Objective To compare the accuracy of placement of ventricular shunt tube,the efficacy and complications of the neuronavigation-assisted ventriculoperitoneal shunt (group A) and traditional ventriculoperitoneal shunt (group B).Methods A retrospective study was made on 40 cases of hydrocephalus managed with neuronavigation-assisted ventriculoperitoneal shunt or ventriculoperitoneal shunt from January 2012 to June 2016.There were 18 cases [12 males,6 females;(47.5 ±8.5) years of age] in group A and 22 cases [14 males,8 females;(44.5 ± 7.5) years of age] in group B.Therapeutic effect and complications were analyzed postoperatively.The accuracy rate in ventricular end shunt placement that was free from the frontal horn of lateral ventricle and flush the Moro hole had also been studied.Results The position of ventricular shunt of all the patients were postoperative timely review of the CT view,and hospital outpatient follow-up periodical for 3-24 months after discharge from hospital.Patients with postoperative timely review of head CT and found that group A of ventricular end of the shunt tube position reach a set position in 16 cases,2 cases had not reached the set position,the accuracy rate was 88.89％.There were 8 cases in group B reach to the set position and 14 cases did not and the accuracy rate was 36.36％.After the statistical analysis there were significant differences (P ＜ 0.05).The total efficiency of A and B groups (excellent + effective) were 94.4％ and 86.4％ (P ＞ 0.05).Postoperative complications included bleeding,infection,obstruction of the shunt,excessive shunt,shunt insufficiency and so on.During follow-up,group A appeared excessive shunt in 1 case;group B incision infection in 1 case,4 cases of shunt obstruction,excessive shunt in 1 case,2 cases of deficiency of shunt.Two groups of patients were recovery well through the drainage tube pressure adjustment or set it once again.The incidence of complications in group A was 5.56％,group B was 36.36％.There was no significant difference between group A and group B (P ＞ 0.05).In group A,there was no obstruction of shunt tube,ventricular end of the shunt tube blockage occurred in 4 cases in group B,the incidence rate was 18.18％ (P ＞ 0.05).Conclusion Neuronavigation guided ventriculoperitoneal shunt placement to the accuracy of position setting has significant advantages over traditional ventriculoperitoneal shunt in the ventricular end of the shunt tube and it has some advantages in reducing postoperative complications.

BACKGROUND:The bioceramics has the ideal pore size, high porosity and the through-hole rate, can provide the ideal physiological activity space for the bone cel repair, and can obviously improve bone conduction. OBJECTIVE:To explore the bone conduction and bone induction in the repair of bone defects in the stage of bone defect of bionic biphasic ceramic bioactive bone. METHODS:A total of 20 New Zealand white rabbits were randomly divided into bioactive glass and biomimetic biphasic ceramic bioactive bone groups, and were used to construct the animal bone damage model. They were given the repair with bioactive glass and biomimetic biphasic ceramic bioactive bone. RESULTS AND CONCLUSION:At 4 weeks after model establishment, scanning electron microscopy demonstrated that dense periosteal tissue was observed in the biomimetic biphasic ceramic bioactive bone group. At 8 weeks, dense combination was found, and no obvious fissure existed. At 12 weeks, complete bone demarcation blurred, showing a natural transition. Moreover, the binding site was very dense. There were a large number of new bone tissues, bone trabecula was regular and connected to a piece. The bone material has been largely degraded. Bone defects were repaired completely. The bone density was close to normal bone. At 8 weeks, in the bioactive glass group, the binding site presented obvious fissure. At 12 weeks, the fissure had been connected, but the binding was not tight as compared with the bionic biphasic ceramic biologic active bone group. The bone defect got preliminary repair. A smal number of new bone formed trabecular bone, but could not connect or traverse. There was no recanalization of the marrow cavity. A few continuous bone cal us traversed the broken end. These data demonstrate that bionic biphasic ceramic bioactive bone has good bone conduction, bone induction and biocompatibility in the repair of segmental bone defects.

Brain arteriovenous malformation (bAVM) is a common cerebrovascular disease in clinical practice. Compared with adults, children with bAVM are more prone to rupture and bleeding, and have a higher mortality and disability. Therefore, it is very important to accurately evaluate the bleeding risk of children with bAVM and reasonably select intervention measures to improve the prognosis. The treatment methods of children with bAVM mainly include conservative treatment, microsurgical treatment, endovascular embolization, stereotactic radiosurgery, and multimodal combined treatment. At present, the treatment indications and specific treatment options for children with bAVM are controversial.

In order to prove that ectopic over-expression of Pim-2 could induce malignant transformation of human liver cell line L02, three groups of cells were set up including human liver cell line L02 (L02), L02 cells transfected with Pim-2 gene (L02/Pim-2) and L02 cells transfected with empty-vector (L02/Vector). Pim-2 expression levels were detected. The morphology, proliferation level, apoptosis rate and migration ability of the cells were detected respectively. Then the cells were subcutaneously inoculated into athymic mice and the microstructures of the neoplasm were observed. Compared with the controls, Pim-2 expression levels were significantly higher in L02/Pim-2 cells (P<0.05), and their morphology had obvious malignant changes. They also showed a significantly increased proliferation rate (P<0.05) and migration capacity (P<0.05), as well as a significantly decreased apoptosis rate (P<0.05). Only the athymic mice inoculated with L02/Pim-2 cells could generate neoplasm, and the morphology of the neoplasm coincided with that of the hepatoma. The results manifest that ectopic Pim-2 gene could be stably expressed in L02/Pim-2 cells. Both the morphological and biological changes of L02/Pim-2 cells demonstrate the trend of malignant transformation. L02/Pim-2 cells could generate hepatoma in athymic mice. In conclusion, Pim-2 could induce malignant transformation of human liver cell line L02.
Animals ; Apoptosis ; Cell Line ; Cell Movement ; Cell Proliferation ; *Cell Transformation, Neoplastic ; Humans ; Liver/pathology/physiology ; *Liver Neoplasms/genetics/pathology ; Mice ; Mice, Nude ; Neoplasm Transplantation ; *Oncogenes ; Protein-Serine-Threonine Kinases/genetics/*metabolism ; Proto-Oncogene Proteins/genetics/*metabolism

The clinical assessment of the risk of rupture and dissection of thoracic aortic aneurysm(TAA) is mainly dependent on the measurement of the maximum diameter and growth rate of the aneurysm itself. The use of aortic size alone may ignore the role of vascular heterogeneity in assessing the risk of catastrophic complications. Biomechanics could help predict the risk of TAA in a more sophisticated way. In this paper, we reviewed the latest advances in biomechanical assessment of risk characteristics of TAA.

Objective To analyze the medication rules of Professor LAO Shaoxian in the treatment of gastric stuffiness based on syndrome differentiation.Methods The effective prescriptions for patients with gastric stuffiness treated by Professor LAO Shaoxian from March 2017 to March 2022 were collected,and the general information,chief complaints,diagnosis,syndrome differentiation and prescriptions of patients were extracted.Excel software and the ancient and modern medical records cloud platform(V 2.3.7)were used to construct the prescription database.Data mining function was used to carry out analysis of the syndrome type of prescription,analysis of the frequency and property of Chinese herbs,as well as association rule analysis and cluster analysis.Results A total of 272 prescriptions were included,involving 164 kinds of medicinal herbs.The main traditional Chinese medicine(TCM)syndrome types are damp-heat syndrome and qi stagnation syndrome.The frequency of 25 herbs was more than or equal to 30 times.The representative herbs is Pinellinae Rhizoma Praeparatum,Glycyrrhizae Radix et Rhizoma,Citri Reticulatae Pericarpium,Perillae Caulis and Aucklandiae Radix.The medicinal properties are mainly warm and flat.The medicinal flavors are spicy,bitter and sweet.The drug meridians mainly included the spleen,stomach and lung meridians,followed by the liver meridian.There were 23 core drug pairs obtained by association rules,such as"Aucklandiae Radix-Perillae Caulis","Citri Reticulatae Pericarpium-Perillae Caulis",and"Pinellinae Rhizoma Praeparatum-Citri Reticulatae Pericarpium".Clustering analysis of drugs can be divided into three combinations,which have the effects of regulating qi and relieving distension,resolving dampness,and clearing heat and detoxifying.Conclusion The core prescription of Professor LAO Shaoxian in the treatment of gastric stuffiness is Aucklandiae Radix,Perillae Caulis,Citri Reticulatae Pericarpium,Pinellinae Rhizoma Praeparatum,Glycyrrhizae Radix et Rhizoma,Kaki Calyx,Aurantii Fructus Immaturus and Arecae Pericarpium.It focuses on regulating qi movement of middle jiao and treating spleen and stomach simultaneously.The main therapeutic method is regulating qi and relieving distension.At the same time,attention should be paid to the application of dampness-dispelling and stagnation-removing,heat-clearing and detoxifying drugs.The clinical therapy of Professor LAO Shaoxian on gastric stuffiness is significant,which can be used as a reference for diagnosis and treatment.

Objective:To evaluate the clinical efficacy and safety of using the F4.8 Visual Puncture Micro-percutaneous nephrolithotomy to treat the female distal calculi associated with stricture.Methods:From June 2017 to December 2019, 32 female patients with distal ureteric calculi associated with stricture, aged(35.0±10.3) years ( range from 16 to 75 years)old, were enrolled into this retrospective study. They were diagnosed by colour doppler ultrasound, IVU(intravenous Urography), or CT, et al. The average stone size was (13.0±3.6)mm in diameter(range from 3 to 20 mm), and the stone obstruction duration was from 2 to 35 days, with average of(5±17) days. Twenty-seven cases were on the unilateral ureter and 5 cases were on the bilateral ureters. There were 17 cases undergoing ESWL 2 weeks before. Six cases of stone diameter less than 6 mm were administered medical therapy for more than 7 days. All the 32 case underwent ureteroscopic lithotripsy but failed because of the ureter stricture. They all suffered from hydronephrosis, with the diameter of renal collecting system from 15 to 45 mm, with(23±15)mm on average. The lithotomy position was taken, and the F4.8 Visual Micro-percutaneous nephrolithotomy using 0.9% Sodium chloride was applied to enter into ureter through urethra. There were 21 cases of ureter orifice stricture, including 8 cases associated with avulsion or perforation, 9 cases associated with intramural ureter abnormality and stricture, the zebra guidewire being failed to enter. The F4.8 Visual Micro-percutaneous nephrolithotomy cooperated with water pressure modulation was used to flush and open the ureter orifice and intramural ureter for entering. Holmium lase was used for lithotripsy. Two cases stone were infective and obstructed seriously. F4.8 Visual Micro-percutaneous nephrolithotriptor entered the ureter and destroyed the stones, and the stone fragments were discharged. Stone migrated upward and escaped occurred in 1 case, then the zebra guidewire was indwelled and ureteroscope was used for lithotripsy successfully. All cases were indewelled F4.7 doubld-J tube and urethral catheter after operation.Result:All the 32 patients underwent lithotripsy successful by one-stage. The operation time was 15-43 min [averaged (35.0±8.7)min]. All patients were recovered and discharged 4-7(averaged 5.3) days after operation. Three patients occured fever, T>38.5℃, and they recovered by using sensitive antibiotics according to the blood and urine culture. No severe complications occurred, such as ureteral perforation or extravasation. All patients were reviewed by ultrasound and KUB 3 days after operation, finding 24 cases with stone free, and 8 cases of a little residual stone, with the stone free rate of 75%. One month later, ultrasound and IVU was performed, and no residual stone was detected, with the stone free rate of 100%. The hydronephrosis alleviated by varying degrees. The diameter of the renal collecting system was from 0 to 35 mm, with(12±9)mm on average. The IVU showed the ureter was unobstructed. Conclusions:The F4.8 Visual Micro-percutaneous nephrolithotomy is safe and effective for the female distal calculi associated with stricture, when routine ureteroscopic lithotripsy failed.

Objective To explore risk factors of early lung infection after liver transplantation and to construct a prediction model of early lung infection after liver transplantation.Methods The clinical data of 269 patients who underwent orthotopic liver transplantation for the first time were retrospectively analyzed.Patients were divided into the infected group(n=97)and the non-infected group(n=172)according to whether pulmonary infection occurred within 30 days after operation.The preoperative general data,preoperative laboratory examination results,intraoperative and postoperative data of the patients were collected.Multivariate Logistic regression analysis were used to screen risk factors of pulmonary infection.Based on the results of multivariate analysis,the prediction model was constructed and the prediction efficiency of the model was evaluated.Results Univariate and multivariate Logistic regression analysis showed that preoperative PNI≤41.70(OR=1.972,95%CI:1.047-3.714,P=0.036),LMR≤1.52(OR=2.020,95%CI:1.102-3.705,P=0.023),MELD score＞10.72(OR=1.985,95%CI:1.103-3.573,P=0.022),operative time＞448.00 min(OR=2.676,95%CI:1.515-4.727,P=0.001)and intensive care unit(ICU)hospitalization time＞4.0 days(OR=2.623,95%CI:1.335-5.154,P=0.005)were independent risk factors for early pulmonary infection after liver transplantation.The ROC area under the curve(AUC)of the prediction model based on the results of multivariate Logistic regression analysis was 0.768,the sensitivity was 80.41%and the specificity was 60.47%.Conclusion The prediction model based on PNI,LMR,MELD score,operation time and ICU hospitalization time can effectively predict the occurrence of early pulmonary infection after liver transplantation.

Objective:To explore the effect of action research in first aid skills training for nurses in Pediatric Clinic.Methods:This study was a own control study. From March to August 2020, convenience sampling was used to select 28 nurses from the Pediatric Clinic of the West China Second University Hospital, Sichuan University as the research subject. The first aid skills training for nurses was optimized through the spiral cycle process of "plan-action-observation-reflection" using action research. Before the training, after the first cycle, and after the second cycle, the self-designed First Aid Skills Assessment and Training Satisfaction Evaluation Scale was used, combined with the results of semi-structured interviews, to evaluate the first aid skills and training satisfaction of nurses in Pediatric Clinic before and after the program improvement.Results:Before training, in the first cycle, and in the second cycle, the nurses' first aid theory (except resuscitation balloon usage dimension) , first aid operation scores and satisfaction scores were compared, and the differences were statistically significant ( P<0.05) . Conclusions:The systematic training of first aid knowledge and operation for nurses in Pediatric Clinic by action research can effectively improve nurses' first aid skills and training satisfaction.

BACKGROUND: A retrospective review of the surgical treatment of refractory chest tumors involving the heart or large vessels with cardiopulmonary bypass (CPB). METHODS: To summarize 11 cases of chest tumor patients who had undergone cardiopulmonary bypass surgery from January 2008 to May 2017 in our hospital, and analyze the general condition, clinical characteristics, treatment methods, postoperative hospitalization time, complications and follow-up results of all patients. RESULTS: All 11 patients were operated with cardiopulmonary bypass. Total resection of tumors in 8 cases and most of the excision in 3 cases. 1 case of left atrial metastatic leiomyosarcoma were excised in the left atrium, and then the right lung resection was performed. 1 case of left lung central lung cancer resection through the median sternum incision. 2 cases underwent pulmonary artery repair at the same time, 3 cases underwent partial pericardiectomy and 3 cases underwent pulmonary wedge resection at the same time. All the patients were effectively relieved after the operation. No death rate in hospital and 30 days after operation. 3 cases of postoperative pulmonary infection were recovered after the treatment of antibiotics. 1 case of lymphoma relapsed 6 months after surgery and died one year later. 1 case of pericardial fibrosarcoma had local recurrence and extensive metastasis at 13 months after operation, and died after 15 months. 1 case of pulmonary leiomyosarcoma were found to have local recurrence 15 months after the operation and were relieved after chemotherapy. The remaining 8 patients survived, and no obvious recurrence and distant metastasis were found in the computed tomography (CT) examination. CONCLUSIONS The CPB assisted surgical treatment can be performed for patient of refractory chest tumors involving the heart or large vessels. It can improve the surgical resection rate of refractory chest tumors, effectively alleviate the effects on respiratory and circulatory functions, and significantly prolong the survival period of these patients.
Adult ; Cardiopulmonary Bypass ; adverse effects ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; mortality ; physiopathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Pulmonary Artery ; diagnostic imaging ; physiopathology ; surgery ; Retrospective Studies