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Objective:To analyze the application of indocyanine green (ICG) fluorescence imaging in laparoscopic resection of pancreatic cancer.Methods:Data of 15 patients undergoing laparoscopic surgery for pancreatic cancer in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from June 2022 to March 2023 were retrospectively analyzed, including 13 males and 2 females, aged (67.0±8.6) years. ICG were intraoperatively injected to visualize the lesion and guide surgical resection. The surgical methods, postoperative pathology, ICG fluorescence imaging and tumor margins were reviewd.Results:Among the patients, seven underwent laparoscopic pancreaticoduodenectomy, seven underwent laparoscopic radical antegrade modular pancreaticosplenectomy, and one conversed to open pancreaticoduodenectomy due to combined superior mesenteric vein reconstruction. Postoperative pathology confirmed pancreatic moderately differentiated adenocarcinoma in nine cases, pancreatic moderately-low differentiated adenocarcinoma in four cases, pancreatic follicular cell carcinoma in one case, and inflammatory lesion in one case. Negative surgical margins were confirmed in all cases. Pancreatic lesion were visualized in 14 cases (fluorescent delineation of the tumor capsule) but not well visualized in one case (with moderately differentiated adenocarcinoma). In the case of inflammatory disease, the lesion parenchyma were visualized.Conclusion:ICG injection in laparoscopic surgery enables visualization of pancreatic tumor, which facilitates tumor localization and margin determination.
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AIM: To compare and observe the accuracy of five intraocular lens(IOL)power calculation formulas in patients with cataracts who have previously undergone corneal refractive surgery.METHODS: Prospective case series study. A total of 23 cataract patients(34 eyes)with a history of myopic corneal refractive surgery at Jinan Mingshui Eye Hospital from September 2021 to March 2023 were collected, including 1 eye treated with photorefractive keratectomy(PRK)and 22 patients(33 eyes)treated with laser-assisted in situ keratomileusis(LASIK). Preoperative ocular biometry was performed using the IOL Master 700, while corneal true net refractive power(TNP)was measured via Pentacam analyzer. Anterior segment optical coherence tomography(OCT)was used to assesse net corneal power(NCP), posterior corneal refractive power, and central corneal thickness(CCT). The Shammas, Haigis-L, Potvin-Hill Pentacam, OCT, and Barrett True K formulas were utilized for IOL power calculations, with the optimal power selected accordingly. At 1 mo postoperatively, actual refractive outcomes were determined through subjective refraction, based on objective optometry results. The refractive prediction error(RPE)and refractive absolute error(RAE)of each formula were calculated and compared, and the percentage of eyes with RAE ≤0.5 D and ≤1.0 D was counted.RESULTS: No significant statistical difference was found in the RPE of the five formulas when compared to zero(all P>0.05), nor were there significant differences in RPE and RAE among the formulas(F=0.554, P=0.696; H=4.402, P=0.354). The RAE was within ≤0.5 D for 26 eyes(76%)using the Potvin-Hill Pentacam formula and for 24 eyes(71%)using the Barrett True K formula, with both formulas achieving an RAE within ≤1.0D in 33 eyes(97%).CONCLUSIONS: The Barrett True K and Potvin-Hill Pentacam formulas demonstrated high predictive accuracy for IOL power calculations in post-corneal refractive surgery cataract patients. Given the variability in corneal refractive power among these patients, further research on IOL power calculation is warranted. Clinically, it is advisable to consider a range of formulas for optimal outcomes.
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Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation
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Objective:To investigate the impact of switching to low iodine drinking water in areas with high water iodine levels on the iodine nutritional status and thyroid function of pregnant women.Methods:A cross-sectional survey was conducted in Gaoqing County, Zibo City, Shandong Province. Pregnant women who underwent prenatal examinations at the Obstetrics Clinic of Gaoqing County People's Hospital from 2019 to 2021 were selected as the survey subjects. With reference to the Criteria for the Classification of Water Source High Iodine Areas and High Iodine Disease Areas (GB/T 19380-2016), pregnant women with drinking water iodine > 100 μg/L were considered as the high water iodine group and ≤100 μg/L was the non-high water iodine group. Basic information, one random urine sample, fasting blood sample, 24-hour urine sample and drinking water sample of pregnant women were collected, and thyroid ultrasound examination was performed on pregnant women. Urinary iodine (UI) concentration (UIC) and drinking water iodine concentration (WIC) were measured by inductively coupled plasma mass spectrometry, and 24-hour urinary iodine excretion (UIE) and daily iodine intake (TII) of pregnant women were calculated. Serum thyroid hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and anti-thyroid autoantibodies (TgAb) were determined by automatic chemiluminescence immunoassay. Creatinine (CR) was determined using deproteinized endpoint microplate method and UI/CR was calculate. Results:A total of 797 pregnant women were included, and the UIC was 150.2 (88.1, 281.3) μg/L, the iodine nutrition was generally at an appropriate level. Among them, 584 pregnant women in the non-high water iodine group had a UIC of 120.9 (74.9, 191.5) μg/L, which was at the iodine deficiency level; 213 pregnant women in the high water iodine group had a UIC of 321.1 (201.9, 569.1) μg/L, which was at the iodine super-appropriate level; the differences in WIC, UIC, UIE, TII, and UI/CR between the two groups were statistically significant ( Z = 21.63, 13.34, 15.14, 15.14, 11.81, P < 0.001). After stratification by different gestational periods, the differences were statistically significant when comparing WIC and TSH in pregnant women in the non-high water iodine group and UI/CR in pregnant women in the high water iodine group by gestational period ( H = 59.13, 7.30, 13.60, P < 0.05). A total of 744 pregnant women were tested for thyroid function, and 128 cases of TSH > 2.5 mU/L, 15 cases of hypothyroxemia, and 19 cases of subclinical hypothyroidism were detected, with detection rates of 17.2%, 2.0%, and 2.6%, respectively. The differences were statistically significant when comparing TSH and TPOAb levels and the proportion of pregnant women with TSH > 2.5 mU/L in the high water iodine and non-high water iodine groups ( Z = 3.04, - 2.17, χ 2 = 6.94, P = 0.002, 0.030, 0.008). The thyroid glands of pregnant women were examined in 720 cases, and 30 cases of goiter and 150 cases of thyroid nodules were detected, with detection rates of 4.2% and 20.8%, respectively. The median thyroid volume was 8.92 ml in the high water iodine group and 8.60 ml in the non-high water iodine group, which were both within the normal range, with no statistically significant difference between the groups ( Z = - 0.75, P = 0.455). Conclusions:After changing to low iodine water, the overall iodine nutrition of pregnant women in Gaoqing County is now at an appropriate level, and the reduction of water iodine effectively reduces the risk of TSH abnormalities in local pregnant women. However, pregnant women in the non-high water iodine group are iodine deficiency, and pregnant women in the high water iodine group are at iodine super-appropriate, and the iodine nutrition level of pregnant women in this area is highly variable, which causes the "illusion" that the overall iodine level of local pregnant women is suitable.
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Objective:To learn about the prevalence of iodized salt in coastal counties (cities and districts, hereinafter referred to as counties) of Shandong Province, evaluate the iodine nutritional status of children and pregnant women, so as to provide data support for timely targeted prevention and control measures and scientific adjustment of intervention strategies.Methods:In 2021, in 37 coastal counties of Shandong Province, one township was selected from each of the five directions of the east, west, south, north, and middle of each county, one primary school was selected from each township, 40 non-boarding students aged 6 - 12 years old were selected from each primary school. In addition, 20 pregnant women were selected from each township. Children's and pregnant women's household salt samples and urine samples were collected to detect salt iodine and urinary iodine contents. The children from 19 counties selected from the 37 coastal counties of Shandong Province were examined by B-mode ultrasound, and the goiter rate of children was calculated.Results:Totally 7 736 household edible salt samples from the children were tested, and the coverage rate of iodized salt, iodized salt qualified rate and qualified iodized salt consumption rate was 74.3% (5 746/7 736), 74.3% (4 267/5 746) and 55.2% (4 267/7 736), respectively. A total of 7 740 urine samples were collected from the children, the median urinary iodine was 174.0 μg/L. A total of 4 344 children were selected for thyroid examination, and the goiter rate was 3.0% (131/4 344). Totally 4 513 household edible salt samples from the pregnant women were tested, and the coverage rate of iodized salt, iodized salt qualified rate and qualified iodized salt consumption rate was 83.7% (3 779/4 513), 77.6% (2 933/3 779) and 65.0% (2 933/4 513), respectively. A total of 7 740 urine samples were collected from the pregnant women, the median urinary iodine was 133.5 μg/L.Conclusions:Children in 37 coastal counties of Shandong Province are generally at the appropriate level of iodine, but pregnant women still have the risk of iodine deficiency. Comprehensive prevention and control measures for iodine deficiency disorders need to be continuously implemented to consolidate and deepen the achievements of iodine deficiency prevention and control.
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Objective:To analyze the risk factors of clinically-relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD) and penetrating pancreaticojejunostomy (PPJ).Methods:The clinical data of 108 patients who underwent PD and PPJ in the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Wannan Medical College from January 2017 to October 2022 were analyzed retrospectively, including 65 males and 43 females, aged 65.5 (54.2, 72.0) years. The incidences of POPF, biliary fistula, abdominal bleeding and other related complications were reviewed. The related factors of CR-POPF were analyzed by univariate analysis, and the statistically significant factors were included in multivariate logistic regression analysis.Results:A total of 108 patients were successfully treated with PD, including laparoscopic PD in 76 cases (70.4%) and open PD in 32 cases (29.6%). PPJ was performed in PD, including the continuous fashion in 39 cases (36.1%), intermittent fashion in 49 cases (45.4%) and modified continuous fashion in 20 cases (18.5%). The operation time was 390.0 (314.0, 480.0) min, the intraoperative blood loss was 200.0 (100.0, 384.0) ml, the postoperative hospital stay was 12.0 (10.0, 15.0) d, and the incidence of POPF (grade B + C) was 11.1% (12/108). Body mass index, pancreatic CT value and pancreatic duct size were the significant factors of CR-POPF (all P<0.05). Multivariate logistic regression analysis showed that age ( OR=0.895, 95% CI: 0.822-0.975), pancreatic CT value ( OR=0.812, 95% CI: 0.698-0.946) and pancreatic duct size ( OR=0.457, 95% CI: 0.220-0.952) were risk factors of CR-POPF after PPJ (all P<0.05). Conclusion:PPJ is a safe method of pancreaticoenterostomy, and CR-POPF may be related to younger patients, lower pancreatic CT value and the smaller pancreatic duct size.
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Objective:To explore the effects of frailty syndrome on activities of daily living and its associated risk for adverse outcomes among elderly residents in China.Methods:Using open data from "China Health and Retirement Longitudinal Survey", the 2011 baseline survey was conducted on general information, health risk factors, chronic disease, data obtained from various ability assessments and Fried frailty criteria assessments for community elderly aged 60 years and over.The follow-up data were used to analyze the adverse outcomes of frailty syndrome using a covariation-adjusted Logistic regression model.Results:Among the 5 630 people in the baseline population, 34.9%(1 963/5 630 cases)were non-frailty, 57.4%(3 236 cases)were pre-frailty, and 7.7%(431 cases)were frailty.The frailty group had higher rates of falls, hip fractures, hospitalizations, and death than the pre-frail and non-frail groups at the 3rd, 5th, and 8th years of follow-up.At follow up to 2015, the covariate-adjusted analysis of the study population showed that as compared with the non-frail group, the frail group had increased risks of falling( OR=1.738, 95% CI: 1.292-2.338, P<0.001), increased risks of hip fracture( OR=2.672, 95% CI: 1.365-5.233, P=0.004), increased risks of hospitalization( OR=1.670, 95% CI: 1.224-2.277, P=0.001), increased risk of death( OR=1.599, 95% CI: 1.256-2.035, P<0.001), increased risks of declined upper limb activity( OR=2.769, 95% CI: 2.101-3.650, P<0.001), of declined instrumental activity of daily living( OR=2.567, 95% CI: 1.941-3.395, P<0.001), and of declined basic activities of daily living( OR=2.790, 95% CI: 2.110-3.689, P<0.001). Conclusions:Frailty syndrome increases the risk of decreased ability to live, falls, hip fractures, hospitalization and death in older adults.Frailty screening is an effective tool for predicting the risk of adverse outcomes in elderly community populations.
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Objective To explore the relationship between serum levels of tyrosine hydroxylase (TH) and the risk of cerebral infarction in Parkinson's patients. Methods A total of 129 patients with confirmed Parkinson's disease who were hospitalized in our hospital were selected, among the 58 patients had Parkinson's disease complicated with cerebral infarction (complicated with cerebral infarction group), and the remaining 71 patients had Parkinson's disease alone (control group). Blood TH levels and other potential related information were collected retrospectively at the time of diagnosis. Comparative analysis of data was performed using SPSS software. Results Comparing the serum TH expression levels in patients with Parkinson's disease and patients with cerebral infarction at admission , the serum TH level in patients with cerebral infarction was lower. Results also showed that the levels of CRP, IL-6, MDA, and Hcy were higher in patients with cerebral infarction, while PON-1 level was lower. In addition, patients with cerebral infarction had lower motor ability (higher UPDRS Ⅲ score). Further regression analysis was carried out with the occurrence of Parkinson's disease complicated with cerebral infarction as the dependent variable and the potential influencing factors as the independent variable. The results indicated that factors such as low expression of TH, high expression of inflammatory factors, and high expression of oxidative stress factors were positively correlated with the risk of complications of the two diseases. Conclusion The low expression of TH, inflammatory state and high oxidative stress state are the potential risk factors for Parkinson's disease complicated with cerebral infarction, which deserves clinical attention.
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Objective:To analyze the monitoring results of skeletal fluorosis in coal-burning type endemic fluorosis areas in Guizhou Province, and evaluate the effectiveness of comprehensive treatment of coal-burning type endemic fluorosis in the affected areas.Methods:In 2009, 2014, and 2019, monitoring of skeletal fluorosis was carried out in six counties (cities, districts) of Renhuai City, Qixingguan District, Dafang County, Qianxi City, Puding County, and Pu'an County in Guizhou Province. Age stratification was conducted in each county (city, district) for permanent residents aged 25 and above, and survey subjects were selected for X-ray examination of skeletal fluorosis.Results:The detection rates of skeletal fluorosis in 2009, 2014, and 2019 were 51.48% (798/1 550), 34.88% (308/883), and 6.51% (60/922), respectively, showing a decreasing trend year by year (χ 2trend = 505.83, P < 0.001), decreased by 44.97 percentage points from 2009 to 2019. The age distribution of patients with skeletal fluorosis was mainly in the age group of 55 years and older, with annual proportions of 53.88% (430/798), 56.49% (174/308), and 78.33% (47/60), all higher than 50%. In 2009, 2014, and 2019, 483, 222 and 21 cases of mild skeletal fluorosis were detected, and 315, 86, and 39 cases of moderate to severe skeletal fluorosis were detected. There was a statistically significant difference in disease grading among different years(χ 2 = 32.63, P < 0.001). Among them, there were statistically significant differences in the grading of skeletal fluorosis in Qixingguan District, Qianxi City, Puding County, and Pu'an County(χ 2 = 14.56, 12.24, 35.01, 23.35, P < 0.05). Conclusions:The detection rate of skeletal fluorosis in Guizhou Province decreases year by year, and the prevention and control effect is significant. Patients with skeletal fluorosis are mainly in the age group of 55 years and older, and the proportion of patients with moderate to severe skeletal fluorosis is increasing. We should continue to monitor and manage the treatment of current patients with skeletal fluorosis.
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Tinnitus is an auditory perception in the absence of an auditory stimulus, and its pathogenesis is extremely complex and has not been clear so far. Tinnitus is a common disease in neurology and otorhinolaryngology. About 10% adults have experienced tinnitus. At present, there is no cure, which brings a heavy burden to society and economy. With the development of neuroimaging technology, functional magnetic resonance imaging (fMRI) has been widely used in the study of brain functional networks in neuropsychiatric diseases. This review briefly describes the pathogenesis of subjective tinnitus and summarizes the research and progress of sound therapy and neuromodulation based on brain functional network, in order to provide help for diagnosis, early treatment and clinical prognosis of tinnitus.
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Objective:To explore the neural mechanism of language dysfunction in patients with subacute stroke using functional near-infrared spectroscopy (fNIRS).Methods:Sixteen patients with non-fluent aphasia after subacute stroke (aphasia group), 16 patients with non-aphasia after stroke (non-aphasia group), and 16 healthy middle-aged and elderly subjects (control group) were enrolled into our study. The 6-min resting-state data of fNIRS were collected. Four language-related regions, Broca area, Wernicke area, dorso lateral prefrontal cortex (DLPFC), and supplementary motor area (SMA), were selected as regions of interest (ROIs), and the whole brain functional connection strength and functional connection strength in ROIs and between each two ROIs were analyzed by NirSpark software.Results:Compared with the control group (0.53±0.15) and non-aphasia group (0.47±0.12), the aphasia group had significantly decreased whole brain functional connection strength (0.29±0.14, P<0.05). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the left Wernicke area, right Wernicke area, left Broca area, left SMA area, right SMA area and left DLPFC area ( P<0.05, FDR). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the right Wernicke-left Wernicke area, right Wernicke-right Broca area, right Wernicke-left Broca area, right Wernicke-right DLPFC area, right Wernicke-left DLPFC area, right Wernicke-right SMA area, right Wernicke-left SMA area, left Wernicke-right Broca area, left Wernicke-left Broca area, left Wernicke-right DLPFC area, left Wernicke-left DLPFC, left Wernicke-right SMA area, left Wernicke-left SMA area, right Broca-left Broca area, right Broca-left DLPFC area, right Broca-right SMA area, right Broca-left SMA area, left Broca-right DLPFC area, left Broca-left DLPFC area, left Broca-right SMA area, left Broca-left SMA area, right DLPFC-left DLPFC area, right DLPFC-right SMA area, right DLPFC-left SMA area, left DLPFC-right SMA area, left DLPFC-left SMA area, and right SMA-left SMA area ( P<0.05, FDR). Conclusion:Abnormal functional connectivity strength of the whole brain and language-related key brain areas might be the neural mechanism of language dysfunction in patients with non-fluent aphasia after subacute stroke.
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This paper is intended to analyze the driving force behind and main strategies for innovation and development of individual protective equipment in extreme environments by the U.S.Armed Forces,and outline the current develop-ments and representative achievements of individual protective equipment by the U.S.Armed Forces for environments of high altitude,extreme cold and extreme heat.It is recommended that the top-level design be adopted,physiological modeling and analysis technologies for big data be given more attention,key technologies be innovated,and intelligent,information-based and lightweight new individual medical protective equipment be developed with more effort.
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Objective:To investigate the effects of preserving a large subfibular bone and ligament reinforcement to treat chronic ankle instability in children.Methods:A retrospective study was conducted to analyze the clinical data of qualified 43 children with chronic ankle instability and a large subfibular bone (the maximum diameter greater than 8 mm) who had been treated at Children's Osteopathy Hospital, Honghui Hospital, Xi'an Jiaotong University from May 2019 to February 2022. There were 29 boys and 14 girls with an age of (9.5±1.2) years. According to treatment methods, they were divided into group A (19 cases) where the subfibular bone was excised and the ligaments were reinforced and group B (24 cases) where the subfibular bone was preserved and the ligaments were reinforced. The talar anterior displacement and talar inclination angle at preoperation and immediate postoperation, and the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) at preoperation and the last follow-up were recorded in both groups to make comparisons between the 2 groups and between preoperation and postoperation. Wound healing and complications were also recorded.Results:There was no significant difference in the preoperative general data between the 2 groups, showing comparability ( P>0.05). All patients were followed up for (11.6±5.8) months. In all patients, the talar anterior displacement and talar inclination angle at immediate postoperation were significantly improved compared with the preoperation, and the ankle-hindfoot AOFAS score and VAS at the last follow-up also significantly improved compared with the preoperation ( P<0.05). The talar anterior displacement at immediate postoperation in group B [5.0 (4.3, 5.0) mm] was significantly shorter than that in group A [6.0 (5.0, 6.0) mm] ( P=0.013). There were no significant differences between the 2 groups in the talar inclination angle at immediate postoperation, or in the ankle-hindfoot AOFAS score or VAS at the last follow-up ( P>0.05). Postoperative incision healing was good in all patients. Probably due to intraoperative pulling up of the incision, superficial peroneal nerve numbness occurred in 1 case but recovered spontaneously. The subfibula bones in group B healed within 1 year. Conclusion:For chronic ankle instability in children with a large subfibular bone, preservation of the subfibular bone and ligament reinforcement can better restore the ankle anteroposterior stability.
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Objective:To compare the differences of brain activation in patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) under contact heat stimulation (CHS), and to explore the characteristics of pain-related brain networks in NMOSD and MS patients.Methods:Fourteen NMOSD patients (NMOSD group) and 12 MS patients (MS group) admitted to Affiliated Hospital of North Sichuan Medical College from September 2022 to December 2022 who met the diagnostic criteria were collected. Twelve healthy individuals (HC group) matched with gender and age were recruited during the same period. Visual Analogue Scale (VAS) score was used to evaluate the pain of the subjects, CHS painful stimuli were given, and task-state functional magnetic resonance imaging (fMRI) scans were performed at the same time, and the differences in brain activation among the 3 groups were analyzed and compared.Results:(1) Compared with the HC group, the NMOSD group had a stronger activation degree than the HC group in the brain regions including the cortex around the left distance fissure, bilateral medial superior frontal gyrus; the activation degree of the NMOSD group was weaker than that of the HC group in the brain areas including the left medial and paracingulate gyrus, right superior parietal gyrus, left postcentral gyrus, and right supplementary motor area (all P<0.05). (2) Compared with the HC group, the brain regions whose activation degree was weaker in the MS group included the left caudate nucleus, left medial and paracingulate gyrus, left paracentral lobule, right superior parietal gyrus, left postcentral gyrus, left precuneus, right supplementary motor area, right superior temporal gyrus and right thalamus, and there was no brain area in the MS group whose activation degree was stronger than that of the HC group (all P<0.05). (3) Compared with the MS group, the brain regions with stronger activation degree in the NMOSD group included the left perifissure cortex and right thalamus, but no brain regions with weaker activation degree were found in the NMOSD group (all P<0.05). (4) There was a correlation between somatic pain VAS scores and activation of the medial superior frontal gyrus in the NMOSD group ( r=0.66, P<0.05). Conclusions:The results of CHS-fMRI in the NMOSD group, MS group and HC group showed that multiple brain regions were activated, indicating that multiple brain regions were involved in the generation and processing of pain, and there was a pain-related brain network. Pain-related brain networks were altered in NMOSD patients and MS patients, and there were differences in pain-related brain networks between the two diseases.
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Objective:To observe the changes in brain functional magnetic resonance imaging (fMRI) in migraine patients under olfactory stimuli and analyze the characteristics of olfactory-related brain networks.Methods:Twenty-seven migraine patients (migraine group) enrolled in the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from January 2021 to January 2022 were included, and 20 healthy adults were recruited as control group during the same period. All subjects underwent synchronous fMRI scanning under olfactory task stimulation, and magnetic resonance imaging data processing was performed using SPM12 and Matlab2019b softwares, and statistical analysis was performed with SPSS 23.0 software.Results:The activated brain regions in the control group included the left cerebellum, left inferior temporal gyrus, left fusiform gyrus, right middle frontal gyrus, right anterior central gyrus, insula, right central sulcus, superior marginal gyrus, right lenticular putamen, middle cingulate gyrus, paracentral lobule, and superior parietal gyrus ( P<0.05). The activated brain regions in the migraine group included the left cerebellum, right fusiform gyrus, right inferior temporal gyrus, right anterior central gyrus, and right posterior central gyrus ( P<0.05). Compared with the control group, the activation intensity of the migraine group was weaker in the right insula, right middle frontal gyrus orbit, left inferior frontal gyrus orbit, right dorsolateral superior frontal gyrus, right superior temporal gyrus, right superior occipital gyrus, medial and paracingulate gyrus, and right superior parietal gyrus ( P<0.05). Conclusion:Migraine patients have multiple brain regions involved in olfactory processing and have specific olfactory-related brain networks.
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Objective:To improve training quality and to standardize the assessment procedures of radiology standardized residency training by analyzing the results of the clinical skills completion assessment for radiology standardized residency training in Liaoning Province in 2020.Methods:Totally 186 trainees participated the assessment with 6 exams in 3 days, including "Man-Machine interview" and "oral interview". Reliability and validity of the test were analyzed first. The accuracy were compared among the three parts of radiology, ultrasound and nuclear medicine, and also among the three portions of imaging description, diagnosis and relative question. Trainees of different type, gender and from different regions were further compared respectively. Scores of different examiners were also compared. SPSS 20.0 software was used for t-test and one-way ANOVA. Results:The Cronbach's α coefficient ranged from 0.65 to 0.87, and KMO values were nearly or higher than 0.7. Scores of both "Man-Machine interview" and "oral interview" parts were better relative to the total scores (relativity coefficient 0.698-0.969). The accuracy of radiology was relatively higher and more stable (nearly 80%), nuclear medicine had the lowest accuracy (nearly 50%), and that of ultrasound fluctuated obviously (56.2%-88.8%). The accuracy was the highest for imaging description, followed by diagnosis, and the lowest for relative question portion. There were significant differences between male and female residents in "Man-Machine interview" portion ( P=0.028), while there was not in "oral interview" ( P=0.050). There were significantly statistical differences in trainees' scores between different regions ( P=0.009 for "Man-Machine interview" and P<0.001 for "oral interview"). Trainees from Shenyang and Dalian got almost the same scores, which were significantly higher than those from other cities. Trainees with master's degree were scored higher than others trainees that were not (all P<0.001). Significant score differences were found between the two examiners in only one examiner group (1/18) ( P=0.011). Conclusion:By the analysis of test results, we find the shortage of both training and assessment process, which is beneficial to adjusting the training process, improving the training quality, and promoting the further standardization and development of the assessment system of radiology standardized residency training.
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Objective:To investigate the efficacy of internal fixation with common intramedullary nail versus bone cement reinforced antirotation intramedullary nail in the treatment of femoral intertrochanteric fracture. Methods:A total of 106 patients with femoral trochanteric fractures who were surgically treated in Weihaiwei People's Hospital from January 2018 to January 2019 were selected and divided into a control group and an observation group with 53 patients in each group. The control group received internal fixation with common intramedullary nails. The observation group was fixed with bone cement reinforced anti-rotation intramedullary nails. The therapeutic effects were compared between the two groups.Results:There were no significant differences in the amount of blood loss, postoperative Visual Analogue Scale score, amount of fluid drainage, postoperative time to get out of bed, and postoperative hospital stay between the two groups ( t = 1.33, 0.19, 0.34, 0.58, 0.37, all P > 0.05). Operative time in the observation group was significantly longer than that in the control group [(80.21 ± 6.52) minutes vs. (75.92 ± 8.15) minutes, t = 2.99, P < 0.05]. Time to fracture healing in the observation group was significantly shorter than that in the control group [(9.25 ± 1.12) weeks vs. (10.05 ± 1.31) weeks, t = 3.37, P < 0.05]. The incidence of complications in the observation group was significantly lower than that in the control group [3.77% (2/53) vs. 16.98% (9/53), χ2 = 4.97, P = 0.025]. At 6 and 12 months after surgery, Harris hip scores in the observation group were (82.84 ± 6.58) points and (85.55 ± 7.91) points, respectively, which were significantly higher than (78.35 ± 7.54) points and (79.92 ± 9.94) points in the control group ( t = 3.26, 3.22, both P < 0.05). Conclusion:Internal fixation with bone cement-reinforced anti-rotation intramedullary nails for treatment of femoral trochanteric fractures can shorten the time to fracture healing, reduce complications, and improve hip joint function.
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Objective:To analyze the efficacy of quantitative parameters related to spectral CT iodine concentration (IC) values in evaluating regional lymph node metastasis in patients with gastric adenocarcinoma.Methods:The clinical data and CT images of 55 patients with gastric adenocarcinoma diagnosed by pathology from June 2021 to June 2022 were collected retrospectively at Shengjing Hospital of China Medical University. Patients were divided into lymph node metastatic lesion group (32 cases) and lymph node non-metastatic lesion group (23 cases) according to whether there were metastatic lymph nodes in all the lymph nodes examined in the pathological results. Then lymph nodes were taken as the research object, and all lymph nodes were divided into the metastatic lymph node group (25 lymph nodes) and the non-metastatic lymph node group (27 lymph nodes) according to the nature of lymph nodes recorded in the pathological report. The IC values and normalized IC (nIC) values of gastric cancer lesions and lymph nodes in the arterial and venous phases (ICa and ICp, nICa and nICp) were obtained. The difference of IC and nIC values between arterial and venous phases (?IC and ?nIC) were calculated, and the arterial enhancement fraction (AEF, ratio of ICa and ICp of lymph nodes ) was calculated. Student′s t test or Mann-Whitney U test was used to compare the differences of quantitative parameters between the two groups. The parameters with statistical differences were analyzed by the receiver operating characteristic curve to obtain the diagnostic efficacy of each parameter in evaluating lymph node metastasis of gastric cancer, and the Z test was used to compare the area under the curve (AUC) of each parameter. Results:The ICp, nICp, ?IC and ?nIC of the lymph node metastatic lesion group were higher than those of the lymph node non-metastatic lesion group (all P<0.05). The AUC were 0.738, 0.746, 0.811 and 0.821. The short diameter, ICa, nICa and AEF values of lymph nodes in the metastatic lymph node group were higher than those in the non-metastatic lymph node group (all P<0.05). The AUC were 0.821, 0.832, 0.734 and 0.863. There were significant differences in AUC between ICp and ?IC, ?nIC ( Z=2.41, 3.29, P=0.016, 0.001), and between nICp and ?IC, ?nIC ( Z=2.10, 3.09, P=0.036, 0.002) in gastric cancer lesions. There were statistically significant differences in AUC between nICa and ICa, AEF ( Z=2.09, 2.41, P=0.037, 0.016) in lymph nodes. Conclusions:The quantitative parameters related to IC values of spectral CT can be applied to evaluate the properties of regional lymph nodes in patients with gastric adenocarcinoma, where ?IC, ?nIC of lesions and AEF of lymph nodes have the best efficacy.
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Sarcopenia is a geriatric syndrome characterized by loss of skeletal muscle mass and strength and functional decline due to aging.In recent years, with the increase of the aging population, the incidence of the disease continues to rise.It is associated with a variety of adverse events such as falls, frailty, increased mortality, and other adverse events.Therefore, as research continues to lead to improved understanding on risk factors, pathophysiological mechanisms and intervention of sarcopenia, rehabilitation has become an important means in clinical treatment.This paper systematically reviews the progress in rehabilitation therapy for patients with sarcopenia, in order to summarize evidence for clinical intervention of sarcopenia.
Résumé
Objective:To evaluate the efficacy and safety of docetaxel plus hormone therapy in metastatic prostate cancer.Methods:From April 2016 to April 2019, 204 cases with bone metastatic prostate cancer in the Second Hospital of Tianjin Medical University were analyzed retrospectively. There were 97 patients responded to hormone therapy including 92 cases with high-burden metastasis (more than 4 bone metastases with one or more beyond the axial skeleton) and 5 cases with low-burden metastasis, with average age of 70 years (range 42-87 years) and median prostate specific antigen (PSA) of 74.1 ng/ml (range 11.0-145.0 ng/ml). Among them, there were 35 patients (36.1%) with a Gleason score of 7 or lower, and 62 patients (63.9%) with a Gleason score of 8 or higher. There were 26 patients suffering from bone pain, with average numerical rating scales(NRS) score of 3.7. In addition, there were 107 patients being resistant to hormone therapy, with average age of 73 years (range 56-83 years), and median PSA of 84.5 ng/ml (range 12.4-490.2 ng/ml), including 32 patients (29.9%) with a Gleason score of 7 or lower, and 75 patients (70.1%) with a Gleason score of 8 or higher. Among them, there were 75 patients suffering from bone pain, with average NRS score of 5.4. All patients received continuous hormone therapy combined with docetaxel (at a dose of 75 mg per square meter of body-surface area every 3w, plus prednisone 5 mg twice a day), and PSA progression-free survival (PSA-PFS), NRS score, pain relief, and adverse events were analyzed. Additional analysis of the correlation between PSA-PFS and subgroups with age, PSA level and Gleason score were performed.Results:For patients with metastatic hormone sensitive prostate cancer (mHSPC), 6 (6.2%) cases only received 1-2 cycles of chemotherapy due to different reasons, and the others received 3-6 cycles(average 4.7)with the median follow-up of 15 months. Of patients who received ≥3 cycles, there were 36 cases presenting PSA progression, with the median PSA-PFS of 22 months, average NRS score decline from 3.9 to 3.0, and pain relief rate of 72.0%(18/25). For patients with metastatic castration-resistant prostate cancer (mCRPC), 9 (8.4%)cases only received 1-2 cycles of chemotherapy, and the others received 3-14 cycles (average 5.6). Of patients who received≥3 cycles, there were 51 cases with PSA progression, with the median PSA-PFS of 11 months, average NRS score decline from 5.6 to 4.4, and pain relief rate of 48.6%(35/72). Subgroup analysis showed a significant correlation between PSA level and PSA-PFS for patients with mCRPC( P=0.026). Age or Gleason score was not significantly correlated to PSA-PFS in mHSPC or mCRPC( P>0.05). For patients with mHSPC, grade 3 or 4 neutropenia occurred in 17 cases(17.5%), nausea and vomiting in 27 cases(27.8%), and fatigue in 25 cases(25.8%). For patients with mCRPC, grade 3 or 4 neutropenia occurred in 24 cases (22.4%), nausea and vomiting in 34 cases(31.8%), and fatigue in 26 cases(24.3%). Allergic reaction and sensory neuropathy toxicity were occasional. Conclusion:Efficacy of docetaxel plus hormone therapy was confirmed in metastatic prostate cancer and adverse events were tolerable.