Reconstruction of the Cervical Lateral Mass Using 3-Dimensional-Printed Prostheses

Qiang Jian,Zhenlei Liu,Wanru Duan,Jian Guan,Fengzeng Jian,Zan Chen 대한척추신경외과학회 2022 Neurospine Vol.19 No.1

Objective: This study aimed to investigate the outcome of using 3-dimensional (3D)-printed prostheses to reconstruct a cervical lateral mass to maintain cervical stability. Methods: We retrospectively analyzed data of 7 patients who underwent cervical lateral mass reconstruction using a 3D-printed prosthesis, comprising axial and subaxial lateral mass reconstruction in 2 and 5 patients, respectively. Bilateral mass was reconstructed in 1 patient and unilateral mass in the remaining 6 patients. Results: Using a 3D-printed lateral mass prosthesis, internal fixation was stable for all 7 patients postoperatively. No implant-related complications such as prosthesis loosening, displacement, and compression were observed at the last follow-up. Conclusion: Reconstruction of the lateral mass structure is beneficial in restoring load transfer in the cervical spine under physiological conditions. A 3D-printed prosthesis can be considered a good option for reconstruction of the lateral mass as fusion was achieved, with no subsequent complications observed.

Thermal balance performance simulation and optimization of full-ground crane cabins

Yongkang Shi,Zhenlei Chen,Haitao He,Fan Shi,Penyong Liu,Yong Wang 대한기계학회 2021 JOURNAL OF MECHANICAL SCIENCE AND TECHNOLOGY Vol.35 No.2

To solve the excessive thermal load problem of the crane engine and engine compartment, a combined 1-D and 3-D thermal simulation method is developed to numerically simulate the heat flow field inside and outside the engine compartment, the engine thermal system and the cooling system. Simultaneously, to ensure the accuracy of the numerical calculation boundary and the feasibility of the combined thermal simulation method, the trailer heat balance test is conducted under the rated conditions and the maximum torque conditions. By reasonably sealing the heat dissipation assembly at the front of the nacelle, bottom guards under the engine are added and other improvement measures are taken. It is found that the engine outlet’s coolant temperature is decreased by 15.9 °C under rated conditions when the improved crane is in the 36 °C environment. While the outlet’s coolant temperature is decreased by 20 °C under maximum torque conditions.

Positive effects of porcine IL-2 and IL-4 on virus-specific immune responses induced by the porcine reproductive and respiratory syndrome virus (PRRSV) ORF5 DNA vaccine in swine

Deyuan Tang,Jian Liu,Chunyan Li,Hua Zhang,Ping Ma,Xianfeng Luo,Zhiyong Zeng,Nining Hong,Xia Liu,Bin Wang,Feng Wang,Zhenlei Gan,Fei Hao 대한수의학회 2014 JOURNAL OF VETERINARY SCIENCE Vol.15 No.1

The purpose of this study was to investigate the effects ofporcine interleukin (IL)-2 and IL-4 genes on enhancing theimmunogenicity of a porcine reproductive and respiratorysyndrome virus ORF5 DNA vaccine in piglets. Eukaryoticexpression plasmids pcDNA-ORF5, pcDNA-IL-2, andpcDNA-IL-4 were constructed and then expressed in Marc-145cells. The effects of these genes were detected using an indirectimmunofluorescent assay and reverse transcriptionpolymerase chain reaction (RT-PCR). Characteristicfluorescence was observed at different times after pcDNAORF5was expressed in the Marc-145 cells, and PCR productscorresponding to ORF5, IL-2, and IL-4 genes were detected at48 h. Based on these data, healthy piglets were injectedintramuscularly with different combinations of the purifiedplasmids: pcDNA-ORF5 alone, pcDNA-ORF5 + pcDNA-IL-2,pcDNA-ORF5 + pcDNA-IL-4, and pcDNA-ORF5 + pcDNAIL-4 + pcDNA-IL-2. The ensuing humoral immune responses,percentages of CD4+ and CD8+ T lymphocytes, proliferationindices, and interferon-γ expression were analyzed. Resultsrevealed that the piglets co-immunized with pcDNA-ORF5 +pcDNA-IL-4 + pcDNA-IL-2 plasmids developed significantlyhigher antibody titers and neutralizing antibody levels, hadsignificantly increased levels of specific T lymphocyteproliferation, elevated percentages of CD4+ and CD8+ Tlymphocytes, and significantly higher IFN-γ production thanthe other inoculated pigs (p < 0.05).

Location Distribution of Fistulas and Surgical Strategies for Spinal Extradural Meningeal Cysts: A Retrospective Analysis of 30 Cases at a Single Center

Qiang Jian,Gang Song,Zhenlei Liu,Wanru Duan,Jian Guan,Fengzeng Jian,Zan Chen 대한척추신경외과학회 2022 Neurospine Vol.19 No.1

Objective: This study aimed to illustrate the features of fistula location distribution, surgical strategies, and outcomes in spinal epidural meningeal cysts (SEMCs). Methods: The authors searched and reviewed the medical records for cases of SEMCs. Imaging features, operative reports, and media were reviewed to accurately describe the surgical techniques employed. We recorded the level and laterality of the fistula according to the operative report and the media. Consistency analysis was performed on the dominant laterality of the cyst on preoperative axial magnetic resonance imaging and laterality of the fistula in the operative media or report. When cyst and fistula lateralities were the same, they were considered consistent. Finally, the Japanese Orthopedic Association (JOA) score was used to obtain patient-reported results at each follow-up. Results: Thirty patients with SEMCs were identified. Fistula repair was performed in all patients. Two patients experienced cyst recurrence after surgery and were repaired during the second surgery. Based on imaging findings, SEMCs mostly occurred in the thoracolumbar junction. Most of the fistulas (87.88%) were at the T12 or L1 levels. In patients with multiple adjacent SEMCs, the fistula may be at one end of the cyst rather than in the middle level of the cyst. A fistula laterality of 72.72% was consistent with cyst laterality. The JOA improvement rate was 61.84% ± 26.63%. Conclusion: Most fistulas were always located at the T12–L1 level as well as the middle level of the cyst, which is always consistent with cyst laterality. In patients with multiple adjacent SEMCs, the fistula may be at one end of the cyst. Cleft closure is key to healing SEMCs.

Relationship Between Syrinx Resolution and Cervical Sagittal Realignment Following Decompression Surgery for Chiari I Malformation Related Syringomyelia Based on Configuration Phenotypes

Chunli Lu,Longbing Ma,Jian Guan,Zhenlei Liu,Kai Wang,Wanru Duan,Zan Chen,Hao Wu,Fengzeng Jian 대한척추신경외과학회 2022 Neurospine Vol.19 No.4

Objective: Combined with different configuration types of syringomyelia, to analyze the correlation between syrinx resolution and changes in cervical sagittal alignment following Foramen magnum and Magendie dredging (FMMD) for syringomyelia associated with Chiari I malformation (CM-I), and to further explore the respective relationship with clinical outcome. Methods: A consecutive series of 127 patients with CM-I and syringomyelia who underwent FMMD in our center met the inclusion criteria of this study. Their clinical records and radiologic data were retrospectively reviewed. The Japanese Orthopedic Association (JOA) scoring system and the Chicago Chiari Outcome Scale (CCOS) were used to evaluate the surgical efficacy. The phenotypes of syringomyelia and the clinical characteristics of the patients were analyzed according to grouping by cervical curvature at baseline. Results: The preoperative straight or kyphotic cervical alignment is more common in the moniliform syrinx. After surgery, the syrinx resolution and cervical sagittal realignment in the moniliform group are more obvious, and the corresponding prognosis is relatively better. Spearman correlation analysis showed that the ΔS/C ratio (the change ratio of syrinx/cord) was positively correlated with the CCOS (p = 0.001, r = 0.897) and ΔC2–7A (the change of lower cervical angle) (p = 0.002, r = 0.560). There was also a correlation between the ΔJOA score (the change rate of the JOA score) and ΔC2–7A (p = 0.012, r = 0.467). Conclusion: After decompression surgery, syrinx resolution may coexist with the changes in the subaxial lordosis angle, especially for syrinx in moniliform type, and the relationship between syrinx resolution and cervical sagittal realignment might be valuable for evaluating the surgical outcome.

Quantitative Reduction of Basilar Invagination With Atlantoaxial Dislocation by a Posterior Approach

Jian Guan,Fengzeng Jian,Qingyu Yao,Chenghua Yuan,Can Zhang,Longbing Ma,Zhenlei Liu,Wanru Duan,Xingwen Wang,Xuefeng Bo,Zan Chen 대한척추신경외과학회 2020 Neurospine Vol.17 No.3

Objective: This study evaluated the feasibility and efficacy of quantitative reduction and fixation to treat basilar invagination (BI) with atlantoaxial dislocation (AAD). Methods: Posterior occipitocervical angle (POCA), occiput–C2 angle (Oc–C2A), clivusaxial angle (CAA), and C2–7 angle (C2–7A) were considered for quantitative reduction. Twelve patients with BI complicated with AAD received posterior interarticular release and individualized cage implantation to restore vertical dislocation. The POCA was adjusted using cantilever technology to further reduce the horizontal dislocation and adjust lower cervical vertebral angle. All patients received a radiological follow-up for ≥12 months. Improvements in spinal cord function were evaluated using Japanese Orthopedic Association (JOA) score. Results: All the patients received successful quantitative reduction for BI-AAD, and bony fusion was achieved without spinal cord injury after surgery for 12 months. The JOA score was improved significantly to 15.2 ± 0.9 twelve months after surgery (p < 0.01). Radiological follow-up revealed that individualized cage and POCA play vital roles in quantitative correction: (1) distance of the dens above McRae’s line and atlantodens interval were restored to normal level, respectively; (2) changes in Oc–C2 angle (ΔOc–C2A), C2–7 angle (ΔC2–7A), clivus-axial angle (ΔCAA), and POCA (ΔPOCA) were all caused by changes in axis tilt. Based on the changes of radiological parameter we deduced the formula for quantitative reduction by linear regression analysis: -ΔPOCA = ΔOc–C2A = -ΔC2–7A = ΔCAA. Conclusion: Quantitative posterior reduction by individualized cage and adjusting ΔPOCA is feasible for treating BI with AAD.

Role of Preoperative Albumin Quotient in Surgical Planning for Posttraumatic Syringomyelia: A Comparative Cohort Study

Pingchuan Xia,Houyuan Lv,Chenghua Yuan,Wanru Duan,Jiachen Wang,Jian Guan,Yueqi Du,Can Zhang,Zhenlei Liu,Kai Wang,Zuowei Wang,Xingwen Wang,Hao Wu,Zan Chen,Fengzeng Jian 대한척추신경외과학회 2024 Neurospine Vol.21 No.1

Objective: Surgical procedures for patients with posttraumatic syringomyelia (PTS) remain controversial. Until now, there have been no effective quantitative evaluation methods to assist in selecting appropriate surgical plans before surgery. Methods: We consecutively enrolled PTS patients (arachnoid lysis group, n = 42; shunting group, n = 14) from 2003 to 2023. Additionally, 19 intrathecal anesthesia patients were included in the control group. All patients with PTS underwent physical and neurological examinations and spinal magnetic resonance imaging preoperatively, 3–12 months postoperatively and during the last follow-up. Preoperative lumbar puncture was performed and blood-spinal cord barrier disruption was detected by quotient of albumin (Qalb, cerebrospinal fluid/serum). Results: The ages (p = 0.324) and sex (p = 0.065) of the PTS and control groups did not differ significantly. There were also no significant differences in age (p = 0.216), routine blood data and prognosis (p = 0.399) between the arachnoid lysis and shunting groups. But the QAlb level of PTS patients was significantly higher than that of the control group (p < 0.001), and the shunting group had a significantly higher QAlb (p < 0.001) than the arachnoid lysis group. A high preoperative QAlb (odds ratio, 1.091; 95% confidence interval, 1.004–1.187; p = 0.041) was identified as the predictive factor for the shunting procedure, with the receiver operating characteristic curve showing 100% specificity and 80.95% sensitivity for patients with a QAlb > 12.67. Conclusion: Preoperative QAlb is a significant predictive factor for the types of surgery. For PTS patients with a QAlb > 12.67, shunting represents the final recourse, necessitating the exploration and development of novel treatments for these patients.