Guixing Qiu

Peking Union Medical College Hospital, Peping, Beijing, China

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Publications (99)240.09 Total impact

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    ABSTRACT: Tumor-induced osteomalacia is a rare and fascinating paraneoplastic syndrome usually caused by a small, benign phosphaturic mesenchymal tumor. Most tumors are treated surgically, but we are unaware of any reports that compare the results of curettage and segmental resection for lesions in long bones. Seventeen patients (ten male and seven female) with tumor-induced osteomalacia lesions in long bones, who underwent surgical treatment from December 2004 to August 2013 in our hospital, were included in this retrospective study. The mean follow-up (and standard deviation) was 35 ± 27 months (range, twelve to 116 months). The characteristics of the tumor and the effects of different surgical treatments (curettage compared with segmental resection) were evaluated. All patients showed typical clinical characteristics of tumor-induced osteomalacia, including elevated serum fibroblast growth factor-23 (FGF-23); 82% of tumors were in the epiphysis, and 82% grew eccentrically. The mean maximum diameter of the tumors was 2.4 ± 2.0 cm. The complete resection rates were similar for curettage (67%) and segmental resection (80%). However, the recurrence rate after curettage (50%) was higher than that after segmental resection (0%). The complete resection rate for secondary segmental resection (75%) was not different from that for primary segmental resection (83%). All of our cases of tumor-induced osteomalacia were caused by phosphaturic mesenchymal tumors. After successful removal of tumors, serum FGF-23 returned to normal within twenty-four hours and serum phosphorus levels returned to normal at a mean of 6.5 ± 3.5 days. Most lesions in long bones are located in the epiphysis, so curettage is first suggested to maintain joint function. If curettage is incomplete or there is a recurrence, secondary segmental resection should be considered curative. Changes of serum FGF-23 and phosphorus levels before and after the operation may be of prognostic help. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.
    The Journal of Bone and Joint Surgery 07/2015; 97(13):1084-94. DOI:10.2106/JBJS.N.01299 · 4.31 Impact Factor
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    ABSTRACT: Lumbosacral hemivertebra poses a unique problem because it can cause gross imbalance and progressive compensatory thoracolumbar deformity. Previous studies have reported lumbosacral hemivertebra resection through a combined anterior and posterior approach, but there have been no reports on the results and complications of hemivertebra resection via a posterior-only procedure and short fusion with large series of patients. This retrospective study of a prospective collected database comprises a consecutive series of 14 congenital scoliosis due to lumbosacral hemivertebra treated by 1-stage posterior hemivertebra resection with short segmental fusion, with at least a 2-year follow-up period (24-144 months). Surgical reports and patient charts were reviewed. Radiographic evaluation included measured changes in segmental scoliosis and lordosis, compensatory scoliosis, thoracic kyphosis, lumbar lordosis, and trunk shift. Quality of life data from Scoliosis Research Society (SRS)-22 questionnaires were also collected. Our results showed that the mean follow-up period was 38.4 months. The mean fusion level was 3.2 segments. Mean operation time was 207.8 min with the average blood loss of 235.7 ml. The mean segmental scoliosis was 30° preoperatively, 5° postoperatively (83 % correction rate), and 4° (87 %) at the latest follow-up. The compensatory coronal curve of 30° was spontaneously corrected to 13° at most recent follow-up. Trunk shift was significantly improved on both coronal (63 %) and sagittal plane (58 %) after the surgery, and kept stable during the follow-up. The total SRS-22 score, the self-image domain score and the satisfaction domain score demonstrated significant improvement compared with preoperative status. Only one intra-operative complication was observed, a pedicle fracture. In summary, our results showed that one-stage HV resection and short segment fusion by a posterior approach can offer excellent scoliosis correction and trunk shift improvement without neurological complications, while saving motion segments as much as possible. This strategy is not only corrective of the deformity but also preventive of compensatory curve progression, thus avoiding long lumbar fusion.
    European Spine Journal 05/2015; DOI:10.1007/s00586-015-3995-x · 2.47 Impact Factor
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    ABSTRACT: The X-ray films of the patients with Marfan syndrome scoliosis (MSS) look like those with adolescent idiopathic scoliosis (AIS). In literature, there are many reports on the correction results of AIS, while there are a few studies focused on the difference of the correction results between MSS and AIS. This study aims to analyze whether there are differences of posterior correction surgery in MSS and AIS. All the patients included underwent posterior correction surgery. The radiographic data, operation duration, estimated blood loss, transfusion, fusion levels, and correction rate were retrospectively reviewed and analyzed between the two groups. Group MSS included 42 patients, 11 male and 31 female, with an average age of 15.2 years old. Group AIS included 168 patients (ratio, 1:4), 34 male and 134 female, with an average age of 14.5 years old. Twenty-three patients in group MSS and 94 patients in group AIS were followed up regularly, with an average time of 18.4 and 18.5 months, respectively. The mean coronal Cobb angle of the major curve before operation and at final follow-up, the correction rate, fusion level, operation duration, estimated blood loss during operation, and transfusion between the two groups were 60.4 and 57.5°, 14.6 and 15.2°, 76.4 and 74.1 %, 11.5 and 11.0 vertebrae, 4.6 and 4.0 h, 845 and 698 ml, and 1151 and 894 ml, respectively. The age, gender ratio, curve type, and coronal Cobb angle of the major curve were all matched (all P > 0.05). Group MSS had a longer operation duration and more estimated blood loss compared with those of group AIS (both P < 0.05), while there was no significant difference in terms of fusion level, transfusion, coronal Cobb angle of the major curve at final follow-up, and the correction rate (all P > 0.05). When performing posterior correction for scoliosis, the surgeons should be aware that the patients with Marfan syndrome scoliosis had more estimated blood loss and longer operation duration than AIS patients, while the correction rate was similar.
    Journal of Orthopaedic Surgery and Research 05/2015; 10(1):73. DOI:10.1186/s13018-015-0210-z · 1.58 Impact Factor
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    ABSTRACT: Chitosan/glycerophosphate (CS/GP) hydrogels represent novel strategy for cartilage repair through combing with cartilage-forming chondrocytes. The aim of this work is to examine the change of gelation time and temperature of CS/GP hydrogels with different ratio, and to characterize their degradation property and effect on chondrocytes which could be used as seed cells for cartilage regeneration. The results showed that the gelation temperature increased by decreasing glycerophosphate content or increasing chitosan content. The gelation time was elongated with the GP content decreased. Through co-culture system, CS/GP hydrogels were found to have no negative effect on chondrocytes proliferation and viability. The secretion of IL-6 and TNF-α by chondrocytes remained unchanged under the co-culture with CS/GP hydrogels for up to 96 h. The expression of collagen II, which play a functional role in the regulation of chondrogenic differentiation, was steady during co-culture. In conclusion, the gelation temperature and time depend on the CS/GP ratio in the hydrogels, and CS/GP hydrogels represented biocompatible carriers for cartilage regeneration.
    04/2015; 5(4). DOI:10.1166/jbt.2015.1319
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    ABSTRACT: Type 2 diabetes is associated with acute and chronic complications and poses a large economic, social, and medical burden on patients and their families as well as society. This study aims to evaluate the direct economic burden of type 2 diabetes in China. Data source: systematic review on cost of illness, health care costs, direct service costs, drug costs, and health expenditures in relation to type 2 diabetes was conducted up to 2014 using databases such as Pubmed; EBSCO; Elsevier ScienceDirect, Web of Science; and a series of Chinese databases, including Wanfang Data, China National Knowledge Infrastructure (CNKI), and the China Science and Technology Journal Database. Factors influencing hospitalization and drug fees were also identified. Study eligibility criteria: (1) estimation of the direct economic burden including hospitalization and outpatient cost of type 2 diabetes patients in China; (2) evaluation of the factors influencing the direct economic burden. Articles only focusing on the cost-effectiveness analysis of diabetes drugs were excluded. The direct economic burden of type 2 diabetes has increased over time in China, and in 2008, the direct medical cost reached $9.1 billion, Both outpatient and inpatient costs have increased. Income level, type of medical insurance, the level of hospital care, and type and number of complications are primary factors influencing diabetes related hospitalization costs. Compared to urban areas, the direct non-medical cost of type 2 diabetes in rural areas is significantly greater. The direct economic burden of type 2 diabetes poses a significant challenge to China. To address the economic burden associated with type 2 diabetes, measures need to be taken to reduce prevalence rate and severity of diabetes and hospitalization cost.
    02/2015; 6(1). DOI:10.1007/s13300-015-0096-0
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    ABSTRACT: To determine the postoperative complications of primary total knee arthroplasty (TKA) within 30 postoperative days, and the different causes for revision surgery during follow-up. Between January 2001 and December 2012, a total of 1 920 patients underwent 2 779 primary TKA with fixed bearing platform in Peking Union Medical College Hospital, with 323 for male and 1 607 for female. The revision surgery at index time and the hemophiliac arthropathy were excluded for this study. The average age was (66 ± 9) years (from 25 to 86 years).Osteoarthritis accounted for 1 720 cases (89.58%), rheumatoid arthritis for 168 cases (8.75%), ankylosing spondylitis for 12 cases (0.63%), secondary arthritis for 20 cases (1.04%). The postoperative complications with 30 postoperative days and revision surgery during follow-up were recorded. Follow-up was concluded at December 2013. Totally, 1 854 patients (2 693 knees) were successfully followed-up.Forty-one patients experienced systemic complication within 30 postoperative days, with the rate of 2.21%. The most common reasons of systemic complication were the respiratory complication and cardiovascular complication in origin, with the rate of 0.49% (9/1 854) and 0.38% (7/1 854) respectively. The average rate of deep venous thrombosis in this group was 3.02% (56/1 854). The local complication rate within 30 days was 1.29% in this group. Totally 59 knees experienced the revision surgeries during average 67 months follow-up. The most common causes for revision surgery in relative values were septic loosening, with the rate of 1.19% (32 in 2 693 knees), followed by postoperative stiffness, with the rate of 0.37% (10 in 2 693 knees). The most common reasons of systemic complication with 30 postoperative days after primary TKA procedure are the respiratory complication and cardiovascular complication in origin. The most common reason for revision surgery during mid-term follow-up for primary TKA is septic loosening.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 02/2015; 53(2):106-9.
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    ABSTRACT: Background Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis. Methods We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions. Results We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11%); we did not observe any null mutations in TBX6 in 166 controls (P<3.8×10(-6)). These null alleles include copy-number variants (12 instances of a 16p11.2 deletion affecting TBX6) and single-nucleotide variants (1 nonsense and 4 frame-shift mutations). However, the discordant intrafamilial phenotypes of 16p11.2 deletion carriers suggest that heterozygous TBX6 null mutation is insufficient to cause congenital scoliosis. We went on to identify a common TBX6 haplotype as the second risk allele in all 17 carriers of TBX6 null mutations (P<1.1×10(-6)). Replication studies involving additional persons with congenital scoliosis who carried a deletion affecting TBX6 confirmed this compound inheritance model. In vitro functional assays suggested that the risk haplotype is a hypomorphic allele. Hemivertebrae are characteristic of TBX6-associated congenital scoliosis. Conclusions Compound inheritance of a rare null mutation and a hypomorphic allele of TBX6 accounted for up to 11% of congenital scoliosis cases in the series that we analyzed. (Funded by the National Basic Research Program of China and others.).
    New England Journal of Medicine 01/2015; DOI:10.1056/NEJMoa1406829 · 54.42 Impact Factor
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    ABSTRACT: Study Design: A retrospective study. Objective: The objective of this study is to report the result of patients with neurofibromatosis type 1(NF-1), dystrophic scoliosis, and rib head protrusion into the spinal canal who received posterior scoliosis correction surgery without rib head resection. Summary of Background data: A total of 124 patients with NF-1 and dystrophic scoliosis were treated at our institution during the study period. Eight patients with a median age of 12 years had rib head protrusion into the spinal canal and received surgery and were included in the analysis. Methods: All eight patients (six male, two female) treated from 2003 to 2013 and received posterior correction with a pedicle screw-rod 3-dimensional correction system or screw-hook hybrid system. Scoliosis correction rate and percentage of spinal canal occupied by the rib head were analyzed. Results: The median patient age, number of segments fused, and follow-up duration were 12 years, 10.5, and 22.5 months, respectively. There were no surgery-related complications, and symptoms in all patients were improved after surgery. The median postoperative and 1-year follow-up sagittal kyphotic angles were significantly smaller as compared to the preoperative value (28.5[degrees] and 31[degrees] vs. 62.5[degrees], P=0.012). The median postoperative coronal Cobb angle of the main thoracic curve was significantly smaller compared to the preoperative value (29[degrees] vs. 64.5[degrees], P=0.012). The median percentage of the spinal canal occupied by the intraspinal rib was significantly lower at 1-year follow-up compared with the preoperative value (23.1% vs. 28.6%, P=0.018). Conclusions: Posterior correction without rib head excision can provide good outcomes for patients with NF-1 and dystrophic scoliosis and rib head protrusion into the spinal canal.
    Journal of Spinal Disorders & Techniques 01/2015; DOI:10.1097/BSD.0000000000000240 · 1.89 Impact Factor
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    ABSTRACT: Cartilage-derived mesenchymal stem cells (MSCs) have been isolated with different methods. In this study lateral and medial femoral condyles were respectively collected from patients with late-stage osteoarthritis during the total knee arthroplasty. After digestion of the cartilage tissues with type II collagenase and analysis by fluorescence-activated cell sorting (FACS) with CD146, a chondroprogenitor cell sub-population were isolated and purified. The expression of other MSC-associated markers in the CD146+ chondroprogenitors was analyzed by flow cytometry. Multi-lineage differentiation capacity of CD146+ chondroprogenitors was compared with that of unsorted chondrocytes and adipose-derived MSCs (ADMSCs). Higher percentage of CD146+ chondroprogenitors isolated from the medial femoral condyles was observed than that from the lateral. CD146+ chondroprogenitors expressed high levels of MSC-specific surface antigens, and showed higher chondrogenesis capacity than ADMSCs and unsorted chondrocytes in a 3D cell pellet culture model. Thus CD146 might be a new cell surface marker for cartilage progenitor cell population in the late-stage osteoarthritis. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res
    Journal of Orthopaedic Research 01/2015; 33(1). DOI:10.1002/jor.22731 · 2.97 Impact Factor
  • Guixing Qiu
    Zhonghua wai ke za zhi [Chinese journal of surgery] 01/2015; 53(1):22-6.
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    ABSTRACT: BC (bacterial cellulose) exhibits quite distinctive properties than plant cellulose. The outstanding properties make BC a promising material for preparation of artificial blood vessel. By taking advantage of the high oxygen permeability of PDMS (polydimethylsiloxane) as a tubular template material, a series of BC tubes with a length of 100 mm, a thickness of 1 mm and an outer diameter of 4 or 6 mm were biosynthesized with the help of Gluconacetobacter xylinum. Through characterization by SEM (scanning electron microscope), tensile testing and thermal analysis, it is demonstrated that BC tubes are good enough for artificial blood vessel with elaborated nano-fiber architecture, qualified mechanical properties and high thermal stability. In addition, measurement of biocompatibility also shows that BC tubes are greatly adaptable to the in vivo environment. The results indicate that BC tubes have great potential for being utilized as tubular scaffold materials in the field of tissue engineering.
    Materials Science and Engineering C 01/2015; 46:111–117. DOI:10.1016/j.msec.2014.10.023 · 2.74 Impact Factor
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    ABSTRACT: Chemotherapy is the most common therapeutic strategy used to treat osteosarcoma. The present study aimed to investigate the effects of functionally activated chloride channels on cisplatin‑induced apoptosis of MG‑63 human osteosarcoma cells. An MTT assay and flow cytometry were used to detect proliferation and apoptosis of the cells, respectively. Live cell imaging was used to detect volume changes in response to treatment with cisplatin and/or chloride channel blockers. The effects of these treatments on chloride currents were also assayed using the patch‑clamp technique. The results of the present study indicate that chloride channel blockers may suppress cisplatin‑induced apoptosis. The MG‑63 cells cultured with cisplatin demonstrated an apoptotic volume decrease, as well as suppression of cell proliferation; which were reversed by co‑treatment with chloride channel blockers. These results suggest that cisplatin may activate chloride channels, and that channel activation is an early signal in the pathways that lead to cisplatin‑induced apoptosis and inhibition of proliferation in MG‑63 cells. In conclusion, these results indicate that chloride channels have an important role in cisplatin treatment of osteosarcoma.
    Molecular Medicine Reports 12/2014; 11(4). DOI:10.3892/mmr.2014.3068 · 1.48 Impact Factor
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    ABSTRACT: A retrospective study of 1162 consecutive patients who underwent spinal deformity surgical procedures at our spine center from January 2010 to December 2013.
    Spine 11/2014; 39(24):E1425-32. DOI:10.1097/BRS.0000000000000589 · 2.45 Impact Factor
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    ABSTRACT: The aim of the present study was to summarize and analyze the complications of posterior vertebral column resection in patients with spinal tumors. The complications of 40 patients following surgery were recorded, and surgery-related parameters including segments, bleeding volume and surgical duration were recorded and analyzed. SPSS 12.0 software was used to analyze the correlation between the complications and these parameters retrospectively. A total of 36 complications were reported. The median follow-up duration of the patients was 14 months (range, 4-78 months). Transient late tracheal extubation was associated with higher intraoperative bleeding volume, lower preoperative forced vital capacity and forced expiratory volume in 1 sec. Replaced spinal segment subsidence was associated with increased duration of surgery, higher intraoperative bleeding volume and higher total blood transfusion volume. Thrombocytopenia was associated with increased duration of surgery and higher total blood transfusion volume. The majority of the complications were minor and did not affect the recovery of the patients. Active prevention is necessary to reduce the incidence of complications, in particular, major ones.
    Experimental and therapeutic medicine 11/2014; 8(5):1539-1544. DOI:10.3892/etm.2014.1929 · 0.94 Impact Factor
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    ABSTRACT: The long term outcome of patellar resurfacing in Chinese has not been well described. This study evaluated more than 10-year clinical outcomes and survivorship of patellar resurfacing or nonresurfacing in total knee arthroplasty. From January 1993 to December 2002, 265 patients accepted total knee arthroplasty in Department of Orthopaedic Surgery, Peking Union Medical College Hospital. Among them, 226 patients (246 knees) were successfully followed up, with 176 knees for patellar resurfacing and 70 knees for nonresurfacing. The survivorship of total knee arthroplasty between two groups and the hospital for special surgery knee score (HSS), patellar score, patellar related complication and radiological results were studied at the latest follow-up. The HSS knee score increased from 55.9±12.2 preoperatively to 92.0±10.9 postoperatively for patellar resurfacing group and from 56.6±9.9 to 94.2±11.4 for nonresurfacing group after average 11.4-year follow-up. Patellar score increased from 13.93±2.42 preoperatively to 28.33±2.20 for resurfacing group and from 13.55±2.73 to 27.8±2.37 for nonresurfacing group. There was no statistically significant difference for both HSS score, patellar score between the two groups with higher rate of anterior knee pain for nonresurfacing group. Patellar nonresurfacing had higher lateral subluxation than resurfacing group according to radiological evaluation. Patients with rheumatoid arthritis had 5.5 fold patellar related complication than patients with osteoarthritis. The 10-year survival rate was not statistically significant different between the two groups (P = 0.12). There was no significant difference of long-term clinical outcome and survivorship between patellar resurfacing and nonresurfacing. Patellar nonresurfacing can be advisable during primary total knee arthroplasty especially in Chinese patients with osteoarthritis. Selective patellar resurfacing for patients with rheumatoid arthritis can achieve lower patella related complication.
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    ABSTRACT: Purpose To analyze risk factors for an increase in proximal junctional angle (PJA) after posterior selective thoracolumbar/lumbar (TL/L) curve fusion in patients with adolescent idiopathic scoliosis (AIS). Methods AIS patients that underwent selective posterior TL/L curve fusion with a minimum of 2-year follow-up were identified. Demographic and radiographic data were collected before surgery, at first erect after surgery and at final follow-up. Multiple linear regression analysis was performed to determine the relation of PJA changes during follow-up and eight potential risk factors, including locations of upper instrumented vertebra (UIV), locations of lower instrumented vertebra (LIV), length of fusion segments, types of pedicle screw alignment, lumbar lordosis (LL) at first erect after surgery, LL changes before and after surgery, sagittal vertical axis (SVA) at first erect after surgery and SVA changes before and after surgery. Results A total of 41 patients were included in this study. There were 37 female and 4 male with a mean age of 14.7 years at surgery. PJA was increased from 5.5° immediately after surgery to 10.8° at the last follow-up (P Conclusions Location of LIV above or equal to L3, higher postoperative LL and deteriorative negative SVA with surgery were potential risk factors for increased PJA during follow-up. Postoperative LIV inclination more than 5ºmight be also an indicator for an increase in PJA.
    European Spine Journal 10/2014; 24(2). DOI:10.1007/s00586-014-3639-6 · 2.47 Impact Factor
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    ABSTRACT: Congenital insensitivity to pain with anhidrosis is a rare autosomal recessive disorder. It has been reported that the defect in the NTRK1 gene encoding tropomyosin-related kinase A (TrkA) can cause congenital insensitivity to pain with anhidrosis. Nerve growth factor (NGF), the product of NGFB, mediates biological effects by binding to and activating tropomyosin-related kinase A. In addition, necdin (encoded by NDN) is also essential in nerve growth factor-tropomyosin-related kinase A pathway. We performed mutation analysis in NTRK1, NGFB, and NDN genes in a Chinese Han 17-year-old female patient with congenital insensitivity to pain with anhidrosis and her healthy family members. As a result, the patient was found to have a novel insertion in exon 7 (c.727insT) of NTRK1, which causes premature termination, and a single nucleotide polymorphism (rs2192206 G>A) in NDN. Our findings imply that the genetic variations of the nerve growth factor-tropomyosin-related kinase A pathway play an important role in congenital insensitivity to pain with anhidrosis.
    Journal of Child Neurology 10/2014; DOI:10.1177/0883073814552438 · 1.67 Impact Factor
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    ABSTRACT: To explore the relationship between bore diameter of porous hydroxyapatite (HA) scaffolds and the adhesion, proliferation and metabolism of osteoblasts by 3D cultivation. MC3T3-E1 cell suspension was separately dropped axially through different bore diameter scaffolds (Group A:150 µm, Group B:300 µm) to confirm initial seeding. Then scaffolds were transferred into a perfusion bioreactor of 5% CO2 at 37°C for 5 days with an average flow of 3.4 ml/min. After perfusion cultivation, cell proliferation between different groups of scaffolds was determined by methyl thiazolyl tetrazolium (MTT) assay and cell metabolic activities were determined by glucose consumption. Lastly cell adhesion and proliferation were observed directly by scanning electronic microscope (SEM). The results of MTT assay showed that the optical density/mass ratios were 1.31 ± 0.26 in group A and 1.51 ± 0.43 in group B. There was no significant difference (t test, P = 0.36). Glucose consumption in group A was significantly lower than that in group B [(162.38 ± 33.09) vs (217.97 ± 27.91) µmol/L, P = 0.01]. The adhesion, proliferation, pseudopodia and extracellular matrix of osteoblasts in internal part of scaffolds after perfusion cultivation were observed by SEM. With excellent biocompatibility, porous HA scaffolds are available for fabricating tissue engineering bones. There is no effect of bore diameter on the proliferation of osteoblasts. But it affects the metabolic activity of osteoblasts. So bore diameter may be increased within a feasible range on the premise of mechanical properties.
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    ABSTRACT: Study Design. Retrospective Case SeriesObjective. The objectives of this study were to 1) determine the rate of POUR in a series of patients undergoing lumbar spine surgery 2) compare length of stay between patients who developed POUR and patients who did not, and 3) identify the patient and surgical factors associated with the development of POUR.Summary of Background Data. Although post-operative urinary retention (POUR) is a common complication in many surgical subspecialties, sparse literature is present regarding development of POUR after posterior lumbar surgical procedures.Methods. A retrospective review was conducted of all posterior lumbar surgery cases performed at single institute from July 2008 to July 2012. Data collected included demographic variables (age, sex, BMI), length of stay, comorbid medical conditions, and surgical data. Wilcoxon rank sum test with continuity correction was used to compare length of stay between patients who developed POUR and patients who did not. A multivariate logistic regression model was created using all patient and surgical factors and systematically pruned of variables not improving overall predictive power.Results. 647 patients (291 decompression, 356 decompression and fusion) were included in the study. 36 of 647 patients had urinary retention after lumbar spine surgery (5.6%). Patients who developed POUR had a longer length of stay compared to patients who did not develop POUR (3.94 days vs. 2.34 days, p = 0.005). Male gender, BPH, age, diabetes, and depression were significantly associated with development of POUR (OR: 3.05, 9.82, 1.04, 3.32, and 2.51, respectively). Smoking was inversely associated with the development of POUR (OR: 0.45).Conclusions. The risk of developing POUR following posterior lumbar spine surgery is approximately 5%. Male gender, BPH, age, diabetes, and depression were significantly associated with the POUR group. Patients who developed POUR had a greater length of stay.
    Spine 09/2014; 39(23). DOI:10.1097/BRS.0000000000000587 · 2.45 Impact Factor
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    ABSTRACT: Study Design. A retrospective radiographic analysis.Objective. To assess the effect of unfused segments in the reconstitution of coronal balance after posterior selective thoracolumbar/lumbar (TL/L) curve fusion for adolescent idiopathic scoliosis.Summary of Background Data. Current literature suggests that compensatory changes occur after selective TL/L curve fusion surgery. Hitherto the roles of the unfused levels in coronal balance reconstitution have not fully understood.Methods. Radiographic data of idiopathic scoliosis patients that underwent selective posterior TL/L curve fusion at our hospital before October 2011 with a minimum of 2 years follow-up period was retrospectively analyzed. Changes of coronal trunk shift during the follow-up period were studied and multiple linear regression analysis was performed to determine its correlation with changes of upper and lower curve of unfused thoracic segments, instrumented segments angle, distal unfused segments angle and coronal sacral inclination.Results. A total of 43 patients were included in this study. Pre-operative and first erect radiographs demonstrated trunk shifts of 21.1mm and 18.7mm respectively, showing no significant differences (P = 0.205). At the last follow-up, it compensated to 9mm, which showed significant differences (P<0.01). Regression analysis of all patients showed that coronal trunk shift changes only correlated with distal unfused segments angle changes. Subgroup analysis based on the magnitude of preoperative thoracic curve found that only distal unfused segments had an impact on coronal balance reconstitution. However, subgroup analysis based on the flexibility of preoperative thoracic curve showed that both proximal unfused thoracic segments and distal unfused lumbar segments contributed to coronal balance compensation in patients with a thoracic curve flexibility rate of more than 70%.Conclusions. The reconstitution of coronal balance was mainly compensated by distal unfused segments after selective posterior fusion of TL/L idiopathic scoliosis. The effect of unfused thoracic segments in coronal balance reconstitution mainly depended on its flexibility.
    Spine 09/2014; 39(24). DOI:10.1097/BRS.0000000000000602 · 2.45 Impact Factor

Publication Stats

445 Citations
240.09 Total Impact Points

Institutions

  • 2002–2015
    • Peking Union Medical College Hospital
      • Department of General Surgery
      Peping, Beijing, China
  • 2009–2014
    • Chinese Academy of Medical Sciences
      Peping, Beijing, China
  • 2002–2013
    • Peking Union Medical University
      Peping, Beijing, China