Jian-Wei Li

Nanfang Hospital, Shengcheng, Guangdong, China

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Publications (7)3.53 Total impact

  • Fang-Gen Tang, Dan Jin, Jian-Wei Li
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    ABSTRACT: OBJECTIV: To explore the value of three-dimensional digital reconstruction techniques in the diagnosis and treatment of proximal humeral fractures. From January, 2008 to May, 2010, 25 patients with proximal humeral fractures underwent preoperative examinations with conventional X-ray, plain CT scan and 3D-CT scan. Based on the two-dimensional gray-scale CT scan data in DICOM format, personalized virtual fracture models were reconstructed using Amira4.1 software and compared with the conventional imaging examination methods for fracture typing to identify the fracture classification. Personalized surgical treatment was implemented according to the typing of the fractures, and the patients were followed up postoperatively for 8 to 35 months (mean 21 months) for functional evaluation using the Constant-Murley score. In the 25 cases of proximal humeral fractures, plain X-ray examination obtained a clear diagnosis and classification of the fractures in 15 cases, and CT scan, three-dimensional CT, and personalized three-dimensional model reconstruction confirmed the diagnosis and classification in 20, 22, and 25 cases, respectively. The humeral fractures healed generally 6 months after the operation, and the patients showed a Constant-Murley score ranging from 70 to 100 (mean 88). Preoperative personalized three-dimensional reconstruction of proximal humeral fracture can help obtain a more accurate diagnosis of the fracture type to facilitate the decision on the optimal surgical plan, surgical approach and internal fixation methods.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 11/2012; 32(11):1671-4.
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    ABSTRACT: Aim: We conducted the present study to assess health-related quality of life (HRQoL) among bone cancer patients after surgical treatment in one large teaching hospitals in China, and assess the risk factors for improving the physical or mental HRQoL. Methods: 344 eligible adult patients who were admitted to the hospital with malignant bone tumors during the period of Jun. 2008 to Dec. 2011, and a reference group with 361 health cases was recruited in the same hospital during the same period. All 344 patients were followed up for one year. The HRQoL before treatment and after one year was evaluated with the Medical Outcome Short Form 36 (SF-36). Results: All 8 domains of HRQoL had the lowest scores greatly improved over the first year after discharge. However, the patients still had significantly lower scores in every domain than the reference group one year after discharge. Age and type of surgery were associated with HRQoL in the mental domain. Conclusion: The HRQoL of patients with malignant bone tumors greatly improved one year after the treatment. This study also highlighted the utility of HRQoL assessment for prognostic evaluation of patients after surgical treatment for bone cancer.
    Asian Pacific journal of cancer prevention: APJCP 01/2012; 13(7):3099-102. · 1.50 Impact Factor
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    ABSTRACT: To explore the surgical technique and clinical value of treatment for posttraumatic large circular soft tissue defect in the lower extremities using a combination of posterior tibial vascular bridge flap in the unaffected leg and skin graft covered by vacuum sealing drainage (VSD). From January 2008 to June 2010, 11 cases with posttraumatic large circular soft tissue defects with deep tissue exposed or partial necrosis in the lower extremities were treated by bridge flaps and combined with free skin graft covered by VSD. There are 7 males and 4 females, with an average age of 32.5 years (range from 15 to 52 years). The size of wound varied from 24 cm × 13 cm to 45 cm × 24 cm. After the wound were completely debrided, the external fixation or internal fixation was conducted for the patients with unstable fracture. Then VSD were used to covered the wound for 1-2 times with a period of 5 to 7 days according to the wound condition. After granulation tissue grew, bridge flap transplantation was performed to repair tissue defect and cover the exposed bone, which combined with skin graft covered by VSD was used to cover the residual wound. Survival rate and quality healing of the flaps were followed up postoperatively. The granulation growth of 11 cases with large circular soft tissue defect in the lower extremities associated tissue exposure was good after the application of VSD. All the cases were covered by free flap transplantation and skin grafting except for 6 cases due to large defect. The wound was covered by skin re-grafting in 4 cases and frequently dressing change in 2 cases. All the flaps were successful with good infection control and no sinus. The average period of follow-up was 10.6 months (5 - 24 months). All the patients were satisfied with the good outline and good function of the affected limb. Patients with posttraumatic large circular soft tissue defect in the lower extremities can be effectively treated with a combination of bridge flaps and free skin graft covered by VSD, which can shorten the course of treatment, and restore the function of affected extremities as much as possible.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 01/2012; 50(1):39-44.
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    ABSTRACT: Cartilage injury has a very poor capacity for intrinsic regeneration. The cell-based treatment strategy for the cartilage repair using differentiated bone marrow mesenchymal stem cells (BMSCs) is, however, a promising approach to the chondral repair. This study was aimed to explore the chondrogenic potential of the goat BMSCs in the Transwell co-culture system and the poly-laetide-co-glycolide (PLGA) scaffolds. The BMSCs were isolated from the goat iliac crest while the chondrocytes were obtained from the goat's last costal cartilage. In the Transwell co-culture system, the BMSCs co-cultured with chondrocytes were designed as group A, whereas the goat's BMSCs induced with the chondrogenic medium were group B. Both groups A and B were the experimental groups, while group C that only contained BMSCs was the control group. In the PLGA scaffolds co-culture system, BMSCs were seeded into the PLGA scaffolds, which were suspended in the 24-well plate, and the control group was established by presence or absence of chondrocytes at the bottom of the 24-well plate. Toluidine blue staining, Alcian blue staining, collagen II immunofluoresence, collagen II immunochemical staining, collagen I, collagen II, COL2a Q-PCR and osteopontin Q-PCR were used to examine the chondrogenic conditions as well as the expressions of chondrogenic and osteogenic genes. Cells isolated from the aspirates of the goat bone marrow proliferated rapidly and gained characteristics of stem cells in Passage 4. However, the differentiations of chondrocytes were not apparent in Passage 3. The results from Toluidine blue staining, collagen II immunofluoresence and PCR showed the transformation of BMSCs to chondrocytes in the Transwell co-culture system and PLGA scaffolds. Although the cartilage gene expressions were upgraded in both chondrogenesis group and co-culture system, the osteopontin gene expression, which represents osteogenic level, was also up-regulated. The Transwell co-culture system and the PLGA scaffolds co-culture system can promote the chondrogenic differentiation of the goat's BMSCs, while up-regulated osteopontin gene expression in the Transwell co-culture system implies the osteogenic potential of BMSCs.
    Chinese medical journal 10/2011; 124(19):3080-6. · 0.90 Impact Factor
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    ABSTRACT: To discuss the experience with three-dimensional reconstruction technique in initial clinical application in gastrocnemius muscle flap surgery. From 2007 to 2008, 7 patients received gastrocnemius muscle flap surgeries to repair the wounds. Preoperative CT angiography or magnetic resonance imaging (MRI) was performed after injection of the contrast media for individualized three-dimensional gastrocnemius muscle flap reconstruction using Amira4.1 software. According to the size of the defect in the wound, individualized three-dimensional gastrocnemius muscle flap was designed and harvested from the posterior leg. Individualized three-dimensional reconstruction of the gastrocnemius flap was performed in 7 cases, and the reconstructed flaps clearly displayed the blood vessels, skin and the adjacent three-dimensional structures. In 6 cases the main perforating branched and trunk of the blood vessels in the designed flap were consistent with the surgical findings; in 1 case, the perforating branches failed to be clearly displayed in the designed flap, and surgical examination identified perforating branches with an average diameter of 0.5 mm (minimally 0.3 mm). The flaps survived in all the 7 cases. Three-dimensional reconstruction of the gastrocnemius flap based on the lower limb CT angiography or MRI allows three-dimensional observation of the anatomy of the flap and accurate marking of the extent of the flap to be harvested, therefore avoiding intraoperative injuries to the blood vessels to better survival of the flaps.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 05/2009; 29(4):747-50.
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    ABSTRACT: To explore the isolation, in vitro culture and chondrogenic differentiation of goat bone marrow mesenchymal stem cells (BMSCs). Bone marrow was harvested from a 10-month-old Chinese goat for adherent culture of the BMSCs in vitro. Flow cytometry was performed to detect the cell surface markers of the BMSCs of the fourth generation. The induction medium (containing 10% fetal bovine serum, high-glucose DMEM, 6.25 microg/ml insulin, 6.25 microg/ml transferrin, 50 microg/ml vitamin C, 100 nmol/L DXM and 10 ng/ml transforming growth factor-beta1) was then applied for chondrogenic differentiation. Cytochemical staining, RT-PCR and Western blotting were performed to detect the expressions of type II collagen and aggrecan in the cells at the time points of 0, 1, 2 and 4 weeks. The goat BMSCs grow well in vitro with a high purity in the fourth generation. The expression of chondrocyte phenotypes were observed at 1, 2 and 4 weeks, which became more obvious as the culture prolonged. The mRNA and protein expression of type II collagen and aggrecan in the BMSCs increased obvious after the induction and had reached a satisfactory level by 2 weeks. Goat BMSCs have the potential to differentiate into chondrocytes in vitro, and the results of this study provide the experimental basis for application of goat BMSCs in bone and cartilage tissue engineering in vivo.
    Nan fang yi ke da xue xue bao = Journal of Southern Medical University 04/2009; 29(3):419-22.
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    ABSTRACT: Developments in the field of digitalized technique and three-dimensional (3D) reconstruction methods allowed a precise description of anatomy structures. With the development of computer reconstructive techniques, we could get more precise anatomic images. Digitized visible models of these structures can be as a useful tool in clinical training. The purpose of this study was to observe the anatomy of arteria circumflexa femoris lateralis (ACFL) flap and to discuss the methods in the visualization of anterolateral thigh (ATL) flap by digitalized technique. Six adults volunteer underwent contrast-enhanced CT angiography of pelvic and lower limbs utilizing a 64-row multi-slice spiral CT after median cubital vein injection with Ultravist (3.5 ml/s). 2D images from these data in Dicom format were transformed into computer. Next two adult fresh cadaver specimens, one male and one female, were subject to radiographic CT scanning before and after perfused with lead oxide-gelatine mixture, whose collimation are 0.5 mm (120 kV, 110 mA, 512 x 512 matrix). Through Amira 3.1 (TGS) software, the 2D images in Dicom format were transformed into the 3D models of the entire region. The structures of arteria circumflexa femoris lateralis (ACFL) were observed and the digitized visible models of ALT flap were established through 3D computerized reconstructions methods from these data using Amira 3.1 software. Then merging volume rendering with surface rendered reconstruction from lead oxide-gelatine mixture perfusion database. The 3D reconstructed visible models established from these datasets perfectly displayed the characteristic of ACFL and ALT flap anatomy. The digitized models could offer the anatomy of ALT flap perfectly, and the reconstructed methods may be used in other flap reconstruction with 3D demonstration.
    Surgical and Radiologic Anatomy 03/2008; 30(1):77-81. · 1.13 Impact Factor