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1.
Chinese Journal of Orthopaedics ; (12): 1367-1372, 2021.
Article in Chinese | WPRIM | ID: wpr-910724

ABSTRACT

Total hip arthroplasty plays a key role in the end-stage diagnosis and treatment of a variety of femoral and hip diseases, but the risk of dislocation caused by traditional bone cement prosthesis has always been one of the key constraints of total hip arthroplasty. Bousquet added a polymer lining between the femoral head and acetabulum to separate the activities between the lining and acetabulum. The dual mobility acetabular cup system can effectively reduce the incidence of prosthesis dislocation. The first generation of the dual mobility acetabular cup system is lined with polyethylene. With the progress of modern material medicine technology, a new type of the dual mobility acetabular cup system with smooth surface, bionic coating and high cross-linked polyethylene liner has been gradually formed, and its performance has been improved. Because of the existence of the inner liner, the distance between the femoral head and acetabulum of the dual mobility acetabular cup system is larger, which can allow greater range of motion, has higher stability, is not easy to dislocate, and has lower wear degree of the prosthesis at the same time. Therefore, the dual mobility acetabular cup system is more and more widely used in clinical practice, especially for the elderly with high risk of dislocation, revision surgery or neuromuscular dysfunction. But on the other hand, based on the design principle of dual motion total hip prosthesis, the disadvantages such as intraprosthetic dislocation caused by multiple factors and the lack of fixation holes result in the dual motion total hip system easily triggering acetabular loosening when targeting patients such as severe bone defects, thus limiting its further use. The dual motion total hip system can be tailored to different clinical applications, such as for populations with different characteristics, and for different methods of primary surgery, with different application strategies, thereby reducing the incidence of postoperative revision. In this paper, we take the application of the dual motion total hip acetabular system in the total hip arthroplasty as the core, and the system puts forth the principle of the dual motion total hip acetabular system, compared with traditional bone materials, introduces its advantages and disadvantages, and reveals its application strategy in the clinic, and gives an outlook for the future application of the dual motion total hip acetabular system in orthopedics.

2.
Article in Chinese | WPRIM | ID: wpr-910375

ABSTRACT

Objective:To analyze the target design and dosimetric parameters of patients with recurrent adenoid cystic carcinoma (ACC) in the parotid gland who were treated with 125I interstitial brachytherapy alone. Methods:A retrospective analysis was conducted for 25 patients with recurrent adenoid cystic carcinoma in parotid gland who were histopathologically diagnosed between January 2015 and October 2019. These patients were treated with 125I interstitial brachytherapy alone, with prescribed doses of 100-120 Gy. The target volume was designed according to the pathological characteristics of ACC and recurrence sites. The pre- and post-operation dosimetric parameters (i.e., local control rates) were calculated using the treatment planning system. Results:In this study, the local recurrence sites included the superficial lobe (10/25) and deep lobe (7/25) of the parotid gland primarily and the skull base region (four patients) and mastoid posterior region (four patients) secondarily. The number of 125I seeds ranged from 16 to 111, with a median number of 59. The activity of radioactive particles was 18.5-25.9 MBq. The 3- and 5-year local control rates were 81.5% and 61.5%, respectively. No significant differences were found between pre- and post-operative dosimetric parameters such as D90, V100, and V150. There was no significant difference in local control rates among the four different recurrence sites. Conclusions:125I interstitial brachytherapy is proven to be an effective approach in the treatment of recurrent adenoid cystic carcinoma in the parotid gland. Satisfying local control rates can be achieved through target delineation performed according to recurrence sites and perineural invasion characteristics of ACC.

3.
Chinese Journal of Orthopaedics ; (12): 694-704, 2021.
Article in Chinese | WPRIM | ID: wpr-884762

ABSTRACT

Objective:To analyze the literature of Ilizarov methods, visualizing and discussing the research status, research hotspots and research trends.Methods:A bibliometric study on Ilizarov methods was performed. Using keyword "Ilizarov" and the Chinese translations to retrieve Chinese publications from CNKI database, Wanfang DATA, VIP database and SinoMed database. Using keywords "Ilizarov method, Ilizarov technique, Ilizarov treatment" to retrieve English publications from Web of Science Core Collection database before January 2021, extracting the information including author, journal, country, institution, keywords and cited times. Using the tools of bibliometrics and VOSviewer to analyze the data and draw knowledge maps.Results:A total of 1 789 Chinese publications and 1 709 English publications were included. USA, UK and China were on the top 3 list of the number of publications. Orthopaedic Journal of China, Chinese Journal of Orthopaedic Trauma, Chinese Journal of Reparative and Reconstructive Surgery, Chinese Journal of Orthopaedics, and Chinese Journal of Bone and Joint Surgery published the most literature. 7 English journals were identified as core journals in the field of Ilizarov methods, among which Clinical Orthopaedics and Related Research, Journal of Bone and Joint Surgery (British Volume), International Orthopaedics were JCR Q1 journals. According to the visualized keywords co-occurrence clusteranalysis, the research topics in Chinese literature could be sorted into 6 clusters, the latest hotspots were bone nonunion caused by infection and the treatment for the diabetic foot. In the English literature, the research topics could be sorted into 4 clusters, while the latest topics were infected and posttraumatic bone defects. Conclusion:The number of research on Ilizarov methods is increasing around the world, researches from China are gradually becoming one of the main forces. The research trends at home and at abroad are the same in essentials while differing in minor points, and researches with Chinese characteristics are developing. The strengthening of international cooperation is essential to the development of Ilizarov methods.

4.
Article in Chinese | WPRIM | ID: wpr-884466

ABSTRACT

Objective:To explore and evaluate the accuracy, conformity, and clinical application value of digital surgical techniques in guiding 125I seed implantation in the brachytherapy of deep head and neck tumors. Methods:Twelve patients with deep head and neck tumors who received brachytherapy of radioactive 125I seed implantation were selected for the study.The locations of the implantation needles and seeds were designed based on CT images before the operation.A digital positioning model was built according to the treatment plan to accurately import the planned locations of implantation needles into the surgical navigation system.Meanwhile, an individualized puncture guidance template was designed and printed according to the patients′ facial profiles as well as the locations and directions of the implantation needles.During the operation, the template was put in place under the guidance of the navigation system and meanwhile, the implantation needle puncture and radioactive seed implantation were conducted under the joint guidance of the visual needle path and real-time implantation needle locations in the navigation system and template guidance holes.The locations of the implantation needle and the seeds were validated by CT scan and the dose distribution in target areas was calculated.Adverse reactions such as hematoma, pain, infection, nonunion of puncture sites, and tumor cell implantation were observed during and after the operation. Results:All 12 patients successfully received implantation needle puncture and radioactive seed implantation under the guidance of the digital surgical techniques, achieving excellent effects of real-time visualization guidance.Meanwhile, the locations and number of the implantation needles and seeds were consistent with the treatment plan and were distributed evenly.Furthermore, according to postoperative verification, D90 ranged from 83.7 Gy to 131.0 Gy, with an average of 107.5 Gy; V100 was 89.6%-99.3%, with an average of 94.6%, and V150 ranged from 40.2% to 58.9%, averaging 47.8%.No serious adverse reactions were observed during and after the operation. Conclusions:With digital surgical techniques, the surgical navigation system and 3D-printed individualized puncture guidance template jointly guided the implantation needle puncture and 125I seed implantation, improving the accuracy and conformity of the brachytherapy.Therefore, they have clinical application value in head and neck brachytherapy, especially in deep areas with complex anatomical structures.

5.
Article in Chinese | WPRIM | ID: wpr-884465

ABSTRACT

Objective:To evaluate the efficacy of 125I interstitial brachytherapy in the treatment of local advanced parotid adenoid cystic carcinoma (ACC), and to analyze prognostic factors affecting treatment outcome, in order to provide references for the treatment of local advanced parotid adenoid cystic carcinoma. Methods:Patients with histology-confirmed ACC of the parotid who received 125I interstitial brachytherapy in Peking University Hospital of Stomatology between Aug 2007 and Jan 2018 were included.Prognostic factors affecting overall survival (OS), progression-free survival (PFS), and local control rate (LCR) were analyzed.Meanwhile, distant metastases as well as acute and long-term radiological toxicities were described. Results:A total of 16 patients (11 females, mean age 55.4 years) of stage cT 4bN 0M 0 who received definitive 125I interstitial brachytherapy were included.The median follow-up period was 41.5 months (8-104 months), and the 1-, 3- and 5-year OS were 86.7%, 72% and 54%, respectively.Five patients suffered from local recurrence, the 1-, 3- and 5-year LCR were 93.7%, 80% and 68.7%, respectively, and the 1-, 3- and 5-year PFS were 74%, 53%, and 18.9%, respectively.Nine cases developed distant metastases.Among them, intracranial and pulmonary metastases took place the most frequently and six patients who had skull base invasion developed multi-organ metastases.An encased carotid artery was an independent prognostic factor for distant metastases (HR=12, P=0.045). Severe radiological toxicities were observed in eight patients (8/16, 50%), including radio-dermatitis, hearing loss, progressive trismus, and eye toxicities. Conclusions:The 5-year LCR in patients treated with definitive 125I interstitial brachytherapy for local advanced ACC of the parotid was 68.7%, and skull base invasion and an encased carotid artery were independent adverse prognostic factors of bad prognosis and multi-organ metastases.

6.
Article in Chinese | WPRIM | ID: wpr-883830

ABSTRACT

Objective:To evaluate the value of neutrophil to lymphocyte and platelet ratio (N/LPR) for predicting 28-day mortality in sepsis patients.Methods:A retrospective analysis was conducted. The clinical data of 154 sepsis patients admitted to intensive care unit (ICU) of the Affiliated Hospital of Jiangsu University from June 2017 to June 2020 were enrolled. The time of first diagnosis of sepsis in ICU was taken as the research starting point, and the death or 28 days as the end point. The 28-day outcomes of patients were recorded. The counts of peripheral blood neutrophil (NEU), lymphocyte (LYM) and platelet (PLT) were collected from all the enrolled patients within 3 days after diagnosis of sepsis. The ratios of N/LPR and NEU/LYM (NLR) were calculated respectively. The differences of N/LPR and NLR between survival group and death group were compared. Receiver operating characteristic (ROC) curve analysis was used to analyze the value of N/LPR and NLR on predicting the 28-day mortality of sepsis patients. According to the best cut-off value of ROC curve analysis, the 28-day mortality of patients with sepsis was analyzed by subgroup analysis, and the 28-day cumulative survival of patients with sepsis was analyzed by Kaplan-Meier survival curve.Results:Of the 154 sepsis patients, the patients with age < 18 years, pregnancy, blood disease, taking aspirin or other antiplatelet drugs within 1 week, taking leucocyte drugs within 1 week, length of ICU stay < 3 days and incomplete data were excluded. Finally, 50 patients were enrolled. Among them, 30 patients survived on the 28th day and 20 died. Compared with the survival group, the levels of N/LPR and NLR in the death group were significantly increased (N/LPR: 23.85±11.99 vs. 12.41±5.25, NLR: 17.83±8.69 vs. 10.75±3.63), with statistical differences (both P < 0.01). ROC curve analysis indicated that the area under ROC curve (AUC) of N/LPR for predicting 28-day death of sepsis patients was 0.827, it was higher than that of NLR (AUC = 0.762). Base on N/LPR≥15.48 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and the specificity was 80.0%, respectively. Base on NLR≥10.65 as a predictor of cut-off value of death in 28 days of sepsis patients, the sensitivity was 75.0% and specificity was 56.7%, respectively. Subgroup analysis showed that the 28-day mortality in the patients with N/LPR≥15.48 ( n = 21) was significantly higher than those with N/LPR < 15.48 ( n = 29; 71.4% vs. 17.2%, χ 2 = 14.901, P < 0.01); and the 28-day mortality in the patients with NLR≥10.65 ( n = 28) was also significantly higher than those with NLR < 10.65 ( n = 22; 53.6% vs. 22.7%, χ 2 = 4.884, P < 0.05). The results were consistent with Kaplan-Meier survival curve analysis. Conclusion:Peripheral blood N/LPR has a good predictive value for 28-day mortality of sepsis patients, and which is better than NLR.

7.
Journal of Medical Biomechanics ; (6): E896-E902, 2021.
Article in Chinese | WPRIM | ID: wpr-920700

ABSTRACT

Objective Aiming at the problem that mechanical properties for the continuum of muscle tissues cannot be considered in active and passive behaviors of different structurally coupled muscles, a method of passive and active coupling in the same constitutive equation was proposed to construct ahyperelastic active and passive constitutive model of skeletal muscle continuum. Methods In order to calibrate parameters of the passive constitutive model, the uniaxial tensile experiment method and conditions were given, and through theoretical derivation, the specific method of using experimental data to solve the passive model parameters was introduced. In order to verify effectiveness of the active model, the model was verified with an example. Results The curves predicted by the model were in good agreement with the experimental output stress-stretch ratio curves. At the same strain, the maximum error of passive stress and total stress were only 20 kPa and 40 kPa. Conclusions The continuum hyperelastic constitutive model can better simulate active and passive behavior of skeletal muscles, which is beneficial for modeling and simulation of human muscles in further study.

8.
Article in Chinese | WPRIM | ID: wpr-867901

ABSTRACT

Objective:To report our experience in treatment of patients with orthopaedic trauma during COVID-19 epidemic.Methods:We retrospectively analyzed the 67 patients with orthopedic trauma who had been treated at Department of Orthopaedics, Peking Union Medical College Hospital from February 1 to March 31, 2020. After screening for COVID-19 infection was performed under strict protection, the patients were diagnosed and assigned to outpatient emergency treatment or hospitalization according to their specific condition. Twenty-six patients were treated at the outpatient emergency department. They were 8 males and 18 females with an average age of 69.5 years. Of them, 6 with vertebral compression fracture were placed on bed brakes, 14 with limb fracture immobilized after close reduction, 2 with skin laceration treated with debridement and suture, and 4 with hip fracture immobilized in bed. In the 41 hospitalized patients, there were 14 males and 27 females with an average age of 68.5 years. In them, hemiarthroplasty was performed for 7 femoral neck fractures, kyphoplasty for 5 vertebral compression fractures, total elbow arthroplasty for one humeral intercondylar fracture, exploration and suture for one case of Achilles tendon rupture, and internal fixation surgery for the remaining 27 cases.Results:Most of the patients had osteoporotic fractures which accounted for 61.5% (16/26) of the outpatients and 68.3% (28/41) of the inpatients, respectively. The duration from injury to surgery averaged 2.3 days and the length of hospitalization 4.5 days for the 41 hospitalized patients, decreased compared with the corresponding data (3.1 days and 11.5 days) for the similar inpatients in the same period last year. In the 41 inpatients, fever was observed upon hospitalization in 4 cases and after operation in 26 cases, and related to their primary injury or surgical trauma in all. Acute pulmonary embolism happened during operation in one patient with femoral shaft fracture.Conclusions:The prevention and control of COVID-19 should be continued. The awareness and behavior of health care providers are expected to be enhanced by strict screening protocol, protection and supervision. The proportion of elderly patients with osteoporotic fracture increased during the COVID-19 pandemic. Shortage of blood was the major problem affecting the treatment. Timely surgical treatment should be indicated for the patients with orthopedic trauma, especially those with lower extremity fracture.

9.
Article in Chinese | WPRIM | ID: wpr-866713

ABSTRACT

Objective:To study the effect of Buzhong Yiqi Recipe on the use time of ventilator in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods:From July 2017 to February 2019, 64 patients with AECOPD and respiratory failure treated in People's Hospital of Gaomi were divided into two groups according the random digital table method, with 32 cases in each group.The control group was treated with routine therapy, and the treatment group was treated with Buzhong Yiqi formula on the basis of routine therapy.The arterial blood gas index and ventilator time before and after treatment were compared between the two groups.Results:The mechanical ventilation time, intensive care unit hospitalization time of the treatment group was (14.56±3.52)d, (17.58±4.95)d, which were shorter than that those of the control group [(16.59±2.89)d, (20.37±5.62)d], and the differences were statistically significant( t=4.76, 5.04, all P<0.05). There were no statistically significant differences in arterial blood gas between the two groups after treatment(all P>0.05). Conclusion:Buzhong Yiqi Recipe can shorten the use time of ventilator in AECOPD patients with respiratory failure.

10.
Article in Chinese | WPRIM | ID: wpr-745827

ABSTRACT

Objective To analyze clinicopathological characteristics and the potential risk-related factors of female breast hyperplasia in different age groups.Method From Jan 2015 to Dec 2016,patients diagnosed with breast hyperplasia in 12 hospitals were evaluated.All patients completed the self-designed questionnaires on women'health,including basic demographic information,clinic examination information,radiologic information and pathologic results.The patients were divided into a young group (< 45 years old) and an elderly group (from 45 to 75 years old).Results There were 3 684 cases of breast hyperplasia,including 2 291 cases in young group and 1 393 cases in elder group,respectively Clinically breast pain type were most commonly observed in both young and older groups (50.3% vs.42.7%,P < 0.001).While pathological research based on biopsy showed that breast adenopathy were the most common changes in both groups (67.9% vs.61.7%,P <0.001).More breast cancer cases were identified in elder group than that in young group,especially in clinically lump type patients (9.4% vs.4.2%,P < 0.001).Compared with elder group,patients in young group have different distribution characteristics regarding to fertility factors,lifestyle factors and psychology scale including anxiety and depression.Conclusion Distributions of clinicopathological characteristics and risk factors of female breast hyperplasia differ across different age groups.

11.
Article in Chinese | WPRIM | ID: wpr-743506

ABSTRACT

Objective To explore the short-term efficacy in children with head and neck rhabdomyosarcoma (HN-RMS) treated by multidisciplinary therapy,and to analyze the prognostic factors,so as to guide the diagnosis and treatment.Methods Patients with HN-RMS admitted at Hematology Oncology Center of Beijing Children's Hospital (BCH),Capital Medical University between December 2012 and May 2017,were included in this case-observation study.The clinical characteristics were analyzed and the treatment effect and prognostic factors were summarized.Results A total of 48 cases were collected,including 36 boys and 12 girls,with a median age of 4.6 years.Primarysite parameningeal RMS(PM-RMS) (34 cases,70.8%),orbital (2 cases,4.2%) and non-orbital,non-parameningeal region(12 cases,25.0%) were found.Twenty cases belonged to alveolar type(41.7%),and 28 cases were of embryonaltype(58.3%).The diameter of the tumor was >5 cm(n =25,52.1%),and ≤5 cm(n =23,47.9%).IRS staging:there were 29 cases(60.4%) of stage Ⅱ-Ⅲ,19 cases (39.6%) of stage Ⅳ;29 cases (60.4%) of low-medium risk,and 19 cases (39.6%) of high risk.Twenty-three patients (47.9%) received surgery,and 25 cases (52.1%) received biopsy only.All patients (48 cases) received systemic chemotherapy.Twenty patients (41.6%) received external radiation,15 cases (31.3%) received 125I particle implantation,6 cases (12.5%) received proton therapy,but 3 cases (6.2%)did not receive radiation.The follow-up time lasted 13-57 months[(24.1 ± 12.3) months].The 2-year overall survival(OS) rate was (66.4 ± 7.2)%,and 2-year event free survival (EFS) rate was (59.9 ± 7.5) %.Patients with tumor diameter ≤ 5 cm had higher OS and EFS than patients with tumor diameter >5 cm [2-year OS (87.4±6.8)% vs.(42.9 ±6.8)%,2-year EFS (78.8 ±8.6%) vs.(38.5 ±10.8)%],and the differences were statistically significant (all P =0.006).Patients with orbital and non-orbital,non-parameningeal RMS had higher OS and EFS than PM-RMS [2-year OS 100% vs.(87.5% ± 11.7) % vs.(57.0 ± 8.8) %;2-year EFS 100% vs.(88.9 ± 10.5)% vs.(51.1 ± 8.9)%],and the differences were statistically significant (P =0.008,P =0.030).Patients who received surgery had higher OS and EFS than those who did not received surgery [2-year OS (80.7±8.8)% vs.(53.3 ± 10.4)%;2-year EFS (71.1 ±10.1)% vs.(49.5±10.4)%],and the differences were statistically significant (P =0.008,P =0.026).COX regression analysis showed tumor diameter > 5 cm was an adverse prognostic factor (OR =4.124,95% CI:1.213-14.025,P =0.023).Conclusions PM-RMS accounted for a high proportion in RMS patients.The primary site and the size of the tumor are the main prognostic factors.Intensive therapy is expected to improve the prognosis of HN-RMS with meningeal invasion.

12.
Article in Chinese | WPRIM | ID: wpr-774192

ABSTRACT

Three-dimensional finite element model of elbow was established to study the effect of medial collateral ligament (MCL) in maintaining the stability of elbow joint. In the present study a three-dimensional geometric model of elbow joint was established by reverse engineering method based on the computed tomography (CT) image of healthy human elbow. In the finite element pre-processing software, the ligament and articular cartilage were constructed according to the anatomical structure, and the materials and contacts properties were given to the model. In the neutral forearm rotation position and 0° flexion angle, by comparing the simulation data of the elbow joint with the experimental data, the validity of the model is verified. The stress value and stress distribution of medial collateral ligaments were calculated at the flexion angles of elbow position in 15°, 30°, 45°, 60°, 75°, 90°, 105°, 120°, 135°, respectively. The result shows that when the elbow joint loaded at different flexion angles, the anterior bundle has the largest stress, followed by the posterior bundle, transverse bundle has the least, and the stress value of transverse bundle is trending to 0. Therefore, the anterior bundle plays leading role in maintaining the stability of the elbow, the posterior bundle plays supplementary role, and the transverse bundle does little. Furthermore, the present study will provide theoretical basis for clinical recognizing and therapy of elbow instability caused by medial collateral ligament injury.


Subject(s)
Biomechanical Phenomena , Cadaver , Collateral Ligaments , Physiology , Elbow Joint , Physiology , Finite Element Analysis , Humans , Range of Motion, Articular , Tomography, X-Ray Computed
13.
Frontiers of Medicine ; (4): 267-276, 2019.
Article in English | WPRIM | ID: wpr-771316

ABSTRACT

Shenkang injection (SKI) is a classic prescription composed of Radix Astragali, rhubarb, Astragalus, Safflower, and Salvia. This treatment was approved by the State Food and Drug Administration of China in 1999 for treatment of chronic kidney diseases based on good efficacy and safety. This study aimed to investigate the protective effect of SKI against high glucose (HG)-induced renal tubular cell senescence and its underlying mechanism. Primary renal proximal tubule epithelial cells were cultured in (1) control medium (control group), medium containing 5 mmol/L glucose; (2) mannitol medium (mannitol group), medium containing 5 mmol/L glucose, and 25 mmol/L mannitol; (3) HG medium (HG group) containing 30 mmol/L glucose; (4) SKI treatment at high (200 mg/L), medium (100 mg/L), or low (50 mg/L) concentration in HG medium (HG + SKI group); or (5) 200 mg/L SKI treatment in control medium (control + SKI group) for 72 h. HG-induced senescent cells showed the emergence of senescence associated heterochromatin foci, up-regulation of P16 and cyclin D1, increased senescence-associated β-galactosidase activity, and elevated expression of membrane decoy receptor 2. SKI treatment potently prevented these changes in a dose-independent manner. SKI treatment prevented HG-induced up-regulation of pro-senescence molecule mammalian target of rapamycin and p66Shc and down-regulation of anti-senescence molecules klotho, sirt1, and peroxisome proliferator-activated receptor-g in renal tubular epithelial cells. SKI may be a novel strategy for protecting against HG-induced renal tubular cell senescence in treatment of diabetic nephropathy.


Subject(s)
Animals , Cells, Cultured , Cellular Senescence , Cyclin D1 , Metabolism , Cyclin-Dependent Kinase Inhibitor p16 , Metabolism , Diabetic Nephropathies , Drug Therapy , Drugs, Chinese Herbal , Pharmacology , Epithelial Cells , Metabolism , Glucose , Kidney Tubules, Proximal , Male , Mice , Mice, Inbred C57BL
14.
Chinese Journal of Orthopaedics ; (12): 1257-1263, 2019.
Article in Chinese | WPRIM | ID: wpr-803103

ABSTRACT

Objective@#To evaluate the feasibility of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) system to predict peri-operative risk in degenerative scoliosis patients scheduled for spinal surgery.@*Methods@#Clinical data of 227 cases with degenerative scoliosis (Male∶Female=57∶170, Mean age=66.2±7.7 years), who accepted the operation of instrumentation and fusion in our hospital from January 2013 to July 2017, were retrospectively reviewed according to the E-PASS system, including peri-operative complications. Both hospital stayand post-operative hospital staywere compared between the groups with and withoutthe complications using t test. All E-PASS scores, including Preoperative Risk Score (PRS), Surgical Stress Score (SSS) and Comprehensive Risk Score (CRS), were analyzed between the two groups using Mann-Whitney Utest.The relationship between complications and PRS, SSS and CRS were analyzed using Spearmancorrelation analysis. The predictiveaccuracy of PRS, SSS and CRS were analyzed using the area under the receiver operating characteristic (ROC) curve (AUC).@*Results@#There were a total of 47 patients (20.7%) suffering peri-operative complications, including 27 cases (11.9%) with complications at surgical sites and 23 cases (10.1%) with complications at non-surgical sites. Both hospital stay (t=-4.722, P<0.001)and post-operative hospital stay (t= -4.867, P<0.001) were increased because of the complications. All E-PASS scores, including PRS (P=0.005), SSS (P=0.003) and CRS (P<0.001) were significantly higher in patients with peri-operative complications and they were linearly correlated with the overall incidence of the complications(ρ=0.185-0.259). In particular, PRS was correlated with complications at non-surgical sites (ρ=0.162) and SSS with surgical site complications(ρ=0.162). The area under the receiver operating characteristic curve (AUC) for PRS and SSS was higher in patients with complications at non-surgical and surgical sites (AUC=0.655 and 0.650), respectively.The AUC for CRS exhibited good predictive power for both types of complications (AUC=0.662 and 0.631).@*Conclusion@#The peri-operative morbidity of spinal surgery for degenerative scoliosis was relatively higher. The E-PASS system could correctly predict the morbidity.

15.
Chongqing Medicine ; (36): 1212-1214, 2018.
Article in Chinese | WPRIM | ID: wpr-691939

ABSTRACT

Objective To investigate the application value of indomethacin in pancreatitis after endoscopic retrograde cholan-giopancreatography(ERCP)in the patients with choledocholithiasis.Methods Ninety elderly patients with choledocholithiasis were divided into the observation group and control group according to the random number table method,45 cases in each group.The two groups received the therapy of conventional ERCP scheme.The control group used diazepam,pethidine and anisodamine before op-eration.The observation group was preoperatively added with indomethacin on the basis of the control group.The therapeutic effects were analyzed and compared between the two groups.Results The number of intraoperative gastric peristalsis and operation time in the observation group were significantly lower than those in the control group(P<0.05).The level of serum amylase at postoperative 6,24 h in the observation group was significantly lower than that in the control group(P<0.05).The level of serum CRP and MMP-9 at postoperative 24 h in the observation group was significantly lower than that in the control group(P<0.05). The incidence rates of pancreatitis and hyperamylasemia in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Indomethacin can effectively reduce the number of intraoperative gastric peristalsis,postoperative hy-peramylasemia and incidence rate of acute pancreatitis,reduces the level of serum inflammatory factors,and has fewer adverse reac-tions,which is worthy of application.

16.
Chinese Journal of Stomatology ; (12): 748-752, 2018.
Article in Chinese | WPRIM | ID: wpr-807598

ABSTRACT

Objective@#To analyze the absorptive radiation dose of non-target sensitive organs under the NewTomVGi oral and maxillofacial cone-beam CT scanning in different view fields.@*Methods@#The thermoluminescence dosimeter chip was placed in the non-target sensitive organ of the simulated radiology head model, and 6 scanning fields were measured and analyzed (standard resolution: scanning range was 15 cm×15 cm, 15 cm×12 cm, 12 cm×8 cm, 8 cm×8 cm respectively). High definition resolution: the radiation absorption dose of thermoluminescence with the scanning range of 12 cm×8 cm, 8 cm×8 cm, respectively.@*Results@#Under the same resolution, the absorptive dose increased with the expansion of scanning field, and the amount of absorbent during high resolution scanning was higher than that during the standard resolution with the same scanning field.@*Conclusions@#New TomVGi oral and maxillofacial cone-beam CT has sighificant difference in radiation dose in different view fields. The appropriate view field should be selected according to the patient′s clinical needs, so as to reduce unnecessary radiation dose during medical imaging examination.

17.
Article in Chinese | WPRIM | ID: wpr-807443

ABSTRACT

Objective@#To evaluate the mental health of female doctors and nurses.@*Methods@#Investigat the psychologic status of female doctors and nurses using symptom checklist 90. And statistical software was applied to analyze results of symptom checklist 90.@*Results@#There were differences in the score of SCL-90 between doctor and nurse groups, the difference was statistically significant (P<0.05) . Negative life events (OR=2.940) , relative suffer from mental illness (OR=3.683) , shift work (OR=1.611) and heavy workload (OR=2.265) were found to risk factors for the positive of SCL-90.@*Conclusion@#There were differences in the score of SCL-90 between doctor and nurse groups. Negative life events, relative suffer from mental illness, shift workand heavy workload are risk factors for SCL-90 positive of female doctors and nurses.

18.
Article in Chinese | WPRIM | ID: wpr-708145

ABSTRACT

Objective To evaluate the influence of 125I seed implantation brachytherapy on QOL of patients with salivary gland malignant tumor which couldn't be treated by conventional surgery and its influence factors. Methods 23 patients with malignant salivary gland cancer which couldn't be treated by conventional surgery were selected from Peking University School of Stomatology from 2013 to 2017. The patients were treated by 125I seed implantation brachytherapy. EORTC QLQ-C30 ( V3. 0 ) as well as QLQ-H&N35 QOL scale ( Chinese version) were used for the assessment of post-treatment QOL. Results The survival rate of one year and three years after treatment in 23 patients was 100% and 67%, respectively. The score of the quality of life before and after treatment was 201. 48 and 199. 48, respectively. The difference was not significant after the test ( P>0. 05 ) . The level of total QOL and function score were relatively high. Among the influence factors, location of tumor significantly influenced QOL( F=9. 127,P<0. 05). Other factors still needed research based on larger sample. Conclusions 125I seed implantaion brachytherapy can better protect the head and neck function and maintain the quality of life of patients with salivary gland malignant tumor.

19.
Article in Chinese | WPRIM | ID: wpr-708040

ABSTRACT

Objective To analyze the feasibility of local target in early parotid carcinoma brachytherapy.Methods The retrospective study collected 14 early parotid gland carcinoma patients during November 2004 and February 2013 at Peking University School and Hospital of Stomatology.All of them proceeded conservative surgery and 125I interstitial brachytherapy postoperatively.According to the different target designs,the patients were divided into two groups as local target group and whole target group.The disease-free survival rate and overall survival rate were analyzed.The target volume,the number of 125I seeds and dose of crisis organs such as mandibular ramus,pharynx constrictor,cervical spinal cord,external auditory canal,middle ear,mastoid in the affected side were compared between two groups.Results After 51-116 months of follow-up,disease-free survival rate and overall survival rate in both groups were 100%.The mean D90 of CTV in local target group was(90.3 ±20.4)Gy,and (104.3 ± 10.1)Gy in whole target group.There was no statistical difference between two groups(P > 0.05),while there were statistical differences in target volume (t =5.003,P < 0.05),which were (9.2 ± 2.4) and (35.1 ± 13.5)cm3 respectively.Mean dose of organs at risk between two groups including mandibular ramus,pharynx constrictor,external auditory canal,middle ear,mastoid and maximal dose of cervical spinal cord in the affected side also had significant differences(t =3.534,4.279,3.034,3.471,7.221,6.103,P <0.05).Local target group had less target volume and less dose in organs at risk.Conclusions The conservative surgery combined with local target brachytherapy is feasible for the early low grade parotid gland carcinomas,with acceptable survival rate and less risk in organs at risk.

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Article in Chinese | WPRIM | ID: wpr-687590

ABSTRACT

Males typically have high rates of morbidity of primary bladder neck obstruction, while the existing urodynamic examination is invasive and more likely to cause false diagnosis. To build a non-invasive biomechanical detecting system for the male lower urinary tract, a finite element model for male lower urinary tract based on the collodion slice images of normal male lower urinary tract was constructed, and the fluid-structure interaction of the lower urinary tract was simulated based on the real urination environment. The finite element model of the lower urinary tract was validated by comparing the clinical experiment data with the simulation result. The stress, flow rate and deformation of the lower urinary tract were analyzed, and the results showed that the Von Mises stress and the wall shear stress at the membrane sphincter in the normal male lower urinary tract model reached a peak, and there was nearly 1 s delay than in the bladder pressure, which helped to validate the model. This paper lays a foundation for further research on the urodynamic response mechanism of the bladder pressure and flow rate of the lower urinary tract obstruction model, which can provide a theoretical basis for the research of non-invasive biomechanical detecting system.

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