O-arm navigation versus C-arm navigation for guiding percutaneous long sacroiliac screws placement in treatment of Denis type Ⅱ sacral fractures / 中国修复重建外科杂志

OBJECTIVE@#To compare the effectiveness of O-arm navigation and C-arm navigation for guiding percutaneous long sacroiliac screws in treatment of Denis type Ⅱ sacral fractures.@*METHODS@#A retrospective study was conducted on clinical data of the 46 patients with Denis type Ⅱ sacral fractures between April 2021 and October 2022. Among them, 19 patients underwent O-arm navigation assisted percutaneous long sacroiliac screw fixation (O-arm navigation group), and 27 patients underwent C-arm navigation assisted percutaneous long sacroiliac screw fixation (C-arm navigation group). There was no significant difference in gender, age, causes of injuries, Tile classification of pelvic fractures, combined injury, the interval from injury to operation between the two groups ( P>0.05). The intraoperative preparation time, the placement time of each screw, the fluoroscopy time of each screw during placement, screw position accuracy, the quality of fracture reduction, and fracture healing time were recorded and compared, postoperative complications were observed. Pelvic function was evaluated by Majeed score at last follow-up.@*RESULTS@#All operations were completed successfully, and all incisions healed by first intention. Compared to the C-arm navigation group, the O-arm navigation group had shorter intraoperative preparation time, placement time of each screw, and fluoroscopy time, with significant differences ( P<0.05). There was no significant difference in screw position accuracy and the quality of fracture reduction ( P>0.05). There was no nerve or vascular injury during screw placed in the two groups. All patients in both groups were followed up, with the follow-up time of 6-21 months (mean, 12.0 months). Imaging re-examination showed that both groups achieved bony healing, and there was no significant difference in fracture healing time between the two groups ( P>0.05). During follow-up, there was no postoperative complications, such as screw loosening and breaking or loss of fracture reduction. At last follow-up, there was no significant difference in pelvic function between the two groups ( P>0.05).@*CONCLUSION@#Compared with the C-arm navigation, the O-arm navigation assisted percutaneous long sacroiliac screws for the treatment of Denis typeⅡsacral fractures can significantly shorten the intraoperative preparation time, screw placement time, and fluoroscopy time, improve the accuracy of screw placement, and obtain clearer navigation images.

Efficacy of miniplates plus reconstruction plate fixation assisted by preoperative digital design in the treatment of comminuted posterior acetabular wall fracture / 中华创伤杂志

Objective:To compare the clinical effect of miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation in the treatment of comminuted posterior acetabular wall fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 35 patients with comminuted posterior acetabular wall fracture admitted to General Hospital of Central Theater Command of PLA from January 2012 to June 2019, including 26 males and 9 females, aged 25-63 years [(45.5±9.8)years]. A total of 16 patients received miniplates plus reconstruction plate fixation assisted by preoperative digital design (digital design group) and 19 patients received conventional miniplates plus reconstruction plate fixation (conventional group). The operation time, intraoperative blood loss, hospitalization time and fracture healing time were compared in the two groups. Matta radiological standard score was performed to assess the quality of fracture reduction at postoperative 2 days. Modified Merle d′Aubign-Postel score was used to evaluate hip function at postoperative 3 months, 6 months and final follow-up. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(30.1±8.9)months]. The operation time and intraoperative blood loss were (114.7±16.1)minutes and (323.4±26.1)ml in digital design group, significantly less than (179.8±67.3)minutes and (392.6±87.8)ml in conventional group (all P<0.01). There were no significant differences in hospitalization time, fracture healing time, excellent and good rate of quality of fracture reduction between the two groups (all P>0.05). The modified Merle d′Aubign-Postel score was higher in digital design group [(14.1±2.3)points, (15.4±2.3)points and (17.1±1.8)points] than those in conventional group [(13.7±2.2)points, (15.0±2.5)points and (16.8±2.1)points] at 3 months, 6 months and last follow-up, but there were no significant differences (all P>0.05). The modified Merle d′Aubign-Postel score showed significant differences within each group at each time point (all P<0.01). In digital design group, one patient was found with heterotopic ossification and one with traumatic arthritis. In conventional group, two patients were found with heterotopic ossification, one with traumatic arthritis and one with avascular necrosis of the femoral head. The rate of postoperative complications was 12.5% (2/16) in digital design group and was 21.1% (4/19) in conventional group ( P>0.05). Neither of the two groups had complications such as penetration of screws into the articular cavity, failure of internal fixation or iatrogenic sciatic nerve injury. Conclusion:Both miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation can achieve satisfactory clinical efficacy in the treatment of comminuted posterior acetabular wall fracture, but the former can significantly reduce operation time and intraoperative blood loss.

Clinical study on Sun's sequential therapy of allergic rhinitis with lung deficiency and cold syndrome / 国际中医中药杂志

Objective:To evaluate the efficacy of Sun's sequential therapy (SST) of Chinese Medicine on allergic rhinitis with lung deficiency and cold syndrome.Methods:A total of 60 AR patients with lung deficiency and cold syndrome in otolaryngology clinic of Guang'anmen Hospital, from January to July 2020, who met the inclusion criteria, were randomly divided into 2 groups according to the random number table method, with 30 patients in each group. The Traditional Chinese Medicine (TCM) group was treated with oral Yupingfeng Powder and Cang'erzi Powder and the SST group was treated with oral and nasal steaming of Yupingfeng Powder and Cang'erzi Powder. Both groups were treated for 14 days. The clinical symptoms were scored before and after treatment, and the Nasal mucosa eosinophil (EOS) count was graded by Sheldon method to evaluate the clinical efficacy.Results:Twenty five patients in the SST group and 28 in the TCM group were analyzed. The total effective rate was 88.0% (22/25) in the SST group and 89.3% (25/28) in the TCM group, and there was no significant difference between the two groups ( χ2=2.83, P=0.883). The scores of nasal obstruction, runny nose, sneeze and total score in the SST group were significantly lower than those in the TCM group ( P<0.01), and the difference of Nasal mucosa EOS grade in SST group (2.76±0.27 vs. 1.52±0.36) was significantly higher than that of the TCM group ( P=0.01). Conclusion:The SST of Chinese medicine can improve the symptoms of nasal congestion, runny nose and sneezing in AR patients with lung deficiency and cold syndrome, and reduce the distribution of Nasal mucosa EOS.

Miniplates combined with reconstruction plate for the treatment of comminuted posterior wall acetabular fractures / 中华创伤杂志

Objective:To evaluate the clinical results of miniplates combined with reconstruction plate in treating comminuted posterior wall acetabular fractures.Methods:A retrospective case series study was conducted for 27 patients with comminuted posterior wall acetabular fractures treated in General Hospital of Central Theatre Command of PLA from October 2015 to June 2019. There were 18 males and 9 females, at age of 23-61 years［（45.9±10.9）years］. All patients were treated by using miniplates combined with the reconstruction plate. The operation time, intraoperative blood loss, intraoperative blood transfusion, length of hospital stay and time of fracture healing were recorded. The reduction quality was evaluated according to Matta radiographic standard at 2 days postoperatively. The modified Merle D'Aubigné-Postel score was adopted to evaluate the hip function at 3, 6 months postoperatively and the final follow-up. Postoperative complications were observed, and heterotopic ossification was assessed by Brooker grading standard.Results:All patients were followed up for 12-48 months［36（24, 36）months］. The operation time was 123-242 minutes［（165.4±29.8）minutes］; the intraoperative blood loss was 170-550 ml［（358.3±111.3）ml］; nine patients required intraoperative blood transfusion of 300-500 ml［（377.8±66.7）ml］. The length of hospital stay was 12-29 days［（21.4±4.7）days］. The fracture healing time was 12-24 weeks［（16.3±3.0）weeks］. According to Matta radiographic standard, the reduction quality was excellent in 21 patients, good in 3 and poor in 3 at 2 days postoperatively, with the excellent rate of 89%. The modified Merle D'Aubigné-Postel score was 9-16 points［（13.1±1.9）points］at 3 months postoperatively, was 10-18 points［（15.4±2.0）points］at 6 months postoperatively, and was 12-18 points［（16.9±1.8）points］at last follow-up（ P<0.01）. The modified Merle D'Aubigné-Postel score between 3 months and 6 months was significantly different（ P<0.01）, and the difference between 6 months and the follow-up was statistically significant（ P<0.01）. The modified Merle D'Aubigné-Postel score was graded as excellent in 0 patient, good in 7, fair in 11 and poor in 9 at 3 months postoperatively, with the excellent rate of 26%; graded as excellent in 3 patients, good in 19, fair in 2 and poor in 3 at 6 months postoperatively, with the excellent rate of 81%; graded as excellent in 18 patients, good in 5, fair in 3 and poor in 1 at the last follow-up, with the excellent rate of 85%（ P<0.01）. No iatrogenic sciatic nerve injury, deep vein thrombosis or wound infection occurred after operation. No hardware loosening or loss of reduction occurred during the follow-up. The post-traumatic arthritis was identified in 2 patients. The avascular necrosis of femoral head was observed in 1 patient and thereafter underwent total hip replacement. The heterotopic ossification occurred in 3 patients, among which 2 patients were graded as Brooker class I and 1 as class II, but there was no adverse effect on hip function. Conclusions:Miniplates combined with reconstruction plate in the treatment of comminuted posterior wall acetabular fractures have reliable fixation effect and attain good reduction, high fracture healing rate, less complications and satisfactory functional recovery.

3D navigation versus C-arm fluoroscopy for placement of percutaneous double-segment long sacroiliac screws in treatment of injury to posterior pelvic ring / 中华创伤骨科杂志

Objective:To compare the efficacy of 3D navigation versus C-arm fluoroscopy for placement of percutaneous double-segment long sacroiliac screws in the treatment of injury to the posterior pelvic ring.Methods:A retrospective study was conducted in the 48 patients with pelvic fracture who had been treated surgically from February 2015 to October 2020 at Department of Orthopaedics, General Hospital of Central Command of PLA. The patients were divided into a navigation group and a fluoroscopy group according to their different auxiliary ways to assist screw placement. In the navigation group of 27 patients, there were 19 males and 8 females, with an age of (45.5±7.4) years; in the fluoroscopy group of 21 patients, there were 14 males and 7 females, with an age of (44.1±10.1) years. The 2 groups were compared in terms of placement time for each screw, fluoroscopy time for each screw, adjustments of guide wire, accuracy of screw position, quality of fracture reduction, fracture union time, pelvic function, and postoperative complications.Results:The 2 groups were comparable because there was no significant difference between them in the preoperative general data ( P>0.05). The placement time for each screw [(12.7±2.2) min], fluoroscopy time for each screw [(40.7±9.3) s] and adjustments of guide wire [1 (0,1) time] in the navigation group were significantly less than those in the fluoroscopy group [(23.7±3.6) min, (71.4±14.1)s and 5 (4,6) times] (all P<0.05); the assessment of screw placement in the former (49 excellent, 4 good and one poor cases) was significantly better than that in the latter (29 excellent, 8 good and 5 poor cases) ( P<0.05). The 48 patients were followed up for 8 to 25 months (mean, 13.1 months). There were no significant differences between the 2 groups in fracture union time, quality of fracture reduction or Majeed scores for the pelvic function (all P>0.05).Symptoms of injury to the L5 nerve root were observed in one patient in the fluoroscopy group; none of the patients reported postoperative complications like wound infection, screw loosening or breaking. Conclusions:Compared with C-arm fluoroscopy, 3D navigation may better assist placement of percutaneous double-segment long sacroiliac screws in the treatment of injury to the posterior pelvic ring, because 3D navigation can significantly shorten the time for screw placement and the fluoroscopy time for screw placement, reduce adjustments of guide wire, and improve accuracy of screw placement.

Effect of different holmium laser fiber on regional temperature during lithotripsy with pediatric ureteroscope / 中华泌尿外科杂志

In order to assess the thermal effect of different holmium laser fiber during lithotripsy with WOLF F4.5/6.5 pediatric ureteroscope, we established an impacted ureter calculi model. Under 100mmHg irrigation pressure, regional temperature of different holmium laser fiber with varied working time and power were recorded. We found that the regional temperature was related with laser fiber diameters, power and working time settings. With 550 μm laser fiber, laser firing time longer than 3 s or 365 μm laser fiber firing more than 6 s, regional temperature exceeded 42℃, which would bring thermal injury towards ureter and subsequently cause ureter stricture.

Impact of previous abdominal surgery on the outcomes of laparoscopic resection for colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of previous abdominal surgery(PAS) on laparoscopic resection of colorectal cancer.</p><p><b>METHODS</b>The retrospective cohort study was adopted.Clinical data of consecutive colorectal cancer patients with PAS history (past history of at least one abdominal surgery, exclusion of previous inguinal hernia repair, simple laparoscopic approach, appendectomy of the right lower quadrant and endoscopic therapy) undergoing laparoscopic surgery at the Cancer Hospital of Chinese Academy of Medical Sciences between 2010 and 2015 were collected, meanwhile other colorectal cancer patients without PAS history were selected according to 1 to 1 match in age, sex, body mass index, American Society of Anesthesiologists score, tumor location, type of surgery, and staging of tumor. A total of 464 pairs were successfully matched. Intraoperative and postoperative conditions, perioperative complications and prognosis were compared between the two groups.</p><p><b>RESULTS</b>In PAS group, there were 341 males (73.5%) and 123 females (26.5%) with a median age of 62 (24-85) years; 317(68.3%) cases with only one previous abdominal surgery and 147(31.7%) with more than one; 389(83.8%) cases with abdominal midline incisions, 37(8.0%) with transverse incisions, 34(7.3%) with right subcostal incision and 4(0.9%) with left subcostal incision; 146(31.5%) cases undergoing gynecologic surgery, 84(18.1%) cholecystectomy, 52(11.2%) gastroduodenal surgery, 89(19.2%) colorectal surgery, 11(2.4%) small intestine surgery, 23(5.0%) hapatectomy, 16(3.4%) pancreatic surgery, 8(1.7%) urological surgery, 18(3.9%) retroperitoneal tumor resection and 1(0.2%) other surgery. In no PAS group, there were 328 males (70.7%) and 136 females (29.3%) with a median age of 62(24-86) years. No significant differences in baseline data were found between the two groups (all P>0.05). As compared to no PAS group, PAS group had longer mean operative time [(208.0±27.0) minutes vs. (179.0±15.3) minutes, t=4.695, P=0.003] and higher rate of conversion to laparotomy [18.1%(84/464) vs. 11.6%(54/464), χ=7.217, P=0.003]. In the PAS group, conversion to laparotomy was more common due to adhesion reaction [8.8%(41/464) vs. 4.5%(21/464), χ=4.886, P=0.007]. There were no significant differences between the two groups in intraoperative bleeding and transfusion, lymph node dissection, circumferential margin and surgical margin, time to the first diet and postoperative hospital stay(all P>0.05). No significant differences in intraoperative and postoperative morbidity of complication were found between PAS group and no PAS group [3.7%(17/464) vs. 2.8%(13/464), P=0.346; 20.3%(94/464) vs. 18.5%(86/464), P=0.739]. Median follow-up of the whole patients was 32.0(0.5-79.0) months, and there was no significant difference between the two groups [PAS group 31.0(0.5-79.0) months vs. no PAS group 33.0(1.0-75.0) months, P=0.391]. In PAS and no PAS group, the 3-year disease-free survival rate was 68.1%(95%CI: 62.0%-74.2%) and 68.5%(95%CI: 63.0%-74.0%)(P=0.764), and 3-year overall survival rate was 78.5%(95%CI: 72.8%-81.4%) and 80.2%(95%CI:74.3%-86.1%)(P=0.528) respectively, whose differences were not significant.</p><p><b>CONCLUSION</b>Except higher risk of conversion to laparotomy due to adhesion reaction, laparoscopic resection of colorectal cancer is safe and feasible in patients with PAS, and the prognosis is not affected by PAS.</p>

Treatment and prognosis analysis of 64 cases with anorectal malignant melanoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the surgical treatment patterns and clinicopathological prognostic factors of anorectal malignant melanoma (ARMM).</p><p><b>METHODS</b>The medical records and follow-up data of 64 patients with anorectal malignant melanoma undergoing surgical treatment from August 1972 to December 2015 were collected and analyzed retrospectively. Distant metastasis was discovered in 4 patients when diagnosis, of whom 3 underwent abdominoperineal resection(APR), the other underwent wide local excision (WLE). In the other 60 cases, 46 underwent ARP(1 case received additional right inguinal lymph node dissection), the other 14 underwent WLE(1 case received additional right inguinal lymph node dissection).</p><p><b>RESULTS</b>The median follow-up time of 64 cases was 24(4 to 139) months. The 1-year, 3-year and 5-year overall survival rate was 70.3%, 35.3% and 18.4%, respectively. The 5-year survival rate of 60 patients without distant metastasis undergoing APR and WLE was 19.7% and 23.1%, and the median survival was 19.6 and 24.3 months, respectively(P =0.634), which was not significantly different. According to the Kaplan-Meier method for univariate analysis, involved margins (P=0.024), lymph metastasis (P=0.018) and clinical staging(P=0.003) had significant effects on overall survival. Multivariate analysis indicated that only the lymph node metastasis was significant predictive factor (RR=16.614, 95%CI:1.165 to 236.847, P=0.038).</p><p><b>CONCLUSIONS</b>The prognosis of ARMM is poor. The lymph node metastasis is the main predictive factors. Operation procedure (APR or WLE) has no obvious effect on prognosis.</p>

Effects of Dong's Extraordinary Acupoints Acupuncture and Rehabilitation on Neural Function in Patients with Upper Limb Spastic Hemiplegia after Stroke / 中国康复理论与实践

@#Objective To observe the effects of Dong's Extraordinary Acupoints acupuncture and rehabilitation on upper limb spastic hemiplegia after stroke. Methods 105 patients with upper limb spastic hemiplegia after stroke were randomized into 3 groups as groups A, B, C equally, and receiving Baclofen and rehabilitation training, acupuncture at Dong's Extraordinary Acupoints, and both acupuncture at Dong's Extraordinary Acupoints and rehabilitation training for 8 weeks, respectively. They were assessed with China Stroke Scale (CSS) and modified Ashworth Scale (MAS) before and after treatment Results The CSS and MAS scores obviously improved after treatment in each group (P<0.01), and improved more in the group C than in the group A and B for CSS (P<0.05). Conclusion Both acupuncture at Dong's Extraordinary Acupoints and rehabilitation can improve the neural function and upper limb muscle tension in patients with upper limb spastic hemiplegia after stroke, with the synergistic effects.

Effects of chemically modified sugarcane bagasse on butanol production by immobilized Clostridium acetobutylicum XY16 / 生物工程学报

Sugarcane bagasse modified by polyethylenimine (PEI) and glutaraldehyde (GA) was used as a carrier to immobilize Clostridium acetobutylicum XY16 in the process of butanol production. The effects of chemically modified sugarcane bagasse on batch and repeat-batch fermentations were investigated. Batch fermentation was conducted with an addition of 10 g/L modified sugarcane bagasse and 60 g/L glucose, resulting in a high solvent concentration of 21.67 g/L and productivity of 0.60 g/(L x h) with the treatment of 4 g/L PEI and 1 g/L GA. Compared to the fermentations by free cells and immobilized cells on unmodified sugarcane bagasse, the productivity increased 130.8% and 66.7%, respectively. The fibrous-bed bioreactor also maintained a stable butanol production during repeat-batch fermentations, achieving a maximum productivity of 0.83 g/(L x h) with a high yield of 0.42 g/g.

Expression and significance of IL-17 in breast cancer / 国际检验医学杂志

Objective To investigate the expression of IL-17 in the serum and T cells of the patients with breast cancer and its correlation with breast cancer functional indicators.Methods The flow cytometry analysis was adopted to detect the percentage of peripheral blood CD3 + CD4 + IL-17 + T cells in breast cancer patients;the ELISA method was used to detect serum IL-17 content;the chemiluminescence immunoassay was used to detect CA153 and CA125 levels.The correlation between IL-17 with various indi-cators was analyzed.Results The percentage of CD3 + CD4 + IL-17 + T cell in peripheral blood of the breast cancer patients had sta-tistically significant difference compared with the healthy control group(P <0.05);serum IL-17 level had statistically significant difference compared with the healthy control group(P <0.05);serum IL-17 level was positively correlated with the percentage of CD3 + CD4 + IL-17 + T cells and the CA153 level;IL-17 level had no significant correlation with serum CA125 level.Conclusion The IL-17 expression level is associated with breast cancer.

Clinical application of the reformed purse-string suturing and stitching technique in procedures for prolapses and hemorrhoids(PPH) / 中国基层医药

Objective To discuss advantages of the reformed technique of purse-string sutures in PPH for the treatment of severe hemorrhoids.Methods 172 cases with severe hemorrhoids received PPH with the reformed purse-string sutures.The reformed purse-string sutures were positioned right above the anocutaneous line by 2～3cm.The chorda chirurgicalis moved from upward to downward at a tilt in the submucosal layer,and the reformed pursestring stitches were made.Results The average operation time was 17minutes,the average width of the excised mucosal ring was 3.lcm,and the average hospitalization time was 2.6 days.The prolapsed hemorrhoids went back after surgery.No fecal incontinence,recurrence of prolapsed hemorrhoids or anastomotic stenosis occurred within 1～24 weeks fonow-up.Conclusion The reformed suturing technique of purse-string stitches is safe,effective and recommendable.

Periareolar incision in treatment of gynecomastia / 中国基层医药

Objective To investigate the feasibility and safety of periareolar incision in treating gynecomastia, and whether it produces good cosmetic effects. Methods A total of 42 patients with gynecomastia treated by micro-incision of areola were retrospectnely anslyzed. Results The operation was successfully performed in all the 42 patients. Follow-up was done for 3 to 24 months, the surgical scars were obscure, and the sensation of nipple or areola were good. No operation-related complications were observed. Conclusion The periareolar incision in the treatment of gynecomastia was feasible and recommendable in terms of cosmetic maintenance and safety.

Effect of Lead Pollution on Health of Residents Living on Highway-sides in Mountain Areas / 环境与健康杂志

Objective To investigate the body burden of lead and the related health effects in the residents living on the highway-sides of the mountain areas in Fujian province,China.Methods Eighty-nine subjects living nearby the highway-sides(exposed group) and 69 subjects far away from the highway(control group) were recruited by stratified random sampling method.Their basic situation and relevant index were investigated with questionnaire;The lead levels of blood and urine were determined by graphite furnace atomic absorption spectrometric method and compared;The temperature,pulse rate and blood pressure were taken to analyze the related health effects;and the influence factors of blood lead levels were analyzed by single factor analysis method,rank correlation analysis method and multiple regression analysis method.Results The blood and urine lead level of exposure group([94.19 26.51),(15.36?7.67)?g/L ]were significantly higher than that of the control group[(62.83?13.33),(7.24?4.62) ?g/L;t=8.981 0、7.766 2,P

Distribution of Cadmium and Lead in Soil and Rice Along Road Polluted by Traffic Exhaust / 环境与健康杂志

coarse polished rice for lead respectively. Positive correlations were observed in contents of cadmium and lead between soil and rice (r=0.942～0.994, P

Blood Lead Level and Influencing Factors for Children Living in Area near Highway in Mountain Region / 环境与健康杂志

Objective To know the blood level and the influencing factors for the children living in the area near highway in the mountain region. Methods From December,2006 to April,2007,one hundred and eighteen children aged 8-12 years (exposed group) living in the area near highway in the mountain region and fifty-one children aged 8-12 years (control group) living in the area far away from the highway were selected by random cluster sampling. Lead level of the soil and crops on the highway-sides (pollution area)and the area far away from the highway (control area) was determined. The basic situation was investigated by the questionnaire, the blood lead level was determined by graphite furnace atomic absorption spectrometry. The influence of lead on children's intelligence, physical growth and the influencing factors for blood lead level were analyzed. Results The average lead level of the soil [(96.89?15.05) mg/kg] and crops [(0.86?0.29) mg/kg] in the polluted area was significantly higher compared with the control [soil lead: (29.83?1.41)mg/kg,crops lead:(0.17?0.03) mg/kg], and revealed statistical significance respectively (P