Efficacy and safety of MatrixRIB fixation system in the treatment of severe rib fractures / 中华老年医学杂志

Objective To investigate the efficacy and safety of MatrixRIB fixation system in the treatment of severe rib fractures.Methods A total of 131 patients with severe rib fractures undergoing open reduction and internal fixation using MatrixRIB fixation system in our department were enrolled.Data including demographics,injury characteristics,surgical procedure details and postoperative recovery were collected.The operation experiences were summarized,and complications,postoperative and follow-up data were analyzed.Results Totally 637 (637/891)rib fractures were fixed.No internal fixation disorder was found,but 1 case had displacement after internal fixation.The majority of patients were extubated immediately after surgery.The mean time of pressure-support ventilation after surgery was 47.6(7 143)hours.The chest instability and pain were improved in all patients after surgery.At 3 to 6 months after treatment,70 patients(70/102)returned to work,and 87 patients(87/89)recovered previous normal life.Conclusions MatrixRIB fixation system is easy to operate in the treatment of severe rib fractures and has good clinical outcomes with few complications.Patients' pain is significantly relieved with satisfactory rehabilitation.

Depletion of PRDM9 inhibited the osteogenic differentiation potential of periodontal ligament stem cells / 中华口腔医学杂志

Objective@#To investigate the effect of PR domain zinc finger protein 9 (PRDM9), one of the histone methylated transferases, on osteogenic differentiation ability of periodontal ligament mesenchymal stem cells (PDLSC).@*Methods@#PDLSC with PRDM9 gene knocked down by PRDM9 shRNA using recombinant lentiviral vector were allocated into the PRDM9sh group, and the transfected shRNA was as the control group. The gene expression efficiency was evaluated by reverse transcription polymerase chain reaction (RT-PCR). Alkaline phosphatase activity (ALP), alizarin red staining, mineralization and osteocalcin, which belongs to osteogenic differentiation markers detected by RT-PCR and Western blotting to detect the osteogenic differentiation ability of stem cells from periodontal ligaments in vitro. In vivo, PRDM9sh and control group cells was transplanted into the dorsal dermal to explore the osteogenesis. The area percentage of new osteogenic tissue was calculated by image pro software and statistically analyzed.@*Results@#RT-PCR results showed that the relative expression of PRDM9 gene in PRDM9sh (0.460±0.017) was significantly lower than that in control group (1.000±0.107) (P<0.05). The results of ALP activity determined at 5 days postinduction in a significant decrease in PRDM9sh cells (0.762±0.063) compared with control group (1.225±0.058) (P<0.01). Alizarin red staining induced by osteogenesis at 2 weeks and 3 weeks showed that the staining of PRDM9sh was significantly lighter than that in control group. Quantitative calcium analysis results showed that the calcium ion concentration induced by osteogenesis at 2 weeks and 3 weeks [(0.071±0.004), (0.075±0.001)] in PRDM9sh was significantly lower than that in control group at 2 weeks and 3 weeks [(0.282±0.006), (0.485+0.004)] (P<0.01). RT-PCR results showed that the relative expression of osteocalcin mRNA in PRDM9sh (1.059±0.148) was significantly lower than that in control group at 2 weeks (2.542±0.190) (P<0.01). Western blotting results showed that osteocalcin expression in PRDM9sh was significantly lower than that in control group at 1 and 2 weeks after osteogenesis induction. Animal transplantation experiments results indicated that PRDM9 significantly inhibited the osteogenesis of PDLSC in vivo, and the proportion of osteogenic area calculated showed that the osteogenic capacity of PRDM9sh [(3.8±2.41)%] was significantly lower than that in control group [(24.54±7.06)%](P<0.05).@*Conclusions@#Depletion of PRDM9 repressed the osteogenic differentiation of stem cells from periodontal ligament in vitro and in vivo.

Endoscopic transthoracic sympathectomy:effects on the treatment of hyperhidrosis palmaris and quality of life / 中华老年医学杂志

Objective To investigate the effects of endoscopic transthoracic sympathectomy on the treatment of hyperhidrosis palmaris(sweaty hands)and quality of life.Methods The clinical data of 62 patients with sweaty hands admitted from June 2010 to May 2016 were retrospectively analyzed.The 62 patients were randomly divided into two groups:thoracoscopic sympathectomy was performed at T2-3 in the control group,while at T3-4 in the experimental group.The self-reports of quality of life(QOL)before and after the operation were collected as follows:the severity of sweaty hands assessed by hyperhidrosis disease severity scale (HDSS:the higher score the more severe hyperhidrosis),the improvement of QOL assessed by sweaty hands assessment scale(the higher score the more improvement)and surgical efficacy.Results The improvements of HDSS and satisfaction score were higher in the experimental group than in the control group(P＜0.05).The differences between pre-and post-operation in the five dimensions of social interaction,gestation,daily behavior,work and social psychology were better in the experimental group than in the control group(all P＜ 0.05).Conclusions Thoracoscopic sympathectomy at T2-4 and T3-4 is an effective treatment for sweaty hands.But surgery at T3-4 levels,which is associated with a larger improvement in quality of life and fewer complications,is recommended as a priority option for a surgical treatment.

Clinical analysis of perioperative application and complications of Intra-aortic Balloon Pump in cardiac surgery / 中国综合临床

Objective To assess the perioperative efficacy and complications of intra-aortic balloon pump(IABP) in patients with cardiac operation.Methods A total of 36 cases with IABP patients from January 2011 to September 2016 were studied in Luhe Hospital of Beijing Affiliated to Capital Medical University,inluding 27 patients with coronary atherosclerotic heart disease(CAD),8 patients with valvular heart diseaseand and 1 patient with left atrial myxoma.The clinical data was collected to analyze IABP efficacy and complications.Results There were 10(27.8%) patients died,the mortality rate of CAD patients was lower than that of non-CAD patients(18.5% vs.55.6%,X2=4.615,P=0.032).The related complications after IABP implantation included:6(16.7%) cases suffered from thrombocytopenia,3(8.3%) cases with lower limb ischemia,2(5.6%) cases with lower extremity arterial thromboembolism,2(5.6%) cases with femoral artery pseudoaneurysm,2(5.6%) cases with acute pancreatitis,1(2.8%) cases with intestinal necrosis by mesenteric ischemia,2(5.6%) cases with gastrointestinal bleeding,3(8.3%) cases with hemorrhage in puncture site,4(11.1%) cases of fever,1(2.8%) case with pipeline leak,and 1(2.8%) case no pressure lumen data.After treatment with IABP,in 26 cases survival patients,the hemodynamic indexes(mean arterial pressure,heart rate,central venous pressure,urine volume) were significantly improved and the amount of dopamine and epinephrine decreased(t=-22.35,64.41,53.31,-23.82,26.07,14.15 respectively,P<0.05).Conclusion IABP can significantly improve the perioperative efficacy.The active treatment on complications is important to reduce the death induced by IABP.

The efficacy and safety of conservative treatment versus surgery for traumatic flail chest in elderly patients / 中华老年医学杂志

Objective To compare the clinical safety and efficacy of conservative treatment and surgery for traumatic flail chest in elderly patients.Methods From January 2013 to January 2017,68 elderly patients with traumatic flail chest in the Department of Thoracic Surgery,Beijing Lu He Hospital were enrolled.Based on different treatment methods,patients were divided into a conservative treatment group (n =34) and a surgery group (n =34),and the clinical safety and efficacy were compared between the two different treatment groups.Results Patients in the surgery group were associated with significantly decreased mechanical ventilation time,and days stayed in ICU and hospital,compared with the conservative treatment group (all P＜0.05).However,incidences of atelectasis and/or pneumonia,duration of pain and oxygen therapy,total thoracic drainage volume and extubation time were similar between the two groups (all P＞0.05).Rates of delayed or nonunion (2.9％ vs.17.6％) and thoracic deformity (0.0％ vs.11.8％) were significantly lower in the surgery group than those in the conservative treatment group (x2=3.981 and 4.250,both P＜0.05).Conclusions Surgery can safely and effectively reduce incidences of complications in elderly patients with traumatic flail chest disease and shorten the time of hospitalization.Therefore,the short-and longterm effects are promising and warrant further investigation.

Research Advances in Resistance to Platinum-based Chemotherapy in Lung Cancer / 中国医学科学院学报

Platinum-based chemotherapy is the the cornerstone of treatment of many cancers. Combinations of platinum drugs with other agents are still the mainstream therapies for non-small cell lung cancer,showing significant effectiveness in an early phase. Along with the treatment,the tumor cells can become resistant to chemotherapy drugs,which affect the efficacy and prognosis. The mechanisms of drug resistance are complicated,including abnormal expressions of membrane proteins,enhanced DNA repair functions,abnormal regulation mechanisms of apoptosis,and enhanced cellular detoxification function. In this article we summarize some of the main mechanisms of platinum resistance in lung cancer cells,with an attempt to identify new potential target analogues or inhibitors and improve the efficacies of the combined use of platinum-based drugs.

Two methods of tubular stomach in esophageal surgery / 中国医师进修杂志

Objective To explore which method is more advantaged by comparing two kinds of tubular stomach in esophageal cancer operation and the occurrence of postoperative complications.Methods There were 47 esophageal cancer patients and they were randomly divided into two groups:A group including 24 patients and making mechanical clipping lesser curvature,B group including 23 patients and hand-sewn shrink lesser,and the major complications were analyzed and compared.Results All patients underwent radical tumor resection without the operative mortality.There was 1 patient of acute hemorrhagic of gastric resection margin in A group,and there was 1 patient of thoracic gastric leakage and 1 patient of anastomotic fistula in B group.In 12-month follow-up,there was 1 patient of anastomotic narrow in A group and 4 cases in B group (P ＞ 0.05).After 3,6 and 12 months,emptying dysfunction was not found by upper gastrointestinal imaging and CT,but the thoracic stomach expansion was found in two groups,and the degree of thoracic stomach expansion in B group was more serious than that in A group,the part of the thoracic stomach of 3 patients in B group protruding into the opposite chest.There was 1 patient with thoracic-gastro syndrome after eating in A group and 3 patients in B group (P ＞ 0.05).There were 3 patients with mild reflux esophagitis in A group and 10 patients with serious reflux esophagitis in B group (P＜0.05).Conclusion Comparing two operative methods,the mechanical clipping lesser curvature is more advantaged than hand-sewn shrink lesser.

VATS for bilateral bullae of lung / 中国基层医药

Objective To explore the operation procedures,result of bilateral video-assisted thoracoscopic bleb resection.Methods Bilateral bullae of lung successfully underwent bilateral video-assisted thoracoscopic interthoracic operation were analyzed.Results All cases recovered well postoperatively.There were no intermediate thoracotomy and operative mortality.The mean operation time was 150min.The mean operation blood loss was 105ml.The mean duration of chest tube drainage was 3～6d.The mean postoperative capacity of chest tube drainage was 860ml.Conclusion This technique is safe,effective procedure,and reduce operative expenses.

Comparative Study of Oxygen and Pressure Support Therapy on Plateau Hypoxia at an Altitude of 3992 Meters / 中国呼吸与危重监护杂志

Objective To compare the effects of oxygen therapy and local pressurization in alleviating plateau hypoxia at high altitude.Methods Forty-five healthy male soldiers were investigated at an altitude of 3992 meters.The subjects were randomly divided into three groups, ie.an oxygen inhalation group, a single-soldier oxygen increasing respirator (SOIR) group and a BiPAP group.The oxygen inhalation group was treated with oxygen inhalation via nasal catheter at 2 L/min.SOIR was used to assist breath in the SOIR group.The BiPAP group were treated with bi-level positive airway pressure ventilation, with IPAP of 10 cm H20 and EPAP of 4 cm H2O.PaO2、PaCO2、SpO2 and heart rate were measured before and 30 minutes after the treatment.Results There were continuous increase of PaO2 from (53.30±4.88) mm Hg to (58.58±5.05) mm Hg and (54.43±3.01) mm Hg to (91.36±10.99) mm Hg after BiPAP ventilation and oxygen inhalation, respectively (both P < 0.01).However, the PaO2、of the SOIR group was decreased from (56.00±5.75) mm Hg to (50.82±5.40) mm Hg (P < 0.05).In the other hand, the PaCO2、 was increased from (30.41±1.51) mm Hg to (32.5±2.98) mm Hg in the oxygen inhalation group (P< 0.05), declined from (28.74±2.91) mm Hg to (25.82±4.35) mm Hg in the BiPAP group (P < 0.05), and didn't change significantly from (28.65±2.78)mm Hg to (29.75±3.89) nun Hg in the SOIR group (P > 0.05).Conclusions Both BiPAP ventilation and oxygen inhalation can alleviate plateau hypoxia by improving PaO2 at 3992 meter altitude while SOIR has no significant effect.

Arthrolysis and skeletal traction in treatment of knee ankylosis / 中华创伤骨科杂志

Objective To sum up a new surgical method to treat knee ankylosis with skeletal traction following arthrolysis. Methods Skeletal traction through supracondyle of femur or through patella was applied for 48 patients with knee ankylosis after dissection of both intra and extra articular adhesion and quadricepsplasty. Results The follow up period ranged from 3 to 36 months. The flexion angles of the knee joint increased 70?to 105?in 34 patients. Conclusion Skeletal traction following arthrolysis to treat knee ankylosis can prolong the length of quadriceps,increase the flexion angle of the knee joint step by step and facilitate early functional recovery after operation.