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1.
Article in Chinese | WPRIM | ID: wpr-883551

ABSTRACT

Objective:To explore the application and effect of team-based learning (TBL) combined with flipped classroom in the teaching of physiology.Methods:A total of 70 medical students were selected and randomly divided into two groups, experimental group ( n=34) and control group ( n=36). Both groups studied digestion physiology by different method. In the experimental group, the students were taught by TBL combined with flipped classroom. The control group was given traditional teaching. The students studied and discussed problems in a team, and shared the answers in the flipped classroom. The effects of teaching were evaluated by the final test scores and the self-made questionnaire. SPSS 17.0 was used for t test on data comparison between the two groups. Results:The test scores of digestion physiology in the experimental group were (5.47±1.02) points, which were significantly higher than those of the control group (4.42±1.63) points, with significant differences ( P=0.020). A total of 34 questionnaires were issued and 34 valid questionnaires were collected, with an effective rate of 100%. The questionnaire results showed that TBL combined with flipped classroom was accepted and approved by about 82% of students in the experimental group who agreed that the teaching model helps enhance students' initiative and interest in learning, develop their sense of cooperation and comprehensive application ability. Conclusion:TBL combined with flipped classroom is feasible and effective in the physiological teaching, and it can be popularized in medical courses.

2.
Chinese Journal of Orthopaedics ; (12): 1735-1743, 2021.
Article in Chinese | WPRIM | ID: wpr-910767

ABSTRACT

Objective:To compare the efficacy of fusion and non-fusion hybrid operation with Dynesys system with the traditional fusion operation with rigid instrumentation in the patients with multi-segment lumbar degenerative disease.Methods:A total of 30 patients with multi-segment lumbar degenerative disease who were subjected to operation from January 2017 to October 2019 in Shenzhen People's Hospital were included in the study. There were 13 males and 17 females, age: 60.8±13.2 years, range: 25 to 83 years. 28 patients with two segments, 1 with three segments, and 1 with four segments. The patients were divided into two groups, i.e the hybrid operation group (13 cases, 9 males and 4 females, average age: 56.6 years, range: 25 to 83 years) versus the traditional fusion group (17 cases, 4 males and 13 females, average age: 63.9 years, range: 46 to 80 years). The main outcome measures were visual analogue scale (VAS), Oswestry disability index (ODI), range of motion (ROM), adjacent segment degeneration (ASD) and complications.Results:There were no statistically significant differences in operation data, such as operation time, intraoperative blood loss, postoperative drainage volume and length of hospitalization, between the two groups. There were no significant differences for ROM in the surgical segments between the two groups before operation (hybrid group and traditional group were 9.6°±4.9° vs. 8.9°±6.1°, t=0.341, P=0.736, respectively). However, after 12 months follow-up, the ROM disappeared in the traditional group and was partially preserved in the hybrid group, with statistically significant differences (hybrid group and traditional group were 5.4°±2.7° vs. 0°, t=9.104, P=0.001, respectively). There was a statistical difference in intervertebral disc height between the two groups at 12 months post-operation, though no statistical difference was found before operation (8.8±1.9 mm vs. 10.5±1.7 mm, t=2.927, P=0.006). There was no statistically significant difference in the intervertebral disc height of the upper adjacent vertebrae between the two groups before and after operation. There were statistically significant differences in ODI scores before operation (63.4%±11.0% vs. 71.3%±9.2%, t=2.146, P=0.041), and 12 months post-operation (17.2%±2.1% vs. 15.5%±2.3%, t=2.091, P=0.046), while no statistical difference was found in VAS scores. Conclusion:The fusion and non-fusion hybrid operation with Dynesys system has comparable clinical efficacy with the traditional fusion operation with rigid instrumentation in the treatment of multisegment lumbar degenerative disease. Meanwhile, the hybrid surgery can preserve the motion of surgical segments and provide a dynamic stability of the vertebral body. The hybrid surgery can be used as a new surgical method for multi-segment lumbar degenerative disease.

3.
Article in Chinese | WPRIM | ID: wpr-907744

ABSTRACT

Objective:To investigate the predicting value of high sensitivity C-reactive protein (hs-CRP) and albumin (Alb) ratio on prognosis of patients with in-hospital cardiac arrest (IHCA).Methods:A total of 107 patients with IHCA and spontaneous circulation recovery (ROSC) after cardiopulmonary resuscitation (CPR) in the Affiliated Hospital of Xuzhou Medical University during January 1, 2017 and September 30, 2020 were selected as the subjects and divided into the survival group and death group according to the survival condition on day 14 after IHCA. The correlation between ratio of high sensitivity C-reactive protein/albumin (hs-CRP/Alb) and the prognosis of patients was analyzed.Results:No statistical significant differences were found between the survival and death groups in sex, age, medical history, ECG monitoring, recovery ventilation mode, percentage of first monitoring of heart rate and pre-resuscitation Alb (all P > 0.05). However, there were significant differences in the percentage of non-cardiogenic CA and adrenaline dose > 5 mg, time of CPR, concentrations of blood lactic acid, Alb, hs-CRP, and ratio of hs-CRP/Alb (all P < 0.05). Logistic regression analysis showed that percentage of adrenaline dose > 5 mg, concentration of blood lactic acid, time of CPR, and ratio of hs-CRP/Alb were independent risk factors for predicting death. ROC curve analysis showed that hs-CRP/Alb ratio, and concentration of hs-CRP and Alb had predictive value on the death of patients with IHCA; the areas under the curves of hs-CRP/Alb ratio, hs-CRP and Alb concentration were 0.876, 0.864 and 0.745, respectively. The predictive efficiency of hs-CRP/Alb ratio was better than that of hs-CRP concentration or Alb concentration. Conclusions:hs-CRP/Alb ratio has predictive value for the prognosis of patients with IHCA and the predictive value is superior to that of hs-CRP and Alb concentration.

4.
Article in English | WPRIM | ID: wpr-922601

ABSTRACT

OBJECTIVES@#High fat-induced podocyte injury is one of the important factors leading to obesity related nephropathy (ORG), but the mechanism is not clear. This study aims to explore the mechanism of period circadian clock 3 (PER3) in the oxidative stress and inflammation induced by palmitic acid (PA) in podocytes.@*METHODS@#The C57BL/6J mice were fed with chow and high-fat diet for 16 weeks. The PER3 expression in kidney tissues were detected in the normal body weight group and the obesity group. The PER3 mRNA and protein expression were detected after the podocytes were induced with different concentrations (0, 50, 150 and 300 μmol/L) of PA for 48 h. The PER3 mRNA and protein expression were detected after the podocytes were induced with 150 μmol/L PA for 0, 24, 36, and 48 h. Triglyceride (TG) levels were examined in the PA group, the adenovirus (ad)-PER3+PA group, and the siRNA-PER+PA group after the podocytes were transfected by Ad-PER3 or small interfering RNA (siRNA)-PER3 for 48 h and subsequently were induced with 150 μmol/L PA for 48 h. The differential gene expression was detected using RNA sequencing (RNA-seq) after podocytes were transfected by siRNA-PER3 (siRNA-PER3 group) and siRNA-control (siRNA-control group), respectively. The mRNA levels of nephrin, podocin, podocalyxin, podoplanin, superoxide dismutase 1 (SOD1), glutathione peroxidase 1 (GPX1), catalase (CAT), and the levels of malondialdehyde (MDA), glutathione (GSH), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and interleukin-2 (IL-2) were detected after podocytes were transfected with Ad-PER3 or Ad-control for 48 h and then they were induced by 150 μmol/L PA for 48 h.@*RESULTS@#The PER3 was down-regulated in the obesity group compared with the normal body weight group (@*CONCLUSIONS@#PER3 can decrease the PA-induced oxidative stress and inflammatory factor secretion via inhibiting the lipogenesis in podocytes.


Subject(s)
Animals , Circadian Clocks , Mice , Mice, Inbred C57BL , Oxidative Stress , Palmitic Acid/toxicity , Podocytes/metabolism
5.
Article in English | WPRIM | ID: wpr-887747

ABSTRACT

Malocclusion is one of the three most common oral diseases reported by World Health Organization(WHO). In China, its incidence rate is rising. Malocclusion seriously affects the dental and maxillofacial function, facial appearance and growth development of nearly 260 million children in China, and what is more, it affects their physical and mental health development. Malocclusion occurrence is related to genetic and environmental factors. Early treatment of malocclusion can create a good dental and maxillofacial development environment, correct abnormal growth and control the adverse effects of abnormal genetic factors. It can effectively reduce the prevalence of children's malocclusion and enhance their physical and mental health. This is an urgent need from the economic perspective of our society, so it has great practical and social significance. Experts from the project group "standard diagnose and treatment protocols for early orthodontic intervention of malocclusions of children" which initiated by China National Health Institute of Hospital Administration wrote the "China Experts' Consensus on Preventive and Interceptive Orthodontic Treatments of Malocclusions of Children", which aims to guide and popularize the clinical practice, improve the clinical theory and practice level, and accelerate the disciplinary development of early treatment of children's malocclusion in China. The consensus elaborates the harmfulness of malocclusion and the necessity of early treatment, and brings up the principles and fundamental contents. Based on the law of dental and maxillofacial development, this paper puts forward the guiding suggestions of preventive and interceptive treatments in different stages of dental development ranging from fetus to early permanent dentition. It is a systematic project to promote and standardize the early treatment of malocclusion. Through scientific and comprehensive stratified clinical practice and professional training, the clinical system of early treatment of malocclusion in China will eventually be perfected, so as to comprehensively care for children's dental and maxillofacial health, and improve their oral and physical health in China.


Subject(s)
Child , China/epidemiology , Consensus , Dental Care , Humans , Malocclusion/prevention & control , Orthodontics, Interceptive
6.
Article in Chinese | WPRIM | ID: wpr-886686

ABSTRACT

@#Most of the proteomics analysis methods based on tandem mass spectrometry rely on the matching scoring of actual spectrum and theoretical spectrum, the interference of a large number of co-eluting peptides could cause error in the identification and quantification of peptides and proteins. Peptide retention time prediction, as a auxiliary and verification index of the peptide, can transition the chromatographic behavior into stable independent time attributes, and improve the accuracy of the peptide identification. Prediction of peptide chromatographic retention in complex systems is also of great significance for optimizing proteomics determination conditions and improving the detection rate and repeatability of mass spectrometry data in data-independent acquisition. This review focused on the chromatographic retention prediction method of unmodified peptides and modified peptides, summarizes the content, characteristics and limitations of four types of peptide retention time prediction methods based on standardized indexes, peptide molecular models, amino acid residue parameters, and machine learning, as well as their applications in proteomics, with a prospect of their future.

7.
Article in Chinese | WPRIM | ID: wpr-879289

ABSTRACT

Cryogels are a type of hydrogel material which are fabricated by cryopolymerization at subzero temperature. Due to their unique macroporous structure, shape memory properties and injectability, cryogels have gained significant interest in the fields of tissue engineering for encouraging the repair and regeneration of injured tissues. In this review, the basic concepts relevant to cryogels are introduced, and then the fabrication principle, the process parameters and the unique properties of cryogel are discussed. Next, the latest advances of cryogels as three-dimensional scaffold for various tissue engineering applications are given. Finally, this review summarizes the current limitations of cryogels, and strategies to further improve their properties for tissue engineering. The purpose of this article is to provide a reference guide for the researchers in related fields.


Subject(s)
Cryogels , Porosity , Tissue Engineering , Tissue Scaffolds
8.
Chinese Medical Journal ; (24): 1152-1159, 2021.
Article in English | WPRIM | ID: wpr-878126

ABSTRACT

BACKGROUND@#Compared to adult studies, studies which involve the treatment of pediatric congenital hypogonadotropic hypogonadism (CHH) are limited and no universal treatment regimen is available. The aim of this study was to evaluate the feasibility of human chorionic gonadotropin (hCG)/human menopausal gonadotropin (hMG) therapy for treating male adolescents with CHH.@*METHODS@#Male adolescent CHH patients were treated with hCG/hMG (n = 20) or a gonadotropin-releasing hormone (GnRH) pump (n = 21). The treatment was divided into a study phase (0-3 months) and a follow-up phase (3-12 months). The testicular volume (TV), penile length (PL), penis diameter (PD), and sex hormone levels were compared between the two groups. The TV and other indicators between the groups were analyzed using a t-test (equal variance) or a rank sum test (unequal variance).@*RESULTS@#Before treatment, there was no statistical difference between the two groups in terms of the biochemistry, hormones, and other demographic indicators. After 3 months of treatment, the TV of the hCG/hMG and GnRH groups increased to 5.1 ± 2.3 mL and 4.1 ± 1.8 mL, respectively; however, the difference was not statistically significant (P > 0.05, t = 1.394). The PL reached 6.9 ± 1.8 cm and 5.1 ± 1.6 cm (P  0.05, t = 0.314). After 9 to 12 months of treatment, the T level was higher in the hCG/hMG group. Other parameters did not exhibit a statistical difference.@*CONCLUSIONS@#The hCG/hMG regimen is feasible and effective for treating male adolescents with CHH. The initial 3 months of treatment may be a window to optimally observe the strongest effects of therapy. Furthermore, results from the extended time-period showed positive outcomes at the 1-year mark; however, the long-term effectiveness, strengths, and weaknesses of the hCG/hMG regimen require further research.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT02880280; https://clinicaltrials.gov/ct2/show/NCT02880280.


Subject(s)
Adolescent , Adult , Child , Chorionic Gonadotropin/therapeutic use , Gonadotropin-Releasing Hormone , Humans , Hypogonadism/drug therapy , Male , Menotropins/therapeutic use , Spermatogenesis , Testosterone
9.
Article in English | WPRIM | ID: wpr-880650

ABSTRACT

OBJECTIVES@#Systemic lupus erythematosus (SLE) is a kind of autoimmune inflammatory connective tissue disease which seriously endangers human health. Genetic factors play a key role in the pathogenesis of SLE. This study aims to investigate a novel phospholipase D2 (PLD2) mutation associated with familial SLE, and further explore the underlying mechanism of the mutation in SLE.@*METHODS@#The blood samples from a SLE patient, the patient's parents, and 147 normal controls were collected and DNA was extracted. Whole genome high-throughput sequencing was performed in the patient and her parents and the results were further analyzed by various bioinformatics methods. The wild type (wt), mutant type (mu), and negative control PLD2 plasmids were further constructed and transfected into 293 cells. The expression level of HRAS protein in 293 cells was detected by Western blotting.@*RESULTS@#In this SLE family, the female SLE patient and her mother, 1 in generation II and 1 in generation III had typical clinical manifestations of SLE, and all of them had lupus nephritis at early stage. The genetic characteristics are consistent with autosomal dominant inheritance. A novel PLD2 heterozygous mutation (c.2722C>T) was found in the patient and her mother, but not in her father and other normal controls. Compared with wtPLD2 plasmid and negative control PLD2 plasmid, the expression of HRAS in 293 cells transfected with muPLD2 plasmid was significantly up-regulated (both @*CONCLUSIONS@#PLD2 c.2722C>T mutation may be one of the pathogeny of SLE in this family.


Subject(s)
Case-Control Studies , Female , High-Throughput Nucleotide Sequencing , Humans , Lupus Erythematosus, Systemic/genetics , Lupus Nephritis , Mutation , Phospholipase D
10.
Article in Chinese | WPRIM | ID: wpr-879903

ABSTRACT

OBJECTIVE@#To study the efficacy and safety of intensity-modulated radiotherapy (IMRT) in children with high-risk neuroblastoma (NB).@*METHODS@#A retrospective analysis was performed on the medical data of 24 children with high-risk NB who were diagnosed and treated with IMRT in the Department of Hematology and Oncology, Hunan Provincial People's Hospital, from April 2018 to December 2020. The medical data included age, radiotherapy dose, times of radiotherapy, laboratory examination results, adverse reactions, and survival.@*RESULTS@#All 24 children (14 boys and 10 girls) received IMRT, with a mean age of (65±23) months and a median age of 59 months. The primary tumor was located in the abdomen in 23 children and 1 child had primary tumor in the mediastinum. The median age was 41.5 months at the time of radiotherapy. The radiation dose of radiotherapy ranged from 14.4 to 36.0 Gy, with a mean dose of (22±3) Gy and a daily dose of 1.8-2.0 Gy. The radiotherapy was performed for a total number of 8-20 times, with a mean number of 11.9 times. Among these children, 6 received radiotherapy for the residual or metastatic lesion. Of all the 23 children, 3 experienced cough, 2 experienced diarrhea, and 1 experienced vomiting during radiotherapy. At 2 weeks after radiotherapy, serum creatinine ranged from 2.3 to 70.1 μmol/L and alanine aminotransferase ranged from 9.1 to 65.3 μ/L. Ten children experienced grade Ⅲ bone marrow suppression and 2 experienced grade Ⅳ bone marrow suppression 1 to 2 weeks after radiotherapy. Four children experienced grade Ⅲ bone marrow suppression and 1 experienced grade Ⅳ bone marrow suppression 3 to 4 weeks after radiotherapy. During a median follow-up time of 13.5 months, 23 children (96%) achieved stable disease and 1 died. Up to the follow-up date, second malignant tumor or abnormal organ function was not observed.@*CONCLUSIONS@#IMRT can improve the local control rate of NB. IMRT appears to be safe in the treatment of children with NB.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Neuroblastoma/radiotherapy , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-879866

ABSTRACT

A boy, aged 4 years and 6 months, had disease onset of fever, cough, pale complexion, and weakness, with hepatosplenomegaly, lymphadenectasis, and pancytopenia. He had been having repeated respiratory and digestive tract infections. Gene detection showed a pathogenic heterozygous mutation, c.C2147 > T(p.T716M), in the


Subject(s)
Child, Preschool , Fever , Heterozygote , Humans , Immune System Diseases/genetics , Male , Mutation , STAT3 Transcription Factor/genetics , Syndrome
12.
Article in Chinese | WPRIM | ID: wpr-879829

ABSTRACT

OBJECTIVE@#To study the long-term clinical effect of multicenter multidisciplinary treatment (MDT) in children with renal malignant tumors.@*METHODS@#A retrospective analysis was performed on the medical data of 55 children with renal malignant tumors who were diagnosed and treated with MDT in 3 hospitals in Hunan Province from January 2015 to January 2020, with GD-WT-2010 and CCCG-WT-2016 for treatment regimens. A Kaplan-Meier survival analysis was used to analyze the survival of the children.@*RESULTS@#Of the 55 children, 10 had stage I tumor, 14 had stage Ⅱ tumor, 22 had stage Ⅲ tumor, 7 had stage IV tumor, and 2 had stage V tumor. As for pathological type, 47 had FH type and 8 had UFH type. All children underwent complete tumor resection. Of the 55 children, 14 (25%) received preoperative chemotherapy. All children, except 1 child with renal cell carcinoma, received postoperative chemotherapy. Among the 31 children with indication for radiotherapy, 21 (68%) received postoperative radiotherapy. One child died of postoperative metastasis. The incidence rate of FH-type myelosuppression was 94.4%, and the incidence rate of UFH-type myelosuppression was 100%. The median follow-up time was 21 months and the median survival time was 26 months for all children, with an overall survival rate of 98% and an event-free survival rate of 95%.@*CONCLUSIONS@#Multicenter MDT has the advantages of high success rate of operation and good therapeutic effect of chemotherapy in the treatment of children with renal malignant tumors, with myelosuppression as the most common side effects, and radiotherapy is safe and effective with few adverse events. Therefore, MDT has good feasibility, safety, and economy.


Subject(s)
Child , Family , Humans , Kidney Neoplasms/therapy , Progression-Free Survival , Retrospective Studies
13.
Article in Chinese | WPRIM | ID: wpr-872922

ABSTRACT

Objective:To observe the clinical efficacy of Juanbitang iontophoresis combined with warm acupuncture in treatment of wind cold and blocking collaterals syndrome due to external humeral epicondylitis (EH) and the effect on serum oxidative stress index. Method:From January 2018 to October 2019, 180 patients with EH wind cold and blocking collaterals syndrome were randomly divided into the warm acupuncture group, the traditional Chinese medicine(TCM) group and the combination group, with 60 cases in each group. The TCM group was treated with modified Juanbitang combined local iontophoresis at Quchi (affected side), Zhouliao (affected side), Ashi (affected side), 30 min/time/day, while the warm acupuncture group was treated with warm acupuncture once a day, 5 days/week. The combination group was treated with warm acupuncture in addition to the therapy of the TCM group, and the three groups were treated for 4 weeks. JOA’s elbow joint function scale, HSS’ elbow joint score scale and pain visual simulation score (VAS) were used to evaluate the symptoms and signs and the improvement of daily life before and after treatment. Enzyme linked immunosorbent assay(ELISA) method was used to detect the contents of late oxidized protein products (AOPP), malondialdehyde (MDA), superoxide dismutase (SOD) and heme oxygenase-1 (HO-1) in serum of patients before and after treatment. The cure rate, the total effective rate and the recurrence rate of 1 month and 3 months after treatment were compared. Result:Compared with before treatment, JOA and HSS scores increased, whereas VAS scores decreased (P<0.05). AOPP and MDA contents decreased, while SOD and HO-1 contents increased in the combination group and the TCM group (P<0.05). Compared with the TCM group and the warm acupuncture group after treatment, JOA, HSS score and pain R value increased, whereas VAS score decreased (P<0.05). Compared with the warm acupuncture group after treatment, serum AOPP, MDA content decreased, while SOD, HO-1 content increased (P<0.05). After 4 weeks of treatment, the cure rate and the effective rate of combination group were higher than those of the TCM group (χ2cure rate=4.617, χ2effective rate=6.471, P<0.05) and the warming acupuncture group (χ2cure rate=4.207, χ2effective rate=6.775, P<0.05). One month after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=7.617, χ2effective rate=13.347, P<0.05) and the warm acupuncture group (χ2cure rate=4.762, χ2effective rate=6.277, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=9.32, P<0.05) and the warm acupuncture group (χ2=3.899, P<0.05). Three months after the treatment, the cure rate and the effective rate of the combination group were higher than those of the TCM group (χ2cure rate=4.789, χ2effective rate=9.643, P<0.05) and the warm acupuncture group (χ2cure rate=4.458, χ2effective rate=9.251, P<0.05). The recurrence rate of the combination group was lower than that of the TCM group (χ2=4.599, P<0.05) and the warm acupuncture group (χ2=4.518, P<0.05). Conclusion:Modified Juanbitang and the warm acupuncture has a good clinical efficacy in the treatment of EH wind cold and blocking collaterals syndrome and is worthy of clinical promotion.

14.
Article in Chinese | WPRIM | ID: wpr-866249

ABSTRACT

Objective:To observe the efficacy and safety of postural modified Valsalval manoeuvre in terminating paroxysmal supraventricular tachycardia (PSVT).Methods:From January 2017 to June 2018, a total of 98 patients with PSVT were selected in the Affiliated Hospital of Xuzhou Medical University.They were randomly allocated to standard Valsalval manoeuvre group(48 cases) and postural modified Valsalval manoeuvre group(50 cases) according to sealed envelope method.The patients in standard Valsalval manoeuvre group carried out standard semi-recumbent Valsalva manoeuvre, while the other group received semi-recumbent with supine repositioning and passive leg raise immediately after the Valsalva strain.The general clinical data, total cardioversion success rate, first-time cardioversion success rate and the incidence of adverse reactions were compared between the two groups.Results:There were no statistically significant differences in male proportion, age, history of PSVT or coronary heart disease, incidence of hypertension, diabetes and heart rate, systolic and diastolic blood pressure at attack between the two groups(all P>0.05). The total cardioversion success rate [40.0%(20/50)], first-time cardioversion success rate [28.0%(14/50)] in the modified group were significantly higher than those in the standard group [16.7%(8/48), 12.5%(6/48)](χ 2=27.924, 16.308, all P<0.05). The incidence of adverse reactions was low in both two groups, and there was no statistically significant difference( P>0.05). Conclusion:Postural modified Valsalval manoeuvre can effectively improve the cardioversion success rate of PSVT, and has high safety, which is worthy of clinical promotion.

15.
Article in Chinese | WPRIM | ID: wpr-866026

ABSTRACT

Objective:To study and train urological resident's laparoscopic operation skills based on retroperitoneal laparoscopic adrenalectomy.Methods:From January 2011 to January 2020, 121 urology residents were selected to complete the basic skills training including laparoscopic simulator, and gradually engaged in and operated laparoscopic minimally invasive surgery for adrenal tumor. The training stage included training and examination of laparoscopic simulator module, establishment of lateral position and puncture hole in lumbar surgery, anatomy of kidney at three levels and exposure and removal of adrenal tumor. The training of four stages was completed by step-by-step advanced assessment.Results:Fifteen doctors could complete laparoscopic adrenalectomy operation under the supervision and guiding of teachers (12.4%), 71 residentss could independently complete the operation requirements in the first three stages (58.7%).Conclusion:The study has proved that the main factors affecting the advanced training of retroperitoneal laparoscopic adrenalectomy were the operation assessment score of laparoscopic simulator, the duration of the standardized residency training in urology department, the case number of participating in retroperitoneal laparoscopic adrenalectomy, and the times that teachers and training residents exchanged the positions of main knife and assistant during the operation.

16.
Article in Chinese | WPRIM | ID: wpr-799756

ABSTRACT

Objective@#To observe the efficacy and safety of postural modified Valsalval manoeuvre in terminating paroxysmal supraventricular tachycardia (PSVT).@*Methods@#From January 2017 to June 2018, a total of 98 patients with PSVT were selected in the Affiliated Hospital of Xuzhou Medical University.They were randomly allocated to standard Valsalval manoeuvre group(48 cases) and postural modified Valsalval manoeuvre group(50 cases) according to sealed envelope method.The patients in standard Valsalval manoeuvre group carried out standard semi-recumbent Valsalva manoeuvre, while the other group received semi-recumbent with supine repositioning and passive leg raise immediately after the Valsalva strain.The general clinical data, total cardioversion success rate, first-time cardioversion success rate and the incidence of adverse reactions were compared between the two groups.@*Results@#There were no statistically significant differences in male proportion, age, history of PSVT or coronary heart disease, incidence of hypertension, diabetes and heart rate, systolic and diastolic blood pressure at attack between the two groups(all P>0.05). The total cardioversion success rate [40.0%(20/50)], first-time cardioversion success rate [28.0%(14/50)] in the modified group were significantly higher than those in the standard group [16.7%(8/48), 12.5%(6/48)](χ2=27.924, 16.308, all P<0.05). The incidence of adverse reactions was low in both two groups, and there was no statistically significant difference(P>0.05).@*Conclusion@#Postural modified Valsalval manoeuvre can effectively improve the cardioversion success rate of PSVT, and has high safety, which is worthy of clinical promotion.

17.
Chinese Journal of Surgery ; (12): 42-47, 2020.
Article in Chinese | WPRIM | ID: wpr-798711

ABSTRACT

This review focused on the progress in laparoscopic pancreaticoduodenectomy(LPD) in the past six years.With the appropriate approaches under laparoscopy, including the resection and reconstruction, LPD has been proved to be safe and feasible. In some centers, LPD has been routine with rapid growth of numbers, it not only benefit the patients with fast recovery, but also benefit the trainees with similar sights as the primary surgeon and good videos of the procedures. However, LPD is still controversial as the more complications in some centers and inconclusive oncologic outcomes. Thus, in the further, a long-time outcome monitoring of LPD is essential. A registry of a prospectively maintained database may be a need for LPD to evaluate its outcomes by multicenter randomized control trials, and real world research may be of value. Structured LPD training programs are valuable for the new surgeons.

18.
Article in Chinese | WPRIM | ID: wpr-828240

ABSTRACT

OBJECTIVE@#To provide reference of the ideal entry point for antegrade femoral nailing according to analysis correlation between highest point of greater trochanter and the middle line of the medullary cavity in adults by three-dimensional images.@*METHODS@#From January 2016 to January 2017, 107 adults who underwent continuous computed tomography (CT) scans were ultimately enrolled, including 64 males and 43 females with an average age of (51.7±16.4) years old;54 patients on the left side and 53 patients on the right side. Three-dimensional images were built by using image-processing software (Volume Viewer) to reconstruct geometry of cortex and medullary canal. All people weregrouped according to different femoral greater trochanter morphology, such as anterior apex (AA), posterior apex (PA), middle apex (MA) and none apex (NA). Forwards inclination was adjusted to apparent neck shaft angle (ANSA) and true neck shaft angle (TNSA) on the coronal and saggittal view, recorded as C-ANSA, C-TNSA, S-ANSA, S-TNSA respectively, vertical distance from the middle line of femur medullary cavity to the highest point of greater trochanter of femur on the 4 positions were measured and performed statistical analysis, multiple linear regression was applied to analysis relationship between clinical data and VD value.@*RESULTS@#(1)Comparison of VD value among 4 groups on the 4 positions, there were no difference in VD value between AA and MA groups on the S-ANSA position;and no differences in VD value among AA, MA and NA groups on the C-ANSA and C-TNSA position. (2)There were differences in VD value among AA, MA and NA groups on the sagittal plane;while had difference in VD value between PA and NA group on the coronal plane. (3)Prediction equation of VD value on S-ANSA and S-TNSA position by multiple linear regression showed R=0.343, F=3.409, =0.012 on the S-ANSA position;R=0.317, F=2.846, =0.028 on the S-TNSA position; neck shaft angle and sex were risk factors of VD value on the sagittal plane, while no difference in VD value on the coronal position.@*CONCLUSION@#(1)When indentify insertion point in adult femoral nail according to the highest point of greater trochanter as anatomic landmark, the morphology of greater trochanter of femur should be distinguished to certain observation position, then evaluate migration before and after on the sagttial plane and lateral offset on the coronal plane. (2)Migration before and after on the sagttial plane is increase with increase of neck shaft angle, and the degree of migration of female before and after is less than that of male.


Subject(s)
Adult , Aged , Female , Femur , Fracture Fixation, Intramedullary , Humans , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Male , Middle Aged , Tomography, X-Ray Computed
19.
Article in Chinese | WPRIM | ID: wpr-826356

ABSTRACT

To evaluate the effect of monochromatic energy image on inferior vena cava imaging quality on dual-layer detector spectral CT. Totally 39 patients who were clinically suspected of abdominal disease and referred to perform contrast-enhanced computed tomography(CT)were prospectively enrolled and underwent abdominal examination using a single-source,dual-detector spectral CT.The delayed phase scan was performed 3 minutes after injection of 60 ml of iopamidol(320 mg/ml)at a rate of 3 ml/s.The raw images were reconstructed to obtain conventional mixed energy images and spectral based images(SBI).The 40,50,60,and 70 keV single energy images were obtained.The CT value,noise,and signal-to-noise(SNR)of inferior vena cava and the contrast-to-noise(CNR)of inferior vena cava relative to psoas major on conventional mixed energy images and the 40,50,60,70 keV single energy images were measured.The SNRs and CNRs on monoenergetic 40-70 keV images were compared with polychromatic 120 kVp images.ANOVA was used to compare the CT value,noise,SNR,and CNR among these five groups.The optimal monoenergetic image set was chosen. The differences in CT value,noise,SNR,CNR of inferior vena cava were statistically significant among five groups(all <0.05).The SNR and CNR in 40 keV group and 50 keV group were significantly higher than those in other groups(all <0.05).The SNR of 40 keV group was significantly higher than that of 50 keV group(=0.002).The CNR of 40 keV group was not statistical different compared with that of 50 keV group(=0.630). 40 keV is the optimal monoenergetic energy level for the inferior vena cava on dual-layer detector spectral CT and may be valuable for the diagnosis of inferior vena cava disease.


Subject(s)
Abdomen , Humans , Radiographic Image Interpretation, Computer-Assisted , Signal-To-Noise Ratio , Tomography, X-Ray Computed , Vena Cava, Inferior
20.
Journal of Biomedical Engineering ; (6): 1073-1079, 2020.
Article in Chinese | WPRIM | ID: wpr-879238

ABSTRACT

Portal hypertension (PHT) is a common complication of liver cirrhosis, which could be measured by the means of portal vein pressure (PVP). However, there is no report about an effective and reliable way to achieve noninvasive assessment of PVP so far. In this study, firstly, we collected ultrasound images and echo signals of different ultrasound contrast agent (UCA) concentrations and different pressure ranges in a low-pressure environment based on an


Subject(s)
Contrast Media , Humans , Hypertension, Portal/diagnostic imaging , Liver Cirrhosis , Portal Vein/diagnostic imaging , Ultrasonography
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