Objective To compare the clinical outcomes of dilator-kyphoplasty (DKP) and balloonkyphoplasty (BKP) in treatment of osteoporotic vertebral compression fractures. Methods From May 2007 to March 2009, 23 cases with 26 vertebrae were treated with DKP, while 29 cases with 29 vertebrae were treated with BKP procedures. The operating time, bleeding volume and injecting volume of cement were recorded during operation. The distribution of cement, the restoration of vertebral height and Cobb angle were observed. The patients' visual analogue scales (VAS) score and Oswestry disability index (ODI) score were evaluated after operation. Results There were no differences in operative time, bleeding volume of every vertebrae and cement injected volume between these two groups (P＞0.05). The vertebral height, Cobb angle, VAS and ODI scores were significantly improved than those of pre-operation in these two groups (P＜0.05). The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups (P＜ 0.05). There were 1 case (1 vertebra, 3.8%) underwent cement leakage in DKP groups and 5 cases (5 vertebrae, 17.2%) in BKP groups. Conclusion DKP and BKP were effective in the treatment of osteoporotic vertebral compression fractures. The height of the anterior vertebrae and Cobb angle in DKP groups were restored significantly than those in BKP groups.

In order to analyze and study the hemolysis performance of the centrifugal maglev blood pump, which was designed by ourselves, this paper built the mathematical model and computational fluid dynamics analyzed it using Fluent. Then we set up the in vitro hemolysis experiment platform, in case of the design condition, the content of free hemoglobin and hematocrit in plasma were measured in a certain time interval, and calculated the normalized index of hemolysis of the blood pump. The numerical simulation results show the internal static pressure distribution is smooth inside the pump, the wal shear stress inside the pump is less than 150 Pa. Therefore, the red blood cel damage and exposure time is independent. The normalized index of hemolysis is (0.002 9±0.000 7) mg/L, which is in accordance with human physiological requirement.

Objective To evaluate the safety and efficacy of transurethral frontfiring photoselective vaporesection for the treatment of cystitis glandularis,by comparing with the transurethral bipolar plasmakinetic resection.Methods From January 2014 to July 2016,41 patients with pathologically diagnosed cystitis glandularis in our hospital,were divided into two groups,including 22 cases underwent transurethral frontfiring photoselective vaporesection(the observation group),and the other 19 cases underwent transurethral bipolar plasmakinetic resection(the control group).All patients were regularly treated with postoperative intravesical instillation chemotherapy with pirarubicin.The clinical data of two groups were statistically analyzed to compare the differences of the safety and efficacy.Results All the surgeries were performed successfully.There were no statistical significances in perioperative data,the operation time,the decreased concentration of hemoglobin(Hb)and Na+,operative related complications, indwelling catheter duration and hospitalization duration between the two groups.The first-time cure rate and the effective rate of transurethral frontfiring photoselective vaporesection showed significantly better than those of transurethral bipolar plasmakinetic resection(P<0.05 for each).Conclusion Comparing the traditional transurethral bipolar plasmakinetic resection for the treatment of cystitis glandularis,tansurethral frontfiring photoselective vaporesection with postoperative intravesical instillation chemotherapy with pirarubicin,is a safer,simpler,and more effective method,which could be a new optional method in the conditional hospitals,deserving the worthy of clinical popularization.

Objectives:To investigate the effect of fat suppression (FS) T 2WI on the interobserver agreement and diagnostic performance of clear cell likelihood score version 2.0 (ccLS v2.0) for clear cell renal cell carcinoma (ccRCC). Methods:In this retrospective study, the MR images of 111 patients with pathologically confirmed small renal masses (SRM) from January to December 2021 were analyzed in the First Medical Centre, Chinese PLA General Hospital. Of the 111 SRM, 82 cases were ccRCC and 29 cases were non-ccRCC. Two radiologists independently assessed ccLS scores based on T 2WI signal intensity (hypointense, isointense, hyperintense) and other MRI features (ccLS-T 2WI). After a one-month interval, the ccLS scores were independently evaluated utilizing the frequency-selective saturation FS-T 2WI and other MRI features (ccLS-FS-T 2WI). Fisher′s exact test was used to compare the difference in SRM signal intensity on T 2WI and FS-T 2WI. The weighted Kappa test was performed to assess the interobserver agreement of the two radiologists, and differences in the weighted Kappa coefficients were compared using the Gwet consistency coefficient. Receiver operating characteristic curves were drawn to evaluate the diagnostic performance of ccLS-T 2WI and ccLS-FS-T 2WI in diagnosing ccRCC, and the area under the curve (AUC) was compared utilizing the DeLong test. Results:The signal intensity of 111 SRM on T 2WI and FS-T 2WI had statistically significant difference (χ 2=126.33, P<0.001), consistent in 88 cases (79.3%) and varied in 23 cases (20.7%). The weighted Kappa coefficient of ccLS-T 2WI was 0.57 (95%CI 0.45-0.69) between the two radiologists, and the weighted Kappa coefficient of ccLS-FS-T 2WI was 0.55 (95%CI 0.42-0.67), and the difference was not statistically significant ( t=-0.65, P=0.520). The AUC of ccLS-T 2WI for ccRCC diagnosis was 0.92 (95%CI 0.86-0.97), while the AUC of ccLS-FS-T 2WI for ccRCC diagnosis was 0.91 (95%CI 0.85-0.96), and the difference was not statistically significant ( Z=1.50, P=0.133). Conclusions:The interobserver agreement and diagnostic performance of ccLS v2.0 based on T 2WI and FS-T 2WI sequences for ccRCC are comparable, and FS-T 2WI is applicable for the clinical application of ccLS v2.0.

Objective:To investigate the efficacy of the posterior axillary approach in the treatment of some scapular fractures.Methods:Retrospectively analyzed were the data of 41 patients with scapular fracture who had been treated through the posterior axillary approach at Department of Traumatology, The Second Hospital of Jilin University from April 2018 to July 2021. There were 32 males and 9 females, aged from 24 to 83 years (average, 52.4 years). Of them, 7 were complicated with multiple injuries, 16 with other fractures, and 4 with brachial plexus injury. Recorded were length of surgical incision, intraoperative blood loss, operation time, and range of shoulder motion, Disability of Arm Shoulder and Hand (DASH) score, Constant shoulder score and postoperative complications at the last follow-up.Results:In this cohort, length of incision ranged from 7 to 12 cm (average, 9.3 cm), intraoperative blood loss from 80 to 150 mL (average, 110.5 mL), exposure time of the posterior axillary approach from 5 to 10 min (average, 7.9 min), and fracture operation time from 85 to 140 min (average, 110.8 min). The 41 patients were followed up for 6 to 36 months (mean, 14.3 months) after surgery. At the last follow-up, the average ranges of shoulder motion were 177° (from 150° to 180°) in flexion, 175° (from 140° to 180°) in abduction and 47° (from 30° to 50°) in extension, the average DASH score was 36.4 points (from 34 to 46 points), and the average Constant score 96.0 points (from 84 to 100 points). There were no complications like loss of fracture reduction, loosening or breakage of plate or screw during follow-up. Incision healing was delayed in 2 patients and mild heterotopic ossification occurred in 2 patients.Conclusion:As a new surgical approach for some scapular fractures, the posterior axillary approach allows internal fixation of the fractures of the scapular glenoid, neck and body under direct vision, leading to good-looking postoperative wound and reliable curative effects.

Objective·To systematically review the effectiveness of actigraphy on the evaluation of circadian rhythm characteristics in patients with depression.Methods·A systematic literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,PsycINFO,CNKI,WanFang Data,and Chinese biomedical literature database(CBM),from the inception of each database to May 5th,2023.Case control studies that used actigraphy to evaluate circadian rhythms in patients with depression and compared them with healthy controls were collected.Literature was screened according to the inclusion and exclusion criteria,and the quality of the included literature was evaluated by using the Newcastle-Ottawa Scale.The meta-analysis was performed by using RevMan 5.4 software.Results·A total of 9 articles were included,including 390 patients with depression and 288 healthy controls.The meta-analysis showed that the MESOR(midline statistic of rhythm)(SMD=-0.29,95%CI-0.51 ?-0.07,P=0.009)of the circadian cosine function in patients with depression was lower than that in healthy controls;sleep onset(MD=33.06,95%CI 14.90 ? 51.23,P=0.000)and sleep offset(MD=53.80,95%CI 22.38 ? 85.23,P=0.000)were later in patients with depression than those in healthy controls;no statistical difference was found in the activity level of the most active 10 hours(SMD=-0.26,95%CI-0.52 ? 0.01,P=0.060)between patients with depression and healthy controls,although there was a trend for lower activity in patients with depression;no statistical difference was found in the acrophase(MD=25.33,95%CI-12.41 ? 63.06,P=0.190)of the circadian cosine function between patients with depression and healthy controls;no clear statistical significance of the difference was found in the amplitude(SMD=-0.14,95%CI-0.42 ? 0.14,P=0.340)and the activity level of the least active 5 hours(SMD=0.31,95%CI-0.10 ? 0.71,P=0.140)between patients with depression and healthy controls.Conclusion·Actigraphy can reflect circadian rhythm disruption in patients with depression to some extent,but the limited number of included studies and inconsistencies in the study populations and methodologies have affected the quality and results of the analyses.More high-quality clinical trials are needed to provide evidence.

Objective:To investigate the impact of the interval period between biopsy and MR examination on tumor detection and extraprostatic extension (EPE) assessment for prostate cancer (PCa) using multi-parametric MRI (mpMRI).Methods:The study was cross-sectional and retrospectively included 130 patients with PCa who underwent RP and preoperative systematic biopsies followed by mpMRI between January 2021 and December 2022 in the First Medical Center of Chinese PLA General Hospital. Patients were divided into 3 groups according to interval following biopsy (group A,<3 weeks, 31 cases; group B, 3-6 weeks, 67 cases; group C,>6 weeks, 32 cases). The percentages of hemorrhage volume in the total prostate were drawn on T 1WI and calculated. The junior, senior and expert radiologists independently localized the index lesions and calculated the accuracy for tumor detection, in addition to assessing the probabilities of EPE according to EPE grade. The correlation between the hemorrhage extent and interval was analyzed using the Spearman correlation coefficient. The accuracy for tumor detection was compared using χ2 test among groups. The diagnostic performance of the radiologists for EPE prediction was assessed using the receiver operating characteristic curve, and the differences between the corresponding area under the curve (AUC) were compared using the DeLong test. Results:The percentage of hemorrhage was correlated with the interval between biopsy and MR examination ( r=-0.325, P<0.001). The detection accuracy of junior radiologist was 83.9% (26/31), 76.1% (51/67), and 78.1% (25/32) in group A, B and C, respectively; no differences were observed in the detection accuracy among three groups ( χ2=0.76, P=0.685). The detection accuracy of senior radiologist was 83.9% (26/31), 80.6% (54/67), and 71.9% (23/32) in 3 groups with no differences ( χ2=1.53, P=0.464). The detection accuracy of expert radiologist was 80.6% (25/31), 77.6% (52/67), and 93.8% (30/32) with no differences ( χ2=3.95, P=0.139). The AUC (95% CI) for predicting EPE were 0.830 (0.652-0.940), 0.704 (0.580-0.809), 0.800 (0.621-0.920) in the group A, B and C for junior radiologist; 0.876 (0.708-0.966), 0.768 (0.659-0.863), 0.896 (0.736-0.975) for senior radiologist; and 0.866 (0.695-0.961), 0.813 (0.699-0.895), 0.852 (0.682-0.952) for expert radiologist, respectively. No differences were observed among the subgroups in each radiologist ( P>0.05). Conclusion:The interval period does not significantly affect the detection accuracy and EPE assessment of PCa using mpMRI. There is probably no necessity for prolonged intervals following systematic biopsy to preserve the clarity of MRI interpretation for PCa.

Objective To evaluate the efficacy and safety of tip-flexible ureterorenoscope (tf-URS) with holmium laser for one-stage management of parapelvic cyst.Methods The clinical data of 26 patients treated with tf-URS incision and drainage using holmium laser from February 2016 to August 2018 were reviewed.The study were including 15 male and 11 female patients,ranging from 32 to 68 years old,with an average of 53.5 years old.There were 24 cases of unilateral single renal parapelvic cyst and 2 cases of bilateral single renal parapelvic cyst.There were 4 cases in 26 cases with unilateral single renal parapelvic cyst and contralateral single renal cyst,2 cases with unilateral single renal parapelvic cyst and ipsilateral kidney of stones.The diameter of parapelvic cyst was 3.4-5.6 cm,average 4.8 cm.All patients had undergone holmium laser endo-decortication of parapelvic cyst by tf-URS.With general anesthesia,tf-URS accessed pelvis retrogradely and decorticated parapelvic cyst with 200 μm Holium laser to drainage the cyst to pelvis.If the tf-URS was not placed successfully for the first time,Double-J tubes were retained for 1-2 weeks before treatment.The operative time,hospitalization time,blood loss,postoperative complications and clinical symptoms were collected and analyzed.Results The one-time access success rate of insertion of ff-URS was 88.5％ (23/26).All operations were successful without severe complications.The average time of operation was 17.2 min,ranging from 11 to 25 min.In 3-30 months follow-up,the cysts disappeared in 22 patients and reduced by more than one half in 1 patients.Flank pain relieved in 19 patients.Conclusions Holmium laser endo-decortication of parapelvic cyst by tf-URS could be a simple,minimally invasive,safe and effective method for parapelvic cyst,which is worthy of further promotion and application in clinical practice.

Purpose To explore the diagnostic value of prostate imaging report and data system 2.1(PI-RADS v2.1)combined with prostate-specific antigen density(PSAD)for clinically significant prostate cancer(csPCa)in prostate-specific antigen(PSA)gray area(4-10 ng/ml)based on two-center data.Materials and Methods The clinical and imaging data of patients with PSA gray zone prostate disease who underwent multi-parametric magnetic resonance imaging and all pathological data in the First Medical Center(center 1)and the Sixth Medical Center(center 2)of the Chinese PLA General Hospital from January 2017 to May 2022 were retrospectively selected and analyzed.The patients from center 1 were used as the training group(220 cases),and the patients from center 2 were used as the test group(50 cases).Logistic regression was used to determine the independent predictors of csPCa in the training group,and the diagnostic efficacy of multi-parameter combination for csPCa was analyzed,which was further verified in the test group.Results There were significant differences in prostate volume,PSAD and PI-RADS v2.1 scores between the csPCa and non-csPCa groups in the training group(Z=-6.468,6.589,75.676,all P＜0.001).Logistic regression analysis showed that PI-RADS v2.1 score and PSAD were the independent risk factors for csPCa(both P＜0.001).The area under the curve of the Logistic regression model composed of PI-RADS v2.1 and PSAD for predicting csPCa in the PSA gray zone was 0.860(95％CI 0.808-0.903)in the training group and 0.906(95％CI 0.790-0.970)in the test group,respectively.The area under the curve of Logistic regression model was significantly higher than that of PI-RADS v2.1 and PSAD,respectively,with statistically significant difference(both P＜0.05).When the PI-RADS v2.1 score was low or moderate risk and PSAD＜0.15 ng/ml2,csPCa in the training group and the test group was with low detection rate.Conclusion PI-RADS v2.1 score and PSAD may be the independent risk factors for predicting csPCa in the PSA gray zone.The combined application of the two methods is better than the single method in the diagnosis of csPCa in the PSA gray zone,with benefits for clinical biopsy decision-making.