Fluid Therapy ; methods ; Humans ; Intensive Care Units ; Leg ; physiopathology ; Patient Positioning ; methods

The current conventional portals for hip arthroscopic surgery are the anterior, anterolateral, and posterolateral portals. For lesions in the medial anteroinferior or posteroinferior portion of the hip, these portals provide insufficient access to the lesion and consequently lead to incomplete treatment. Thus, in such a situation, a medial portal approach might be helpful. However, operators have avoided this procedure because of the risk of injury to the obturator, femoral neurovascular structures, and the medial femoral circumflex artery. Thus, to overcome the disadvantages of the conventional method for medial lesions of the hip, we performed a cadaveric study to evaluate the technique, usefulness, and risk of the medial portal technique.
Aged ; Arthroscopy/*instrumentation/*methods ; Female ; Hip Joint/*surgery ; Humans ; Male ; Middle Aged ; Patient Positioning

Objective:To investigate the influence of Barbecure combined with Epley on residual dizziness of horizontal canal benign paroxysmal positional vertigo（HC-BPPV） by SRM-vertigo diagnosis system. Methods:A total of 406 patients diagnosed with HC-BPPV from Nov 2021 to Nov 2022 were enrolled by rapid axial roll test and Dix-Hallpike in the department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xi'an Jiaotong University. The patients were divided into two groups by hospital card numbers, in which the numbers that were odd were considered as group A, and the numbers that were even were considered as group B. The group A underwent two circles of Barbecure repositioning procedure by SRM-vertigo diagnosis system, while the group B underwent two circles Barbecure combined with Epley repositioning procedure by SRM-vertigo diagnosis system. The treatment was stopped on the next day when two groups of patients were cured, and those who were not cured will continue treatment with the same method. Results:The cure rate of group A was 83.41%, and the cure rate of group B was 80.51%, the difference between the two groups was not-statistically significant difference（P>0.05）. The rate of residual dizziness of group A was 23.30%, the rate of residual dizziness of group B was 11.46%, the difference between the two groups was statistically significant（P<0.05）. Conclusion:The Barbecure combined with Epley otoliths repositioning maneuver by SRM-vertigo diagnosis system can significantly reduce the rate of residual dizziness after the treatment of HC-BPPV, and improve the quality of life of patients.
Humans ; Benign Paroxysmal Positional Vertigo/therapy* ; Dizziness ; Quality of Life ; Patient Positioning/methods* ; Semicircular Canals

OBJECTIVE: To analyze the clinical effect of different canalith repositioning maneuver in the treatment of the apogeotropic nystagmus of horizontal semicircular canal benign paroxysmal positional vertigo (apogeotropic HSC-BPPV). METHOD: Forty patients of apogeotropic HSC-BPPV colleted from March 2014 to May 2015 were divided into two groups, each group had 20 cases. The control group was repositioned with the Gufoni maneuver before the Barbecue maneuver, the research group with the improved Nuti maneuver. RESULT: The success rate of the research group was not lower than that of the control group, which hadn't statistical (P > 0.05). And after the Barbecue maneuver, all patients have been recovered. CONCLUSION Comparing with the Gufoni maneuver, the improved Nuti maneuver designed by us, had the same success rate to treat apogeotropic HSC-BPPV, and is easier to learn,with more compliance,more comfort and more repeatability.
Benign Paroxysmal Positional Vertigo ; therapy ; Humans ; Nystagmus, Pathologic ; therapy ; Patient Positioning ; methods ; Semicircular Canals ; physiopathology

Objective:To evaluate the influence of an additional roll test on the repositioning procedure by SRM-vertigo diagnosis system for horizontal canal benign paroxysmal positional vertigo（HC-BPPV）. Methods:A total of 713 patients diagnosed with HC-BPPV in Department of Otolaryngology Head and Neck Surgery，the First Affiliated Hospital of Xi'an Jiaotong University from Jan 2020 to Feb 2022 were enrolled. The patients were divided into two groups by hospital card numbers, in which the number is odd were considered as group A, and the number is even were considered as group B. The group A underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, while the group B first performed an additional roll test and then underwent two circles of Barbecue repositioning procedure by SRM-vertigo diagnosis system, to observe the cure rate and compare influence of HC-BPPV by an additional roll test. The quality of life and sleep of patients before and one-month after the treatment were assessed by the dizziness handicap inventory（DHI） and the pittsburgh sleep quality（PSQI）. Results:The cure rate of group A was 63.21%, and the cure rate of group B was 87.68%，the difference between the two groups was statistically significant（P<0.05）; The DHI score of patients after the repositioning was significantly lower than that before the repositioning（P<0.05）. The PSQI score after the repositioning was significantly lower than that before the repositioning（P<0.05）. The DHI and the PSQI scores after the repositioning were significantly lower than that before the repositioning, with a statistically significant difference （P< 0.05）. The total score of DHI in group B after treatment was lower than that in group A, with a statistically significant difference（P<0.05）. The total score of PSQI in group B after treatment was lower than that in group A, with non-statistically significant difference （P< 0.05）. Conclusion:An additional roll test before the repositioning procedure by SRM-vertigo diagnosis system can significantly improve the cure rate of HC-BPPV, relieve anxiety, and improve the quality of life.
Humans ; Benign Paroxysmal Positional Vertigo/diagnosis* ; Quality of Life ; Patient Positioning/methods* ; Dizziness ; Semicircular Canals

PURPOSE: To report the initial clinical outcomes of the newly devised sliding loop technique (SLT) used for renorrhaphy in patients who underwent robot-assisted laparoscopic partial nephrectomy (RALPN) for small renal mass. MATERIALS AND METHODS: We reviewed the surgical videos and medical charts of 31 patients who had undergone RALPN with the SLT renorrhaphy performed by two surgeons (CWJ and CK) between January 2014 and October 2014. SLT renorrhaphy was performed after tumor excision and renal parenchymal defect repair. Assessed outcomes included renorrhaphy time (RT), warm ischemic time, perioperative complications, and perioperative renal function change. RT was defined as interval from the end of bed suture to the renal artery declamping. RESULTS: In all patients, sliding loop renorrhaphy was successfully conducted without conversions to radical nephrectomy or open approaches. Mean renorrhaphy and warm ischemic time were 9.0 and 22.6 minutes, respectively. After completing renorrhaphy, there were no adverse events such as dehiscence of approximated renal parenchyma, renal parenchymal tearing, or significant bleeding. Furthermore, no postoperative complications or significant renal function decline were observed as of the last follow-up for all patients. The limitations of this study include the small volume case series, the retrospective nature of the study, and the heterogeneity of surgeons. CONCLUSIONS: From our initial clinical experience, SLT may be an efficient and safe renorrhaphy method in real clinical practice. Further large scale, prospective, long-term follow-up, and direct comparative studies with other techniques are required to confirm the clinical applicability of SLT.
Adult ; Aged ; Female ; Hemostasis, Surgical/methods ; Humans ; Kidney Neoplasms/*surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Nephrectomy/*methods ; Patient Positioning/methods ; Robotic Surgical Procedures/*methods ; *Suture Techniques ; Treatment Outcome

The major problems of revision surgery for recurrent lumbar disc herniation (LDH) include limited visualization due to adhesion of scar tissue, restricted handling of neural structures in insufficient visual field, and consequent higher risk of a dura tear and nerve root injury. Therefore, clear differentiation of neural structures from scar tissue and adhesiolysis performed while preserving stability of the remnant facet joint would lower the risk of complications and unnecessary fusion surgery. Biportal endoscopic spine surgery has several merits including sufficient magnification with panoramic view under very high illumination and free handling of instruments normally impossible in open spine surgery. It is supposed to be a highly recommendable alternative technique that is safer and less destructive than the other surgical options for recurrent LDH.
Adult ; Diskectomy/*methods ; Endoscopy/*methods ; Humans ; Intervertebral Disc Displacement/*surgery ; Lumbar Vertebrae/surgery ; Lumbosacral Region/*surgery ; Male ; Minimally Invasive Surgical Procedures/*methods ; Patient Positioning

OBJECTIVETo evaluate the value of CT common rail technique for application in intensity-modulated radiotherapy for nasopharyngeal carcinoma (NPC).

METHODSTwenty-seven NPC patients underwent Somatom CT scans using the Siemens CTVision system prior to the commencement of the radiotherapy sessions. The acquired CT images were registered with the planning CT images using the matching function of the system to obtain the linear set-up errors of 3 directions, namely X (left to right), Y (superior to inferior), and Z (anterior to posterior). The errors were then corrected online on the moving couch.

RESULTSThe 27 NPC patients underwent a total of 110 CT scans and the displacement deviations of the X, Y and Z directions were -0.16∓1.68 mm, 0.25∓1.66 mm, and 0.33∓1.09 mm, respectively.

CONCLUSIONCT common rail technique can accurately and rapidly measure the space error between the posture and the target area to improve the set-up precision of intensity-modulated radiotherapy for NPC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; radiotherapy ; Patient Positioning ; Radiotherapy, Intensity-Modulated ; methods ; Tomography, X-Ray Computed ; methods

Since its initial introduction in 1976, percutaneous nephrolithotomy (PCNL) has been widely performed for the management of large renal stones and currently is recommended for staghorn calculi, kidney stones larger than 2 cm, and shock wave lithotripsy-resistant lower pole stones greater than 1 cm. However, except for open and laparoscopic surgery, PCNL is the most invasive of the minimally invasive stone surgery techniques. Over the years, technical and instrumental advances have been made in PCNL to reduce morbidity and improve effectiveness. A thorough review of the recent literature identified five major areas of progress for the advancement of PCNL: patient positioning, method of percutaneous access, development of lithotriptors, miniaturized access tracts, and postoperative nephrostomy tube management. This review provides an overview of recent advancements in PCNL and the outcomes of each area of progress and notes how much we achieve with less invasive PCNL. This information may allow us to consider the future role and future developments of PCNL.
Catheters, Indwelling ; Drainage ; Humans ; Kidney Calculi/*surgery ; Lithotripsy/instrumentation ; Nephrostomy, Percutaneous/*instrumentation/*methods ; *Patient Positioning ; *Postoperative Care ; Radiology, Interventional ; Ultrasonography, Interventional

OBJECTIVE: To analyze clinical features with benign paroxysmal positional vertigo (BPPV) and discuss the attentions in the canalith repositioning procedures. METHOD: A total of 76 male and female patients aged 80 and over with BPPV (elderly group) and 76 patients aged 60-65 years old with BPPV (older group) was retrospectively analyzed. RESULT: (1)Semicircular canal condition: in elderly group, posterior semicircular canal was involved in 72 cases, whereas the horizontal semicircular 4 cases. In older group, posterior semicircular canal was involved in 70 cases, whereas the horizontal semicircular and multiple canals in 5 cases and 1 case respectively. (2) Precipitating factors: precipitating factors of elderly were variety. Its closely related with emotion, infection, seasonal alternation surgery, and trauma. There were significant differences between the two groups (P<0. 05). (3) The symptoms of undergoing treatment and post-treatment: the duration of dizziness and carebaria were significant difference after canalith repositioning procedure treatment between two groups (P<0. 05), the duration of balance disturbance and symptoms of vegetative nerve functional disturbance like nausea and sweating were significant difference (P<0. 05). (4) Treatment and outcomes: the remission, partial remission rate were 34. 2 %, 81. 6% re- spectively, after the first or second time of repositioning treatment. The efficacy of repositioning treating at the first time was significantly different between two groups (P<0. 05). It was poor efficacy in elderly group. There is no difference in efficacy for repositioning treatment at the second or third time (P>0. 05). (5) The elderly always accompanied with other medical condition and had risk factors of cerebrovascular disease. The efficacy was not associated with the complication(P>0.05). However, it was most likely to overtreatment caused by emphasizing other medical conditions treatment. BPPV was easy to ignore and misdiagnose, meanwhile, delayed the diagnosis and increased the medical costs. (6) Many elderly were accompanied cervical spondylosis, lumbar spondylosis body stiffness and fear of vertigo which increased the difficulty of repositioning treatment. (7) Recurrence: we followed up 2 years after treatment. In older group, 11 patients (14. 5%)were relapsed. In elderly group, 29 patients (38. 2%) relapsed. There were significant differences between the two groups (P<0. 05). CONCLUSION There are various precipitating factors in elderly patients with BPPV, the most frequent precipitating factors were related to psychological factor and overfatigue. The symptoms of the patients attack BPPV was always mask with other diseases, but do not impact on the efficacy of Canalith repositioning at the first time; Even the efficacy of repositioning is poor at the first time, it's effective and safety after multiple treatments of repositioning; It prolonged the symptoms including carenaria, dizziness and nausea after treatment.
Aged ; Benign Paroxysmal Positional Vertigo ; complications ; diagnosis ; psychology ; therapy ; Dizziness ; Emotions ; Female ; Humans ; Male ; Masks ; Patient Positioning ; adverse effects ; methods ; Recurrence ; Retrospective Studies ; Semicircular Canals ; Spondylosis ; Vertigo