The study of comparing three different cannula operations for peritoneal dialysis / 中华危重病急救医学

Objective:To observe the clinical effect of the cannula under laparoscopy, percutaneous puncture cannula, and conventional surgery cannula for peritoneal dialysis.Methods:From May 3, 2015 to February 14, 2020, 87 patients with end-stage renal disease needing peritoneal dialysis in Ningbo Zhenhai People's Hospital were enrolled. These patients were divided into three groups including cannula under laparoscopy (23 cases), percutaneous puncture cannula (29 cases), and conventional surgery cannula (35 cases). The baseline characteristics, perioperative conditions (surgical time, post-surgical hospitalization time), the incidence of recent complications (abdominal hemorrhage, direct abdominal hemorrhage, incision pain, leakage, catheter shift, peritonitis), and long-term complications (catheter shift, peritonitis, hernia, thoracic and abdominal fistula, abdominal tube obstruction) among the three groups were compared.Results:Compared with the group of conventional surgery cannula, the operation time in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly shorter (minutes: 32.5±12.3, 28.9±11.8 vs. 61.3±15.4, both P < 0.05), the in-hospital stay in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were reduced (days: 9.8±3.4, 9.2±2.6 vs. 10.7±3.2), but there was no statistical significance among the three groups ( P > 0.05). The incidence of abdominal bleeding, rectus abdominis bleeding, and incision pain in the group of cannula under laparoscopy and the group of percutaneous puncture cannula were significantly lower than those in the group of conventional surgery cannula [incidence of abdominal bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of rectus abdominis bleeding: 4.3% (1/23), 3.4% (1/29) vs. 22.9% (8/35), incidence of incision pain: 8.7% (2/23), 10.3% (3/29) vs. 42.9% (15/35), all P < 0.01]. The difference between the group of cannula under laparoscopy and the group of percutaneous puncture cannula had no statistical significance. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 27.6% (8/29), 31.4% (11/35), both P < 0.05]. Compared with the group of conventional surgery cannula and the group of percutaneous puncture cannula, the incidence of catheter displacement in long-term complications in the group of cannula under laparoscopy was significantly reduced [4.3% (1/23) vs. 24.1% (7/29), 31.4% (11/35), both P < 0.05], however, the difference of that between the group of conventional surgery cannula and the group of percutaneous puncture cannula was not statistically significant. The incidence of hernia in the group of cannula under laparoscopy was significantly higher than that in the group of percutaneous puncture cannula or in the group of conventional surgery cannula [21.7% (5/23) vs. 3.4% (1/29), 2.8% (1/35), both P < 0.05], and all of that were umbilical hernia, however, the difference of that between the group of percutaneous puncture cannula and the group of conventional surgery cannula was not statistically significant. Conclusion:Compared with the traditional conventional surgical cannula placement methods, percutaneous puncture has the advantages of simple operation, short operation time, small trauma, but still cannot reduce the incidence of drift tube; laparoscopic peritoneal dialysis tube has the advantages of short operation time, small trauma and low catheter displacement rate, but increases the risk of umbilical hernia.

Lateral patellar retinacular release combined with decomposition:Repair without damage to the patellar cartilage surface / 中国组织工程研究

BACKGROUND:Excessive lateral pressure syndrome is often associated with lateral retinacular tension and radiographic patel ar tilt. CT scan displayed that lateral retinacular release can effectively correct patel ar tilt. OBJECTIVE:To study the effect of arthroscopic lateral retinacular release combined with intraosseous dril ing and decomposition in the treatment of excessive lateral pressure syndrome. METHODS:Thirty-two patients with excessive lateral pressure syndrome were treated by arthroscopic lateral release combined with intraosseous dril ing and decomposition. The Lysholm scoring system was used to evaluate the treatment effect. RESULTS AND CONCLUSION:The mean duration of fol ow-up was 12 months. After 1 month, pain of al patients was released or disappeared;after 1 year, pain of 26 cases disappeared basical y. Lysholm scoring system assessment showed 20 cases were rated as excellent, six cases were as good, four cases were as fair and two cases were as poor. The excellent and good rate was 83.6%. The patients’ subjective satisfaction rate was 92.8%. The results indicate that arthroscopic lateral release combined with intraosseous dril ing and decomposition is a good method to treat excessive lateral pressure syndromewere. It has the advantages of less trauma and rapid recovery. Patel ar decomposition has a good effect in the treatment of patel ofemoral pain associated with patel ar tilt outward and lightens articular cartilage degeneration without damage to patel ar cartilage surface.

Progress in the research of chemical structural modification of ursolic acid and structure-activity relationship / 中国药科大学学报

Ursolic acid, a pentacyclic triterpene compound, naturally occurs in a large variety of plants, has at-tracted considerable interest owing to its significant biological activities. In recent years, more and more scientists have been working on the structural modification at the C-3 position , C_(12)-C_(13) double bond or C-28 position of ur-solic acid in order to improve their biological activities. Herein a brief introduction of the recent progresses on the chemical structural modification and the structure-activity relationship of ursolic acid and its derivatives are re-viewed.