0.05), but the trachea cannula duration and residence time in ICU were significantly shorter in study group (10.36?3.14h and 36.47?6.25h, respectively) compared with those in control group (15.72?2.23h and 56.12?7.31h, respectively) (P

Objective To improve the diagnosis and therapy of uroseptic shock by percutaneous nephrolithotomy. Methods Five cases clinical data of uroseptic shock by percutaneous nephrolithotomy were analyzed retrospectively. Results Incidence rate of uroseptic shock by percutaneous nephrolithotomy was 0.5 % (5/1120), total deaths rate was 0.2 % (2/1120), death rate of uroseptic shock was 40%(2/5). Conclusions Uroseptic shock by percutaneous nephrolithotomy is extremely dangerous complication and primary death cause. Its characteristic such as: better masking, urgent onset,quick progress and high death rate. It is benefit to decrease incidence rate and mortality by prehension characteristic,control risk factor, early diagnosis and therapy.

Objective To investigate the application of combination of thoracolumbar injury classification severity score and load sharing classification (TLICS + LSC) in deciding the surgery for thoracolumbar fractures.Methods A retrospective case series study was conducted to analyze the clinical data of 42 patients with thoracolumbar fractures admitted to Sir RunRun Shaw Hospital affiliated to Medical College of Zhejiang University from January 2013 to November 2015.There were 28 males and 14 females,aged 19-58 years [(39.5 ± 11.5)years].The injured segments included T11 in 2 patients,T12 in 12,L1 in 4,L2 in 24.According to American Spinal Injury Association (ASIA) classification,there were two patients with grade A,five patients with grade B,six patients with grade C,and two patients with grade D.The rest of the patients had good neurological function.Surgical methods were selected according to the TLICS + LSC system.Seventeen patients were treated with posterior internal fixation (TLICS ＞ 4 points,LSC ＜ 7 points) (Group A),19 patients were treated with anterior reconstruction and internal fixation (TLICS ≤4 points,LSC ≥ 7 points) (Group B),and six patients were treated with anterior reconstruction and posterior internal fixation (TLICS ＞ 4 points,LSC ≥ 7 points) (Group C).ASIA grading criteria were used to assess the neurological function recovery of the patients.Vertebral height and sagittal Cobb angle changes were measured on full-length,lateral X-ray or CT sagittal reconstruction images.Artificial vertebral body and screw loosening were observed on lateral X-ray or CT sagittal reconstruction images.Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) were used to evaluate pain relief and functional recovery.Results All patients were followed up for 18-24 months [(22.2 ± 2.0) months].base on ASIA grading criteria:one grade A (Group C) was restored to grade C,three grade B (Group B) were restored to grade D,two grade B (Group C) were restored to grade C,six grade C (four in Group A,two in Group B) and two grade D (Group A) were restored to grade E (P ＜ O.05).The correction of sagittal Cobb angle was restored from (26.1 ± 5.6) ° before surgery to (3.7 ± 1.5) ° immediately after surgery and was (4.8 ± 1.0) ° at last follow-up (P ＜ 0.05).There was no loosening of artificial vertebral body or screw in any patient.The VAS score dropped from (6.3 ± 0.9) points before surgery to (2.0 ± O.7) points at the last follow-up,and ODI score was also significantly decreased from (72.6 ± 9.2) points before surgery to (25.2 ± 5.2) points at the last follow-up (P ＜ 0.05).Conclusion The combination of TLICS and LSC can clearly guide the surgical decision-making of patients with thoracolumbar fracture.The operation plan can be made according to the results of the combined scoring.After the operation,the local kyphosis angle of the patients recovers significantly,the pain is relieved and the function is improved significantly.

Objective To establish a novel rat model of chronic skeletal muscle composite injury in the lumbar region,to explore its mechanism and treatment method in depth.Methods Twenty-eight SD rats were randomly divided into control group(n = 10),Hitting injury model(HIM)group(n = 9),Composite damage model(CDM)group(n = 9)(vertical blow combined with forced prolonged sitting).Open field test,HE staining and PCR sequencing were performed 3 days after modeling.Results The open field distance of rats in HIM group was significantly shorter than that in the CDM group,and both groups had shorter distances than the control group.HE staining showed multiple muscle fiber breaks,significant widening of muscle gaps,uneven distribution of muscle nuclei,and visible congestion in the model group of simple blow injury;In the CDM group,muscle fibers were ruptured,the muscle gaps were slightly widened,and inflammatory cell infiltration was observed between the muscles,especially around the muscle fiber breakage,with muscle fiber nuclei gathering.A volcano plot of the sequencing result suggested significant differences in the Pf4 gene.GO analysis of muscle tissue in model group rats showed upregulation of oxygen binding and carrier activity pathways.Conclusions This study attempted to establish a composite skeletal muscle injury model to study the pathological changes of chronic skeletal muscle injury in the low back pain and evaluate the efficacy of treatment method.It has practical application value in animal experiments for chronic non-specific low back pain.

Objective:To explore the feasibility of deep learning-based restoration of obscured thyroid ultrasound images.Methods:A total of 358 images of thyroid nodules were retropectively collected from January 2020 to October 2021 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and the images were randomly masked and restored using DeepFillv2. The difference in grey values between the images before and after restoration was compared, and 6 sonographers (2 chief physicians, 2 attending physicians, 2 residents) were invited to compare the rate of correctness of judgement and detection of image discrepancies. The ultrasound features of thyroid nodules (solid composition, microcalcifications, markedly hypoechoic, ill-defined or irregular margins, or extrathyroidal extensions, vertical orientation and comet-tail artifact) were extracted according to the Chinese Thyroid Imaging Reporting and Data System (C-TIRADS). The consistency of ultrasound features of thyroid nodules before and after restoration were compared.Results:The mean squared error of the images before and after restoration ranged from 0.274 to 0.522, and there were significant differences in the rate of correctness of judgement and detection of image discrepancies between physicians of different groups(all P<0.001). The overall accuracy rate was 51.95%, the overall detection rate was 1.79%, there were significant differences also within the chief physicians and resident groups (all P<0.001). The agreement rate of all ultrasound features of the nodules before and after image restoration was higher than 70%, over 90% agreement rate for features such as solid composition and comet-tail artifact. Conclusions:The algorithm can effectively repair obscured thyroid ultrasound images while preserving image features, which is expected to expand the deep learning image database, and promote the development of deep learning in the field of ultrasound images.

Objective To observe the clinical efficacy of Yinlian Gargle in the treatment of acute radiation-induced oropharyngeal mucositis after nasopharyngeal carcinoma radiotherapy.Methods Thirty-two patients with nasopharyngeal carcinoma,who had received first radiation,were randomly split into two groups:the trial group(19 cases)and the control group(13 cases).After all groups were treated with radiotherapy and chemotherapy,the control group was given rinse treatment with saline whereas the trial group was given Yinlian Gargle.The incidence of severe acute radiation-induced oropharyngeal mucositis,the duration and intensity of oropharyngeal discomfort and pain(NRS score),quality of life(QOL-NPC score),duration and intensity of radiation-induced side effects(SE-QOL-NPC score)and symptoms of dry mouth(SE1 score)were monitored before and after intervention in two groups.Results The incidence of grade Ⅲ or above radiation-induced oropharyngeal mucositis until the sixth week of radiotherapy in the trial group was considerably lower than that in the control group(P＜0.001),while the incidence of grade I or above radiation-induced oropharyngeal mucositis at 1 month after radiotherapy in the trial group was obviously lower than that in the control group(P＜0.001).The NRS score of pharyngeal discomfort of the trial group was lower than that of the control group starting from the second week of radiotherapy(P＜0.05).The NRS score of oral and oropharyngeal pain was lower than that of the control group starting from the fourth week of radiotherapy(P＜0.05).The SE1 score of the trial group was higher than that of the control group starting from the fifth week of radiotherapy(P＜0.05).After one month of the completion of the radiotherapy,the NRS score of pharyngeal discomfort and the NRS score of oral and oropharyngeal pain in the trial group were lower than those of the control group(P＜0.001).The QOL-NPC score,SE-QOL-NPC score,and SE1 score were all higher than those in the control group(P = 0.05 or P＜0.05).Conclusion Patients with nasopharyngeal cancer can greatly reduce their risk of developing severe acute radiation-induced oropharyngeal mucositis,effectively delay and relieve related symptoms,and enhance quality of life by consistently using Yinlian Gargle during radiotherapy.Additionally,a month after the completion of radiotherapy,it still has positive therapeutic effects on acute radiation-induced oropharyngeal mucositis.