BACKGROUND:Now the filling material which is used for the treatment of osteoporotic compression fractures is mainly polymethacrylic acid (PMMA),but the PMMA as a permanent foreign body cannot promote bone regeneration,and has a downward extension of the possibility of mechanical properties with time prolonging,so a new type of filling material used to substitute PMMA is looking.OBJECTIVE:To investigate the effect and image characteristics of different filling materials on percutaneous vertebroplasty performing on a goat model of osteoporotic compression fracture.METHODS:Three vertebral fracture models were established on osteoporosis goats by using an appropriate mechanical stress.Under the G-arm X-ray machine,the fractured vertebrae was performed with percutaneous vertebroplasty and then filled with polymethyl methacrylate (PMMA),self-setting calcium phosphate cement (CPC) and recombinant human bone morphogenetic protein-2(rhBMP-2)/self-calcium phosphate cement.RESULTS AND CONCLUSION:① A total of 36 vertebral bodies of 12 goats were successfully performed with percutaneous vertebroplasty,and there was no significant difference in filling quantity among three materials (3.5±1.8) mL (P>0.05).Bolus resistance of PMMA was strong,but operative time was short,and the image was great;the bolus resistance of self-CPC and rhBMP-2/self-CPC was weak,operative time was long,but there was no leakage placeholde.②CT scanning results on the 2~(nd) day after surgery demonstrated that the three materials were disorderly distributed in the vertebral body,showing high-density patching shaping.Six out of 36 vertebral bodies were leakage,which was induced by PMMA (n=4),self-CPC (n=1),and rhBMP-2/self-CPC (n=1).③ Scanning electron microscope indicated that all materials in the PMMA group were not able to closely bind with host bone,but self-CPC and rhBMP-2/self-CPC were able to closely bind with host bone.The results suggested that rhBMP-2/self-CPC is characterized by long-term operation,short time of bone substitute,and stabilization of reconstructed spine.

Objective To evaluate the outcome and safety of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) in the management of esophageal mucosal lesion.Methods The clinical data of 70 patients with esophageal mucosal lesion were analyzed.Twenty-five patients were treated by ESD (ESD group) and 45 patients were treated by EMR (EMR group).The enbloc resection rate,tissue healing resection rate,operation time,complication and recurrence rate were compared between two groups.Results The enbloc resection rate,tissue healing resection rate in ESD group were significantly higher than those in EMR group [60.0％(15/25) vs.48.9％(22/45),48.0％(12/25) vs.40.0％ (18/45)] (P ＜0.05).The local recurrence rate in ESD group was lower than that in EMR group [4.0％ (1/25) vs.20.0％ (9/45)] (P ＜ 0.05).The severe complication such as delayed hemorrhage,perforation,stenosis between two groups had no significant difference (P ＞ 0.05).The operation time in ESD group was (64.3 ±27.1) min,and significantly longer than that in EMR group [(27.6 ± 14.1) min] (P ＜0.05).Conclusions Compare with EMR,ESD has better enbloc resection rate,tissue healing resection rate,and lower recurrence rate.It is more safe and effective in the therapy of esophageal mucosal disease.

Objective To explore the pathological changes of liver fibrosis of patients with schistosomiasis liver fibrosis.Methods Between January 2003 and January 2009,microstructure retrospective observation of liver biopsy pathological paraffin specimens by optical microscope was carried out in 9 cases of patients with schistosomiasis liver fibrosis in Quzhou people's hospital internal medicine.Then those paraffin blocks were changed to resin embedding blocks and superfine slices were made.Ultrastructure observation by electronic microscope was carried out.Results Visible fibrous scar formation and fiber calcified nodule eggs in microscopic structure of liver tissue in 9 cases of patients with schistosomiasis liver fibrosis were observed.Ultrastructural observation of the 9 cases of patients with schistosomiasis liver fibrosis showed that most of the liver cell profile was clear,liver cell nucleus gap expanded,the number of rough endoplasmic reticulum decreased,swollen mitochondria crest occurred,collagen deposited around hepatic sinus and surroundings and collagen fiber bundle around small veins extended to hepatic lobule and surroundings,and calcified nodule eggs were not easy to find.Conclusions Under an electron microscope,diseased tissue cells can be observed at subcellular level or organelle level,which provides more insight into the pathology of schistosomiasis liver fibrosis.Calcified egg nodules are easily found by an optical microscope other than an electron microscopy.The two can complement each other.

Objective To investigate the regularity and significance of serum interleukin-6(IL-6) levels in the patients with sepsis.Methods Forty sepsis patients with APACHEⅡ scores over 12 and 30 normal controls were involved in the study.The IL-6 levels in serum were detected with radio-immunity analysis assay and the correlations among the IL-6 levels,the prognosis and APACHEⅡ score were investigated.Results In the patients with sepsis,the average level of IL-6 in serum was(152.02?55.77) pg/ml,which was significantly higher than that of the control group [(85.79?30.96) pg/ml](P

OBJECTIVE: To discuss the the control of hyperglycemia in patients with severe acute pancreatitis(SAP).METHODS: Patients were treated with NPH(subcutaneous injection) or continuous subcutaneous insulin injection(CSII) or Insulin glargine(subcutaneous injection).Incidences of hypoglycemia and hyperglycemia and the blood sugar level within 5 days of admission were measured.RESULTS: The incidences of blood glucose level being ≤4.0 mmol?L-1 or ≥11.1 mmol?L-1 were significant different in CSII group and insulin glargine group compared with NPH group respectively(P

Objective To evaluate the diagnosis and application values of endoscopic ultrasonography (EUS) with micro-probe in duodenal lesions.Methods Clinical data of 37 patients with duodenal lesions and underwent EUS with micro-probe were analyzed retrospectively.All lesions were treated with endoscopic mucosal resection or surgical resection to get the pathological diagnosis.The diagnostic accuracy of EUS with microprobe and endoscopic biopsy was analyzed respectively.Results The overall diagnosis accuracy of EUS with micro-probe on duodenal lesions was 78.38％ (29/37),with a higher diagnostic rate in duodenal lipoma 4/4and duodenal adenomas 10/12 than in early duodenal cancer 2/4 or inflammatory hyperplasia 3/8.The overall diagnostic accuracy of biopsy on duodenal lesions was 40.54％ (15/37),with a higher diagnosis rate on duodenal carcinoid 1/1 and adenoma 7/12 than on duodenal stromal tumor 1/10 and lipoma 1/4.Conclusion Pathological evaluation of endoscopic biopsy sample is not a golden standard for the diagnosis of duodenal lesions,while EUS with micro-probe has better diagnostic and application value.

Objective:To explore the short-term outcomes of a 3D printed trabecular block cage to assist posterior internal fixation for the treatment of patients with basilar invagination and atlantoaxial dislocation.Methods:Between June 2017 and February 2019, 12 patients with basilar invagination and atlantoaxial dislocation underwent atlantoaxial distraction and posterior internal fixation at Department of Orthopedics, The First Affiliated Hospital to Zhengzhou University. They were 5 males and 7 females, aged from 34 to 62 years (average, 45.6 years). 3D printed cages were inserted intraoperatively between the joints of the atlantoaxial lateral mass. The atlanto-dental interval interval (ADI), cervico-medullary angle (CMA) and distance from tip of the odontoid process to Chamberlain's line (DOCL) and the Japanese Orthopedic Association (JOA) scale were compared between preoperation and 12 months postoperation to observe the fusion of the joints of the atlantoaxial lateral mass.Results:Operation went on uneventfully in all the 12 patients. Operation time averaged 116.5 min (from 85 to 190 min), fluoroscopy frequency 9.4 times (from 6 to 21 times), and intraoperative bleeding 82.3 mL (from 50 to 210 mL). No such postoperative complications occurred as cerebrospinal leak, cerebral infarction, or breakage, displacement or loosening of implants. All patients were followed up for 18 to 42 months (mean, 26.3 months). Their preoperative JOA, ADI, CMA and DOCL [8.33±0.98, (8.66±1.64) mm, 119.63°±4.15° and (9.66±2.15) mm] were significantly improved to 14.17±1.03, (2.63±0.59) mm, 153.76°±7.88° and (2.07±0.69) mm ( P<0.05) at 12 months postoperation. Bony fusion was achieved in all the operative segments. Conclusion:In the treatment of patients with basilar invagination and atlantoaxial dislocation, a 3D-printed trabecular block cage can be used to assist posterior internal fixation to achieve satisfactory reduction and maintain the height of joint space, leading to satisfactory short-term outcomes.

Robot assisted surgery is becoming a widely popular technology and is now entering the total knee replacement. The development of total knee replacement and the operation system structure are introduced in this paper. The vision position technology and the related calibration technology, which are very important, are also analyzed. The experiments of error analysis in our WATO system demonstrate that the position and related calibration technologies have a high precision and can satisfy surgical requirement.
Arthroplasty, Replacement, Knee ; instrumentation ; methods ; Humans ; Pattern Recognition, Automated ; methods ; Robotics ; instrumentation ; Surgery, Computer-Assisted ; instrumentation ; methods

Objective:To explore the clinical value of antegrade transabdominal nasobiliary duct placement in the treatment of fine diameter choledocholithiasis in the elderly.Methods:From June 2021 to June 2022, 60 elderly patients with fine diameter common bile duct stones who were treatment in the Shandong Chengwu County People′s Hospital were enrolled. All patients underwent laparoscopic common bile duct exploration (LCBDE), 28 patients in the experimental group were underwent antegrade transabdominal placement of nasal bile ducts, 32 patients in the control group were treated with T-tube drainage. The operative index, postoperative complications and total medical expenses, postoperative patient satisfaction were compared between the two groups.Results:The operation was successful in both groups, and no conversion to laparotomy or death occurred. The indwelling time of common bile duct drainage, postoperative hospital stay in the experimental group were shorter than those in the control group, the incidence of postoperative pain was lower than that in the control group, the postoperative patient satisfaction was higher than that in the control group: (6.46 ± 1.04) d vs. (33.63 ± 1.19) d, (8.11 ± 0.74) d vs. (10.38 ± 1.54) d, 3.6%(1/28) vs. 21.9%(7/32), (9.21 ± 0.83) scores vs. (7.56 ± 0.62) scores, there were statistical differences ( P<0.05). The surgical time, postoperative activity time, gastrointestinal function recovery time and total medical expenses between the two groups had no statistical differences( P>0.05). The postoperative complications between the two groups had no statistical differences ( P>0.05). Conclusions:Anterior transabdominal nasobiliary duct placement can shorten the retention time and hospitalization time of the common bile duct drainage tube, reduce the incidence of postoperative complications, and promote rapid recovery. It is a safe and effective surgical method.

OBJECTIVE: The prior functional MRI studies have demonstrated significantly abnormal activity in the bilateral superior temporal gyrus (STG) of anxiety patients. The purpose of the current investigation was to determine whether the abnormal activity in these regions was related to a loss of functional connectivity between these regions. MATERIALS AND METHODS: Ten healthy controls and 10 anxiety patients underwent noninvasive fMRI while actively listening to emotionally neutral words alternated by silence (Task 1) or threat-related words (Task 2). The participants were instructed to silently make a judgment of each word's valence (i.e., unpleasant, pleasant, or neutral). A coherence analysis was applied to the functional MRI data to examine the functional connectivity between the left and the right STG, which was selected as the primary region of interest on the basis of our prior results. RESULTS: The data demonstrated that the anxiety patients exhibited significantly increased activation in the bilateral STG than the normal controls. The functional connectivity analysis indicated that the patient group showed significantly decreased degree of connectivity between the bilateral STG during processing Task 2 compared to Task 1 (t = 2.588, p = 0.029). In addition, a significantly decreased connectivity was also observed in the patient group compared to the control group during processing Task 2 (t = 2.810, p = 0.012). CONCLUSION: Anxiety patients may exhibit increased activity of the STG but decreased functional connectivity between the left and right STG, which may reflect the underlying neural abnormality of anxiety disorder, and this will provide new insights into this disease.
Adult ; Anxiety Disorders/pathology/*physiopathology ; Case-Control Studies ; Emotions/physiology ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Middle Aged ; Temporal Lobe/pathology/*physiopathology