To summarize the accumulated successful experiences, defeated cases and lessons the recent year’s clinical studies, works and experiences of hip prosthesis combining the relevant status abroad and to analyze some questions such as the operations are not standardized; the indications are not strict; overemphasizing the navigation and mini-invasion; clinical techniques are irregular, and the patients should be educated, and so on. The above questions influence the good development of the Chinese joint prosthesis and reduce the clinical outcomes of the joint prosthesis. Taken together, these questions should be concerned and resolved. Relevant solutions are discussed.

Sleep apnea syndrome(SAS) and its harm to the health are briefly introduced,the review on history and classification of sleep non-invasive ventilator is presented,and therapy mechanism of CPAP on SAS is described.Furthermore,the specifications of three popular CPAP in the market are compared and some new technologies of CPAP are discussed.

OBJECTIVE: To evaluate therapeutic effect and safety of poly DL-lactic bio-absorbable screws in the treatment of Pipkin fractures.METHODS: A total of 13 Patients of Pipkin fractures received treatment at the Department of Orthopaedics, Third People's Hospital of Wujiang City and Department of Orthopaedics, First Affiliated Hospital of Soochow University from March 2003 to October 2007 were selected, including 10 males and 3 females, mean aged 30.5 years. Six of them had a Pipkin type Ⅰ fracture,4 had a Pipkin type Ⅱ fracture, and 3 patients had a Pipkin type Ⅳ fracture. In all the operative procedures, a dorsolateral Kocher-Langenbeck approach was used.RESULTS: After an average duration of 47.9 months follow-up, all fractures achieved complete bony healing. One patient had femoral head avascular necrosis and 1 had persistent hip pain, but no heterotopic ossification was observed. According to Harris hip score: Pipkin type I 85 points, type Ⅱ 90 points and type Ⅳ 77 points. According to the Thompson-Epstein hip scale, 3 patients were rated as excellent, 8 good, 1 fair, and 1 poor; the excellent and good rate was 84.6%.CONCLUSION: Poly DL-lactic bio-absorbable screw fixations are safe and effective in treating Pipkin fractures.

An impeller plays a significant role in the non-invasive ventilator. This paper shows a model of impeller for noninvasive ventilator established with the software Solidworks. The model was studied for feasibility based on ANSYS. Then stress and strain of the impeller were discussed under the external loads. The results of the analysis provided verification for the reliable design of impellers.
Equipment Design ; Humans ; Respiration, Artificial ; instrumentation ; Software ; Stress, Mechanical ; Ventilators, Mechanical

Objective:To explore the application effects of modified laparoscopic total extraperitoneal hernia repair (TEP) and laparoscopic transabdominal preperitoneal hernia repair (TAPP) in inguinal hernia.Methods:One hundred and twenty-five patients with inguinal hernia in Yiwu Central Hospital from February 2017 to December 2019 were selected for retrospective study. They were divided into modified TEP group (63 cases) and TAPP group (62 cases). The modified TEP group was treated with modified TEP, and the TAPP group was treated with TAPP. The perioperative operation related indexes, serum oxidative stress indexes, 1-year recurrence rate and semen quality indexes were compared between the two groups.Results:The scores of visual analogue scale after operation for 24 h in the modified TEP group was lower than that in the TAPP group: (1.68 ± 0.39) scores vs. (1.97 ± 0.46) scores, P<0.05. After operation for 3 d, the levels of serum superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) in the modified TEP group were higher than those in the TAPP group: (92.79 ± 8.82) μmol/L vs. (84.40 ± 7.36) μmol/L, (81.52 ± 9.37) U/L vs. (75.75 ± 8.50) U/L; and the level of malondialdehyde (MDA) in the modified TEP group was lower than that in the TAPP group: (23.42 ± 3.3) μmol/L vs. (26.71 ± 3.92) μmol/L; the differences were statistically significant ( P<0.05). There was no significant difference in 1-year recurrence rate between the two groups ( P>0.05). One year after operation, the levels of acid phosphatase (ACP), fructose (FRU) and α- glucosidase (α- Glu) in the modified TEP group were higher than those in the TAPP group: (180.87 ± 20.15) kU/L vs. (159.85 ± 14.50) kU/L, (3.37 ± 0.84) g/L vs.(2.53 ± 0.67) g/L, (62.94 ± 6.25) kU/L vs. (43.96 ± 5.31) kU/L, the differences were statistically significant ( P<0.05). Conclusions:Both modified TEP and TAPP are effective methods for the treatment of inguinal hernia, but the former can reduce surgical trauma, recover quickly, and protect normal reproductive function.

OBJECTIVETo study the expression and clinical significance of MTDH and VEGF in triple-negative breast cancer (TNBC).

METHODSTissue samples of 168 breast cancers (including 112 TNBC tissue and 56 non-TNBC tissue), 10 breast fibroadenomas and 15 normal breast tissues were collected. Postoperative specimens were examined by immunohistochemistry for MTDH and VEGF expression. The correlation between the expression of MTDH and VEGF and clinicopathological features was analyzed.

RESULTSMTDH and VEGF were expressed in 57.1% and 49.4% of breast cancer patients, 64.3% and 56.3% in TNBC patients, respectively, significantly higher than that in the non-TNBC tissues, breast fibroadenomas and normal breast tissues (P<0.05 for all). Statistically significant correlation was found between the MTDH and VEGF expressions (r=0.356, P<0.001). Moreover, MTDH expression was correlated with tumor size, BMI index, lymph node metastasis, pathological stage, recurrence and metastasis, and the expression of p53 and Ki-67 proteins (P<0.05 for all). The VEGF protein expression was correlated with lymph node metastasis, pathological staging, recurrence and metastasis, and the expression of Ki-67 protein (P<0.05 for all). The patients with high expression of MTDH and VEGF showed a lower DFS and OS (P<0.05 for both).

CONCLUSIONSMTDH and VEGF expression may be correlated with tumor angiogenesis and progression and has the potential to be valuable prognostic factors in patients with TNBC.

Biomarkers, Tumor ; metabolism ; Breast ; metabolism ; Cell Adhesion Molecules ; metabolism ; Disease-Free Survival ; Female ; Fibroadenoma ; blood supply ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Proteins ; metabolism ; Neovascularization, Pathologic ; Prognosis ; Triple Negative Breast Neoplasms ; blood supply ; metabolism ; pathology ; Vascular Endothelial Growth Factor A ; metabolism

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To research the procedure for creating an animal model of mitral regurgitation by implanting a device through the apical artificial chordae tendineae, and to assess the stability and dependability of the device. Methods Twelve large white swines were employed in the experiments. Through a tiny hole in the apex of the heart, the artificial chordae tendineae of the mitral valve was inserted under the guidance of transcardiac ultrasonography. Before, immediately after, and one and three months after surgery, cardiac ultrasonography signs were noted. Results All models were successfully established. During the operation and the follow-up, no swines died. Immediately after surgery, the mitral valve experienced moderate regurgitation. Compared with preoperation, there was a variable increase in the amount of regurgitation and the values of heart diameters at a 3-month follow-up (P<0.05). Conclusion In off-pump, the technique of pulling the mitral valve leaflets with chordae tendineae implanted transapically under ultrasound guidance can stably and consistently create an animal model of mitral regurgitation.