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Objective:To evaluate the efficacy of combined fascia sheath suspension (CFS) and frontalis muscle flap suspension in the treatment of severe congenital blepharoptosis.Methods:We searched PubMed, EMbase, Cochrane Library, web of science and Chinese Hownet, Wanfang, VIP, CBM and other databases to collect randomized and non-randomized controlled trials comparing the efficacy of CFS and frontalis muscle flap suspension in the treatment of severe congenital ptosis, from the establishment of literature retrieval database to March 2020; two researchers used RevMan 5.3 software to select and exclude the literature, extract the data and evaluate the quality, set up appropriate effect index and conduct Meta-analysis.Results:Eleven studies included 661 patients, There were 312 cases in study group and 349 cases in control group. The results of Meta analysis showed that the OR of the two groups was 4.88 with 95% CI (2.69, 8.85); the OR of failure rate was 0.20, with 95% CI (0.11, 0.37); the OR of complications was 0.22, with 95% CI (0.14, 0.34). All three groups of data were statistically significant ( P<0.05). Conclusions:The available evidence shows that the combined fascia sheath suspension (CFS) is effective in the treatment of severe congenital blepharoptosis compared with frontalis muscle flap suspension, but the complications of CFS are lower and the satisfaction is higher; these findings have yet to be validated by more high-quality studies due to limitations in the quality and quantity of studies included.
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Chronic heart failure （CHF）， the end stage of heart disease due to a variety of causes， features high disability rate and mortality， which has become a hot spot in cardiovascular field. As recorded in Treatise on Cold Damage（《伤寒论》）， Zhenwutang is composed of Radix Aconiti Lateralis Preparata， Poria Cocos， Rhizoma Atractylodis Macrocephalae， Paeoniae Radix Alba， and Rhizoma Zingiberis Recens. With the functions of warming Yang and excreting water， it is a classical prescription for the treatment of CHF in clinical settings. By searching China National Knowledge Infrastructure （CNKI）， PubMed， Wanfang Data， and VIP， we find Zhenwutang exerts therapeutic effect on CHF through multiple targets and multiple pathways. Experiments show that it alleviates CHF by antagonizing the overactivation of neuroendocrine system， inhibiting immune-inflammatory response， suppressing cardiac remodeling， restricting apoptosis， regulating autophagy， improving myocardial energy metabolism， inhibiting oxidative stress injury， protecting endothelial function， and decreasing volume load. Clinical research shows that Zhenwutang can significantly alleviate the clinical symptoms of CHF patients in a safe manner with little adverse reactions. This paper systematically summarizes the mechanisms of and clinical research on Zhenwutang in the treatment of CHF in recent years， so as to provide theoretical and experimental data for the further research and development of Zhenwutang.
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Objective: To evaluate the complications of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach. Methods: A retrospective analysis of complications was conducted on 1, 198 cases of Da Vinci robotic thyroid surgery by bilateral axillo-breast approach of the 960 th Hospital of the People's Liberation Army from February 2014 to March 2020. There were 263 men and 935 women, age ranged from 9 to 68 years old, and included 288 benign lesions and 910 malignancies according to preoperative imaging examination, FNAC, and intraoperative frozen pathology. Results: Surgical complications occurred in 187 (15.61%) patients, including 10 cases of temporary larynx nerve injury (0.83%), 1 case of permanent larynx nerve injury (0.08%), and 152 cases of temporary hypoparathyroidism (12.69%), no permanent hypoparathyroidism, 1 case of hypoglossal injury (0.08%), 2 cases of facial nerve jaw branch damage (0.17%), 2 cases of trachea injury (0.17%), no esophagus damage, 5 cases of celiac leakage (0.42%), 3 cases of neck skin adhesion (0.25%), 2 cases of subdermal bleeding (0.17%), 2 cases of skin burns (0.17%), 5 cases of hematoma (0.42%), 1 case of cephalic artery rupture (0.08%), 1 case of jugular vein rupture (0.08%), no tumor cultivation, no arm plex nerve, accessory nerve or phrenic nerve damage. Conclusion: Da Vinci robot thyroid surgery by bilateral axillo-breast approach is safe, with less severe complications.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Axilla , Breast Neoplasms , Carcinoma, Papillary/surgery , Neck Dissection , Retrospective Studies , Robotic Surgical Procedures , Robotics , Thyroid Neoplasms/surgery , Thyroidectomy/adverse effectsABSTRACT
Three different kinds of sinomenine in situ liquid crystal were prepared for different prescriptions, to investigate the rheological properties before and after in situ treatment and evaluate its feasibility for embolization. Rheological experiments were carried out with cone plate fixtures. Both the steady-state rheological and non-steady-state rheological properties of in-situ gels and the swelling gels were studied and compared. Steady-state rheological study results showed that all the three liquid embolic agents were non-newtonian fluid before and after in situ treatment, which would become less ropy when they were pressed with shear stress; their viscosities differed by 2-5 orders of magnitude. It had a yield value of about 10 Pa before in situ treatment and about 4 500 Pa after in situ treatment. All the six systems had thixotropy while their dynamic viscosities were not influenced by the shear rate, all less than 0.3 Pa·s before in situ treatment more than 1 Pa·s after in situ treatment, differing by an order of magnitude. The results of temperature sweeping showed a slight decrease with a steady rate in viscosity within the range of 10-50 °C, differing by 3-4 orders of magnitude. The results of unsteady rheology showed that there was no obvious linear viscoelastic region in the three kinds of agents, indicating the properties of liquid. After in situ treatment, their linear viscoelastic range γ<1% (No.3 was 5%), and their elastic modulus G' was larger than the viscous modulus G", indicating the properties of solid. Frequency scanning results showed that for the systems at low frequencies, G">G', system viscosity in a dominant position; while at high frequencies, G'>G", system elasticity in a dominant position. The results of compound viscosity test also proved that the liquid embolic agent in situ can form a cubic liquid crystal (the structure of No. 3 was destroyed after in situ treatment). The DHR-2 rheometer was used to investigate the rheological properties of in situ gels with three different prescriptions. The method is simple and the result is reliable, which can provide more theoretical reference for the evaluation and practical application of the product.
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OBJECTIVE: To prepare and characterize sinomenine liquid crystal gel, study the rheological properties and in vitro transdermal properties and compare with sinomenine ointment and sinomenine hydrophilic gel. METHODS: Sinomenine liquid crystal gel was prepared by using phytanetriol-water system and then characterized by polarized light microscope(PLM)and small angle X-ray diffraction(SAXS). Using DHR-2 rheometer, the rheological properties of sinomenine liquid crystal gel were investigated and compared with those of sinomenine ointment and sinomenine hydrophilic gel. Modified Franz diffusion cell was used for in vitro transdermal experiment and the in vitro transdermal properties were compared with sinomenine hydrogels and ointments. RESULTS: The appearance of sinomenine liquid crystal gel was colorless, clear and transparent, and showed dark field under PLM. SAXS showed cubic phase. The rheological parameters were good. The steady-state infiltration rates of sinomenine liquid crystal gel, ointment and hydrophilic gel were 153.93, 119.99, and 106.89 μg·cm-2·h-1, and their 48 h cumulative permeation amounts(%)were 93.76%, 91.55%, and 87.60%, respectively. CONCLUSION: PLM and SAXS can be used to characterize the liquid crystal gel.The prepared sinomenine liquid crystal gel has good appearance and suitable rheology, and its infiltration rate and 48 h cumulative permeation amount are superior to those of ointment and hydrophilic gel, which provides theoretical reference for sinomenine percutaneous administration.
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Objective To develop and design the imagery training program,according with the nature of swimming and taking into ac-count with the mental characteristics and individual needs of the disabled. Methods According to the International Classification of Func-tioning,Disability and Health(ICF),the orientation function of the blind swimming athletes and the orientation function of the body posi-tion and the image training were analyzed theoretically.Imagery training was used as the independent variable,and the specific role of imag-ery training in improving athletic performance is observed in the imagery training intervention of the outstanding blind Olympic swimmer Li.Results and Conclusion Imagery training was an effective method for the blind swimmer to establish the orientation direction and body position function,and it can help the blind swimmer keep a straight line,reduce dependence on touch lane,and improve the performance.
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Objective To discuss effects of three different-intensity exercise on oxidative stress and adiponectin/adiponectin receptor1/2 of the liver in obese rats.Methods Thirty-two Sprague-Dawley rats were fed high-lipid fodder and became the obesity model after 16 weeks.Then they were randomly divided into a high-lipid control group (HF),a low-intensity exercise group (HS),a moderate-intensity exercise group (HM) and an exercise group with progressive intensity (HI),each of 8.Another 8 rats were chosen into a normal control group (NC).The speed of treadmill running of group HS and HM was 10m/min and 15m/min respectively,while that of group HI was10m/min for 20 min,followed by another 20min at and still another 20min at 28～30m/min,five days a week for 6 weeks.Six weeks later,the weight,alanine transaminase (ALT),aspartate transaminase (AST),superoxide dismutase (SOD),malondialdehyde (MDA),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),adiponectin receptors1/2,adiponectin,triglyceride (TG),cholesterol (TC),high-density lipoproteincholesterol (HDL-C),low-density lipoproteincholesterol (LDL-C) and free fatty acid (FFA) were tested.Results Compared with group NC,significant increase was observed in the average weight,TG,TC,LDL-C,FFA,ALT,AST,MDA,TNF-α and IL-6 (P＜0.05 or P＜0.01),while significant decrease was found in the average HDL-C,SOD,adiponectin and adiponectin receptors1/2 of group HF (P＜0.05 or P＜0.01).Compared with group HF,there was significant decrease in the average weight,TG,LDL-C,FFA,ALT,MDA,TNF-α and IL-6 (P＜0.05 or P＜0.01),but significant increase in the average SOD,adiponectin,AR1 and AR2 of group HS,HM and HI (P＜0.05 or P＜0.01),and only HDL-C of group HM increased significantly(P＜0.05).Compared with group HS and HI,significant decrease was found in the average FFA and MDA (P＜0.05),while significant increase was found in the average adiponectin and AR2 of group HM (P＜0.05).Conclusion Aerobic exercise can improve abnormal hepatic lipid metabolism and oxidative stress,strengthen free radical scavenging capacity,prevent liver cell inflammation injury and ameliorate liver metabolism disorder of obese rats induced by high-lipid fodder.Moreover,the effect of moderate-intensity exercise is superior to low-intensity exercise or exercise with progressive intensity,whose mechanism may be related to further activating liver adiponectin receptor 2 through increasing serum adiponectin.