Feasibility and safety of one-stage bilateral video-assisted thoracic surgery for resection of bilateral multiple pulmonary nodules / 南方医科大学学报

OBJECTIVE@#To evaluate the feasibility and safety of one- stage bilateral video-assisted thoracic surgery (VATS) for resection of bilateral multiple pulmonary nodules (BMPNs).@*METHODS@#We analyzed the clinical characteristics, pathological features, perioperative outcomes and follow-up data of 41 patients with BMPNs undergoing one-stage bilateral VATS from July, 2011 to August, 2021.@*RESULTS@#One-stage bilateral VATS was performed uneventfully in 40 of the patients, and conversion to open surgery occurred in 1 case. The surgical approaches included bilateral lobectomy (4.9%), lobar-sublobar resection (36.6%) and sublobar-sublobar resection (58.5%) with a mean operative time of 196.3±54.5 min, a mean blood loss of 224.6±139.5 mL, a mean thoracic drainage duration of 4.7±1.1 days and a mean hospital stay of 14±3.8 days. Pathological examination revealed bilateral primary lung cancer in 15 cases, unilateral primary lung cancer in 21 cases and bilateral benign lesions in 5 cases. A total of 112 pulmonary nodules were resected, including 67 malignant and 45 benign lesions. Postoperative complications included pulmonary infection (5 cases), respiratory failure (2 cases), asthma attack (2 cases), atrial fibrillation (2 cases), and drug-induced liver injury (1 case). No perioperative death occurred in these patients, who had a 1-year survival rate of 97.6%.@*CONCLUSION@#With appropriate preoperative screening and perioperative management, one-stage bilateral VATS is feasible and safe for resection of BMPNs.

A preliminary study of teaching effect of problem-based learning with arthroscopic simulated / 中华医学教育探索杂志

Objective To investigate the teaching effect of problem-based learning (PBL) for specific cases combined with arthroscopic simulated training in the clinical teaching of arthroscopy for orthopedics.Methods A total of 40 clinical interns in Department of Orthopaedics,the First Affiliated Hospital of Chongqing Medical Hospital were selected and divided into experimental group and control group.The interns in the control group received traditional clinical training,and those in the experimental group received the clinical teaching of PBL for specific case combined with arthroscopic simulated training.SAS 9.2 software was used for a statistical analysis ofteaching outcomes.Results The experimental group had a significantly higher score of comprehensive professional ability than the control group [(43.00 ± 6.15) vs.(35.90 ± 4.94),P＜0.05].Compared with the control group,the experimental group had significantly better scores of all items of professional ability assessment except patients' evaluation of interns (all P＜0.05).As for the quality of teaching,compared with the control group,the experimental group had significantly higher numbers of interns who agreed to each assessment item except the item of improvement in coordination and cooperation ability.Conclusion The clinical teaching method of PBL for specific case combined with arthroscopic simulated training can improve learning enthusiasm and ability and proficiency of clinical operational skills among clinical interns,and therefore,it holds promise for application in clinical teaching.

Difference and clinical significance of serum GP73 between alcoholic liver disease and non-alcohol fatty liver disease / 中华实验和临床病毒学杂志

Objective@#The present study was designed to evaluate the clinical significance of serum GP73 in patients with alcohol liver disease.@*Methods@#Thirty-two patients with alcoholic liver disease (ALD), 40 patients with non-alcohol fatty liver disease(NFLAD), and 40 apparently healthy individuals were included in this study.@*Results@#Compared with Those of healthy control population(43.91±19.02 ng/ml), the serum GP73 levels in ALD patients(93.39±66.91 ng/ml) were significantly increased, and also markedly higher than those of NFLAD patients (55.38±21.00 ng/ml). Taken the NFALD as"healthy controls" population, and ALD population as"patients" , the GP73 may be used to differentiate the ALD from NFLAD. The area of ROC analysis was 0.66(95%CI: 0.52~0.80, P=0.02). We set 75.65 ng/ml as the cut-off value for ALD diagnosis, the sensitivity and specificity were 50.0% and 85.0% respectively.@*Conclusion@#Serum GP73 levels in ALD patients were significantly higher than those of NFALD patients. GP73 may be a new marker for differentiating ALD from NFALD.

The performance evaluation of reticulocytes detected by XN-3000 automatic blood analyzer / 中国医学装备

Objective:To evaluate the performance of reticulocyte (Ret) detected by Sysmex XN-3000 automatic blood analyzer.Methods: 96 blood samples were collected randomly in clinical detection of reticulocytes, and respectively were detected by XN-3000 automatic blood analyzer and microscopy. The precision, stability, linearity and carryover of Ret in blood samples detected by XN-3000 automatic blood analyzer were evaluated by the correlation analysis of the results from the two methods and the correlation analysis would be completed by microscopy.Results: precision, linear range and sensitivity of Ret measured by XN-3000 were within the allowable range. The stability did not change significantly below 4℃ within 48h (CV<1%). The carryover rate was 0.14%. The results measured by XN-3000 were well compared with microscopy (r=0.979).Conclusion: Sysmex XN-3000 automatic blood analyzer is applied to the clinical detection of large quantities of specimens and it is ideal for measuring Ret.

Treatment of radial head fracture by internal fixation with bold canal titanium screws / 中华创伤杂志

Objective To observe clinical results and indications of open reduction and internal fixation by bold canal titanium screws for treatment of radial head fractures. Methods From May 2003to February 2007,18 cases of radial head fractures were treated by open reduction and intemal fixation with bold canal titanium screws.There were 12 males and 6 females at age range of 15-53 years(mean 28.6 years).Of all,13 cases had Mason typeⅡ fractures,3 Mason typeⅣ and 2 Mason typeⅣ.Rehabilitation began as early as possible after operation if the internal fixation was secure;otherwise,rehabilitation began 2 weeks after operation.Postoperative plain radiography was made to observe fracture healing and complications. Results After operation,the rehabilitation was done at the first day in 15 cases and at 2 weeks in 3,with mean fracture healing time of 3 months.Function of elbows and rotation of forearnls were excellent except for 2 eases with Mason Ⅳ fractures.No deep branch of radial nerve injury occurred. Conclusion Open reduction and internal fixation with bold titanium canal screws can attain satisfactory clinical results in treatment of Mason type Ⅱ and Mason typeⅢradial head fractures.

Treatment of humeral proximal fracture with locking proximal humerus plate / 中华创伤杂志

Objective To summarize the clinical effect of open reduction and internal fixation for the proximal humeral fracture with locking proximal humerus plate (LPHP). Methods A total of 45 cases with complex humeral fractures were operated via deltoid-pectoral approach. According to the Neer classification, there were 33 cases with three-part fractures and 12 with four-part fractures. Neer nu- merical rating system was employed to evaluate postoperative function of the involved shoulder. Results Of all, 38 cases were followed up for a mean 14.7 months, which showed fracture union within 3 months in 35 cases and fracture union within 4 months in 3. According to the Neer numerical rating system, re- suh was excellent in 20 eases and satisfactory in 15, with total excellence rate of 92%. Conclusion LPHP is characterized by stable fixation, minor complication and high satisfaction, and hence is an effec- tive method for proximal humeral fractures.

A comparative assessment of short-term outcomes of Corail entirely hydroxyapatite-coated versus cemented femoral stem prosthesis in total hip arthroplasty for elderly femoral neck fracture / 中国矫形外科杂志

[Objective]To compare the short-term clinical effect of Corail entirely hydroxyapatite(HA)-coated versus cemented femoral stem prosthesis in total hip arthroplasty(THA) for elderly femoral neck fracture.[Method]Fifty-four cases of unilateral femoral neck fracture in patient over 75 were retrospectively analyzed from January 2007 to June 2008.In them,21cases underwent THA using Corail femoral prosthesis(HA group),and the other 33 were treated with cemented THA(cement group).The difference was compared in time of hospitalization,time of operation,blood loss,hemodynamic parameters,adverse effect,Harris scoring and radiological results.[Result](1)The average operation time were(52.6?7.2)minutes in HA group and(62.5?8.5)minutes in cement group,with significant difference(P

Experimental study on influence of storage time in vitro on bone autograft healing / 重庆医科大学学报

Objective:To discover the influence within four hours of different storage time in vitro on the osteogenic capability in bone autograft.Methods:The ilium blocks in 0.9% saline were kept at room temperature for 0、1、2、 3 or 4 hours before replacement to extra-skeletal muscle gaps in the same rabbit.The grafts transplanted to muscle gaps were divided into two types:irrigating bone marrow with saline and non-irrigating bone marrow.The histological specimens of the autograft in extra-skeletal muscle gaps were taken at the 3rd day and 1、2、4、6 weeks after operation, stained by ALP.PAS and HE,and analysed by histomorphometry.Results:There were survival osteocytes and osteoblasts in all ectopic graft groups three days after operation,but no new bone formation.New osteoid tissues were formed one week after operation, and they increased at the second week and were gradually transformed into woven bone and lamellar bone tissues in all ectopic graft groups. The results of histomorphometry analysis showed there was no remarkable difference among all ectopic graft groups.Conclusion:Storage of the bone blocks in 0.9% saline for four hours before implant has no remarkable influence on the capacity of bone formation in bone autograft.Irrigating bone marrow with saline would not influence the survival of autograft and the capacity of new bone formation.Therefore,it is a reasonable method to keep bone blocks in saline before implant.

Metal on metal hip replacement for the traumatic arthritis developed from fracture of acetabulum / 重庆医科大学学报

Objective:to explore the clinical curative effect of treatment for the traumatic arthritis developed from fracture of acetabulum with metal on metal hip replacement.Methods:a total of 11 cases(aged from 31～55,averaged 43.2 and the mean body mass index was 24?2.3,with a range between 20.3 and 29.2)of traumatic arthritis developed from open reduction and internal fixation for the fracture of acetabulum were admitted from September 2003～April 2007,among which 9 cases were male,2 female,and the aetiology of the acetabular fractures could be classified as follows:traffic accident trauma in 8 cases were,high falling injury in 2 cases,heavy pound in 1 case.According to the Letournel classification,there are 3 cases of posterior column accompanied with posterior wall fracture,2 cases of posterior wall accompanied with posterior dislocation,2 cases of transverse accompanied with posterior wall,2 cases of both column,one cases of posterior wall and one cases of transverse fracture.All the cases were examined before the former and this operation respectively by X-ray and 3D CT to evaluate the fracture configuration and the bone defect.The involved hip function was evaluated according to the Harris score pre-and 2 years postoperatively.Results:All the incisions healed by first intension,and no complications like dislocation, nerve and blood vessel injury were developed.All the 11 cases were followed up,time ranged from 24 to 67 months,and averaged 38.5? 9.5 months.According to the Harris score system,the involved hip function showed excellent result in 2 cases,satisfactory in 8 cases, poor in one case,and the excellent and the satisfactory cases accounted for 90.1%.Conclusion:Metal on metal hip replacement for the traumatic arthritis developed from fracture of acetabulum could preserve the hip function with less complications,which makes the patients satisfied and deserves clinical expansion.