ABSTRACT
BACKGROUND:The maximum muscle strength is typically used for evaluating the recovery of muscle function after anterior cruciate ligament reconstruction.Recent studies have suggested that neuromuscular function should also be considered,such as rate of force development,which measures the slope of the force time curve at different time intervals under conditions of isometric muscle contraction. OBJECTIVE:To elaborate on the current research status and shortcomings of muscle isometric rate of force development in patients undergoing anterior cruciate ligament reconstruction surgery,and analyze the degree of defects in quadriceps femoris and hamstring isometric rate of force development at different times after surgery;to analyze the effect of isometric rate of force development on postoperative functional performance,thereby providing important information for optimizing postoperative rehabilitation following anterior cruciate ligament reconstruction,reducing secondary injury to patients,and reducing the incidence of knee osteoarthritis. METHODS:Literature retrieval of CNKI,VIP,WanFang and PubMed was performed using"anterior cruciate ligament,rate of force development"as Chinese search terms and"anterior cruciate ligament,rate of force development,rate of torque development"as English search terms.Finally,69 articles were included according to inclusion and exclusion criteria. RESULTS AND CONCLUSION:Most studies have found defects in bilateral muscle isometric rate of force development in patients undergoing anterior cruciate ligament reconstruction within 6 months.Early isometric rate of force development of the bilateral hamstring muscles(i.e.the slope of the force time curve at any time interval during muscle contraction of 100 ms)showed significant improvement after 6 months.However,long-term defects in early isometric rate of force development of the bilateral quadriceps indicate long-term damage to the neuromuscular function of the quadriceps after surgery.There is limited research on late isometric rate of force development(the slope of the force time curve at any time interval after 100 ms of muscle contraction),and conclusions cannot be drawn.Regarding landing exercises(jumping to the ground,lateral cutting,etc.)and daily activities(walking,running),early isometric rate of force development of the quadriceps is more correlated with isometric peak torque.Abnormal biomechanical changes during exercise are considered an important risk factor for secondary injury and traumatic knee osteoarthritis in patients.Actively improving early isometric rate of force development of the quadriceps may reduce the incidence of secondary injury and traumatic knee osteoarthritis.Currently,there is limited evidence to suggest that whole-body vibration training can improve early isometric rate of force development of the quadriceps femoris in patients undergoing anterior cruciate ligament reconstruction.It is recommended to use neuromuscular electrical stimulation to intervene in the quadriceps and hamstring in the early postoperative stage and implement explosive force and high resistance training in the late postoperative stage,which may improve the isometric rate of force development in patients.Generating sufficient muscle strength in a short period of time is necessary to effectively protect the anterior cruciate ligament,while the relationship between isometric rate of force development in the hamstring muscle and functional performance is still unclear,which may provide information on preventing secondary injury in patients.It is recommended to use the isometric rate of force development as one of the evaluation indicators for guiding rehabilitation and restoring movement.In addition to focusing on improving symmetry and differences from normal individuals,the hamstring to quadriceps strength ratio should also be considered.An appropriate range of ratios can ensure the balance of muscles during rapid muscle exertion,which may reduce the occurrence of secondary injuries.However,the normal range of ratios is not yet clear.Future research should consider the effects of graft type and knee flexion angle on isometric rate of force development,in order to identify neuromuscular dysfunction in patients as much as possible and help them recover better.
ABSTRACT
Chyle leak or chyle ascites is a specific form of lymphatic leakage after radical laparoscopic colorectal cancer surgery,the incidence of which has been reported in the literature to be 1％-6.5％,leading to the development of hydropower imbalance,malnutrition,impaired immune function,prolonged hospital stay and even an impact on oncological prognosis.Different surgical sites,number of lymph nodes dissected,duration of surgery,prognostic nutritional index,metastasis of the main lymph nodes,operator and age are risk factors for postoperative chyle leak in colorectal cancer.It usually occurs 4-8 days after surgery and is characterized by a sudden increase of drainage after eating which is milky,odourless and tasteless,and may be combined with abdominal pain,bloating and increased body temperature.After prolonged chyle leak,patients may develop water-electrolyte disturbance,malnutrition and hypoproteinemia.The chyle test is useful in the qualitative diagnosis of chyle leak and can be performed to detect triglyceride concentrations.Conservative treatment is the preferred treatment strategy for chyle leak,and if conservative treatment fails,surgery may be considered.Knowledge of the distribution pattern of colorectal lymphatic drainage and precise control of lymph node dissection are key measures to prevent chyle leak after laparoscopic colorectal cancer surgery.
ABSTRACT
The treatment strategy for colon cancer with liver metastasis has always been a great challenge for clinical surgeons.Single treatment method such as surgical resection or systemic chemotherapy can no longer meet the treatment needs of such patients.With the extensive development of the multi-disciplinary team(MDT)for colorectal cancer based on surgery,more and more patients with advanced colorectal cancer have obtained better treatment effects and survival benefits.A case of descending colon cancer with huge hepatic metastasis diagnosed and treated by a multi-disciplinary team was reported,aiming to provide reference for clinical practice.
ABSTRACT
Stage T4 colon cancer is divided into two categories:tumor penetrating the visceral peritoneum(T4a)and tumor directly invading or attaching to adjacent organs or structures(T4b).Treatment of T4 colon cancer requires technically demanding surgical procedures,including total resection of adjacent infiltrating organs or structures,and is characterized by a high incidence of postoperative complications and a high rate of positive surgical margin microscopy.It has been found that taking laparoscopic surgery for T4 colon cancer may decrease long-term survival and increase the rate of peritoneal metastasis,but taking laparoscopic surgery for colon cancer also has the potential advantages in increasing perioperative benefits and improving the prognosis.With the upgrade of laparoscopic equipment and the improvement of surgeons'surgical skills,more and more surgeons have adopted laparoscopic surgery to treat T4 colon cancer.Currently,the oncologic safety of laparoscopic surgery for T4 colon cancer has not been effectively evaluated.Therefore,this article reviews the advantages,risks,and the choice of treatment strategies for laparoscopic surgery for T4 colon cancer,taking into account the current status and progress of domestic and international studies.
ABSTRACT
BACKGROUND:Adolescent idiopathic scoliosis is a common disease that can affect physical appearance of adolescents in the clinic at present. However, there are lacks of studies on coronal plane imbalance after fixation using Logistic regression equation at present. OBJECTIVE:To investigate the reasons for coronal plane imbalance after fixation in patients with Lenke type II adolescent idiopathic scoliosis. METHODS:141 cases of Lenke type II adolescent idiopathic scoliosis admitted by Department of Spinal Surgery of the First Affiliated Hospital of Xinjiang Medical University in China from January 2001 to November 2012 were chosen as subjects. Multivariate single factor and multiple-factor Logistic regression were performed. Risk factors for the coronal plane imbalance after fixation in adolescent idiopathic scoliosis patients were screened, and predictive models were established. RESULTS AND CONCLUSION:Coronal plane imbalance occurred in 30 of the 141 patients, accounting for 21.28%. For Lenke type II adolescent idiopathic scoliosis patients, preoperative apical vertebral Nash-More rotation level 3-4, Risser grade 4-5, major curve correction rate/flexibility>1, lower thoracic Cobb angle>70° were vulnerable to postoperative coronal plane imbalance. Multivariate logistic regression showed that vertebral rotation, Risser grade, major curve correction rate/flexibility, lower thoracic Cobb angle were independent risk factors for postoperative coronal plane imbalance in Lenke type II adolescent idiopathic scoliosis patients. The predictive model was Y=1/[1+exp(-1.182X 1+1.228X 2+1.671X 3-0.71X 4+0.407)].