Search Results

You are looking at 1 - 7 of 7 items for

  • Author or Editor: Zhou Feng x
  • User-accessible content x
Clear All Modify Search
Full access

Feng Shen, Bin Zhou, Quan Li, Ming Li, Zhiwei Wang, Qiang Li, and Bo Ran

OBJECT

The object of this study was to review the effectiveness in treating severe and rigid scoliosis with posterioronly spinal release combined with derotation, translation, segmental correction, and an in situ rod-contouring technique.

METHODS

Twenty-eight patients with severe and rigid scoliosis (Cobb angle > 70° and flexibility < 30%) were retrospectively enrolled between June 2008 and June 2010. The average age of the patients was 17.1 years old (range 12–22 years old), 18 were female, and 10 were male. Etiological diagnoses were idiopathic in 24 patients, neuromuscular in 2 patients, and Marfan syndrome in 2 patients. All patients underwent posterior spinal release, derotation, translation, segmental correction, and an in situ rod-contouring technique. The scoliosis Cobb angle in the coronal plane, kyphosis Cobb angle, apex vertebral translation, and trunk shift were evaluated preoperatively and postoperatively.

RESULTS

The average operative time was 241.8 ± 32.1 minutes and estimated blood loss was 780.5 ± 132.6 ml. The average scoliosis Cobb angle in the coronal plane was corrected from 85.7° (range 77°–94°) preoperatively to 33.1° (range 21°–52°) postoperatively, with a correction ratio of 61.3%. The average kyphosis Cobb angle was 64.5° (range 59°–83°) preoperatively, which was decreased to 42.6° (range 34°–58°) postoperatively, with a correction ratio of 33.9%. After an average of 24 months of follow-up (range 13–30 months), no major complications were observed in these patients, except screw pullout of the upper thoracic vertebrae in 2 patients and screw penetration into the apical vertebrae in 1 patient.

CONCLUSIONS

Posterior spinal release combined with derotation, translation, segmental correction, and an in situ rod-contouring technique has proved to be a promising new technique for rigid scoliosis, significantly correcting the scoliosis and accompanied by fewer complications.

Full access

Yao Li, Zhonghai Shen, Xiangyang Wang, Yongli Wang, Hongming Xu, Feng Zhou, Shaoyu Zhu, and Huazi Xu

OBJECT

The authors' goal in this paper was to quantify reference data on the dimensions and relationships of the maximum posterior screw angle and the thoracic spinal canal in different pediatric age groups.

METHODS

One hundred twelve pediatric patients were divided into 4 age groups, and their thoracic vertebrae were studied on CT scans. The width, depth, and maximum posterior screw angles with different screw entrance points were measured on a Philips Brilliance 16 CT. The statistical analysis was performed using the Student t-test and Pearson's correlation analysis.

RESULTS

The width and depth of the thoracic vertebrae increased from T-5 to T-12. The width ranged from 18.5 to 37.1 mm, while the depth ranged from 16.1 to 28.2 mm. The maximum posterior screw angle decreased from T-5 to T-12 in all groups. The ranges and mean angles at the entrance points were as follows: initial entrance point, 6.9° to 12.3° with a mean angle of 9.1°; second entrance point, 20.6° to 27.0° with a mean angle of 24.2°; and third entrance point, 29.2° to 37.5° with a mean angle of 33.7°. There were no significant age-related differences noted for the maximum posterior screw angles.

CONCLUSIONS

The angle decreased from T-5 to T-12. No significant age-related differences were noted in the maximum posterior screw angles. Screws should be placed between the initial and second points and parallel to the coronal section or at a slight anterior orientation.

Free access

Xinghui He, Jian Zhou, Yuguang Guan, Feng Zhai, Tianfu Li, and Guoming Luan

OBJECTIVE

The authors of this study aimed to investigate surgical outcomes and prognostic factors in older patients with drug-resistant temporal lobe epilepsy (TLE) who had undergone resective surgery.

METHODS

Data on patients older than 45 years of age with drug-resistant TLE who had undergone resective surgery at Sanbo Brain Hospital, Capital Medical University, between January 2009 and August 2017 were retrospectively collected. Postoperative seizure outcomes were evaluated according to the International League Against Epilepsy (ILAE) classification. Patients belonging to ILAE classes 1 and 2 were classified as having a favorable outcome, whereas patients belonging to ILAE classes 3–6 were classified as having an unfavorable outcome. Univariate analysis and multivariate logistic regression analysis were used to identify the potential predictors of seizure outcomes.

RESULTS

A total of 45 patients older than 45 years of age who had undergone resective epilepsy surgery for TLE were included in the present study. Eight (17.8%) of 45 patients had preoperative comorbidity in addition to seizures. The average age at the time of surgery was 51.76 years, and the average duration of epilepsy at the time surgery was 18.01 years. After an average follow-up period of 4.53 ± 2.82 years (range 2–10 years), 73.3% (33/45) of patients were seizure free. Surgical complications were observed in 13.3% of patients. Univariate and multivariate analyses revealed that an MRI-negative finding is the only independent predictor of unfavorable seizure outcomes (OR 0.06, 95% CI 0.01–0.67, p = 0.023).

CONCLUSIONS

Resective surgery is a safe and effective treatment for older patients with drug-resistant TLE. An MRI-negative finding independently predicts unfavorable seizure outcomes.

Full access

Qiang Tan, Qianwei Chen, Yin Niu, Zhou Feng, Lin Li, Yihao Tao, Jun Tang, Liming Yang, Jing Guo, Hua Feng, Gang Zhu, and Zhi Chen

OBJECTIVE

Intracerebral hemorrhage (ICH) is associated with a high rate of mortality and severe disability, while fibrinolysis for ICH evacuation is a possible treatment. However, reported adverse effects can counteract the benefits of fibrinolysis and limit the use of tissue-type plasminogen activator (tPA). Identifying appropriate fibrinolytics is still needed. Therefore, the authors here compared the use of urokinase-type plasminogen activator (uPA), an alternate thrombolytic, with that of tPA in a preclinical study.

METHODS

Intracerebral hemorrhage was induced in adult male Sprague-Dawley rats by injecting autologous blood into the caudate, followed by intraclot fibrinolysis without drainage. Rats were randomized to receive uPA, tPA, or saline within the clot. Hematoma and perihematomal edema, brain water content, Evans blue fluorescence and neurological scores, matrix metalloproteinases (MMPs), MMP mRNA, blood-brain barrier (BBB) tight junction proteins, and nuclear factor–κB (NF-κB) activation were measured to evaluate the effects of these 2 drugs in ICH.

RESULTS

In comparison with tPA, uPA better ameliorated brain edema and promoted an improved outcome after ICH. In addition, uPA therapy more effectively upregulated BBB tight junction protein expression, which was partly attributed to the different effects of uPA and tPA on the regulation of MMPs and its related mRNA expression following ICH.

CONCLUSIONS

This study provided evidence supporting the use of uPA for fibrinolytic therapy after ICH. Large animal experiments and clinical trials are required to further explore the efficacy and safety of uPA in ICH fibrinolysis.

Full access

Feng Zhou, Zixiao Yang, Wei Zhu, Liang Chen, Jianping Song, Kai Quan, Sichen Li, Peiliang Li, Zhiguang Pan, Peixi Liu, and Ying Mao

OBJECTIVE

Epidermoid cysts of the cavernous sinus (CS) are rare, and no large case series of these lesions has been reported. In this study, the authors retrospectively reviewed the outcomes of the surgical management of CS epidermoid cysts undertaken at their center and performed a review of any such cysts reported in the literature over the past 40 years.

METHODS

Clinical data were obtained on 31 patients with CS epidermoid cysts that had been surgically treated at the authors’ hospital between 2001 and 2016. The patients’ medical records, imaging data, and follow-up outcomes were retrospectively analyzed. The related literature from the past 40 years (18 articles, 20 patients) was also evaluated.

RESULTS

The most common chief complaints were facial numbness or hypesthesia (64.5%), absent corneal reflex (45.2%), and abducens or oculomotor nerve deficit (35.5%). On MRI, 51.6% of the epidermoid cysts showed low T1 signals and equal or high T2 signals. In the other lesions, the radiological findings varied considerably given differences in the composition of the cysts. Surgery was performed via the extradural approach (58.1%), intradural approach (32.3%), or a combined approach (9.7%). After the operation, symptoms remained similar or improved in 90.3% of patients and new oculomotor paralysis developed after the operation in 9.7% of patients. Seven patients (22.6%) developed meningitis postoperatively (5 aseptic and 2 septic), and all of them recovered. All patients achieved good recovery before discharge (Karnofsky Performance Status score ≥ 70). Over an average follow-up of 4.6 ± 3.0 years in 25 patients (80.6%), no recurrence or reoperation occurred, regardless of whether total or subtotal resection of the capsule had been achieved.

CONCLUSIONS

Both the extradural and intradural approaches can enable satisfactory lesion resection. A favorable prognosis and symptomatic improvement can be expected after both total and subtotal capsule resections. Total capsule resection is encouraged to minimize the possibility of recurrence provided that the resection can be safely performed.

Full access

Abudumijiti Aibaidula, Wang Zhao, Jin-song Wu, Hong Chen, Zhi-feng Shi, Lu-lu Zheng, Ying Mao, Liang-fu Zhou, and Guo-dong Sui

OBJECT

Conventional methods for isocitrate dehydrogenase 1 (IDH1) detection, such as DNA sequencing and immunohistochemistry, are time- and labor-consuming and cannot be applied for intraoperative analysis. To develop a new approach for rapid analysis of IDH1 mutation from tiny tumor samples, this study used microfluidics as a method for IDH1 mutation detection.

METHODS

Forty-seven glioma tumor samples were used; IDH1 mutation status was investigated by immunohistochemistry and DNA sequencing. The microfluidic device was fabricated from polydimethylsiloxane following standard soft lithography. The immunoanalysis was conducted in the microfluidic chip. Fluorescence images of the on-chip microcolumn taken by the charge-coupled device camera were collected as the analytical results readout. Fluorescence signals were analyzed by NIS-Elements software to gather detailed information about the IDH1 concentration in the tissue samples.

RESULTS

DNA sequencing identified IDH1 R132H mutation in 33 of 47 tumor samples. The fluorescence signal for IDH1-mutant samples was 5.49 ± 1.87 compared with 3.90 ± 1.33 for wild type (p = 0.005). Thus, microfluidics was capable of distinguishing IDH1-mutant tumor samples from wild-type samples. When the cutoff value was 4.11, the sensitivity of microfluidics was 87.9% and the specificity was 64.3%.

CONCLUSIONS

This new approach was capable of analyzing IDH1 mutation status of tiny tissue samples within 30 minutes using intraoperative microsampling. This approach might also be applied for rapid pathological diagnosis of diffuse gliomas, thus guiding personalized resection.

Full access

Lingyang Hua, Hongda Zhu, Jingrun Li, Hailiang Tang, Dapeng Kuang, Yin Wang, Feng Tang, Xiancheng Chen, Liangfu Zhou, Qing Xie, and Ye Gong

OBJECTIVE

Malignant meningioma is rare and classified as Grade III in the WHO classification of CNS tumors. However, the presence of estrogen receptor (ER) in WHO Grade III meningiomas and its correlation with patients’ outcomes are still unclear. In this single-center cohort study, the authors analyzed clinical features, treatment, and prognosis of these malignant tumors in patients with long-term follow-up.

METHODS

A total of 87 patients who were pathologically diagnosed with WHO Grade III meningiomas between 2003 and 2008 were enrolled in this study and followed for at least 7 years. Clinical information was collected to analyze the factors determining the prognosis.

RESULTS

Twelve patients with rhabdoid, 12 with papillary, and 63 with anaplastic meningioma were included. The mean progression-free survival (PFS) and overall survival (OS) were 56.2 ± 49.8 months and 68.7 ± 47.4 months, respectively. No significant differences were observed among the 3 histological subtypes in either PFS (p = 0.929) or OS (p = 0.688). Patients who received gross-total resection had a longer PFS (p = 0.001) and OS (p = 0.027) than those who received subtotal resection. Adjuvant radiotherapy was associated with OS (p = 0.034) but not PFS (p = 0.433). Compared with primary meningiomas, patients with recurrent disease had worse PFS (p < 0.001). For patients who had malignant transformations, the prognosis was poorer than for patients without malignant transformations for both PFS (p = 0.002) and OS (p = 0.019). ER-positive patients had a significantly worse prognosis than ER-negative patients regarding both PFS (p = 0.003) and OS (p < 0.001), whereas no association between progesterone receptor and patients’ outcomes was observed. Multivariate analysis demonstrated that ER expression was an independent prognostic factor for both PFS (p = 0.008) and OS (p < 0.001).

CONCLUSIONS

This retrospective study showed that patients with meningioma with ER-positive expression had a much worse prognosis than those with ER weak–positive or ER-negative status. The results demonstrated that ER is an independent prognostic factor for both PFS and OS of patients with WHO Grade III meningioma. The authors also found that more radical resection of the tumor, as well as postoperative radiotherapy, may prolong patients’ survival time.