Impact of sinonasal anatomic changes after endoscopic anterior skull base surgery on nasal airflow and air conditioning: a computational fluid dynamics study / 中华耳鼻咽喉头颈外科杂志

Objective: To analyze the impact of the sinonasal anatomic changes after endonasal endoscopic anterior skull base surgery on the nasal airflow and heating and humidification by computational fluid dynamics (CFD), and to explore the correlation between the postoperative CFD parameters and the subjective symptoms of the patients. Methods: The clinical data in the Rhinology Department of the First Affiliated Hospital of Zhengzhou University from 2016 to 2021 were retrospectively analyzed. The patients received the endoscopic resection of the anterior skull base tumor were selected as the case group, and the adults whose CT scans had no sinonasal abnormalities were chosen as the control group. The CFD simulation was performed on the sinonasal models after reconstructed from the patients' sinus CT images during the post-surgical follow-up. All the patients were asked to complete the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) to assess the subjective symptoms. The comparison between two independent groups and the correlation analysis were carried out by using the Mann-Whitney U test and the Spearman correlation test in the SPSS 26.0 software. Results: Nineteen patients (including 8 males and 11 females, from 22 to 67 years old) in the case group and 2 patients (a male of 38 years old and a female of 45 years old) in the control group were enrolled in this study. After the anterior skull base surgery, the high-speed airflow moved to the upper part of the nasal cavity, and the lowest temperature shifted upwards on the choana. Comparing with the control group, the ratio of nasal mucosal surface area to nasal ventilation volume in the case group decreased [0.41 (0.40, 0.41) mm-1 vs 0.32 (0.30, 0.38) mm-1; Z=-2.04, P=0.041], the air flow in the upper and middle part of the nasal cavity increased [61.14 (59.78, 62.51)% vs 78.07 (76.22, 94.43)%; Z=-2.28, P=0.023], the nasal resistance decreased [0.024 (0.022, 0.026) Pa·s/ml vs 0.016 (0.009, 0.018) Pa·s/ml; Z=-2.29, P=0.022], the lowest temperature in the middle of the nasal cavity decreased [28.29 (27.23, 29.35)℃ vs 25.06 (24.07, 25.50)℃; Z=-2.28, P=0.023], the nasal heating efficiency decreased [98.74 (97.95, 99.52)% vs 82.16 (80.24, 86.91)%; Z=-2.28, P=0.023], the lowest relative humidity decreased [(79.62 (76.55, 82.69)% vs 73.28 (71.27, 75.05)%; Z=-2.28, P=0.023], and the nasal humidification efficiency decreased [99.50 (97.69, 101.30)% vs 86.09 (79.33, 87.16)%; Z=-2.28, P=0.023]. The ENS6Q total scores of all patients in the case group were less than 11 points. There was a moderate negative correlation between the proportion of the inferior airflow in the post-surgical nasal cavity negatively and the ENS6Q total scores (rs=-0.50, P=0.029). Conclusions: The sinonasal anatomic changes after the endoscopic anterior skull base surgery alter the nasal airflow patterns, reducing the efficiency of nasal heating and humidification. However, the post-surgical occurrence tendency of the empty nose syndrome is weak.

Effect of 3D printing technology on pelvic fractures:a Meta-analysis / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the effect of 3D printing technology applied in the surgical treatment of pelvic fractures through the published literatures by Meta-analysis.</p><p><b>METHODS</b>The PubMed database, EMCC database, CBM database, CNKI database, VIP database and Wanfang database were searched from the date of database foundation to August 2017 to collect the controlled clinical trials in wich 3D printing technology was applied in preoperative planning of pelvic fracture surgery. The retrieved literatures were screened according to predefined inclusion and exclusion criteria, and quality evaluation were performed. Then, the available data were extracted and analyzed with the RevMan5.3 software.</p><p><b>RESULTS</b>Totally 9 controlled clinical trials including 638 cases were chosen. Among them, 279 cases were assigned to the 3D printing technology group and 359 cases to the conventional group. The Meta-analysis results showed that the operative time[SMD=-2.81, 95%CI(-3.76, -1.85)], intraoperative blood loss[SMD=-3.28, 95%CI(-4.72, -1.85)] and the rate of complication [OR=0.47, 95%CI(0.25, 0.87)] in the 3D printing technology were all lower than those in the conventional group;the excellent and good rate of pelvic fracture reduction[OR=2.09, 95%CI(1.32, 3.30)] and postoperative pelvic functional restoration [OR=1.94, 95%CI(1.15, 3.28) in the 3D printing technology were all superior to those in the conventional group.</p><p><b>CONCLUSIONS</b>3D printing technology applied in the surgical treatment of pelvic fractures has the advantage of shorter operative time, less intraoperative blood loss and lower rate of complication, and can improve the quality of pelvic fracture reduction and the recovery of postoperative pelvic function.</p>

An UHPLC-MS/MS method for simultaneous determination of quercetin 3-O-rutinoside, kaempferol 3-O-rutinoside, isorhamnetin 3-O-rutinoside, bilobalide and ligustrazine in rat plasma, and its application to pharmacokinetic study of Xingxiong injection / 中国天然药物

The present study was designed to develop and validate a rapid, sensitive, and reliable ultra-high performance liquid chromatography coupled with tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous determination of five major active constituents in the traditional Chinese medicinal preparation Xingxiong injection (XXI) in rat plasma, including quercetin 3-O-rutinoside (QCR), kaempferol 3-O-rutinoside (KFR), isorhamnetin 3-O-rutinoside (ISR), bilobalide (BB), and ligustrazine (LGT). The plasma samples were pretreated by protein precipitation with acetonitrile. The chromatographic separation was achieved on a Waters Symmetry C analytical column (2.1 mm × 100 mm, 3.5 μm) with a mobile phase of 0.1% aqueous formic acid (A)-acetonitrile (B). Quantitation of the five bioactive constituents was achieved. Naringin was used as the internal standard (IS). All the calibration curves showed good linearity (r > 0.996) over the concentration range, with the lowest limit of quantification (LLOQ) between 2-18 ng·mL. The intra- and inter-day accuracy and precision of the analytes were both within acceptable limits. Moreover, satisfactory extraction recoveries (90.92%-104.03%) were obtained by protein precipitation. The validated method was successfully applied to a pharmacokinetic study of XXI in rats after intravenous administration at three doses. The pharmacokinetic parameters of the five compounds varied in a dose-dependent manner within the tested dosage range. The present study was the first report of pharmacokinetic study for XXI.

Protection of the proximal colon segment during laparoscopic proctosigmoidectomy / 中华胃肠外科杂志

To evaluate the protection of proximal colon segment by analyzing blood supply disorder of proximal colon segment during laparoscopic proctosigmoidectomy(11 cases) in the Chaoyang Hospital of Capital Medical University. It is concluded that the disorder of blood supply of proximal colon segment during laparoscopic proctosigmoid surgery has two reasons. One is the anatomic factor of mesenteric vessels; the other is the inappropriate operative procedure. It is recommended that left colonic artery should be retained, and inferior mesenteric artery should be handled at a low level, thus, the risk of proximal intestine blood supply disorder caused by vascular anatomy variation can be reduced.

Efficacy and safety of intravenous levosimendan compared with dobutamine in decompensated heart failure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To compare the efficacy and safety of intravenous levosimendan and dobutamine in patients with decompensated heart failure refractory to conventional medications.</p><p><b>METHODS</b>Patients were recruited into this multicentre, randomised, positive-controlled and parallel-group study to receive either levosimendan or dobutamine therapy. In the levosimendan group, an initial loading dose of levosimendan of 12 microg x kg was infused over 10 min, followed by a continuous infusion of 0.1 microg x kg(-1) x min(-1) for 1 h and then 0.2 microg x kg(-1) x min(-1) for 23 h. In the control group, dobutamine was infused for 1 h at an initial dose of 2 microg x kg(-1) x min(-1) without a loading dose, followed by a continuous infusion of 4 microg x kg(-1) x min(-1) for 23 h. Hemodynamic responses at 24 h were evaluated by echocardiography (in both groups) and Swan-Gans catheter (in the levosimendan group). Clinical assessment was performed to evaluate efficacy and safety of the medications.</p><p><b>RESULTS</b>A total of 225 patients from 12 medical centers were evaluated; 119 assigned to levosimendan and 106 assigned to dobutamine group. The effectiveness rate was 31.9% (38 patients) in the levosimendan group and 17.9% (19 patients) in the dobutamine group (P < 0.01). At 24 h, left ventricular ejection fraction (LVEF) was improved by 6. 4% in the levosimendan group, compared with 4.6% in the dobutamine group (P > 0.05). Stroke volume (SV) was increased by 11.1 ml in the levosimendan group and 2.8 ml in the dobutamine group respectively (P < 0.05). Dyspnea and clinical manifestations improvements were more significant in levosimendan therapy group compared to dobutamine group. There were less adverse effects including hypokalemia, hypotension and ventricular premature beats in the levosimendan group than in the dobutamine group (P < 0.05).</p><p><b>CONCLUSION</b>Levosimendan was well tolerated and superior to dobutamine for patients with decompensated heart failure refractory to conventional medications.</p>

Inguinal hernia repair with tension-free hernioplasty under local anesthesia

To evaluate the use of local anesthesia in tension-free hernioplasty in a local hospital. The study took place at Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China during the period from January 2007 to May 2008. All 110 patients who had undergone inguinal hernia repair with mesh under local anesthesia were included in the study. To increase the homogeneity of the sample, we excluded umbilical hernia repairs, parastomal hernia repairs, non-elective procedures, procedures not involving mesh, and repairs performed concurrently with another surgical procedure. We performed a retrospective review of all 110 patients' data. The average operating time was 45 minutes [30-70 minutes], and the average hospital stay was 3-4 days. There was no postoperative mortality in this study. No surgical site infection occurred. Two patients [18%] that suffered from a moderate scrotal hematoma had recovered after extract injection therapy was applied. The duration of incisional pain was 2-3 days, and no patient required post-operative analgesia. During the follow-up, no recurrence occurred. The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment