ABSTRACT
<p><b>BACKGROUND</b>Sagittal translation (ST) is an accidental event that surgeons commonly encounter during a spinal osteotomy in the correction of kyphosis in ankylosing spondylitis (AS). However, there is a paucity of effective techniques to prevent ST. The purpose of this study was to propose a pedicle subtraction osteotomy (PSO) with a cage as a method to prevent ST and to explore the efficacy and feasibility of this method in the treatment of kyphosis in AS.</p><p><b>METHODS</b>We retrospectively reviewed 89 consecutive patients with AS kyphosis who underwent a PSO (Group B, 46 patients) or a PSO with a cage (Group A, 43 patients) from February 2009 to December 2013. Pre- and post-operative radiographic results were reviewed. ST and complications were analyzed in both groups. Clinical assessment was performed using the Scoliosis Research Society-22 (SRS-22) outcomes metric. The patients were followed up for at least 2 years.</p><p><b>RESULTS</b>Group A achieved the same re-alignment of the kyphotic spine as Group B. Two (4.7%) of the 43 patients in Group A and 14 (30.4%) of the 46 patients in Group B had intraoperative ST (χ2 = 10.020, P = 0.002). Significant differences were identified between the two groups in the height change of the osteotomized column. SRS-22 scores improved significantly in both groups. Seven patients experienced neurologic complications (1 in Group A and 6 in Group B). Eight patients had cerebrospinal fluid leakage (2 in Group A and 6 in Group B).</p><p><b>CONCLUSION</b>PSO with a cage significantly avoided ST during the osteotomy procedure and might represent a new, safe, and feasible choice for treating patients with AS kyphosis.</p>
ABSTRACT
Objective. To study whether or not noradrenaline system participates in the process of orexin-A wakepromoting from alcohol coma. Methods Twenty-four adult female SPF SD rats were divided into four groups, 6 each, and the model of alcohol coma was reproduced. Experimental rats were then divided randomly into rats receiving injection of artificial cerebrospinal fluid (ACSF, control group), orexin-A (orexin-A group), noradrenaline α1 receptor antagonists--prazosin (prazosin group), or prazosin + orexin-A (prazosin-orexin-A group) into the lateral ventricle. The depth of coma was evaluated by the duration of loss of righting reflex (LORR) and δ wave in electrocorticogram (ECoG). Result The duration of LORR was significantly longer and the ratio of δ wave higher in the prazosin-treated rats than those in control group (P0.05). But the values were significantly different from those in the orexin-A group (P<0.01). Conclusion Noradrenaline system may participate in the wake-promoting process of alcohol coma by orexin-A.
ABSTRACT
Objective: To investigate the efficacy of postoperative transcatheter arterial chemoembolization (TACE) on survival of patients after resection of huge hepatocellular carcinoma. Methods: This study retrospectively collected the clinical data of 256 huge hepatocellular carcinoma patients who had received radical resection. Among them 136 patients received postoperative adjuvant TACE 4-6 weeks post resection, and the other 120 patients received surgical resection only. Stratification analysis was performed on all the patients according to with or without high risk factor for residual tumor (satellite nodules, tumor thrombosis in the > 2nd stream of the portal vein, and un-integrated membrane). Survival rate was compared between the two groups. Results: For patients who had huge HCC without high risk factor for residual tumor, the 1-, 3-, and 5-year survival rates were 80.43%, 59.92%, and 47.18% for post-operative adjuvant TACE group, respectively; 74.05%, 53.40%, and 45.77% for surgical resection group, respectively. There was no statistical difference in the survival rate between the two groups (P = 0.7693). For those with high risk factor for residual tumor, 1-, 3-, and 5-year survival rates were 72.15%, 32.27%, and 22.35% for postoperative adjuvant TACE group, respectively; and 45.36%, 22.47%, and 19.67% for only surgical resection group, respectively. There was statistical difference between the two groups (P = 0.004 9). COX regression analysis indicated that postoperative adjuvant TACE (HR:0.620, 95% CI: 0.442 - 0.870) and high risk factor for residual tumor (HR:2.235, 95% CI: 1.491-3.351) were independent risk factors for postoperative long-term survival. Conclusion: Postoperative TACE is highly helpful in increasing the long-term survival rate of patients with huge hepatocellular carcinoma, and it is more effective in elongating the postoperative survival time of patients with high risk factor for residual tumor.