Clinical efficacy of modified sacral fixation under Leonardo da Vinci robot laparoscopy for pelvic organ prolapse.

OBJECTIVE: The aim of this study was to analyze the clinical efficacy of modified sacral fixation under Leonardo da Vinci robot laparoscopy for pelvic organ prolapse (POP). PATIENTS AND METHODS: Sixty POP patients admitted to our hospital from January 2020 to December 2021 were picked and divided into Group A (laparoscopic Y-mesh, n = 20), Group B (laparoscopic sacrovaginal fixation, n = 20), and Group C (da Vinci robotic sacral fixation, n = 20). These three groups were compared in terms of the perioperative indexes, such as operation time, intraoperative blood loss, postoperative indwelling catheter days, anal exhaust time, postoperative hospitalization days, etc. The occurrence of short-term and long-term complications in the three groups was compared. The changes of the following index values in the POP quantification system (POP -Q) staging before and 1 year after surgery were recorded and compared among the three groups. It mainly includes the midline of the anterior vaginal wall at 3 cm from the hymenal margin (Aa), the farthest point of the anterior vaginal vault from point Aa (Ba), the farthest point of the ectocervix (C), the location of the posterior vaginal vault or rectal uterine trap (D), the midline of the posterior vaginal wall at 3 cm from the hymenal margin (Ap), and the reflection of the posterior vaginal vault at the farthest point from the Ap point (Bp) values. The changes in Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20) and Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) were recorded and compared before and 1 year after the operation. RESULTS: The patients in Group C had significantly lower intraoperative bleeding, postoperative indwelling catheter days, anal exhaust time, and postoperative hospitalization days compared with those in Group A and Group B (p < 0.05). There existed no statistical difference in the incidence of short-term and long-term complications between Group B and Group C (p > 0.05), but both were much lower than Group A (p < 0.05). The differences in POP-Q staging, PFDI-20 scale, and PISQ-12 scale were not statistically significant among the three groups before surgery (p > 0.05), and the POP-Q staging Aa, Ba, C, D, Ap, and Bp values, PFDI-20 scale, and PISQ-12 scale were strongly improved in three groups after the surgery (p < 0.05). However, the POP-Q staging, PFDI-20 scale, and PISQ-12 scale among the three groups had no obvious difference after the surgery (p > 0.05). CONCLUSIONS: The efficacy of modified sacral fixation under Leonardo da Vinci robot laparoscopy for POP was comparable to that of laparoscopic Y-mesh treatment and laparoscopic sacral vaginal fixation. However, da Vinci's robotic sacral fixation had the advantages of less intraoperative bleeding and faster postoperative recovery, which helped patients recover quickly and improved their quality of life.

[Clinical analysis of 66 cases of pseudo fever].

Some patients who present with a "fever" may only have a localized increase in body surface temperature, while their core body temperature remains normal. This phenomenon is commonly referred to as pseudo fever. A retrospective analysis of clinical data from January 2013 to January 2020 at our fever clinic showed that 66 adolescents were diagnosed with pseudo fever. These patients typically showed a gradual increase in axillary temperature after their cold symptoms had disappeared. Most patients reported no significant complaints other than mild dizziness. Laboratory tests showed no significant abnormalities, and antipyretics were ineffective in lowering their body temperature. Pseudo fever is a relatively independent clinical phenomenon that is distinct from functional fever or simulated fever, and its underlying mechanism remains to be studied.

The role of mitochondrial DNA mutations in a Han Chinese population on sepsis pathogenesis.

OBJECTIVE: Individual susceptibility to sepsis has received increasing attention in recent years, and the study of genetic variations has become a hotspot regarding sepsis pathogenesis. We, therefore, investigated the association between mitochondrial genotype and sepsis susceptibility. PATIENTS AND METHODS: One hundred patients admitted with sepsis and registered by five intensive care units (ICUs) in the People's Liberation Army Hospital and the Beijing Aerospace Center Hospital between January 2015 and January 2016 were enrolled as a case group, and 100 healthy persons were recruited as a control group. Patients' general information was obtained, and clinical evaluations and mitochondrial sequence screening were performed. RESULTS: A total of 718 single nucleotide polymorphisms (SNPs) were detected in 708 loci in 100 patients. There were 1754 mutations in 456 loci in the coding region and 567 mutations were found in the RNA region. A total of 34 loci (from 40 cases) were novel mutations. A10398G (52.52%), C5178A (24.24%), C150T (17.17%), G3010A (17.17%), and T16189C (16.16%) were the most frequently observed conserved non-synonymous mutations that were differently expressed between the case and control groups (p<0.05). A5863T and C3270 deletion mutations were located on the genes encoding tRNATyr and tRNALeu, respectively. Small changes in the tRNA gene were likely to result in protein level changes. CONCLUSIONS: We suggest that mitochondrial SNPs may be associated with the pathogenesis of sepsis.

The role of the hippocampus and the function of calcitonin gene-related peptide in the mechanism of traumatic brain injury accelerating fracture-healing.

OBJECTIVE: This research attempts to identify the part the hippocampus plays in accelerated fracture-healing after traumatic brain injury as well as to test functions of calcitonin gene-related peptide (CGRP) during this process. MATERIALS AND METHODS: Experiments were carried out on Male Sprague-Dawley rats that were split into four groups at random: TBI-fracture group, fracture-only group, TBI-only group, and control group. In the first week, blood specimen would be drawn from rats among the groups except those of the control group at three-time points (24, 72 and 168 hours) post-damage. These rats would be assessed from the neurological perspective based on their grades of performance in a sequence of tests 24 hours before and 12 hours after brain injury. Blood samples were also taken from the control group 24 hours before the injury, and whole brain tissues in the injured groups were harvested at 72 and 168 hours post-injury. We compared the serum CGRP concentration, the distribution of CGRP, the CGRP expression, and the expression of CGRP in the hippocampus, the expression of CGRP in the hippocampus, the expression of CGRP in the hippocampus, and the expression of CGRP in the brain by immunohistochemistry, Western blotting, RT- Of CGRP RNA expression levels. RESULTS: Neurological examinations suggested that the functions of the cerebral cortex, cerebellum, and brain stem showed significant differences pre- and post-injury (p < 0.001). ELISA analysis indicated a great density of CGRP in TBI-fracture group at different time points. Furthermore, in the TBI-fracture group, CGRP in both hippocampus and the whole brain showed a noticeable augment in RT-PCR and western blot analysis at 72 and 168 h post-injury, and only in this group, immunohistochemistry analysis indicated that CGRP was present in the hippocampus at 168 hours post-injury. CONCLUSIONS: We observed that the hippocampus and CGRP were responsible for quick bone-healing mechanisms. We suggest a role for the hippocampus in accelerated fracture healing. CGRP expression, as determined by IHC, cannot be observed in other groups, indicating that the hippocampus may be the specific component of the brain that responds to "big stress".