Ting Wang

Peking Union Medical College Hospital, Peping, Beijing, China

Are you Ting Wang?

Claim your profile

Publications (9)3.96 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Comparison of 2 radiographic scoliosis classification systems by multiple surgeons. Compare the reliability of Peking Union Medical College (PUMC) and Lenke scoliosis classification systems and analyze their differences. The PUMC classification is a newly reported system based on radiographic measurements with recent popularity, while the Lenke classification is widely accepted worldwide in surgical design. Both these classification systems have their own individual characteristics, hence it is necessary to compare their reliability. Five scoliosis surgeons independently evaluated and classified presurgical radiographs of 62 adolescent idiopathic scoliosis patients based on the PUMC and Lenke classification systems on 2 separate occasions. Radiographs were cleaned before each evaluation. Inter- and intraobserver reliabilities were quantified using Kappa statistics. Data were compared using chi2 analysis. The PUMC classification's inter- and intraobserver percentage of agreement averaged to 91.0% (Kappa coefficient 0.896) and 90.2% (Kappa coefficient 0.892), respectively. While those of the Lenke curve type classification were 86.5% (Kappa coefficient 0.808) and 87.4% (Kappa coefficient 0.826). The PUMC classification from 10 individual measurements had 17 cases (27.4%) of disagreements, while in the Lenke curve type classification, 24 cases (38.7%) had disagreements. PUMC classification normally has discrepancies between type IIb, IIc, and IId, while Lenke classification has discrepancies in curve types 1 and 2. Out of 17 inconsistent PUMC curve type cases, 7 did not affect surgical fusion levels, while in the Lenke's only 2 out of 24 cases with discrepancies did not affect fusion range selection, with an obvious statistical difference. The reliability of both PUMC classification and Lenke curve type classification were categorized as good-to-excellent. PUMC classification is relatively simple, with less confusion among inter- and intraobservers, with corresponding surgical fusion guidance and planning. The mismatch of curve classification had less influence on PUMC's fusion range selection than Lenke's.
    Spine 11/2008; 33(22):E836-42. · 2.16 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To compare the intra-observer reproducibility and inter-observer reliability regarding the results of Lenke's and Peking Union Medical College (PUMC) classification systems for adolescent idiopathic scoliosis (AIS). Five spine surgeons independently measured the X ray films of 62 AIS patients using both Lenke and PUMC classification systems. Three weeks later, the spine surgeons repeated the same classification process. No measurement trace was allowed to be left on the X ray films. SAS software was used to calculate the Kappa values and analyze the intra-observer reproducibility and inter-observer reliability The overall reliability and reproducibility rates of the Lenke classification system were 69.8% (Kappa value = 0.675) and 74.2% (Kappa value = 0.690) respectively, in which the curve characteristic parameter reliability and reproducibility rates were 86.5% (Kappa value = 0.808) and 87.4% (Kappa value 0.826) respectively, the lumbar correction reliability and reproducibility rates were 95.2% (Kappa value = 0.919) and 94.5% (Kappa value = 0.908) respectively, and the sagittal thoracic correction reliability and reproducibility rates were 85.2% (Kappa value = 0.734) and 89.0% (Kappa value = 0.805 respectively). The reliability and reproducibility rates of the PUMC classification system were 91.0% (Kappa value = 0.896) and 90.2% (Kappa value = 0.892) respectively. The reliability and reproducibility rates of the Lenke classification system were better than the previously reported results. However, the PUMC classification system expresses better reliability and reproducibility. The PUMC classification system is relatively easier with fewer curve types, hence leading to less divergence among the clinicians. Comparing to the classifications used in the past, both classification systems have the advantages of correctly categorizing AIS according to its individual traits, as well as accurately examining the X ray results, hence achieving significance in terms of surgical outcome and design.
    Zhonghua yi xue za zhi 10/2007; 87(33):2332-5.
  • Source
    Ye Tian, Ting Wang, Gui-xing Qiu
    Chinese medical journal 11/2006; 119(20):1757-9. · 0.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To explore an improved operation approach to make up the ethical deficiency of classical bipedal rat model. 20 SD rats were randomly divided into an improved group and a traditional group averagely. Improved group were operated with plexus brachialis nerve amputation, while traditional group with forelimbs amputation close to shoulder joint. Forelimb and shoulder joint movements were observed and electromyography of the peripheral muscles around shoulder joint were recorded to make certain the paralytic scope. Operation duration and axillary artery hurt probability of both the improved and traditional operation were compared to evaluate the operation risk of improved approach. Mean total upright time on 2 d, 1 w, 2 w, 4 w and 6 w post-operation and upright posture on 6 w post-operation were recorded to evaluate the human-upright-posture-simulating effect of bipedal rats operated with improved approach. Compared with classical amputation approach, improved approach exhibited simpler operation procedure, shorter operation duration and lower axillary artery hurt probability. Electromyography revealed that all forelimb muscles and most shoulder-peripheral muscles were denervated, forelimbs of the improved bipedal rats were absolutely paralyzed and shoulder joint reserved only slight abduction function. The mean total upright time of improved bipedal rats was longer than the classical ones after 2 w post-operation, while upright posture showed no difference with classical bipedal rats. The improved operation approach not only simplified operation procedures, but also achieved even better effect than classical amputation operation and exempted bipedal rat model from the ethical shadow.
    Zhonghua yi xue za zhi 11/2006; 86(39):2781-5.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To look into the character of the expression of collagen type II and transforming growth factor beta1 (TGF-beta1), basic fibroblast growth factor (bFGF) in the apical articular process cartilages of adolescent idiopathic scoliosis (AIS) and congenital scoliosis (CS) patients. The articular processes of 22 AIS and 18 CS were collected. The techniques of HE staining, immunohistochemistry and in situ hybridization were adopted in this research. By comparing the apical processes with the end processes, the convex processes with the concave processes, the AIS processes with CS processes, the pathological changes of the articular process cartilages of these patients and the distribution of collagen type II and TGF-beta1, bFGF in them were studied. The images of immunohistochemistry and in situ hybridization were input into the image analysis system and were analyzed semi-quantitatively. The SAS software (8.01) was adopted, and P < 0.05 was defined as the significant level. The expression of collagen type II and TGF-beta1, bFGF in AIS was similar to CS: the concave sides of apexes were higher than the convex sides. The comparisons had statistical significance. There was no statistical significance between upper and lower end vertebrae in convex and concave sides, between convex and concave sides in upper and lower end vertebrae. The apical vertebrae were significantly higher than the ipsilateral sides of upper or lower end vertebrae for collagen type II. There was no statistical difference of the expression at the concave, convex, upper, lower end vertebrae between AIS and CS. The cartilages of the apical processes show some signs of regression and hypoplasia in scoliosis. The concave side is more severe than the convex side. Increase of collagen type II and TGF-beta1, bFGF in the concave sides of apical processes in scoliosis may be the results of reconstruction of extracellular matrix and the compensation reactions which are caused by abnormal biomechanical forces such as compressive stresses. Compressive stress on the concave sides has more influences on the expression of collagen type II than tensile stress on the convex sides.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 10/2006; 44(20):1422-6.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate the characteristics of the expression of transforming growth factor-beta(1) (TGF-beta(1)) and basic fibroblast growth factor (bFGF) in the apical articular process cartilages of adolescent idiopathic scoliosis (AIS) patients. The specimens of articular processes of 22 AIS patients and 18 congenital scoliosis (CS) patients were collected during operation. The pathology of the processes was observed with H.E staining. Immunohistochemistry and in situ hybridization were adopted to detect the expression of TGF-beta(1) and bFGF. The differences in the pathological changes, and expression of TGF-beta(1) and bFGF between the apical processes and the end processes, the convex processes and the concave processes, and the AIS processes and CS processes. The images of immunohistochemistry and in situ hybridization were input into the image analysis system and were analyzed semi-quantitatively. The SAS (8.01) software was adopted and (128.1 +/- 50.6 vs 165.4 +/- 59.2, 126.5 +/- 47.0 vs 168.3 +/- 46.8; 76.6 +/- 29.9 vs 96.4 +/- 28.4, 73.7 +/- 31.6 vs 101.8 +/- 39.4; 77.1 +/- 52.2 vs 114.4 +/- 59.4, and 69.5 +/- 40.1 vs 109.8 +/- 51.0 (P < 0.05) was defined as the significant levels. The expression of TGF-beta(1) and the expression of bFGF were not significantly different between the AIS patients and the CS patients. The TGF-beta(1) expression in the concave side of the apical vertebrae of the AIS group was 165.4 +/- 59.2, significantly higher than that in the convex sides (128.1 +/- 50.6, P = 0.03), and the TGF-beta(1) expression in the concave side of the apical vertebrae of the CS group was 168.3 +/- 46.8, significantly higher than that of the convex side (126.5 +/- 47.0, P = 0.02). However, there was no statistically significant differences in the TGF-beta(1) expression between the concave and convex sides of the upper and lower end vertebrae and between the upper and lower end vertebrae. The bFGF expression in the concave side of the apical vertebrae of the AIS group, and the bFGF expression in the concave side of the apical vertebrae of the CS group was 101.8 +/- 39.4, significantly higher than that of the convex side (73.7 +/- 31, P = 0.02). However, there were no statistically significant differences in the bFGF expression between the concave and convex sides of the upper and lower end vertebrae and between the upper and lower end vertebrae. The cartilages of the apical processes show some signs of regression and hypoplasia in AIS patients, especially at the concave side in comparison with the convex side. Increase of TGF-beta(1) and bFGF in the concave sides of apical processes in AIS may be the results of reconstruction of extracellular matrix and the compensation reactions which are caused by abnormal biomechanical forces, especially compressive stresses.
    Zhonghua yi xue za zhi 06/2006; 86(21):1478-83.
  • Chinese medical journal 09/2005; 118(15):1313-7. · 0.90 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To discuss the diagnosis and surgical treatment of congenital scoliosis (CS) with split cord malformation (SCM). From May 1999 to June 2004, 353 cases of CS were admitted, and 58 cases were diagnosed CS combined with SCM via myelography and (or) CTM. According to Pang's classification for SCM, patients were divided into type I SCM and type II SCM. Two cases gave up operation, and surgeries were performed in 56 patients. Except that one case with arachnoid cyst underwent intraspinal exploration, all other 55 cases underwent spinal correction without dealing with the intraspinal abnormalities. Clinical manifestation, radiological findings, operative methods and results were retrospectively analyzed in this paper. There were 11 patients (19%) with type I SCM and 47 patients (81%) with type II SCM. In the 56 cases who had surgical treatment, the Cobb angle in the patients with type I SCM (11 cases) was (60 +/- 25) degrees, and in type II SCM (45 cases) was (67 +/- 21) degrees pre-operation. The Cobb angle in type I SCM was (29 +/- 13) degrees and in type II SCM was (39 +/- 19) degrees post-operation, with the correction rate (51 +/- 17)% and (41 +/- 24)% respectively. No statistic differences were found between both types. And there were no new neurological deficits in both groups after the spinal correction operation. After average 17.3 months (4-59 months) follow-up, the correction loss was (6 +/- 10) degrees, (5 +/- 8) degrees in 7 patients with type I SCM and (6 +/- 10) degrees in 19 patients with type II SCM. There was no statistic difference in correction loss between both types. In the follow-up, the neurological symptoms and signs of the patients were stable. Considering the incidence of intraspinal anomalies in patients with congenital scoliosis, intraspinal examination via myelography, CTM or MRI should be performed prior to spinal correction surgery. For congenital scoliosis with type I SCM, the bone spur need not be excised before spinal correction if there is no signs of spinal cord tethered and the bone spur locate in the middle of the split cord where there are much space to accommodate it. For congenital scoliosis with type II SCM, if there are no progressive neurological manifestations, the split cord in the single tubular can tolerate the manipulation of spinal correction as the normal spinal cord.
    Zhonghua wai ke za zhi [Chinese journal of surgery] 07/2005; 43(12):770-3.
  • [Show abstract] [Hide abstract]
    ABSTRACT: To discuss the operation treatment for the severe and rigid idiopathic scoliosis. The clinical data of 24 patients with severe and rigid idiopathic scoliosis, 15 females and 9 males, with an average age of 17 (12 approximately 20) who had undergone operations from June 1999 to June 2003 were analyzed retrospectively. The patients were classified according to PUMC operative classification systerm, including 16 cases of type Ia, 2 cases of type Ib, 3 cases of type IIb2, and 1 case of types IIb1, IIc2, and IIc3 each. The average standing coronal Cobb angle was 98 degrees (80 degrees to 117 degrees ) and the average flexibility rate of the major curves was 20.8% (5% to 29.5%) before operation. Fifteen cases had sagittal deformities. Bone fusion was performed on all the cases according to the PUMC classification principles. 17 cases received anterior spinal release with posterior correction by two stages, and 2 cases by one stage. 5 cases received one-stage posterior correction. All the patients were followed up for 12 approximately 30 months (18 months on average). The mean standing coronal Cobb angle of the major curves was reduced to 58 degrees (32 degrees to 100 degrees ) after operation with a correction rate of 41.0% (10.9% to 61.0%). The results of sagittal plane correction were satisfying. The mean Cobb angle of the major curves at the final follow up was 63 degrees (31 degrees to 104 degrees ), and the mean lost was 5 degrees (0 degrees to 10 degrees ). One case had to undergo revision surgery because of hook displacement. One case had steel wire broken but without neurological symptoms and only needed observation. No pseudoarthrosis and decompensation occurred. Compared with vertebral osteotomy for the correction of scoliosis, the anterior spinal release combined with posterior correction and simple posterior correction have the advantages of low risk, less blood loss, and low infection rate. They can be used effectively and safely for the correction of idiopathic severe and rigid idiopathic scoliosis. The key points for the surgical procedures are appropriate correction and recovery of the balances of the coronal and sagittal planes.
    Zhonghua yi xue za zhi 04/2005; 85(12):807-10.