after operation, the fixator was removed. The patients were followed up for 12 months, complications and tissues surrounding the fixator were observed. At 1, 3, 6, and 12 months after treatment, changes in Cobb angle, visual analogue scale score and Oswestry disability index were observed. RESULTS AND CONCLUSION: (1) The average operation time was 90.25 minutes; intraoperative blood loss was 85.15 mL. (2) At different time points after treatment, Cobb angle, visual analogue scale score and Oswestry disability index of the patients were significantly decreased at 1 month after treatment, and maintained stable from then on. Cobb angle, visual analogue scale score and Oswestry disability index were significantly less at 1, 3, 6 and 12 months after treatment compared with that before treatment (P < 0.05). There was no significant difference in each indicator at different time points after treatment (P > 0.05). (3) Two patients affected wound infection, and were cured after symptomatic treatment. No complications such as thrombosis appeared. During removal of the screw, surrounding tissues were observed. There was no inflammatory hyperplasia of soft tissue around the fixator. No fibrous tissue or black wall was found. (4) These results confirm that Sextant minimally invasive pedicle screw internal fixation in elderly patients with osteoporotic vertebral fractures can obtain satisfactory therapeutic effect, and has good biocompatibility. © 2016, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.

Zhuang R.R.,Second Hospital of Fuzhou | Song Y.F.,Second Hospital of Fuzhou | Chen Z.Q.,Fujian Medical University | Ma M.,Fujian Medical University | And 3 more authors.
American Journal of Obstetrics and Gynecology | Year: 2011

Objective: Delivery-related levator avulsion can cause pelvic floor dysfunction. We compared agreement between tomographic ultrasound and magnetic resonancebased models for the detection of levator defects. Study Design: Sixty-nine Chinese women with pelvic organ prolapse were assessed prospectively by 3-dimensional ultrasound scans and magnetic resonance imaging. Levator-urethra gap (LUG), levator-symphysis gap (LSG), and puborectalis attachment width were measured offline with state-of-the-art software. Interobserver variability and agreement between the 2 methods were determined. Results: Interobserver repeatability was moderate-to-excellent for all parameters that were measured with both methods and agreement between methods in diagnosing levator avulsion. LUG and LSG measurements were significantly higher in women with a levator avulsion. With a diagnosis of complete levator avulsion, receiver operating characteristics analysis suggested a cutoff of 23.65 mm for LUG and 28.7 mm for LSG. Conclusion: Levator avulsion can be diagnosed reliably by tomographic ultrasound scanning and magnetic resonance imaging evaluation, and linear measures, such as LSG and LUG, can be proxy measurements for avulsion. © 2011 Mosby, Inc.

Wu G.,Fujian Medical University | Song Y.,Second Hospital of Fuzhou | Zheng X.,Fujian Medical University | Jiang Z.,Fujian Medical University
Tissue and Cell | Year: 2011

We aimed to investigate the application of adipose-derived stromal cells in the treatment of stress urinary incontinence (SUI). Animal models of stress urinary incontinence were established with Sprague-Dawley female rats by complete cutting of the pudendal nerve. Rat adipose-derived stromal cells were isolated, cultured and successfully transplanted into animal models. Effects of stem cell transplantation were evaluated through urodynamic testing and morphologic changes of the urethra and surrounding tissues before and after transplantation. Main urodynamic outcome measures were measured. Intra-bladder pressure and leak point pressure were measured during filling phase. Morphologic examinations were performed. Transplantation of adipose-derived stem cells significantly strengthened local urethral muscle layers and significantly improved the morphology and function of sphincters. Urodynamic testing showed significant improvements in maximum bladder capacity, abdominal leak point pressure, maximum urethral closure pressure, and functional urethral length. Morphologic changes and significant improvement in urination control were consistent over time. It was concluded that periurethral injection of adipose-derived stromal cells improves function of the striated urethral sphincter, resulting in therapeutic effects on SUI. Reconstruction of the pelvic floor through transplantation of adipose-derived cells is a minimally invasive and effective treatment for SUI. © 2011 Elsevier Ltd.

Wei M.,Second Hospital of Fuzhou | Wang W.,Second Hospital of Fuzhou | Zhuang Y.,Second Hospital of Fuzhou
European Spine Journal | Year: 2016

Purpose: Bibliometrics is increasingly used to assess the quantity and quality of scientific research output in many research fields worldwide. However, the bibliometric studies in the field of spine surgery are scarce. This study aimed to evaluate the worldwide research productivity in the field of spine surgery using bibliometric methods and to provide an insight into the spine research for surgeons and researchers. Methods: Articles published between 2004 and 2013 were retrieved using the Scopus database in 5 spine journals, including Spine, European Spine Journal, The Spine Journal, Journal of Neurosurgery: Spine, and Journal of Spinal Disorders and Techniques. The number of articles, trend of publications, countries’ contribution and h-index, authorship, subspecialty, funding source, journal pattern, institutions, and top cited articles were analyzed. Results: A total of 13,115 publications were identified in the database of Scopus from 2004 to 2013. The time trend of the number of articles showed a significant increase of 1.9-fold between 2004 and 2013 (p = 0.000). The largest number of articles in the field of spine surgery was from United States (39.17 %), followed by Japan (10.74 %) and China (8.62 %). United States also have the highest h-index (106), followed by Canada (60) and United Kingdom (54). China (p = 0.000) and South Korea (p = 0.000) have a significantly increasing trend of contribution proportion to the world spine production over time in years, but h-index was still low (39 and 38, respectively). Spine published the highest number of articles (45.44 %), followed by European Spine Journal (21.43 %) and Journal of Neurosurgery: Spine (13.32 %). The most productive institutions were University of California, San Francisco (1.98 %), followed by Thomas Jefferson University (1.61 %) and University of Toronto (1.41 %). Conclusions: There has a rapid increase of scientific research productivity in the field of spine surgery during the past 10 years. United States has special contributions to the body of spine publications. China and South Korea have increasing contributions to the field of spine surgery. © 2016, Springer-Verlag Berlin Heidelberg.

Liu G.,Second Hospital of Fuzhou | Jiang C.,Second Hospital of Fuzhou | Li D.,Second Hospital of Fuzhou | Wang R.,Second Hospital of Fuzhou | Wang W.,Second Hospital of Fuzhou
Tumor Biology | Year: 2014

The molecular mechanism underlying cancer invasiveness and metastasis of gastric carcinoma remains elusive. Here, we reported significant decrease in microRNA (miRNA)-34a and significant increase in phosphorylated epidermal growth factor receptor (EGFR) and matrix metalloproteinase-7 (MMP7) in the resected gastric carcinoma from the patients, compared with adjacent normal tissue. Moreover, strong correlation was detected among these three factors. To examine whether a causal link exists, we used two human gastric carcinoma lines, SNU-5 and HGC27, to study the molecular basis of miRNA-34a, EGFR signaling, and MMP7 activation. We found that EGF-induced EGFR phosphorylation in SNU-5 or HGC27 cells activated MMP7 and consequently cancer invasiveness. Both an inhibitor for EGFR and an inhibitor for Akt significantly inhibited the EGFinduced activation of MMP7, suggesting a phosphatidylinositol 3-kinase (PI3K) signaling cascade dependent pathway. Moreover, miRNA-34a levels were not affected by EGF-induced EGFR phosphorylation. However, overexpression of miRNA-34a antagonized EGF-induced MMP7 activation without affecting EGFR phosphorylation in SNU-5 or HGC27 cells. Taken together, our data suggest that miRNA- 34 inhibits EGFR signaling via downstream PI3K signaling cascades to regulate MMP7 expression in gastric carcinoma. Thus, miRNA-34a, EGFR, and MMP7 appear to be promising therapeutic targets for preventing the metastasis of gastric carcinoma. © International Society of Oncology and BioMarkers (ISOBM) 2014.

Guan Z.,Second Hospital of Fuzhou
Journal of cataract and refractive surgery | Year: 2012

To describe and quantify the pattern of corneal astigmatism in cataract surgery candidates and to provide information for cataract surgeons and intraocular lens (IOL) manufacturers. Zhongshan Hospital, Fudan University, Shanghai, China. Cross-sectional study. The datasets of cataract surgery candidates acquired between November 1, 2009, and November 30, 2011, were collected and analyzed. Keratometry values were optically measured by partial coherence interferometry (IOLMaster) before cataract extraction. Spearman rank correlation coefficients were used to estimate bivariate correlations. The power vector method, J(0) and J(45) values, and linear regression models were used to assess the association between age and astigmatism. The study evaluated the keratometry values in 1430 eyes (827 patients) with a median age of 75 years (range 16 to 98 years). The corneal astigmatism was 1.00 diopter (D) or higher in 45.45% of eyes. The magnitude of corneal astigmatism was positively correlated with age (ρ = 0.126, P = .000). A trend toward increasing against-the-rule astigmatism with age was found by linear regression models; the per-year increase in age was associated with a J(0) decrease of 0.016 D in right eyes and 0.018 D in left eyes (both P = .000). No association was found between age and J(45). Most eyes having corneal astigmatism of 1.00 D or greater could be covered by the range of the cylindrical power of the toric IOLs available on the market. Against-the-rule corneal astigmatism of relatively younger cataract surgery candidates should be managed more aggressively. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Dong O.,Second Hospital of Fuzhou
Hepato-Gastroenterology | Year: 2012

Background/Aims: 1H-NMR is a powerful approach of metabolomics. This study aimed to apply it to the profiling of serum metabolites in patients with pancreatitis, and to analyze the characteristic metabolites of pancreatitis. Methodology: Serum samples were taken from 17 pancreatitis patients and 23 healthy subjects and subjected to 1H-NMR and principle component analysis to compare endogenous small-molecule metabolites. Results: 3-hydroxybutyrate, trimethylamine-N-oxide, acetate and acetone levels were significantly lower in the pancreatitis group than in the control group. Isoleucine, acetylglycine, triglyceride and inosine levels were significantly higher in the pancreatitis group than in the control group. Conclusions: 1H-NMR-based metabolomics is an effective method to investigate the small-molecule metabolites in the sera of patients with pancreatitis. Metabolites identified in this study may be exploited as metabolic markers for the early detection of pancreatitis. © H.G.E. Update Medical Publishing S.A.

Zhuang Y.,Second Hospital of Fuzhou | Wei M.,Second Hospital of Fuzhou
Tumor Biology | Year: 2014

Osteosarcoma is the most common primary malignant bone tumor of childhood. Vascular endothelial growth factor (VEGF) expression has been implicated in tumor development and progression of osteosarcoma, but previous studies investigating the impact of VEGF expression on overall survival in patients with osteosarcoma report conflicting findings. A meta-analysis of published studies was performed. The pooled hazard ratio (HR) with its 95 % confidence interval (95 % CI) was used to assess the impact of VEGF expression on overall survival in patients with osteosarcoma. Nine studies with a total of 432 osteosarcoma patients were included into this meta-analysis. There was no between-study heterogeneity among those nine studies (I 2 = 0.0 %). Overall, high VEGF expression was obviously associated with poorer overall survival (HR = 1.68, 95 % CI 1.33-2.12, P < 0.001). Sensitivity analysis performed by excluding single study in turns showed the pooled estimate was stable. Egger's test also did not suggest evidence for publication bias (P = 0.216). Therefore, this meta-analysis suggests that VEGF expression has an important impact on overall survival in patients with osteosarcoma and high VEGF expression is associated with poorer overall survival. © 2014 International Society of Oncology and BioMarkers (ISOBM).

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