Progress in extension lag after knee surgery / 中华骨科杂志

Most literature defines knee extension lag as the failure of the knee joint to achieve the passive extension angle, and some literature defines the inability of the knee to complete the last 15° extension as knee extension lag. Extension lag is one of the common complications after knee surgery, which seriously affects the postoperative knee joint function of patients. Disuse atrophy due to prolonged postoperative bed rest, arthrogenic muscle inhibition due to pain and (or) swelling, direct injury to the knee extensor mechanism during surgery and nerve dysfunction of the quadriceps muscle can all contribute to extension lag. While rehabilitation exercises, physical therapy and medication can significantly improve the patient's symptoms, extension lag due to the knee extension device injury requires surgery if necessary to regain normal knee function. As surgical techniques continue to be refined and rehabilitation interventions advance, the prevention of extension lag and the minimization of angle of knee extension lag need to be given adequate attention by patients, physicians, and researchers. This article reviews clinical studies related to extension lag after knee surgery, focusing on etiology, treatment, prevention and prognosis, with the aim of providing a basis and guidance for the current clinical management.

Modified Bascom cleft lift procedure for chronic pilonidal sinus / 中华普通外科杂志

Objective To evaluate the clinical efficacy of modified Bascom cleft lift procedure in the treatment of chronic sinus.Methods Modified Bascom cleft lift procedure was performed in 53 patients admitted from Oct 2012 to Jul 2016.49 cases were male and 4 were female.The average age was (25.4± 2.3) years.Results All patients were satisfied with the operation.There were 49 cases of primary healing and 4 cases of incision complications.The average follow-up was (12.1 ±4.3) months,no recurrence was observed.Conclusion The modified Bascom cleft lift technique is effective and reliable,with less complications and a lower recurrence rate.

Progress of Da Vinci Robot in Surgical Treatment of Gastric Cancer / 中国综合临床

Objective The Da Vinci single－site surgical platform (DVSSP) is an intelligent operation platform widely used worldwide. It possesses 3D vision ,flexible operation and other advantages, so in the field of gastrointestinal surgery, it has been gradually applied to radical gastrectomy, radical gastrectomy, radical resection of colorectal cancer, gastric fundus folding, Heller myotomy, weight loss surgery and small bowel surgery, and the satisfactory clinical effect has been achieved. For gastric cancer surgery, compared with traditional laparoscopy and laparotomy, the robot operation is more accurate, flexible, and has obvious minimally invasive advantages. The intraoperative treatment and postoperative curative effect are better than the traditional laparoscopy. With the support of a large number of clinical cases, DVSSP has been proven to be a new platform for minimally invasive surgery and has considerable value in the field of gastric cancer surgery. However, there is still a long operation time and a high cost of operation. The long－term effect of gastric cancer surgery needs further observation.

Dosimetric analysis of CT-guided salvage interstitial brachytherapy for recurrent cervical cancer / 中华放射肿瘤学杂志

Objective To analyze the dosimetric advantages of CT-guided interstitial brachytherapy for recurrent cervical cancer. Methods A total of 16 patients with recurrent cervical cancer after radical surgery and adjuvant external beam radiotherapy received interstitial brachytherapy with CT-guided implantation of metal needles. The high-risk clinical target volume (HR-CTV) was given 36 Gy in 6 fractions.D90for HR-CTV in the brachytherapy and the cumulative D2 cm3values for the bladder,rectum,and sigmoid colon in the previous external beam radiotherapy and the brachytherapy were analyzed.Results The mean D90value for HR-CTV was 52.5±3.3 Gy. The cumulative D2 cm3values for the bladder, rectum, and sigmoid colon were 85.6±5.8 Gy,71.6±6.4 Gy,and 69.6±5.9 Gy,respectively.The mean number of metal needles was 6.1±1.5 in each brachytherapy. The actual 1-year overall survival and local control were 81% and 69%, respectively. Conclusions CT-guided interstitial brachytherapy for recurrent cervical cancer shows good dose-volume histogram parameters and few complications, so it may be clinically feasible. However,its long-term clinical efficacy needs further observation.

The therapeutic evaluation of video-assisted anal fistula treatment for Parks Ⅱ anal fistula / 中华普通外科杂志

Objective To evaluate video-assisted anal fistula treatment (VAAFT) for Parks type Ⅱ anal fistula.Methods 40 Parks type Ⅱ anal fistula patients underwent VAAFT procedure from June 2015 to June 2017.Results were compared with 40 cases treated by incision and thread drawing.Results There was no significant difference between the two groups for curative effect,postoperative urinary retention,wound edema,bleeding and recurrence rate after 6 months of operation (90％ vs.95％,x2 =0.722,P =0.697;5％ vs.8％,x2 =0.213,P=1.0;2％ vs.8％,x2 =1.053,P=0.615;0 vs.5％,x2 =2.051,P =0.494;10％ vs.5％,x2 =0.721,P =0.675).Pain on first day and one week after operation in the VAAFT was less [(1.9±0.6) vs.(3.7±1.0),t =9.438,P=0.001;(0.9±0.7) vs.(1.9±0.8),t=6.269,P=0.001],hospital stay was shorter [8.4 ±1.3) d vs.(9.2 ±2.2) d,t =2.030,P=0.047],wound healing was faster [(27 ±8) dm.(38 ±6) d,t =7.328,P =0.001].The Jorge-Wexner incontinence score [(0.5±0.7) vs.(1.2±1.3),t =2.951,P=0.005] and the fecal incontinence severity index [(1.1±1.6) vs.(5.1 ±3.2),t =7.097,P=0.001] were lower in patients receiving VAAFT procedure.Conclusion Video-assisted anal fistula treatment is a safe and effective surgical method with the advantages of less trauma,and pain,quicker recovery and no damage to the anal sphincter.

Numerical simulation of two-phase hemodynamics under the fluid-solid coupling interaction in the artery / 介入放射学杂志

Objective To study the two-phase flow dynamics distribution and red blood cell distribution under the fluid-solid coupling interaction in left coronary artery at the typical time point within one cardiac cycle,and to investigate the formation and development mechanisms of left coronary artery atherosclerotic plaque Methods The blood was regarded as a two-phase fluid.Based on fluid-solid interaction between blood and vascular wall,the computational fluid dynamics method was used to make the transient numerical simulation of two-phase flow in the left coronary artery under fluid-solid interaction;the distribution of blood flow in the left coronary artery at the typical time point within one cardiac cycle was studied,the relationship between hemodynamic parameters and the formation of atherosclerotic plaque was analyzed.Results A lowspeed eddy zone existed in an area between the distal segment of circumferential branch and the proximal outside of blunt-edge branch of the left coronary artery,where both internal wall shear stress and red blood cell volume fraction were very small and the blood flow pattern was very complicated.Conclusion At the lowspeed eddy zone that carries small wall shear stress,the lipid concentration polarization and macromolecular material deposition are easy to be produced.The area that has less red blood cells is liable to develop hypoxia,resulting in increased vascular wall permeability and intimal injury,which will activate the immune system,causing lipid accumulation in vascular wall and intimal hyperplasia and,thus,to induce the formation of atherosclerotic plaque.(J Intervent Radiol,2017,26:253-257)

Numerical analysis of unsteady blood flow model of fluid-solid interaction in carotid artery / 介入放射学杂志

Objective To study the distribution of hemodynamics in carotid artery under the fluid-solid interaction at the typical point of time during a single cardiac cycle, and to explore the mechanism of the formation and development of carotid atherosclerotic plaque. Methods Numerical analysis the blood flow characteristics within a cardiac cycle in carotid artery was analyzed by using computational method of fluid dynamics. Based on the hemodynamic parameters, the influences of the cardiac systole and diastole on the blood flow distribution were analyzed. Results The distribution of blood flow in the carotid artery within a typical cardiac cycle was obtained. Compared with the findings in cardiac diastole, a larger area of blood stasis at the entrance of external carotid artery was observed. In this area, the flow velocity, the wall pressure and the wall shear stress were all lower, while the arterial wall deformation and von Mises equivalent stress were larger. Conclusion Under fluid-solid interaction, the low blood flow in carotid artery causes blood reflux, resulting in the deposition of lipid, fiber and other large molecular materials. The low wall pressure produced“negative pressure” effect, thus the normal blood flow is changed, the flow velocity becomes slow, and the blood supply of the brain becomes insufficient. The low wall shear stress destroys the blood flow near the wall, causing the increase of platelet activity and intimal hyperplasia. The larger arterial wall deformation variable and von Mises equivalent stress can cause stress concentration and increase vascular rupture risk.

Dynamic changes of chest CT in adult patients with severe adenovirus pneumonia / 实用放射学杂志

Objective To explore the characteristics of chest multi-slice spiral CT and dynamic changes in adult patients with se-vere adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory ade-novirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT exami-nations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with ground-glass opacity (GGO)in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

Promotion of rat skin healing by using natural polymer chitosan derivatives / 生物医学工程学杂志

We in the present study observed the effect of N-fructose modified chitosan quaternary ammonium derivatives on on rat skin wound healing through animal experiments. Forty rats were randomly divided into eight groups (5 in each group). Four groups among the all 8 groups were the experimental groups, while the other 4 groups were the control groups. Next to the skin along the back of the spine, 1.50 cm x 2.00 cm x 0.16 cm full-thickness skin was cut to make an excision wound model for every rat. Those in the experimental groups were treated with the N-fructose-modified chitosan quaternary ammonium derivatives ointment dressing the wound, while those in the control groups with sterile medical vaseline processing. We dressed the wounds twice a day to observe the wound healing of all rats in different groups. We then observed the wound healing and wound pathology after 3, 7, 10, 15 days re spectively in different groups. Results showed significant differences of the time of wound healing, area of wound healing and volume of wound healing between the experimental groups and control groups (P < 0.05). It can be well concluded that N-fructose-modified chitosan quaternary ammonium derivatives does not harm the skin, but could promote skin healing, so that they could be suitable skin repair materials and ideal raw materials for medical dressing.

Expressions of IL-16, IFN-γ and CXCR3 in plasma of patients with chronic obstructive pulmonary disease and their clinical significance / 实用医学杂志

Objective Toexplore the expressions of interleukin-16 (IL-16), interferon-γ (IFN-γ), CXC chemokine receptor 3 (CXCR3), and CRP and their clinical significance in acute exacerbation chronic obstructive pulmonary disease by observing the changes in these factors in patients with AECOPD. Methods 103 patients with AECOPD and 20 healthy controls were collected. According to the 2013 GOLD guideline, all the patients with AECOPD were divided into4 groups(group A of 21 patients, B of 30, C of 27, andD of 25). Results As compared withthe control group, plasma concentrations of IL-16, IFN-γ, CXCR3. and CRP were significantly increased in the patients with AECOPD (P < 0.01), and as the severity of the disease was elevating, these expression levels were significantly increased.While the expression levels of IL-16, IFN-γ, CXCR3, and CRP levels were significantly reduced after treatment, but they were still higherthan those in the control group (P < 0.05). The expression levels of serum IL-16, IFN-γ, CXCR3, and CRP were significantly correlated in patients with AECOPD. Conclusions Expressions of IL-16, IFN-γ and CXCR3 are significantly increased in AECOPD, which is correlated with disease severity and decreased after treatment, suggesting that these three factors may be associated with the occurrence and development of COPD.

Comparative study of standard large trauma craniectomy and routine temporoparietal craniectomy in treating acute posttraumatic brain swelling / 中国医师进修杂志

Objective To investigate the clinical effects of standard large trauma craniectomy in patients with acute posttraumatic brain swelling. Methods A cohort study was performed in 74 patients of acute posttraumatic brain swelling with midline shifting more than 5 mm, who were divided randomly into two groups: standard large trauma craniectomy group (n =37) and routine temporoparietal craniectomy group as control group (n =37). The vital sign, the intracranial pressure (ICP) and complications were observed during the treatment. The Glasgow outcome scale (GOS) and mortality rate as well as the complications were evaluated after treatment. Results The mean ICP in the large trauma craniectomy group at 24, 48, 72 and 96 hours was much lower than those of the control group ( P

Experimental observation on the effects of different chitosan on preventing peritoneal adhesion in rats / 生物医学工程学杂志

This experiment was designed to investigate the effects of different chitosan on preventing peritoneal adhesion in rats. 240 SD rats were divided into 2 jumbogroups: jumbogroup A (144 rats) treated with chitosan gel and jumbogroup B (96 rats) with chitosan/gelatin mixed film. In jumbogroup A, 144 rats were randomly divided into 3 groups further, and different methods were used to induce peritoneal adhesions in each group while in the experiment group the wounded processus vermiformis was coated with chitosan gel before it was put back into the abdominal cavity. In jumpbogroup B, 96 rats were randomly divided into 4 groups (24 each) after surgical induction of perioneal adhesions; group B1 served as control group while in groups B2, B3 and B4, pure chitosan film and the chitosan film containing gelatin were respectively spread over the surface of the wounded. 2 and 4 weeks after surgical induction, exploratory laparatomy was performed on the rats to evaluate peritoneal adhesion, and the adhesive tissues were examined histopathologically. The results show that chitosan gel has perfect protective efficacy against traumatic or ischemic peritoneal adhesion, but pure chitosan film and the film chitosan containing gelatin could exacerbate peritoneal adhesion further.

Effects of Tingli Shengmai Decoction on myocardial fibrosis and expression of TGF-?_1 of rats with congestive heart failure / 中华中医药杂志

Objective: To explore the mechanism of congestive heart failure (CHF) by observing the effects of Tingli Shengmai Decoction on myocardial fibrosis and expression of TGF-?1 of rats with CHF. Methods: The CHF animal models were duplicated by the abdomen arteriarctia method, and 60 male wistar rats were randomly divided into the sham-operation group, the model group, the high-dose of Tingli Shengmai Decoction group, the low-dose of Tingli Shengmai Decoction group and the positive medicine (Xinbaowan) control group. After 4 weeks common fed, every group rats were given a certain dose of distilled water or medicine. After 8 weeks, hemodynamic parameters were detected, MASSON staining was used in the study of collagen type in left ventricular interstitial tissue, collagen volume fraction (CVF) were measured by image analysis, and expression of TGF-?1 in myocardium were evaluated by immunohistochemical staining. Results: Compared with the sham-operated group, CVF of model control group increased significantly (P

Cryotherapy of employing Argon/Helium assisted with TACE in treating unresectable primary liver carcinoma / 介入放射学杂志

Objective To investigate the effect of cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma. Methods 124 cases with primary liver carcinoma were randomly divided into two groups:60 cases were treated by TACE and cryotherapy; the other 64 cases were simply done by TACE as control. In general, TACE was undertaken once a month and altogether three times for a course. Cryotherapy was undergone 1-3 times for a course. Results The total effective rates (CR+PR) were 45.3% for the control group and 68.3% for the combined therapy group, with an obvious difference between the two groups, 0.5,1,1.5 years survival rate were 81.3%,62.5%,43.8% respectively in the control group;93.3%,83.3%,63.3% respectively for the combined group. There was an obvious difference between the two groups of 1,1.5 years of survival rates. Conclusions Cryotherapy of employing Argon/Helium assisted with TACE for the unresectable primary liver carcinoma is feasible with raising the effective rate and prolonging survival time.