Objective To investigate the security and validity of transabdominal preperitoneal prosthetic (TAPP) in treatment of incarcerated hernia.Methods One hundred and twenty-four patients with incarcerated hernia were divided into 2 groups by random pair method:observation group with treatment of laparoscopic reposition and TAPP (56 cases) and control group with treatment of open reduction and tension-free hernioplasty (68 cases).The operative time,hospital stay,bed time,hospital costs,recurrence rate and complication were compared between the 2 groups.Results All patients in observation group were received laparoscopic surgery successfully.The operation time,hospital stay,bed time in observation group were significandy shorter than those in control group [(37.52 ± 7.78) min vs.(44.23 ± 11.32) min,(4.53 ± 0.89) d vs.(6.85 ± 2.03) d,(9.30 ± 2.65) h vs.(12.63 ± 3.97) h],there were statistical differences (P ＜0.05).The hospital costs in observation group was significandy higher than that in control group [(9 324 ± 599) yuan vs.(7 203 ± 507) yuan],there was statistical difference (P ＜ 0.05).There was no statistical difference in complication rate between the 2 groups (P ＞ 0.05).Follow-up 1 year,there was no recurrence patient in observation group and 1 patient was recurrence in control group,there was no statistical difference between the 2 groups (P ＞ 0.05).Conclusions TAPP is safe and effective with advantages of mini-invasion,quicker recovery but more hospital costs in treatment of incarcerated hernia.The recurrence rate of TAPP is similar to tension-free hernioplasty.

An introduction to the telemedicine service of the hospital in its web-based hospitalprogram which covers theweb-based healthcare center,and thehealthcare cabin to interact with the center remotely.The center operates on the telehealth management platform based on cloud computing, offering remote monitoring,health assessment,health management,follow-up,online consultation,pre-registration and mobile payment.Theweb-based hospitalcan simplify the medical service flow,alleviate the complaints incurred by concentrated quality medical resources,influx of patients and limited physical space of tertiary hospitals,and the tense doctor-patient relationship as well.

Objective To study the effect of 125Iodine seed on the rabbit ischiadic nerve at different time point after implantation. Methods Thirty healthy New-Zealand rabbits were randomly assigned into 3 groups( 2-week group, 2-month group and 4-month group) using envelope method. During operation, 10 radioactive 125I seeds were implanted randomly near one of the ischiadic nerve, while 10 non-radioactive seeds were implanted into the contralateral ischiadie nerve. According to treatment plan system(TPS),90% of the prescription dose (PD)was centered in the specific place, where the nerves were chosen to be studied. After 2 weeks, 2 months and 4 months respectively, nerve electro-physiolngy experiment was used to evaluate the bilateral ischiadic nerves, at the same time the morphology of the ischiadic nerve was examined by general observation, light microscope and electron microscope. The electron microscope photo with the same ×4000 amplification was divided into 100( 10 × 10) cages and non-specific changes in one cage account for 1%. The t test and sum rank test were used for statistics. Results Potential leaking point of experimental ischiadic nerves near heart in 2-week group ,2-month group and 4-month group were (0.52± 0.26), (0.60±0.19), (0.48±0.17)V, while that of the control sides were (0.59±0.19), (0.60± 0.15), (0.53±0.13 ) V, there was no statistical significance in the same group respectively (t=0.91, 0.03,0.67,P>0.05). Potential leak point of experimental ischiadic nerves far from heart in 2-week group, 2-month group and 4-month group were (0.51±0.15), (0.52 s0. 11 ), (0. 53±0.15) V,the control sides were (0.52±0.10), (0.56±0.12), (0.54±0.10)V, there was no statistical significance in the same group respectively (t= 0.25,0.74,0.17, P > 0.05 ). Action potential amplitude of experimental ischiadic nerves near heart in 2-week group,2-menth group and 4-month group were (13.18±4.09), (12.78± 4.42), (12.09±1.20) mV, while that of the control sides were (10.55± 4.21 ), ( 10.31±4.22), (12.88±3.54) mV, there was no statistical significance in the same group respectively (t=1.57,1.36, 0.50,P>0.05). Action potential amplitude of experimental ischiadic nerves far from heart in 2-week group,2-month group and 4-month group were (11.18±3.38), (11.68±3.21), ( 12.52±3.09) mV, while that of the control sides were (11.56±4.80), (10.71±3.40), (11.67±2.48) mV ,there was no statistical significance in the same group respectively(t=0.29,1.01,0.55, P>0.05 ). Nerve conduction velocity of experimental ischiadic nerves in 2-week group,2-month group and 4-month group were (40.56± 9.46), (38.79±5.78), (39.44±8.64) m/V, the control sides were (42.56±6.59), (44.64±7.53), (43.33±6.05)m/V, there was no statistical significance in the same group respectively( t = 0.57,1.94, 0.01,P>0.05). There were some changes in general observation and light microscope, in electron microscope, many non-specificity changes were observed. All of these changes included delamination, collapse, disaggregation of the myelinated nerve, mitochondria swelling and vacuolization of neurilemma cell and axon. The ratio of degenerative alterations in nerves was 60% --70% in 2-week group, 50% in 2-month group and 30% in 4-month group, and there was statistical significance among three groups (P<0.05). Conclusion 125I permanent plantation in our test dose has little effect on ischiadic nerve, all these non-specificity changes were observed in electron microscope, and it has no evident impacts on physiological functions.

Objective To investigate the clinical efficacy and safety of testosterone supplement and Mreceptor blockers in the treatment of patients with lower urinary tract symptoms(LUTS)in late -onset hypogonadism(LOH). Methods 28 cases diagnosed as LOH with mild to moderate LUTS were collected.They were given testosterone supplementation (oral testosterone undecanoate capsules,80mg,2 times/d)and M receptor blocker (oral succinate solifenacin tablet,5mg,1 time /d)treatment for 1 -3 months.After treatment for 1 month and 3 months respectively, reviewd PSA,serum total testosterone (TT),international prostate of urinary storage symptoms score (urinary storage IPSS),quality of life (QOL)score,international index of erectile function (IIEF -5)score,maximum urinary flow rate (Qmax),residual urine (Ru)and rectal examination (DRE).The improvement of LUTS before and after treatment was evaluated.Results 1 month after treatment,1 patient was difficult to tolerate the solifenacin side effects and took testosterone supplementation alone.The rest 27 patients were able to take medicine for 3 months.After 1 month and 3 months treatment,the IPSS score had significant differences compared with before treatment[(10.3 ±2.1)points vs (14.2 ±3.3)points and (9.42 ±1.8)points vs (14.2 ±3.3)points,t =13.67,14.72,all P <0.05 ].After 3 months treatment,the QOL and IIEF -5 scores were (2.1 ±0.7)points vs (4.3 ±0.6)points and (16.8 ± 3.6)points vs (11.9 ±2.5)points,Qmax was (12.5 ±5.6)mL/s vs (9.8 ±4.8)mL/s(t =6.42,5.64,14.92,all P <0.05 ),the difference was statistically significant compared with before treatment.There were no significant changes in PSA and RU before and after treatment.All patients had no severe complications such as acute urinary retention.Conclusion Combination of testosterone and testosterone in the treatment of LUTS patients in LOH is safe and effective,and can significantly improve the LUTS and quality of life.

Objective To investigate the efficacy and safety of continuous regional arterial infusion (CRAI) in patients with severe acute pancreatitis (SAP).Methods One hundred SAP patients (including 41 gallstone,26 alcoholism,13 hypertriglyceridemia,11 after heavy meals,and 9 unknown) who were admitted into our hospital from January 2013 to October 2017 were assigned to the CRAI group (n =58) and the control group (n =42).The levels of laboratory measurements,hospitalization time and costs,complications and outcomes were compared between the two groups.Results On the sixth and tenth day of treatment,the levels of white blood cell,hemodiastase,urine amylase,blood glucose,blood calcium and APACHE-Ⅱ score improved in both the 2 groups.The degrees of improvement in the CRAI group were better than that in the control group.The abdominal pain relief time [(3.3± 1.2)d vs.(5.9±2.3)d],hemodiastase recovery time [(7.9±1.8)d vs.(13.3±2.5)d],and hospitalization stay [(21.3±3.6)d vs.(32.4±4.3)d] were shorter in the CRAI group.The costs were similar in the two groups.Retroperitoneal infection,pancreatic pseudocyst,and pancreatic drainage were less in the CRAI group.The improved and cure rates were 94.8％ and 70.7％ in the CRAI group,which were higher than those in the control group (71.4％ and 47.6％,respectively).Moreover,the ineffective treatment and mortality rates were 5.2％ and 1.7％ in the CRAI group,which were lower than those in the control group (28.6％ and 14.3％,respectively).Conclusions CRAI was an efficacious and safe treatment for patients with SAP.It can be used as an alternative to other effective treatments.

Objective:To investigate the early clinical effectiveness of using customized 3D printed acetabular augment to repair large acetabular bone defects in delayed total hip arthroplasty after failed treatment of acetabular fractures.Methods:A retrospective study was conducted to analyze the 6 patients who had undergone 3D printed acetabular augment to reconstruct acetabular bone defects in delayed total hip replacement from July 2021 to January 2023 after failed treatment of acetabular fractures. They were all males, with an age of (51.3±15.0) years. Paprosky classification: 2 cases of type ⅡB, 1 case of type ⅡC, and 3 cases of type ⅢA. Recorded were surgical time, intraoperative bleeding, hospitalization time, and visual analogue scale (VAS), and modified Merle d'Aubigné & Postel score, Harris hip score, and leg length discrepancy at the last follow-up.Results:For the 6 patients, the mean surgical time was (222.5±46.9) min, the mean intraoperative bleeding 1,100 (1,000, 2,625) mL, the mean hospitalization time (9.0±4.5) d, and the mean follow-up time (11.8±7.9) months. At the last follow-up, the VAS [(2.5±1.0) points] significantly decreased compared with the preoperative value [(6.2±0.8) points], the modified Merle d'Aubigné & Postel score [(13.2±2.1) points] and Harris hip score [(67.8±15.3) points] significantly increased compared with the preoperative values [(6.7±0.8) and (34.2±8.4) points], the vertical position of center of rotation [(22.5±5.2) mm] and the horizontal position of center of rotation [(40.7±2.6) mm] were significantly reduced compared with the preoperative values [(38.1±14.2) and (53.1±10.0) mm] ( P<0.05). At the last follow-up, the leg length discrepancy was (6.2±3.6) mm, showing no statistically significant difference from the preoperative value [(18.7±1.7) mm] ( P>0.05). At the last follow-up, no clear line at the cup-bone or augment-bone interface, or no possible prosthetic loosening or displacement was observed on the X-ray films. Conclusion:In delayed total hip arthroplasty after failed treatment of acetabular fractures, the customized 3D printed augment for repair of large bone defects in the acetabulum can reconstruct the normal rotation center of the hip joint, provide reliable stability for the cup prosthesis, and enable patients to obtain significant improvements in hip function.

With the improvement of living standards in recent years, the incidence rate of nonalcoholic fatty liver disease (NAFLD) has kept increasing, with 15%-30% in general population and 50%-90% in obese population. The "second-hit" theory has been widely recognized as the pathogenesis of NAFLD. In-depth studies have found that intestinal flora imbalance may promote the progression of NAFLD by increasing energy absorption in the body, damaging intestinal mucosal barrier, and producing large amounts of toxic metabolites, which provides a new direction for exploring the pathogenesis of NAFLD and effective therapies. This article reviews the role of intestinal flora imbalance in the development and progression of NAFLD.

Objective:To explore the short-term efficacy of fixation with a 3D printed individualized custom-made plate in the treatment of elderly patients with periprosthetic femoral fracture.Methods:Retrospectively analyzed were the 5 elderly patients with periprosthetic femoral fracture who had been treated by fixation with a 3D printed individualized custom-made plate from January 2022 to July 2022 at Department of Orthopaedics and Traumatology, Beijing Jishuitan Hospital. There were 3 males and 2 females, aged 81, 86, 77, 91 and 87 years, respectively. One left and 4 right limbs were affected. Vancouver classification: type B1 ( n=3), type B2 ( n=1), and type C ( n=1). The time from operation to injury was 5, 6, 10, 5 and 7 days, respectively. Preoperatively, the femur affected, prosthesis and individualized plate with a greater trochanteric hook, loop cable channel and bone-like trabecular microporous structure were custom-made by 3D printing according to 1:1 models. Virtual operations were simulated to formulate surgical protocols. The operation time, length of surgical incision, intraoperative blood loss and transfusion, hospital stay, hip function and complications at the last follow-up were recorded. Results:The 5 patients were followed up for 12, 7, 10, 3 and 6 months, respectively. There were no events of superficial incision or deep prosthesis infection. Respectively, the operation time was 1.8, 1.7, 2.3, 2.0 and 3.3 h; the length of surgical incision 31, 30, 38, 27 and 30 cm; the intraoperative bleeding volume 400, 300, 300, 500 and 600 mL; the length of hospital stay 8, 9, 15, 14 and 11 d. Four patients received intraoperative blood transfusion of 300, 900, 150 and 1, 050 mL, respectively. One patient died of a heart attack 3 months after discharge; another patient developed dyskinesia at the contralateral limb 3 months after discharge due to cerebral infarction and died of recurrent cerebral infarction 7 months after discharge. At the last follow-up, the Harris hip scores of 3 patients were 86, 77 and 69 points, respectively. None of the patients had complications like breakage or loosening of implants.Conclusion:In the treatment of elderly patients with periprosthetic femoral fracture, fixation with a 3D printed individualized custom-made plate may lead to fine limb function and good short-term curative efficacy.

Objective:To elucidate the recent therapeutic efficacy of the intelligent fracture reduction robotic system in managing pelvic fractures.Methods:A retrospective evaluation of 49 pelvic fracture patients treated using the intelligent fracture reduction robotic system at Beijing Jishuitan Hospital's trauma orthopedics department between March 2021 and December 2022 was conducted. The cohort included 30 males and 19 females, with a mean age of 51.51±18.71 years (20-92 years range). Fractures were classified according to the Tile system: B1 type in 2 cases, B2 in 7, B3 in 3, C1 in 30, and C2 in 3. The median interval between injury and surgery was 6 days, with a range of 2-22 days. The robotic system assisted in pelvic fracture reduction and stabilization surgeries. Preoperative and postoperative evaluations involved pelvic CT scans, anteroposterior, inlet, and outlet radiographic images. Fracture displacement and reduction outcomes were assessed via X-ray imagery. Data captured included intraoperative blood loss, duration of surgery, fracture stabilization techniques, and postoperative monitoring period. The Majeed scoring system gauged functional outcomes.Results:Of the patients, 48 underwent minimally invasive interventions with robotic assistance, while one case necessitated open reduction and internal fixation due to an unsuccessful reduction. The duration between injury and operation ranged from 2 to 22 days. Average surgical time stood at 206.5±7.1 minutes (105-440 min range), and median intraoperative blood loss was 100ml (10-600 ml range). Using the Matta reduction criteria, 30 postoperative cases exhibited excellent and 9 good outcomes for posterior pelvic ring displacement, translating to a 93% (38/41) positive rate. For anterior pelvic ring shifts, 45 showed excellent and 3 good outcomes, culminating in a 100% (48/48) success rate. Follow-up for the 48 cases lasted 11.0 months (3-23 months range), with the Majeed functional score averaging 81.9±17.0 points (42-100 point range). 27 cases scored excellent, and 11 good, yielding a combined positive outcome rate of 79.2% (38/48).Conclusion:Employing the intelligent fracture reduction robotic system in pelvic fracture treatments facilitates minimally invasive interventions and yields favorable short-term clinical results.

BACKGROUND:Scaffold materials serve as platforms that provide space and structure,playing a crucial role in the regeneration of cartilage tissue.Scholars from around the world are exploring different approaches to fabricate more ideal scaffold materials. OBJECTIVE:To review the design principles and preparation methods of cartilage scaffolds,and to further explore the advantages and limitations of various preparation methods. METHODS:Literature searches were conducted on the databases of CNKI,WanFang Data,PubMed,and FMRS from 1998 to 2023.The search terms were"cartilage repair,cartilage tissue engineering,cartilage scaffold materials,preparation"in Chinese and English.A total of 57 articles were ultimately reviewed. RESULTS AND CONCLUSION:(1)The articular cartilage has a unique structure and limited self-repair capacity after injury.Even if self-repair occurs,the newly formed cartilage is typically fibrocartilage,which is far inferior to normal articular cartilage in terms of structure and mechanical properties.It is difficult to maintain normal function and often leads to degenerative changes.Currently,the design and fabrication of scaffold materials for cartilage repair need to consider the following aspects:biocompatibility and biodegradability,suitable pore structure and porosity,appropriate mechanical properties,and bioactivity.(2)Research on the preparation of cartilage scaffolds has made significant progress,continuously introducing new preparation methods and optimization strategies.These methods have their advantages and disadvantages,providing more possibilities for customized preparation and functional design of cartilage scaffolds according to specific requirements.