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Objective:To evaluate our self-designed pre-positioned 3D honeycomb guide device in the internal fixation with percutaneous cannulated screws for femoral neck fractures.Methods:A retrospective study was conducted to analyze the data of 60 patients with femoral neck fracture who had been treated with cannulated screw fixation at Department of Orthopaedics, Kunshan Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine from June 2019 to June 2022. According to the difference in intraoperative positioning for placement of cannulated screws, the patients were divided into a study group of 30 cases whose placement of cannulated screws was assisted by our self-designed pre-positioned 3D honeycomb guide device, and a control group of 30 cases whose cannulated screws were positioned freehand. In the study group, there were 17 males and 13 females with an age of (44.9±9.2) years, and 2 cases of type Ⅱ, 18 cases of type Ⅲ, and 10 cases of type Ⅳ by the Garden classification. In the control group, there were 11 males and 19 females with an age of (43.5±7.9) years), and 1 case of type Ⅱ, 16 cases of type Ⅲ, and 13 cases of type Ⅳ by the Garden classification. Closed reduction and inverted triangle internal fixation with 3 cannulated screws were conducted for all fractures. The Garden crossline index, operation time, fluoroscopy frequency, needle drillings, fracture healing time, and Harris hip functional score at the last follow-up were compared between the 2 groups. The postoperative imaging indicators in the 2 groups were measured, including screw spacing, distance from screw to neck cortex, screw coverage area, parallel deviation between screws, and deviation from screw to neck axis.Results:There were no statistically significant differences in the baseline characteristics between the 2 groups, indicating comparability ( P>0.05). All patients were followed up for (14.4±1.9) months after surgery. In the study group, operation time [(33.1±5.5) min], fluoroscopy frequency [(13.7±2.2) times], needle drillings [(3.7±0.6) times], distance from screw to neck cortex [(12.4±2.8) mm], parallel deviation between screws in the anteroposterior view (2.2°±1.1°), parallel deviation between screws in the lateral view (2.4°±1.0°), deviation from screw to neck axis in the anteroposterior view (4.0°±0.9°) and deviation from screw to neck axis in the lateral view (3.2°±0.8°) were all significantly smaller than those in the control group [(46.5±8.6) min, (23.1±5.2) times, (11.0±2.2) times, (19.0±3.3) mm, 6.5°±2.6°, 7.1°±2.9°, 7.7°±2.6°, and 9.2°±3.1°] (all P<0.05). The screw spacing [(45.7±5.8) mm] and screw coverage area [(74.1±10.9) mm 2] in the study group were both significantly larger than those in the control group [(31.3±7.7) mm and (55.5±9.0) mm 2] ( P<0.05). There was no statistically significant difference between the 2 groups in Garden crossline index, fracture healing time, follow-up time, or Harris hip functional score at the last follow-up ( P>0.05). Follow-ups revealed 1 case of bone non-union in the study group and 2 cases of bone non-union and screw withdrawal in the control group, but no such complications as infection, deep vein thrombosis, screw penetration or rupture, or femoral head necrosis in either group. Conclusion:In the internal fixation with percutaneous cannulated screws for the treatment of femoral neck fractures, our self-designed pre-positioned 3D honeycomb guide device can shorten surgical time, significantly reduce fluoroscopy frequency and needle drillings, and effectively improve accuracy of screw placement.
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Objective:To evaluate the effect of the impaction of posterior wall on the prognosis following open reduction and internal fixation for fractures of acetabular posterior wall.Methods:A retrospective study was conducted to analyze the data from the 83 patients with fracture of acetabular posterior wall who had been consecutively treated by open reduction and internal fixation at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital from January 2017 to December 2020. The patients were divided into 2 groups based on involvement of posterior wall impaction. In the impaction group of 33 cases, there were 26 males and 7 females with an age of (47.4±11.6) years; in the non-impaction group of 50 cases, there were 43 males and 7 females with an age of (41.3±12.0) years. The quality of postoperative fracture reduction, the function of the affected hip at the last follow-up, and the complication rate during follow-up were compared between the 2 groups. Multifactorial binary logistic regression and age subgroups were used to analyze the effects of posterior wall impaction on functional outcomes.Results:The age, rate of associated injuries in other body parts, and rate of posterior wall comminution in the impaction group were significantly higher than those in the non-impaction group ( P<0.05), but there was no statistically significant difference in other general data of patients between the 2 groups ( P>0.05). All patients were followed up for (44.5±13.3) months after surgery. The rate of anatomical reduction in the non-impaction group (96.0%, 48/50) was significantly higher than that in the impaction group (57.6%, 19/33) ( P<0.05), and the good and excellent rate by the modified Merle d'Aubigné & Postel scale at the last follow-up in the non-impaction group (84.0%, 42/50) was significantly higher than that in the impaction group (51.5%, 17/33) ( P<0.05). There was no significant difference in the incidence of complications between the 2 groups ( P>0.05). After adjusting for age and gender, the difference in hip function was still significantly different between the 2 groups ( OR=0.23, 95% CI: 0.06 to 0.79, P=0.020). The effect of posterior wall impaction on functional outcomes was statistically significant in patients aged ≥50 years ( P=0.008), whereas the difference was not statistically significant in patients aged <50 years ( P=0.194). Conclusions:Compared with non-impaction ones, acetabular fractures of posterior wall impaction tend to lead to poorer quality of reduction, which in turn affects the postoperative recovery of hip joint function. The impact of impaction fractures on functional recovery is more significant in patients aged 50 years and above.
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After kidney transplantation , timely detection of changes in transplanted kidney function may guide clinical managements and prevent or delay irreversible damage to transplanted kidney. Functional magnetic resonance imaging (fMRI) of transplanted kidney is a promising non-invasive technique of acquiring microstructural and microfunctional profiles of transplanted kidney. In recent years, various diffusion imaging modalities, arterial spin labeling (ASL) and blood oxygen level dependent-magnetic resonance imaging (BOLD-MRI) have gradually been applied for transplant kidneys. Transplant kidney function may be evaluated non-invasively from such microscopic perspectives as water molecule diffusion, blood flow perfusion and blood oxygen level. This review focused upon evaluating the renal function and identifying the causes of the renal function decline of transplanted kidney through various fMRI techniques and provide new rationales for clinical diagnosis.
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Objective:To study positive rates and typing of oligoclonal bands (OCB) in patients with neurological disorders, and to reveal the clinical significance and applicational value of OCB test.Methods:A retrospective analysis was performed on the detection results of 3 217 patients with neurological disorders who undertook both serum and cerebrospinal fluid OCBs in the First Hospital of Peking University from January 2012 to August 2022. According to the final diagnosis, the patients were divided into 13 groups including multiple sclerosis (479 cases), neuromyelitis optica spectrum disorders (935 cases), autoimmune encephalitis (192 cases), viral encephalitis (94 cases), nervous system complication after HSCT (232 cases), Guillain-Barré syndrome (644 cases), chronic inflammatory demyelinating polyneuropathy (157 cases), etc. Cerebrospinal fluid and serum OCBs were detected using isoelectric focusing electrophoresis combining immunofixation, then classified into Ⅰ-Ⅴ types according to the morphology. Consequently, positive rates and types were analyzed for each group. χ2 test was used for comparison between groups. Results:The positive rates of cerebrospinal fluid OCB in multiple sclerosis, nervous system complication after hematopoietic stem cell transplantation (HSCT), autoimmune encephalitis, viral encephalitis, neuromyelitis optica spectrum disorders, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy were respectively 66.8% (320/479), 48.7% (113/232), 46.4%(89/192), 19.1% (18/94), 17.6% (165/935), 9.9% (64/644), 5.1% (8/157). For patients with multiple sclerosis, neuromyelitis optica spectrum disorders, viral encephalitis, and autoimmune encephalitis, Type Ⅱ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.1% (301/320), 78.7% (70/89), 77.8% (14/18), and 77.6% (128/165) respectively, indicating intrathecal IgG synthesis; for patients with nervous system complication after HSCT, Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy, type Ⅳ bands took the majority of cerebrospinal fluid OCB-positive cases with the rates of 94.7% (107/113), 82.8% (53/64) and 100% (8/8), indicating no obvious intrathecal IgG synthesis. The positive rates of cerebrospinal fluid oligoclonal bands were significantly different among all groups (χ 2=1 268.31, P<0.001). Conclusion:The positive rates of cerebrospinal fluid oligoclonal bands are different among different neurological disorders, in which the positive rate of cerebrospinal fluid OCB is higher with type Ⅱ bands as the majority type in multiple sclerosis, which indicates that the detection and typing of cerebrospinal fluid OCB are helpful for the diagnosis of various neurological diseases, especially for multiple sclerosis.
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AIM: To observe the clinical effect of invisible anchor hook intraocular lens(IOL)fixation surgery.METHODS: Prospective and uncontrolled case study. A total of 19 patients(19 eyes)with aphakia, IOL dislocation, or lens dislocation from January 2019 to December 2020 were selected for this study, all of whom underwent anchor hook IOL scleral fixation implantation surgery. The main postoperative observation indicators are best corrected visual acuity(BCVA), uncorrected visual acuity(UCVA), corneal endothelial cell density, tilt of IOL position, and complications.RESULTS: The UCVA(LogMAR)before and at 1 mo after surgery was 1.06±0.63 and 0.40±0.26, respectively(P<0.01), BCVA(LogMAR)before and at 1 mo after surgery was 0.27±0.51 and 0.06±0.15, respectively(P=0.09), and the average corneal endothelial cell density was 2406±625 and 2004±759 cells/mm2(P=0.13). The complications that occurred at 1 d postoperatively were 2 and higher grade aqueous flare(3 eyes), wrinkling of the corneal posterior elastic layer(2 eyes), and transient elevated intraocular pressure(2 eyes). No IOL dislocation occurred during 24 mo follow-up.CONCLUSION:The anchor hook type IOL scleral interlayer fixation technique, which involves anterograde insertion and retrograde fixation of the interstitial thread, is similar to the principle of anchor hook and achieves good IOL stability and visual effects.
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Objective:To evaluate the feasibility and clinical effectiveness of placing a nasointestinal ileus tube (NTI) during extensive adhesive bowel obstruction (ABO) surgery.Methods:A retrospective analysis was performed for the clinical and follow-up data of 60 patients with extensive ABO admitted to the Department of General Surgery of Daxing District Hospital of Capital Medical University from April 2019 to April 2021, of which 30 patients underwent intraoperative NIT intraintestinal alignment (observation group) and 30 patients who did not undergo NIT intraintestinal alignment (control group) during the same period. There were 12 males and 18 females in the observation group. There were 16 males and 14 females in the control group. The operation time, gastrointestinal function recovery time, discharge time, total effective rate and postoperative complication rate were compared between the two groups, and the quantitative data of the recurrence rate of intestinal obstruction at 24 months after surgery were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups. Numerological data were presented as cases (percentage) [ n (%)], and chi-square tests were used for comparison between groups. Results:All patients were successfully completed the surgery and discharged from the hospital. There was no statistically significant difference in total effective rate between the control group and the observation group( χ2=3.16, P=0.237). The surgical time in the observation group was slightly longer than that in the control group [(110.6±4.6) min vs (94.3±2.5) min, t=17.27, P=0.001]. The recovery time of gastrointestinal function and hospitalization time in the observation group were shorter than those in the control group[(8.13±1.00) d vs (8.70±0.70) d, t=2.53, P=0.014; (12.83±1.57) d vs (13.67±1.03) d, t=0.03, P=0.018]. The incidence of postoperative complications was lower than that in the control group (10% vs 30%, P=0.028), and the difference was statistically significant. Conclusion:Intraoperative application of NIT is safe and effective, and can significantly reduce the recurrence rate of postoperative intestinal obstruction.
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Objective To compare the clinical efficacy of natural orifice specimen extraction surgery(NOSES)combined with enhanced recovery after surgery(ERAS)and conventional laparoscopic surgery in treatment of rectal cancer patients.Methods A hundred patients with rectal cancer in the Department of Colorectal and Anal Surgery,the 940th Hospital of Joint Logistics Support Force of PLA were selected as the research objects from January 2019 to December 2021,including 49 cases treated with NOSES combined with ERAS were set as the observation group,and 51 cases treated with conventional laparoscopic surgery of rectal cancer were set as the control group.Postoperative C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),white blood cell count(WBC),percentage of neutrophil(NEUT),K+ concentration,postoperative peristalsis recovery time,first time out-of-bed activity,first liquid feeding time,removal time of urinary,and drainage tubes,hospital stay and intraoperative blood loss,number of lymph node detection,positive margin rate,incidence of complications,and pain score were compared between the two groups.Results The observation group showed significant lower postoperative CRP,PCT,IL-6 levels when compared with control group(P<0.05),while no significant difference in K+ concentration between the two groups(P>0.05).The recovery time of intestinal peristalsis,the time of the first out-of-bed activity,the first liquid feeding time,the time of removal of the urinary tube and the drainage tube,and the number of days of hospitalization in observation group were all superior to the control group(P<0.05).The observation group with the duration of surgery was longer than the control group,and the difference was statistically significant(P<0.05).There were no significant differences in intraoperative bleeding,number of lymph nodes detected and positive rate of resection margins between the two groups(P>0.05).There was no significant difference in the incidence of complications between the two groups(4.1%vs.7.8%,P>0.05).The observation group showed significant lower pain scores than control group on the 1st,2nd and 3rd day after surgery(P<0.05).Conclusions NOSES combined with ERAS in treatment of rectal cancer patients is safe and feasible,can narrow the surgical incision,alleviate stress response and postoperative pain,improve postoperative efficacy and reduce the occurrence of complications,so is worthy of promotion and application.
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Objective To investigate the expression of MutS homolog 3(MSH3)in oral squamous cell carcinoma and its significance.Methods The MSH3 protein expression was examined by immunohistochemistry in 20 normal oral mucosa and 60 oral squamous cell carcinoma tissues.Results Our results showed that MSH3 expression in oral squamous cell carcinoma tissues was lower than normal oral mucosa.The MSH3 expression in oral squamous cell carcinoma tissues with better differentiation was higher than that with worse differentiation.The positive MSH3 expression decreased from oral squamous cell carcinoma patients without lymph nodal metastasis to that with metastasis.MSH3 expression was not related to the patients'gender,age,tumour location or size.Conclusion Downregulation of MSH3 is consistent with poorly differentiation and nodal metastasis in oral squamous cell carcinoma.MSH3 may play a significant role in the malignant progression of oral squamous cell carcinoma.
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Diabetic osteoporosis （DOP） is a kind of bone complication caused by diabetes， which is characterized by the decrease of bone mineral density， the change of bone microstructure and the increase of bone fragility. The process of DOP is closely related to high glucose， insulin resistance， oxidative stress and other mechanisms. The Wnt/β-catenin signaling pathway plays an important role in mediating insulin resistance and bone metabolic balance in diabetes. Regulation of Wnt signal transduction promotes the expression of glycogen synthase kinase-3β（GSK-3β）phosphorylation and improves glucose and lipid metabolism. The Wnt/β-catenin signaling pathway is also an important way regulating osteocyte-driven bone remodeling， which not only plays an important regulatory role in the balance between osteoblasts and osteoclasts and improve bone metabolic homeostasis， but also promotes the expression of osteopontin， osteocalcin and type Ⅰ collagen， and improves bone proliferation and osteogenic differentiation by regulating the Wnt pathway. In recent years， the research of traditional Chinese medicine （TCM） in the prevention and treatment of DOP has gradually increased， and the exploration of TCM to interfere with the Wnt pathway to improve DOP has made some progress. This paper collects and summarizes the studies on the Wnt signaling pathway in glucose metabolism， bone metabolism and DOP worldwide in the past decade， as well as the related literature on the intervention of DOP by TCM compounds （classical and other compounds）， single Chinese medicine and TCM monomers based on the Wnt pathway， in order to provide a reference and direction for the development of new drugs for clinical prevention and treatment of DOP.
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Circadian rhythm is an internal regulatory mechanism formed in organisms in response to the circadian periodicity in the environment, which modulates the pathophysiological events, occurrence and development of diseases, and the response to treatment in mammals. It significantly influences the susceptibility, injury, and recovery of ischemic stroke, and the response to therapy. Accumulating evidence indicates that circadian rhythms not only regulate the important physiological factors of ischemic stroke events, such as blood pressure and coagulation-fibrinolysis system, but also participate in the immuno-inflammatory reaction mediated by glial cells and peripheral immune cells after ischemic injury and the regulation of neurovascular unit(NVU). This article aims to link molecular, cellular, and physiological pathways in circadian biology to the clinical consequences of ischemic stroke and to illustrate the impact of circadian rhythms on ischemic stroke pathogenesis, the regulation of NVU, and the immuno-inflammatory responses. The regulation of circadian rhythm by traditional Chinese medicine is reviewed, and the research progress of traditional Chinese medicine intervention in circadian rhythm is summarized to provide a reasonable and valuable reference for the follow-up traditional Chinese medicine research and molecular mechanism research of circadian rhythm.
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Animals , Ischemic Stroke , Medicine, Chinese Traditional , Circadian Rhythm , Blood Coagulation , Blood Pressure , MammalsABSTRACT
To explore the research hotspots and frontier directions of pyroptosis in the field of traditional Chinese medicine(TCM), the authors searched CNKI and Web of Science for literature related to pyroptosis in TCM, screened literature according to the search strategy and inclusion criteria, and analyzed the publication trend of the included literature. VOSviewer was used to draw author cooperation and keyword co-occurrence network diagrams, and CiteSpace was employed for keyword clustering, emergence, and timeline view. Finally, 507 Chinese literature and 464 English literature were included, and it was found that the number of Chinese and English literature was increasing rapidly year by year. The co-occurrence of the authors showed that in terms of Chinese literature, there was a representative research team composed of DU Guan-hua, WANG Shou-bao and FANG Lian-hua, and for English literature, the representative research team was composed of XIAO Xiao-he, BAI Zhao-fang and XU Guang. The network visualization of Chinese and English keywords revealed that inflammation, apoptosis, oxidative stress, autophagy, organ damage, fibrosis, atherosclerosis, and ischemia-reperfusion injury were the primary research diseases and pathological processes in TCM; berberine, resveratrol, puerarin, na-ringenin, astragaloside Ⅳ, and baicalin were the representative active ingredients; NLRP3/caspase-1/GSDMD, TLR4/NF-κB/NLRP3, and p38/MAPK signaling pathways were the main research pathways. Keyword clustering, emergence, and timeline analysis indicated that the pyroptosis research in TCM focused on the mechanism of TCM monomers and compounds intervening in diseases and pathological processes. Pyroptosis is a research hotspot in the area of TCM, and the current discussion mainly focuses on the mechanism of the therapeutic effect of TCM.
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Pyroptosis , Medicine, Chinese Traditional , NLR Family, Pyrin Domain-Containing 3 Protein , Pattern Recognition, Automated , ApoptosisABSTRACT
Depression is a complex mental disease with polygenic inheritance and a high incidence.Our understanding of the clinical manifestations and pathogenesis of depression has recently improved.Continuous progress in gene-editing technologies has increased the construction efficiency and reduced the cost of gene-knockout animals,leading to their increasing use in the fields of basic research and drug development for depression and providing a powerful tool for revealing the pathogenesis of depression.In this review,we summarize recent progress in understanding the roles and mechanisms of candidate genes in depression using knockout model mice.
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Objective:To investigate the expressions of matrix metalloproteinase 7(MMP7)and secretory leukocyte protease inhibitor(SLPI)in papillary thyroid carcinoma(PTC)and their signifi-cances.Methods:Based on the gene expression data of thyroid cancer in the tumor Genome Atlas(TCGA)database,a total of 567 samples were collected,including 509 cancer tissues and 58 normal tissues.The gene matrix data were extracted and sorted out.Two groups of differentially expressed genes were screened by using the R language edger package,and the potential key genes were screened by the mcode plug-in in Cytoscape.Select a key gene and mine closely related genes through the UALCAN database.Immunohistochemical SABC method was used to detect the ex-pressions of MMP7 and SLPI proteins in PTC tissues and their paracancerous tissues collected from 69 patients in Binzhou People's Hospital Affiliated to Shandong First Medical University from January 2020 to June 2021,and the association of expression levels of MMP7 and SLPI with the clinico-pathological factors of PTC patients was also analyzed.Results:Based on the data of TCGA database,1471 genes were obtained,of which 1000 were up-regulated and 471 were down-regu-lated.Through the mcode plug-in in Cytoscape,20 key genes were screened(MMP7,CCL18,CYR61,SPECC1,CRABP2,PLXNA3,KRT17,TMEM59L,RETN,SRF,ITGB4,PPL,PLEKHN1,RMI2,LCN6,SPX,NRIP1,ARHGEF28,SLC39A14,SNCA).Through the UALCAN database,the correlation between MMP7 and SLPI was retrieved(Pearson correlation coefficient was 0.5,P＜0.05).The results of immunohistochemistry showed that the positive expression rates of MMP7 and SLPI proteins in PTC tissues were significantly higher than those in paracancerous tissues[82.6％(57/69)vs 29.0％(20/69),71.0％(49/69)vs 15.9％(11/69)],and the differences were statistically significant(x2 val-ues were 40.222 and 42.579,both P＜0.01).The expressions of MMP7 and SLPI in PTC tissues were correlated with TNM stage,differentiation,extramembranous invasion and lymph node metastasis(all P＜0.05).There was a positive correlation between MMP7 and SLPI proteins expressions in PTC(r=0.381,P=0.001).Conclusions:The interaction between MMP7 and SLPI proteins can be in-volved in the development and progression of PTC.
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Objective:To compare the long-term clinical outcomes between cannulated screw internal fixation for stable femoral neck fractures and arthroplasty for unstable ones in the elderly patients.Methods:A retrospective study was conducted to analyze the 542 patients with femoral neck fracture who had been admitted to Department of Orthopedics and Traumatology, Beijing Jishuitan Hospital, Capital Medical University from May 2015 to April 2017. The 542 patients were divided into 2 groups based on fracture stability and treatment method. In the stable group (Garden type Ⅰ, type Ⅱ, and abduction compression type) of 121 cases who underwent cannulated screw internal fixation, there were 28 males and 93 females with a mean age of (77.6±8.1) years, and 20 cases of type Ⅰ, 101 cases of type Ⅱ, and 34 cases of abduction compression type by the Garden classification. In the unstable group (Garden type Ⅲ, type Ⅳ, and type Ⅱ with a posterior tilt angle >20°) of 421 cases who underwent arthroplasty, there were 130 males and 291 females with a mean age of (78.7 ± 6.9) years, and 14 cases of type Ⅱ, 403 cases of type Ⅲ, and 4 cases of type Ⅳ by the Garden classification. The postoperative mortality, reoperation rate, and mobility at the last follow-up were compared between the 2 groups.Results:There were no statistically significant differences in the baseline characteristics, except for serum albumin concentration and peripheral white blood cell count at admission, between the 2 groups, indicating comparability ( P>0.05). The hospital stay in the stable group [5.0 (4.0, 6.0)d] was significantly shorter than that in the unstable group [6.0 (5.0, 8.0)d], and the follow-up time for the stable group [54.4 (49.3, 58.7) months] significantly longer than that for the unstable group [52.2 (46.0, 59.3) months] ( P<0.05). A total of 158 patients (45 cases in the stable group and 113 cases in the unstable group) were lost to the last follow-up. At the last follow-up, the mortality in the stable group (18.4%, 14/76) was significantly lower than that in the unstable group (31.5%, 97/308), the reoperation rate in the former (15.8%, 12/76) significantly higher than that in the latter (3.6%, 11/308), and the capability of daily activities in the former (by the fracture mobility scoring: level 1 in 35 cases, level 2 in 13 cases, level 3 in 3 cases, level 4 in 2 cases, and level 5 in 1 case) significantly better than that in the latter (level 1 in 99 cases, level 2 in 47 cases, level 3 in 24 cases, level 4 in 22 cases, and level 5 in 5 cases) (all P<0.05). Conclusion:Compared with the arthroplasty for unstable femoral neck fractures, cannulated screw internal fixation for stable femoral neck fractures leads to a lower long-term mortality and a better capability of daily activities, but a significantly higher reoperation rate.
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Objective:To assess the impact of the general education course entitled " The Basics of Radiation Protection" on enhancing undergraduates′ awareness of radiation safety, a questionnaire was utilized. Additionally, this study aims to propose novel strategies for improving health literacy among undergraduates, fostering the development of innovative, talented individuals with reasonable knowledge structures and strong practical abilities.Methods:From 2021 to 2022, 127 undergraduates from all colleges of Shandong University took the general course" The Basics of Radiation Protection". To compare the learning effects of the medical and non-medical students, invitations to participate in this study were extended to 101 (79.5%) students from School of Medicine and School of Electrical Engineering. A questionnaire survey was conducted to determine and compare the changes in the students’ basic cognition of radiation safety and protection before and after learning the course. The aim was to evaluate the teaching effectiveness and significance of the course.Results:From 2021 to 2022, 94 undergraduates from School of Medicine and School of Electrical Engineering accepted the invitation and voluntarily completed questionnaires twicely, accounting for 74.0% of the total number of selected students. The questionnaire survey showed that through course learning, the cognitive level of radiation protection among college students had significantly improved. The Likert quantification scores befroe taking the course were 3.59±1.35, 3.81±1.17, 3.45±1.16, 4.11±1.13, 3.62±1.05, 3.98±1.24 and after completing the course 4.94±0.32, 4.87±0.32, 4.96±0.21, 4.98±0.15, 4.81±0.39, 4.98±0.15, respectively, with the difference being statistically significant ( t=6.55, 5.50, 9.10, 5.36, 7.60, 5.34, P< 0.05). Further analysis revealed that different professional backgrounds affected students′ understanding of radiation safety and protection: before learning this course, medical students were superior to electrical engineering students in their knowledge of ionizing radiation ( t=5.69, 4.06, 6.46, 6.27, 7.78, P < 0.001). After taking the course, the cognitive level of students from both majors had considerably improved, but there was no significant difference ( P> 0.05). Feedback on the course learning showed that the awareness of " routine radiation protection" had significantly improved (96.8%), pseudoscience and pseudoinformation could be identified (93.6%), " nuclear power" -related fears had been dispelled (95.7%), and the concept of " cherishing life" had been effectively established (91.5%). Conclusions:The general education course " The Basics of Radiation Protection" has effectively improved the students′ awareness of radiation safety, strengthened their knowledge regarding radiation safety and protection, and provided a new avenue for cultivating innovative talents on a well-structured knowledge base. The course would be worth further promoting and applying in the education of undergraduates with different backgrounds and taking different majors.
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Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.
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Objective:To investigate the effect of Qingjin Huazhuo Decoction combined with conventional western medicine on blood hypercoagulability in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of phlegm-heat stasis lung syndrome.Methods:Randomized controlled trial. According to random number table method, allocation of cases in the observation and control groups. From April 2021 to March 2022, 66 hospitalized patients with AECOPD of phlegm-heat stasis and lung syndrome were randomly divided into control group ( n=32) and study group ( n=34). The control group was treated with conventional western medicine. The study group was treated with Qingjin Huazhuo Decoction on the basis of the control group. Both groups were treated for 7 days. Plasma thrombomodulin (TM), thrombin-antithrombin complex (TAT), tissue plasminogen activator-plasminogen activator inhibitor-1 complex (t-PAIC), plasmin-antiplasmin complex (PIC), prothrombin time (PT), partial thromboplastin time (APTT) and D-dimer levels were measured by automatic immunoassay analyzer; serum TNF-α levels were measured by ELISA and CRP levels were measured by immunoturbidimetry. Adverse reactions and acute thrombotic events during treatment were recorded. Results:During the treatment period, 4 of 66 patients had hemolysis, 2 were mistakenly included in the withdrawal study, 28 in the final control group and 32 in the study group were included for the analyses. After treatment, plasma t-PAIC [(6.19±1.93) μg/L vs. (7.42±2.71) μg/L, t=2.04] level in study group was significantly lower than that of the control group ( P<0.05), and the serum TNF-α [(71.15±25.25) ng/L vs. (122.60±98.76) ng/L, t=2.42] level was significantly lower than that of the control group ( P<0.05), plasma PT [(11.98±0.74) s vs. (11.55±0.77) s, t=-2.19] was significantly longer than that of the control group ( P<0.05). No thrombotic events occurred during hospitalization in the study group, and 1 case of acute myocardial infarction occurred in the control group. Conclusion:Qingjin Huazhuo Decoction combined with conventional western medicine therapy can improve the blood hypercoagulability of AECOPD patients with phlegm-heat stasis lung syndrome.
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Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People's Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40％(123/125),94.25％(82/87),and 97.89％(602/615)respectively,the difference was statistically significant(P＜0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P＞0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75％,which in group A was 4.00％(5/125),in group B was 9.20％(8/87),and in group C was 2.93％(18/615),and the incidence of complications in group B was obviously higher than that in group C(P＜0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P＞0.05).The overall incidence of postoperative long-term complications was 4.72％(39/827),which in group A was 4.80％,in group B was 14.95％,and in group C was 3.25％,and the incidence of complications in group B was strikingly higher than that in group A and group C,the difference was statistically significant(P＜0.05).Comparison of groups for the rates of various complications showed that the incidence of catheter fracture in group B was higher than that in group C,and the clipping syndrome occurred only in group B,the difference was statistically significant(P＜0.0167).There was no significant difference in the incidence of other complications between each other among the three groups(P＞0.05).The abnormal port-taking rate was 1.45％,including 3 patients in group A,7 patients in group B,and 2 patients in group C.The postoperative abnormal port-taking rate in group B was the highest(8.05％),which was significantly different from that in group C(P＜0.0167).Conclusion For intravenous infusion port implantation,axillary vein approach is clinically safe,comfortable,minimally-invasive and highly-efficient method,it is superior to internal jugular vein approach and subclavian vein approach in effectively reducing the incidence of complications and improving the postoperative abnormal port-taking rate of patients.Therefore,this technique can be regarded as a first choice in clinical practice.(J Intervent Radiol,2023,32:1212-1216)
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Objective:To explore the clinical outcomes of intraoperative fluoroscopy on femoral tunnel placement in treating professional snow sports athletes with anterior cruciate ligament (ACL) injury.Methods:A retrospective case series study was used to analyze the clinical data of 13 professional snow sports athletes with ACL injury treated in the National Institute of Sports Medicine, General Administration of Sport of China from January 2016 to January 2019. There were 5 males and 8 females, aged 16-27 years [(18.5±3.0)years]. Intraoperative lateral fluoroscopy combined with quadrant method was performed for the accurate femoral tunnel placement in single-bundle ACL reconstruction by using autologous hamstring tendon in all patients. KT1000 side-to-side difference (KT1000-ssd), pivot shift test, International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Marx activity scale and maximum extension and flexion resistance ratio of the involved and uninvolved knee were compared before operation (or before injury) and at 3, 6, 12 and 24 months after operation. Whether returning to the field, time taken in returning to the field and re-injury were recorded at each follow-up visit. ACL graft signal intensity ratio (SIR) in MRI of the involved knee was evaluated at postoperative 24 months.Results:All patients were followed up for 24-33 months [(25.8±2.7)months]. There were 7 patients with KT1000-ssd degree I, 5 with degree II and 1 with degree III before operation, compared to 12 patients with KT1000-ssd degree 0 and 1 with degree I at 3 and 6 months after operation and 13 patients with KT1000-ssd degree 0 at 12 and 24 months after operation. The pivot shift test was grade I in 8 patients and grade II in 5 before operation, compared to 11 patients with degree 0 and 2 with degree I at 3 months after operation and 12 patients with degree 0 and 1 with degree I at 6, 12 and 24 months after operation. IKDC subjective score was (68.0±4.3)points, (84.7±7.9)points, (94.6±3.3)points and (96.5±1.8)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, IKDC subjective score was significantly improved compared to the preoperative (48.3±25.0)points (all P<0.01). The Lysholm score was (63.4±6.6)points, (80.1±6.5)points, (93.8±4.6)points and (96.5±2.4)points at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the Lysholm score was significantly improved compared to the preoperative (47.5±29.4)points (all P<0.01). The Marx activity scale was (7.4±0.5)points, (13.8±0.7)points, (14.6±0.8)points and (15.0±0.7)points at postoperative 3, 6, 12 and 24 months, respectively, significantly lower than (16.0±0.0)points before the injury (all P<0.01). The maximum extension resistance ratio of the involved and uninvolved knee was 0.60±0.10, 0.85±0.08, 0.91±0.06 and 0.97±0.04 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum extension resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.57±0.18 (all P<0.01).The maximum flexion resistance ratios of involved and uninvolved knee were 0.64±0.09, 0.82±0.06, 0.89±0.04 and 0.94±0.06 at postoperative 3, 6, 12 and 24 months, respectively. Six months after operation, the maximum flexion resistance ratio of the involved and uninvolved knee was significantly increased compared to the preoperative 0.60±0.12 (all P<0.01). Thirteen athletes returned to the field within 12 months after operation with the time taken in returning to the field ranging from 5-12 months [(8.7±1.9)months]. There was no ACL re-injury at postoperative 24 months. The ACL graft SIR in MRI of the involved knee was 1.80±0.20 at postoperative 24 months. Conclusion:Intraoperative fluoroscopy on femoral tunnel placement in the treatment of professional snow sports athletes with ACL injury can significantly improve the knee joint stability, subjective function, sports performance and muscle strength within 6 months, and can help them return to the field within 12 months, and accelerates graft healing.
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Objective:To evaluate a novel distraction reductor in the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution.Methods:From January 2019 to December 2020, 27 patients with unstable distal radius fracture complicated with metaphyseal volar comminution were treated at Department of Orthopaedics, Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences. They were 6 males and 21 females, with an age of (69.4±9.4) years. All fractures were unilateral and closed, involving the right side in 17 cases and the left side in 10 cases. All patients were treated by internal fixation with an anatomical locking plate through the volar approach and the novel distraction reductor was used to reduce the fracture ends. Regular imaging examinations were performed to evaluate the reduction, maintenance and union of fractures after surgery. One year after operation, the curative efficacy was assessed by evaluation of the range of wrist motion, Disabilities of the Arm, Shoulder and Hand (DASH) score, Gartland-Werley score and Bartra radiology score.Results:All the operations went on successfully with a duration of (92.3±8.9) min. All the incisions healed primarily. The follow-up time was (15.9±2.9) months. The radial height, palmar tilt, ulnar inclination and articular surface step-off immediately after operation [(11.23±1.51) mm, 12.10°±3.44°, 20.54°±3.44°, and (0.95±0.42) mm] were not significantly lost compared with those one year after operation [(11.22±1.55) mm, 12.07°±3.44°, 20.51°±3.33°, and (0.93±0.40) mm] (all P>0.05). One year after operation, the range of wrist motion was good with dorsiflexion of 59.7°±5.5°, palm flexion of 63.0°±9.1°, pronation of 66.5°±5.5°, supination of 61.2°±5.6°, radial deviation of 22.7°±4.8°, and ulnar deviation of 30.3°±6.1°; DASH score was 13.5±5.5; Bartra radiology score was 88.6±6.5, giving an excellent and good rate of 88.9% (24/27);Gartland-Werley score was 2.7±2.1, giving an excellent and good rate of 92.6% (25/27). Follow-ups observed no poor fracture healing, internal fixation failure, tendon or nerve injury or traumatic arthritis. Conclusion:In the surgical treatment of unstable distal radius fractures with metaphyseal volar comminution, the novel distraction reductor can lead to ideal reduction of displaced fractures and effectively correct the shortening caused by volar cortex comminution to achieve satisfactory functional effects in clinic.