Adolescent ; Adult ; Aged ; Child ; Drainage ; nursing ; Female ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Soft Tissue Injuries ; surgery ; Vacuum

Objective:To analyze the biomechanical stress distribution on the sagittal fractured of the mandibular condyle(SFMC) fixed by double plates in 3 different ways.Methods:The fixation finite element models with double straight plates(SS),one straight and one L-form plates(SL),and double L-form plates(LL)were established.The biomechanical stresses on condyle were calculated with finite element analysis.Results:In the model of SS fixation the maximum equivalent stress (MES),maximum total displacement (MTD)and maximum total corner(MTC)of condylar stump were 525.475 MPa,0.902 2 mm and 0.260 1°;MES,MTD,and MTC on fractured free-end were 4.425 MPa,0.882 7 mm and 0.019 9°,respectively.In the model of SL fixation MES,MTD and MTC on condylar stump were 1 135 MPa,0.9367 mm and 0.126 1°;MES,MTD and MTC on fractured free-end were 2.656 MPa,0.887 1 mm and 0.016 9°,respectively.In the model of LL fixation MES,MTD and MTC on condylar stump were 2 208 MPa,0.923 8 mm and 0.172 2°;MES,MTD and MTC on fractured free-end were 14.66 8 MPa,0.876 6 mm and 0.018 1°,respectively.Conclusion:Double L plates fixation is a proper way for SFMC.

OBJECTIVE: To evaluate the effect of femoral I.D.E.A.L localization in single bundle anterior cruciate ligament reconstruction (ACLR). METHODS: From January 2019 to October 2022, 122 patients with anterior cruciate ligament injury were treated with ACLR, including 83 males and 39 females. The age ranged from 23 to 43 years old, with an average of (32.19 ±8.55) years old. The course of disease ranged from 1 week to 6 months. According to the different surgical schemes, the patients were divided into two groups, namely the traditional group, which adopted the over-the-top femoral lateral positioning scheme, including 64 patients. The I.D.E.A.L group adopted the I.D.E.A.L femoral lateral positioning scheme, including 58 patients. The patient has pain and dysfunction of knee joint before operation. MRI of knee joint indicates anterior cruciate ligament injury. The visual analogue scale(VAS), International Knee Documentation Committee(IKDC) scoring system and Lysholm scoring system were used to evaluate the knee joint function of the patient. KT-2000 was used to detect the recovery of knee joint after operation and to count the postoperative complications. RESULTS: The wounds healed well after operation. One hundred and twenty-tow patients were followed up for 15 to 46 months, with an average of (25.45±9.22) months. The knee joint stability of patients after operation was significantly increased. The VAS at 1 day and 1 week after operation of patients in the I.D.E.A.L group was significantly lower than that in the traditional group(P<0.05). The IKDC score and Lysholm score of patients in the I.D.E.A.L group were significantly higher than those in the traditional group(P<0.05). In the traditional group, there were 6 cases of short-term (<1 month) complications and 19 cases of long-term (≥1 month)complicatios. In the I.D.E.A.L group, there were 3 cases of short-term complications and 7cases of long-term complications(P<0.05). CONCLUSION The single bundle anterior cruciate ligament reconstruction and femoral I.D.E.A.L positioning can achieve better early postoperative effect and reduce early postoperative pain.
Male ; Female ; Humans ; Young Adult ; Adult ; Anterior Cruciate Ligament/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Treatment Outcome ; Knee Joint/surgery* ; Anterior Cruciate Ligament Reconstruction

Objective To investigate the abnormal region of gray matter and distribution in patients with Parkinson’s disease (PD),and explore the brain structural changes closely related to mild cognitive impairment(MCI).Methods 20 cases of PD-MCI, 1 7 cases of PD-nMCI and 20 normal controls (NC)were examined by 3D-T1 WI brain volume sequence.The data of three groups were analyzed using voxel-based morphometry(VBM)based on SPM8 to generate gray matter map.Results Compared to NC,decreased gray matter volume in PD-nMCI was observed in the right temporal lobe,including the middle temporal gyrus,inferior temporal gyrus,and right fusiform gyrus,uncus and left superior temporal gyrus.Compared to PD-nMCI,decreased gray matter volume in PD-MCI was observed in the bilateral midfrontal gyrus,inferior frontal gyrus,left precentral gyrus,right midtemporal gyrus,superior temporal gyrus,bilateral insular,and right cuneus,lingual gyrus,posterior cingutate.Conclusion Decreased gray volume in PD-nMCI is mainly located in the right temporal lobe and right uncus.With occurrence of MCI,abnormal brain regions are gradually extended.Gray matter atrophy in the bilateral midfrontal gyrus,inferior frontal gyrus,and left precentral gyrus are related to the MCI.

Objective To investigate the efficacy of percutaneous transhepatic variceal embolization (PTVE) with Cyanoacrylate (TH glue) in treating large gastric fundal variceal bleeding.Methods PTVE was performed on 24 patients with TH glue injected into the main stem of left gastric vein and its fundic branches.The degree of varices in gastric fundus,rebleeding rate and survival rate after the procedure were compared with those before.Results Varices in gastric fundus were all embolized successfully with TH glue.The diameter of varices was reduced to below 5mm or disappeared in 20 patients (83.3％),and reduced to 5-10mm in the other 4 ( 16.7％ ) During the follow-up period of 3-36 months(mean 16.6 months),the rebleeding rate and mortality were 12.5 ％ ( 3/24 ),and 12.5 ％ (3/24),respectively.One patient died of liver cancer,and two others died of chronic liver failure.Conclusion PTVE with TH glue is of ideal therapeutic effect to block the feeding veins of large gastric fundal varices.

OBJECTIVE: Dexmedetomidine (DEX), the most specific α ₂-adrenergic receptor agonist widely used for its sedative and analgesic properties, has been reported to upregulate HIF-1α expression to protect hypoxic and ischemic tissues. However, it is largely unclear whether DEX can also upregulate Hypoxia-inducible factor-1 alpha (HIF-1α) expression and its downstream vascular endothelial growth factor-A (VEGFA) in cancer tissues with oxygen-deficient tumor microenvironment. METHODS: We used SMMC-7721 cells, MHCC97-H cells, and a mouse model of orthotopic hepatic carcinoma to explore the effect of DEX on angiogenesis and vasculogenic mimicry (VM) and its mechanism. Under normoxic (20% O ₂) and hypoxic (1% O ₂) conditions, DEX was used to intervene cells, and yohimbine was used to rescue them. RESULTS: The results showed that DEX promoted angiogenesis and VM in human liver cancer cells within a certain dose range, and the addition of yohimbine inhibited this effect. DEX could activate HIF-1α/VEGFA pathway, which was further verified by silencing HIF-1α. Consistently, in vivo results also showed that DEX can up-regulate HIF-1α/VEGFA expression, and enhance the number of VM channels and microvessel density (MVD). CONCLUSION We believe that HIF-1α/VEGFA might be an important signaling pathway by which DEX promotes angiogenesis and VM formation in human hepatocellular carcinoma, whereas α ₂-adrenergic receptor mediation might be the critical mechanisms.
Animals ; Humans ; Mice ; Adrenergic alpha-2 Receptor Agonists/pharmacology* ; Carcinoma, Hepatocellular ; Cardiovascular Physiological Phenomena ; Dexmedetomidine/pharmacology* ; Hypoxia ; Liver Neoplasms/drug therapy* ; Oxygen ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A/genetics* ; Receptors, Adrenergic, alpha-2/metabolism*

The mechanisms underlying exercise-induced neuroprotective effects after traumatic brain injury (TBI) remained elusive, and there is a lack of effective treatments for TBI. In this study, we investigated the effects of an integrative approach of exercise and Yisaipu (TNFR-IgG fusion protein, TNF inhibitor) in a mouse TBI model. Male C57BL/6J mice were randomly assigned to a sedentary group or a group that followed a voluntary exercise regimen. The effects of 6-week prophylactic preconditioning exercise (PE) alone or in combination with post-TBI Yisaipu treatment on moderate TBI associated deficits were examined. The results showed that combined treatments of PE and post-TBI Yisaipu were superior to single treatments on reducing sensorimotor and gait dysfunctions in mice. These functional improvements were accompanied by reduced systemic inflammation largely via decreased serum TNF-α, boosted autophagic flux, and mitigated lesion volume after TBI. Given these neuroprotective effects, composite approaches such as a combination of exercise and TNF inhibitor may be a promising strategy for facilitating functional recovery from TBI and are worth further investigation.
Animals ; Brain Injuries, Traumatic/pathology* ; Disease Models, Animal ; Male ; Mice ; Mice, Inbred C57BL ; Neuroprotective Agents/pharmacology* ; Recovery of Function ; Tumor Necrosis Factor Inhibitors

OBJECTIVETo study and compare the operative results of the early and late treatment of orbital blow-out fracture.

METHODSOrbital blow-out fractures were reconstructed and repositioned. Three dimensional measurements, CT scanning, diplopia analysis, Medpor filling of the orbit were used for the operation and the study. The operative results were compared between 15 cases of early and 16 cases of late reconstruction of blow-out fracture.

RESULTSIn the early treatment group, there were 8 cases of diplopia, 15 cases of orbital invagination and 10 cases of disesthesia of the infraorbital nerve. After surgery, diplopia was corrected in 7 cases; invagination was corrected in all the 15 cases; disesthesia of the infraorbital nerve was corrected in 8 cases. In the late treatment group, there were 10 cases of diplopia, 16 cases of orbital invagination and 9 cases of disesthesia of the infraorbital nerve. After surgery, diplopia was corrected in 3 cases, unimproved in 4 cases, aggravated in 2 cases. 5 of them received reoperation of extraocular muscle for diplopia. Orbital invagination was uncorrected in 3 cases. 2 of them were re-operated on. Disesthesia of the infraorbital nerve was unimproved in 2 cases. By comparing the operation results, of the two groups using FISHER accuracy inspection, the significant difference was only in the correction of the double visions (chi 2 = 4.865, P < 0.05).

CONCLUSIONEarly operation for orbital blow-out fracture is easier, with better results, fewer complications and reoperations than the late operation.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Orbital Fractures ; surgery ; Postoperative Complications ; epidemiology ; Reconstructive Surgical Procedures ; methods ; Time Factors

Objective:To study the effect of sedative combined with cis-atracurium in rapid induction intubation in emergency department.Methods:From October 15, 2017 to April 15, 2019, 52 critically ill patients who needed tracheal intubation in emergency department of the People's Hospital of Changzhi were selected.And the patients were numbered according to the time sequence of enrollment, and then randomly divided into group A and group B according to the random number table, with 26 cases in each group.Group A was given sedatives combined with cis-atracurium to induce rapid intubation.Group B only received sedatives to induce intubation.The success rate of intubation, successful intubation time were compared between the two groups.Before and after endotracheal intubation, the heart rate, mean arterial blood pressure, pulse oxygen concentration and the change of catecholamine concentration were compared.Results:The success rate of intubation in group A was 100.0%, which in group B was 76.9%, the difference between the two groups was statistically significant (χ 2=12.15, P<0.05). The time required for successful intubation in group A was (5.2±0.8)s, which in group B was (8.5±2.5)s, the difference was statistically significant (χ 2=6.41, P<0.05). After intubation, the pulse oxygen concentration in group A was significantly increased compared with before intubation ( t=-7.99, P<0.05). After intubation, the heart rate, mean arterial pressure, and serum norepinephrine, dopamine levels in group A were reduced compared with before intubation, but there were no statistically significant differences (all P>0.05). The serum adrenaline level was higher compared with before intubation, but there was no statistically significant difference ( t=-1.03, P>0.05). In group B, the pulse oxygen concentration was significantly increased after intubation compared with before intubation ( t=5.74, P<0.05), but the heart rate, mean arterial pressure, and the change of blood catecholamine concentration levels in group B had no statistically significant differences ( P>0.05). Conclusion:In the airway management of critically ill patients in emergency department, the application of sedatives combined with cis-atracurium to rapidly induce intubation can improve the hypoxia symptoms of patients more rapidly and can keep patients' hemodynamics, catecholamine concentration is relatively stable, it has the characteristics of safety and efficiency.

Objective To investigate the MRI findings and the variability of quantitative indicators in intracranial hypotension syndrome (IHS) to yield a deeper understanding of the disease.Methods The clinical data and MR imaging findings of 26 patients with IHS confirmed by lumbar puncture during August 2006 to December 2013 in our hospital were retrospectively analyzed.Other 26 healthy volunteers matched with gender and age were recruited as control group.The MRI findings (dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and sagging brain) and quantitative assessments (mamillopontine distance and pontomesencephalic angle) were evaluated retrospectively by two doctors,the consistency between the two doctors was assessed by Kappa consistency test.The difference of mamillopontine distance and pontomesencephalic angle between patient group and control group was assessed by t test.The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy and assure the optimal diagnostic threshold.Results There were excellent interobserver agreements for dural thickening and enhancement,pituitary enlargement,subdural collections,venous engorgement and the measurement of mamillopontine distance and pontomesencephalic angle (Kappa=l.000,0.846,1.000,0.906,0.919 and 0.808,P＜0.05).Sagging brain showed moderate agreement between readers (Kappa=0.606,P＜0.05).The mamillopontine distance (5.4±1.6 mm) and pontomesencephalic angle (47.8±8.7 °) in patient group were significantly lower than those of control group (6.9±1.1 mm and 61.0±6.1 °,P＜0.05).The area under ROC curve of mamillopontine distance and pontomesencephalic angle was 0.774 and 0.908,respectively,and the diagnostic value ofpontomesencephalic angle was higher than that of the mamillopontine distance.The sensitivity and specificity were 73.1％ and 73.1％,respectively,when mamillopontine distance was 6.4 mm.The sensitivity and specificity were 76.9％ and 96.2％,respectively,when pontomesencephalic angle was 51.7°.Conclusions The MR imaging findings present characteristic features of IHS.The quantitative indicators including mamillopontine distance and pontomesencephalic angle are helpful in clinical diagnosis of IHS.