Objective To develop the physical model of male pelvic organ group and conduct corresponding prostate puncture experiments.Because sufficient research and plenty of surgical training is very important for improving the surgical treatment effect of prostate puncture surgery,in which the deformation of needle and tissue has significant influences on surgical precision.Methods Based on the magnetic resonance images,the 3D reconstruction of human pelvic organs group was performed,and then the monomer organ moulds were designed.The monomer organ models were made by a new type of polyvinyl alcohol (PVA) hydrogel which is a biomimetic material and can simulate biomechanical properties of different tissues by adjusting the proportion of components.The monomer organ models were assembled to simulate the internal environment of pelvic cavity based on the human anatomical structure,and the experiments of insertion force and deformation were conducted.Results The results of insertion force experiments indicated that the mechanical properties of the proposed model of pelvic organ group were coincident with the force variation in real surgury.During the insertion deformation experiments,the deformation of needle and organs could be clearly observed in the ultrasound images,which indicates that the pelvic organ group has good ultrasonography compatibility.Conclusions The proposed physical model of male pelvic organ group can meet the requirements of experiment research and surgical training of prostate puncture,which provides foundation for improving precision and popularization of puncture surgery.

Objective To establish an animal model of dermatophytosis and to evaluate antifungal efficacy on dermatophytosis with this model. Methods Animal models of dermatophytosis were established by inoculating dermatophyte suspension onto abraded skin on the back of guinea pigs. Thirty- eight healthy guinea pigs were randomly and equally divided into 2 groups, namely, Trichophyton mentagrophytes group (infected with T. mentagrophytes), and Microsporum canis group (infected with M. canis), and each group was classified into three subgroups, i.e., itraconazole group treated with oral itraconazole of 4 mg per kilogram body weight per day from day 0 to day 14 after infection, terbinafine group treated with oral terbinafine of 5 mg per kilogram body weight per day from day 0 to day 14 after infection, and untreated group receiving no therapy. The therapeutic effect was evaluated according to skin lesion score and fungal examination results on day 8, 11 and 14 after infection. Results Obvious lesions were observed and fungal examination was positive in untreated, infected pigs on day 8 after infection. In T. mentagrophytes-infecyted pigs, the skin lesion score on day 8, 11, 14 was 9, 1 and 0 in itraconazole group, 8, 5, and 1 in terbinafine group, 48, 52, 40 in untreated group, respectively, and there was significant difference between treated and untreated groups on the three time points (all P<0.01); the mycological cure rates on the above time points were 66.7%, 83.3%, 83.3%, in itraconazole-treated pigs, 83.3%, 83.3%, 83.3%, in terbinafine-treated pigs, 0, 0, 0 in untreated pigs, respectively, with no significant difference between itraconazole and terbinafine group (all P>0.05) but statistical difference between untreated and treated groups (all P<0.01) on all time points. Meanwhile, in M. canis-infected pigs, the skin lesion score on day 8, 11, 14 reached 3, 0, 0 in itraconazole group, 9, 2, 0 in terbinafine group, 46, 47, 39 in untreated group, respectively, and mycological cure rates 83.3%, 83.3%, 83.3% in itraconazole group, 83.3%, 83.3%, 83.3% in terbinafine group, 0, 0, 0 in untreated group, respectively; significant difference was noticed in the two parameters between the treated and untreated groups (all P<0.01) but not between the two treated groups (all P>0.05). Conclusion Itraconazol and terbinafine exhibit similar excellent antifungal activity in routine model of T. mentagrophytes-and M. canis-dermatophytosis.

Objective To summarize diagnostic methods and surgical management experience of penetrating chest trauma . Methods The clinical data of 603 patients in our department during the past 10 years were analyzed retrospectively in respects of features of injury ,diagnostic methods ,surgical management and outcome ,etc .Results Location of the wounds :the wounds on the left anterior chest wall had 151 cases ,on the left posterior chest wall 134 cases ,on the right anterior chest 137 cases ,on the right posterior chest 108 cases ,on the bilateral chest 22 cases ,on the root of the neck 35 cases ,on the upper abdome 16 cases .In 453 ca‐ses examined by CT ,96 .03% of these cases were found to be abnormal .In 252 cases examined by X ray ,71 .03% of these cases were found to be abnormal .166 underwent thoracotomy ,26 underwent VATS(Video assisted Thoracoscopic Surgery ) .411 under‐went non operative management .583 were cured ,76 cases developed complications .20 were died .Conclusion Multi spiral CT is a rapidly and accurate diagnostic method to penetrating chest trauma .Incision of thoracotomy is employed according to the lethal damage and the most serious injury organ .

OBJECTIVETo probe into effective surgical procedures and improve the outcome of treatment for patients with severe hepatic injury.

METHODSA retrospective study involving 113 patients with severe hepatic trauma (AAST grade IV and V) during the past 12 years was carried out. Ninety-eight patients underwent surgical treatment. Surgical interventions including hepatectomy or direct control of bleeding vessels by finger fracture technique with Pringle maneuver, selective ligation of hepatic artery, retrohepatic caval repair with total hepatic vascular occlusion, and perihepatic packing were mainly used.

RESULTSIn the 98 patients treated operatively, the survival rate was 69.4% (68/98). Among 40 patients with juxtahepatic venous injury (JHVI), 15 were cured with the maximum blood transfusion of 12,000 ml. Eight cases of Grade IV injury treated nonoperatively were cured. The percentage of failure of nonoperative management was 42.9% (6/14). The overall mortality rate was 32.7% (37/113), and 57% of the deaths were due to exsanguination.

CONCLUSIONSReasonable surgical procedures based on classification of hepatic injuries can increase the survival rate of severe liver trauma. Accurate perihepatic packing is effective in dealing with JHVI.

Adolescent ; Adult ; Age Factors ; Aged ; Female ; Hemostasis, Surgical ; methods ; Hepatectomy ; methods ; mortality ; Humans ; Injury Severity Score ; Laparotomy ; methods ; Liver ; injuries ; surgery ; Liver Diseases ; etiology ; mortality ; surgery ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Factors ; Survival Rate ; Treatment Outcome

Objective To investigate the clinical characteristics and risk-factors of traumatic basal ganglia stroke (TBGS) in children.Methods A retrospective case study was conducted to analyze the clinical and imaging data of 16 children with TBGS in the First Hospital of Jilin University from January 2014 to June 2017.A total of 16 TBGS cases (11 males,5 females) were diagnosed and the age ranged from 0.5 to 13.0 years.The prognosis of children with TBGS at different ages (≥5 years and＜5 years) and with different traumatic stroke (infarction and hemorrhage) were compared.Fisher's test was used to compare the prognosis of different groups.Results All cases had clear history of head trauma and varying degrees of limb paralysis after injury,including 4 cases of facial paralysis,3 cases of consciousness disturbance and 1 case of seizures.Head CT scan of the 16 cases showed 11 cases of ischemic stroke and 5 cases of hemorrhagic stroke.Moreover,scattered calcification was observed in the bilateral basal ganglia point of 8 cases.Neurotrophic treatment,microcirculation improvement and nerve rehabilitations were given according to the clinical and imaging data.One patient was treated with craniotomy and hematoma clearance.Of the 16 cases,11 cases were restored to normal,while 3 cases developed limb paralysis and 2 cases died.The prognosis of 11 cases of traumatic basal ganglia infarction (10 cases recovered and 1 case remained hemiplegic) was relatively better than that of 5 cases of hemorrhage (1 case recovered,2 cases remained hemiplegic and 2 cases died) (x2=8.045,P=0.013).In addition,the children younger than 5-year-old (all 8 cases recovered) had a better prognosis than the children older than 5-year-old (8 cases,3 of whom recovered,3 cases remained hemiplegia,2 cases died)(x2=12.121,P＜0.01).Conclusions The anatomical characteristics of basal ganglia and calcification of the lenticulostriate artery are risk-factors for TBGS in children.The prognosis of infarcted children and younger children is relatively better.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.