The 306 Hospital of Chinese PLA

Beijing, China

The 306 Hospital of Chinese PLA

Beijing, China
SEARCH FILTERS
Time filter
Source Type

PubMed | Henan Provincial Peoples Hospital, Shanghai JiaoTong University, Shandong University, Tianjin Medical University and 16 more.
Type: | Journal: Diabetes research and clinical practice | Year: 2016

This study explored the possibility of developing an alternative, simple and rapid test for the screening of distal symmetrical polyneuropathy (DSPN), for use in local primary care facilities.4023 patients with type 2 diabetes mellitus (T2DM), aged 18-80 years, from 21 hospitals in China were screened for inclusion in a prospective diagnostic assessment of DSPN, between April 2011 and March 2012. Patients underwent nerve conduction study (NCS; as the gold standard) and clinical assessments of ankle reflexes (AR) and thermal (T), vibration (V), pressure (P), and pinprick (PP) sensations.Results from various combinations of these clinical assessments were compared to determine the optimal screening regimens. The Toronto Consensus Panel definition was used to confirm clinical DSPN (symptoms or signs plus abnormal NCS). 3883 of the 4023 patients (M:F, 2162:1721; mean age, 56.7913.16 years) were included. No significant differences were found between the two most efficient clinical assessment combinations, AR+PP+T+V and AR+T+V (P=0.9612). Compared to the diagnosis made using AR+T+V, the same diagnosis was reached using AR+PP+P+V+T in 100% of patients with probable clinical DSPN, 84.05% with possible clinical DSPN, and 96.84% with no DSPN. The AR+T+V assessment was also 40% faster than the AR+PP+P+V+T assessment.Combined AR+T+V assessment is a valuable tool for screening diabetic patients for DSPN, potentially decreasing costs to local primary care facilities and making care more available to underserved populations.


Ma H.-S.,The 306 Hospital of Chinese PLA | Wang X.-P.,The 306 Hospital of Chinese PLA | Tan R.,The 306 Hospital of Chinese PLA | Chen Z.-M.,The 306 Hospital of Chinese PLA | And 9 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Severe spinal angular kyphosis aggravated spinal cord injury and early degeneration, even caused incomplete paralysis or complete paralysis. Surgical treatment is the only solving approaches and method, but it is difficult, exhibits high risk, and easily affects postoperative complications. OBJECTIVE: To analyze the science and effectiveness of posterior vertebral column resection osteotomy combined with step correction in treatment of stiff angular kyphosis based on biomechanical principle. METHODS: A total of 90 cases underwent posterior vertebral column resection osteotomy combined with bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation were selected, including 37 males and 52 females, at the average age of 47 years. Kyphotic angle, spinal sagittal imbalance, trunk side offset rate, operation time, intraoperative blood loss were compared and analyzed before and after treatment. RESULTS AND CONCLUSION: The kyphotic angles were 31°-138° (averagely 90.1°) preoperatively and 10°-90° (averagely 41.6°) postoperatively, with an improvement rate of 65%. The distance from C7 plumb line to the S1 upper edge was averagely 5.2 mm, with a correction rate of 73%. Intraoperative blood loss was 1 200-6 000 mL, averagely 2 089 mL. Operation time was 212-470 minutes, averagely 326 minutes. The patients were followed up for 20 to 35 months after the surgery. Osteotomy segments had achieved bone fusion in all patients, and no complications of spinal cord injury or orthopedic angle loss appeared. These data verified that in the accordance with cell biomechanics and spinal biomechanical principles, bilateral pedicle screw spinal cord gradually shortening echelon tight closure and orthopedic fixation protected utmost spinal cord cells against injury in the correction of thoracolumbar angular kyphosis. There is sufficient basis for cell physiology and it accorded biomechanical and physiological characteristics. During the surgery, we should pay attention to protection and release of nerve root and avoid postoperative corresponding nerve root irritation. Full fusion ensures kyphosis correction and avoids spine lateral offset, is an effective safeguard for the recovery of spinal function and postoperative orthopedic effect. © 2014 Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.


Ma H.-S.,The 306 Hospital of Chinese PLA | Wang X.-P.,The 306 Hospital of Chinese PLA | Tan R.,The 306 Hospital of Chinese PLA | Chen Z.-M.,The 306 Hospital of Chinese PLA | And 10 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: The treatment difficulties of thoracolumbar angular kyphosis surgery are: low correction rate, hard to rebuild sagittal plane, easily induce neurological complications, postoperative loss of balance, high incidence of pseudarthrosis and postoperative loss of correction degree. OBJECTIVE: To explore the safety and efficacy of modified posterior vertebral column resection osteotomy and bilateral pedicle screw combined with echelon tight closure spinal cord technique and implant fixation for severe spinal angular kyphosis. METHODS: A total of 87 severe spinal angular kyphosis patients, 36 males and 51 females, who were treated in the Department of Orthopedics, the 306 Hospital of Chinese PLA from January 2006 to December 2013, were enrolled in this study. They underwent posterior vertebral column resection, bilateral pedicle screw combined with echelon tight closure spinal cord, and implant fixation. Kyphosis, spinal sagittal imbalance, offset rate towards trunk side, operation time and intraoperative blood loss were observed before and after treatment. RESULTS AND CONCLUSION: The preoperative average kyphosis was 90.1° (31°-138°). The postoperative average kyphosis was 27.9° (15°-57°). The improvement rate was 76%. The improvement rate of trunk sagittal offset was 76%. Intraoperative blood loss was 800-3 000 mL, and average blood loss was 2 300 mL. The operation time was 5-7 hours, averagely 5.9 hours. Before treatment, two patients affected neurologic symptoms in double lower extremity, and their Frankel classification was grade C and became grade E after treatment. All patients were followed up for 9-57 months. Bony fusion was achieved in all patients. No complications of spinal cord injury appeared, and no orthopedic angle missing occurred. These results indicate that during posterior vertebral column resection for treating severe angular stiffness of the thoracic kyphosis, blood vessels could be maintained greatly. Blood vessel injury-induced ischemic changes in spinal cord and ischemic reperfusion injury could be avoided. To reduce hemorrhage and to keep effective blood volume in patients with low body mass are effective for early recovery after treatment. Bilateral pedicle screw combined with echelon tight closure spinal cord technique greatly protected spinal cord cells against injury. We should pay attention to the protection and loose of nerve root to avoid postoperative nerve root irritation. Sufficient bone fusion ensures kyphosis correction, avoids spine lateral offset, and plays a key role in spinal function and postoperative orthopedic effect. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All Rights Reserved.


Lu M.,The 306 Hospital of Chinese PLA | Wang X.-P.,The 306 Hospital of Chinese PLA | Ma H.-S.,The 306 Hospital of Chinese PLA | Yue C.-S.,The 306 Hospital of Chinese PLA | And 6 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: The evaluation and the correction of sagittal plane balance are attributed to the good restoration effect of kyphosis deformity, and the measurement method of spinal-pelvis parameters are one of the effective method for assessing spinal imbalance. OBJECTIVE: To measure spine-pelvis parameters in stiff angular kyphosis patients treated with posterior vertebral column resection osteotomy combined with step correction, design surgical scheme, analyze postoperative biomechanical characteristics of lumber vertebra, and evaluate long-term prognosis. METHODS: Thirty-seven patients with severe angular kyphosis deformity treated with posterior vertebral column resection osteotomy, bilateral screw-rob combined with echelon tight closure for spinal cord shortening, and internal fixation in the Department of Orthopedics at the 306 Hospital of Chinese PLA. The lumbar lordosis angle, thoracic vertebrae kyphosis angle, thoracic waist kyphosis angle, pelvic tilt angle, sacrum tilt angle, pelvic index, spine-sacrum angle, saggital plane vertebral axis were measured before surgery, after surgery and at the final follow-up. The spinal kyphosis angle, spinal sagittal plane imbalance, lateral trunk shift rate, operation time, intraoperative blood loss, follow-up time, kyphosis correction angle, and correction of lateral trunk shift were recorded before and after surgery. RESULTS AND CONCLUSION: The average operation time was 326 min (212-470 min), intraoperative blood loss was 2 089 mL (1 200-6 000 mL), the number of resected vertebral bodies was 104, and the osteotomy plane was localized at T4 -L2. All the patients were followed up for 20-35 months. The average postoperative spinal kyphosis angle was 41.6° (10°-90°) and the correction rate was 65%. The average distance of C7 plumb line lateral to the posterior upper edge of S1 was 5.2 mm (-12 mm to 23 mm) after surgery, the correction rate was 73%. Two cases appeared neurological complications, accounting for 6%; and two cases appeared non-neurological complications, accounting for 6%.The anatomical parameters of the involved patients were significantly improved after surgery, compared with before surgery (P < 0.05). During the follow-ups, the osteotomy segments achieved bony fusion, no spinal cord injury and other complication were observed, and no loss of correction rate was found. Preoperative and postoperative measurement of the spine-pelvis parameters in patients with stiff spinal angular kyphosis can contribute to the understandings of spine-pelvis sequence and trunk anteroposterior balance, obtain technical parameters of osteotomy angle, achieve preoperation design, and make appropriate choice of osteotomy plane, so the restoration effect is more close to the biomechanical characteristics of human spine and lumbar vertebrae. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.


Wang X.-P.,The 306 Hospital of Chinese PLA | Ma H.-S.,The 306 Hospital of Chinese PLA | Chen Z.-M.,The 306 Hospital of Chinese PLA | Yuan W.,The 306 Hospital of Chinese PLA | And 6 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Lumbar degenerative diseases are commonly found in the elderly. Thus, surgery risk is very high. To solve this problem, some scholars put forward the concept of selective decompression. However, it is hard to identify the corresponding segment or position in some patients, so selective decompression cannot obtain perfect repair effects in many previous prospective randomized controlled studies. OBJECTIVE: To analyze the effectivity of single level decompression and fusion for multiple level lumbar disc herniation combined with lumbar spondylolisthesis. METHODS: A total of 23 cases of multiple level lumbar disc herniation with lumbar spondylolisthesis from January 2010 to December 2013 were enrolled in this study. Repair method: single level decompression and fusion. Using conventional X-ray, lumbar MRI,, disease stage and instability interval were assessed in combination with selective nerve root closed, and dynamic X-ray measurements (over-extension, over-flexion, left and right flexion). Dynamic X-ray measurements and Posner score were used to identify stability of responsible segment. Lumbar MRI was utilized to identify obvious degeneration of intervertebral discs. Selective nerve root closed was applied to identify the major responsible interspace. Low back pain visual analog scale and the Japanese Orthopaedic Association score were employed to assess patient’s repair effects. The improvement of clinical symptoms could be used as the criteria of curative effects. RESULTS AND CONCLUSION: All patients were followed up for 12-36 months. Low back pain visual analog scale and the Japanese Orthopaedic Association score were significantly improved during final follow-up. The improvement rate of the Japanese Orthopaedic Association score was 88%. The improvement rate of the visual analog scale was 93%. Nerve root irritation was not visible after surgery. Bone fusion was found in fusion segment of all patients. No loosening, fracture or pulling out appeared. No lumbar sagittal imbalance was detectable. Results indicated that it is necessary to give correct general diagnosis and evaluation according to symptoms, signs and radiological features before surgery. Decompression to responsible interspace, short level fixation, pedicle screw, connecting rods and interbody fusion can increase supporting force of pre-column. Stress on the screw and rod maintains dynamic equilibrium. Simultaneously, stable screw-rod fixation system is also conducive to the bone healing in anterior bone graft material. Frame structure formed by internal fixation significantly elevates the anti-rotation capability, forming strong three-dimensional fixation. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.


Chen X.-M.,The 306 Hospital of Chinese PLA | Ma H.-S.,The 306 Hospital of Chinese PLA | Tan R.,The 306 Hospital of Chinese PLA | Tian T.,The 306 Hospital of Chinese PLA | And 3 more authors.
Chinese Journal of Tissue Engineering Research | Year: 2014

BACKGROUND: Ideal method for spinal fusion is interbody fusion, which was firstly applied by Robinson and Smith in 1955 on the removal of herniated intervertebral discs through the anterior cervical approach, followed by interbody grafting. Subsequently the presumption of interbody contents emerges to promote spinal fusion. The spinal interbody fusion has achieved significant developments and is considered one of standard treatments for spinal degeneration. OBJECTIVE: To investigate the long-term efficacy of multilevel anterior cervical decompression and cage-assisted fusion for cervical spondylosis. METHODS: From October 2000 to October 2002, twenty cases with cervical spondylosis underwent three-level cage-assisted anterior cervical depression and fusion in the 306 Hospital of Chinese PLA (including 15 males and 5 females). The involved patients aged 48-65 years, with mean 56.4 years. The affected lesions were observed at the C4-7level in 12 cases and at the C3-6 level in 8 cases. JOA scores were recorded before treatment and at final follow-up to evaluate the improvement rate. Clinical results were graded using the Odom criteria. Radiological results at the anterioposterior and lateral film positions were observed before and after treatment, as well as at final follow-up. Cervical spine curvature (Cobb angle) was measured before and after treatment. Adjacent segment degeneration and graft fusion rate were observed upon final follow-up. RESULTS AND CONCLUSION: All 20 patients were successfully operated. No neurological and fixation-related complications occurred. The follow-up period was arranged from 10 to 132 months. The JOA score was (9.85 ± 0.81) preoperatively and (14.40 ± 0.94) postoperatively, showing significant difference. The average JOA improvement rate was 81%. Odom grading at final follow-ups included 14 excellent cases, 4 good cases, and 2 fair cases. No adjacent segment lesions were observed, Cage sedimentation was visible in two cases, and cervical curve maintained good. Graft fusion rate was 100% at final follow-up. Radiograph analysis indicated that, Cobb angle of cervical lordosis was significantly higher at postoperative 1 year and at final follow-up compared with preoperative measurement (P < 0.01), and no difference was significant between postoperative 1 year and final follow-up (P > 0.05). Multilevel cage-assisted anterior cervical decompression and fusion is an effective and safe way for multilevel cervical spondylosis and the long-term outcomes are good. © 2014, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.

Loading The 306 Hospital of Chinese PLA collaborators
Loading The 306 Hospital of Chinese PLA collaborators