Huilin Yang

Jining Medical University, Chi-ning-shih, Shandong Sheng, China

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Publications (95)213.22 Total impact

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    ABSTRACT: Sacral chordoma is an aggressive, locally invasive neoplasm, and has a poor prognosis. However, the molecular basis for the clinical behavior remains unknown. The purpose of this study was to investigate the expression of phosphatase and tensin homolog deleted on chromosome 10 (PTEN) and mammalian target of rapamycin (mTOR) in sacral chordoma, and explore their roles in the prognosis. PTEN and mTOR were detected immunohistochemically in 40 sacral chordoma tissues and 10 adjacent normal tissues. Correlations between PTEN and mTOR expression and clinicopathological factors were analyzed. Kaplan-Meier survival curves and log-rank test were used to analyze the continuous disease-free survival time (CDFS). The expression of PTEN in sacral chordoma was significantly lower than that in adjacent normal tissues, while the levels of mTOR expression in sacral chordoma were significantly higher than that in adjacent normal tissues (P = 0.000, P = 0.030). The positive expression of mTOR appears to correlate with the negative expression of PTEN in sacral chordoma (P = 0.021). PTEN-negative expression and mTOR-positive expression were associated with tumor invasion into the surrounding muscles (P = 0.038, P = 0.014). Log-rank test showed that PTEN-negative and mTOR-positive expressions had an important impact on the patients' CDFS (P = 0.011, P = 0.015). Our results suggest that PTEN and mTOR might play an important role in the local invasiveness of sacral chordoma. PTEN and mTOR might be recognized as important prognostic predictors of recurrence and could be used as potential therapeutic targets for the treatment for sacral chordoma.
    Medical Oncology 04/2014; 31(4):886. · 2.14 Impact Factor
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    ABSTRACT: Nerve conduit is one of strategies for spine cord injury (SCI) treatment. Recently, studies showed that biomaterials could guide the neurite growth and promote axon regeneration at the injury site. However, the scaffold by itself was difficult to meet the need of SCI functional recovery. The basic fibroblast growth factor (bFGF) administration significantly promotes functional recovery after organ injuries. Here, using a rat model of T9 hemisected SCI, we aimed at assessing the repair capacity of implantation of collagen scaffold (CS) modified by collagen binding bFGF (CBD-bFGF). The results showed that CS combined with CBD-bFGF treatment improved survival rates after the lateral hemisection SCI. The CS/CBD-bFGF group showed more significant improvements in motor than the simply CS-implanted and untreated control group, when evaluated by the 21-point Basso-Beattie-Bresnahan (BBB) score and footprint analysis. Both hematoxylin and eosin (H&E) and immunohistochemical staining of neurofilament (NF) and glial fibrillary acidic protein (GFAP) demonstrated that fibers were guided to grow through the implants. These findings indicated that administration of CS modified with CBD-bFGF could promote spinal cord regeneration and functional recovery.
    Science China. Life sciences 01/2014; · 2.02 Impact Factor
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    ABSTRACT: The aim of this study was to measure changes in the cross-sectional area of the spinal canal and the area of the intervertebral foramen for each pedicle segment before and after the pedicle extension using computer-simulated transpedicular osteotomy to provide a theoretical basis for clinical decompression in the lumbar spinal canal. Using spiral CT scanning of the original lumbar spine, a finite element model was established. The pedicle was cut and extended by 2 mm, 4 mm, 6 mm, and 8 mm for respective modeling. The changes in the area of each plane of the vertebral canal and the area of the intervertebral foramen were measured. With the gradual extension of the pedicle, the areas of the spinal canal and intervertebral foramen also significantly increased compared with those of the original lumbar spine (P<0.05). The extension of the pedicle using transpedicular osteotomy can significantly increase the cross-sectional area of the lumbar canal and the area of the intervertebral foramen. This finding provides a new theoretically practicable method for the clinical decompression of the lumbar spinal canal.
    International journal of clinical and experimental medicine 01/2014; 7(1):163-169.
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    ABSTRACT: Background Low back pain is a frequently occurring disease caused by intervertebral disc degeneration. Mesenchymal stem cells (MSCs) are a possible treatment modality. Studies have shown MSCs can be transformed into nucleus pulposus-like cells under normoxic conditions. However, this is not a true representation of the hypoxic environment nucleus pulposus cells experience during in vivo growth and differentiation. Purpose To determine the effects of a hypoxic environment on the differentiation of human placenta derived mesenchymal stem cells (PMSCs) to nucleus pulposus-like cells. Study Design An experimental study. Methods PMSCs were cultured and the mesenchymal lineage was confirmed by flow cytometry. Two groups of PMSCs were then cultured under different oxygen concentrations creating a hypoxic group and normoxic group. The proliferation of cells in each group was compared by CCK-8 on day 1, 3, 5, and 7. RT-PCR on days 3 and 7 compared the expressions of Sox-9, type II collagen, aggrecan, and HIF-1α between the two groups. Immunofluorescence was used to compare the expression of type II collagen between the two groups of after 14 days. Results PMSCs were successfully isolated and cultured. Mesenchymal markers were positive. On day 3 and 5, the hypoxic group had a significantly higher proliferation rate than the normoxic group (p<0.05). The expression of Sox-9 and HIF-1α was significantly higher (p<0.05) in the hypoxic group at 3 and 7 days. Type II collagen and aggrecan expression was significantly higher (p<0.05) in the hypoxic group at 7 days. The hypoxic group stained more positive for type II collagen at 14 days. Conclusions Hypoxic conditions lead to an increased differentiation and proliferation of nucleus pulposus-like cells. PMSCs cultured in nucleus pulposus inducing media and a hypoxic environment show enhanced expression of the nucleus pulposus-like cell markers Sox-9, type II collagen, aggrecan, and and HIF-1α.
    The spine journal: official journal of the North American Spine Society 01/2014; · 2.90 Impact Factor
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    ABSTRACT: The management of amyelic thoracolumbar burst fractures remains controversial. In this study, we compared the clinical efficacy of percutaneous kyphoplasty (PKP) and short-segment pedicle instrumentation (SSPI). Twenty-three patients were treated with PKP, and 25 patients with SSPI. They all presented with Type A3 amyelic thoracolumbar fractures. Clinical outcomes were evaluated by a Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) preoperatively, postoperatively, and at two years follow-up. Radiographic data including the anterior and posterior vertebral body height, kyphotic angle, as well as spinal canal compromise was also evaluated. The patients in both groups were similar regarding age, bone mineral density (BMD), follow-up period, severity of the deformity and fracture. Blood loss, operation time, and bed-rest time were less in the PKP group. VAS, ODI score improved more rapidly after surgery in the PKP group. No significant difference was found in VAS and ODI scores between the two groups at final follow-up (p > 0.05). Meanwhile, the height of anterior vertebrae (Ha), the height of posterior vertebrae (Hp) and the kyphosis angle showed significant improvement in each group (p < 0.05). The postoperative improvement in spinal canal compromise was not statistically significant in the PKP group (p > 0.05); there was a significant improvement in the SSPI group (p < 0.05). Moreover, these postoperative radiographic assessments showed significant differences between the two groups regarding the improvement of canal compromise (p < 0.05). At final follow-up, remodeling of spinal canal compromise was detected in both groups. Conclusion: Both PKP and SSPI appeared as effective and reliable operative techniques for selected amyelic thoracolumbar fractures in the short-term. PKP had a significantly smaller blood loss and shorter bed-rest time, but SSPI provided a better reduction. Long-time studies should be conducted to support these clinical outcomes.
    Acta orthopaedica Belgica 12/2013; 79(6):718-25. · 0.63 Impact Factor
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    ABSTRACT: Osteoporotic vertebral biconcave-shaped fractures are not commonly seen in clinical practice. Some articles have been published showing the outcome of vertebroplasty (PV) and balloon kyphoplasty (BKP), but few comparative studies have been performed. To compare the effect and safety of PV and BKP in treating osteoporotic vertebral biconcave-shaped fractures. In this retrospective comparative study, 38 patients with osteoporotic vertebral biconcave-shaped fractures were treated by PV, and 41 patients were treated by BKP from May 2005 to July 2011. The heights of the compromised vertebral body and the kyphotic angles were measured. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate pain and functional activity, respectively. The occurrence of refracture and cement leakage were determined, and the costs were recorded. The mean VAS and ODI scores significantly improved for both procedures at postsurgical measurements (P < 0.05), and the improvement sustained at the final follow-up. In both groups, there were no significant differences in terms of restoration of the anterior vertebral height and correction of the kyphotic deformity. However, BKP was more effective in restoring the middle vertebral height than PV. Cement leakages were observed in nine (23.7%) treated vertebral bodies in PV group and in three (7.4%) treated vertebral bodies in BKP group, which was a statistically significant difference (P < 0.05). There were four new osteoporotic vertebral fractures in the PV group and two in the BKP group during the follow-up period. The mean cost in the BKP group (6200 ± 122.1 USD) was higher than the PV group (2100 ± 112.5 USD) (P < 0.05). Both PV and BKP achieved similar improvements in pain and functional outcomes for the treatment of osteoporotic vertebral biconcave-shaped fractures. BKP had a significant advantage over PV in terms of the restoration of the middle vertebral height and fewer cement leakages than PV.
    Acta Radiologica 11/2013; · 1.33 Impact Factor
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    ABSTRACT: The purpose of this study was to investigate the isolation and culture of muscle‑derived stem cells (MDSCs) and their capability to differentiate into osteoblasts in vitro. Skeletal muscle tissue was obtained from double hind limbs of New Zealand white rabbits under sterile conditions and isolated by collagenase digestion. Following passages in basic medium, the primary cells were desmin (+), myosin (+) and CD105 (+). Differentiation of MDSCs was induced by osteogenic medium. Using a 3‑(4,5‑dimethylthiazol‑2‑yl)‑2,5‑diphenyl tetrazolium bromide assay, the differentiated cell population was found to proliferate faster than the undifferentiated. Alkaline phosphatase staining and alizarin red staining revealed that the differentiated cells were mineralized in vitro. Quantitative polymerase chain reaction assays also showed increased mRNA expression of osteogenic genes in differentiated cells. In conclusion, stem cells were successfully isolated and cultured from rabbit skeletal muscle tissue and were able to differentiate into osteoblasts following induction. These observations may indicate an ideal stem cell source for tissue engineering.
    Molecular Medicine Reports 10/2013; · 1.17 Impact Factor
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    ABSTRACT: Sacral chordoma is a rare and aggressive tumor, with a high rate of local recurrence even when the tumor is radically resected. The fundamental knowledge of its biological behavior remains unknown. Insulin-like growth factor II mRNA-binding protein 3 (IMP3) is one of the RNA binding proteins and is expressed during embryogenesis and in various malignant tumors. This study evaluated expression of IMP3 in sacral chordoma for association with patient's clinicopathological factors. A total of 32 patients with sacral chordoma (17 male and 15 female) and 10 samples of distant normal tissues were collected for analysis of IMP3 expression using immunohistochemistry. Association between IMP3 expression and clinicopathological factors (such as patient's age, gender, tumor location, tumor size, surrounding muscle invasion, Ki-67 expression, and tumor recurrence) were statistically analyzed. IMP3 was expressed in 20 (62.5 %) patients, whereas there was no expression in the 10 distant normal tissues. IMP3 expression was associated with tumor invasion into the surrounding muscle (P = 0.028), high levels of Ki-67 expression (P = 0.009), and tumor recurrence (P = 0.012). The log-rank test revealed that patients with positive IMP3 expression had a shorter continuous disease-free survival time than those with negative IMP3 expression (P = 0.016). IMP3 expression was independent of age, gender, tumor location and tumor size. These results indicate that IMP3 was overexpressed in sacral chordoma and this expression was associated with tumor invasion and recurrence; thus, IMP3 may play an important role in tumor progression and could serve as a prognostic biomarker for sacral chordoma and IMP3 could be used as a potential therapeutic target for the treatment of sacral chordoma.
    Journal of Neuro-Oncology 10/2013; · 3.12 Impact Factor
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    ABSTRACT: The present study aimed to assess a posterior approach for the surgical resection of giant sacral neurogenic tumors, and to evaluate the oncological and functional outcomes. A total of 16 patients with giant sacral neurogenic tumors underwent pre-operative embolization and subsequent posterior sacral resection between January 2000 and June 2010. Benign tumors were identified in 12 cases, while four cases exhibited malignant peripheral nerve sheath tumors (MPNSTs). An evaluation of the operative techniques used, the level of blood loss, any complications and the functional and oncological outcomes was performed. All tumor masses were removed completely without intra-operative shock or fatalities. The mean tumor size was 17.5 cm (range, 11.5-28 cm) at the greatest diameter. The average level of intra-operative blood loss was 1,293 ml (range, 400-4,500 ml). Wound complications occurred in four patients (25%), including three cases of cutaneous necrosis and one wound infection. The mean follow-up time was 59 months (range, 24-110 months). Tumor recurrence or patient mortality as a result of the disease did not occur in any of the patients with benign sacral neurogenic tumors. The survival rate of the patients with malignant lesions was 75% (3/4 patients) since 25 % (1/4 patients) had multiple local recurrences and succumbed to the disease. The patients with benign tumors scored an average of 92.8% on the Musculoskeletal Tumor Society (MSTS) score functional evaluation, while the patients with malignant tumors scored an average of 60.3%. A posterior approach for the surgical resection of giant sacral neurogenic tumors, combined with pre-operative embolization may be safely conducted with satisfactory oncological and functional outcomes.
    Oncology letters 07/2013; 6(1):251-255. · 0.24 Impact Factor
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    ABSTRACT: The pre-operative embolization of hypervascular spinal tumors is often performed to decrease intraoperative blood loss and facilitate tumor resection; however, few studies have been published on its effectiveness in giant cell tumors (GCT) of the sacrum and spine. The purpose of the present study was to investigate the value of surgical excision with pre-operative transarterial embolization for GCTs of the sacrum and spine, and to evaluate the follow-up outcomes. A retrospective study was performed on 28 patients with GCTs of the sacrum and spine, who underwent surgical treatment combined with pre-operative transarterial embolization between June 1995 and August 2011. The intraoperative blood loss, transfusion, duration of surgery, treatment, local recurrence, complications, follow-up status and functional outcome were reviewed. The average follow-up period was 86.3 months (range, 12-193 months). All the patients were treated with intralesional resection without any intraoperative shock or fatalities. The average intraoperative level of blood loss was 1,528.6 ml (range, 400-5,800 ml), the average transfusion volume was 1,514.3 ml (range, 400-6,000 ml) and the average duration of surgery was 225.4 min (range, 120-470 min). In total, eight (28.6%) patients developed recurrence and two patients succumbed. A total of eight (28.6%) patients experienced complications and 24 (85.7%) retained normal neurological function. Pre-operative embolization significantly decreases intraoperative blood loss and facilitates the maximal removal of the tumor. Pre-operative embolization followed by intralesional resection is able to achieve satisfactory local control and clinical outcomes. It is an effective technique for excising GCTs of the sacrum and spine.
    Oncology letters 07/2013; 6(1):185-190. · 0.24 Impact Factor
  • The spine journal: official journal of the North American Spine Society 05/2013; · 2.90 Impact Factor
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    ABSTRACT: Percutaneous kyphoplasty (PKP) represents a powerful tool in the management of oncology patients who suffer from painful osteolytic spinal lesions, due to the minimally invasive nature of the procedure. However, there have been few reports on the role of PKP in the treatment of osteoblastic metastatic spinal lesions. We report our experience of the treatment of six patients with painful osteoblastic metastatic spinal lesions using PKP. Immediate relief of pain and improvement of functional status were achieved in all of them without PKP-related complications, which may encourage more studies of PKP in the palliative treatment of patients with painful osteoblastic metastatic spinal lesions.
    Journal of Clinical Neuroscience 05/2013; · 1.25 Impact Factor
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    ABSTRACT: This article describes the independent factors that affect kyphotic angle reduction in the treatment of osteoporotic vertebral compression fractures with kyphoplasty. Between January 2008 and September 2011, one hundred twenty-six patients with a single-level osteoporotic compression fracture who underwent kyphoplasty were evaluated for a minimum of 1 year postoperatively. Nine independent variables related to patient characteristics (age, sex, bone mineral density [BMD], and body mass index), fracture characteristics (fracture level, fracture age, and preoperative kyphotic angle), and surgical variables (total injected cement volume and cement leakage) were assessed. Kyphotic angle reduction was the dependent variable. Univariate and multivariate linear regression analyses were used to determine the factors associated with kyphotic angle reduction.Significant improvements occurred in mean anterior vertebral height variation, middle vertebral height variation, kyphotic angle, and visual analog scale and Oswestry Disability Index scores immediate postoperatively and at final follow-up compared with the preoperative values. Univariate analyses indicated correlations between kyphotic angle reduction with BMD, fracture age, preoperative kyphotic angle, and cement volume. The final multiple linear regression model resulted in a formula that accounted for 23.3% of the variability in kyphotic angle reduction: preoperative kyphotic angle (b=0.260; P=.002), BMD (b=-0.249; P=.004), and fracture age (b=-0.226; P=.009). Kyphoplasty is a safe and effective treatment for osteoporotic compression fractures.
    Orthopedics 04/2013; 36(4):e509-e514. · 1.05 Impact Factor
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    ABSTRACT: INTRODUCTION: Very severe osteoporotic vertebral compression fractures (vsOVCFs), which are vertebral bodies collapsed to less than one-third of their original height, are considered as a relative contraindication to vertebral augmentation techniques. The purpose of our study was to evaluate the safety and efficacy of balloon kyphoplasty in treating vsOVCFs. METHODS: Between January 2005 and December 2010, 26 patients (23 women, 3 men) with 27 very severe vertebral fracture bodies underwent balloon kyphoplasty. The vertebral height, local kyphotic angle, visual analogue scale (VAS) and Oswestry Disability Index (ODI) values were assessed before the operation, 1 day after the operation and at the final follow-up. Post-operative computed tomography scans were used to detect cement leakage. RESULTS: Asymptomatic cement leakage occurred in 7 of 27 treated vertebral fractures (25.9 %). Three patients (11.5 %) were proved to have subsequent vertebral compression fractures (VCFs). There were significant improvements in the vertebral height and kyphotic angle after surgery (p < 0.01). A total of 22 patients (84.6 %) exhibited partial or complete pain relief, and the mean VAS and ODI scores decreased significantly from pre-operation to post-operation (p < 0.01). CONCLUSION: Kyphoplasty is a safe and effective procedure for the treatment of vsOVCFs. It achieved significant vertebral height restoration and kyphotic angle reduction. Relief of pain and improvement in function were also observed in most patients.
    Neuroradiology 03/2013; · 2.70 Impact Factor
  • Journal of spinal disorders & techniques 02/2013; · 1.21 Impact Factor
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    ABSTRACT: Phosphorylated retinoblastoma protein (p-Rb), a well identified cell cycle related protein, is involved in regulating the biological functions of various cell types including neurons. One attractive biological function of p-Rb is releasing E2F transcription factor to induce S-phase entry and cellular proliferation of mitotic cells. However, some studies point out that the role of p-Rb in post-mitotic cells such as mature neurons is unique; it may induce cellular apoptosis rather than proliferation via regulating cell cycle reactivation. Up to now, the knowledge of p-Rb function in CNS is still limited. To investigate whether p-Rb is involved in CNS injury and repair, we performed a traumatic brain injury model in adult rats. Up-regulation of p-Rb was observed in the injured brain cortex by western blot analysis and immunohistochemistry staining. Terminal deoxynucleotidyl transferase deoxy-UTP-nick end labeling (TUNEL) and 4',6-diamidino-2-phenylindole (DAPI) staining suggested that p-Rb was relevant to neuronal apoptosis after brain injury. In addition, glutamate excitotoxic model of primary cortex neurons was introduced to further investigate the role of p-Rb in neuronal apoptosis; the result implied p-Rb was associated with cell cycle activation in the apoptotic neurons. Based on our data, we suggested that p-Rb might play an important role in neuronal apoptosis after traumatic brain injury in rat; which might also provide a basis for the further study on its role in regulating cell cycle re-entry in apoptotic neurons, and might gain a novel strategy for the clinical therapy for traumatic brain injury.
    Journal of molecular histology 01/2013; · 1.75 Impact Factor
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    ABSTRACT: Background Whether kyphoplasty or vertebroplasty is better for painful osteoporotic vertebral compression fracture is a widely debated issue. Studies on the comparison of the 2 approaches are relative limited and a wide variation exists in the patient population, study design, and results. These factors make it difficult for workers in this field to know the exact value of the 2 approaches. Objective To perform a systematic review and meta-analysis to compare the clinical outcomes and complications of kyphoplasty versus vertebroplasty for painful osteoporotic vertebral compression fractures (OVCF). Study design A systematic review and meta-analysis. Methods MEDLINE, EMBASE, and other databases were searched for all the relevant original articles published from January 1987 to September 2012 comparing kyphoplasty with vertebroplasty for painful OVCF. The following outcomes were mainly evaluated: visual analog scale (VAS), vertebral height, kyphosis angle, new vertebral fractures, and cement leakage. Results A total of 15 articles fulfilled all the inclusion criteria. The baseline characteristics such as sex, age, and number of prevalent fractures were comparable for both groups (P > .05). VAS score for the kyphoplasty group was significantly more than that for the vertebroplasty group at 1-3 days, 3 months, 6 months, 1 year, and 2 years after surgery (P < .05). Vertebral height in the kyphoplasty group was significantly higher than the vertebroplasty group at 3 months, 6 months, and 2 years (P < 0.05). Kyphosis angle in the kyphoplasty group was significantly lower at 3 months, 6 months, and 2 years (P < 0.05). The occurrence of new vertebral fractures in the kyphoplasty group had no significant difference with the vertebroplasty group at 3 months, 6 months, and 2 years (P > 0.05). The occurrence of cement leakage was significantly lower in the vertebroplasty group (P < 0.05). Limitations The main limitations of this review are that the demographics and comorbidities of study participants were not reported. These possible sources of heterogeneity could not be examined. Conclusions Percutaneous kyphoplasty is better than vertebroplasty in the treatment of painful OVCF. Kyphoplasty had better improvement at VAS score, vertebral height, and kyphosis angle with lower occurrence of cement leakage.
    The International Journal of Spine Surgery. 01/2013;
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    ABSTRACT: Percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) is utilized for the treatment of vertebral compression fractures (VCFs). The present study was conducted to evaluate biopsy results obtained from VCFs during PVP or PKP. Between January 2003 and December 2011, 692 vertebral body biopsies were obtained from 546 patients (442 females and 104 males; mean age, 72.3 years), who underwent PVP or PKP for treatment of VCFs. A history of malignancy was identified in 44 patients. Histological/immunohistochemical evaluations were performed by experienced pathologists and 89.9% of biopsies obtained from 546 patients were suitable for histological/immunohistochemical evaluation. The biopsy results of 398 patients were in good agreement with the diagnosis of osteoporotic VCFs. Among the 44 patients with a history of malignancy, malignancy was identified in 25 patients, while osteoporosis was identified in 16 patients. Biopsies of the other 3 patients were not suitable for pathological examination. There were only 2 patients with previously undiagnosed malignancy. One patient was diagnosed with multiple myeloma, while another patient was diagnosed with metastatic carcinoma. In the present study, the rate of unsuspected malignancy was 0.4%. No symptomatic complications occurred as a result of biopsy. The results indicate that biopsy is safely performed during PVP or PKP and it is an efficacious procedure that verifies the pathological process and assists in identifying previously unsuspected processes responsible for VCFs. We recommend obtaining the biopsy of every collapsed vertebral body during PVP or PKP procedures.
    Oncology letters 01/2013; 5(1):135-138. · 0.24 Impact Factor
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    ABSTRACT: Nonunion complicating ulna fracture surgery in one patient. To treat nonunion of the ulna using bone transport combined with locking plate and bone grafting. A 54-year-old male patient developing nonunion of the ulna 3 years after left ulna fracture surgery was included in this study. Bone transport combined with locking plate and bone grafting was applied to treat the patient, with the purpose of achieving the goal of bone healing at the site where nonunion occurred. Postoperative imaging data of the patient suggested bone healing at the site where nonunion and bone transport (by osteotomy) occurred. The patient had no special chief complaints and his forearm rotation functions were normal. Bone transport combined with locking plate and bone grafting can provide a new option for treatment of nonunion of the ulna.
    International journal of clinical and experimental medicine 01/2013; 6(10):996-1000.
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    ABSTRACT: Most osteoporotic vertebral fractures (OVFs) can be treated successfully with conservative methods. In about 10% of patients, nonunion develops and warrants surgical management with minimally invasive procedures such as vertebroplasty and kyphoplasty. Nevertheless, for patients with nonunion fractures that involve the posterior vertebral body wall, vertebroplasty and kyphoplasty are relatively contraindicated due to the risk of extravertebral polymethylmethacrylate cement leakage through vertebral fracture cracks. To this end, we developed a method for pedicle screw fixation combined with transpedicular bone grafting for such a condition. Briefly, after posterior pedicle screw fixation and reduction in the affected vertebra, the demineralized bone matrix was inserted into the vertebral body via a 'bone grafting funnel' created through the pedicle of the affected vertebra. The current retrospective study analysed the safety and efficacy of this approach. A total of 12 patients who fulfilled the criteria were treated with this procedure. Visual analogue scale scores for back pain and anterior vertebral heights were recorded. At 3-month follow-up, pain was significantly relieved compared with presurgery and the anterior vertebral heights were successfully restored and maintained. In conclusion, short-segment pedicle instrumentation combined with transpedicular bone grafting is a useful alternative in the treatment of nonunion of OVFs with loss of posterior edge integrity.
    European Journal of Orthopaedic Surgery & Traumatology 01/2013; 23(1):21-6. · 0.18 Impact Factor

Publication Stats

264 Citations
213.22 Total Impact Points

Top Journals


  • 2013
    • Jining Medical University
      Chi-ning-shih, Shandong Sheng, China
  • 2011
    • The First People's Hospital of Changzhou
      Wujin, Jiangsu Sheng, China
  • 2008–2010
    • Suzhou University
      Suchow, Anhui Sheng, China
  • 2009
    • University of Toledo
      • Department of Orthopaedic Surgery
      Toledo, OH, United States
  • 2007
    • Medical University of Ohio at Toledo
      • Department of Orthopaedic Surgery
      Toledo, Ohio, United States