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BACKGROUND:Stability of the support surface and visual input are important factors affecting static balance,but most of the studies on the balance ability of elderly with mild cognitive impairment have focused on the stable hard support surface,and the control of static balance on the unstable support surface under different visual input conditions is not known. OBJECTIVE:To investigate the static balance ability of the elderly with mild cognitive impairment on soft and hard support surfaces under different visual input conditions. METHODS:Twenty-one elderly people with mild cognitive impairment and nineteen elderly people with normal cognition were selected for the study,and the Kistler three-dimensional dynamometer was used to conduct four tests:standing with two feet on hard support surface with eyes open,standing with two feet on soft support surface with eyes open,standing with two feet on hard support surface with eyes closed,standing with two feet on soft support surface with eyes closed,and standing with two feet on soft support surface with eyes closed,and the duration of each test was 30 seconds.The plantar center of pressure data were collected and compared between the two groups under different visual conditions on the soft and hard support surfaces. RESULTS AND CONCLUSION:(1)Under the condition of visual input,the total excursions(soft support surface:P=0.003),the total excursions-medial-lateral sides(soft support surface:P=0.001,hard support surface:P<0.001)and the 95%confidence ellipse area(soft support surface:P=0.001,hard support surface:P<0.001)of the center of pressure in the elderly with mild cognitive impairment on the soft and hard support surfaces were significantly higher than those of the elderly with normal cognition.(2)In the absence of visual input,the root mean square distance(P=0.014),the root mean square distance-medial-lateral sides(P=0.014),and the 95%confidence ellipse area(P=0.001)of center of pressure in the elderly with mild cognitive impairment on the soft support surfaces were significantly higher than those of the elderly with normal cognition,but there were no significant differences between the groups on the hard support surface(P>0.05).(3)These findings confirm that compared with the elderly with normal cognition who could make full use of visual sensory input to maintain body balance on the soft and hard support surfaces,mild cognitive impairment elderly presented a deficit in balance function.In particular,mild cognitive impairment elderly relied more on ankle proprioception to maintain balance when visual interference was present,suggesting that mild cognitive impairment elderly should focus on strengthening ankle proprioceptive training.
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Objective Analyze the surveillance results of foodborne illness from a level A tertiary general hospital in Shandong Province from 2019 to 2021,to provide a realistic basis for the continuous development and improvement of foodborne disease surveillance.Methods The data were collected from a level A tertiary general hospital in Shandong Province from 2019 to 2021 in the food safety risk assessment business application platform of national health insurance information project of National Health Security Disease Control Information System,and stool/anal swab samples were collected as required for pathogen detec-tion.Results From 2019 to 2021,a total of 2 323 cases of foodborne diseases were reported and 682 samples were collected,with a sampling rate of 29.36％,and 134 positive cases were detected,with a detection rate of 19.65％.The difference between the detection rates of different years was statistically significant(P＜0.05).The detection rate of norovirus was the highest(9.53％),followed by Vibrio parahaemolyticus(8.94％)and Salmonella(1.91％).The difference between the detection rates of different pathogens was statistically significant(P＜0.05).The sex ratio of 2 323 cases was 1:1.28.Among the different age distributions,20-29 years old accounted for the highest proportion(29.19％),followed by 30-39 years old(27.21％)and＜20 years old(11.71％).The highest number of cases was reported from June to September,the peak was reached from July to Au-gust,and the number of cases was gradually reduced in October and later.Among different occupational groups,housework and unemployed people accounted for the highest proportion(30.18％),followed by farmers(15.93％),students(13.65％)and commercial service workers(11.80％).The main symptoms of the digestive system were diarrhea in 2 093 cases(90.10％),abdominal pain in 1 741 cases(74.95％),nausea in 1 575 cases(67.8％)and vomiting in 1 401 cases(60.31％).The main diarrhea was watery stool in 1 954 cases(84.12％).The main systemic symptoms were fatigue in 454 cases(19.54％)and dehydration in 212 cases(9.13％).The main clinical diagnosis was acute gastroenteritis in 1 980 cases(85.23％)and infec-tious diarrhea in 199 cases(8.57％).The suspected exposed foods were mainly aquatic animals and their products(25.10％)and meat and meat products(19.37％).The main eating places of suspected exposed foods were families(57.34％),followed by restaurants(21.91％),other places(5.94％)and street food stalls(5.21％).Conclusion From 2019 to 2021,the pathogens of foodborne diseases detected were mainly norovirus and Vibrio parahaemolyticus,mainly in the age group of 20 to 39 years old,and the occupation distribution was mainly household and unemployed people,farmers,students and commercial serv-ice personnel,with digestive system symptoms such as nausea,vomiting,abdominal pain and diarrhea.The suspected exposed foods are mainly aquatic animals and their products and meat and meat products,and the main eating places are families,restau-rants and street food stalls.The surveillance and reporting of foodborne diseases should continue to be strengthened in the future.
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The liver is a common metastatic site of malignant tumors， and liver metastasis is also the leading cause of death due to metastatic tumors. Metastatic liver cancer has high heterogeneity， and there has been slow progress in the treatment of metastatic liver cancer for a long time. In recent years， the development of surgical techniques， systemic therapy， and the multidisciplinary team （MDT） diagnostic and therapeutic mode has led to revolutionary changes in the clinical management of metastatic liver cancer. The article reviews the recent progress in the treatment of metastatic liver cancer from the three aspects of surgical treatment， systemic therapy， and locoregional therapy. Combined therapy based on chemotherapy， targeted therapy， and immunotherapy remains the basic multimodality therapy for metastatic liver cancer. In addition， the development of locoregional therapy has brought new treatment options for patients with metastatic liver cancer. Standardized diagnosis and treatment based on high-level evidence-based evidence and related guidelines and individualized precise treatment under the guidance of MDT will be the future directions for the clinical management of metastatic liver cancer.
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Objective:To compare the specific mechanism and effects between christina loosestrife and snowbellleaf tickclover herb on kidney calcium oxalate calculi in rats.Methods:A total of 54 SPF grade SD male rats were fed adaptically for 1 week to 180-200 g, the models of rats with kidney calcium oxalate calculi were established by intragastric administration with glycol, and divided into nine groups according to random number table method and controlled, which were healthy control group (group A), positive control group (model group, group B), low, medium and high doses of christina loosestrife groups (C1, C2, C3, 3 groups), low, medium and high doses of snowbellleaf tickclover herb groups (D1, D2, D3, 3 groups), therapeutic control group (potassium sodium hydrogen citrate group, group E), 6 rats in each group. After 4 weeks, samples were collected to determine the urine and serum biochemical indexes of each group, and Von Kossa staining was used to detect kidney calcium oxalate crystals. Calcium oxalate crystal deposition in kidney tissues of rats was observed under polarization microscope, and the difference of efficacy between the two drug effects was determined by the percentage of positive area in photos and the urine and serum biochemical indexes. The measurement data were expressed as mean ± standard deviation ( ± s), one-way analysis of variance was used for comparison between groups, and SNK- q test was used for comparison between two groups. Kruskal-Wallis test was used to compare crystal formation between groups. Results:Compared with the positive control group and christina loosestrife groups, high dose of snowbellleaf tickclover herb could significantly reduce serum creatinine level ( P<0.01), the mean serum creatinine of rats with christina loosestrife was (86.70±11.49) μmol/L, that of rats with snowbellleaf tickclover herb was (70.72±9.08) μmol/L, the difference was statistically significant ( P<0.01). High dose of christina loosestrife and snowbellleaf tickclover herb could significantly increase urinary magnesium and decrease serum urea levels, and there was no statistical significance between them ( P>0.05). Compared with the positive control group, high dose of christina loosestrife ( P<0.000 1) and snowbellleaf tickclover herb ( P<0.000 1) could both inhibit the formation of calcium oxalate crystals and protect the kidney of rats, and there was no statistical significance between the two effects ( P>0.05). The levels of urine pH value could not be increased, while the levels of urinary calcium urinary oxalic acid and 24 h urine volume, serum calcium, serum phosphorus, serum magnesium, blood uric acid and content of kidney oxalate could not be decreased significantly after using these two drugs. Conclusion:Snowbellleaf tickclover herb is better than christina loosestrife in preventing recurrence of kidney calcium oxalate calculi and protecting renal function.
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Objective:To investigate the clinical efficacy and safety of transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy in the treatment of complex renal calculi.Methods:A total of 72 patients with complex renal calculi admitted to Beijing Friendship Hospital, Capital Medical University from November 2019 to April 2022 were prospective selected, which were randomly divided into study group and control group by the random number table method, with 36 cases in each group. The control group underwent single channel minimally invasive percutaneous nephrolithotomy, while the study group underwent transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephrolithotomy. The perioperative indexes (operation time, postoperative hospital stay, intraoperative blood loss), stone removal effect, renal function indicators [blood urea nitrogen (BUN), serum creatinine (SCr)] and complication rate were compared between the two groups. Measurement data were expressed as mean ± standard deviation ( ± s), and t-test was used for inter-group comparison. The Chi-square test or Fisher exact probability method were used to compare the count data of two groups. Results:The operation time [(101.05±11.34) min vs (107.84±10.28) min] and postoperative hospital stay [(8.54±3.15) d vs (12.36±4.08) d] in the study group were significantly shorter than those in the control group, and the difference were statistically significant ( P<0.05). The amount of intraoperative bleeding was close to that in the control group, but the difference was not statistically significant ( P>0.05). The primary stone clearance rate and summary stone clearance rate in the study group were 91.67% (33/36) and 100.0% (36/36), respectively, which were significantly higher than 69.44% (25/36) and 83.33% (30/36) in the control group, and the differences were statistically significant ( P<0.05). The postoperative BUN and SCr levels in the study group were (5.24±0.31) mmol/L and (90.65±25.57) μmol/L, respectively, the control group was (7.69±0.78) mmol/L and (131.96±37.80) μmol/L, respectively. BUN and SCr levels in the study group were significantly lower than those in the control group, and the differences were statistically significant ( P<0.05). The total incidence of postoperative complications in the study group was significantly lower than that in the control group (5.56% vs 16.67%), and the difference was statistically significant ( P<0.05). Conclusion:Transurethral flexible ureteroscopy combined with single channel minimally invasive percutaneous nephroscopy is an ideal method for the treatment of complex renal calculi, which has good removal effect, less complications and helps to improve renal function.
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Objective:To investigate the application effects of self-developed rapid tracheotomy apparatus for acute tracheotomy.Methods:A total of 120 patients who underwent an acute tracheotomy in the Weihai Branch of The 970 Hospital of PLA Joint Logistics Support Force from January 2019 to December 2020 were included in this study. These patients were randomly divided into a rapid group and a conventional group, with 60 patients in each group. Patients in the rapid group underwent tracheotomy with a self-developed rapid tracheotomy apparatus. Patients in the conventional group underwent the standard steps of traditional tracheostomy. The operation time, incision length, amount of bleeding, and incidence of postoperative complications were compared between the two groups.Results:The operation time in the rapid group was significantly shorter than that in the conventional group [(4.5 ± 0.9) minutes vs. (19.3 ± 4.7) minutes, t = 23.86, P < 0.001]. The length of incision in the rapid group was significantly shorter than that in the conventional group [(2.8 ± 0.3) cm vs. (4.2 ± 1.3) cm, t = 8.68, P < 0.001]. The amount of bleeding during the surgery in the rapid group was significantly less than that in the conventional group [(4.4 ± 1.6) mL vs. (11.8 ± 4.1) mL, t = 12.99, P < 0.001]. The incidence of postoperative complications in the rapid group was significantly lower than that in the conventional group ( χ2 = 4.66, P = 0.031). Conclusion:The self-developed rapid tracheotomy apparatus for acute tracheotomy can be used to establish an artificial airway quickly and minimally invasively by simplifying the operational steps. It is remarkably innovative to increase safety with open-view operations and decrease the incidence of complications. It can be repeatedly sterilized and reused, which is worthy of clinical application and popularization.
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Objective:To explore the outcome of sponge forceps assisted threading with Speedbridge technique for the treatment of acute closed Achilles tendon rupture.Methods:A retrospective case series study was conducted on 20 patients with acute closed Achilles tendon rupture treated in Zhengzhou Orthopedic Hospital from December 2019 to December 2021. There were 18 males and 2 females, with age range of 24-43 years [(29.5±7.6)years]. All patients were with unilateral injury, involving the left side in 13 patients and right side in 7. Examinations revealed a palpable defect in the Achilles tendon and positive Thompson test. A longitudinal incision was made at the medial edge of the ruptured tendon. Three nonabsorbable sutures were passed through the proximal stump with sponge forceps, bypassed the rupture site and fixed directly into the calcaneal bone. The disrupted tendon ends were aligned by the tendon-bundle technique using 4-0 absorbable sutures. The operation time and incision length were documented. The ankle joint range of motion (dorsiflexion/plantar flexion), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Achilles tendon total rupture score (ATRS) in the affected and healthy side were compared at 3, 6 and 12 months postoperatively. The wound healing and complications were observed.Results:All patients were followed up for 12-16 months [(13.2±2.5)months]. The operation time was 40-66 minutes [(52.0±10.3)minutes], with the incision length of 3-4 cm [(3.3±0.7)cm]. In the affected side at 3 and 6 months postoperatively, the ankle joint dorsiflexion [(5.6±1.5)°, (10.5±0.2)°] and plantar flexion [(28.4±3.2)°, (33.5±1.5)°] showed statistically significant difference compared with the healthy side (all P<0.05). The ankle joint dorsiflexion [(13.9±0.7)°] and plantar flexion [(38.3±4.4)°] in the affected side were not statistically different from that of the healthy side at 12 months postoperatively (all P>0.05). The AOFAS ankle-hindfoot score was (58.3±5.4)points, (84.9±7.1)points and (91.8±6.3)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). The ATRS was (60.5±4.9)points, (85.5±9.0)points and (93.1±5.7)points at 3, 6 and 12 months postoperatively, showing a gradual rise (all P<0.05). All incisions were healed primarily. No patients had wound infection, nerve injury or re-rupture. Pain at the anchor insertion site occurred in 2 patients at 1 month after operation and relieved after active functional rehabilitation at 4 months after operation. Transient pain at the Achilles tendon insertion occurred in 1 patient at 6 months after operation, and relieved after 2 weeks of oral non-steroidal anti-inflammatory drugs treatment. Conclusion:For acute closed Achilles tendon rupture, sponge forceps assisted threading with Speedbridge technique can attain short operation time, small incision and good functional recovery, with few complications.
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The need for long-term treatments of chronic diseases has motivated the widespread development of long-acting parenteral formulations (LAPFs) with the aim of improving drug pharmacokinetics and therapeutic efficacy. LAPFs have been proven to extend the half-life of therapeutics, as well as to improve patient adherence; consequently, this enhances the outcome of therapy positively. Over past decades, considerable progress has been made in designing effective LAPFs in both preclinical and clinical settings. Here we review the latest advances of LAPFs in preclinical and clinical stages, focusing on the strategies and underlying mechanisms for achieving long acting. Existing strategies are classified into manipulation of
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Objective:To investigate the prognostic significance of the lymphovascular invasion (LVI) in patients with upper tract urothelial carcinoma(UTUC) after radical nephoureterectomy (RNU) and Gemcitabine and Cisplatin combination Chemotherapy (GC).Methods:The clinical data of 95 patients with UTUC admitted to Beijing Friendship Hospital, Capital Medical University from March 2013 to March 2019 were analyzed retrospectively. There were 50 males and 45 females; the average age was 63 years, ranged from 36 to 81 years. According to the situation of LVI, they were divided into LVI positive group ( n=25) and LVI negative group ( n=70). Chi-square test was used to analyze the clinicopathological parameters of the two groups of patients. Kaplan-Meier method was used to draw the survival curves of the overall survival (OS) time and recurrence-free survival (RFS) time of the two groups of patients. The difference between the two groups was used Log-Rank test. The risk factors related to OS and RFS were evaluated using univariate and multivariate Cox regression models. Results:All patients were followed up for 2-82 months, with an average follow-up time of 36 months. Among them, 20(21.1%) died and 36(37.9%) relapsed. There were significant differences in T stage ( P=0.046), lymph node metastasis ( P=0.032), and tumor location ( P=0.019) between LVI negative group and LVI negative group. Univariate analysis showed that hydronephrosis ( P=0.026), lymph node metastasis( P=0.001), LVI ( P=0.001), chemotherapy cycle ( P=0.045) were correlated with OS; hydronephrosis ( P=0.031), tumor T stage ( P=0.013), lymph node metastasis ( P=0.004), LVI ( P=0.001) were significantly correlated with RFS. Multivariate analysis showed that hydronephrosis ( P=0.016), lymph node metastasis ( P=0.016), and LVI( P=0.003) were significantly correlated with OS. Lymph node metastasis ( P=0.018), LVI ( P=0.003) were significantly correlated with RFS. In conclusion, LVI was an independent risk factor for OS and RFS. The OS [(40.7±6.5) months for LVI positive group, (68.5±3.2) months for LVI negative group, χ2=15.750, P<0.001] and RFS [(31.0±5.7) months for LVI positive group, (58.0±8.8) months for LVI negative group, χ2=10.986, P=0.001] of patients with LVI positive group were worse than those with LVI negative group, the differences were statistically significant. Conclusions:LVI is more likely to be possitive in patients with high T stage, lymph node metastasis and single renal pelvis cancer, which provides a basis for risk stratification of patients with UTUC. After radical resection and adjuvant chemotherapy, the benefit of OS and RFS in patients with positive LVI was significantly worse than that in patients with negative LVI.
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Objective:To explore the risk factors of tumor recurrence after radical nephroureterectomy combined with Gemcitabine and Cisplatin(GC) systemic intravenous chemotherapy for upper tract urothelial carcinoma (UTUC), establish a recurrence risk prediction model, and conduct preliminary verification.Methods:One hundred and one cases of UTUC were analyzed from January 2013 to October 2019 in Beijing Friendship Hospital, Capital Medical University retrospectively. All patients underwent radical nephroureterectomy+ bladder cuff resection, and were treated with GC intravenous adjuvant chemotherapy, among which 19 underwent preoperative neoadjuvant chemotherapy. The study collected general information and clinical characteristics of the patients, and follow up the patient's recurrence. Tumor recurrence and relapse free survival (RFS) were the main observation indexes. The patients were divided into the recurrent group and the non-recurrent group according to their recurrence. Kaplan-Meier and Log-rank methods were used to estimate and compare the RFS rates of the two groups. Univariate difference analysis was used to identify the indicators that were significantly different between patients in the recurrence group and the non-recurrence group, and the COX proportional hazard model was further used to explore the correlation between each factor and the tumor recurrence. According to the weights of relevant risk factors, an individual prognostic index (PI) equation was established, a recurrence prediction model was constructed, and the receiver operating characteristic (ROC) curve was used for verification.Results:One hundred and one patients were followed up for 2-82 months, with median 22 months. 40 patients had recurrence, including 32 in the bladder and 8 in the contralateral upper urinary. One-year RFS was 82.10%, two-year RFS was 68.90% and 5-year RFS was 42.10%. COX proportional risk model results showed that tumor hydronephrosis (X1), lymphovascular invasion (X2) and tumor T stage (X3) were independent risk factors, while neoadjuvant chemotherapy (X4) and chemotherapy cycle (X5) were independent protective factors. Individual PI equation =0.964X1+ 0.688X2+ 0.508X3-1.566 X4-0.675X5. The ROC curve was drawn to show that the optimal pointcut value was 179.5 when the Youden index was 0.537, the sensitivity of the model was 0.750, the specificity was 0.787, and the area under the curve (AUC) was 0.838(95% CI: 0.758-0.918). Conclusions:Hydronephrosis, tumor T stage, lymphovascular invasion, neoadjuvant chemotherapy and chemotherapy cycle are independent factors affecting the recurrence of UTUC patients. The multi-factor risk prediction model is suitable for evaluating the possibility of tumor recurrence after radical surgery combined with GC chemotherapy in UTUC patients, which can provide scientific evidence for the prognosis assessment of patients.
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Objective To evaluate Evans lateral lengthening calcaneal osteotomy(E-LLCOT) in the treatment oftalocalcaneal coalitions (TCCs) with forefoot abduction deformity in the teenagers.Methods From February 2014 to August 2018,11 teenaged patients (14 feet) were treated at Department of Foot and Ankle Surgery,Zhengzhou Orthopaedics Hospital for TCCs with severe forefoot abduction deformity.They were 6 males (8 feet) and 5 females (6 feet),aged from 13 to 17 years (average,15 years).Their diseases involved bilateral feet in 3 cases and unilateral foot in 8,the left foot in 7 cases and the right in 7.All patients underwent TCCs resection followed by E-LLCOT.Their talonavicular coverage angles (TCA) and talar-second metatarsal angles (T2-MT) on the anteroposterior film and talar horizontal angles (TH) and talar-first metatarsal angles (T1-MT) on the lateral film were measured preoperatively and at the last follow-up.The foot functions were evaluated preoperatively and at the last follow-up using the ankle-hindfoot scores of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS).Results All the 11 patients were followed up for 12 to 24 months (average,16.5 months).The mean preoperative TCA (22.3°,from 20° to 26°) was improved to 10.5° (from 8° to 13°) at the last follow-up;the mean T-2MT was improved from preoperative 17.6° (from 16° to 20°) to 6.5° (from 5° to 11°) at the last follow-up;the mean TH on the lateral view was improved from preoperative 35° (from 25° to 40°) to 17.5° (from 16° to 21°) at the last follow-up;the mean T-1MT was improved from preoperative 15.5° (from 10° to 22°) to 3.5° (from 2° to 6°) at the last follow-up;the mean AOFAS score was improved from 56.5 (from 50 to 62) preoperatively to 90.6 (from 75 to 95) at the last follow-up;the mean VAS score was improved from 6.0 (from 5 to 7) preoperatively to 2 (from 0 to 3) at the last follow-up.Conclusion For TCCs with severe forefoot abduction deformity in the geenagers,E-LLCOT after TCCs resection can effectively correct deformity,relieve pain and achieve significant functional and radiographic improvements.
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Objective:To analyze the therapeutic effect of ankle arthrodesis with reverse proximal humerus internal locking system plating plus cannulated screwing via the transfibular approach in the treatment of end-stage ankle arthrosis.Methods:From April 2014 to January 2018, 19 patients (19 ankles) with end-stage ankle osteoarthritis were treated at Department of Foot and Ankle Surgery, Zhengzhou Orthopaedics Hospital by ankle arthrodesis with reverse PHILOS plating plus cannulated screwing via the transfibular approach for multi-plane fixation. They were 9 men and 10 women, aged from 36 to 65 years (average, 46.7 years). The disorder was further diagnosed as traumatic arthritis in 9 cases, as osteoarthritis in 6, as talar necrosis in 2 and as equinovarus in 2, and affected the left ankle in 11 cases and the right in 8. All cases belonged to stage Ⅲ osteoarthritis according to the Morrey-Wiedeman imaging classification. Their American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), joint fusion and complications were observed preoperatively and at the last follow-up.Results:All the 19 patients were followed up for 18 to 62 months (average, 31.5 months). Their AOFAS scores were improved from preoperative 46.3±2.1 to 81.6±0.9 at the last follow-up, and their VAS was reduced from preoperative 7.1±0.2 to 2.0±0.2 at the last follow-up, showing significant differences ( P<0.001). All their ankle joints obtained bony fusion after 9 to 14 weeks (mean, 11.5 weeks). No implant loosening or breakage was observed. All the patients were satisfied with their operative results at the last follow-up. Dorsal lateral foot numbness was observed in one patient who became asymptomatic after neurotrophic medication for 3 months. Lateral distal wound dehiscence happened during removal of stitches at 2 weeks after operation in another patient but healed after debridement. The last follow-up found subtalar joint degeneration in 2 cases and talonavicular joint degeneration in one but no clinical symptoms in the 3. Conclusion:Ankle arthrodesis with reverse PHILOS plating plus cannulated screwing via the transfibular approach is a fine treatment for end-stage ankle arthrosis, because it leads to reliable fixation, short fusion time, alleviated pain and improved ankle function.
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As indications of radiotherapy in the treatment of breast cancer continue to expand, more and more patients need radiotherapy after mastectomy. With the development of breast reconstruction, radiotherapy and its timing will affect breast reconstruction while patients benefit from tumor treatment and may lead to different postoperative complications and cosmetic effects. How to optimize the comprehensive therapeutic strategies of postoperative breast reconstruction and radiotherapy for breast cancer, especially the techniques of breast reconstruction and the choices of radiotherapy timing, has become an issue of common concerns of multidisciplinary treatment involving radiotherapy, breast surgery, and plastic surgery. This paper aims to review and summarize the latest high-quality research in this field including the impact of radiotherapy and its timing on tissue expander/prosthetic breast reconstruction, rate of prosthetic reconstruction, and postoperative patient satisfaction so that scholars can understand the latest research progress of radiotherapy and breast reconstruction and clinicians can optimize therapeutic regimens.
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BACKGROUND: It has been found that the distribution and diffusion degree of bone cement are the main factors influencing the clinical effect of percutaneous vertebroplasty. OBJECTIVE: To explore the feasibility of analyzing bone cement distribution form and diffusion degree based on Mimics software, and to evaluate the relationship of clinical efficacy with bone cement distribution form and diffusion degree. METHODS: A total of 170 cases of osteoporotic vertebral compression fracture admitted to Zigong No. 4 People's Hospital from January 2017 to March 2018 were included, including 41 cases of males and 129 cases of females aged 60-97 years. All of them were treated with percutaneous vertebroplasty. X-ray and CT examination were done at postoperative 2 days, and the bone cement distribution was classified into five types based on the distribution of bone cement in X-ray images, including type Ⅰ (most cement continuously and evenly distributed in the vertebral body), type Ⅱ (most cement distributed in the central vertebral bodies), type Ⅲ (most cement distributed on both sides of vertebral body), type Ⅳ (most cement distribution at the side of the vertebral bodies and the central), type Ⅴ (most cement distribution at the side of the vertebral body). Mimics project files were created based on CT image data to calculate bone cement volume and diffusion volume. After 6 months of follow-up, visual analogue scale score, Oswestry disability index and Cobb angle were compared among groups to analyze the relationship between bone cement distribution, bone cement diffusion volume, bone cement diffusion volume ratio and clinical efficacy. RESULTS AND CONCLUSION: (1) The visual analogue scale score and Oswestry disability index of the five types of bone cements were significantly improved at 2 days and 6 months after surgery compared with preoperative data (P < 0.05), the Cobb angle of the type Ⅰ group was significantly improved compared with preoperative data (P < 0.05), and the Cobb angles of the type Ⅱ-Ⅴ groups showed no difference from the preoperative data (P> 0.05). (2) The diffusion volume of bone cement was (6.69±1.19) mL, and the diffusion volume ratio of bone cement was (20.93±3.13) ％. There was no correlation between the volume of bone cement injection and the visual analogue scale score, Oswestry disability index and Cobb angle at 2 days and 6 months after surgery. There was a negative correlation between the bone cement dispersion volume and the visual analogue scale score at 6 months after surgery, and the Oswestry disability index score at 2 days and 6 months after surgery (P < 0.05), but the correlation was weak. The diffusion volume ratio of bone cement was negatively correlated with the visual analogue scale score and Oswestry disability index score at 2 days and 6 months after surgery (P < 0.05), showing a strong correlation. These findings show that, based on the three-dimensional reconstruction function of Mimics software, the diffusion volume and diffusion volume ratio of bone cement can be accurately calculated. The bone cement evenly distributed can alleviate the local kyphosis. The diffusion volume ratio of bone cement is positively correlated with clinical efficacy, which is more valuable than the volume of bone cement.
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OBJECTIVE@#To establish a quantitative fluorescent detection method using DAPI for detecting inorganic polyphosphate (polyP) in enterohemorrhagic Escherichia coli (EHEC) O157:H7.@*METHODS@#The DNA of wild-type strain of EHEC O157:H7 was extracted and purified. DAPI was combined with the extracted DNA and polyP45 standards for measurement of the emission spectra at 360 nm and 415 nm fluorescence spectrophotometry. The fluorescence of DAPI-DNA and DAPI-polyP complexes was detected by fluorescence confocal microscopy to verify the feasibility of DAPI for detecting polyP. To determine the optimal pretreatment protocol for improving the cell membrane permeability, the effects of 6 pretreatments of the cells (namely snap-freezing in liquid nitrogen, freezing at -80 ℃, and freezing at -20 ℃, all followed by thawing at room temperature; heating at 60 ℃ for 10 min; treatment with Triton x-100; and placement at room temperature) were tested on the survival of EHEC O157:H7. The fluorescence values of the treated bacteria were then measured after DAPI staining. A standard calibration curve of polyP standard was established for calculation of the content of polyP in the live cells of wildtype EHEC strain and two mutant strains.@*RESULTS@#At the excitation wavelength of 360 nm, the maximum emission wavelength of DAPI-DNA was 460 nm, and the maximum emission wavelength of DAPI-polyP was 550 nm at the excitation wavelength of 415 nm. The results of confocal microscopy showed that 405 nm excitation elicited blue fluorescence from DAPIDNA complex with the emission wavelength of 425-475 nm; excitation at 488 nm elicited green fluorescence from the DAPIpolyP complex with the emission wavelength of 500-560 nm of. Snap-freezing of cells at -80 ℃ followed by thawing at room temperature was the optimal pretreatment to promote DAPI penetration into the live cells. The standard calibration curve was =1849+127.5 (R=0.991) was used for determining polyP content in the EHEC strains. The experimental results showed that wild-type strain had significantly higher polyP content than the mutant strains with deletion.@*CONCLUSIONS@#We established a convenient quantitative method for direct and reliable detection polyP content to facilitate further study of polyP and its catalytic enzymes in EHEC O157:H7.
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Escherichia coli O157 , Protéines Escherichia coli , PolyphosphatesRÉSUMÉ
Objective As one of the important parts of medical scientific research outcomes,the significance of nursing patents is becoming more and more prominent during recent years.However,the nursing department is the blind spot of intellectual property in most hospitals.This article tried to explore strategies to eliminate harriers to the implementation of nursing intellectual property rights in order to promote nursing patents.Methods This paper conducted systematic analysis of the problems and obstacles in the implementation and transformation of nursing patents,and proposed tailored administrative plan.Results Identified obstacle factors include personal reasons of the nursing staff,heavy daily clinical work,as well as the immature patent system and patent market in China.Accordingly,our hospital adopted several corrective measurements,for instance,improving the support for the implementation of nursing patents,strengthening the cultivation and incubation of the intellectual property of nursing staff and standardizing the patent management.Conclusions These measures have effectively im proved the awareness and enthusiasm of nurses' patent knowledge.And we have obtained the ice breaking of the transformation of nursing patents in our hospital.
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Objective To explore the appropriate scientific research award mechanism to promote the transformation of scientific and technological achievements.Methods Literature review was adopted to conduct comprehensive analysis of the incentive mechanisms of foreign patent transformation as well as related policies in China.Results Aimed to providing sufficient opportunities and motivation for the patent transformation platform,increasing the proportion of incentives for R&D personnel and setting up performance rewards for scientific research administration,a policy named Provisions on the proportion of rewards for R&D personnel after the transformation of intellectual property rights in Zhongshan Hospital was developed,which effectively facilitated the medical patents to market transformation.Conclusions It is alerted that improve the enthusiasm of relevant personnel for patent transformation plays important role in increasing the transformation of medical patents.
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Objective To evaluate distractor-assisted reduction for Lisfranc injury complicated with compressive fracture of lateral foot column.Methods A retrospective study was conducted of the 18 patients who had been treated surgically at Department of Foot and Ankle Surgery,Zhengzhou Orthopaedics Hospital between May 2014 and March 2017 for Lisfranc injury complicated with compressive fracture of lateral foot column.They were 10 males and 8 females,with an average age of 38.4 years (from 25 to 65 years).The injury involved the right foot in 11 cases and the left foot in 7.Their concomitant injuries were 12 compressive cuboid fractures and 6 compressive fractures of the calcaneal anterior process.According to the Chiodo-Myerson classification,there were 13 cases of three-column injury,3 ones of middle-lateral column injury and 2 ones of medial-lateral column injury.All the injuries were closed.After the condition of foot soft tissues permitted,open reduction assisted by a distractor and internal fixation with a mini locking plate was performed.Functional outcomes were assessed according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scores and visual analogue scale (VAS) at the final follow-ups and complications during follow-up.Results The 18 patients were followed up for one to 4 years (average,2 years).Their AOFAS hindfoot-ankle scores ranged from 55 to 96 points (average,80.4 points);their VAS ranged from 0 to 6 points (average,1.5 points).Radiographic evidence of degeneration was noted in 10 patients.Of them,2 reported persistent pain which was cured by arthrodesis after conservative therapy failed and one presented with symptoms of injury to sural and cutaneous nerves which disappeared after oral administration of neurotrophic drugs for half a year.No such complication as skin necrosis,infection or implant failure occurred in other patients.Conclusion Open distractor-assisted reduction and internal fixation of lateral foot column with a mini locking plate,combined with bone graft if necessary,is an effective treatment for Lisfranc injury complicated with compressive fracture of lateral foot column,because it can effectively restore the alignment of lateral column and result in satisfactory therapeutic effects.
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Objective To evaluate the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation.Methods From February 2014 to June 2017,15 patients (15 feet) with intra-articular calcaneal fracture associated with peroneal tendon dislocation were treated at Department of Foot and Ankle Surgery,Orthopaedics Hospital of Zhengzhou.There were 9 males (9 feet) and 6 females (6 feet),and 8 left feet and 7 right feet.The patients were aged from 20 to 55 years (average,42.5 years).After reduction of calcaneal fractures,titanium plates and screws were used for fixation.The bone canal was established on the lateral malleolus,and the torn superior peroneal retinaculum was fixed to the lateral malleolus by suture after reduction of the peroneal tendon.The ankle joint was immobilized with a plaster brace in the metatarsal flexion for 6 weeks.The postoperative outcomes were evaluated by the American Orthopaedic Foot & Ankle Society (AOFAS) score and visual analogue scale (VAS);complications were recorded.Results All the 15 patients were followed up for 12 to 36 months (average,20.5 months).All the calcaneal fractures fully healed and no re-dislocation of the peroneal tendon occurred.The AOFAS hindfoot-ankle scores ranged from 80 to 95 points,averaging of 87.4 points;the VAS scores ranged from 0 to 5 points,averaging 1.5 points.Delayed wound healing was observed in one case but primary healing was achieved eventually with regular dressing change.Another case presented with symptoms of injury to the cutaneous branch of the sural nerve which disappeared after oral administration of neurotrophic drugs for 6 months.Another case suffered from subtalar arthritis accompanied by persistent pain which disappeared after subtalar arthrodesis.No other complications were observed in the other patients.Conclusion In the surgical treatment of intra-articular calcaneal fractures associated with peroneal tendon dislocation,the peroneal tendon dislocation should be treated simultaneously with the intra-articular calcaneal fracture to achieve satisfactory clinical outcomes.
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Objective To investigate the therapeutic effect of damage control neurosurgery (DCNS) on patients with bilateral frontal contusion.Methods Thirty-three patients with bilateral frontal contusion,admitted to and accepted DCNS in our hospital from September 2017 to January 2019,were chosen in our study.According to DCNS rules,the disease condition changes of these patients were monitored,the internal environment disorders after trauma were adjusted,plasma osmotic pressure was increased,and blood oxygen saturation was maintained;once the patients grew worse,craniotomy and decompression should be undertaken immediately;the patients were followed up for 6 months after the injury and Glasgow outcome scale (GOS) was used to determine the prognoses of these patients.Results Among the 33 patients,25 (76％) received conservative treatment successfully,8 (24％) were converted to surgery during conservative treatment.Among the 8 patients,5 received unilateral craniotomy and three received bilateral craniotomy.The lower the Glasgow coma scale scores,the lower the proportion of conservative patients.GOS 6 months after injury showed good recovery in 11 patients,mild disability in 16 patients,severe disability in 4 patients,and plant survival in two patients;22 patients from the conservative treatment group and 5 from the surgery group had good recovery or mild disability.Conclusion DCNS can reduce the operation rate and its complications so as to make the patients recover earlier and better in the treatment of bilateral frontal contusion.