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@#The precise localization of pulmonary nodules has become an important technical key point in the treatment of pulmonary nodules by thoracoscopic surgery, which is a guarantee for safe margin and avoiding removal of too much normal lung parenchyma. With the development of medical technology and equipment, the methods of locating pulmonary nodules are also becoming less trauma and convenience. There are currently a number of methods applied to the preoperative or intraoperative localization of pulmonary nodules, including preoperative percutaneous puncture localization, preoperative transbronchial localization, intraoperative palpation localization, intraoperative ultrasound localization, and localization according to anatomy. The most appropriate localization method should be selected according to the location of the nodule, available equipment, and surgeon鈥檚 experience. According to the published literatures, we have sorted out a variety of different theories and methods of localization of pulmonary nodules in this article, summarizing their advantages and disadvantages for references.
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Objective:To explore the fixation with S 2 alar iliac screws (S 2AI) for unstable injury to the pelvic posterior ring. Methods:The clinical data of 18 patients were analyzed retrospectively who had been treated for unstable injury to the posterior pelvic ring by S 2AI screw fixation at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University and at Department of Orthopaedics and Traumatology, The First Affiliated Hospital to University of South China from September 2017 to December 2020. They were 8 males and 10 females, with an average age of 40 years (from 20 to 64 years). According to Tile classification, there were 3 cases of type B2, 10 cases of type C1 and 5 cases of type C2. Sacral nerve injury was complicated in 3 patients (2 cases of Gibbons grade Ⅱ and one of Gibbons grade Ⅲ). Short-segment S 1-S 2AI fixation was used in 6 cases, contralateral S 1-S 2AI fixation in one case, lumbar-pelvic fixation in 5 cases, and sacroiliac triangle fixation in 6 cases. The accuracy of S 2AI placement was evaluated by CT after operation according to the Shillingford method; the reduction quality of pelvic fractures and complications were documented. Results:All the 18 patients were followed up for 19.8 months (from 12 to 36 months). Bony union was achieved in all fractures. A total of 21 S 2AI were implanted in the 18 patients without intraoperative neurovascular injury. Postoperative CT found penetration into the iliac cortex by S 2AI in 2 cases. According to the Matta criteria, the fracture reduction was excellent in 10 cases, good in 7 and fair in one. Of the 3 patients with preoperative sacral nerve injury, 2 with grade Ⅱ injury recovered to grade Ⅰ and one with grade Ⅲ injury recovered to grade Ⅱ after operation. Superficial infection occurred at the incision site in 2 patients after operation, and complications such as protrusion, rupture or loosening of implants were observed in none of the patients. Conclusion:S 2AI fixation can be flexibly applied to various types of posterior pelvic ring injury and can provide the pelvic ring and the lumbosacral junction with rigid fixation, leading to a low complication rate.
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Unstable sacral fracture is usually caused by high-energy trauma. Unstable sacral fracture often results in damage to the mechano-conductive structures of the spine and pelvis and thereby affects walking dysfunction. Treatment of sacral fracture has been a challenge due to the complex local anatomy, unique biomechanics and poor bone quality of the sacrum. The screw-rod fixation system has always played an important role in the treatment of variant sacral fracture and more severe sacral fracture. With the introduction of new technology, the screw-rod fixation system has evolved into a variety of structural types. According to whether the fixation range extends to the spine, it can be divided into two categories including spine-pelvic stabilization techniques and pelvic stabilization techniques. The authors review the progress of the screw-rod fixation system in the treatment of sacral fracture from aspects of biomechanical properties and clinical efficacy, so as to provide a reference for the selection of clinical internal fixation.
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Peripheral odontogenic keratocysts are rarely observed, and cases of odontogenic keratocysts of buccal soft tissues are even rarer. This study was performed to present two rare cases of odontogenic keratocysts in buccal soft tissues and review related literature.
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Humans , Odontogenic Cysts/diagnosis , Odontogenic TumorsABSTRACT
Objective:To investigate the correlation between item d560 of the International Classification of Functioning, Disability and Health (ICF) and the swallowing function of convalescing stroke patients.Methods:A total of 140 convalescent stroke survivors were evaluated for dysphagia using the ICF-d560 and the modified Watian drinking water test. Linear regression was used to analyze the influence of clinical factors when choosing a swallowing function assessment scale. Spearman correlation was computed to explore the correlation between ICF item d560 and the modified Watian drinking water test.Results:According to the ICF-d560 results, 10% of the patients had a mild disorder, with another 37.1% moderate, 29.3% severe and 23.6% completely dysphagic. The corresponding percentages according to the improved Watian drinking water test were 44.3% mild, 31.4% moderate and 24.3% severe. The total correlation coefficient between the two sets of results was 0.86, which was related to the stroke type, age, gender and stroke risk factors. The correlation coefficient of the cerebral infarction group was significantly higher than the cerebral hemorrhage group′s coefficient, and that of the women was slightly higher than that of the men. The strength of the correlation increased with age. The correlation coefficient was 0.84 among both diabetics and hypertension sufferers.Conclusions:Results from the ICF-d560 and the modified Wada drinking water test correlate well, which can provide a screening tool for swallowing function based on the ICF theoretical framework.
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Objective:Comparison of biomechanical stability of S 2-alar-iliac screw and S 1 pedicle screw fixation (S 2AI-S 1) with conventional sacroiliac screw in the treatment of Denis type II sacral fractures by finite element analysis. Methods:The lumbar spine and pelvis of a male volunteer with normal skeletal structure were scanned by CT, followed by three-dimensional reconstruction. The finite element model of right Denis type II sacral fracture and pubic symphysis injury was constructed using ANSYS 17.0 software. The anterior pelvic ring is fixed with a five-hole steel plate, and the posterior pelvic ring is fixed with four different internal fixation methods, namely, sacroiliac screw (S 1 segment half-thread hollow screw), S 2AI-S 1 and S 2AI screw and contralateral S 1 screw fixation (S 2AI-CS 1). By restraining the bilateral acetabular and applying 500 N vertical stress above the L 4 vertebral body, the maximum displacement, maximum von Mises stress and vertical stiffness of the three groups of internal fixation were compared. Results:In terms of the maximum displacement of the sacrum in the vertical and anteroposterior directions, the S 2AI-S 1 model was the smallest (1.40 mm, 1.40 mm, respectively), while the S 2AI-CS 1 model was the largest (1.60 mm, 1.56 mm, respectively); In terms of the maximum displacement of the sacrum in the horizontal direction, the S 2AI-S 1 model is the smallest (0.19 mm), while the SIS model is the largest (0.37 mm); In terms of the maximum von Mises stress of internal fixation, the stress of the sacroiliac screw model is the largest (216.02 MPa), while the stress of the S 2AI-S 1 model is the smallest (39.82 MPa); In terms of the maximum von Mises stress of the bone around the screw, the stress of the sacroiliac screw model (39.68 MPa) is the largest and that of the S 2AI-S 1 model is the smallest (31.56 MPa); In terms of the vertical displacement of the center point of the upper surface of the S 1 vertebral body, the sacroiliac screw, S 2AI-S 1 and S 2AI-CS 1 groups were 0.83 mm, 0.73 mm and 0.93 mm, respectively. Using the vertical displacement of the center point of the upper surface of the S 1 vertebral body to predict the vertical stiffness of the three groups of models, from large to small, are S 2AI-S 1, sacroiliac screw and S 2AI-CS 1. Conclusion:S 2AI-S 1 fixation has good biomechanical stability in three-dimensional finite element analysis. It can be used as a new type of internal fixation for the treatment of sacral fractures and is worthy of promotion.
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In order to better utilize saffron floral bio-residues(SFB), a qualitative and quantitative analysis of flavonoids in SFB was conducted using UPLC-MS and UPLC, respectively. On the one hand, 50 flavonols and 5 anthocyanins were putatively characte-rized by using UPLC-Q-TOF-MS. On the other hand, an UPLC method was established for determining the fingerprint of SFB as well as testing the main flavonoids kaempferol-3-O-sophoroside and delphinidin-3,5-di-O-glucoside. Contents of kaempferol-3-O-sophoroside and delphinidin-3,5-di-O-glucoside of 10 batches of samples were 44.21-58.73 mg·g~(-1) and 2.11-6.37 mg·g~(-1), respectively, and the similarities of 10 batches were more than 0.99. In addition, the color of the samples was digitized by using electronic eye technology, and it was found that the color of the samples was significantly correlated with the content of delphinidin-3,5-di-O-glucoside. The richness of flavonoids in SFB indicated its potential for development and utilization, and the large variation in anthocyanin content among samples from different regions suggested that more attention should be paid to the methods of sample pretreatment and storage.
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Chromatography, High Pressure Liquid , Chromatography, Liquid , Crocus , Flavonoids , Flowers , Tandem Mass SpectrometryABSTRACT
@#Uniportal video-assisted thoracic surgery (UniVATS) is a significant approach of mini-invasive surgery for lung cancer. UniVATS was first used for treatment of lung cancer in 2010. The European consensus and the Chinese consensus were published in 2019 and 2020 respectively. The latest Chinese consensus included the definition of UniVATS, indications for lung cancer treatment, safety and feasibility, surgical skills, learning curve, short-term and long-term results, providing suggestions for the standardization of uniportal video-assisted thoracic surgery, which are essential to improve the quality of surgery and reduce the incidence of related complications. The Chinese consensus also summarized the current status of subxiphoid UniVATS and non-intubated UniVATS for lung cancer. Considering the technical difficulties and challenges, the application of both technologies in clinical treatment has certain limitation. This article aims to give an interpretation of the results of the Chinese consensus and the similarities and to compare the differences with the European consensus, and to provide a reference for the majority of thoracic surgery colleagues.
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@#Objective To explore the training mode of robotic surgical system for thoracic surgeons. Methods Thirteen surgeons enrolled in the Department of Thoracic Surgery, Ruijin Hospital from May 2015 to December 2019 were targeted for training. Training methods included learning basic knowledge of Da-Vinci robotic system, simulation platform training, physical simulation training, training on animal models, practice of thoracic surgery and video analysis. Results The robotic operation skills of the surgeons were improved. Currently 4 surgeons were qualified for using robotic system to do thoracic surgery, and 9 surgeons had assistant qualification. Conclusion Multiple modes of training can help surgeons learn and master the techniques of robotic surgery, and will provide the basis for robotic training standard.
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Viruses infect host cells by binding to receptors on their surfaces of cells. Receptor is an important factor affecting host range and interspecific transmission. In December 2019, an outbreak of unexplained pneumonia occurred in Wuhan, Hubei province. The pathogen was a new coronavirus, named 2019 novel coronavirus (2019-nCoV) by WHO. Angiotensin-converting enzyme 2 (ACE2) was found to be the receptor of 2019-nCoV. This review provides a brief overview of human coronavirus receptors and their applications, with a view to providing references for the tracing, cross-species transmission, epidemiological analysis and antiviral and vaccine studies of 2019-nCoV.
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Objective:To explore any correlation between ratings using item d550 of the International Classification of Functioning, Disability and Health (ICF-d550) and the nutritional status of patients with cerebrovascular disease.Methods:Nutritional assessments of 260 patients with cerebrovascular diseases hospitalized in a geriatric care hospital were carried out using the ICF-d550 and NRS2002 nutrition risk screening. The enter method was used to analyze the relationship between clinical factors and the scales. Spearman correlation coefficients quantified the correlation between ICF-d550 and NRS2002 results and the influence of clinical factors.Results:According to the ICF-d550 ratings the incidence of nutritional disorders was 85.00% while the NRS2002 reported 68.85%. The correlation coefficient between the two sets of results was 0.49, with the correlation coefficient of the males (0.53) slightly higher than that of the females (0.43). The correlation strengthened with age. The correlation coefficients of thin, normal and overweight persons were 0.61, 0.44 and 0.50 respectively.Conclusions:The ICF-d550 and NRS2002 can both be used to evaluate the nutritional risk of elderly patients with cerebrovascular disease, with good correlation.
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Viruses infect host cells by binding to receptors on thesurface of cells. Receptor is an important factor affecting host range and interspecific transmission. In December 2019, an outbreak of unexplained pneumonia occurred in Wuhan, Hubei province. The pathogen was a new coronavirus, named 2019 NovelCoronavirus (2019-nCoV) by WHO. Angiotensin-converting enzyme 2 (ACE2) was found to be the receptor of 2019-nCoV.This review provides a brief overview of human coronavirus receptors and their applications, with a view to providing references for the tracing, cross-species transmission, epidemiological analysis and antiviral and vaccine studies of 2019-nCoV.
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Thoracic outlet syndrome(TOS) are constellation of symptoms caused by compression of the neurovascular bundle including the brachial plexus, the subclavian artery and the subclavian vein at the thoracic outlet region. It includes neurogenic TOS, venus TOS, arterial TOS, and neurogenic TOS is the most common type. TOS has varied manifestations and lack of confirmatory testing, therefore, the diagnosis should be conbination with thorough history, physical examination and associated supplementary examinations. Conservative and surgical treatment can be choosed for TOS and the outcomes are generally good. Conservative management is the initial treatment strategy for neurogenic TOS. In cases of symptomatic vascular TOS and neurovascular TOS, which has been failed by conservative treatment, surgery should be considered more promptly.
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Humans , Brachial Plexus , Conservative Treatment , Physical Examination , Thoracic Outlet Syndrome , Diagnosis , TherapeuticsABSTRACT
Objective To investigate the regulatory effects of CD24 on Ly6Chi macrophages in liv-er and its influences on bile duct ligation ( BDL)-induced hepatic fibrosis in mice. Methods Liver fibrosis was induced in wild-type ( WT) and CD24-/- mice by surgical ligation of the biliary duct. Levels of alanine amino transferase ( ALT) in serum were detected and liver sections were stained with haematoxylin and eosin ( H&E) staining to assess the severity of liver injury. Sirius Red staining was used to observe the degree of liver fibrosis. Real-time PCR was performed for detecting the expression of hepatic fibrosis-related markers and TGF-β1 at mRNA level. The percentage of macrophages and the number of TGF-β1-producing macro-phages were measured by flow cytometry. Results BDL-induced liver fibrosis was exacerbated in CD24-/-mice than in WT mice as demonstrated by more serious hyperplasia in bile duct, more inflammatory infiltra-tion at the portal area and higher levels of ALT in serum. Results of Sirius red staining also showed that the liver fibrosis was more severe in CD24-/- mice than in WT mice. Moreover, α-SMA and collagen typeⅠalpha 1 (Col1a1) were significantly upregulated in CD24-/- mice. Flow cytometry analysis revealed that CD24 was highly expressed by hepatic macrophages in BDL-induced WT mice, and the percentages of hepat-ic macrophages were significantly elevated in CD24-/-mice compared with those in WT mice. Further analy-sis revealed that the percentages of Ly6Chi hepatic macrophages in CD24-/- mice were higher than those in WT mice, but there was no significant difference in the percentages of Ly6Clo macrophages. The expression of TGF-β1 at mRNA level was increased in CD24-/-mice as compared with that in WT mice after BDL. Mo-reover, intracellular staining showed that Ly6Chi hepatic macrophages in CD24-/- mice secreted more TGF-β1 than the macrophages in WT mice. Conclusions CD24 might attenuate the BDL-induced liver fibrosis in mice via regulating the percentage of hepatic Ly6Chi macrophages and the secretion of TGF-β1.
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Surgical treatment of acetabular fracture is very challenging because the acetabular geometry is complex.As anterior and posterior columns are the main support structures of the acetabulum,anatomical reduction and strong internal fixation of the two acetabular columns can achieve the best prognosis for patients with acetabular fracture.Constant study of the complex anatomy around the acetabulum reveals an infra-acetabular screw channel that can pass through both columns.Biomechanical studies show that use of an additional infra-acetabular screw can greatly strengthen the internal fixation of acetabular fracture.Biomorphological studies prove that an infra-acetabular screw channel of 5 mm in diameter is available in more than 90％ of people which allows insertion of a 3.5 mm screw.Imaging studies demonstrate that one infra-acetabular screw can be safely placed under the guidance of C-arm roentgenography.In surgery of acetabular fracture,surgeons have used infra-acetabular screws,the clinical value of which has been confirmed by good functional recovery of the patients after surgery.This paper presents an overview of the progress in research on infra-acetabular screwing for acetabular fracture.
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Objective: To discuss the clinical efficacy of modified Da Chengqitang by enema in treatment of postoperative inflammatory intestinal obstruction (EPISBO) after the operation and its effect on inflammatory factors, gastrointestinal motility and intestinal barrier function. Method: One hundred and six patients were randomly divided into control group (52 cases) and observation group (54 cases) by random number table. Patients in both groups were given fasting for solids and liquids, gastrointestinal decompression, maintaining water and electrolyte balance, nutritional support and other basic therapies. Patients in control group were given somatostatin for injection for continuous micro-pumping, 0.003 5 mg·h-1·kg-1, dexamethasone acetate tablets, 2.5-5 mg/time, 2 time/days. Patients with concurrent infection got ceftazidime for injection, 30-100 mg·kg-1, 2-3 intravenous drips. In addition to the therapy of control group, patients in observation group were also given modified Da Chengqitang, 125 mL/time, 2 times/days. A course of treatment was 5 days. Time of remission of abdominal distention, recovery of exhaust gas, bowel sounds and diet, defecation, hospitalization and transitional surgery were recorded. And main gastrointestinal symptoms and signs were scored. And levels of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), vasoactive intestinal peptide (VIP), gastrin, motilin, diamine oxidase and D lactic acid were detected. Result: After treatment, according to rank sum test analysis, the clinical efficacy in observation group was better than that in control group (PPPPα, hs-CRP, VIP, DAO, D-lactic acid and scores of main gastrointestinal symptoms and signs were all lower than those in control group (PPConclusion: In addition of routine therapy of western medicine, modified Dachengqi Tang had effects in resisting inflammation, regulating gastrointestinal hormones, and protecting intestinal barrier function, so can improve gastrointestinal motility, alleviate symptoms, shorten the course of disease and improve the clinical efficacy.
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Resorption of alveolar bone that occurs following tooth extraction is irreversible, it may compromise the restoration of implants or conventional prostheses. Ridge preservation can minimize ridge resorption after tooth extraction. In this article, healing features of socket after tooth extraction, factors influencing ridge remodeling, and the use of bioma-terials were reviewed.
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Humans , Alveolar Bone Loss , Alveolar Process , Alveolar Ridge Augmentation , Tooth Extraction , Tooth Socket , Wound HealingABSTRACT
<p><b>Objective</b>To make a preliminary investigation on the safety and efficacy of focused low-intensity extracorporeal shock wave therapy (LI-ESWT) in the treatment of erectile dysfunction (ED).</p><p><b>METHODS</b>We treated 32 ED patients by focused LI-ESWT with the device of Medispec's ED1000. Before and at 4 and 12 weeks after treatment, we evaluated the erectile function of the patients using the International Index of Erectile Function-erectile function domain (IIEF-EF), Erection Hardness Score (EHS), Sexual Encounter Profile questions 2 and 3 (SEP2 and SEP3), and Global Assessment Questionnaire questions 1 and 2 (GAQ1 and GAQ2), and recorded the incidence rate of adverse events.</p><p><b>RESULTS</b>The patients averaged 30.69 years of age. Compared with the baseline, the mean IIEF-EF score of the patients was significantly increased at 4 and 12 weeks after LI-ESWT (14.94 vs 20.97 and 21.47, P <0.01), and so were the EHS (1.75 vs 2.66 and 2.56, P <0.01) and the "Yes" answers to SEP2 (21.88% vs 68.75% and 71.88%), SEP3 (0 vs 43.75% and 56.25%), GAQ1 (NA vs 81.25% and 71.88%) and GAQ2 (NA vs 65.63% and 68.75%). The total effectiveness rates at 4 weeks and 12 weeks were 75% and 71.88% respectively. One of the patients felt penile shaft pain with mild ecchymosis after LI-ESWT but was recovered without special treatment a week later.</p><p><b>CONCLUSIONS</b>LI-ESWT can significantly improve the erectile function of ED patients with no obvious adverse effects within 12 weeks after treatment.</p>
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Adult , Humans , Male , Double-Blind Method , Ecchymosis , Erectile Dysfunction , Therapeutics , Extracorporeal Shockwave Therapy , Methods , Pain, Procedural , Penile Erection , Physiology , Surveys and Questionnaires , Treatment OutcomeABSTRACT
Objective To report the clinical characteristics of alien hand syndrome(AHS). Methods Eight AHS inpatients from July,2015 to July,2017 were reviewed from the etiology,clinical manifestations, imaging characteristics and outcome. Results The etiology of the patients was cerebrovascular disease. The clinical features included alien hand (8 cases), movement disorder(8 cases),cognitive disorder(5 cases),speech disorder(4 cases)and affective disorder(3 cas-es).Imaging indicated the lesions involved callosum(8 cases),frontal lobe(2 cases),parietal lobe(3 cases),tem-poral lobe(2 cases)and basal ganglial region(1 case).There were four cases healing,two improving,two of re-mission after medicine and rehabilitation. Conclusion ASH is mainly resulted from cerebrovascular disease, in which callosum and frontal lobe are mostly in-volved,features in different forms,and prognoses well.
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Objective To explore the effect of allopurinol on renal function in hyperuricemia patients complicated with chronic renal insufficiency.Methods From February 2015 to August 2017,100 hyperuricemia patients complicated with chronic renal insufficiency in the Affiliated Hospital of Hangzhou Normal University were selected as the study object,and they were randomly divided into observation group and control group according to the digital table,with 50 cases in each group.The observation group was treated with allopurinol,and the control group was not used allopurinol,The clinical indexes of the two groups before and after treatment were comparatively analyzed.Results The MAP[(102.8 ±22.2)mmH vs.(103.8 ±19.6)mmH],24h urinary protein[(2.5 ±1.4)g/d vs.(2.5 ±0.8)g/d],hemoglobin[(121.7 ±20.5)g/L vs.(120.7 ±26.9)g/L] and CRP[(6.8 ±1.9)mg/L vs.(6.4 ±2.0)mg/L] index in the observation groupbefore and after treatment had no statistically significant differences(t=1.253,0.223,3.1.052,1.324,all P>0.05),the serum uric acid [(449.8 ±154.7)μmol/L vs.(344.6 ± 124.7)μmol/L],serum creatinine[(147.8 ±53.4)μmol/L vs.(160.2 ±51.9)μmol/L] and eGFR[(44.4 ± 17.6)vs.(41.8 ±22.4)] were improved after treatment compared with those before treatment,and the differences were statistically significant(t=18.632,25.632,5.534,10.547,12.635,all P<0.05).Of the observation group and control group,the MAP were(103.4 ±19.5)mmHg,(105.8 ±23.2)mmHg,respectively and the 24h urine protein were(2.4 ±1.2)g/d,(2.4 ±1.2)g/d,respectively,and the hemoglobin were(120.8 ±22.4)g/L,(119.4 ± 25.8)g/L,respectively,and the CRP were(6.8 ±2.5)mg/L,(6.2 ±1.8)mg/L,respectively.and before and after treatment,there were no statistically significant differences(t=0.256,0.522,1.635,0.362,all P>0.05).The levels of serum uric acid [(468.7 ±114.9)μmol/L vs.(524.8 ±118.9)μmol/L],serum creatinine [(142.33 ± 50.2)μmol/L vs.(182.3 ±63.2)μmol/L] and eGFR [(44.7 ±14.5)vs.(37.2 ±21.8)] before treatment between the two groups had no statistically significant differences(all P>0.05).After treatment,the levels of serum uric acid[(344.6 ±124.7)μmol/L] and serum creatinine[(160.2 ±51.9)μmol/L] in the observation group were significantly lower than those in the control group [(524.8 ±118.9)μmol/L,(182.3 ±63.2)μmol/L]and the value of eGFR in the control group [(41.8 ±22.4)] was significantly higher than that in the control group [(37.2 ± 21.8)],the differences were statistically significant(t =10.635,26.352,8.041,all P <0.05).Conclusion Allopurinol not only can effectively protect the patient's kidneys,reduce the patients'blood uric acid levels,but also can effectively reduce the late glycosylated end products(which)levels.