A modified fixation technique for the treatment of buried penis in children / 亚洲男科学杂志(英文版)

For many years, surgical treatment of buried penis in children has been researched by several scholars, and numerous methods exist. This study aimed to explore the clinical effect of a modified fixation technique in treating buried penis in children. Clinical data of 94 patients with buried penis who were treated using the modified penile fixation technique from March 2017 to February 2019 in Fujian Maternity and Child Health Hospital (Fuzhou, China) were retrospectively collected, compared, and analyzed. Clinical data of 107 patients with buried penis who were treated using traditional penile fixation technique from February 2014 to February 2017 were chosen for comparison. The results showed that at 6 months and 12 months after surgery, the penile lengths in the modified penile fixation group were longer than those in the traditional penile fixation group (both P < 0.05). The incidence of postoperative skin contracture and penile retraction in the modified penile fixation group was less than that in the traditional penile fixation group (P = 0.034 and P = 0.012, respectively). When the two groups were compared in terms of parents' satisfaction scores, the scores for penile size, penile morphology, and voiding status in the modified penile fixation group were higher than those in the traditional penile fixation group at 2-week, 6-month, and 12-month follow-ups after surgery (all P < 0.05). We concluded that the modified penile fixation technique could effectively reduce the incidence of skin contracture and penile retraction and improve the penile length and satisfaction of patients' parents.

Clinical study on core decompression in treating osteonecrosis of the femoral head of the necrotic bone-in different site / 中国骨伤

OBJECTIVE@#To analyze the clinical effect of decompression and bone grafting on osteonecrosis of the femoral head(ONFH) at different sites of necrotic lesions.@*METHODS@#A total of 105 patients with ARCOⅡstage ONFH admitted from January 2017 to December 2018 were retrospectively analyzed. There were 71 males and 34 females, with an average age of (55.20±10.98) years old. The mean course of all patients was(15.91±9.85) months. According to Japanese Inveatigation Committee (JIC) classification, all patients were divided into 4 types:17 cases of type A, 26 cases of type B, 33 cases of type C1 and 29 cases of type C2. All four groups were treated with decompression of the pulp core and bone grafting. Visual analogue scale(VAS) and Harris hip joint score were used before and at 3, 6, 12, and 24 months after the operation, and the collapse of the femoral head was observed by X-ray examination within 2 years.@*RESULTS@#All 105 patients were successful on operation without complications, and the mean follow-up duration was (24.45±2.75) months. Harris score showed that there was no statistical difference among four groups before surgery and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in intragroup Harris scores at preoperative and postoperative time points among four groups (P<0.01). VAS showed that there was no statistical difference among four groups before and 3, 6 months after surgery (P>0.05);at 12 and 24 months after surgery, there were significant differences among all groups (P<0.01). There were significant differences in VAS at preoperative and postoperative time points among four groups (P<0.01). None of the patients in four groups had femoral head collapse before and 3, 6 months after surgery. At 12 months after operation, there were 3 cases of femoral head collapse in group C and 4 cases in group C2(P>0.05);At 24 months after operation, 1 case of femoral head collapse occurred in group B, 6 cases in group C1 and 8 cases in group C2(P<0.05).@*CONCLUSION@#Core decompression and bone grafting can improve the effect of ONFH and hip preservation. The effect of hip preservation for ONFH is closely related to the location of the osteonecrosis lesion, so the influence of the location of lesion on the effect of hip preservation should be considered in clinical treatment, so as to make better preoperative hip preservation plan.

Clinical tolerability and pharmacokinetics of troxacitabine / 中华肿瘤杂志

Objective: To investigate the safety and efficacy of troxatabine in advanced or relapsed malignant tumors resistant to standard therapy in China. Methods: This is a phase Ⅰ prospective study. During dose escalation, patients in Cancer Hospital, Chinese Academy of Medical Sciences received a single-dose intravenous infusion of troxacitabine. The planned dosing groups were 1.8, 3.6, 4.8, 6.4 and 8.0 mg/m(2) on days 1 and 8 every 3 weeks. The data of all patients were collected for safety analyses. Safety and tolerability were evaluated by monitoring adverse events. Results: Nineteen patients were enrolled from April 2018 to May 2019. The major adverse events were fatigue (89.5%, 17/19), leukopenia (84.2%, 16/19) and neutropenia (78.9%, 15/19). The dose limiting toxicity was neutropenia. The maximum tolerated dose was 6.4 mg/m(2). The best effect was stable disease (43.8%). The half-life of elimination phase from 15.91 hours to 76.63 hours in each dose group. Conclusions: The toxicity of troxacitabine is well tolerant. We recommend that the dose for Phase Ⅱ clinical trial should be 6.4 mg/m(2).

The effect of scrotal versus inguinal orchiopexy on the testicular function of children with clinically palpable, inguinal undescended testis: a randomized controlled trial / 亚洲男科学杂志(英文版)

To compare the impact of the scrotal vs inguinal orchidopexy approach on the testicular function of infants with cryptorchidism, a randomized controlled trial was conducted involving boys who were 6-12 months old at surgery and were diagnosed with clinically palpable, inguinal undescended testis. Between June 2021 and December 2021, these boys at Fujian Maternity and Child Health Hospital (Fuzhou, China) and Fujian Children's Hospital (Fuzhou, China) were enrolled. Block randomization with a 1:1 allocation ratio was employed. The primary outcome was testicular function assessed by testicular volume, serum testosterone, anti-Müllerian hormone (AMH), and inhibin B (InhB) levels. Secondary outcomes included operative time, amount of intraoperative bleeding, and postoperative complications. Among 577 screened patients, 100 (17.3%) were considered eligible and enrolled in the study. Of the 100 children who completed the 1-year follow-up, 50 underwent scrotal orchidopexy and 50 underwent inguinal orchidopexy. The testicular volume, serum testosterone, AMH, and InhB levels in both groups increased markedly after surgery (all P < 0.05), but there were no apparent differences between groups at 6 months and 12 months after operation (all P > 0.05). No differences between the scrotal and inguinal groups were noted regarding the operative time ( P = 0.987) and amount of intraoperative bleeding ( P = 0.746). The overall complication rate (2.0%) of the scrotal group was slightly lower than that of the inguinal group (8.0%), although this difference was not statistically significant ( P > 0.05). Both scrotal and inguinal orchiopexy exerted protective effects on testicular function in children with cryptorchidism, with similar operative status and postoperative complications. Scrotal orchiopexy is an effective alternative to inguinal orchiopexy in children with cryptorchidism.

Curative effect analysis of different surgical methods in the treatment of adrenal tumors in children / 中华实用儿科临床杂志

Objective:To investigate the clinical efficacy of laparoscopic adrenalectomy and traditional open adrenalectomy for adrenal tumors in children.Methods:In Department of Pediatric Surgery, Fujian Provincial Maternity and Children′s Hospital from June 2008 to June 2016, the clinical data of 31 pediatric adrenal tumors was retrospectively analyzed.According to different surgical methods, they were divided into traditional open adrenalectomy group and laparoscopic adrenalectomy group.Bleeding loss, operation duration, incision length, abdominal drainage time, postoperative hospital stay, postoperative complications and recurrence were compared between the 2 groups.Results:There was no significant difference in age, sex, weight, and tumor size between the 2 groups (all P>0.05). The intraoperative bleeding loss was (18.06±4.86) mL for open adrenalectomy group and (15.20±4.48) mL for laparoscopic adrenalectomy group, and there existed no significant difference in the amount of bleeding between the 2 groups( T=-1.702, P>0.05). The operation duration was (137.44±19.32) min for open adrenalectomy group versus (134.80±6.21) min for laparoscopic adrenalectomy group, and there was no significant difference in operation duration between the 2 groups ( T=-0.504, P>0.05). The length of incision was (7.94±1.34) cm for open adrenalectomy group versus (3.44±0.21) cm for laparoscopic adrenalectomy group, the length of incision in laparoscopic group was shorter than that in open adrenalectomy group.There was significant difference in the length of incision between the 2 groups ( T=-12.843, P<0.001). The hospitalization time was (9.63±2.55) d for open adrenalectomy group versus (7.20±1.37) d for laparoscopic adrenalectomy group, the hospitalization time in laparoscopic group was shorter than those in open adrenalectomy group.The difference of operation time between the 2 groups was statistically significant ( T=-3.261, P=0.003). The average indwelling time of abdominal drainage tube was(5.94±1.53) d for open adrenalectomy group versus (4.80±1.74) d for laparoscopic adrenalectomy group, with no significant difference in postoperative abdominal drainage time between the 2 groups( T=-1.938, P>0.05). There was 1 case of retroperitoneal hematoma in laparoscopic adrenalectomy group and 2 cases of complications in open adrenalectomy group.There was no significant difference in the incidence of complications between the 2 groups ( P=1.000). There were 3 cases of distant metastasis and 1 case of recurrence in laparoscopic group, and 2 cases of distant metastasis and 1 case of recurrence in open adrenalectomy group.There was no significant difference in recurrence between the 2 groups ( P=1.000). Conclusions:Compared with open adrenalectomy surgery, laparoscopic adrenalectomy in children has various advantages, including beautiful incision, less trauma and fast recovery.However, it is necessary to select the appropriate cases.

Role of synapsin-Ⅰ phosphorylation in herkinorin-induced reduction of oxygen-glucose deprivation/restoration-caused damage to cortical neurons and relationship with cPKCγ in newborn mice / 中华麻醉学杂志

Objective:To evaluate the role of synapsin-Ⅰ phosphorylation in herkinorin-induced reduction of oxygen-glucose deprivation/restoration (OGD/R)-caused damage to cortical neurons and the relationship with conventional protein kinase C (cPKC)γ in newborn mice.Methods:Primary cortical neurons of cPKCγ + /+ and cPKCγ -/- mice (within 24 h after birth) were cultured for 7 days.Each type of neurons were then divided into 3 groups ( n=5 each) using a random number table method: control group (group C), OGD/R group and herkinorin group (group H). The neurons were subjected to oxygen-glucose deprivation (OGD) for 1 h followed by restoration of oxygen-glucose supply for 24 h. Herkinorin 10 μmol/L was added immediately after onset of OGD, the neurons were then incubated for 1 h, and herkinorin was washed out at the end of OGD in group H. At 24 h of oxygen-glucose restoration, cells were collected for measurement of the cell survival rate by methyl thiazolyl tetrazolium assay, and immunofluorescence was used to measure the number of neurites and the length of dendrites.Western blot was applied to detect the expression of phosphorylated synapsin-Ⅰ (p-synapsin-Ⅰ). Results:Compared with group C, the cell survival rate and the number of neurites were significantly decreased, the length of dendrites was shortened, and the expression of p-synapsin-Ⅰ was down-regulated in cPKCγ + /+ and cPKCγ -/- mice in group OGD/R and group H ( P<0.05). Compared with group OGD/R, the cell survival rate and the number of neurites were significantly increased, the length of dendrites was prolonged, the expression of p-synapsin-Ⅰ was up-regulated in cPKCγ + /+ mice in group H ( P<0.05), and no significant change was found in the parameters mentioned above in cPKCγ -/- mice in group H ( P>0.05). There was no significant differences in the expression of synapsin-Ⅰ in neurons among the three groups of cPKCγ + /+ mice and among the three groups of cPKCγ -/- mice ( P>0.05). Conclusion:Herkinorin can reduce OGD/R-caused damage to cortical neurons through decreasing cPKCγ membrane translocation and inhibiting synapsin-Ⅰ phosphorylation in newborn mice.

Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children aged <3 years: 10-year experience with 1034 cases / 亚洲男科学杂志(英文版)

This study was performed to summarize our clinical experience with testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children. This study included 1034 children with palpable cryptorchidism from March 2009 to March 2019. A scrotal stria incision was used to perform testicular descent and fixation. Overall, 1020 children successfully underwent surgical testicular descent and fixation through a scrotal stria incision, and 14 patients underwent conversion to inguinal incision surgery. All patients were discharged 1-2 days after the operation. During hospitalization and follow-up, 55 patients developed complications, including 10 patients with testicular retraction, 7 with poor healing of the incision, and 38 with a scrotal hematoma. No patients developed testicular atrophy, an indirect inguinal hernia, or a hydrocoele. Testicular descent and fixation through a scrotal stria incision for the treatment of palpable cryptorchidism in children is safe and feasible in well-selected cases. This method has the advantages of no scarring and a good cosmetic effect.

Iliocostalis Plane Block in Analgesia for Video-assisted Thoractomy:Report of One Case / 中国医学科学院学报

Interfascial plane block is a quick,safe and simple technique that offers effective analgesia for video-assisted thoracotomy.However,the currently described methods still have certain limitations.We explored the application of a novel interfascial plane block method-iliocostal plane block in video-assisted thoracotomy,along with the use of stained cadaveric anatomy,with an attempt to shed new light on the analgesia for video-assisted thoracotomy.

Recombinant expression of Crassostrea gigas defensin in Pichia pastoris and its antibacterial activity / 生物工程学报

Defensins are endogenous cationic antimicrobial peptides rich in arginine and cysteine residues. They are important immune factors resisting pathogenic bacteria infection for mollusks. The 43 amino acid residues near the carboxyl terminal for Crassostrea gigas defensin (CgD) form its mature peptide region, responsible for the biological activity of CgD. First, two target genes, CgDH⁺ (with 6×His-tag at 3' end) and CgDH- (without 6×His-tag at 3' end) were separated and amplified by RT-PCR with specific primers from Crassostrea gigas mantle. These two target genes were ligated to the expression vector pPICZαA to construct recombinant expression vectors, pPICZαA-CgDH⁺ and pPICZαA-CgDH-, which were transformed into competent Pichia pastoris X-33 cells by electroporation respectively. The recombinant target proteins, CgDH⁺ and CgDH-, were induced for 72 h with 1% methanol at 29 °C and 250 r/min. The recombinant CgDH⁺ (5.78 kDa) was purified by immobilized metal affinity chromatography (IMAC), and identified by MALDI-TOF-TOF analysis, demonstrating that it was the expected target protein. Based on the concentration of the purified product, the estimated yield of recombinant CgDH⁺ was 2.32 mg/L. Antimicrobial assay showed that the culture medium supernatant containing recombinant CgDH⁺ and recombinant CgDH-, respectively, had activities against Staphylococcus aureus and Pseudomonas aeruginosa, indicating that the existence of 6×His tag in the recombinant proteins do not affect their biological activities.

Chemical constituents of lipophilic parts in water extrct from stem of Mahonia fortunei / 中草药

Objective To study the chemical constituents of lipophilic parts in water extracts from the stem of Mahonia fortunei. Methods The compounds were isolated and purified by repeated column chromatography on silica gel and high performance liquid chromatography, and their structures were determined by spectroscopic data analysis. Results Thirty-eight compounds were obtained from lipophilic parts in water extracts from the stem of M. fortunei and identified as maltol (1), 3-hydroxy-4-methoxyphenylethanol (2), syringylethanone (3), 1-hydroxy-3-(4-hydroxy-3-methoxyphenyl)-2-propanone (4), α-hydroxypropiosyringone (5), corydaldine (6), zhebeiresinol (7), vanillic acid (8), springic acid (9), noroxyhydrastinine (10), (+)-syringaresinol (11), episyringaresinol (12), schisandrin (13), neoechinulin A (14), 8-oxyjatrorrhizine (15), 8-oxyberberine (16), 5-hydroxymaltol (17), methyl-5- hydroxy-2-pyridinecarboxylate (18), vomifoliol (19), 2,3-dihydroxy-1-(4-hydroxy-3,5-dimethoxyphenyl)-1-propanone (20), oleracein E (21), acortatarin A (22), 5-epi-acortatarin A (23), 5-(methoxymethyl)-1H-pyrrole-2-carbaldehyde (24), (+)-lyoniresinol (25), (−)-secoisolariciresinol (26), ciwujiatone (27), protocatechuic acid (28), adenosine (29), 3,4,5-trimethoxyphenyl-1-O-β-D- glucopyranoside (30), 2-(4-hydroxy-3-methoxyphenyl) ethyl-O-β-D-glucopyranoside (31), tortoside B (32), oldhamioside (33), (+)-syringaresinol-4′-O-β-D-glucopyranoside (34), episyringaresinol-4′-O-β-D-glucopyranoside (35), berberine (36), 3,4,5-trimethoxyphenyl-(6′-O-syringoyl)-O-β-D-glucopyranoside (37), and salidroside (38), respectively. Conclusion Compounds 3—7, 13—15, 17—19, 21—27, 29, 31, 33, and 38, are isolated from the genus Mahonia for the first time. Moreover, the nuclear magnetic resonance data of compound 15 is assigned for the first time.

Clinical application of negative pressure dressing in the full-thickness skin grafting / 中华烧伤杂志

Objective@#To investigate the effect of different negative pressure of wound negative pressure dressing (NPD) on the survival of full-thickness skin grafts of patients.@*Methods@#One hundred and eleven patients who need skin grafting, conforming to the inclusion criteria were hospitalized in our unit from August 2012 to March 2017, and their clinical data were retrospectively analyzed. Forty-seven patients hospitalized from August 2012 to October 2015 were assigned into traditional treatment group. Sixty-four patients hospitalized from November 2015 to March 2017 were divided into -9.975 kPa negative pressure treatment group (n=34) and -13.300 kPa negative pressure treatment group (n=30). Patients in traditional treatment group received conventional dressing after full-thickness skin grafting. Patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups received -9.975 kPa and -13.300 kPa NPD based on traditional treatment after vacuum sealing, respectively. Dot necrosis area of skin grafts and erosion and escharosis of graft edges of patients in the three groups on post operation day 10 were observed. The percentage of dot necrosis area of skin grafts and occurrence rate of erosion and escharosis of skin graft edges were calculated, respectively. Data were processed with chi-square test, Fisher′s exact test, and Kruskal-Wallis H test.@*Results@#Percentages of dot necrosis area of skin grafts of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 17.81%, 3.20%, and 3.00%, respectively. Percentage of dot necrosis area of skin grafts of patients in traditional treatment group was significantly higher than that in -9.975 kPa and -13.300 kPa negative pressure treatment groups (Z=-5.770, -4.690, P<0.001). Percentages of dot necrosis area of skin grafts of patients in -9.975 kPa and-13.300 kPa groups were close (Z=-0.619, P>0.05). The occurrence rates of erosion and escharosis of skin graft edges of patients in traditional treatment group and -9.975 kPa and -13.300 kPa negative pressure treatment groups were 78.7% (37/47), 32.4 (11/34), and 36.7% (11/30), respectively. Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were better than those in traditional treatment group (P<0.001). Erosion and escharosis of skin graft edges of patients in -9.975 kPa and -13.300 kPa negative pressure treatment groups were close (P>0.05).@*Conclusions@#The use of -9.975 kPa and -13.300 kPa NPD in skin grafts after full-thickness skin grafting significantly diminishes the occurrence rates of dot necrosis area of skin grafts and erosion and escharosis of graft edges.

Purification and Enrichment of Polycyclic Aromatic Hydrocarbons Pollutions in Oil-Field Water by Column Clean-up Coupled with Dispersive Liquid-Liquid Microextraction / 分析化学

A sample pretreatment method combining column clean-up with dispersive liquid-liquid microextraction (CCU-DLLME) for determination of polycyclic aromatic hydrocarbons (PAHs) in oil-field water was proposed. With this method,most organic interferences in matrix were cleaned up,and PAHs were purified, enriched and analyzed by gas chromatography/mass spectrometry directly. The influences on extraction efficiency including the kinds of column packing,weight ratio between column packing and sample, column flow rate,type and volume of extraction solvent, type and volume of disperser solvent and extraction time were investigated, respectively. Finally, 12 g of H103 macroporous resin was selected as column packing,12﹕5 of weight ratio between column packing and sample and 4 BV/h of column flow rate were selected in CCU. The resulting eluate was added with 1.00 mL of acetone (disperser solvent) and 15 μL of carbon tetrachloride (extraction solvent),followed by DLLME for 2 min. Under the optimum conditions,the enrichment factor of PAHs was 730-1579,the limits of detection (S/N=3) were 1.1-5.3 ng/L, the linear range was 0.01-50 μg/L,the RSDs(n=5) were 0.6%-3.4% and the recoveries were 82.6%-104.6%. This method could greatly reduce the influence of organic interferences in matrix, and was fit for the rapid analysis of pollutants in oil-field water especially.

Bedside ultrasound measurement of gastric content and volume / 基础医学与临床

Perioperative pulmonary aspiration is a serious complication during general anesthesia .For patients with un-known gastric condition , there is no effective method for the noninvasive evaluation of gastric content and volume preop-eratively.Because of the portable and real-time detection, bedside ultrasound can significantly reduce the risk of periop-erative reflux and pulmonary aspiration , which makes preoperative gastric contents visualized and accurate .

Epidural ropivacaine block increasing anesthetic potency of propofol / 基础医学与临床

Objective To investigate the effects of epidural ropivacaine block combined with propofol intravenous anesthesia on CaMKⅡ and ERK1/2 total protein (T-CaMKⅡ and T-ERK1/2) and phosphorylation(p-CaMKⅡ and p-ERK1/2) levels in the hippocampus and cortex of rats.Methods Rats were randomly assigned to three groups: group P(control,propofol intravenous anesthesia),group PS(propofol and epidural normal saline) and group PR(propofol and epidural 0.5% ropivacaine).Anesthesia were performed in 72 h after epidural catheter placement.The rats in group PR received 70 μL of 0.5% ropivacaine to achieve epidural block.1% propofol was infused through rats caudal vein.Propofol dosage for anesthesia induction was 12 mg/kg,for anesthesia maintenance was 40 mg/(kg·h).Before the rats were decapitated,the depth of anaesthesia was assessed as either light anesthesia or deep anesthesia by checking of pinch withdrawalreflex,eyelid reflex and spontaneous rapid whisking of the vibrissae after propofol continuous infusion for 1 h.T-CaMKⅡ/T-ERK1/2 and p-CaMKⅡ/p-ERK1/2 in hippocampus and frontal cortex were examined by Western blot.Results 7 rats were assessed as light anesthesia and one rat as deep anesthesia in group P;6 rats were assessed as light anesthesia and 2 rats as deep anesthesia in group PS;in group PR,1 rat was assessed as light anesthesia and 7 rats as deep anesthesia.Significant differences were seen among three groups (P<0.05).In hippocampus of rats,p-CaMKⅡ(Thr286)43.7%±8.8% and p-ERK1/2 32.4%±7.9% in group PR were significantly lower than those in group P (100%,P<0.05).Conclusions Epidural ropivacaine block may strengthen the depth of anesthesia achieved with propofol intravenous anesthesia.The decrease of p-CaMKⅡ(Thr286) and p-ERK1/2 in hippocampus of rats may explain the effects of epidural block.

Utilization of second sacral alar-iliac technique for lumbosacral fixation in patients with tuberculosis of lumbar and sacrum spine / 中华骨科杂志

Objective To evaluate the feasibility and clinical outcomes of second sacral alar-iliac (S2AI) technique utilized in patients with tuberculosis of Lumbosacral spine.Methods 24 cases (15 male,9 female,aged 36-73 years old,average 47.1 years) of tuberculosis of Lumbosacral spine were collected for surgery using spinal and pelvic fixation system (S2AI or IS) between January 2014 and May 2016.Lumbosacral pain and restricted movement were noticed in all cases,of which 9 cases with radiating pain of lower limb and 7 cases with intermittent claudication,2 cases with saddle anesthesia.Formal anti-tuberculosis medicine treatment was given for at least 2-3 weeks before operation.All patients with lumbosacropelvic fixation were compared by recording with ESR/CRP,preoperatively,postoperatively and the last following-up.The clinical effect oswestry disability index (ODI) score,visual analogue scale (VAS),ambulatory status,SF-36 scale and related complications of 2 groups were also compared.Results The average follow-up period was average 23.4 months in the two groups.The results show that operative time,blood loss,drainage time,hospitalization days and fusion time were not statistically significant;the recording of ESR,CRP,ODI,VAS scores and ambulatory status scores between S2AI and IS groups showed no significantly different,preoperatively,postoperatively and the last following-up.Comparisons within each group were improved at postoperatively and the last following-up related to preoperatively;The difference of the SF-36 scales in each group was statistically significant between preoperatively and the last following-up;There was no statistically difference in recurrence,sinus,pseudarthrosis between two groups,but The S2AI technique was associated with lower rates of symptomatic screw prominence compared to the IS technique.Conclusion Application of S2AI screw technique in the treatment of lumbosacral tuberculosis can achieve solid fixation and satisfactory clinical effect,and reduce the complications of traditional IS screws,which is an alternative method of posterior structure reconstruction of lumbosacral tuberculosis.

The causes and surgical strategy of spinal tuberculosis retreatment / 中华骨科杂志

Objective To investigate the causes of spinal tuberculosis retreatment and its surgical treatment strategy.Methods Between May 2010 and May 2014,96 patients with spinal tuberculosis who had been operated before were retreated.The dates of them were reviewed.There were 51 males and 45 females with mean age of 39.7 years.Deciding upon the revision surgical procedure should be determined by last operation approach,the direction of compression of spinal cord,the position of sinus and extent of foci.The retreated patients were compared with 481 unretreated patients in the following index including sex,age,duration of disease,focus range,nutrition,drug resistant tuberculosis,debridement,stability of instrumentation,postoperative regular chemotherapy,associated tuberculosis.Results The surgery duration time was 160-280 min,average 210 min,and the blood loss was 400-1500 ml,average 600 ml.The VAS score before the operation was 6-9 (average 7.5) and 1-3 (average 1.5) at the last follow-up,the difference was statistically significant.Neurological deficits in 21 patients clinically improved at least one grade according to the ASIA grading system at last follow-up.Kyphosis and scoliosis degrees were corrected significantly postoperatively and the correction was 9.5°±3.6° at the final follow-up.The average angle loss was 3.5°±1.1°.There was significant difference between the kyphosis angles preoperatively,postoperatively and final follow-up.Kirkaldy-Willis function score showed that the total fine rate was 88％.There were 35 patients whose tuberculosis bacterial culture and drug sensitive experiments suggested drug resistance.Wound healing delayed in 7 patients.24 cases had sinus formation,13 cases in which were healed after wound dressing,and 11 cases undertook operation again.Conclusion The causes of spinal tuberculosis retreatment include uncompleted debridement,drug resistant strains of tuberculosis,irregular postoperative anti-tubercular treatment,poor preoperative nutritional status and failure of spinal stability reconstruction.The key of successful revision surgery includes radical debridement,strut grafting with autologous iliac bone block,proper reconstruction of spinal stability,individualized chemotherapy according to the drug-resistance,and the appropriate use of irrigation and drainage postoperatively.

Median effective dose of dezocine inhibiting responses to insertion of laryngeal mask airway when combined with propofol in elderly patients / 中华麻醉学杂志

Objective To determine the median effective dose(ED50)of dezocine inhibiting re-sponses to insertion of laryngeal mask airway(LMA)when combined with propofol in the elderly pa-tients.Methods American Society of Anesthesiologists physical statusⅠorⅡ patients, aged 66-75 yr, with body mass index of 20-25 kg∕m2, were included in this study.Anesthesia was induced with dezocine at the initial dose of 0.2 mg∕kg and propofol which was simultaneously administered by target-controlled infu-sion.The initial target plasma concentration of propofol was 1 μg∕ml, and the concentration was increased in increments of 0.5 μg∕ml every 3 min until the target concentration 3 μg∕ml was achieved.LMA was inserted when bispectral index value reached 50-60.The dose of dezocine was determined using the up-and-down method.The response to insertion of LMA was defined as positive when patients developed coughing, laryn-gospasm and∕or body movement during insertion or within 3 min after insertion.The dose of dezocine was in-creased∕decreased in the next patient if the insertion response was positive or negative.The ratio between the two successive doses was 0.8.The ED50and 95% confidence interval of dezocine inhibiting responses to in-sertion of LMA were calculated.Results When combined with propofol, the ED50of dezocine inhibiting re-sponses to insertion of LMA was 0.126 mg∕kg, and the 95% confidence interval was 0.110-0.143 mg∕kg.Conclusion The ED50of dezocine inhibiting responses to insertion of LMA is 0.126 mg∕kg when combined with propofol in the elderly patients.

Comparison on the preparation of rat models of pneumonia by different infection route / 中国实验动物学报

Objective To explore the preparation of a rat model of pneumonia model induced by Pseudomonas aeruginosa( PA) using different methods,and to lay the foundation for further studies. Methods 48 SD rats were randomly divided into 4 groups:the control group (A), the intratracheal injection group (B), the trachea cannulation group (C) and the intranasal inoculation group ( D) . After intervention with different treatment modalities, the body weight,tempera-ture,white blood cell count and lung pathological changes in the rats of all groups were detected at 5, 10, 15 days. Results 1. The behavior, body weight, temperature, leukocytes and pathological inflammatory changes of the lung in rats of the model groups were significantly different from that of control group. 2. Pseudomonas aeruginosa was detected in rats of all the model groups, but the control group was negative. Conclusions Rat model of Pseudomonas aeruginosa infected pneu?monia can be successfully established by intranasal inoculation. This method can avoid the inflammatory interference from operation, and is simple and suitable for popularization.

Impact of Cytoreductive Nephrectomy on Survival in Patients with Metastatic Renal Cell Carcinoma Treated by Targeted Therapy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The metastatic renal cell carcinoma (mRCC) patients treated with upfront cytoreductive nephrectomy combined with α-interferon yields additional overall survival (OS) benefits. It is unclear whether mRCC patients treated with vascular endothelial growth factor receptor-tyrosine kinase inhibitor (VEGFR-TKI) will benefit from such cytoreductive nephrectomy either. The aim of the study was to identify variables for selection of patients who would benefit from upfront cytoreductive nephrectomy for mRCC treated with VEGFR-TKI.</p><p><b>METHODS</b>Clinical data on 74 patients enrolled in 5 clinical trials conducted in Cancer Hospital (Institute), Chinese Academy of Medical Sciences from January 2006 to January 2014 were reviewed retrospectively. The survival analysis was performed by the Kaplan-Meier method. Comparisons between patient groups were performed by Chi-square test. A Cox regression model was adopted for analysis of multiple factors affecting survival, with a significance level of α = 0.05.</p><p><b>RESULTS</b>Fifty-one patients underwent cytoreductive nephrectomy followed by targeted therapy (cytoreductive nephrectomy group) and 23 patients were treated with targeted therapy alone (noncytoreductive nephrectomy group). The median OS was 32.2 months and 23.0 months in cytoreductive nephrectomy and noncytoreductive nephrectomy groups, respectively (P = 0.041). Age ≤45 years (P = 0.002), a low or high body mass index (BMI <19 or >30 kg/m2) (P = 0.008), a serum lactate dehydrogenase (LDH) concentration >1.5 × upper limit of normal (P = 0.025), a serum calcium concentration >10 mg/ml (P = 0.034), and 3 or more metastatic sites (P = 0.023) were independent preoperative risk factors for survival. The patients only with 0-2 risk factors benefited from upfront cytoreductive nephrectomy in terms of OS when compared with the patients treated with targeted therapy alone (40.0 months vs. 23.2 months, P = 0.042), while those with more than 2 risk factors did not.</p><p><b>CONCLUSIONS</b>Five risk factors (age, BMI, LDH, serum calcium, and number of metastatic sites) seemed to be helpful for selecting patients who would benefit from undergoing upfront cytoreductive nephrectomy.</p>

Experience of standardized training of nerve block for anesthesia residents / 中华医学教育探索杂志

Peripheral nerve block technique is one of the basic skills necessary to residents and it is also one of the difficult points in the resident standardized training in the department of anesthesiology. In order to maximize the learning effect of the anesthesia professional residents in the case of limited number of cases, we need to constantly enrich the teaching technologies and teaching methods. Human 3D anatomy is used for theory teaching to maintain comprehension of nerve anatomy; Ultrasound-guided nerve block technique and ultrasound simulation training are used for nerve block practice to improve nerve block skills;Problem-based learning teaching method is introduced in nerve block cases to increase the residents' ability of clinical cases management.