Objective:To explore the clinical effect of combining kinesio taping with filtered infrared-A irradiation in the treatment of scapulohumeral periarthritis.Methods:Eighty-six patients with scapulohumeral periarthritis were randomly divided into a control group ( n=43) and an observation group ( n=43). Both groups received 20 minutes of irradiation with water-filtered infrared-A per day for 14 days, while the observation group was also given kinesio taping after the irradiation on 6 days of each week for the two weeks. Before and after the 2 weeks of treatment, both groups were evaluated for pain, their active and passive range of motion (AROM and PROM) of the shoulder, as well as the range of motion (ROM) of the shoulder joint, and their Constant-Murley score (CMS). The subjects also evaluated the functioning of their own shoulders using a visual analogue scale (VAS). Results:After the treatment, the average VAS scores of both groups were significantly higher than before the treatment, but the observation group′s average was significantly higher than that of the control group. There was significant improvement in the average AROM and PROM in both groups, but in the observation group the average AROM in anteflexion, rear protraction, abduction and extorsion and the average PROM in anteflexion and abduction were significantly better than the control group′s averages. The average total CMS scores of both groups had also improved significantly, but with significantly greater improvement in the observation group leading to a significant difference between the two groups after the intervention.Conclusions:Supplementing water-filtered infrared-A irradiation with kinesio taping is very effective in relieving pain, as well as improving ROM and life quality for persons with scapulohumeral periarthritis.

ObjectiveTo investigate application of the anterior cervical pedicle screw in the lower cervical spine.MethodsTwenty disarticulated human vertebrae(C3-C7) were evaluated with computed tomography for pedicle morphometry Parameters included vertebral body height,vertebral body depth,vertebral body width,outer pedicle width,outer pedicle height,pedicle axis length,transverse section angle,sagittal section angle,transverse intersection point distance and sagittal intersection point distance.On the basis of these data,the screw channel was determined and the screws were inserted in the specimen.Five patients underwent surgical reconstruction using anterior pedicle screw fixation.After surgery,physical examination and roentgenograms and CT scans were performed in all patients.ResultsThe transverse section angle increased from C3(45.7°±4.0°) to C5(52.1°±5.9° ),but decreased from C6(47.8°±6.7°) to C7(44.4°± 8.3°).The sagittal section angle gradually increased from C3 (93.4°±7.2°) to C6( 112.1°±6.2°) but decreased a little to C7(102.7°±8.5°).The distances in transverse section was about 1.97-3.98 mm and in sagittal section was 3.4-7.5 mm.Anterior pedicle screws were inserted successfully in all specimens without critical pedicle wall perforations.Patients were permitted to ambulate the next day after surgery with a cervical collar.Postoperative neurological improvement was observed in all cases.Postoperative radiographic evaluation confirmed proper insertion of anterior pedicle screws without pedicle perforaton.The average follow-up time was 10.6 months.No anterior pedicle screw breakage and loosening was observed.ConclusionThe entry point in anterior pedicle screw should located in 5mm to upper endplate and near anterior median line.The transverse section angle should be 45.7°-52.1°and the sagittal section angle should be 93.4°-112.1°.The lengths of the screw should be about 32 mm.

Objective To analyze the feasibility and effect of combining intramedullary nails and plates in the treatment of ipsilateral unicondylar tibial plateau fractures with non.contiguous tibial shaft fractures.Methods From May 2003 to November 2005,21 patients with ipsilateral unicondylar tibial plateau fracture and non-contiguous tibial shaft fracture were treated with combining intramedullary nails and plates,including 15 males and 6 females,with the mean age of 34 years (range,20-55 years).The tibial plateau fractures were classified according to Schatzker et al.; 4 cases were type Ⅰ,11 cases type Ⅱ,6 cases type Ⅲ and 1 case type Ⅵ.Middle third tibial shaft fractures were in 13 patients,and distal third tibial shaft fractures were in 8 patients.Once the reduction was obtained,we first fixed tibial plateau with plate and then tibial shaft with medullary nail in 19 cases; in 2 cases,we first fixed the tibial shaft with medullary nail and then tibial plateau with plate.Results 1All patients were followed up for 0.9 to 4 years (average,2.2 years).Bone union was obtained in all patients.The tibial plateau fractures united after an average of 12 weeks,and the tibial shaft fractures united after an average of 29 weeks.Delayed union of the tibial shaft fracture occurred in 3 patients,and the fracture healed finally by removing the proximal locking.Tibial plateau malunion occurred in one patient due to malreduction.According to HSS scores,excellent result was obtained in 17 patients (80.95％),good in 3 patients (14.29％),fair in 1 patient (4.76％).Conclusion With careful attention to some techniques,ipsilateral unicondylar tibial plateau fractures with non-contiguous tibial shaft fractures can be treated successfully by combining medullary nail and plate.

Objective To identify the feasibility and the anatomical parameters of posterior transarticular pedicle screw fixation in the thoracic spine, provide a reference for clinical applications. Methods Twenty human cadaveric thoracic spine segments were dissected posteriorly and anteriorly, with care taken to expose the laminas and pedicles. The entrance point of transarticular pedicle screws was located in the 7 mm away from the above at the inferior margin of the lamina and the inside at the exterior margin, respectively. Posterior transarticular pedicle screws implantation was performed under direct visualization into T1,2,T5,6 and T9,10 Under direct abservation, the feasibility of posterior transarticular pedicle screw fixation was assessed. Then a CT was done. On the morphologic CT scan, the angle and length of the transarticular pedicle crew trajectory were measured. Results The thoracic transarticular pedicle screw trajectory were caudal tilting in the sagittal plane and lateral tilting in the axial plane with successful placement. Screws were placed across the facet joint, and from the inferior articular process of upper thoracic vertebra into the pedicle of lower thoracic vertebra. There was little difference between different number of thoracic vertebrae of the angle, but without significance. The average angles of the screws were 41.4°+3.2°caudal tilting in the sagittal plane and 2.1°±0.7° lateral tilting in the axial plane. The average trajectory lengths were (40.6±4.9)mm, and the lengths increased gradually from upper thoracic vertebra to middle and lower. There were significant differences statistically among T1,2, T5,6 and T9.10 (F=74.09, P＜0.01 ). Conclusion Posterior transarticular pedicle screw fixation is feasible, and there are some directions for implantating the screws. Transarticular pedicle fixation in the thoracic spine affords an alternative to standard pedicle screw placement for thoracic stabilization.

Objective:To investigate the feasibility and safety of laparoscopic liver tumor resection in children.Methods:The clinical data of 6 children undergoing laparoscopic liver tumor resection from June 2018 to March 2020 in the Affiliated Tumor Hospital, Zhengzhou University were retrospectively analyzed.Results:There were 4 males and 2 females among the 6 cases, with the average age of (7±2)years.All the children were admitted to the hospital with a liver occupying examination due to physical discomfort.Preoperative diagnosis: 3 cases of hepatoblastoma, 1 case of primary liver cancer, 1 case of hepatic adenoma and 1 case of hepatic nodular hyperplasia.All the children successfully completed laparoscopic liver tumor resection without conversion to open surgery.Among them, 3 children obtained left hemihepatectomy, 1 child underwent hepatic left lobectomy, 1 child was given VI hepatectomy, and 1 child accepted hepatic caudate lobectomy.The operation time was(90±9)min, and the average intraoperative blood loss was (83±26) mL.All children had no blood transfusion during or after operation.There were no bleeding, bile leakage, infection and liver failure after operation.All children had no gastric tube before surgery and the fluid diet was given on the first day after operation, and the postoperative median hospital stay was 4(3-5) days.The pathology were consis-tent with the preoperative diagnosis, and the resections were all radical operation resections.The follow-up period was from 2 to 23 months, and all the children recovered well and no recurrence was observed.Conclusions:Laparoscopic liver tumor resection in children is safe and feasible, which can minimize trauma, reduce intraoperative bleeding and shorten the hospital stay without increasing the incidence of postoperative complications.Laparoscopic liver tumor resection in children has certain advantages.

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors, and its features of insidious onset, rapid development, and high recurrence bring great challenges to the long-term survival of HCC patients. Molecular-targeted drugs and immune checkpoint inhibitors have become the research hotspots in the treatment of HCC, and a large number of clinical trials have found that combined therapy has achieved a good clinical effect. This article mainly introduces the application of combined therapy with molecular-targeted drugs and immune checkpoint inhibitors and other combined therapies in HCC and points out that combined therapy related to systemic therapy or local therapy has become the latest research hotspot in HCC treatment.

This study shows the case of a patient with peroneus brevis tendon rupture in ankle fracture. The patient com-plained of swelling, pain and activity limitation in her right ankle caused by sprain. She was diagnosed with ankle fracture, supina-tion-adduction (Lauge-Hansen typing) by medical history, physical examination and imaging. The peroneus brevis tendon was not-ed complete ruptured when suturing the incision after ORIF, which was then repaired by "8" shaped suture. Based on literature re-view, the injury mechanism of the case may be because of overload inversion force toward to lateral inferior from the fracture of fib-ula on the peroneus brevis tendon. Additional attention should be paid to patients who suffered from an supination-adduction ankle fracture for whether peroneus brevis tendon tears before and during surgery.

Using mutation PCR, we cloned the target gene containing 421-480nt (141-160aa) and 598-639nt (200-213aa) of VP1 gene of foot and mouth disease virus (FMDV) into the deleted region (508-532aa) of Nsp2 gene of a highly pathogenic porcine reproductive and respiratory syndrome virus derived vaccine strain (HuN4-F112) that was used as vector. The recombinant cDNA was in vitro transcribed followed by transfection of BHK-21 cells for 36 h. Then, the supernatant of the cell culture was continuously seeded to monolayer of MARC-145 cells for recovery of the recombinant virus. CPE was obviously visible after a couple of passages in the seeded MARC-145, and the rescued virus (designated as rPRRSV-F112-O/VP1ep) was identified by Mlu I digestion, sequencing and immunofluorescence assay. Meanwhile, expression of inserted FMDV epitopes was also detected by indirect immunofluorescence assay with polyclonal antibodies against VP1 protein of FMDV. The analysis of biological characteristics shows that the titer of the rescued recombinant PRRSV (TCID50 = -log10(-6.75)/0.1 mL) was similar to its direct parental virus rHuN4-F112-delta508-532, but higher than rHuN4-F112.
Animals ; Antigens, Viral ; immunology ; Base Sequence ; Capsid Proteins ; immunology ; Cell Line ; Cysteine Endopeptidases ; genetics ; Epitopes ; genetics ; Foot-and-Mouth Disease ; immunology ; prevention & control ; Foot-and-Mouth Disease Virus ; genetics ; immunology ; Molecular Sequence Data ; Mutation ; Porcine respiratory and reproductive syndrome virus ; genetics ; immunology ; Recombination, Genetic ; Swine ; Transfection ; Vaccines, Attenuated ; genetics ; immunology ; Viral Envelope Proteins ; genetics ; immunology ; Viral Vaccines ; genetics ; immunology

Objective:To investigate the application value of a new internal cold circula-tion bipolar radio frequency device in open hepatectomy.Methods:The retrospective cohort study was conducted. The clinical data of 85 patients with hepatocellular carcinoma who underwent open hepatectomy at the Affiliated Tumor Hospital of Zhengzhou University from February 2017 to January 2020 were collected. There were 48 males and 37 females, aged from 32 to 74 years, with a median age of 52 years. Of 85 patients, 45 cases undergoing hepatectomy assisted by the new internal cold circulation bipolar radio frequency device were allocated into new internal cold circulation bipolar radio frequency device group, and 40 cases undergoing hepatectomy assisted by Habib-4X bipolar radio frequency device were allocated into Habib-4X group, respectively. Observation indicators: (1) intraoperative situations; (2) postoperative situations; (3) follow-up. Follow-up was conducted by outpatient, inpatient reexamination and telephone interview to detect the postoperative complications and death of patient within postoperative 30 days up to May 2020. Measurement data with normal distribution were represented as Mean± SD, and independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as M(range), and nonparametric Mann-Whitney U test was used for comparison between groups. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Repeated measurement data were anlyzed by the repeated ANOVA. Results:(1) Intraoperative situations: the time of crosscutting process for liver parenchyma, average area transection speed, coagulation tissue width, cases with needle bleeding rate and electrode needle charring were (55±16)minutes, (4.8±1.2)cm 2/minute, (1.4±0.2)cm, 6, 10 for the new internal cold circulation bipolar radio frequency device group, versus (64±15)minutes, (3.6±1.0)cm 2/minute, (1.8±0.2)cm, 14, 25 for the Habib-4X group, respectively, showing significant differences in the above indicators between the two groups ( t=2.665, 4.973, 9.204, χ2=5.525, 14.184, P<0.05). (2) Postoperative situations: for the new internal cold circulation bipolar radio frequency device group, the total bilirubin (TBil) was (20±12)μmol/L, (25±12)μmol/L, (20±14)μmol/L at postoperative 1, 3, 7 days, the prothrombin time (PT) was (15.4±2.2)seconds, (14.2±2.1)seconds, (12.7±0.8)seconds, the alanine aminotransferase (ALT) was (288±248)IU/L, (132±61)IU/L, (67±32)IU/L, the aspartate aminotransferase (AST) was (279±114)IU/L, (50±22)IU/L, (30±13)IU/L. For the Habib-4X group, the TBil was 1(22±15)μmol/L, (23±10)μmol/L, (19±8)μmol/L at postoperative 1, 3, 7 days, PT was (15.8±2.8)seconds, (14.3±2.0)seconds, (13.6±1.3)seconds, the ALT was (369±269)IU/L, (133±99)IU/L, (54±30)IU/L, the AST was (345±125)IU/L, (60±36)IU/L, (32±11)IU/L. There were significant differences in the time effect of PT, ALT, AST between the two groups ( F=18.364, 23.020, 93.786, P<0.05). There was no significant difference in the time effect, between-group effect, interaction effect of TBil or between-group effect, interaction effect of PT, ALT, AST between the two groups ( F=2.421, 1.424, 0.522, 1.593, 0.312, 0.121, 0.267, 1.027, 0.600, P>0.05). (3) Follow-up: 85 patients were followed up for 4 to 39 months, with a median follow-up time of 16 months. There were 5 patients in the new internal cooling circulation bipolar radiofrequency device group and 8 patients in the Habib-4X group with complications, respectively, showing no significant difference in overall complications between the two groups ( χ2=1.292, P>0.05). The number of deaths in the new internal cooling circulation bipolar radio frequency device group and Habib-4X group was 0 and 1, respectively, showing no significant difference between the two groups ( P>0.05). Conclusion:The new internal cold-circulating bipolar radio frequency device for open hepatectomy is safe and effective, which cuts the liver parenchyma faster, has lower carbonization rate at the tip of electrode needle, and has more accurate coagulation range.

Objective:To investigate the features of median arcuate ligament syndrome (MALS) in computed tomography angiography (CTA).Methods:The retrospective and descriptive study was conducted. The clinical and imaging data of 56 patients with MALS who were admitted to Ruijin Hospital, Shanghai JiaoTong University School of Medicine from November 2019 to October 2020 were collected. There were 30 males and 26 females, aged from 19 to 78 years, with a median age of 54 years. All 56 patients underwent CTA. Observation indicators: (1) CTA examination; (2) correlation analysis; (3) surgical situations. Measurement data with normal distribution were represented as Mean± SD. Count data were described as absolute numbers or percentages. Spearman correlation analysis with test level of 0.05 was used to analyze the correlation between celiac trunk stenosis and the distance between the original location of celiac trunk and original location of superior mesenteric artery and the minimum distance of celiac trunk and superior mesenteric artery. Results:(1) CTA examination. ① Celiac trunk stenosis: results of cross sectional examina-tion of CTA showed that of 56 patients, there were 2 cases of celiac trunk occlusion, 10 cases of severe stenosis, 9 cases of moderate stenosis and 35 cases of mild stenosis. Results of sagittal examination of CTA showed that of 56 patients, there were 2 cases of celiac trunk occlusion, 21 cases of severe stenosis, 15 cases of moderate stenosis and 18 cases of mild stenosis. ② Examination of patients with different degree of vascular stenosis: according to the results of sagittal examination of CTA, the 2 cases with celiac trunk occlusion were negative for aneurysms, aortic dissection or vascular variations but positive for compensated varix of the anterior and posterior pancreatico-duodenal arches. Of the 21 cases with celiac trunk severe stenosis, 2 cases were positive for aneurysms, 1 case was positive for aortic dissection, 7 cases were positive for compensated varix of the anterior and posterior pancreaticoduodenal arches, 8 cases were positive for collateral circula-tions of anterior and posterior pancreaticoduodenal archs and 8 cases were positive for vascular variation. Of the 15 cases with celiac trunk moderate stenosis, 2 cases were positive for aneurysms, 3 cases were positive for aortic dissection, 2 cases were positive for compensated varix of the anterior and posterior pancreaticoduodenal arches, 4 cases were positive for collateral circulations of anterior and posterior pancreaticoduodenal archs and 7 cases were positive for vascular variation. Of the 18 cases with celiac trunk mild stenosis, 1 case was positive for aneurysms, 2 cases were positive for aortic dissection, 7 cases were positive for collateral circulations of the anterior and posterior pancreaticoduodenal arches, 6 cases were positive for vascular variation. All 56 patients were negative for ischemia of liver, spleen and stomach. ③ Original location of celiac trunk: of 56 patients, there were 43 cases had celiac trunk originated horizontally from the lower edge of T12 vertebral body, 2 cases had celiac trunk originated from the middle of T12 vertebral body, 1 case had celiac trunk originated from the upper part of T12 vertebral body, 7 cases had celiac trunk originated from the upper part of L1 vertebral body, 1 case had celiac trunk originated from the middle of L1 vertebral body and 2 cases had occluding celiac trunk. (2) Correlation analysis: results of sagittal observation on CTA examination showed the distance between the original location of celiac trunk and original location of superior mesenteric artery of the 56 patients was (6.0±4.0) mm. The distance between the original location of celiac trunk and original location of superior mesenteric artery of patients with celiac trunk mild, moderate or severe stenosis were (6.2±2.8)mm, (8.1±4.4)mm and (5.3±3.2)mm respectively. There were 23 cases of the 56 patients had the distance between the original location of celiac trunk and original location of superior mesenteric artery <5 mm. Results of correlation analysis showed that the degree of celiac trunk stenosis was not related to the distance between the original location of celiac trunk and original location of superior mesenteric artery ( r=?0.205, P>0.05). Results of sagittal observation on CTA examination showed the shortest distance between celiac trunk and superior mesenteric artery of the 56 patients was (3.8±2.4)mm. The shortest distance between celiac trunk and superior mesenteric artery of patients with celiac trunk mild, moderate or severe stenosis were (4.2±2.0)mm, (4.4±3.3)mm and (3.0±1.9)mm, respectively. There were 45 cases of the 56 patients had the shortest distance between celiac trunk and superior mesenteric artery <5 mm. Results of correlation analysis showed that the degree of celiac trunk stenosis was not related to the shortest distance between celiac trunk and superior mesenteric artery ( r=?0.249, P>0.05). (3) Surgical situations: of 56 patients, 2 cases were positive for clinical symptoms of abdominal pain, 54 cases were negative for clinical symptoms, 4 cases under-went surgical treatment and 52 cases not underwent surgical treatment. Of the 4 cases undergoing surgical treatment, 2 cases with abdominal pain were diagnosed as MALS by upper abdominal CTA. Celiac trunk of the 2 cases were severe stenosis and stents implantation under celiac arteriography were performed. Results of postoperative CTA showed celiac trunk was negative for obvious stenosis. The other 2 cases who were negative for clinical symptoms of MALS were planed to pancreaticoduo-denectomy for pancreatic head tumor. Results of preoperative CTA showed severe stenosis of celiac trunk and arterial bypass grafting was performed for the 2 cases during pancreaticoduodenectomy to alleviate liver ischemia caused by gastroduodenal artery ligation which would avoid the incidence of postoperative MALS associated complications. Result of postoperative CTA three-dimensional reconstruction showed the bypass vessel was unobstructed. Conclusion:Based on sagittal result of CTA examination, the stenosis of celiac trunk, the anatomical relationship between celiac trunk and arcuate ligament and the original location of celiac trunk of MALS patients can be evaluated.