Objective To study the effect of intraoperative intermittent pneumatic compression(IPC)on patients undergoing gynaecological laparoscopic surgery.Methods Two hundred infertile patients to undergo exploratory laparotomy were randomized equally into the observation group and the control group.The patients in both groups were managed with laparoscopic operation at lithotomy position under general anaesthesia.During the operation,the control group was treated with nil intervention,while the observation group with IPC.The two groups were compared in terms of blood coagulation indexes before operation,days 1 and 3 after operation,blood flow rate of femoral vein before operation,30 mins and day 1 after the operation,and deep vein thrombosis(DVT) three months after operation.Results Three months after operation,12 cases of DVT occurred in the control group,and only 2 cases in the observation group.The difference was significant between the groups(χ2=6.22,P<0.05).The prothrombintime time and activated par-tialthrom boplastin time in the observation group were both longer than those of the control group,but the human fibrinogen was less(all P<0.05).The blood flow rate of femoral vein in the observation group was higher than that of the control group 30 mins and day 1 after operation(P<0.05),though the rates of femoral vein in the observation group showed insignificant differences between all the time points(F=1.94,P>0.05).Conclusion IPC used during laparoscopic surgery may be safe and effective as a result of improving blood circulation of lower limbs and preventing venothrombosis in lower limbs.

AIM To investigate effect of dipfluzine on sodium current (INa+) in isolated single guinea-pig ventricular myocytes. METHODS INa+ was measured by whole cell patch-clamp technique in single isolated guinea-pig ventricular myocytes which were prepared by enzymatic dissociation method. RESULTSCardiac INa+ was elicited by 50-ms pulses to +50 mV from holding potential at -80 mV with a step of +10 mV, which could be blocked completely by tetrodotoxin 10 μmol·L-1. The peak INa+ occurred at about -20 mV and the reversal potential for INa+ was about +30 mV. Dipfluzine inhibited cardiac INa+ in a concentration-dependent manner. The blocking effect of dipfluzine on INa+ was reversible. Dipfluzine suppressed cardiac INa+, without modifying maximum activation potential and reversal potential. The peak of INa+ was decreased by about 46% at -20 mV and shape of I-V curve was not altered by dipfluzine 40 μmol·L-1. Dipfluzine shifted the steady-state inactivation curve of INa+ towards more negative without changing the slope factor and produced very little change in the steady-state activation curve towards more positive. The mean half activation voltage was (-34.9±5.1) mV and slope factor was (6.0±4.8) mV under control condition and (-33.7±3.6) mV and (5.6±2.4) mV following exposure to dipfluzine 40 μmol·L-1. The half inactivation voltage was (-73.0±4.6)mV and slope factor was (4.8±1.8)mV under control condition and (-82.8±7.2)mV and (4.8±1.8)mV following dipfluzine 40 μmol·L-1 treatment. Dipfluzine delayed recovery of cardiac INa+ from inactivation state. The time course of recovery was (36±11) ms in control group and (79±28) ms in dipfluzine 40 μmol·L-1 group. CONCLUSION Dipfluzine inhi- bits cardiac INa+ in a concentration-dependent manner and has higher affinity for the inactivated state than that for resting state of Na+ channels.

Objective To select early prediction indexes related to the prognosis of severe hepatitis in ultrasonography,and evaluate its clinical value.Methods Clinical data of 269 cases of severe hepatitis patients was analyzed retrospectively.Cox proportional hazards regression model was adopted to analyze 13 possible prediction ultrasonic parameters for severe hepatitis,including thickness of the right hepatic lobe,portal vein (PV) diameter,volume of ascites,etc.After selected from these parameters,the clinical value of early prediction factor was evaluated with ROC curve.Results Multivariate analysis showed that thickness of the right hepatic lobe,portal vein (PV) diameter,opening of paraumbilical vein and bile viscosity were related to the death of severe hepatitis patients (P ＜ 0.05).The thickness of the right hepatic lobe contributed most (Wald =40.479),its sensitivity and specificity for prediction were 93.4％,82.8％ respectively(P ＜ 0.01).Conclusions Thickness of the right hepatic lobe,PV diameter,opening paraumbilical vein and bile viscosity are early prediction factors for severe hepatitis,need to be monitored in treatment,especially for thickness of the right hepatic lobe.

Acute Disease ; Adult ; Female ; Humans ; Mesenteric Ischemia ; etiology ; surgery ; Pregnancy ; Pregnancy Complications ; surgery ; Protein S Deficiency ; complications ; Remission Induction

LINGO-1，a Nogo receptor-interacting protein-1 rich in leucine repeat sequences and immunoglobulin structural domains，which is specifically expressed in neurological diseases. In recent years，more and more evidences indicate that LINGO-1 plays an important role in glial scar formation，cell death and inflammatory reaction. LINGO-1 inhibits oligodendrocyte activation，and prevents axon and myelin formation and functional recovery，and is therefore considered to be a negative regulator of neuronal survival，neurite extension and axon myelination. The change of LINGO-1 level is related to the occurrence and development of many neurological diseases. This article reviews the physiological function of LINGO-1 and summarizes the latest research progress of LINGO-1 in multiple sclerosis，spinal cord injury，neonatal brain injury and epilepsy，so as to explore new strategies for the treatment of neurological diseases.

Objective:To analyze the effectiveness of multi-layer silicone foam dressing in preventing pressure injury of sacrococcygeal and heel by systematic evaluation.Methods:Randomized controlled studies on the effectiveness of multi-layer silicone foam dressings in preventing stress injury of sacrococcygeal and heel of hospitalized patients in CNKI, Wanfang, VIP, CBM, PubMed, Embase, The Cochrane Library and Web of Science were systematically reviewed. The retrieval time was from January 2012 to January 2023, and the Meta were screened and extracted by two researchers respectively. After evaluating the bias risk of the included studies, they were conducted by RevMan 5.4 software.Results:Eight randomized controlled studies involving 4 725 patients were included. Meta-analysis showed that multilayer silicone foam dressing could reduce the incidence of sacrococcygeal stage I pressure injury ( RR=0.18, 95% CI 0.09-0.35, P<0.01), and reduce the incidence of the first-stage heel pressure injury ( RR=0.29, 95% CI 0.13-0.66, P<0.05). It could reduce the incidence of sacrococcygeal stage Ⅱ and more serious pressure injury ( RR=0.42, 95% CI 0.31-0.58, P<0.01), but the influence on the incidence of the second-stage heel pressure injury and more serious heel pressure injury was not clear ( RR=0.52, 95% CI 0.27-0.99, P=0.05) Conclusions:Multi-layer silicone foam dressing can effectively reduce the incidence of sacrococcygeal pressure injury and reduce the incidence of first-stage pressure injury in heel, but the impact on the incidence of second-stage and more serious pressure injury in heel is still unclear.

Social isolation is a serious psychological and social problem that can affect the discharge readiness and stoma adaptation of the patients with intestinal stoma,lead to increase of complication incidence rate,decrease of t reatment compliance and decrease of quality of life.This article comprehensively explains the concept and influencing factors of social isolation in enterostomy patients,and provides the countermeas-ures and suggestions aiming at the intervention plans in order to provide reference for formulating the targeted intervention measures in the future.

Objective:To compare the efficacy of internal limiting membrane (ILM) flip coverage with ILM multilayer tamponade in the treatment of highly myopic macular hole-associated retinal detachment (MHRD).Methods:A retrospective clinical study. From November 2019 to June 2022, 53 cases and 53 eyes of MHRD patients who were examined and diagnosed at the Eye Centre of Renmin Hospital of Wuhan University were included in the study. Among them, 21 cases and 21 eyes were male and 32 cases and 32 eyes were female. The age was (55.28±11.40) years. The patients were categorized into two groups: the ILM coverage group (from November 2019 to September 2020) and the ILM multilayer tamponade group (from October 2020 to June 2022) based on their surgical procedures. The ILM coverage group comprised of 11 cases involving 11 eyes, while the ILM multilayer tamponade group comprised of 42 cases involving 42 eyes. Best-corrected visual acuity (BCVA) and optical coherence tomography were conducted. BCVA was measured using standardized international visual acuity charts and transformed to logarithmic minimum angle of resolution (logMAR) visual acuity for statistical analysis. The affected eyes were all treated with standard transciliary flattening three-channel 23-gauge vitrectomy. The inverted ILM flap technique was combined with flap coverage in the inverted group, while the ILM multilayer tamponade group used circular ILM stripping to preserve the ILM in the macular area and ILM flap around the macular hole with multilayer ILM tamponade. Postoperative follow-up was carried out for a minimum of 6 months. Relevant examinations were conducted during the follow-up using the same equipment and methods as those used before surgery. The BCVA, as well as the closure of macular hole, resurfacing of the retina, and development of macular hyperplasia, were observed.Results:In the ILM-covered group, the macular hole was closed in 7 out of 11 eyes after 1 week of surgery. At 1 month after surgery, the macular hole was closed in all treated eyes. At 6 months after surgery, the macular hole was closed in 9 eyes, while 2 eyes were reopened. In 42 eyes from the ILM-multilayer tamponade group, the macular hole closed after surgery in 41 eyes. At 6 months postoperatively, best corrected visual acuity (BCVA) of eyes in ILM-covered and ILM-multilayer tamponade groups was 0.91±0.29 and 1.05±0.39, respectively, with no statistically significant difference between the two groups ( t=1.140, P=0.260). The BCVA of the eyes in both groups showed a significant improvement compared to the preoperative period with a statistically significant difference ( t=8.490, 13.840; P<0.000 1); 6 months after surgery, 10 out of 11 eyes in the ILM coverage group had a restored retina with no detectable macular hyperplasia; 42 eyes in the ILM multilayer tamponade group had a restored retina, but 19 of these eyes had detectable macular hyperplasia. Conclusions:Either ILM flap coverage or ILM multilayer tamponade contributes to high myopic MHRD closure and improved visual acuity. Compared to ILM flap coverage, ILM multilayer tamponade results in higher and earlier rates of macular hole closure and lower rates of macular hole reopening. However, ILM multilayer tamponade may lead to a higher proportion of macular hyperplasia formation without affecting visual acuity recovery at 6 months after surgery.

Objective To investigate the risk factors of postoperative complications in patients with spinal tuberculosis and analyze the value of prognostic nutritional index(PNI)in predicting these complications.Methods The clinical data of 156 patients with spinal tuberculosis who underwent surgery in the Affiliated Hospital of Zunyi Medical University from January 2018 to July 2022 were retrospectively analyzed.The patients were divided into a complication group and a non-complication group based on the presence or absence of postoperative complications.Baseline data,laboratory indicators,and surgery-related indicators were compared between the two groups.The risk factors for postoperative complications in spinal tuberculosis were analyzed,and receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of PNI for postoperative complications in the patients.Results Among all of 156 patients,68 contracted a total of 82 instances of postoperative complications,with an incidence of 43.59%.Coinfection with pulmonary tuberculosis,preoperative anti-tuberculosis treatment duration more than 4 weeks,surgical operation duration,and drainage days were identified as independent risk factors for postoperative complications in spinal tuberculosis(P<0.05).On the other hand,a higher PNI was found to be a protective factor against postoperative complications of the spinal tuberculosis(P<0.05).The area under the ROC curve for PNI predicting postoperative complications ofthe spinal tuberculosis was 0.805.Conclusion The risk of postoperative complications in patients with spinal tuberculosis is subject to such factors ascoexistence of pulmo-nary tuberculosis,preoperative anti-tuberculosis treatment duration,surgery duration,drainage duration,and preoperative PNI.Preoperative PNI has a certain value for predicting the postoperative complications in the patients.

BACKGROUND:With social progress,the incidence rate of knee osteoarthritis is getting higher and higher in the face of the rapidly developing aging problem in the social population,and the number of total knee replacement operations is gradually increasing. OBJECTIVE:To study the relationship between prosthesis size and stress shielding by improving the tibial prosthesis base. METHODS:A female patient with severe knee osteoarthritis was selected.Based on Mimics,through extracting the bone structure of the knee joint and simulating the total knee replacement surgery,osteotomy,positioning,and implantation operations were carried out to establish the geometric modeling of the total knee replacement prosthesis(including the femoral prosthesis,tibial bracket,and tibial pad),and improve the design of the tibial prosthesis base,analyze the effect of different tibial prosthesis bases on stress shielding of surrounding bone tissue. RESULTS AND CONCLUSION:(1)Compared with single-stem tibial intramedullary stem prosthesis,the design of four-post tibial intramedullary stem prosthesis created a certain degree of stress shielding around the short stem.However,compared with a thicker single long stem,this stress shielding effect was significantly reduced,and the load was evenly distributed among the four short stems,so there was no stress concentration at the bottom of the pile.(2)The design with a rectangular hole in the middle not only provided relatively good stability,but also helped to reduce stress shielding of cancellous bone to a certain extent,with a reduction rate of 77.5%.(3)Compared with a single-stem tibial intramedullary stem prosthesis,both the four-post tibial intramedullary stem prosthesis and the four-post tibial intramedullary stem prosthesis with a hole in the middle have good stability,which can reduce stress shielding to a certain extent without causing stress concentration,providing theoretical guidance for the design of the tibial intramedullary stem.