bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of distribution of bone cement on clinical efficacy and secondary fracture after percutaneous kyphoplasty for osteoporotic vertebral compression fractures
Authors: Pan Zejun , Zhou Quan , Yang Ming , Deng Lei , Hu Xiayu , Lv Nanning , Yang Shaofeng , Yang Huilin 
Published: January 2023

ObjectiveTo investigate the effect of bilateral bone cement distribution on the clinical efficacy of percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture (OVCF).MethodsAccording to strict inclusion and exclusion criteria, 109 cases of OVCF patients treated with bipedicular PKP were included in this study from August 2018 to July 2020. According to the distribution morphology of bilateral bone cement in vertebral body, patients were divided into 3 groups, including Group A (n = 44): bilateral diffuse type; Group B (n = 31): bilateral dense type; Group C (n = 34): mixed type. To assess the clinical and radiographic efficacy of the surgery, the visual analogue scale (VAS) score, Oswestry disability index (ODI) score, anterior vertebral height (AVH), anterior vertebral height ratio (AVHR) and local kyphotic angle (LKA) were recorded at preoperatively, 2 days after surgery and 1 year after surgery.ResultsCompared with the preoperative recorded value, the VAS score, ODI score, AVH, AVHR and LKA of the three groups were significantly improved at 2 days after surgery and 1 year after surgery (p &lt; 0.05). At 1 year after surgery, the VAS score of Group A was better than that of groups B and C (p &lt; 0.05), and there were significantly differences in ODI score, AVH, and LKA between Group A and Group B (p &lt; 0.05). Compared with other bone cement distribution patterns, the incidence of recompression in bilateral diffuse bone cement distribution pattern was lower (p &lt; 0.05).ConclusionIn the mid-term follow-up of patients undergoing bipedicular PKP, diffuse and symmetrical distribution of bone cement can obtain better clinical improvement and lower the incidence of secondary compression.
How to predict the culprit segment in percutaneous transforaminal endoscopic surgery under local anesthesia for surgical treatment of lumbar degenerative diseases? Radiologic images or clinical symptoms
Authors: Zhou Tianyao , Ma Tianle , Gu Yutong , Zhang Liang , Che Wu , Wang Yichao 
Published: January 2023

ObjectivePercutaneous transforaminal endoscopic surgery (PTES) is a novel, minimally invasive technique used to treat lumbar degenerative diseases (LDDs). PTES under local anesthesia was performed to treat the culprit segment of LDDs predicted by radiologic images or clinical symptoms, and the efficacy, security, and feasibility were evaluated.MethodsEighty-seven cases of LDDs with nerve root symptoms, which were not consistent with lumbar degenerative levels and degrees on MRI and CT, were treated with PTES under local anesthesia in a day surgery ward from January 2015 to December 2019. Forty-two patients, whose culprit segments were predicted by radiologic images, were included in group A. The other 45 patients, whose culprit segments were predicted by clinical symptoms, were included in group B. Leg pain VAS and ODI scores before and after PTES were recorded. The outcome was defined according to the MacNab grade at the 2-year follow-up. Postoperative complications were recorded.ResultsIn group A, 2 patients underwent PTES for one segment, 37 patients underwent PTES for two segments, and 3 patients underwent PTES for three segments. One of the one-segment PTES patients had no relief from symptoms and underwent another PTES for other culprit segments 3 months after surgery. In group B, 44 of 45 patients were treated using PTES for one segment and 1 patient was treated for two segments. Group B showed significantly less operative duration, less blood loss, and less fluoroscopy frequency than group A (p &lt; 0.001). The leg pain VAS score and the ODI score significantly decreased after the operation in both groups (p &lt; 0.001), and the excellent and good rates were 97.6% (41/42) in group A and 100% (45/45) in group B at the 2-year follow-up. The leg pain VAS score of group B was significantly lower than that of group A immediately and 1 week, 1 month, 2 months, and 3 months after surgery (p &lt; 0.001). There was no statistical difference in ODI scores and the excellent and good rates between the two groups. No complications, such as wound infection or permanent nerve injury, were observed.ConclusionIt is much more accurate to predict the culprit segment according to clinical symptoms than radiologic images in PTES under local anesthesia for surgical treatment of LDDs.
Clinical efficacy and imaging outcomes of unilateral biportal endoscopy with unilateral laminotomy for bilateral decompression in the treatment of severe lumbar spinal stenosis
Authors: Hu Yutong , Fu Hao , Yang Dongfang , Xu Weibing 
Published: January 2023

ObjectiveTo investigate the clinical efficacy and imaging outcomes of unilateral biportal endoscopy (UBE) with unilateral laminotomy for bilateral decompression (ULBD) in the treatment of severe lumbar spinal stenosis (SLSS).MethodsWe retrospectively analyzed 50 patients with SLSS treated with UBE-ULBD from October 2018 to March 2021. Visual analog scale (VAS) for back and legs pain, Oswestry disability index (ODI), modified Macnab criteria, complications, hospital stay, preoperative and postoperative dural sac cross-sectional area (DSCA) and Schizas grade, mean angle of facetectomy and osseous lateral recess decompression rate were examined.ResultsThe mean follow-up period was 10.7 months. The mean hospital stay was 2.76 ± 1.02 days. At the final follow-up, VAS for back pain and legs pain decreased from 7.22 ± 0.95 to 1.26 ± 0.44 and from 7.88 ± 0.69 to 1.18 ± 0.39, respectively; ODI decreased from 69.88 ± 6.32% to 14.96 ± 2.75%. According to the modified Macnab criteria, the results were excellent in 24 (48%), good in 22 (44%), and fair in 4 (8%). Excellent or good results (a satisfactory outcome) were obtained in 92% of the patients. There were 2 cases of complications of dural sac tear. The postoperative DSCA was significantly enlarged compared with that before surgery, from 44.74 ± 9.85 to 126.86 ± 14.81 mm2. According to Schizas grade, the stenosis grade changes from preoperative grade C in 16 cases, grade D in 34 cases, to postoperative grade A in 40 cases, and grade B in 10 cases. The mean angle of facetectomy of the ipsilateral facet joint was 70.87 ± 5.68∘, contralateral was 65.07 ± 4.98∘. The decompression rate was 70.81 ± 4.43% (ipsilateral side) and 71.22 ± 3.68% (contralateral).ConclusionsUBE-ULBD has a good clinical effect in the treatment of SLSS, and has achieved satisfactory results in spinal canal enlargement, undercutting of facet joints, and decompression effect. It is a safe and effective surgical for SLSS.
A case of giant Ewing's sarcoma (EES)/primitive neuroectodermal tumor (PNET) of the cervicothoracic junction in children with incomplete paralysis of both lower limbs: Case report and literature review
Authors: Zhang Gong-Heng , Lin Jun-Ming , He Zhen-Yu , Yuan Xiao-Jun , Li Guang , Gan Xin-Rong , Xu Wen-Hua , Cao Sheng-Sheng 
Published: January 2023

BackgroundExtraosseous Ewing's sarcoma/primary neuroectodermal tumor (EES/PNET) is a rare, malignant, small round blue cell tumor, which usually involves the larynx, kidneys, and esophagus. The most common metastatic sites are lung and bone. The incidence of epidural EES/PNET was 0.9%, and a detailed search of the PubMed literature found only 7 case reports of epidural ESS/PNET at the cervicothoracic junction in children.Case descriptionWe report a case of epidural ESS/PNET at the cervicothoracic junction in a child with chest and back pain as the first symptom, which worsened after half a year and developed incomplete paralysis of both lower extremities and urinary incontinence. She underwent emergency surgery, chemotherapy and radiotherapy, and died of lung metastases 8 months after surgery.ConclusionPrimary epidural tumors are mostly benign, such as spinal meningiomas and neuromas. Contrary to what has been previously thought, we report a case of malignant epidural EES/PNET at the cervicothoracic junction without bone destruction; The rarity of epidural EES/PNET at the cervicothoracic junction in children has led to a lack of data, particularly on prognostic factors and recurrence patterns. Due to the difficulty of early diagnosis and high mortality, spine surgeons must explore and increase their awareness of this disease.
Percutaneous endoscopic lumbar discectomy as a treatment for lumbar disc herniation linked with posterior ring apophysis separation
Authors: Li Ran , Zhou Hongyou , Han Hao , Fu Dongming , Zhan Zihao , Meng Bin 
Published: January 2023

BackgroundLumbar disc herniation (LDH) linked with posterior ring apophysis separation (PRAS) is a rare and distinct subset of disc herniation. Few studies have evaluated the clinical efficacy of percutaneous endoscopic lumbar discectomy (PELD), which is a procedure used to treat LDH linked with PRAS.ObjectivesTo evaluate the clinical efficacy and safety of PELD in the treatment of LDH linked with PRAS.MethodsPatients who met inclusion criteria (n = 67; 40 males and 27 females) underwent PELD. General and operation-related information and perioperative complications of the patients were recorded. Clinical efficacy was measured using the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) during the follow-up period.ResultsThe mean operation time was 118.04 ± 19.31 min and the mean blood loss was 22.84 ± 15.89 ml. The VAS and ODI scores continued to improve immediately after the surgery to the last follow-up. Four patients experienced postoperative complications i.e., herniation recurrences. The conditions of the patients with the complications improved after treatment.ConclusionsPELD has reliable efficacy and safety in the treatment of LDH linked with PRAS.
The predictive value of revised diastolic dysfunction in outcomes of liver transplantation: A propensity score matching analysis
Authors: Bi Shenghua , Jiang Yueping , Zhao Wenjun , Niu Xiaoyan , Liu Xuechun , Jing Xue 
Published: January 2023

BackgroundDiastolic dysfunction (DD), one of the earliest signs of cirrhotic cardiomyopathy (CCM), is included in the revised 2019 CCM criteria. Nonetheless, relevant research regarding the effects of revised DD on post-liver transplantation (LT) outcomes remains limited.MethodsThis retrospective study enrolled patients who underwent LT for decompensated cirrhosis, from January 2018 to March 2021. Patients were divided into DD and non-DD groups. Clinical data were collected. Patients were followed up with, for at least 1 year post-LT; cardiovascular adverse events (AEs) and survival status were recorded. Risk factors were identified using 1:2 propensity score matching (PSM), after adjusting for confounding factors. The caliper value was set to 0.02.ResultsOf 231 patients, 153 were diagnosed with DD (male, 81.8%; mean age, 51.5 ± 9.5 years). Nineteen patients with DD died within 1 year, post-LT. After PSM, 97 and 60 patients were diagnosed with and without DD, respectively. Patients with DD had longer intensive care unit (ICU) stays, higher perioperative cardiovascular AEs, and higher mortality rates than those without DD. In a multivariate analysis, interventricular septum (IVS), left atrial volume index (LAVI), and potassium levels were independent prognostic factors of perioperative cardiovascular AEs, while a decreased early diastolic mitral annular tissue velocity (e’), increased neutrophil-to-lymphocyte ratio (NLR) and tumor markers were predictors of mortality within 1 year post-LT after PSM (P &lt; 0.05).ConclusionCardiac DD may contribute to perioperative cardiovascular AEs and mortality post-LT. Clinicians should be aware of decompensated cirrhosis in patients with DD.
Comparison of velopharyngeal morphology of two palatoplasty techniques in patients with hard and soft cleft palate
Authors: Fan Xiaofen , Liu Weilong , Nie Jiancun , Chen Xiaoxuan , Dong Yingchun , Lu Yong 
Published: January 2023

PurposeThe study aims to compare the velopharyngeal morphology of hard and soft cleft palate (HSCP) patients after Furlow and Sommerlad palatoplasty.Patients and methodsA total of 51 patients (20 cases in Furlow palatoplasty group, 16 cases in Sommerlad palatoplasty group and 15 normal children in the control group) were included in our study. Velopharyngeal function and speech outcomes of patients with HSCP who had either Furlow palatoplasty or Sommerlad palatoplasty for cleft palate repair were evaluated by perceptual speech assessment (PSA), lateral cephalometric radiographs and nasopharyngoscopy. To assess velopharyngeal morphology of patients treated with two techqiques, we analyzed measurements such as velar length, pharyngeal depth, and the Adequate ratio (the ratio of velar length to pharyngeal depth). Furthermore, skeletal landmarks including cranial base, cervical vertebrae, posterior nasal spine which were defined as the pharyngeal triangle were measured. Finally, the position of the point U relative to the pharyngeal triangle were compared.ResultsVelopharyngeal closure (VPC) rate in Furlow palatoplasty group accounted for 90%, while that in Sommerlad palatoplasty group was 81.3%. PSA of the former group was significantly better than that of the latter group (P &lt; 0.05). Velar length, pharyngeal depth and the Adequate ratio (1.37 ± 0.14 vs. 1.41 ± 0.15) were comparable between the Furlow group and control group (P &gt; 0.05), while Sommerlad group had a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio (1.20 ± 0.18) compared to the above two groups (P &lt; 0.05). Furhermore, the point U of Sommerlad group in the pharyngeal triangle was higher than that of the other two groups.ConclusionsIn the treatment modality of patients with HSCP, both Furlow palatoplasty and Sommerlad palatoplasty seem to be effective. Furlow palatoplasty appears to have velopharyngeal morphology similar to normal control group., while Sommerlad group shows a shorter velar length, deeper pharyngeal depth and a smaller Adequate ratio
Evaluation of adjuvant therapy for T1-2N1miM0 breast cancer without further axillary lymph node dissection
Authors: Li Baiyu , Liu Jianbo , Wu Guangyin , Zhu Qingyao , Cang Shundong 
Published: January 2023

BackgroundFor breast cancer (BC) with sentinel lymph node micrometastases (SLNMs), there are limited data to guide the selection of postoperative adjuvant therapy. This study aimed to identify target populations who might benefit most from adjuvant therapy and examine prognostic factors among patients with T1-2N1miM0 BC with one or two SLNMs who underwent sentinel lymph node biopsy (SLNB) alone.MethodsThere were 7,423 patients diagnosed with T1-2N1miM0 BC between 2010 and 2015, and patients with one or two SLNMs were extracted from the Surveillance, Epidemiology, and End Results database. All the patients underwent SLNB alone without further axillary lymph node dissection, and they were stratified according to adjuvant therapy. The statistical significance of categorical variables was analyzed using the χ2 test. Univariable and multivariable Cox analyses were used to analyze characteristics predictive of Breast-cancer-specific survival and overall survival (OS). Kaplan–Meier methods with the log-rank test was analyzed to compare survival difference between the different treatments.ResultsAdjuvant chemotherapy and radiotherapy improved 5-year OS rates. Multivariate analysis revealed that age ≥70 years, high grade, T2 stage, triple-negative subtype, and absence of radiotherapy were poor prognostic factors for OS. Patients who received breast-conserving surgery (BCS), and those with invasive ductal carcinoma (IDC), luminal A, luminal B, or basal-like subtype, and T1c or T2 stage benefited from adjuvant radiotherapy. Patients who received BCS, and those with IDC, luminal A subtype, and T1b, T1c, or T2 stage benefited from adjuvant chemotherapy.ConclusionOur findings provide a clinical evaluation of treatment choice after surgery, which may help clinicians make individualized clinical decisions.
Ultrasound-guided percutaneous release procedures in the transverse carpal ligament by acupotomy: A cadaveric study
Authors: Zhou Qiaoyin , Shen Yifeng , Zhu Xinyue , Sun Xiaojie , Qiu Zuyun , Li Shiliang , Zhang Weiguang 
Published: January 2023

ObjectiveThis study aimed to determine the safety and accuracy of ultrasound-guided acupotomy percutaneous loosening of the transverse carpal ligament.MethodsThe 100 upper limb specimens were equally divided into the ultrasound-guided acupotomy group (U) and the nonultrasound-guided acupotomy group (N). For the U group, we simulated ultrasound-guided acupotomy loosening of the transverse carpal ligament in a human specimen, and for the N group, we performed the loosening of the transverse carpal ligament through the same approach under nonultrasound-guided conditions. The safety and accuracy of the two methods were compared through measurement.ResultsIn the ultrasound-guided group, the injury rate of nerves, blood vessels and tendons caused by needle-knife release was 0%. In the non-ultrasound-guided group, the rate of nerve, blood vessel and tendon damage was 6 percent, 12 percent and 20 percent, respectively. χ2 test (Fisher exact test) was performed for the nerve and blood vessel damage rates in the two groups (PN &gt; 0.05, PA &lt; 0.05), the difference in nerve damage rates was not statistically significant, but the difference in blood vessel damage rates was statistically significant. Pearson's χ2 test was performed on the tendon injury rates of the two groups (PF &lt; 0.05), and the difference was statistically significant. In the ultrasound-guided group, the proportion of acupotomy marks greater than or equal to half of the width of the transverse carpal ligament was 86%, and the non-ultrasound-guided group was 36%. The accuracy of the two surgical methods was tested by Pearson's χ2 test (PL &lt; 0.05), and the difference was statistically significant. According to the measurement, the ultrasound-guided acupotomy technology had high safety and accuracy.ConclusionIn this study, we designed a new method for cutting the transverse carpal ligament under ultrasound guidance, which is different from surgery. These results indicate that this is a safe and accurate method of interventional treatment of carpal tunnel syndrome.
Postoperative hemorrhage after biomedical glue sling technique in microvascular decompression for vertebrobasilar artery-associated cranial nerve diseases: A retrospective study of 14 cases
Authors: Liu Jiang , Shen Yuxiao , Xiayizhati Kelisitan , Yu Yanbing 
Published: January 2023

BackgroundThe biomedical glue sling technique is a convenient and effective method for vertebrobasilar artery-associated cranial nerve diseases but postoperative hemorrhage is poorly understood.MethodsWe retrospectively reviewed 14 of 1157 patients associated with cranial nerve diseases who were subjected to the biomedical glue sling technique in microvascular decompression at our hospital from January 2015 to January 2020.ResultsThere were 14 patients with cranial nerve diseases included in this study. A clinical diagnosis of postoperative hemorrhage was made after an average of 41.75 h (ranging between 0.5 and 95 h). A cerebellopontine angle hemorrhage was presented in 5 patients, while basal ganglia hemorrhage was observed in 2 patients. Both a cerebellopontine angle and brainstem hemorrhage was seen in 1 patient. Distal supratentorial subdural hemorrhage was recorded in 6 patients. The correlation coefficient was −0.1601 (p = 0.7094) between the standard deviation of systolic blood pressure and the Hemphill Score, −0.2422 (p = 0.5633) between the coefficient of variation of systolic blood pressure and the Hemphill Score, and −0.0272 (p = 0.9489) between the range of systolic blood pressure and the Hemphill Score.ConclusionsThe incidence of postoperative hemorrhage after MVD with the biomedical glue sling technique is higher than with traditional MVD and most cases have a favorable prognosis. Postoperative symptoms are the main area of concern and changes in symptoms usually suggest the occurrence of hemorrhage. Several factors, including surgical procedures, the release of CSF, and blood pressure might be associated with hemorrhaging. We still believe such a technique is an efficient approach to treating complicated cranial nerve diseases.
Modification of m5C regulators in sarcoma can guide different immune infiltrations as well as immunotherapy
Authors: Wu Shusheng , Li Mengge , Su Rixin , Shen Hao , He Yifu , Zhou Yangfan 
Published: January 2023

BackgroundRecent studies have found that 5-methylcytosine (m5C) modulators are associated with the prognosis and treatment of cancer. However, the relevance of m5C modulators in sarcoma prognosis and the tumour microenvironment is unclear.MethodsWe selected 15 m5C regulators and performed unsupervised clustering to identify m5C modification patterns and differentially expressed genes associated with the m5C phenotype in The Cancer Genome Atlas (TCGA) sarcomas. The extent of immune cell infiltration in different clustering groups was explored using single-sample gene set enrichment analysis and estimation algorithms. A principal component analysis algorithm-based m5C scoring protocol was performed to assess the m5C modification patterns of individual tumors.ResultsWe identified two distinct m5C modification patterns in the TCGA sarcoma cohort, which possess different clinical outcomes and biological processes. Tumour microenvironment analysis revealed two groups of immune infiltration patterns highly consistent with m5C modification patterns, classified as immune inflammatory and immune desert types. We constructed m5C scores and found that high m5C scores were closely associated with leiomyosarcoma and other subtypes, and were associated with poorer prognosis, lower PD-L1 expression, and poorer immunotherapy outcomes. The best application was validated against the m5C database.ConclusionWe constructed an m5C score for sarcoma based on the TCGA database and identified a poorer prognosis in the high m5c score group. The stability and good prognostic predictive power of the m5C score was verified by an external database. We found that sarcomas in the low m5C score group may have a better response to immunotherapy.