Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation

Forensic Psychiatry ; Homicide ; Humans

Objective To study the short-term outcome of the uterine fibroids treated with ultrasound-guided percutaneous microwave ablation therapy (PMAT) by magnetic resonance imaging (MRI). Methods PMAT was performed in 46 symptomatic patients with a total of 49 uterine fibroids. Pre-and post-contrast MRI was scanned at 3 days before treatment and 3 days after treatment to assess image changes of both fibroids and surrounding tissues. The fibroids were divided into group A (low signal), B (iso-signal), C (high signal) by the signal intensity on T2WI. According to the volume changes of fibroids and uterine, ablation rate and the reduction rate of the fibroids after treatment were calculated. Results There were 28, 17 and 4 fibroids in the group A, B and C respectively. Before the treatment the volume of the fibroids showed no statistical difference between the group A, B and C (P>0.05). Fibroids and uterine showed shrinkage after the treatment in the group A and B (t=5.644, 5.998, 6.725 and 4.678, all P<0.001). The fibroids ablation rate showed no statistical difference between the groups (F=0.852, P>0.05). Fibroids and uterine showed shrinkage after the treatment in the group C, but there was no obvious statistical difference. Conclusion The outcome of PAMT is good for the fibroids with different signal intensity on T2WI. But the fibroids with high signal intensity are not as sensitive as those with low or iso intensity to achieve the same ablation level.

The chemical consitituents from cytotoxic fraction of the Callicarpa nudiflora extract were isolated and purified by a combination of HP-20 macroporous resin, silica gel and Sephadex LH-20 column chromatographies. The structures were elucidated on the basis of the spectroscopic data and comparison of their spectroscopic data with reported data. The cytotoxicity was evaluated by the MTT assay. The 50% and 70% EtOH elutions of EtOH-extract showed significant cytotoxic activities, leading to the isolation of twelve compounds, which were identified as luteoloside(1), lutedin-4'-O-β-D-glucoside(2), 6-hydroxyluteolin-7-O-β-glucoside(3), lutedin-7-O-neohesperidoside(4), rhoifolin (5), luteolin-7, 4'-di-O-glucoside (6), forsythoside B (7), acteoside (8), alyssonoside (9), catalpol(10), nudifloside(11), and leonuride(12). Compounds 3-6, 10 and 12 were isolated from this genus for the first time, and compound 9 was isolated from this plant for the first time. The cytotoxicity assay demonstrated that flavonoids 1-6, in various concentrations, showed monolithic proliferation inhibitory activities against Hela, A549 and MCF-7 cell lines. Compounds 3, 5 and iridoid glycoside 11 possessed higher cytotoxicacivities. In short, flavonoids are the main components of cytotoxic extract from C. nudiflora, while phenylethanoid glycosides are the predominant ingredient but inactive to cancer cell lines. In addition, the minor iridoid glycoside expressed weak cytotoxic activity.
Callicarpa ; chemistry ; Cell Proliferation ; drug effects ; Cytotoxins ; chemistry ; isolation & purification ; pharmacology ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; pharmacology ; Humans ; MCF-7 Cells ; Molecular Structure

Objective To investigate the effects of single dose of dexmedetomidine and fentynyl on treatment of emergence agitation in adult patients after general anesthesia.Methods Sixty patients suffering from emergence agitation after general anesthesia were divided into two groups randomly(n=30 each):dexmedetomidine group (group D)and fentaynl group (group F).Patients in group D received dexmedetomidine at a dose of 0.5μg/kg,and those in group F received fentanyl at a dose of 1μg/kg respectively.If patients still agitate after above treatment,intermission infusion of propofol at bolus of 1.0 mg/kg was used for further treatment till patients attain peaceful state.Results Twen-ty-nine paients in group D had no agitation,only one patient had mild agitation after administration of dexmedetomidine,while four patients had severe agitation,four patients had moderate agitation and 9 patients had mild agitation after administration of fentanyl(P<0.05);the time from first treatment to no agitation in group D was (11±3)min,shorter than that in group F (27±9)min (P<0.05);the dose of propofol used in group D was (50±0)mg,less than accumulative doses of propofol in group F (270±40)mg (P<0.05);21 (70%)patients in group D had radycardia and 9 (30%)patients in group F had respiratory depression(P<0.05).Conclusion Intravenous dexmedetomidine at a dose of 0.5 μg/kg attainted was effective in treating emergence agitation in adult patients after general anes-thesia as compared with fentanyl.

Bone xenograft bone for the treatment of bone defect is one of the current research focus, which has advantages of extensive sources, low cost, simple preparation method. While the process of single bone xenograft bone in repairing bone defect is very long, and the clinical outcome is not satisfactory. The main problems focus on formation of bone and vascularization. Reconstituted bone xenograft combined with cells and xenogenic bone material could promote vascularization and bone fusion in vivo, thus achieve a clinical effect of autogenous bone in repairing bone defect.
Bone Transplantation ; methods ; Bone and Bones ; blood supply ; Humans ; Transplantation, Heterologous

OBJECTIVE: To explore the application of mixed reality technique for the surgery of oral and maxillofacial tumors. METHODS: In this study, patients with a diagnosis of an oral and maxillofacial tumor who were referred to Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from December 2018 to January 2020 were selected. The preoperative contrast-enhanced computed tomography data of the patients were imported into StarAtlas Holographic Medical Imaging System (Visual 3D Corp., Beijing, China). Three-dimensional (3D) model of tumor and key structures, such as skeleton and vessels were reconstructed to three-dimensionally present the spatial relationship between them, followed with the key structures delineation and preoperative virtual surgical planning. By using mixed reality technique, the real-time 3D model was displayed stereotactically in the surgical site. While keeping sterile during operation, the surgeon could use simple gestures to adjust the 3D model, and observed the location, range, and size of tumor and the key structures adjacent to the tumor. Mixed reality technique was used to assist the operation: 3D model registration was performed for guidance before tumor excision; intraoperative real-time verification was performed during tumor exposure and after excision of the tumor. The Likert scale was used to evaluate the application of mixed reality technique after the operation. RESULTS: Eight patients underwent mixed reality assisted tumor resection, and all of them successfully completed the operation. The average time of the 3D model registration was 12.0 minutes. In all the cases, the surgeon could intuitively and three-dimensionally observe the 3D model of the tumor and the surrounding anatomical structures, and could adjust the model during the operation. The results of the Likert scale showed that mixed reality technique got high scores in terms of perceptual accuracy, helping to locate the anatomical parts, the role of model guidance during surgery, and the potential for improving surgical safety (4.22, 4.19, 4.16, and 4.28 points respectively). Eight patients healed well without perioperative complications. CONCLUSION By providing real-time stereotactic visualization of anatomy of surgical site and guiding the operation process through 3D model, mixed reality technique could improve the accuracy and safety of the excision of oral and maxillofacial tumors.
Augmented Reality ; China ; Humans ; Imaging, Three-Dimensional ; Neoplasms ; Retrospective Studies ; Surgery, Computer-Assisted

BACKGROUND:It is important to maintain the height of joint line in total knee arthroplasty or renovation. Foreign scholars have reported the parameters of the distance from different landmarks to knee joint line, but there is stil a lack of relevant data for Chinese people. OBJECTIVE:To explore the relationships of the knee anatomic landmarks and joint line in normal Chinese, thereby providing clinical evidence for primary total knee replacement and knee renovation. METHODS:Totaly 746 normal knee joints of 409 healthy volunteers from North China and Southwest China were randomly enroled, including 214 males and 195 females, with a mean age of 37.7 years. CT scan was used to reconstruct the three-dimensional knee joint, and the distance between the anatomic landmarks and the joint line was measured using Mimics software. RESULTS AND CONCLUSION:The distance from the center of femoral medial sulcus to the joint line was (25.72±2.52) mm. The distance from the center of lateral femoral condyle prominence to the joint line was (26.30±2.65) mm. The distance from the adduction muscle tubercle to the joint line was (44.60±4.32) mm. The distance from the peak of the tibial tubercle to the joint line was (21.50±3.57) mm. These parameters in male group were significantly higher than those in female group (P < 0.05). In conclusion, these findings provide anatomic evidence for the recovery of joint line in knee replacement or renovation; the variability of the distance from the center of femoral medial sulcus, lateral femoral condyle prominence and adductor tubercle to the joint line is smaler, and therefore, these landmarks have more reference values in total knee arthroplasty.

OBJECTIVETo summarize clinical outcomes of locking compression plate (LCP) combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) for the treatment of Pilon fracture.

METHODSFrom January 2009 to December 2012, Pilon fracture patients treated by LCP with MIPPO were retrospectively analyzed. All open fractures, pathologic fractures and those who had limb vascular disease or nerve injury were excluded. Thirty-eight patients were enrolled, including 29 males and 9 females aged from 21 to 78 years old with an average of 48 years old. According to AO classification, 20 cases were type B, 18 cases were type C. Operative time, blood loss, reduction quality, time of fracture healing complications and postoperative ankle joint function were applied for evaluating clinical outcomes, AOFAS scoring were used for assessing postoperative clinical effects.

RESULTSAll patients were followed up from 13 to 24 months (averaged 18 months). All patients obtained bone union without any plate failures or loss of fixation/reduction. One patient occurred superficial wound infection, and resolved with antibiotics and local wound care. Postoperative average AOFAS score was 81 (ranged 65 to 97).

CONCLUSIONLCP with MIPPO for Pilon fratcure has advantages of less invasion, fewer complications and satisfactory ankle function.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Tibial Fractures ; surgery

Four new triterpenoids, together with six known analogues, were isolated from an aqueous extract of the Ziziphus jujuba var. spinosa seeds, by multiple column chromatographic separation methods using stationary phases of macroporous adsorption resin, MCI resin, normal phase silica gel, Sephadex LH-20, and Toyopearl HW-40C as well as preparative thin-layer chromatography and reversed-phase HPLC. Their structures were determined by spectroscopic data analysis, the new structures were trivially named jujubaceanothoside A (1), 23-epijujuboside A (2), and jujubosides J and K (3 and 4), while the known analogues were identified as jujubosides A-C (5-7) and II (8), alphitolic acid (9), and betulinic acid (10). The structure of 1 was confirmed by single crystal X-ray diffraction.