Humans ; Minimally Invasive Surgical Procedures ; Neurosurgery ; methods

Objective To assess the characteristics of heart rate turbulencer (HRT) in elderly patients with decreased left ventricular diastolie function.Methods 40 patients were divided into two groups:20 patients with enlarged left atrium and 20 patients without enlarged left atrium.20 healthy people were selected as controls. Turbu1ence onset (TO) and turbulence slope (TS) were measured,and correlation was analyzed between TO,TS and the E/A,index of Macruz and heart rate variability (HRV).Results TO was higher (P<0.05) and TS was lower in patients (P<0.01),TO was higber in patients with enlarged left atrium than in with out enlarged lef atrium people (P<0.05) and TS was lower (P<0.01).TO was positively (P<0.01) and TS Was negatively (P<0.05),correlated with the index of Macruz.TO Was negatively (P<0.05) and TS was positively (P<0.05) related to SDNN and SDANN.Conclusion HRT can be used as a potential risk predictor in decreased left ventricular diastolic function patients.

Objective To study factors associated with necrosis and calcification of cyst echinococcosis. Methods This study retrospectively analyzed 191 cases of hepatic cycstic echinococcosis admitted from 2005 to 2008 in the First Affiliated Hospital of Xinjiang Medical University Department of General Surgery, possible relevant factors screened were the patients' gender, age, operation frequency, hepatitis, gall stones, calcium of blood serum, multiple hepatic hydatid cyst, biliary fistulae and hepatic cycstic echinococcosis degeneration. Single-factor analysis and multi-factors analysis were conducted. Results The single-factor independent samples t-test showed that age is significantly related to hepatic cycstic echinococcosis degeneration (t = - 2. 455, P = 0. 008). Single factor Chi-square test showed that factors impacting on hepatic cycstic echinococcosis degeneration were multiple hepatic hydatid cyst and the biliary fistulae (x2 = 6. 848, P = 0. 009; x2 = 7. 149, P = 0. 008). The multiple-factor Logistic regression analysis showed that the age, the multiple hepatic hydatid cyst, and biliary fistulae are the related risk factors(x2 =5. 306,P = 0. 021,OR = 1. 665;x2 = 10. 377,P =0. 001,OR =3. 300;x2 = 4.455,P =0. 035, OR =2. 164) of hepatic cycstic echinococcosis patients with cyst echinococcosis degeneration. Conclusions Age, multiple hepatic hydatid cyst and biliary fistulae are the risk factors associated with degenerative necrosis and calcification of hepatic echinococcosis.

Objective:To analyze the effect and safety of blood glucose fluctuation in brittle diabetes treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor.Methods:Ninety-eight patients with brittle diabetes in Shenzhen Longhua District People's Hospital were selected from May 2017 to May 2019. They were divided into two groups by random number table, 49 cases in each group. The control group was treated with intensive insulin therapy combined with saglitine, while the observation group was treated with intensive insulin therapy combined with sodium-glucose transporter 2 inhibitor. Following up for 12 weeks, the plasma glucose and blood glycemic variations, insulin dosage, plasma 8-iso-prostaglandin F2α, hypersensitive C-reactive protein and safety related indicators were compared between the two groups before and after treatment.Results:Compared with the control group, the standard deviation of blood glucose [(1.8±0.5)mmol/L vs (6.5±1.4)mmol/L, t=7.235], large amplitude glycemic excursions [(6.5±1.1)mmol/L vs (17.3±4.7)mmol/L, t=13.446], postprandial glucose excursion [(1.2±0.4)mmol/L vs (9.2±2.0)mmol/L, t=8.921], inter-quartile range [(3.7±1.1)mmol/L vs (12.4±4.2)mmol/L, t=7.003], means of daily difference [(1.5±0.4)mmol/L vs (4.6±0.8)mmol/L, t=4.537] in the observation group were significantly decreased ( P<0.05), and the levels of plasma 8-iso-prostaglandin F2α [(7.8±1.2)ng/L vs (13.6±2.3)ng/L, t=4.882], hypersensitive C-reactive protein [(5.2±1.3)mg/L vs (8.7±1.3)mg/L, t=4.406], insulin dosage [(30.9±10.2)U/d vs (42.3±13.4)U/d, t=5.726] and body mass index [(18.3±1.2)kg/m 2 vs (21.0±2.3)kg/m 2, t=4.135] also decreased significantly ( P<0.05), and the incidence of hypoglycemic events [16.3%(8/49) vs 36.7%(18/49), χ 2=9.697] and severe hypoglycemia [0 vs 14.3%(7/49), χ 2=7.268] decreased significantly ( P<0.05). Conclusions:Combination of dapagliflozin and intensive insulin therapy can significantly improve glucose metabolism in brittle diabetes, and reduce insulin dosage and hypoglycemic events.

Objective To study the use of early bile duct to bile duct end-to-end(side) anastomosis for extrahepatic bile duct injuries.Methods The clinical data of 25 patients with extrahepatic bile duct injuries with early bile duct to bile duct end-to-end(side) anastomosis were retrospectively analyzed.Results Bile duct injuries happened in laparoscopic cholecystectomy (n=17),laparoscopic exploration of common bile duct (n=1),laparotomy (n=5),and knife wound (n=2).All of the repairs were successfully carried out.Except for one patient who was lost to follow-up,the other patients were followed for over 2 years.There was no bile duct stenosis.One patient died after 5 months of repair in other hospital because of a recurrent bile duct calculus.Conclusions Early bile duct to bile duct end-to-end(side) anastomosis had a good long-term results.The operation needs to be done by a good surgeon or supervised by an experienced specialist in biliary surgery.A prolonged period of T tube stenting is a prerequisite for success.

BACKGROUND:There are controversies about preserving the remnant in the anterior cruciate ligament reconstruction procedure because of its uncertain therapeutic effects.
OBJECTIVE:Tocompare the efficacy and safety of preserving-remnant with removing-remnant for arthroscopic anterior cruciate ligament reconstruction using a meta-analysis.
METHODS:A computer-based online search was conducted in PubMed,Embase,the Cochrane Library, CDSR, CBM, and CNKI databases by using the English key wordsof “anterior cruciate ligamentAND remnant (OR stump)ANDrandomized controled trial (RCT)ORquasi-RCT” and the Chinese key words of“anterior cruciate ligament reconstruction, preserving-remnant, removing-remnant” to screen the relevant articles publishedfrom 1995 to July 2015. Meta-analysis was performed using Review Manager 5.3 software.
RESULTS AND CONCLUSION:A total of 13 randomized controled trials were included. The meta-analysis resultsshowed that there were no statisticaly significant differences in KT1000/2000 scores (OR=-0.28, 95%CI:-0.76-0.20,P=0.25), the good rate of synoveal coverage (OR=-0.30, 95%CI:-0.30-0.90,P=0.32), and the incidence of cyclops leions (OR=0.87,95%CI: 0.63-2.90,P=0.44). Postoperative Lysholm scores (OR=2.45, 95%CI: 0.52-4.39,P=0.01), proprioceptive function (OR=-1.72, 95%CI:-3.32 to 0.13,P=0.03), tunnel enlargement (OR=-0.66, 95%CI:-1.08 to-0.23,P=0.002) in preserving-remnant were superior to removing-remnant for arthroscopic anterior cruciate ligament reconstruction. These results suggest that both preserving-remnantandremoving-remnant for arthroscopic anterior cruciate ligament reconstructioncanobtain satisfactory antero-posterior stability of the knee. Preserving-remnant exhibits superiority in post-operative scores of the knee, proprioceptive function, tunnel enlargement.Furtherhigh-quality randomized controled trials are warranted because of some low-quality studies and the existing biases.

[Objective] To discuss the clinical significance of simple synovial tuberculosis treated and diagnosed by arthroscopy. [Methods] A review study of 8 patients with simple synovial tuberculosis from September 1998 to September 2004. The 8 cases with the main clinical manifestation of articular swelling were confirmed as simple synovial tuberculosis by arthroscopic examination and arthroscopic synovectomy in pathology. [Results] The 8 cases were definitely diagnosed by arthroscopy pathologically. The average follow-up period was two years and four months. For all of the 8 cases, the articular symptoms disappeared, articular function recovered well and the therapeutic effect was satisfactory. [Conclusion] Arthroscopic examination is an effective method to diagnose synovial tuberculosis at early stage. Synovectomy with arthroscopy can remove the pathological synovial membrane and is beneficial to the control of the local tubercular focus.

ObjectiveTo observe the effect of the designed cervical orthosis(CO) and the finished collar in the treatment of vertebroarterial cervical spondylopathy.Methods70 patients with vertebral artery type cervical spondylosis were divided into designed cervical orthosis group (35 casese) and the finished collar group (35 casese) separately.ResultsThe excellent and good rate of the designed cervical orthosis group was 94-3% while that of the finished collar group was 71-4%. There was significant difference between the two groups after 4 weeks of treatment(P<0-01).ConclusionThe designed cervical orthosis(CO) in the treatment of vertebroarterial cervical spondylopathy is more effective than finished collar.

MicroRNAs (miRNAs) play important roles in eukaryotes,plants and some viruses.It is increasingly clear that miRNAs-encoded by viruses can affect the viral life cycle and host physiology.Viral miRNAs could repress the innate and adaptive host immunity,modulate cellular signaling pathways,and regulate the expression of cellular and viral genes.These functions facilitate viral acute and persistent infections,and have profound effects on the host cell survival and disease progression.Here,we discuss the miRNAs encoded by herpesviruses,and their regulatory roles involved in virus-host interactions.

Objective To explore the prevalence and risk factors of knee osteoarthritis (OA) among the elderly in Tianjin. Methods Totally 2038 elderly in Tianjin were investigated from January 2010 to June 2011 according to protocol of APLA-COPCORD Core Questionnaire to identification of risk factors for knee OA. Results The prevalence rates of knee pain and knee OA were 23.1％ and 21.7％,respectively. Knee OA appeared much frequently in women than men (27.6 ％ vs.16.1 ％,x2 =46.893,P＜0.001 ) in the trend of increase with aging(x2 =764.34,P＜0.001).BMI in knee OA group [(25.4±3.3) kg/m2]was significantly higher than in non-knee OA group [(23.8± 2.9) kg/m2],(t =7.944,P＜0.001).Menopause age in female knee OA group was younger than in female non-knee OA group [(50.2±3.7) years vs.(52.8±4.1) years,t=7.665,P＜0.001].Binary logistic regression revealed that age,sex,BMI and age of menopause were risk factors of knee OA,and eating vegetable might prevent from osteoarthritis,whereas there were no significantly association between knee OA and the other factors such as smoking and drinking.Conclusions Age,female and overweight are identified as risk factors of knee OA.