A new classification of left apicoposterior segmental bronchus and its clinical significance / 中国胸心血管外科临床杂志

@#Objective    To analyze a new classification of the left apicoposterior segmental bronchus and summarize its clinical significance. Methods     We accessed the computed tomography imaging data of the inpatients treated in the Department of Thoracic Surgery, Henan Provincial People's Hospital between January and November 2021. We observed and classified the branching pattern of the left apicoposterior segmental bronchus (B1+2) using three-dimensional computed tomography bronchography and angiography (3D-CTBA) technique. And we filtered out the patients who underwent thoracoscopic left apicoposterior segmentectomy and analyzed their clinical data retrospectively to summarize the instructing significance of different bronchial classification in the accurate and safe operation of left apicoposterior segmentectomy. Results     Finally 240 patients were collected, including 131 males and 109 females with a median age of 51.0 (19.0-77.0) years. The anatomical pattern of the left apicoposterior segmental bronchus was divided into four main types based on the branching pattern of the outer subsegmental bronchi (B1+2c): type Ⅰ 10% (24 patients), type Ⅱ 54% (130 patients) , type Ⅲ 17% (40 patients) , type Ⅳ 18% (43 patients) and other variations 1% (3 patients). Thirty-two patients smoothly underwent thoracoscopic left apicoposterior segmentectomy, including 23 patients of type Ⅰ and type Ⅱ receiving LS1+2 resection, the other 9 patients of type Ⅲ and type Ⅳ receiving LS1+2 resection (3 patients), LS1+2c resection (4 patients) and LS1+2(a+b) resection (2 patients). Conclusion     This new classification systematically and concisely elucidates the branching characteristics of the left apicoposterior bronchus. Different branching types are instructive to the left apicoposterior segmentectomy.

Clinical analysis of 8 cases of transverse testicular ectopia / 中华实用儿科临床杂志

Objective:To study the clinical manifestations, diagnostic methods and therapeutic outcomes of transverse testicular ectopia (TTE).Methods:Clinical data of 8 cases of TTE treated in the Department of the First Urologic Surgery, Xinxiang Central Hospital and Department of Pediatric Surgery, the First Affiliated Hospital of Zhengzhou University from May 2004 to November 2018 were retrospectively analyzed.Clinical manifestations, diagnostic methods, surgical treatment and follow-up results of TTE were summarized.Results:The age of 8 cases of TTE was 1 year 5 months to 5 years.Among the 8 cases of TTE, 6 cases were involved with the left side and 2 cases with the right side.All patients were admitted due to scrotal emptiness.Three cases were combined with persistent Müllerian duct syndrome (PMDS) and 1 case combined with hypospadias.Preoperative diagnosis of TTE was definitely made in 5 cases, involving 4 cases diagnosed by ultrasound and 1 case diagnosed by magnetic resonance imaging.Laparoscopy was performed in 2 cases, including 1 case treated with laparoscopic scrotopexy, and the other one transferred to an open surgery of trans-septal orchiopexy due to poor development of the spermatic cord.Open surgery was performed in 6 cases, including 1 case with bilateral testicular fixation in the ipsilateral scrotum due to adhesion of spermatic cord closely, and 5 cases with trans-septal orchiopexy.Müllerian ducts residues were excised during surgery in 3 cases combined with PMDS.Postoperative wound infection or hematoma was not reported in all cases.Orchiepididymitis and the involvement of contralateral testes occurred in 1 case treated with trans-septal orchiopexy at 11 months postoperatively, which were relieved after anti-inflammatory treatment.All cases were postoperatively followed up for 3-48 months, and the development and blood supply of bilateral testes were detected normal by ultrasonography.Postoperative testicular atrophy was not reported.Conclusions:The possibility of TTE should be considered in patients with unilateral cryptorchidism combined with contralateral inguinal mass.Ultrasonography is preferred to the diagnosis of TTE.Laparoscopic surgery plays an important role in the diagnosis and treatment of TTE, which is helpful to identify abnormalities in the Müllerian duct structure.

Analysis of risk factors for recurrence of differentiated thyroid carcinoma after surgical resection combined with iodine-131 and TSH suppression therapy / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the risk factors of recurrence after surgical resection of differentiated thyroid carcinoma combined with iodine-131 and TSH（Thyroid stimulating hormone） inhibition therapy. Methods:From January 2015 to April 2020, the clinical data of patients with structural recurrence and without recurrence were retrospectively collected after surgical treatment combined with iodine-131 and TSH inhibition therapy in the First Medical Center of PLA General Hospital. The general conditions of the two groups of patients were analyzed and the measurement data in line with the normal distribution was used for comparison between groups. For measurement data with non-normal distribution, the rank sum test was used for inter-group comparison. The Chi-square test was used for comparison between the counting data groups. Univariate and multivariate regression analyses were used to determine the risk factors associated with relapse. Results:The median follow-up period was 43 months（range 18-81 months） and 100 patients（10.5%） relapsed among the 955 patients. Univariate analysis showed that tumor size, tumor multiple, the number of lymph node metastases>5 in the central region of the neck, and the number of lymph node metastases>5 in the lateral region were significantly correlated with post-treatment recurrence（P<0.001, P=0.018, P<0.001, P<0.001）. Multivariate analysis showed that tumor size（adjusted odds ratio OR: 1.496, 95%CI: 1.226-1.826, P<0.001）, tumor frequency（adjusted odds ratio OR: 1.927, 95%CI: 1.003-3.701, P=0.049）, the number of lymph node metastases in the central neck region>5（adjusted odds ratio OR: 2.630, 95%CI: 1.509-4.584, P=0.001） and the number of lymph node metastases in the lateral neck region>5（adjusted odds ratio OR: 3.074, 95%CI: 1.649-5.730, P=0.001） was associated with tumor recurrence. Conclusion:The study showed that tumor size, tumor multiple, the number of lymph node metastases in the central region of the neck>5 and the number of lymph node metastases in the side of the neck >5 are independent risk factors for recurrence of differentiated thyroid cancer after surgical resection combined with iodine-131 and TSH inhibition therapy.

Surgical treatment methods and classification of proximal clavicle fracture / 中国骨伤

OBJECTIVE@#To summarize the surgical treatment of different proximal clavicle fractures, and discuss the classification of proximal clavicle fractures.@*METHODS@#Total of 24 patients with displaced proximal clavicle fractures were treated from January 2017 to December 2020 including 16 males and 8 females, aged 28 to 66 years old. Among them, 20 cases were fresh fractures and 4 cases were old fractures. According to the Edinburgh classification, 14 cases were type 1B1 fractures and 10 cases were type 1B2 fractures. The different internal fixation methods were selected for internal fixation treatment according to different fracture types.The operation time, blood loss, preoperative and postoperative displacement difference, fracture healing time and Rockwood scoring system were recorded.@*RESULTS@#All patients were followed up for 12 to 24 months. There were no patients with infection or loss of reduction after the operation. Three patients had internal fixation failure after operation, and the internal fixation device was removed. Results The operation time was 30 to 65 min, and the blood loss was 15 to 40 ml. No important nerves, blood vessels, or organs were damaged. The imaging healing time was 3 to 6 months. According to the Rockwood functional score, the total score was (13.50±1.86), pain (2.57±0.50), range of motion (2.78±0.41), muscle strength (2.93±0.28), restricted daily activity (2.85±0.35), subjective results (2.63±0.61);the results were excellent in 20 cases, good in 3 cases, fair in 1 case.@*CONCLUSION@#Proximal clavicular fracture is a type of fracture with low incidence. According to different fracture types, different internal fixation methods and treatment methods can be selected, and satisfactory surgical results can be achieved.

Clinical efficacy of laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection for hepatocellular carcinoma / 中华消化外科杂志

Objective:To investigate the clinical efficacy of laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection for hepatocellular carcinoma.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 15 patients with hepatocellular carcinoma who underwent laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University from September 2020 to August 2021 were collected. There were 9 males and 6 females, aged 66(range, 35?77)years. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted using outpatient examination and telephone interview to detect tumor recurrence and survival of patients in the postoperative 90 days. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results:(1) Surgical situations. All the 15 patients underwent laparoscopic anatomical right posterior sector combined with anterior-dorsal segment resection successfully, without blood transfusion and conversion to laparotomy during the operation. The operation time, volume of intraoperative blood loss and occlusion time of first porta hepatis of the 15 patients were (155±17)minutes, (254±66)mL and (51±7)minutes, respectively. (2) Postoperative situations. The duration of postoperative hospital stay of the 15 patients was (7.4±2.1)days. Results of postoperative histopathological examination showed hepatocellular carcinoma and R 0 margins in all the 15 patients with a minimum distance from margin to tumor of (1.5±0.8)cm. There was none of the 15 patients transferred to intensive care unit, perioperative death or rehospitalization within 30 days after surgery. Of the 15 patients, 2 cases had postoperative complications, including 1 case with biliary fistula (grade Ⅰ of Clavien-Dindo classification) and 1 case with ascites (grade Ⅱ of Clavien-Dindo classification). Patients with complications were improved after washing and drainage, abdominal puncture and drainage. (3) Follow-up. All the 15 patients were followed up for the postoperative 90 days and none of them had tumor recurrence or death within postoperative 90 days. Conclusion:The laparoscopic anatomical right posterior sector and anterior-dorsal segment resec-tion for hepatocellular carcinoma is safe and feasible.

Comparison of complications between continuous negative pressure drainage and intermittent negative pressure drainage after expanded flap repair and abdominal wall plasty / 中华医学美学美容杂志

Objective:To compare the use of continuous constant negative pressure drainage and intermittent suction mode drainage in abdominal wall angioplasty to minimize the impact of complications.Methods:From May 2017 to August 2019, the Department of Medical Cosmetology and Plastic Surgery, Wuhan Third Hospital treated 76 female patients after expanded flap repair, aged 27-35 years, with an average age of 30.5±14.2 years, and 58 female patients after abdominal wall plasty, aged 38-55 years, with an average age of 47.8±7.8 years. They were divided into intermittent negative pressure drainage group and continuous negative pressure drainage group. The negative pressure values in different intervals were set according to the type of operation. The drainage volume, drainage time, incidence of hematoma, subcutaneous effusion, flap necrosis rate, primary wound healing rate and drainage related bleeding were recorded and compared between the two groups.Results:After expanded flap repair in 38 cases, flap necrosis occurred in 1 case and hematoma in 3 cases; After abdominal wall plasty in 29 cases, flap necrosis occurred in 0 cases and hematoma in 1 case. The primary healing of incision was higher ( P<0.05), the drainage volume was larger, but the drainage time was shorter ( P<0.05), and no bleeding related to drainage was observed. The effect of monitoring drainage was positively correlated with the effect of operation. Conclusions:Continuous and constant negative pressure drainage is related to the prognosis of patients undergoing expansion flap repair and abdominal wall plasty. It is helpful to improve the effect of plastic surgery and the quality of nursing work. It is an effective method for nursing management after plastic surgery.

Chinese experts consensus on standardized surgical management of specimens from radical gastrectomy (2022 edition) / 中华胃肠外科杂志

In the standardized diagnosis and treatment process of advanced gastric cancer, there is a unappreciated key link between standard radical surgery and accurate pathological reports. That is, the process of dissection, fixation, sampling and recording of the specimen by the surgeons, starting from specimen isolation to the management of the pathologist. Standardizing this process can not only accurately reflect the detailed distribution and exact number of lymph nodes, but also clarify the pathological stage of gastric cancer, so as to make adjuvant treatment plans. Moreover, it can also reflect the scope of intraoperative lymph node dissection to ensure the standardized implementation of surgery, including the overall dissection principle (en bloc resection), and therefore can provide a solid foundation for later related researches. So far, there is still a lack of complete and unified standard for the surgical management of specimens after radical gastrectomy in China. On the basis of the relevant researches and clinical practice about specimen management at home and abroad, the Chinese Journal of Gastrointestinal Surgery, in the name of the Gastric Cancer Professional Committee, Chinese Anticancer Association, as well as the Oncogastroenterology Professional Committee, Chinese Anticancer Association, organized dozens of experts to formulate a consensus on the standardized surgical management of specimens after repeated discussions and revisions for two years. This consensus is aimed to standardize the preparations, basic requirements and sample processing procedures before the surgical treatment of postoperative specimens after a radical surgery for gastric cancer patients, including the processing time of specimens, the processing and data archiving of gastric specimens, and lymph node grouping, sorting and fine sorting records, etc and with the purpose of standardizing the surgical treatment of postoperative specimens on the basis of standardized diagnosis and treatment of gastric cancer, in order to further promote the high-quality development of gastric cancer surgery in China.

Surgical treatment of axillary odor in Chinese patients: a meta analysis / 中华医学美学美容杂志

Objective:In China, although axillary osmidrosis is common in plastic surgery, there is no standard procedure for the treatment of axillary osmidrosis. So we compared the efficacy of 6 axillary osmidrosis surgical treatments with network meta-analysis in order to provide reference for the clinical surgical treatment of axillary osmidrosis in Chinese patients.Methods:From January 2018 to December 2021, Chinese and English databases including Wanfang Database, VIP Chinese Science and Technology Periodical Full-text Database (VIP) and CNKI, PubMed, Cochrane Library, Embase were searched by the Plastic Surgery Department of Zhangqiu People′s Hospital in Jinan, Shandong province. And some relevant studies were collected for network meta-analysis.Results:47 studies including a total of 6543 subjects were identified for meta-analysis. After analysis, 4 of the 15 pairwise comparisons were not statistically significant, and the effect of swelling aspiration + subcutaneous pruning was more significant. According to the surface under the cumulative ranking curve (SUCRA), the efficacy of 6 surgical methods for the treatment of axillary osmidrosis was as follows: swelling aspiration + subcutaneous pruning > subcutaneous scratching+ subcutaneous pruning > subcutaneous pruning > fusiform skin resection > subcutaneous scratching > swelling aspiration.Conclusions:In surgical treatment of axillary osmidrosis, swelling aspiration + subcutaneous pruning is the best. It is worth popularizing in the clinical work of treating axillary osmidrosis patients. Due to the limitations of this study, the conclusion of this network meta-analysis still needs to be further confirmed by a well-designed randomized controlled trial.

Effects of slow intravenous infusion of low-dose mannitol on hemodynamics in patients after cardiac surgery under cardiopulmonary bypass / 中华胸心血管外科杂志

Objective:To investigate the effect of slow intravenous infusion of low-dose mannitol on the hemodynamics of patients after cardiopulmonary bypass.Methods:Prospective, continuous inclusion of 62 patients after cardiac surgery under cardiopulmonary bypass. By random number method, they were divided into normal treatment group(group C) with 29 cases and mannitol treatment group(group M) with 33 cases. Group C was treated according to the postoperative routine treatment measures. On the basis of conventional treatment, group M received intravenous infusion of 20% mannitol injection 0.25 g/kg at 1、8、24 hours after operation, and the intravenous infusion time was 60 minutes each time. According to the hemodynamic changes during the two groups of treatment, the effect of slow intravenous infusion of low-dose mannitol on patients after cardiopulmonary bypass under cardiopulmonary bypass was analyzed.Results:In group M, CI and SVI were significantly increased after use of mannitol than before, with statistical significance( P<0.01). SVRI showed a downward trend, and the changes were statistically significant after use of mannitol( P<0.01). PAWP increased first and then decreased after operation, and the changes were statistically significant after mannitol use than before( P<0.05). RAP and MPAP had no significant changes after the first use of mannitol, but the changes after the latter two use mannitol were statistically significant than before( P<0.05). Repeated-measurement data analysis of variance was performed on the hemodynamic parameters of each group, and the results were all P<0.01. Conclusion:Postoperative slow intravenous infusion of low-dose mannitol optimizes hemodynamic status, increases stroke volume, reduces cardiac preload, improves systemic and pulmonary circulation resistance, and promotes recovery of postoperative cardiopulmonary function.

The progress of surgical treatment of Alzheimer’s disease / 中华显微外科杂志

Alzheimer’s disease (AD) is a progressive neurological disease. Its main clinical features include progressive memory loss, cognitive dysfunction, behavioral disorders and decreased ability of daily living. Its etiology is complex, and there is no effective treatment at present. There are many ways to delay or prevent the disease and improve its symptoms, including some drugs to improve neurological symptoms, activity, diet, cognitive training, and so on. In addition, some scholars have tried to treat AD by surgical methods. This article reviews the surgical methods for the treatment of AD.

Efficacy analysis of antibiotic bone cement in treating infectious wound of lower extremity / 中国骨伤

OBJECTIVE@#To discuss the clinical effect of antibiotic bone cement in the treatment of infectious wound of lower extremity.@*METHODS@#From January 2016 to January 2019, 28 patients who had infection wounds of lower extremity were treated by antibiotic bone cement, including 21 males and 7 females with age of 34 to 76 (53.8±16.5) years old. The wound area after the initial debridement was 4 cm×3 cm to 12 cm×8 cm. All patients were treated with the antibiotic bone cement, when infection was controlled and fresh granulation tissue grew on the wound surface, local sutures or skin grafts were performed. The changes of white blood cell (WBC), erythrocyte sedimentation rate(ESR), C reactive protein(CRP) and positive rate of bacterial culture of wound secretions were recorded andcompared before and after 2 weeks of the operation. The healing time, recurrence rate and complications of fresh granulation on wound surface were calculated.@*RESULTS@#All patients were followed up for 3 to 6(4.3±1.2) months. After the recurrence of diabetic foot wound infection, 3 patients presented different degree of rupture, and the remaining patients had good wound healing. No serious complications such as aggravation of infection and amputation occurred. The WBC, ESR and CRP of the patients were decreased significantly after operation compared with that before operation (9.1±1.2)×109/L vs. (11.4±2.2)×109/L, (23.5±7.6) mm/ h vs. (57.1±14.9) mg/L, (44.2±13.1) mg/L vs. (89.2±26.7) mg/L (@*CONCLUSION@#The antibiotic bone cement can control infection of lower extremity wound effectively, promote the growth of fresh granulation tissue and wound healing.

Effect of psychological crisis intervention on the psychological crisis level and self-efficacy of patients with cervical cancer surgery / 中国实用护理杂志

Objective@#To investigate the effect of psychological crisis intervention on the psychological crisis level and self-efficacy of patients with cervical cancer surgery, so as to provide reference for finding effective psychological intervention for patients with cervical cancer surgery.@*Methods@#A total of 134 patients with cervical cancer surgery from January 2016 to December 2017 were divided into treatment group and control group with 67 cases each by randomized digital table method. The control group received routine nursing intervention, while the treatment group combined with psychological crisis intervention. Postoperative follow-up for 6 months, the psychological crisis level, self-efficacy, quality of life and other indicators were compared between the two groups.@*Results@#A total of 63 cases in the treatment group and 60 cases in the control group completed the study. The scores of emotional, cognitive, and behavioral psychological crisis in the treatment group were (4.32±0.56), (3.45±0.54), and (3.56±0.62) points, respectively, which were significantly lower than those in the control group (5.45±0.72), (5.36±0.74), and (4.24±0.68) points, the difference was statistically significant (t=9.742, 16.408, 5.800, P<0.05 or 0.01). Self-decision, self-decompression, and positive attitude scores were (12.45±1.35), (43.12±5.45), and (64.35±7.32) points, respectively, which were higher than the control group (10.32±1.42), (40.12±4.65), and (57.36±6.52) points, the difference was statistically significant (t=8.528, 3.277, 5.582, P <0.05 or 0.01). The cognitive function, social function, physical function and emotional function scores of the treatment group were (8.45±1.10), (8.22±1.14), (7.65±0.72), (8.15±1.21) points, respectively, which were higher than those of the control group (7.12±0.84), (7.32±1.10), (6.54±0.70), (7.45±1.10) points, the difference was statistically significant(t=3.352- 8.663, P <0.05 or 0.01).@*Conclusions@#Psychological crisis intervention can help resolve the psychological crisis of patients with cervical cancer surgery, promote the self-efficacy development and improve the quality of life.

Effect of psychological crisis intervention on the psychological crisis level and self-efficacy of patients with cervical cancer surgery / 中国实用护理杂志

Objective To investigate the effect of psychological crisis intervention on the psychological crisis level and self-efficacy of patients with cervical cancer surgery, so as to provide reference for finding effective psychological intervention for patients with cervical cancer surgery. Methods A total of 134 patients with cervical cancer surgery from January 2016 to December 2017 were divided into treatment group and control group with 67 cases each by randomized digital table method. The control group received routine nursing intervention, while the treatment group combined with psychological crisis intervention. Postoperative follow-up for 6 months, the psychological crisis level, self-efficacy, quality of life and other indicators were compared between the two groups. Results A total of 63 cases in the treatment group and 60 cases in the control group completed the study. The scores of emotional, cognitive, and behavioral psychological crisis in the treatment group were (4.32±0.56), (3.45± 0.54), and (3.56±0.62) points, respectively, which were significantly lower than those in the control group (5.45 ± 0.72), (5.36 ± 0.74), and (4.24 ± 0.68) points, the difference was statistically significant (t =9.742, 16.408, 5.800, P<0.05 or 0.01). Self-decision, self-decompression, and positive attitude scores were (12.45±1.35), (43.12±5.45), and (64.35±7.32) points, respectively, which were higher than the control group (10.32±1.42), (40.12±4.65), and (57.36±6.52) points, the difference was statistically significant ( t =8.528, 3.277, 5.582, P <0.05 or 0.01). The cognitive function, social function, physical function and emotional function scores of the treatment group were (8.45 ± 1.10), (8.22 ± 1.14), (7.65 ± 0.72), (8.15±1.21) points, respectively, which were higher than those of the control group (7.12±0.84), (7.32± 1.10), (6.54 ± 0.70), (7.45 ± 1.10) points, the difference was statistically significant( t =3.352- 8.663, P <0.05 or 0.01). Conclusions Psychological crisis intervention can help resolve the psychological crisis of patients with cervical cancer surgery, promote the self-efficacy development and improve the quality of life.

Clinical analysis of neuroblastoma in 36 children / 中华实用儿科临床杂志

Objective To explore the diagnosis,treatment and prognosis of neuroblastoma in children. Methods The clinical data of 36 children With neuroblastoma admitted to Department of Pediatric Surgery,Henan Pro﹣vincial People＇s Hospital betWeen August 2013 and August 2018,Were retrospectively analyzed. The patients included 22 males and 14 females With the age of 1 month－13 years old[( 20. 0 ± 18. 5)months]. TWenty－one cases of neu﹣roblastoma originated from the adrenal glands,the other 15 cases from the sympathetic ganglion( including 7 cases in retroperitoneum,6 cases in postmediastinum,and 2 cases in neck). Fifteen patients in loW risk and intermediate risk groups underWent primary surgery before multiple chemotherapy,While other 21 cases in high risk groups underWent chemotherapy until the mass could be removed completely,then continuely underWent multiple chemotherapy. Results Of the 36 patients,23 cases(63. 9%)had a radical resection,13 patients underWent palliative resection and 2 pa﹣tients Were treated With vascular repair during surgery(abdominal aorta in 1 patient,inferior vena cava in 1 patient). TWenty－seven patients had effective in formation and 16 patients survived,during folloW－up,12 patients belonged to stage Ⅰ－Ⅲ disease,2 patients stage Ⅳ disease and 2 patients stage Ⅳs disease,respectively. Four cases underWent re－operation due to disease recurrence,then they underWent chemothearopy,and 3 patients Were survival With tumor. Conclusions Neuroblastoma is a highly malignant pediatric cancer accompanied With a high rate of metastasis on ini﹣tial diagnosis. Radical resection is an effective therapeutic strategy for improving the survival rate. If radical resection is impractical,palliative resection combined With chemotherapy can significantly prolong patients＇ survival time. And a better prognosis is achieved if it can be early diagnosed and treated timely.

Progress in surgical treatment of aortic regurgitation caused by Takayasu arteritis / 中国胸心血管外科临床杂志

@#Takayasu arteritis (TA) is a primary, chronic, non-specific, inflammatory disease of the aorta and its larger branches. The pulmonary artery trunk and its branches could be impacted by TA, which could cause stenosis or occlusion of lesion vessels. TA also affects the normal function of the aortic valve and other heart valves, mainly due to valvular insufficiency. Aortic regurgitation caused by TA is mainly treated by surgical operation. In this review, the examination technique, operation timing, operation method and prognosis of aortic valve involved in TA are discussed systematically.

Treatment progress in minimally invasive intramedullary fixation for midshaft clavicle fracture / 中华创伤骨科杂志

Nowadays,more and more studies on mini-invasive treatment of clavicle fractures have been reported.Firstly,based on the newly published literature about intramedullary fixation for midshaft clavicle fractures,this paper reviews its indications and advantages.Next,the design characteristics,surgical procedures,therapeutic effects and latest treatment advances concerning the intramedullary implants are systemically demonstrated and compared.Intramedullary fixation can be used in most midshaft clavicle fractures except those with neurovascular lesions or with comminuted segments,or obsolete ones.The commonly used intramedullary implants include Kirschner wires,cannulated screws,titanium elastic nails,threaded nails,and second-generation intramedullary nails.Intramedullary fixation has potential advantages of a smaller incision,fewer complications,a lower refracture risk and faster bone healing but also limitations in strength and stability.However,more and more intramedullary implants,from cannulated screws to second-generation intramedullary nails,have been used in clinic,leading to fine therapeutic effects.New products are being developed to overcome the previous shortcomings.

Posterolateral minimal invasive plate osteosynthesis for medial open fractures of distal tibia and tibial shaft / 中华创伤骨科杂志

Objective To analyze the posterolateral minimally invasive plate osteosynthesis (MIPO) in the treatment of medial open fractures of distal tibia and tibial shaft.Methods From May 2016 to September 2017,16 medial open fractures of distal tibia and tibial shaft were treated with posterolateral MIPO at Department of Orthopaedics,The First Affiliated Hospital to Anhui University of Science and Technology.They were 10 men and 6 women,from 22 to 61 years of age(average,36.5 years).According to the Gustilo-Anderson classification,type Ⅰ fracture was identified in 5 patients,type Ⅱ fracture in 6 and type Ⅲ fracture in 5.Initially,all the patients received emergency external fixation or calcaneus traction before open reduction and internal fixation was performed when their conditions of soft tissue allowed.X-ray examination of the ankle joint with anteroposterior and lateral views was performed before and after operation.At the last follow-up,the function of ankle joint was evaluated according to the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS).Results All the 16 patients were followed up for an average of 15.3 months (from 8 to 24 months).Fracture healing was achieved in all after an average time of 26.1 weeks (from 20 to 36weeks).There were no such complications as skin necrosis,wound dehiscence,deep infection,implants exposure or failure,or impingement of the flexor hallucis longus.The AOFAS ankle scores averaged 88.6 points (from 74 to 95 points),giving 9 excellent,6 good and one fair cases.Superficial infection occurred in 2 patients but healed after dressing care.Another case showed 5°varus deformity.Conclusion Application of posterolateral MIPO in the treatment of medial open fractures of distal tibia and tibial shaft can effectively protect the medial soft tissue,reduce postoperative wound complications,and safely expose,reduce and fixate the tibial fragments,leading to satisfactory outcomes.

Stereotactic ablation radiotherapy for early stage non-small cell lung cancer: Progress and challenge / 肿瘤

With the continuous development of diagnostic technology, the detection rate of early-stage non-small cell lung cancer (NSCLC) is increasing. For a long time, the standard treatment for early-stage lung cancer is lobectomy combined with lymph node dissection or sublobectomy. Since the emergence of stereotactic body radiotherapy (SBRT), it has long been a preferred alternative for early-stage NSCLC patients who cannot tolerate surgery or because of other reasons. Recent studies have shown that for early-stage NSCLC patients who are operable, SBRT can achieve the same or even better effect as surgery. However, there is still a lot of controversies in the medical community on the application of SBRT to the early-stage NSCLC. How to choose the early-stage NSCLC population that can benefit most from the SBRT treatment is the current research focus. Several ongoing prospective randomized controlled studies may provide an answer.

Application of controllable hair density of eyebrow reconstruction with the treatment of scar baldness during the same operation stage / 中华医学美学美容杂志

Objective To explore a method of eyebrow reconstruction which can control eyebrows,and to repair scar baldness in the same operation stage.Methods Operations were performed in two stages.In the first stage,an expander was placed under the scalp at the same side of the defect eyebrow through the direction of the superficial temporal artery.Other expanders were placed around the scar baldness.After the incision healed,water was injected into the expander.During the expansion,the scalp hair density was approaching the uninjured eyebrow side.Then the second stage operation was prepared:an island flap with superficial temporal artery as axial artery was harvested and the expander was extracted.The subcutaneous tunnel was made in the temporal region of the eyebrow defect side.The expanded superficial temporal artery island scalp flap was passed through the tunnel and transferred to the defect eyebrow area to repair the eyebrow.After incising the scar baldness,the left expanded scalp flaps were transferred to cover the wound.Results 12 patients underwent this method of eyebrow reconstruction with scar baldness,all island scalp flaps survived,with no case of flap necrosis.After 6-24 months of follow-up,the hair density of the reconstructed eyebrows was very close to that of the uninjured side,without excessive thickening or excessive rarefaction.The scalp scars were small and can be shaded by the hair.All patients were satisfied with the operation.Conclusions The method of controllable hair density of eyebrow reconstruction with the treatment of scar baldness has good effects on reconstructing eyebrow defect and scar baldness.It is simple,economic and suitable for further application.

V-Y advancement flap based on the double perforators of the posterior tibial artery for reconstruction of small-area tissue defect in the achilles tendon / 中华显微外科杂志

Objective To investigate the clinical effect of the V-Y advancement flap based on double perfo-rators of the posterior tibial artery for reconstruction of small-area tissue defect in the achilles tendon. Methods From June, 2014 to June, 2017, a total of 8 patients with small-area tissue defect in the achilles tendon were repaired by the V-Y advancement flap based on double perforators of the posterior tibial artery. The size of defects ranged from 1.5 cm ×3.5 cm to 3.5 cm ×5.0 cm, and the size of flaps ranged from 2.0 cm ×8.0 cm to 4.0 cm ×12.0 cm. The donor area was directly sutured. Eight cases were followed-up, and the appearance, quality, color and elasticity was raorded. Results All V-Y advancement flaps based on double perforators of the posterior tibial artery survived, and all donor sites were directly sutured. Followed-up for 3 to 12 months. All V-Y advancement flaps were flat with the sur-rounding tissue. The appearance, quality, color and elasticity of flaps were good. According to the related evaluation criteria made by the American Orthopedic Foot and Ankle Surgery Society (AOFAS), the results of 8 patients were ex-cellent in 6 cases, and good in 2 cases. The patients had a high degree of satisfaction. Conclusion Application of the V-Y advancement flap based on the double perforators of the posterior tibial artery is an ideal method to repair the small-area tissue defect in the achilles tendon. This kind of surgery is simple, safe and has minimal donor site mor-bidity.