The application value of spectral CT venography in the display and staging of deep venous thrombosis in the lower extremity / 实用放射学杂志

Objective To investigate the application value of spectral computed tomography venography(CTV)in the display and staging of deep venous thrombosis(DVT)in the lower extremity.Methods Eighty-two patients with CTV were selected and ran-domly divided into group A(42 patients)and group B(40 patients).Group A:tube voltage 120 kVp.Group B:gemstone spectral ima-ging(GSI)mode,reconstruction of 50 keV and iodine(water)maps.The CT and standard deviation(SD)values of the veins were measured,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated in 120 kVp images of group A and in 50 keV images of group B.Two observers scored the image quality of the 2 groups subjectively,and Kappa test was used to examine the con-sistency.Based on the duration from the occurrence of clinical symptoms,the DVTs were classified.The CT values and iodine con-centration(IC)of DVT were measured in the 120 kVp images of group A and in the iodine(water)maps of group B,respectively.The receiver operating characteristic(ROC)curve was drawn to compare the effectiveness of CT values and IC in diagnosing DVT staging.Results CT values,SNR,and CNR of veins in group B were higher than those in group A(P<0.05).The subjective scores of the two groups were consistent(Kappa=0.926-0.955,P<0.05).The score for the display of veins and thrombus clarity in group B was 5(4,5),which was better than the score of 4(3,4)in group A(P<0.05).The efficiency of IC in diagnosing DVT staging[area under the curve(AUC)=0.973]was better than that of CT values(AUC=0.891).Conclusion The spectral CTV can improve the contrast of lower extremity deep veins and the clarity of thrombus,and can provide more objective indicators for the diagnosis of thrombus staging,which is conducive to accurate clinical diagnosis and treatment.

The comparative study on the extraction methods of exosomes from synovial fibroblasts in patients with rheumatoid arthritis / 中华风湿病学杂志

Objective:To compare the efficiency and purity of exosomes extracted from synovial fibroblasts of patients with rheumatoid arthritis by ultracentrifugation, size exclusion chromatography and modified polymer precipitation.Methods:The exosomes were extracted from human synovial fibroblasts by ultracentrifugation, size exclusion chromatography and modified polymer precipitation. Transmission electron microscopy, particle size detection and western Blot were used to identify the morphological characteristics, particle size distribution, concentration, and expression of marker proteins. One-way analysis of variance (ANOVA) was used for comparison among the three groups, and LSD- t test was used for pairwise comparison. P<0.05 was considered statistically significant. Results:Exosomes could be successfully obtained with all three extraction methods. The typical "saucer-like" structure could be observed under transmission electron microscope. The marker proteins of exosomes TSG101, Syntenin-1 and CD63 were all detectable by western blot. The peaks of main particle size were located within 30~150 nm. As for purity, the exosomes obtained by ultracentrifugation showed the highest purity, while modified polymer precipitation was the worst, with a large number of polymer particles and impurities protein. The purity of exosomes obtained by size exclusion chromatography was the moderate. For extraction efficiency, concentrations of exosomes particles obtained by the three methods were different ( F=9.61, P=0.049), and modified polymer precipitation was significantly higher than ultracentrifugation in terms of concentration of exosomes particles [(98.0±17.0)×10 10 particles/ml vs (11.6±7.7)×10 10 particles/ml, t=-4.34, P=0.023]. Conclusion:Human synovial fibroblasts derived exosomes canbe obtained by three methods. Ultracentrifugation is time-consuming, but can produce high-purity exosomes, which may be considered in the situation when high purity requirement with large volume samples are needed. Size exclusion chromatography is a good choice with high yield and purity exosomes, and suitable for small volume samples. Modified polymer precipitation is not recommended due to production of lowest purity exosomes.

Design and implementation of Internet of Things for emergency medical devices based on cloud-edge-device architecture / 生物医学工程学杂志

Internet of Things (IoT) technology plays an important role in smart healthcare. This paper discusses IoT solution for emergency medical devices in hospitals. Based on the cloud-edge-device architecture, different medical devices were connected; Streaming data were parsed, distributed, and computed at the edge nodes; Data were stored, analyzed and visualized in the cloud nodes. The IoT system has been working steadily for nearly 20 months since it run in the emergency department in January 2021. Through preliminary analysis with collected data, IoT performance testing and development of early warning model, the feasibility and reliability of the in-hospital emergency medical devices IoT was verified, which can collect data for a long time on a large scale and support the development and deployment of machine learning models. The paper ends with an outlook on medical device data exchange and wireless transmission in the IoT of emergency medical devices, the connection of emergency equipment inside and outside the hospital, and the next step of analyzing IoT data to develop emergency intelligent IoT applications.

Flare and change in disease activity among patients with stable rheumatoid arthritis following coronavirus disease 2019 vaccination: A prospective Chinese cohort study / 中华医学杂志(英文版)

BACKGROUND@#Vaccination has been shown effective in controlling the global coronavirus disease 2019 (COVID-19) pandemic and reducing severe cases. This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis (RA).@*METHODS@#A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status. Each of them was examined every 3 to 6 months. In the vaccination group, disease activity was compared before and after vaccination. The rates of flare defined as disease activity scores based on 28-joint count (DAS28) >3.2 with ΔDAS28 ≥0.6 were compared between vaccination and non-vaccination groups.@*RESULTS@#A total of 202 eligible RA patients were enrolled. Of these, 98 patients received no vaccine shot (non-vaccination group), and 104 patients received two doses of vaccine (vaccination group). The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days, respectively. The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar. At enrollment, gender, RA disease course, seropositivity, and disease activity were comparable across the two groups. Flare was observed in five (4.8%) of the vaccination group patients and nine (9.2%) of the non-vaccination group patients at post-vaccination assessment ( P  = 0.221). In terms of safety, 29 (27.9%) patients experienced adverse events (AEs) after vaccination. No serious AEs occurred.@*CONCLUSIONS@#COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity. Patients with stable RA should be encouraged to receive the COVID-19 vaccination.

Development of intelligent monitoring system based on Internet of Things and wearable technology and exploration of its clinical application mode / 生物医学工程学杂志

Wearable monitoring, which has the advantages of continuous monitoring for a long time with low physiological and psychological load, represents a future development direction of monitoring technology. Based on wearable physiological monitoring technology, combined with Internet of Things (IoT) and artificial intelligence technology, this paper has developed an intelligent monitoring system, including wearable hardware, ward Internet of Things platform, continuous physiological data analysis algorithm and software. We explored the clinical value of continuous physiological data using this system through a lot of clinical practices. And four value points were given, namely, real-time monitoring, disease assessment, prediction and early warning, and rehabilitation training. Depending on the real clinical environment, we explored the mode of applying wearable technology in general ward monitoring, cardiopulmonary rehabilitation, and integrated monitoring inside and outside the hospital. The research results show that this monitoring system can be effectively used for monitoring of patients in hospital, evaluation and training of patients' cardiopulmonary function, and management of patients outside hospital.

Early efficacy of three dimensional printed anatomical biomimetic cervical artificial disc replacement in the treatment of cervical degenerative diseases / 中华外科杂志

Objective: To investigate the efficacy and safety of a new cervical artificial disc prosthesis in the treatment of cervical degenerative diseases. Methods: The clinical data of 18 patients with single-level cervical degenerative diseases who underwent three dimensional printed anatomical bionic cervical disc replacement at Department of Spinal Surgery,Honghui Hospital,Xi'an Jiaotong University from May 2019 to July 2020 were analyzed retrospectively. There were 7 males and 11 females,aged (45±8) years old(range:28 to 58 years).The surgical segment was located at C3－4 level in 2 cases, C4－5 level in 5 cases, C5－6 level in 9 cases, and C6－7 level in 2 cases.The clinical and radiographic outcomes were recorded and compared at preoperative,postoperative times of one month and twelve months.The clinical assessments contained Japanese orthopedic association (JOA) score,neck disability index (NDI) and visual analogue scale (VAS).Imaging assessments included range of motion (ROM) of cervical spine, prosthesis subsidence and prosthesis anteroposterior migration.Repeated measurement variance analysis was used for comparison between groups,and paired t test was used for pairwise comparison. Results: All patients underwent the operation successfully and were followed up for more than 12 months.Compared with preoperative score,the JOA score,NDI and VAS were significantly improved after surgery (all P<0.01).There was no significant difference in postoperative ROM compared with 1-and 12-month preoperative ROM (t=1.570,P=0.135;t=1.744,P=0.099). The prosthesis subsidence was (0.29±0.13) mm (range: 0.18 to 0.50 mm) at 12-month postoperatively.The migration of prosthesis at 12-months postoperatively were (0.71±0.20) mm (range: 0.44 to 1.08 mm).There was no prosthesis subsidence or migration>2 mm at 12-month postoperatively. Conclusion: Three dimensional printed anatomical biomimetic cervical artificial disc replacement has a good early clinical effect in the treatment of cervical degenerative diseases, good mobility can be obtained while maintaining stability.

Feasibility of individualized low radiation dose chest enhanced CT imaging: phantom and clinical study / 中华放射医学与防护杂志

Objective:To investigate the effect of the combination of Auto-prescription and ODM full on image quality and radiation dose of chest enhanced CT inorder to explore the feasibility of individualized low radiation dose chest enhanced CT. Methods:The phantoms PH-75 in two sizes were scanned with four scanning modes: group A, 120 kVp + Smart-mA; group B, 120 kVp + Smart-mA+ ODM full; group C, Auto-prescription + Smart-mA; group D, Auto-prescription + Smart-mA+ ODM full. The images of each group were reconstructed with 40%-80% ASIR-V (interval 20%), recorded as A 1-3-D 1-3. Image quality and radiation dose were evaluated in order to obtain optimal scanning modes. Totally 35 cases(from the First Hospital of Dalian Medical University during November 2021 to July 2022) of chest enhancement CT were collected prospectively in the clinical study using the parameters of D 2 group recorded as D patients. Patients in this group received chest enhancement CT scanning for the second time within three months. The CT parameters in first enhanced scanning recorded as A patient were as same as those in group A 1, and the parameters in second scanning recorded as D patient were as same as those in group D 2. The SNRs, CNRs, subjective grading and imaging findings of the lesion in two groups were compared. Results:In phantom study, the radiation dose of each group was statistically significant, and that in D group was the lowest. For two sizes of phantoms, A 1 was uesd as the control group in pairwise comparison. The SDs of B 1, C 1, and D 2 images had no statistical difference with that of A 1 ( P > 0.05), and SD of D 1was higher than that of A 1, and SDs of other groups were lower than that of A 1( F=10.77, 122.50, P<0.05). CNR of B 1 had no statistical difference with that of A 1, and the CNRs of other groups were higher( F=136.20, 30.21, P<0.05). Subjective scores of A 2, C 2, D 2 had no statistical difference with that of A 1 and those of other groups were lower than that of A 1( H=52.89, 43.95, P<0.05). In clinical study, 80 kVp was uesd for 22 cases and 100 kVp was used for 13 cases in D patients group. SNRs and CNRs in the D patients group were all higher than those in the A patients group ( P > 0.05). The consistency of image quality scores for two observers was good ( kappa = 0.754, P < 0.05). The median scores of the two groups were (4, 4). Conclusion:Auto-prescription combined with ODM full in chest enhanced CT imaging can achieve individualized low radiation dose with meeting the requirements of image quality and clinical diagnosis.

Advances on immune-related adverse events associated with immune checkpoint inhibitors / 医学前沿

Immunotherapy has recently led to a paradigm shift in cancer therapy, in which immune checkpoint inhibitors (ICIs) are the most successful agents approved for multiple advanced malignancies. However, given the nature of the non-specific activation of effector T cells, ICIs are remarkably associated with a substantial risk of immune-related adverse events (irAEs) in almost all organs or systems. Up to 90% of patients who received ICIs combination therapy experienced irAEs, of which majority were low-grade toxicity. Cytotoxic lymphocyte antigen-4 and programmed cell death protein-1/programmed cell death ligand 1 inhibitors usually display distinct features of irAEs. In this review, the mechanisms of action of ICIs and how they may cause irAEs are described. Some unsolved challenges, however really engrossing issues, such as the association between irAEs and cancer treatment response, tumor response to irAEs therapy, and ICIs in challenging populations, are comprehensively summarized.

Machine Learning-Based Prediction of COVID-19 Severity and Progression to Critical Illness Using CT Imaging and Clinical Data

Objective@#To develop a machine learning (ML) pipeline based on radiomics to predict Coronavirus Disease 2019 (COVID-19) severity and the future deterioration to critical illness using CT and clinical variables. @*Materials and Methods@#Clinical data were collected from 981 patients from a multi-institutional international cohort with real-time polymerase chain reaction-confirmed COVID-19. Radiomics features were extracted from chest CT of the patients. The data of the cohort were randomly divided into training, validation, and test sets using a 7:1:2 ratio. A ML pipeline consisting of a model to predict severity and time-to-event model to predict progression to critical illness were trained on radiomics features and clinical variables. The receiver operating characteristic area under the curve (ROC-AUC), concordance index (C-index), and time-dependent ROC-AUC were calculated to determine model performance, which was compared with consensus CT severity scores obtained by visual interpretation by radiologists. @*Results@#Among 981 patients with confirmed COVID-19, 274 patients developed critical illness. Radiomics features and clinical variables resulted in the best performance for the prediction of disease severity with a highest test ROC-AUC of 0.76 compared with 0.70 (0.76 vs. 0.70, p = 0.023) for visual CT severity score and clinical variables. The progression prediction model achieved a test C-index of 0.868 when it was based on the combination of CT radiomics and clinical variables compared with 0.767 when based on CT radiomics features alone (p < 0.001), 0.847 when based on clinical variables alone (p = 0.110), and 0.860 when based on the combination of visual CT severity scores and clinical variables (p = 0.549). Furthermore, the model based on the combination of CT radiomics and clinical variables achieved time-dependent ROC-AUCs of 0.897, 0.933, and 0.927 for the prediction of progression risks at 3, 5 and 7 days, respectively. @*Conclusion@#CT radiomics features combined with clinical variables were predictive of COVID-19 severity and progression to critical illness with fairly high accuracy.

Machine Learning-Based Prediction of COVID-19 Severity and Progression to Critical Illness Using CT Imaging and Clinical Data

Objective@#To develop a machine learning (ML) pipeline based on radiomics to predict Coronavirus Disease 2019 (COVID-19) severity and the future deterioration to critical illness using CT and clinical variables. @*Materials and Methods@#Clinical data were collected from 981 patients from a multi-institutional international cohort with real-time polymerase chain reaction-confirmed COVID-19. Radiomics features were extracted from chest CT of the patients. The data of the cohort were randomly divided into training, validation, and test sets using a 7:1:2 ratio. A ML pipeline consisting of a model to predict severity and time-to-event model to predict progression to critical illness were trained on radiomics features and clinical variables. The receiver operating characteristic area under the curve (ROC-AUC), concordance index (C-index), and time-dependent ROC-AUC were calculated to determine model performance, which was compared with consensus CT severity scores obtained by visual interpretation by radiologists. @*Results@#Among 981 patients with confirmed COVID-19, 274 patients developed critical illness. Radiomics features and clinical variables resulted in the best performance for the prediction of disease severity with a highest test ROC-AUC of 0.76 compared with 0.70 (0.76 vs. 0.70, p = 0.023) for visual CT severity score and clinical variables. The progression prediction model achieved a test C-index of 0.868 when it was based on the combination of CT radiomics and clinical variables compared with 0.767 when based on CT radiomics features alone (p < 0.001), 0.847 when based on clinical variables alone (p = 0.110), and 0.860 when based on the combination of visual CT severity scores and clinical variables (p = 0.549). Furthermore, the model based on the combination of CT radiomics and clinical variables achieved time-dependent ROC-AUCs of 0.897, 0.933, and 0.927 for the prediction of progression risks at 3, 5 and 7 days, respectively. @*Conclusion@#CT radiomics features combined with clinical variables were predictive of COVID-19 severity and progression to critical illness with fairly high accuracy.

Preschool period neurodevelopmental follow-up in children underwent antergrade cerebral perfusion / 中华胸心血管外科杂志

Objective:To investigate the preschool period neurodevelopmental status and analyze the perioperative data which associated with delayed neurodevelopment in patients underwent antergrade cerebral perfusion(ACP).Methods:To access the preschool period neurodevelopmental status in patients underwent ACP using Griffiths mental development scale-Chinese(GDS-C). Patients were classified as normal development group(ND) and low development group(LD) depending on the outcomes of assessment. Perioperative data including age, weight, CPB time, aortic cross-clamp time, mean arterial pressure, ACP time and flow were analyzed retrospectively.Results:62 children who met the inclusion criteria, of which 19 were accessed by GDS-C scale. Fourteen cases were lagged in general quotient(GQ) compared with normal children. The outcomes of assessment in six subscales of GDS-C scale indicated that 13 cases were delayed in language(C) and practical reasoning(F). Eight cases were delayed in locomotor(A) and personal-social(B). Eleven cases were delayed in eye-hand coordination(D). Ten cases were delayed in performance(E). The children in LD group had significant longer CPB time and aortic cross-clamp time than those in ND group. There were no differences between two groups in other perioperative data.Conclusion:The incidence of preschool period neurodevelopmental delay after ACP in infants is relatively high. In detailed analysis, their language and practical reasoning ability are lagged significantly. In addition, the longer time of CPB and aortic cross-clamp are associated with the neurodevelopmental delay.

Systemic lupus erythematosus: year in review 2019 / 中华医学杂志(英文版)

Systemic lupus erythematosus (SLE) is an autoimmune disease with extreme heterogeneity and potentially involvement of any organ or system. Numerous unanswered questions and challenges in SLE always prompt further exploration. In 2019, great progress in various aspects of SLE emerged. Both the classification criteria and management recommendation for SLE were updated. New promising medications have been widely developed and tested, although subsequent clinical studies are warranted. As an emerging number of most notable studies in SLE were published in both clinical area and basic research in 2019, we aim to summarize the highest quality data on SLE regarding novel insights of pathogenesis, updated recommendations, hot-spot issues on clinical manifestations, new understanding of disease prognosis, and most importantly, the therapeutic advances in SLE in this review.

Infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position / 中华消化外科杂志

Minimally invasive technique has been widely applied and recognized in gastrointestinal surgery. In recent years, technological innovation related to minimally invasive technology emerges in endlessly. The application of 4K ultra-high definition video display technology has played impartment roles in promoting the development of surgery, technical specifications and training of minimally invasive gastrointestinal surgery. Clearly understand the anatomical structure of the inferior pyloric region is an important theoretical basis for the dissection of No. 6 lymph node. Careful anatomy with good patience of the surgeons, and good cooperation between the surgeon and assistants are helpful to reduce and prevent complications. The authors investigate the infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position.

Lymph node dissection along the left gastroepiploic vessels region in 4K laparoscopic radical gastrectomy with the surgeon on right position / 中华消化外科杂志

Minimally invasive surgery is widely adopted and recognized. In recent years new technologies of minimally invasive surgery emerge in endlessly. Application of 4K laparoscopy promotes the development, stangardization and training of minimally invasive surgery for gastrointestinal and colorectal diseases. Clear understanding of the anatomical structure of left gastroepiploic vessels is helpful for No.4 lymph node dissection. The surgeon′s accurate anatomy, good patience, and the high degree of coordination between surgeons and nurses help to reduce and prevent complications. The authors elaborates on lymph node dissection along the left gastroepiploic vessels region in 4K laparoscopic radical gastrectomy with the surgeon on right position

Infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position / 中华消化外科杂志

Minimally invasive technique has been widely applied and recognized in gastrointestinal surgery. In recent years, technological innovation related to minimally invasive technology emerges in endlessly. The application of 4K ultra-high definition video display technology has played impartment roles in promoting the development of surgery, technical specifications and training of minimally invasive gastrointestinal surgery. Clearly understand the anatomical structure of the inferior pyloric region is an important theoretical basis for the dissection of No. 6 lymph node. Careful anatomy with good patience of the surgeons, and good cooperation between the surgeon and assistants are helpful to reduce and prevent complications. The authors investigate the infrapyloric lymph node dissection in 4K laparoscopic radical gastrectomy with the surgeon on right position.

Lymph node dissection along the left gastroepiploic vessels region in 4K laparoscopic radical gastrectomy with the surgeon on right position / 中华消化外科杂志

Minimally invasive surgery is widely adopted and recognized. In recent years new technologies of minimally invasive surgery emerge in endlessly. Application of 4K laparoscopy promotes the development, stangardization and training of minimally invasive surgery for gastrointestinal and colorectal diseases. Clear understanding of the anatomical structure of left gastroepiploic vessels is helpful for No.4 lymph node dissection. The surgeon′s accurate anatomy, good patience, and the high degree of coordination between surgeons and nurses help to reduce and prevent complications. The authors elaborates on lymph node dissection along the left gastroepiploic vessels region in 4K laparoscopic radical gastrectomy with the surgeon on right position

Management of postoperative recurrence of inguinal hernia in adolescents: An analysis of 9 cases / 中国实用外科杂志

OBJECTIVE: To analyze the reoperation method and effect of recurrent inguinal hernia in adolescents after operation. METHODS: The data of 9 adolescent(13 to 18 years old) inguinal hernia patients with recurrence after surgical treatment admitted in the first people's hospital of Foshan from January 2006 to December 2018 were analyzed retrospectively. The methods of previous operation, reoperation, size of internal ring, major postoperative complications and recurrence rate were collected. RESULTS: Among the 170 adolescent patients who underwent inguinal hernia surgery,there were 9 cases of recurrent indirect inguinal hernia(the previous operation method was high ligation of the internal ring), including 2 cases of open surgery and 7 cases of laparoscopic surgery. Of the 9 patients, 3 had multiple recurrences and 6 had first recurrence. The sizes of internal ring were 0.3 to 3.0 cm in the operation. Surgical methods: 4 cases were performed with laparoscopic high ligation of internal ring, with the sizes of internal ring ranging from 0.3 cm to 2.0 cm. Laparoscopic inguinal hernia mesh repair was performed in 5 patients(3 patients with multiple recurrences)with the sizes of internal ring ranging from 1.5 cm to 3.0 cm. During the follow-up period of 6 months to 10 years, no wound or mesh infection, 3 patients showed discomfort in the inguinal area, 2 patients had mesh repair and 1 patient had high ligation. Seroma appeared in 1 patient which was repaired by mesh. One case of recurrence which was mesh repair.CONCLUSION: The choice of surgical method for recurrent inguinal hernia in adolescents should be based on the previous surgical method, recurrence frequency and the presence of large internal ring defect or transverse abdominal fascia defect. Laparoscopic high ligation is recommended for patients with primary recurrence of small internal ring defect. For patients with multiple recurrence or large internal ring defect, mesh repair is recommended.

Preparation of Polydiallyl Dimethyl Ammonium Chloride Modified Reduced Graphene Oxide/Zinc Oxide Composite Materials and Its Application in Detection of Uric Acid / 分析化学

By using Zinc nitrate as precursor and hydraZine hydrate as reducing agent, polydiallyl dimethyl ammonium chloride modified reduced graphene oxide/Zinc oxide composite materials ( PDDA-rGO/ZnO) were prepared by simultaneous reduction of graphene oxide ( GO) and Zinc nitrate.The composite materials were characteriZed by Fourier transform infrared ( FTIR ) spectroscopy, X-ray diffractometer ( XRD ) and transmission electron microscopy ( TEM) , and their electrochemical catalytic activity for uric acid was studied by cyclic voltammetry ( CV ) and linear sweep voltammetry ( LSV ) measurements.The result showed that PDDA-rGO/ZnO modified glassy carbon electrode prepared here was sensitive, reproducible and stable, and had significant electrocatalytic activity for UA.When using linear sweep voltammetry for detection of UA, the responses of modified electrode were linear with UA concentration in the ranges of 0.02-0.1 mmol/L and 0.1-1.0 mmol/L respectively, with detection limit of 15.9 nmol/L (S/N=3).

Different observations of absorbable hemostatic membrane and hemostatic membrane in transforaminal lumbar interbody fusion / 实用医学杂志

Objective To investigate the effect of absorbable hemostatic membrane on hemostasis in lum-bar surgery.Methods From 2014 to 2015 in our department,40 patients(mainly for lumbar spinal stenosis and lumbar spondylolisthesis patients)were enrolled in lumbar surgery(via transforaminal interbody fusion,TLIF), and were rando mLy divided into the absorbable hemostatic membrane group and the ordinary hemostasis group. The volume of 24-hour incision drainage and the hemoglobin of preoperative and 1 day postoperation were compared between the two groups. Results Compared with the control group,the volume of incision drainage and hemoglobin in the absorbable hemostatic membrane group were significantly decreased at 24 hours after surgery. Conclusions The hemostatic effect of absorbable hemostatic membrane is very good in lumbar surgery,absorb-able hemostatic membrane is worthy of application in spinal surgery.

Curative effect analysis on improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture / 局解手术学杂志

Objective To discuss the clinical effects of improved medial parapatellar approach in the treatment of posterior medial tibial plateau fracture( PMF-TP) . Methods 60 patients with PMF-TP were selected from June 2014 to June 2017 in our hospital;according to the surgical methods,all patients were divided into improved group (30 cases) and medial group (30 cases);the medial group was treated with routine medial approach, while the improved group was treated with improved medial parapatellar approach. The operation, complications, fracture reduction and knee joint function were compared between the two groups. The amount of bleeding,the incidence of complications and the operation,hospitalization,weight bearing exercise and fracture healing time of improved group were significantly lower than those in the after the operation, the knee flexion and extensional activity of improved group was significantly higher than that in the medial group,the difference was statistically significant(P<0. 05). The fracture re-duction and knee joint function excellent rate 6 months after operation of improved group were significantly higher than those in the medial group,the difference was statistically significant(P<0. 05). Results Compared with the posteromedial approach of the knee joint, the im-proved medial parapatellar approach features simple and safe operation. It is beneficial to early functional exercise, fracture reduction and re-habilitation of knee joint function.