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Objective@#To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). @*Materials and Methods@#Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CTguided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. @*Results@#All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. @*Conclusion@#CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.
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For the field detection problems of critical quality attribute(CQA) of moisture content in traditional Chinese medicine(TCM) manufacturing process, big brand TCM Tongren Niuhuang Qingxin Pills were used as the carrier, to establish a moisture content NIR field detection model with or without cellophane in real world production with use of near infrared(NIR) spectroscopy combined with stoichiometry. With the moisture content determined by drying method as reference value, the partial least square method(PLS) was used to analyze the correlation between the spectrum and the moisture reference value. Then the spectral pretreatment methods were screened and optimized to further improve the accuracy and stability of the model. The results showed that the best quantitative model was developed by the spectral data pretreatment of standard normal variate(SNV) with the latent variable factor number of 2 and 7 of Tongren Niuhuang Qingxin Pills with or without cellophane samples. The prediction coefficient of determination(R_(pre)~2) and standard deviation of prediction(RMSEP) of the model with cellophane samples were 0.765 7 and 0.157 2%; R_(pre)~2 and RMSEP of the model without cellophane samples were 0.772 2 and 0.207 8%. The NIR quantitative models of moisture content of Tongren Niuhuang Qingxin Pills with and without cellophane both showed good predictive performance to realize the rapid, accurate and non-destructive quantitative analysis of moisture content in such pills, and provide a method for the field quality control of the critical chemical attributes of moisture in the manufacturing of big brand TCM.
Subject(s)
Drugs, Chinese Herbal , Least-Squares Analysis , Medicine, Chinese Traditional , Spectroscopy, Near-InfraredABSTRACT
@#Objective To evaluate the diagnostic value of artificial intelligence (AI)-assisted diagnostic system for pulmonary cancer based on CT images. Methods Databases including PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and Chinese BioMedical Literature Database (CBM) were electronically searched to collect relevant studies on AI-assisted diagnostic system in the diagnosis of pulmonary cancer from 2010 to 2019. The eligible studies were selected according to inclusion and exclusion criteria, and the quality of included studies was assessed and the special information was identified. Then, meta-analysis was performed using RevMan 5.3, Stata 12.0 and SAS 9.4 softwares. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were pooled and the summary receiver operating characteristic (SROC) curve was drawn. Meta-regression analysis was used to explore the sources of heterogeneity. Results Totally 18 studies were included with 4 771 patients. Random effect model was used for the analysis due to the heterogeneity among studies. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the SROC curve were 0.87 [95%CI (0.84, 0.90)], 0.89 [95%CI (0.84, 0.92)], 7.70 [95%CI (5.32, 11.15)], 0.14 [95%CI (0.11, 0.19)], 53.54 [95%CI (30.68, 93.42)] and 0.94 [95%CI (0.91, 0.95)], respectively. Conclusion AI-assisted diagnostic system based on CT images has high diagnostic value for pulmonary cancer, and thus it is worthy of clinical application. However, due to the limited quality and quantity of included studies, above results should be validated by more studies.
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Objective@#To evaluate the feasibility, safety, and effectiveness of CT-guided microcoil localization of solitary pulmonary nodules (SPNs) for guiding video-assisted thoracoscopic surgery (VATS). @*Materials and Methods@#Between June 2016 and October 2019, 454 consecutive patients with 501 SPNs who received CTguided microcoil localization before VATS in our institution were enrolled. The diameter of the nodules was 0.93 ± 0.49 cm, and the shortest distance from the nodules to the pleura was 1.41 ± 0.95 cm. The distal end of the microcoil was placed less than 1 cm away from the nodule, and the proximal end was placed outside the visceral pleura. VATS was performed under the guidance of implanted microcoils without the aid of intraoperative fluoroscopy. @*Results@#All 501 nodules were marked with microcoils. The time required for microcoil localization was 12.8 ± 5.2 minutes. Microcoil localization-related complications occurred in 179 cases (39.4%). None of the complications required treatment. A total of 463 nodules were successfully resected under the guidance of implanted microcoils. VATS revealed 38 patients with dislocated microcoils, of which 28 underwent wedge resection (21 cases under the guidance of the bleeding points of pleural puncture, 7 cases through palpation), 5 underwent direct lobectomy, and the remaining 5 underwent a conversion to thoracotomy. In 4 cases, a portion of the microcoil remained in the lung parenchyma. @*Conclusion@#CT-guided microcoil localization of SPNs is safe and reliable. Marking the nodule and pleura simultaneously with microcoils can effectively guide the resection of SPNs using VATS without the aid of intraoperative fluoroscopy.
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Objective To select and develop a SNP-STR multiplex amplification system with genetic markers compatible with current STR databases. To understand its genetic polymorphisms in Sichuan Han population and its application value in DNA mixture analysis. Methods Based on the STR genetic markers in commercial kits, SNPs adjacent to these STR markers were selected to be SNP-STR genetic markers. A SNP-STR multiplex amplification system with genetic markers based on allele-specific amplification was constructed using allele-specific amplification primers. The genetic polymorphism of the system in the Sichuan Han population was investigated and the efficiency of systems with different numbers of loci to detect the two individual DNA mixture samples was evaluated. Results An allele-specific multiplex amplification system constituted of 13 SNP-STR genetic markers was selected and constructed. In Sichuan Han population, the heterozygosity of each locus ranged from 0.76 to 0.88, and the combined discrimination power reached 0.999 999 999 999 999 968. In the analysis of the two individual DNA mixture samples： for single-locus amplification, the genotype of the minor components can still be detected when the mixture ratio reaches 1 000∶1; for multiple loci multiplex amplification, the maximum mixture ratio can reach 500∶1. As the number of loci in the system increased, the detection efficiency of the minor components in the DNA mixture decreased. Conclusion SNP-STR genetic markers have a higher polymorphism than STR. The multiplex amplification system made of SNP-STR genetic markers has a better analysis efficiency for mixed samples than traditional STR multiplex amplification system.
Subject(s)
Humans , China , DNA Fingerprinting , DNA Primers , Gene Frequency , Genetic Markers , Microsatellite Repeats , Polymerase Chain Reaction , Polymorphism, Single NucleotideABSTRACT
Objective:To detect whether Toll-like receptor 4 ( TLR4) polymorphisms contributed to primary open angle glaucoma (POAG) in a Chinese population. Methods:A Chinese cohort, including 799 unrelated POAG patients and 799 unrelated controls, was enrolled in our case-control association study. The data was collected at Sichuan Provincial People's Hospital from May 2014 to March 2018. TLR4 functional single nucleotide polymorphisms (SNPs), including rs4986790 and rs4986791, were genotyped by SNaPshot method. Genotype and allele frequencies of the two SNPs were evaluated. This study was approved by the Institutional Review Boards of the Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (No.2016-58), and complied with the guidelines of the Declaration of Helsinki. Written informed consents were obtained from all subjects prior to the study. Results:Allelic association analysis revealed that there were no significant association detected in the allelic distributions between the POAG cases and controls for SNPs rs4986790 ( P=0.317) and rs4986791 ( OR=1.000, 95% CI =0.062 5-16.002 2, P=1.000) in the TLR4 gene. Conditional analysis of the two SNPs did not show any significant difference in genotype and allele frequency between the case and the control groups. No association of the two SNPs with POAG was detected under four different genetic models, including homozygote, heterozygote, dominant and recessive models. Conclusions:Polymorphisms rs4986790 and rs4986791 in the TLR4 gene are not related to POAG in the Chinese cohort.
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BACKGROUND: Proximal femoral nail is the first choice for treating intertrochanteric fractures. The studies concerning proximal femoral nail for senile intertrochanteric fractures mainly focus on proximal femoral nail antirotation/proximal femoral nail antirotation II, Gamma 3 and intertrochanteric antegrade nail. OBJECTIVE: To investigate the clinical efficacy of proximal femoral nail antirotation II versus intertrochanteric antegrade nail in the treatment of intertrochanteric fracture in the elderly. METHODS: Forty-two cases of senile intertrochanteric fractures at Department of Orthopedics, First People’s Hospital of Xuancheng City from January 2016 to December 2018 were included, involving 15 males and 27 females, aged 65-90 years. Among which, 22 patients received internal fixation using proximal femoral nail antirotation II and 20 patients using intertrochanteric antegrade nail. The operation time, intraoperative blood loss, fracture healing time, postoperative complications and the hip function scores at last follow-up were compared. The study was approved by the Ethics Committee of First People’s Hospital of Xuancheng City, approval No. (2015)(17). RESULTS AND CONCLUSION: (1) The operation time in the proximal femoral nail antirotation group was shorter than that in the intertrochanteric antegrade nail group [(69.4±11.5), (90.0±9.7) minutes, P 0.05]. (3) In the proximal femoral nail antirotation group, three cases suffered from pain at the affected limb, and one case of coxa vara deformity. One case in the intertrochanteric antegrade nail group appeared with pain at the affected limb. The postoperative incidence of complications between two groups showed no significant difference (18.2%, 5.0%, P > 0.05). (4) No significant difference was found in the Harris scores at the last follow-up between two groups (90.3±2.8, 91.5±2.4, P > 0.05). (5) There were no fracture adverse reactions related to internal fixation materials in the two groups. (6) In summary, proximal femoral nail antirotation II and intertrochanteric antegrade nail internal fixation are effective methods for intertrochanteric fractures in the elderly. However, proximal femoral nail antirotation II has short operation time and few intraoperative blood losses.
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Objective To observe and study the influence of external drainage of lateral ventricle for contin-uous ventricular infusion and lumbar cistern drainage for the serum and cerebrospinal fluid on inflammatory mediators of patients with intracranial infection ,in order to understand the clinical application value of the treatment methods. Methods From June 2016 to May 2018,56 patients with intracranial infection in the People's Hospital of Lianshui County were selected in the study and randomly divided into two groups according to the random allocation principle , with 28 cases in each group.The control group was treated with repeated lumbar intrathecal drug therapy ,the observa-tion group was treated with external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage.The serum and cerebrospinal fluid inflammatory mediators of two groups before treatment and at the first and second week after treatment were compared.Results The serum and cerebrospinal fluid inflammatory mediators of the two groups before treatment had no statistically significant differences (all P＞0.05).The serum levels of IL-1β, IL-6 and IL-8 of the observation group at the first and second week after treatment were (2.27 ±0.28) μg／L, (9.25 ±0.89)μg／L,(11.15 ±1.35)μg／L and (1.65 ±0.20)μg／L,(7.04 ±0.81) μg／L,(8.42 ±0.79) μg／L, respectively,which were significantly lower than those of the control group [( 4.63 ±0.38 ) μg／L, ( 11.92 ± 1.35)μg／L,(14.28 ±1.75)μg／L and (3.20 ±0.29) μg／L,(9.41 ±1.02) μg／L,(11.32 ±1.47) μg／L] ( t＝26.456,8.737,7.493,23.282,9.628,9.195,all P＜0.01).Two weeks after treatment ,the levels of IL-1,IL-6 and IL-8 in CSF of the observation group were (1.51 ±0.15) μg／L, ( 5.14 ±0.45 ) μg／L and (5.96 ± 0.59)μg／L,respectively,which were significantly lower than those of the control group (t＝12.876,12.810,14.272, all P＜0.01).The levels of leukotriene B4(LTB4),substance P(SP) and nitric oxide(NO) in serum and cerebrospi-nal fluid of the two groups continued to decrease after treatment for one week and two weeks ,and those in the observa-tion group were lower than the control group ( all P＜0.05).Conclusion External drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage can significantly decrease the serum and cerebrospinal fluid inflammatory mediators of patients with intracranial infection ,so the treatment method has high clinical applica-tion significance.
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OBJECTIVE@#To study the effects of the overexpression of autophagy-related gene 3 (ATG3) on autophagy and salinomycin-induced apoptosis in breast cancer cells and explore the underlying mechanisms.@*METHODS@#We used the lentivirus approach to establish a breast cancer cell line with stable overexpression of ATG3. Western blotting, immunofluorescence staining and transmission electron microscopy were used to analyze the effect of ATG3 overexpression on autophagy in breast cancer MCF-7 cells. Using the AKT/mTOR agonists SC79 and MHY1485, we analyzed the effect of AKT/mTOR signal pathway activation on ATG3 overexpression-induced autophagy. Western blotting and flow cytometry were used to analyze the effect of autophagy on apoptosis of the ATG3-overexpressing cells treated with salinomycin and 3-MA (an autophagy inhibitor).@*RESULTS@#In ATG3-overexpressing MCF-7 cells, ATG3 overexpression obviously promoted autophagy, inhibited the AKT/mTOR signaling pathway, significantly weakened salinomycin-induced apoptosis ( < 0.01), caused significant reduction of the levels of the pro-apoptotic proteins cleaved-caspase 3 ( < 0.01) and Bax ( < 0.05), and enhanced the expression of the anti-apoptotic protein Bcl-2 ( < 0.05). The inhibition of autophagy obviously weakened the inhibitory effect of ATG3 overexpression on salinomycin-induced apoptosis.@*CONCLUSIONS@#ATG3 overexpression promotes autophagy possibly by inhibiting the AKT/mTOR signaling pathway to decrease salinomycin-induced apoptosis in MCF-7 cells, suggesting that autophagy induction might be one of the mechanisms of drug resistance in breast cancer cells.
Subject(s)
Female , Humans , Acetates , Pharmacology , Apoptosis , Genetics , Autophagy , Autophagy-Related Proteins , Metabolism , Benzopyrans , Pharmacology , Breast Neoplasms , Metabolism , Pathology , Cell Line, Tumor , Cell Proliferation , Drug Resistance, Neoplasm , Gene Expression Regulation , MCF-7 Cells , Morpholines , Pharmacology , Proto-Oncogene Proteins c-akt , Metabolism , Pyrans , Pharmacology , TOR Serine-Threonine Kinases , Metabolism , Triazines , Pharmacology , Ubiquitin-Conjugating Enzymes , MetabolismABSTRACT
Objective@#To observe and study the influence of external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage for the serum and cerebrospinal fluid on inflammatory mediators of patients with intracranial infection, in order to understand the clinical application value of the treatment methods.@*Methods@#From June 2016 to May 2018, 56 patients with intracranial infection in the People's Hospital of Lianshui County were selected in the study and randomly divided into two groups according to the random allocation principle, with 28 cases in each group.The control group was treated with repeated lumbar intrathecal drug therapy, the observation group was treated with external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage.The serum and cerebrospinal fluid inflammatory mediators of two groups before treatment and at the first and second week after treatment were compared.@*Results@#The serum and cerebrospinal fluid inflammatory mediators of the two groups before treatment had no statistically significant differences(all P>0.05). The serum levels of IL-1β, IL-6 and IL-8 of the observation group at the first and second week after treatment were (2.27±0.28)μg/L, (9.25±0.89)μg/L, (11.15±1.35)μg/L and (1.65±0.20)μg/L, (7.04±0.81)μg/L, (8.42±0.79)μg/L, respectively, which were significantly lower than those of the control group [(4.63±0.38)μg/L, (11.92±1.35)μg/L, (14.28±1.75)μg/L and (3.20±0.29)μg/L, (9.41±1.02)μg/L, (11.32±1.47)μg/L] (t=26.456, 8.737, 7.493, 23.282, 9.628, 9.195, all P<0.01). Two weeks after treatment, the levels of IL-1, IL-6 and IL-8 in CSF of the observation group were (1.51±0.15)μg/L, (5.14±0.45)μg/L and (5.96±0.59)μg/L, respectively, which were significantly lower than those of the control group(t=12.876, 12.810, 14.272, all P<0.01). The levels of leukotriene B4(LTB4), substance P(SP) and nitric oxide(NO) in serum and cerebrospinal fluid of the two groups continued to decrease after treatment for one week and two weeks, and those in the observation group were lower than the control group(all P<0.05).@*Conclusion@#External drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage can significantly decrease the serum and cerebrospinal fluid inflammatory mediators of patients with intracranial infection, so the treatment method has high clinical application significance.
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OBJECTIVE@#To evaluate efficacy of radiographic and clinical of Chevron osteotomy versus Scarf osteotomy for hallux valgus at moderate and severe degree.@*METHODS@#Randomized controlled trial (RCT) about Chevron and Scarf osteotomy for hallux valgus, in PubMed, Embase, Cochrane Library, CBM, CNKI, Wanfang Data were searched by computer from establishing database to June 2018. According to inclusion and exclusion criteria, two researchers independently screened the literatures, evaluated risk of bias and extracted related observation index, RevMan 5.3.5 software was used to perform Meta-analysis. Postoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), AOFAS score, complications and patients' satisfaction degree between Chevron and Scarf osteotomy.@*RESULTS@#Six RCT literatures were included, involving 507 patients, 92.5% patients were at moderate and severe degree, and 261 patients were performed by Chevron osteotomy and 246 patients were performed by Scarf osteotomy. Meta analysis results showed that Chevron osteotomy was better than Scarf osteotomy in correcting HVA [MD=-1.95, 95%CI(-2.64, -1.27), <0.000 01]. While there were no statistical differences in IMA [MD=-0.42, 95%CI(-1.04, 0.21), =0.19], DMAA[MD=0.78, 95%CI(-0.72, 2.29), =0.31], AOFAS score [MD=2.47, 95%CI(-2.38, 7.33), =0.32], complications [RR=1.09, 95%CI(0.54, 2.20), =0.82], and patients' satisfaction degree [RR=1.00, 95%CI(0.96, 1.05), =0.92].@*CONCLUSIONS@#Chevron osteotomy, which has advantages in simple operation, shorten metatarsal bone, less trauma, was better in correcting HVA of hallux valgus at moderate and severe degree, and had similar effects in IMA, DMAA, AOFAS score, complications and patients' satisfactory degree.
Subject(s)
Humans , Hallux Valgus , General Surgery , Metatarsal Bones , Metatarsophalangeal Joint , Osteotomy , Treatment OutcomeABSTRACT
@#AIM: To evaluate the early changes of retinal function in patients with wet age-related macular degeneration(ARMD)after intravitreal Conbercept treatment by multifocal electroretinography(mfERG). <p>METHODS: Wet ARMD patients diagnosed by fundus fluorescein angiography and received intravitreal injection of Conbercept(0.05mL/0.5mg)were included. Best corrected visual acuity(BCVA), incubation of N1, P1 and amplitude of P1 in mfERG test were recorded before and 1mo after treatment. <p>RESULTS: Twenty patients(20 eyes)were enrolled in total. The mean BCVA was 0.80±0.48 LogMAR at baseline and improved to 0.65±0.50 LogMAR after treatment(<i>P</i><0.001). Mean P1 amplitude density of the mfERG Ring 1 increased from 39.59±16.60nV/deg<sup>2</sup> to 53.81±20.41nV/deg<sup>2</sup>(<i>P</i>=0.006). The change in visual acuity was positively correlated with the change in P1 amplitude density of Ring 1(<i>r</i>=-0.776, <i>P</i><0.001). <p>CONCLUSION: Intravitreal conbercept injection can improve the central retinal function of wet ARMD patients in the short term.
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Objective: To reveal the mechanism of the effect of arsenic trioxide (ATO) on hepatocellular carcinoma (HCC) cells through metabolomics study. Methods: HCC cell line HepG2 was treated with ATO for 12 h, 24 h and 36 h respectively. The global metabolite profiles were monitored by metabolomics analysis using GC/MS and LC/MS/MS. Results: A total of 307 certified metabolites were detected. Bioinformatics analysis showed that glycosylation and one-carbon metabolism were the main cellular functions that have been affected. Other affected cellular functions/pathways included mitochondrial function fatty acid β-oxidation, TCA cycle, pentose phosphate pathway (PPP) and glutathione metabolism. Conclusion: ATO treatment affects the main metabolomic pathway of HepG2, and inhibits cell growth and migration, then exacerbates oxidative stress to induce cancer cell apoptosis.
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Genus Lilium plants contain a variety of steroidal saponins, so far at least 82 steroidal saponins have been found in the bulbs of Lilium species, including 13 spirostanol saponins (1-13), 39 isospirostanol saponins (14-52), 7 pseudospirostanol saponins (53-59), and 23 furostanol saponins (60-82). Studies have showed that these steroidal saponins exhibit a wide range of pharmacological activities, including antitumor, antibacterial, antiinflammatory, antioxidant, antidepressant, hepatoprotective, hypoglycemic, sedative-hypnotic effect, and inhibition of cAMP phosphodiesterase and Na⁺-K⁺ ATP, et al. This paper has classified and summarized the 82 steroidal saponins isolated and identified from the bulbs of Lilium species and their correlative biological activities. Also, their structural characteristics and structure-activities relationship have been discussed, which could provide references for further research and application development of Lilium plants.
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<p><b>PURPOSE</b>To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice.</p><p><b>METHODS</b>From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20-65 years). The causes of the fractures included traffic accidents (13 cases), falls from a height (four cases), heavy lifting injuries (three cases), and sport injury (one case). All patients were followed up with radiography and three-dimensional reconstruction computed tomography and other checks and any complications were actively managed. Closed reduction of fracture-dislocation of the hip was attempted under general anesthesia using the Kocher-Langenbeck approach. Femoral head fractures were treated with internal fixation or excision based on the size of the fracture fragments, whereas acetabular fractures were fixed with a reconstruction plate and screws following anatomic reduction.</p><p><b>RESULTS</b>The incisions healed by primary intention in all patients after surgery, without any infection, deep venous thrombosis, or other complications. All 21 patients were followed up for 36-76 months, with an average follow-up duration of 49 months. Postoperative imaging data showed that all dislocations and fractures were anatomically reduced, and bony union of the fractures was achieved. Heterotopic ossification was found in four patients, post-traumatic osteoarthritis in three, and avascular necrosis of the femoral head in two. At the final follow-up, the assessment of hip joint function according to the Thompson-Epstein scoring scale was excellent in 10 cases, good in six cases, fair in three cases, and poor in two cases. The rate of excellent and good functional outcomes was 76.1%.</p><p><b>CONCLUSION</b>The mid-term curative effects of a reconstruction plate and bioabsorbable screws in the treatment of Pipkin type IV femoral head fractures is significant, and such the treatment can significantly improve the patient's joint function and quality of life.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acetabulum , Wounds and Injuries , Bone Plates , Bone Screws , Femur Head , Wounds and Injuries , Follow-Up Studies , Hip Fractures , General Surgery , Plastic Surgery Procedures , MethodsABSTRACT
<p><b>PURPOSE</b>To investigate the early and mid-term results of open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no deltoid ligament repair (DLR) in the treatment of supination-external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B 3.1) and provide evidence for clinical practice.</p><p><b>METHODS</b>This study cohort consisted of 22 patients with SER IV E ankle fractures that underwent ORIF with TEF but no DLR between December 2011 and December 2014. There were 13 males and 9 females, mean age 38.9 years (range, 17-73 years). Eight cases involved the left side and 14 the right side. The causes of fractures included road traffic accidents (11 cases), falling from height (6 cases) and sports injuries (5 cases). The mean period of hospitalization was 9.8 days (range, 6-14 days). For all the patients, MRI and three-dimensional CT were done before surgery and X-rays done preoperatively and during follow-ups. The external frame was kept for 8-10 weeks. The preoperative American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was 56.86 ± 4.400, the Medical Outcomes Short Form 36-item (SF-36) questionnaire score was 57.41 ± 4.102 and the visual analog score (VAS) was 5.50 ± 1.058. Patients' main complaints about inconvenience of daily life were also recorded.</p><p><b>RESULTS</b>All the 22 patients were followed up for 24-63 months (mean, 33.6 months). None of them developed nonunion during the follow-up; pin site infection was observed in one patient and posttraumatic osteoarthritis in another. At the final follow-up, the average AOFAS score, SF-36 score and VAS score were respectively 90.59 ± 5.096, 79.59 ± 5.394 and 1.82 ± 1.181, which were significantly improved compared with the preoperative data (t = 26.221, p < 0.001; t = 11.910, p < 0.001; t = 11.571, p < 0.001). The therapeutic effect was excellent in 13 cases, good in 7 cases and fair in 2 cases, with a good-excellent rate of 90.9%. Patients' main complaints were inconvenience of clothing (17 cases) and extremity cleaning (5 cases).</p><p><b>CONCLUSION</b>In the treatment of SER IV E ankle fractures, ORIF with TEF but no DLR can achieve satisfactory outcome, but long-term effect should be confirmed by large sample randomized controlled trials.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Ankle Fractures , General Surgery , Fracture Fixation , Methods , Ligaments, Articular , General Surgery , Open Fracture Reduction , Methods , Postoperative Care , Retrospective Studies , Rotation , SupinationABSTRACT
<p><b>OBJECTIVE</b>To study whether hypoalbuminemia after pediatric cardiopulmonary bypass (CPB) for cardiac surgery is a risk factor for postoperative acute kidney injury (AKI).</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 1 110 children who underwent CPB surgery between 2012 and 2016. According to the minimum serum albumin within 48 hours postoperatively, these patients were divided into hypoalbuminemia group (≤35 g/L) and normal albumin group (>35 g/L). The two groups were compared in terms of perioperative data and the incidence of AKI. Furthermore, the incidence of AKI was compared again after propensity score matching for the unbalanced factors during the perioperative period. The perioperative risk factors for postoperative AKI were analyzed by logistic regression.</p><p><b>RESULTS</b>The overall incidence rate of postoperative AKI was 13.78% (153/1 110), and the mortality rate was 2.52% (28/1 110). The mortality rate of children with AKI was 13.1% (20/153). The patients with hypoalbuminemia after surgery (≤35 g/L) accounted for 44.50% (494/1 110). Before and after propensity score matching, the hypoalbuminemia group had a significantly higher incidence of AKI than the normal albumin group (P<0.05). The children with AKI had a significantly lower serum albumin level after surgery than those without AKI (P<0.05). The multivariate logistic regression analysis showed albumin ≤35 g/L was one of the independent risk factors for postoperative AKI.</p><p><b>CONCLUSIONS</b>Albumin ≤35 g/L within 48 hours postoperatively is an independent risk factor for postoperative AKI in children after CPB surgery.</p>
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Acute Kidney Injury , Epidemiology , Cardiopulmonary Bypass , China , Epidemiology , Heart Diseases , General Surgery , Hypoalbuminemia , Epidemiology , Perioperative Period , Postoperative Complications , Epidemiology , Propensity Score , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To analyze the perioperative clinical data of children with congenital heart disease complicated by acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery, and to explore potential factors influencing the prognosis.</p><p><b>METHODS</b>A retrospective analysis was performed among 118 children with congenital heart disease who developed AKI within 48 hours after CPB surgery.</p><p><b>RESULTS</b>In the 118 patients, 18 died after 48 hours of surgery. Compared with the survivors, the dead children had significantly higher incidence of cyanotic disease and Risk Adjustment for Congenital Heart Surgery-1 (RACHS-1) scores before surgery; during surgery, the dead children had significantly longer CPB time and aortic cross-clamping time, a significantly higher proportion of patients receiving crystalloid solution for myocardial protection, and a significantly higher mean blood glucose level. Within 48 hours after surgery, the dead children had significantly higher positive inotropic drug scores, significantly higher creatinine values, a significantly higher incidence of stage 3 AKI, a significantly higher proportion of patients receiving renal replacement the, and significantly higher usage of blood products (P<0.05). The mortality rate of the patients increased with increased intraoperative blood glucose levels (P<0.05). Patients with intraoperative blood glucose levels >8.3 mmol/L had a significantly lower postoperative cumulative survival rate and a significantly shorter mean survival time than those with blood glucose levels ≤ 8.3 mmol/L (P<0.05).</p><p><b>CONCLUSIONS</b>Intraoperative blood glucose levels are associated with the prognosis in children with congenital heart disease complicated by AKI after CPB surgery. Maintaining good intraoperative blood glucose control can improve the prognosis of the children.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Acute Kidney Injury , Mortality , Therapeutics , Cardiopulmonary Bypass , Heart Defects, Congenital , Mortality , General Surgery , Postoperative Complications , Prognosis , Retrospective StudiesABSTRACT
Objective To explore the clinical application effects of the logistics robot as innovative mode in consumables management in operating room.Methods Clinical application experiment using self-designed medical logistics robot was conducted.During single point distribution,indicators including the average time/trip of logistics robots,the error rate of transporting goods,replacing the workload of the distributor,the incidence of cost loss,the right rate of avoiding pedestrians,the right rate of avoiding obstacles,the number of being lost,and the speed of operational reaction were recorded.The time of picking(T1),the delivery time(T2),and the check time(T3) of test between logistics robot and manual operation were compared.Results Experiment results were obtained from 422 trips using logistics robot during single point distribution,and the average time for each trip was 1.75 min.one logistics robot was able to take the workload of 3 to 4 people;logistics robot avoided pedestrians for 420 times;it avoided obstacles for 414 times,it was lost for 13 times,and its speed of operational reaction was normal for 419 times;the comparison results between logistics robot and manual operation showed that T1,P＞0.05;T2 and T3,P＜ 0.01,and the distribution time using robot was less than that of manual operation.Conclusion Using logistics robot for distribution of high value consumables can shorten the time of applying consumables,operation with high distribution accuracy and information precision.
ABSTRACT
Objective To observe the types of posterior sclera shape (PSS) and macular shape (MS) in high myopia (HM) and its distributions in the pure HM and pathologic myopia (PM).Methods Together 90 patients with high myopia (163 eyes) in the Third Affiliated Hospital of Nanchang University were included in this study.The medical records from deep range imaging optical coherent tomography (DRIOCT) Atlantis and fundus photography examination were used to analyze the types and distributions of PSS and MS.Then all eyes were grouped into the pure HM group and MP group according to META-PM classification standard for comparing and analyzing the types and distributions of PSS and MS.Results Of all 90 patients (163 eyes),The type Ⅰ,Ⅱ,Ⅲ,ⅨX and Ⅶ PSS was in 44 eyes (27.0％),85 eyes (52.1％),15 eyes (9.2％),15 eyes (9.2％),4 eyes (2.5％),respectively.The type Ⅰ,Ⅱ,Ⅲ,Ⅳ horizontal MS was in 31 eyes (20.3％),23 eyes (15.0％),87 eyes (56.9％),12 eyes (7.8％),respectively.The type Ⅰ,Ⅲ,Ⅳ vertical MS was in 104 eyes (69.8％),28 eyes (18.8％) and 17 eyes (11.4％),respectively.As for horizontal MS combined with vertical MS,type Ⅲ + Ⅰ was in 62 eyes (38.8％),type Ⅰ + Ⅰ in 26 eyes (16.3％),type Ⅲ + Ⅲ in 22 eyes (13.8％),type Ⅱ + Ⅰ in 20 eyes (12.5％),and type Ⅳ + Ⅳ in 10 eyes(6.3％);the others 7 types were in 20 eyes (12.5％).There were statistically significant differences in distribution of PPS and horizontal MS between the pure HM and MP group (x2 =12.67,47.60;P ＜ 0.01).Conclusion Patients with pure high myopia has mainly type Ⅰ,Ⅱ PPS,and type Ⅲ horizontal MS together with type Ⅰ vertical MS plus type Ⅲ + Ⅰ horizontal combined with vertical MS,while type]X PSS and type Ⅳ horizontal MS were commonly seen in PM.