ABSTRACT
Objective:To observe the effects of ultrasound intermediate frequency acupoint targeted drug guiding technology on the recovery of gastrointestinal function and serum gastrin levels in elderly patients after lumbar spine surgery under general anesthesia.Methods:This study used prospective research methods.A total of 90 elderly patients undergoing lumbar spine surgery after general anesthesia in the orthopaedic ward of Beijing Geriatrics Hospital from June 2019 to June 2021 were randomly divided into blank control group, drug control group, and drug-guided treatment group, with 30 cases each group. After the operation, no intervention was given to the blank control group, the drug control group received oral mosapride citrate tablets, the drug-guided treatment group used the D patch to guide the medicine at the two acupoints of Zusanli and Zhongwan with ultrasound medium frequency guided medicine instrument for 1 week each. The serum gastrin levels of the patients in each group were detected 1 d before operation, 3 d after operation, and 1 week after operation, and the time of first exhaust and first defecation after operation were recorded.Results:The results showed that the level of serum gastrin preoperativein the three groups was not significantly different ( P>0.05). On the third day after operation, the levelof serum gastrin in the drug guide treatment group, drug control group and blank control group were lower than those at 1 d before operation: (66.51 ± 5.34) ng/L vs. (69.36 ± 6.50) ng/L, (58.34 ± 5.71) ng/L vs. (68.75 ± 5.13) ng/L, (55.76 ± 6.23) ng/L vs. (70.20 ± 6.71) ng/L, the differences were statistically significant ( P<0.05), and showed a decreasing trend in turn. Among them, the level of serum gastrin in the drug guide treatment group was higher than that in the drug control group and blank control group, the difference was statistically significant ( P<0.05). One week after operation, the level of serum gastrin in the three groups increased compared with the third day after operation ( P<0.05), and the drug guiding treatment group was higher than the drug control group and the blank control group: (72.38 ± 6.78) ng/L vs. (67.15 ± 6.27) ng/L, (63.52 ± 5.38) ng/L, the differences were statistically significant ( P<0.05). The time of first exhaust and defecation after the operation of the three groups of patients, the drug-guided treatment group was significantly shorter than the drug control group and the blank control group: (15.25 ± 3.10) h vs. (20.38 ± 4.21) h and (28.52 ± 3.69) h, (24.14 ± 3.53) h vs. (36.15 ± 3.54) h and (49.51 ± 4.37) h, the differences were statistically significant ( P<0.05). Conclusions:Ultrasound intermediate frequency acupoint drug guiding technology can increase the patient′s serum gastrin level and promote the recovery of gastrointestinal function in elderly patients with lumbar spine surgery after general anesthesia.
ABSTRACT
【Objective】 To explore the correlation between CSAG1 expression and the prognosis and tumor-infiltrating lymphocytes in renal clear cell carcinoma (RCCC), and to predict the survival and tumor progression. 【Methods】 The gene expression profiles and clinical information of CSAG1 were downloaded from the Cancer Genome Atlas (TCGA). Based on the differential mRNA expression, GO annotation and KEGG pathway analysis were performed. The relationship between CSAG1 and tumor immune infiltration was assessed with Tumor Immunoassay Resource (Timer 2.0) database. The mRNA expression of CSAG1 in human RCCC specimens was validated with qRT-PCR. 【Results】 CSAG1 expression was significantly higher in RCCC tissues than in normal tissues (P<0.05). The qRT-PCR results revealed that the mRNA level of CSAG1 was consistent with that predicted by bioinformatic analysis. The KEGG analysis and GO annotation indicated high GSAG1 expression in RCCC was related to transmembrane transport, tricarboxylic acid cycle and lysosome. CSAG1 expression was positively related to the infiltration of pDC, aDC, CD8+ T cells, cytotoxic cells, TFH, TH1 cells, Tem, NK CD56dm cells, Treg and T cells, but negatively correlated with macrophage infiltration. 【Conclusion】 CSAG1 may be associated with poor prognosis of RCCC and become a potential immunotherapy target.
ABSTRACT
【Objective】 To investigate the efficacy and safety of single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy in the treatment of upper tract urothelial carcinoma (UTUC). 【Methods】 Clinical data of 31 UTUC cases treated in our hospital during Nov.2018 and Jun.2022 were retrospectively analyzed, including 11 tumors in the right side, and 20 in left side. There were 14 cases of renal pelvic carcinoma, 16 cases of ureter carcinoma, and 1 case of renal pelvic carcinoma plus ureter carcinoma. 【Results】 All surgeries were successfully performed without conversion to open surgery. The mean operation time was (81.45±19.80) min, and the estimated blood loss was (69.03±24.13) mL. No serious perioperative complications were observed. The average postoperative hospital stay was (6.13±2.44) d, and the median follow-up was 28 (3.0-49.0) months. At the last follow-up, 2 patients died, 3 had recurrence, but no contralateral recurrence was observed. 【Conclusion】 Single position transabdominal and extraperitoneal laparoscopic radical nephroureterectomy is safe, effective and feasible in the treatment of UTUC. It is worth clinical popularization.
ABSTRACT
【Objective】 To explore the safety and efficacy of a modified one-piece posterior laparoscopic total nephroureterectomy with cystic sleeve resection in the treatment of upper urinary tract uroepithelial carcinoma (UTUC). 【Methods】 A total of 24 patients treated during Jan. and Jun. 2022 were involved, including 16 males and 8 females, aged 62 to 90 (average 73) years. The UTUC was in the left side in 15 cases, and in the right side in 9 cases. There were 10 cases of renal pelvis tumor, 6 cases of upper ureteral tumor and 8 cases of lower ureteral tumor. 【Results】 All operations were successful without conversion to open surgery. The operation time ranged from 60 to 100 minutes, average (71.25±9.80) minutes. The intraoperative bleeding volume was 20 to 200 mL, average (30.03±8.13) mL. No significant intraoperative or postoperative complications occurred. The postoperative hospital stay was 4 to 7 days, average (5.83±1.44) days. Bladder perfusion chemotherapy was performed after surgery. 【Conclusion】 The modified one-piece posterior laparoscopic total nephroureterectomy plus cystic sleeve resection for UTUC is an effective and feasible procedure with satisfactory tumor control, which is worth further promotion in clinical practice.
ABSTRACT
ObjectiveTo explore the characteristics of balance and cortical activation in older adults when performing cognition-balance dual tasks. MethodsFrom January to April, 2023, 20 healthy older adults were non-targeted recruited. They completed six tasks of close eyes & fixed platform (CF), close eyes & fixed platform & cognitive task (CFc), open eyes & sway-referenced platform (OS), open eyes & sway-referenced platform & cognitive task (OSc), close eyes & sway-referenced platform (CS), and close eyes & sway-referenced platform & cognitive task (CSc) on the Balance SD, wearing functional near-infrared spectroscopy caps. The overal stability index (OSI) was measured with Balance SD. The premotor cortex (PMC), sensorimotor cortex (SMC) and prefrontal cortex (PFC) were as regions of interest (ROIs), and the β values were calculated. ResultsThe OSI was more as CFc than as CF (Z = -2.014, P < 0.05), and was less as CSc than as CS (Z = -2.063, P < 0.05). The β values of bilateral ROIs were all more as CFc than as CF (|Z| > 2.464, |t| > 3.733, P < 0.05), and as OSc than as OS (|t| > 2.308, P < 0.05); the β value of the right SMC was more as CSc than as CS (t = -2.912, P < 0.05). The number of correct counts was less as CSc than as CFc and OSc (|Z| > 3.643, P < 0.001). ConclusionBalance has been impaired under dual tasks for older adults, while activation of cerebral cortex increases. However, for more difficult balance task, older adults would preferentially maintain postural balance under dual tasks, while cognitive performance decreases, which may be the results from no more activation of cerebral cortex under dual tasks.
ABSTRACT
Objective To observe the efficacy and difference of dispersion of osteoporotic vertebral fractures with high-viscosity cement in the treatment of vertebral compression fractures with different degrees of osteoporosis.Methods From October 2013 to October 2016,a total of 65 patients with clinically diagnosed thoracolumbar osteoporotic fractures in Beijing Geriatrics Hospital were selected,and they were divided into three groups according to Genant semiquantitative method:24cases of] degree group (vertebral compression ≤ 25％),23cases of Ⅱ degree group(vertebral compression of ＞ 25％-40％),18 cases of Ⅲ degree group(vertebral compression ＞ 40％).All patients underwent vertebroplasty and received high viscosity bone cement.CT scan was performed after operation,then the volume of vertebral bone cement dispersion and diffusion coefficient were calculated,the differences among different groups were compared.The visual analogue scale(VAS) of all patients were recorded before operation,1 day after operation and 6 months after operation.The differences of preoperative and postoperative VAS scores were compared to evaluate the therapeutic effect of high viscosity cement on PVP.Results There were no statistically significant differences among the three groups in the time of single vertebral body operation and the amount of cement injected(all P ＞0.05).However,the volume and the diffusion coefficient of the cement in the Ⅲ degree group [(8.25 ± 1.38)mL and (2.15 ± 0.21)] were significantly different from those in the Ⅱ degree group[(9.32 ±1.85) mL and (2.42 ± 0.27)] (t =2.43,3.51,all P ＜ 0.05) and the Ⅰ degree group [(9.38 ± 1.92) mL and (2.44 ± 0.23)] (t =2.12,2.29,all P ＜ 0.05).There were no statistically significant differences in the volume and the dispersion coefficient of cement between the Ⅰ degree group and Ⅱ degree group(t =0.11,0.29,all P ＞0.05).The postoperative VAS score decreased significantly,and the differences were statistically significant among preoperation,postoperative 1 day and postoperative 6 months (t =28.21,27.01,all P ＜ 0.01).Conclusion The VAS score of patients with OVCF decreases significantly after PVP treatment with high viscosity cement.The pain symptoms of patients with OVCF are significantly relieved in both short-term and long-term,and PVP with high viscosity cement has a very low incidence rate of bone cement leakage.The different degree of preoperative vertebral compression doesn't affect the amount of bone cement injection and operation time,but partly impact the dispersion of high viscosity cement,shown as the dispersion volume and diffusion coefficient of bone cement can decline with the increase of the degree of vertebral compression,especially for heavily compressed vertebral fractures,the dispersion of bone cement is clearly diminished.
ABSTRACT
Objective To evaluate the application of 3D printing technology in the treatment of displaced acetabular fractures ( DAF ) complicated with unstable injury to the posterior pelvic ring. Meth-ods A retrospective study was conducted of all the 19 DAF patients complicated with unstable posterior pelvic ring who had been treated from August 2009 to June 2015 in our hospital. They were 12 men and 7 women, aged from 24 to 62 years ( average, 39. 8 years ) . Twelve DAFs were complicated with ipsilateral unstable injury to the posterior pelvic ring, 5 with contralateral unstable injury to the posterior pelvic ring, and 2 with bilateral unstable injury to the posterior pelvic ring. Preoperatively, 3D digital models of the pelvis were reconstructed for the 19 patients using their CT scanning data. Their pelvic models were printed using 3 D printing technology for visual evaluation of their fractures and design of individualized surgical proce-dures. Results With the help of their 3D printing models, the 19 patients obtained successful operations within a mean time of 3. 2 hours. Their intraoperative blood loss averaged 658. 5 mL. They were followed up for an average of 10. 7 months ( range, from 8 to 24 months ) . According to Matta′s criteria for pelvic reduc-tion, 14 cases achieved anatomical reduction, 2 satisfactory reduction and 3 unsatisfactory reduction. Ac-cording to Mears's criteria for reduction of the posterior pelvic ring, 13 cases achieved anatomical reduction, 4 satisfactory reduction and 2 unsatisfactory reduction. The 19 acetabular fractures healed after 9 to 18 weeks ( average, 14. 5 weeks ) . The pelvic fractures healed after 8 to 17 weeks ( average, 13. 5 weeks ) . According to the Merle d'Aubigne-Postel criteria at the last follow-ups, the hip functions were excellent in 7, good in 9, fair in one, and poor in 2 cases. According to the Majeed's functional evaluation, the pelvic functions were excellent in 10 cases, good in 7, fair in one, and poor in one. Complications were incision infection in one, heterotopic ossi-fication in 2, avascular necrosis of the femoral head in one and traumatic arthritis in one. Conclusion In thetreatment of DAF complicated with unstable injury to the posterior pelvic ring, application of 3D printing technology can provide direct visualization of the pelvic and acetabular fractures which facilitate preoperative evaluation and design of individualized surgical protocols, leading to fine outcomes.
ABSTRACT
Objective To explore the efficacy of bismuth containing quadruple therapy in the treatment of peptic ulcer in patients with Helicobacter pylori.Methods We selected 307 peptic ulcer patients with Helicobacter pylori.infection,and randomly divided them into observation group (152 cases)and control group (155 cases).The observation group received quadruple therapy:colloidal bismuth pectin,pantoprazole,amoxicillin and furazolidone, 14d.The control group received the standard triple therapy:pantoprazole,clarithromycin and amoxicillin,14d.The ulcer healing rate,H.pylori eradication rate and adverse reaction were compared between the two groups.Results The ulcer healing rates,remission rates,H.pylori eradication rates in the observation group were 93.5%,92.7%, 94.8%,92.3% respectively,which in the control group were 83.4%,82.7%,84.1%,80.6% respectively,there were statistically significant differences (χ2 =4.15,4.9,6,0.94,all P 0.05).Conclusion Bismuth containing quadruple therapy is associated with a higher rate of H.pylori eradication compared with the standard triple therapy.
ABSTRACT
AIM: To investigate the effect of indomethacin on prevention of heterotopic ossification (HO) after operative treatment of total hip replacement. METHODS: Forty patients taking indomethacin after total hip replacement were enrolled at First Hospital Affiliated to Zhengzhou University from February 2003 to February 2005 as medication group. Forty patients received the same operation were enrolled from February 1996 to February 1999 as control group. The patients in the medication group were taken indomethacin from the first day after operation, 50 mg/times, twice a day, for 3 weeks. The patients were successfully followed up immediately before the end of the operation, at weeks 3, 12, months 3, 6 and 12 after operation. Follow-up included X-ray at normal position of double hips, oblique position of obturator foramen and oblique position of iliac bone to assess the incidence of HO. Hip joint function was assessed according to modified d'Aubigne and Postel standards. RESULTS: Follow-up was performed in 40 patients of the medication group. The follow-ups averaged 21.2 months (ranged from 6 to 37 months). HO occurred in six cases. According to Brooker evaluation of HO, four cases were rated as degree Ⅰ, two as degree Ⅱ, and none as degree Ⅲ or Ⅳ. The incidence of HO was 15%. In the control group, totally 40 patients were followed up, averagely 27.1 months ranged from 5-60 months. The incidence of HO was 40% (16/40). Five patients developed severe HO. Significant differences were found in the incidence of HO and severe HO of the two groups (P