Objective:To investigate the metabolic response of different load of nutrition and recombinant human growth hormone(rhGH)after major abdominal surgery. Methods:32 patients were randomly divided into three groups as fellows:Group A : low calorie load,83.68 kJ/(kg?d);Group B: low calorie load combined with rhGH,83.68 kJ/(kg?d) and rhGH 4 U/d from d1-7 after operation;Group C :high calorie load combined with rhGH,125.52 kJ/(kg?d) and rhGH 4 U/d from d1-7 after operation.The levels of serum albumin and prealbumin and the excretion of urea nitrogen in urine were measured.after operation. Results:On day 8 after operation,the level of prealbumin in group B and C were higher than in group A(P

ObjectiveTo investigate the clinical features and treatment of ascending paralysis after thoracolumbar fracture.MethodsThree male patients with 2 fracture levels at T12 and one at L1 were retrospectively studied.Their mean age was 41.3 years(range,39-42 years).All 3 cases were undertaken open decompression,reduction and internal fixation.Paralysis level began to ascend at 2-5 days after injury,with 2 cases up to C2,3 and 1 case up to T7.Two patients suffered irritating pain over the paralysis level before onset of ascending.Postoperative MRI images demonstrated well reduction and no compression of spinal cord.In the early phase after ascending,MRI obviously showed swelling in spinal cord and long T1 and long T2 signals shaped patchy and stripy distribution in the central area.One patient's MRI displayed that the spinal cord shrinked 16 days after trauma with abnormal high signal in the central area.ResultsTwo cases died of respiratory muscle paralysis and 1 case suffered paraplegia with no recovery 5 years after surgery.ConclusionAscending paralysis after thoracolumbar fracture is a rare complication with very poor prognosis.MRI is available for evaluating operational effects and affected level.The exact mechanism and effective treatment are still unclear and need further investigated.

Objective To screen strains of minipigs sensitive to highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV) for evaluation of HP-PRRS live vaccine.Methods Lantang pigs, Juema, Bama and Wuzhishan ( white) minipigs were inoculated with virulent strain NVDC-JXA1 of PRRSV, and local binary hybrid pigs were used as control.The animals were continuously observed for 5 weeks on mental status, appetite, survival, etc.after inoculation of virus.The dead pigs were autopsied and the lung tissue samples were collected for detecting virus by RT-PCR.By the end of the experiment, serum of survival animals were collected for detecting PRRSV antibody by ELISA assay.Result The animals showed depression, anorexia, and other clinical signs and death in each group after inoculation.Meanwhile, the testing results were all positive in the RT-PCR and ELISA detection.Bama and Wuzhishan ( white) minipigs were the most sensitive to virulent strain NVDC-JXA1 of PRRSV regarding mortality rate.Conclusions Bama and Wuzhishan ( white) minipigs are sensitive to HP-PRRSV, and can be used for the inspection of HP-PRRS live vaccine.

In order to assess the thermal effect of different holmium laser fiber during lithotripsy with WOLF F4.5/6.5 pediatric ureteroscope, we established an impacted ureter calculi model. Under 100mmHg irrigation pressure, regional temperature of different holmium laser fiber with varied working time and power were recorded. We found that the regional temperature was related with laser fiber diameters, power and working time settings. With 550 μm laser fiber, laser firing time longer than 3 s or 365 μm laser fiber firing more than 6 s, regional temperature exceeded 42℃, which would bring thermal injury towards ureter and subsequently cause ureter stricture.

Spinal cord injury is a catastrophic injury causing lifelong severe disabilities, and poses a great burden to the individuals, families and society. In order to promote the standardization in treatment of traumatic spinal cord injury, the consensus on the evaluation, treatment and rehabilitation of traumatic spinal cord injury was suggested by experts, who came from authoritative multicenter in China. The expert consensus, which formed a standardization process from the first aid clinical treatment to rehabilitation of spinal cord injury, shall give a better practical guide for clinic and rehabilitation physicians.

OBJECTIVE: To investigate the effectiveness of preemptive analgesia with imrecoxib on analgesia after anterior cruciate ligament (ACL) reconstruction. METHODS: A total of 160 patients with ACL injuries who met the selection criteria and were admitted between November 2020 and August 2021 were selected and divided into 4 groups according to the random number table method (n=40). Group A began to take imrecoxib 3 days before operation (100 mg/time, 2 times/day); group B began to take imrecoxib 1 day before operation (100 mg/time, 2 times/day); group C took 200 mg of imrecoxib 2 hours before operation (5 mL of water); and group D did not take any analgesic drugs before operation. There was no significant difference in gender, age, body mass index, constituent ratio of meniscal injuries with preoperative MRI grade 3, constituent ratio of cartilage injury Outerbridge grade 3, and visual analogue scale (VAS) score at the time of injury and at rest among 4 groups (P>0.05). The operation time, hospitalization stay, constituent ratio of perioperative American Society of Anesthesiologists (ASA) grade 1, postoperative opioid dosage, and complications were recorded. The VAS scores were used to evaluate the degree of knee joint pain, including resting VAS scores before operation and at 6, 24, 48 hours, and 1, 3, 6, and 12 months after operation, and walking, knee flexion, and night VAS scores at 1, 3, 6, and 12 months after operation. The knee injury and osteoarthritis score (KOOS) was used to evaluate postoperative quality of life and knee-related symptoms of patients, mainly including pain, symptoms, daily activities, sports and entertainment functions, knee-related quality of life (QOL); and the Lysholm score was used to evaluate knee joint function. RESULTS: All patients were followed up 1 year. There was no significant difference in operation time, hospitalization time, or constituent ratio of perioperative ASA grade 1 among 4 groups (P>0.05); the dosage of opioids in groups A-C was significantly less than that in group D (P<0.05). Except for 1 case of postoperative fever in group B, no complications such as joint infection, deep vein thrombosis of the lower extremities, or knee joint instability occurred in each group. The resting VAS scores of groups A-C at 6 and 24 hours after operation were lower than those of group D, and the score of group A at 6 hours after operation was lower than those of group C, and the differences were significant (P<0.05). At 1 month after operation, the knee flexion VAS scores of groups A-C were lower than those of group D, the walking VAS scores of groups A and B were lower than those of groups C and D, the differences were significant (P<0.05). At 1 month after operation, the KOOS pain scores in groups A-C were higher than those in group D, there was significant difference between groups A, B and group D (P<0.05); the KOOS QOL scores in groups A-C were higher than that in group D, all showing significant differences (P<0.05), but there was no significant difference between groups A-C (P>0.05). There was no significant difference in VAS scores and KOOS scores between the groups at other time points (P>0.05). And there was no significant difference in Lysholm scores between the groups at 1, 3, 6, and 12 months after operation (P>0.05). CONCLUSION Compared with the traditional analgesic scheme, applying the concept of preemptive analgesia with imrecoxib to manage the perioperative pain of ACL reconstruction can effectively reduce the early postoperative pain, reduce the dosage of opioids, and promote the early recovery of limb function.
Humans ; Quality of Life ; Analgesics, Opioid ; Analgesia ; Osteoarthritis, Knee ; Pain, Postoperative/prevention & control* ; Anterior Cruciate Ligament Reconstruction ; Knee Injuries

Antineoplastic Agents ; chemistry ; pharmacology ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; pathology ; Cytokines ; immunology ; Drug Screening Assays, Antitumor ; Glypicans ; antagonists & inhibitors ; immunology ; Humans ; Ligands ; Liver Neoplasms ; drug therapy ; immunology ; pathology ; T-Lymphocytes ; drug effects ; immunology

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.