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Objective@#To explore the safety and effectiveness of 3D reconstruction in thoracoscopic posterior basal segmentectomy (S10).@*Methods@#Between March 2018 to September 2018, 14 patients underwent thoracoscopic anatomical resection of the posterior basal segment of the lung (S10).@*Results@#Of the 14 patients, including 5 males and 9 females, age (52.2±5.3)years, size (1.1±0.6)cm, 6 left S10 and 8 right S10. The number of pathological type of microinvasive adenocarcinoma, benign nodule, and metastatic carcinoma was 12, 1, and 1 cases. The average preoperative planning time was (44.9±5.7)min, and the average operation time was (134.8±26.3)min. The blood loss was (25.5±4.1)ml, with (8.1±2.7) lymphadenectomy, no positive metastasis. The coincidence rate of 3D reconstruction and intraoperative anastomosis in the tumor location, B10, A10, and V10 were 100%(14/14), 100%(14/14), 93%(13/14) and 71%(10/14). The median duration of chest tube insertion was (2.3±2.1)day. The incidence of postoperative complications was 21%(3/14), including 7%(1/14) of air leakage, 7%(1/14) of arrhythmia, 14%(2/14) of pulmonary infection, and 14%(2/14) of operation. All the cutting edge was >2 cm. There was no perioperative death, no conversion to thoracotomy or lobectomy. The mean follow-up time was (8.1±2.2)months. There were no recurrence, metastasis or death in the 14 patients. One patient had chronic cough and no hemoptysis.@*Conclusions@#Preoperative 3D reconstruction make the anatomic thoracoscopic posterior basal segmentectomy (S10) safer and more effective.
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BACKGROUND: Type I collagen is a polymer material that has good biocompatibility and good cell affinity, and can degrade under certain conditions. It can also develop good mechanical properties after cross-linking, but it is less reported in the reconstruction of the injured median nerve of the forearm. OBJECTIVE: To explore the preparation method of type I collagen nerve conduit and its mechanism in the reconstruction following median nerve injury in the forearm. METHODS: A total of 40 Sprague-Dawley rats were selected from the Medical Animal Experimental Center, the Affiliated Hospital of Guizhou Medical University, 10 of which were randomly selected as sham surgery group. The remaining 30 rats were used to establish a rat model of median nerve injury in the forearm by laser-induced photochemical reaction. After successful modeling, the model rats were randomly divided into positive control group (n=10), type I collagen group (n=10) and autologous nerve group (n=10). The sham surgery group was routinely fed and did not participate in the modeling; the positive control group did not take special treatment after the successful modeling; the type I collagen group was subjected to bridging with type I collagen nerve conduit; and the autologous nerve group was subjected to bridging with autologous nerve. The repair effects were compared among groups. RESULTS AND CONCLUSION: (1) Under the inverted microscope, the type I collagen was loosely arranged before cross-linking, and it had honeycomb-shaped irregular pores with the pore size of 10-100 μm and the porosity of 20-200 μm, and the pore interstitial was relatively thin. After cross-linking, the type I collagen was densely arranged, the collagen fibers could form relatively regular pores with the pore size of 50-100 μm and the porosity of 20-200 μm, the interstitial mass was thickened, and the spatial structure changed significantly. (2) After 4, 8 and 12 weeks of repair, the scores on the Minnesota Manual Dexterity Test in the type I collagen and autologous nerve groups were significantly lower than those in the positive control group (P < 0.05) and higher than those in the sham surgery group (P < 0.05). (3) At 12 weeks after repair, there was no significant difference in amplitude and latency between the type I collagen group and the autologous nerve group (P> 0.05), but the amplitude and latency in both groups were significantly higher than those in the positive control group (P < 0.05). (4) At 12 weeks after repair, the nerve injury site surrounded by necrotic tissues was visible in the positive control group; no injury was found in the autologous nerve group, and the surrounding necrotic area decreased, indicating good recovery; no injury was shown by toluidine blue staining in the type II collagen group, indicating good recovery. Overall, the type I collagen nerve conduit can be successfully prepared by the self-made mold, and it can be used for the reconstruction following median nerve injury in the rat forearm, helping nerve repair.
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Objective To explore the safety and effectiveness of 3D reconstruction in thoracoscopic posterior basal segmentectomy (S10).Methods Between March 2018 to September 2018,14 patients underwent thoracoscopic anatomical resection of the posterior basal segment of the lung (S10).Results Of the 14 patients,including 5 males and 9 females,age (52.2 ± 5.3) years,size (1.1 ± 0.6) cm,6 left S10 and 8 right S10.The number of pathological type of microinvasive adenocarcinoma,benign nodule,and metastatic carcinoma was 12,1,and 1 cases.The average preoperative planning time was (44.9 ± 5.7) min,and the average operation time was (134.8 ±26.3)min.The blood loss was (25.5 ±4.1)ml,with (8.1 ± 2.7) lymphadenectomy,no positive metastasis.The coincidence rate of 3D reconstruction and intraoperative anastomosis in the tumor location,B10,A10,and V10 were 100％ (14/14),100％ (14/14),93％ (13/14) and 71％ (10/14).The median duration of chest tube insertion was (2.3 ±2.1)day.The incidence of postoperative complications was 21％ (3/14),including 7％ (1/14) of air leakage,7％ (1/14) of arrhythmia,14％ (2/14) of pulmonary infection,and 14％ (2/14) of operation.All the cutting edge was ＞ 2 cm.There was no perioperative death,no conversion to thoracotomy or lobectomy.The mean follow-up time was (8.1 ±2.2)months.There were no recurrence,metastasis or death in the 14 patients.One patient had chronic cough and no hemoptysis.Conclusions Preoperative 3D reconstruction make the anatomic thoracoscopic posterior basal segmentectomy (S10) safer and more effective.
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Objective To compare the differences of bacterial distribution of intestinal flora in Microtus fortis living under laboratory feeding and wild survival conditions. Methods The 16S rDNA-V4-V5 region of bacteria in the ileocecal contents from Microtus fortis raised in lab and captured in wild were measured by high-throughput sequencing. The number of operational taxonomic units(OTUs)were sorted and calculated,and the species abundance and distribution and difference were analyzed. Results The rarefaction curves indicated that adequate sampling was achieved. At the phylum level,the distribution of intestinal flora between two groups was similar. The experimental group had a unique phylum, Lentisphaerae. The wild type group had 3 unique phylums,Fusobacteria,Thaumarchaeota and an unclassified phylum. At the genus level, the kind of intestinal flora in the wild type group was more abundant than the experimental group. Ruminococcus is the largest differential genus. Conclusions The microbial community structure and differences of Microtus fortis living under different conditions are obtained. It may further enrich the basic biology data of Microtus fortis.
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Objective To discuss the relationship between the fracture of the clavicle which was fixed by tor-sional-shaped plate and nonunion after operation.Methods Retrospective analysis was conducted in 426 patients with midshaft clavicle fractures.Among the patients,the A group used torsional-shaped plate to meet the anatomical structure of the clavicle:the medial plate matched under the front face of the clavicle,and the lateral plate matched the up face of the clavicle.And the traditional method was used in the B group.Patients were followed up for at least 12 months,the patients were judged by X-ray criteria for nonunion.Results A total of 28 patients with nonunion, including 4 cases in A group,24 cases in B group.After statistics processing,the difference between A group and B group was significant (χ2 =6.679,P=0.010).Conclusion We find that the treatment of the fracture of the middle part of the clavicle with torsional-shaped plate can effectively reduce the incidence of nonunion.
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Objective To investigate the clinical efficacy of a period of joint fusion and plate internal fixation for four parts calcaneal fractures.Methods The clinical data of 53 patients with four parts calcaneal fractures from January 2009 to January 2013 were analyzed retrospectively.Twenty-two patients were performed a period of joint fusion (joint fusion group),31 patients were performed plate internal fixation (plate internal fixation group).The Bohler angle and Gissane corner before and after operation,operation time and bleeding,the Maryland foot function score between two groups were compared.Results Compared with before operation,the Bohler angle and Gissane corner in plate internal fixation group and joint fusion group were improved significantly after operation (34.6° ± 4.2° vs.5.7° ± 2.4°,125.4° ± 8.2° vs.87.2° ± 6.8°,32.8° ± 3.9° vs.5.4° ± 2.7°,127.6° ± 7.8° vs.86.9° ± 6.7°),and there were significant differences (P ＜0.05),but the Bohler angle and Gissane corner before and after operation between two groups had no significant difference (P ＞ 0.05).The operation time and bleeding were (52.1 ± 5.1) min,(50.0 ± 10.2) ml in plate internal fixation group and (70.3 ± 5.2) min,(105.0 ± 20.5) ml in joint fusion group,and there were significant differences between two groups (P ＜ 0.05).The fineness rate of Maryland foot function at 6 months follow-up between two groups had no significant difference (P ＞ 0.05).Conclusions The plate internal fixation and joint fusion is therapeutic equivalence in treatment of four parts calcaneal fractures.Due to the small surgical trauma and less bleeding of plate internal fixation,it may be preferred in the treatment of four parts calcaneal fractures.
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BACKGROUND:The clinical study on the mechanical properties of biomaterials for cruciate ligament reconstruction is of great importance, which can provide a theoretical basis for the clinical development of materials with good structure, biomechanics and compatibility. OBJECTIVE:To analyze the mechanical properties of vascularized patelar tendon graft. METHODS:The anterior cruciate ligaments of the left foreleg from 42 New Zealand white rabbits were cut off. Then, these rabbits were randomly and evenly divided into two groups: experimental group and control group. Rabbits in the experimental group were implanted vascularized patelar tendon graft for anterior cruciate ligament repair. Rabbits in the control group were implanted with autologous non-vascularized patelar tendon graft for anterior cruciate ligament repair. At the 8th, 12th and 16th weeks after implantation, biomechanical properties of specimens from these two groups were detected. RESULTS AND CONCLUSION: There was no significant difference on the fracture location at different time points between these two groups; at the 12th and 16th weeks after transplantation, the knee laxity in the experimental group was higher than that in the control group (P < 0.05). At the 8th week after transplantation, there was no significant difference in the knee laxity between these two groups. At the 8th, 12thand 16th weeks after transplantation, the maximum load in the experimental group was higher than that in the control group (P < 0.05). At the 8th, 12th and 16th weeks after transplantation, the stiffness in the experimental group was higher than that in the control group (P < 0.05). There was no significant difference in the maximum tensile elongation between these two groups at different time points after transplantation. These results demonstrate that vascularized patelar tendon graft has good mechanical properties.
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BACKGROUND:Microfracture technique and osteochondral transplantation are one of the methods for the treatment of articular cartilage defects with broad application prospects. OBJECTIVE:To investigate the effect of microfracture technique and autologous and al ogeneic osteochondral transplantation in the treatment of knee osteoarthritis complicated with articular cartilage defects. METHODS:The articular cartilage defects were treated with arthroscopic debridement combined with microfracture surgery in the cartilage defect region, and then the clinical effect, clinical symptoms and Tenger sport score were detected. The patients were fol owed-up for 3-24 months. The articular cartilage defects patients treated with autologous osteochondral transplantation were fol owed-up. The effect of autologous osteochondral transplantation was evaluated through assessing the range of motion after transplantation, improvement of clinical symptoms and joint imaging examination. The animal experiment of al ogeneic osteochondral transplantation for the treatment of articular cartilage defects was conducted to evaluate the effect of al ogeneic osteochondral transplantation through general observation of transplantation site, histological and immunohistochemical staining. RESULTS AND CONCLUSION:For the patients treated with arthroscopic microfracture technique, the total efficiency of joint debridement combined with microfracture surgery in the cartilage defect region was 89.7%. For the articular cartilage defects patients treated with autologous osteochondral transplantation, the symptoms of joint pain and swel ing were improved, and the range of motion was normal with rest pain and slight pain after movement occasional y. Radiographic examination showed the transplanted osteochondral was in good position with good healing. In the experiment animals with articular cartilage defects after treated with al ogeneic osteochondral transplantation, the range of motion was normal, transplanted articular surface was finishing, the articular cartilage was covered with hyaline cartilage, and the cells were arranged in order;there was cartilage matrix secretion, and the col agen type II in the repaired articular cartilage was strongly positive with immunohistochemical staining.