ObjectiveTo study the surgical indications of using locking compression plate (LCP) to fix the posterior pelvic ring fracture,and to explore its surgical techniques.MethodsFrom September 2005 to February 2010,30 patients with posterior pelvic ring fracture were treated with LCP.Among them 21 were males,9 were females,with the average age of 38.7 years(ranged from 21 to 68 years).The injuries were caused by traffic accident in 14 cases,fall-down from high place in 10 cases,smash of heavy object in 6cases.According to Tile classification,4 patients were type B2,8 patients were type B3,12 patients were type C1,5 patients were type C2,and 1 patient was type C3.Concurrent injures including:3 cases with lung contusion; 3 cases with abdominal parenchymatous organs rupture,2 cases with intestinal rupture,5 cases with urethral injury,5 cases with traumatic brain injury,and 8 cases with fractures of limbs,spine and acetabulum.ResultsAll the incisions of 30 patients were healed by first intention.No skin necrosis,fat liquefaction and infection.Thirty cases were followed up from 13 to 40 months,with the average time of 25.1months.According to Majeed functional score system,20 cases were excellent,7 cases were good and 3 cases were acceptable,the excellent and good rate was 90％.Twelve cases got bone healing 3 months after operation,10 cases got bone healing 4 months after operation,and 8 cases got bone healing 6 months after operation.All the cases had no reduction loss,no limb length discrepancy,no deep venous thrombosis,and had not accelerated the previous nerve symptom.ConclusionUsing LCP to fix posterior pelvic ring fracture has many advantages,including wide indication,strong strength of fixation,well biomechanical properties,easy-to-use,and very good follow-up results.

A molecularly imprinted two-dimensional photonic crystal hydrogel sensor was developed with erythromycin as imprinted molecule, polystyrene two-dimensional photonic crystal as templates, methanol as solvent, methacrylic acid as monomers and ethylene glycol dimethylacrylate as cross-linkers.The imprinted molecule was removed by methanol/acetic acid (9∶1, V/V).The results showed that the diameter of Debye ring increased 6 mm when the concentration of EM changed from 0 to 1×10-6 mol/L.Namely the lattice spacing decreased 30 nm.In addition, the diameter of Debye ring only increased 1.5 and 2.0 mm when the hydrogel immersed in 1×10-6 mol/L roxithromycin (RM) or erythromycin ethylsuccinate (EEs) solution.The result indicated that the sensor had high selectivity and could be used in determination of erythromycin with low cost and easy operation.

Objective To investigate the predictive value of whole nodule size and solid component size of pulmonary subsolid nodules (SSNs)with different window setting on preoperative HRCT for pathologic grade in lung adenocarcinoma.Methods We retrospectively evaluated preoperative chest HRCT and pathological data of 125 patients with 127 surgically resected lung adenocarcinoma manifesting as SSNs.All specimens were divided into two groups:a total of 69 SSNs in group A,including 22 adenocarcinomas in situ (AIS) and 47 minimally invasive adenocarcinoma (MIA);a total of 58 SSNs in group B,including invasive adenocarcinoma (IAC).Observer 1 used computer aided diagnosis software to measure the volume of whole nodule with lung window setting (WNLW),volume of solid component with lung window setting (SCLW),volume of solid component with mediastinal window setting (SCMW) and volume of solid component with threshold of-300 HU(SCT) of all SSNs.Observer 2 randomly selected 50 SSNs and repeated all the measurements.The interobserver agreement regarding quantitative measurements were evaluated by using intraclass correlation coefficient(ICC).The differences of all quantitative features between two groups were evaluated by Mann-Whitney U test.All the quantitative features were evaluated by using univariate logistic regression analysis,significant quantitative features identified by univariate logistic regression analysis were included in the multivariate logistic regression and independent predictors of pathological grade were obtained.Receiver operating characteristic analysis was conducted for the independent predictive factors that exhibited statistically significant differences in the multivariate logistic regression.Results The interobserver agreement regarding quantitative features were excellent (ICC＞ 0.75).The WNLW,SCLW,SCMW and SCT of group B were significantly larger than those of group A (P＜ 0.001).The univariate logistic regression analysis indicated that WNLW,SCLW,SCMW and SCT were significant (P＜0.001),the multivariate logistic regression analysis indicated that SCT was the independent predictive factor (OR=1.013,95％CI:1.006—1.020,P＜0.001).When SCT larger than 139.00 mm3,SSN was significantly associated with IACs (AUC=0.887,sensitivity=81％,specificity=93％).Conclusion SCT of SSNs on preoperative HRCT can be used to distinguish between AIS-MIA and IAC,which may provide information for choice of operation.

Objective To isolate HIV-specific T cell clone and to expand them in vitro through the activation-induced expression of CD137 molecule.Methods The peripheral blood mononuclear cells were isolated from HIV-infected patients and HIV Gag specific CD3+CD8+CD137+T cell subset were sorted to 96-well plate in 1 cell/well by multicolor flowcytometry and single cell sorting.After 14 days in vitro culture with feeder cells and cytokines, the numbers and phenotypes of the cultured HIV-specific T cells were calcu-lated and identified.Results The CD137 expression was low on rested T cells but up regulated by the stim-ulation with Gag peptide pool.The CD8+CD137+T cells could secret IFN-γ.The number of CD8 T cells reached to 106 after 14 days in culture and expanded to 107-108 cells after 28 days of culture in vitro 100%of the cells remained activated upon Gag stimulation.Conclusion In stead of using IFN-γ, CD137 could be utilized as a novel molecule to isolate and expand HIV specific T cells in vitro.The expanded antigen spe-cific T cell clones could maintain good activation status.

Objective To investigate the predictive value of the whole nodule size and solid component size of lung adenocarcinoma manifesting as subsolid nodule(SSN) in three different dimensions for pathologic grade.Methods We evaluated retrospectively preoperative chest HRCT data of 125 patients with 127 SSNs surgically resected and pathologically conformed lung adenocarcinomas.All specimens were divided into two groups: a total of 69 SSNs in group A, including 22 AIS and 47 MIA;a total of 58 SSNs in group B, only including IAC.Computer aided diagnosis software were used to measure the one dimension maximum diameter of solid component with lung window setting(1D-SCLW),two dimension maximum diameter of solid component with lung window setting(2D-SCLW),one dimension maximum diameter of solid component with mediastinal window setting(1D-SCMW),two dimension maximum diameter of solid component with mediastinal window setting(2D-SCMW),one dimension maximum diameter of whole nodule with lung window setting (1D-WNLW), two dimension maximum diameter of whole nodule with lung window setting (2D-WNLW), and volume of solid component with threshold of-300 HU (SCT) of all SSNs.Results 1D-SCLW, 2D-SCLW,1D-SCMW,2D-SCMW,1D-WNLW,2D-WNLW and SCT of the group B were significantly larger than those of the group A(P=0.000).ROC analyses indicated that the diagnostic efficiency of SCT for the pathologic grade was the highest among 7 CT features(AUC=0.887, sensitivity:81%,specificity:93%);The cut-off values of 1D-SCLW,2D-SCLW,1D-SCMW,2D-SCMW,1D-WNLW, 2D-WNLW and SCT were 17.50 mm,14.75 mm,9.50 mm,7.75 mm,0.50 mm,1.25 mm and 139.00 mm3.Multiple Logistic regression analysis revealed that SCT was the independent predictor of pathologic grade(OR=4.978,95%CI=1.430-17.331,P=0.012).SCT of 139.00 mm3 or greater was a significant indicator of IAC.Conclusion Among the whole nodule size and solid component size of SSN in three different dimensions on preoperative HRCT, SCT is found to be the independent predictor of pathologic grade, which may provide reference for surgery.

Adrenal cortical adenocarcinoma is a rare and often aggressive malignant tumor. For ACC that originated outside the adrenal gland, there are few reports at home and abroad. We report a case of adrenocortical adenocarcinoma that originated from kidney, introduce its diagnosis, treatment and follow-up results in order to provide help for clinical diagnosis and treatment.

Objective To explore the medication law of TCM external treatment for chronic kidney disease-associated pruritus(CKD-aP)by data mining technology.Methods Literature of TCM external treatment for CKD-aP was retrieved from China Knowledge Network(CNKI),VIP Chinese Journal Service Platform(VIP),Wanfang Data Knowledge Service Platform(Wanfang Data),and China Biology Medicine(CBM)since the establishment of the databases to March 31,2023.After screening according to the inclusion criteria,the final inclusion in the literature was determined,effective prescriptions were extracted,and entered into Excel 2019 to establish a prescription database.Excel 2019,SPSS Modeler 18.0,Origin 2021,and Gephi 0.10 softwares were used to perform frequency statistics,gender and taste meridian statistics,association rule analysis,and clustering analysis on prescription drugs.Results Totally 103 effective prescriptions were included,involving 133 kind of Chinese materia medica,with a total frequency of 978 times and 28 drugs with frequency≥10.The top 10 drugs were Dictamni Cortex,Kochiae Fructus,Sophorae Flavescentis Radix,Angelicae Sinensis Radix,Cnidii Fructus,Rhei Radix et Rhizoma,Chuanxiaong Rhizoma,Smilacis Glabrae Rhizoma,Saposheikovize Radix and Schizonepetae Herba,with cold and warm as the main properties,bitter,pungent,and as the main sweet tastes,and liver,heart,stomach,and spleen meridians as the main meridians.The association rule analysis yielded 34 groups of commonly used drug pairs.Clustering analysis obtained 4 clusters of prescriptions.Conclusion TCM external treatment for CKD-aP is mostly based on draining wind and clearing heat,drying dampness and relieving itching,nourishing blood and dispelling wind.The commonly used drugs are Dictamni Cortex,Kochiae Fructus,Sophorae Flavescentis Radix,and Angelicae Sinensis Radix,and the commonly used prescriptions include modified Shechuangzi Powder,Danggui Yinzi Decoction,Mahuang Guizhi Decoction and Xijiao Dihuang Decoction.

Robot assisted laparoscopic surgery is a more advanced minimally invasive procedure with distinct advantages over conventional laparoscopic surgery. Since the introduction of Da Vinci robotic equipment in 2006, a large number of robotic surgeries have been performed in China, especially in the field of Urology, and robotic surgery has been widely used in the treatment of adrenal tumor, renal tumor, bladder cancer, prostate cancer, and other diseases. Based on rich experience of more than 3000 cases of robotic surgery in our center, we summarize the status quo of urologic robotic surgery and discuss its development prospect.

Objective:To explore the feasibility and safety of robot-assisted retrohepatic inferior vena cava(IVC) tumor thrombectomy for renal tumor patients with a single position.Methods:The clinical data of 6 renal tumor patients with retrohepatic IVC thrombus (5 males and 1 female, mean age of 58 years) who underwent robot-assisted retrohepatic IVC tumor thrombectomy with a single position in First Affiliated Hospital of Zhengzhou University from December 2015 to August 2020 were retrospectively reviewed. Four cases had the renal tumor on the right side and two on the left side. The mean tumor size was 9.6 cm(range 7-13 cm). There were 4 cases of Mayo level Ⅱ and 2 cases of level Ⅲ IVC thrombus with the mean IVC thrombus length of 6.5 cm(range 5-8cm). The "IVC-first, kidney-last" robotic technique was developed to minimize chances of IVC thrombus embolization for retrohepatic IVC thrombus, and a "artery-first, vein-second" robotic operative strategy were developed to minimize chances of intraoperative hemorrhage. The whole procedure (the suprahepatic infradiaphramatic IVC, first porta hepatis and left renal vein control, caval exclusion, tumor thrombectomy, IVC repair, radical nephrectomy) was performed exclusively robotically with a single position.Results:All 6 robotic procedures were successful, without open conversion or mortality. The mean operative time was 210 min(130-320 min), estimated blood loss was 800 ml(300-2 100 ml) and three patients (5%) received intraoperative blood transfusion. The mean time of occlusion of IVC was 21 min (15-43min). Incomplete blocking occurred in two cases(one IVC, one first porta hepatis), and tumor thrombectomy were completed with intraoperative loss. IVC invasion was confirmed intraoperatively in one patient and we staple-transected the IVC without reconstruction. Six patients were all transferred to the intensive care unit for median of 2.1 days (1-4 days) after surgery. The mean time of postoperative drainage was 5 days (4-9 days). Renal dysfunction occurred in 3 patients and liver dysfunction occurred in 2 patients, and all recovered after medical therapy. Postoperative pathological diagnosis revealed 5 cases of clear cell carcinoma and 1 case of renal sarcoma, and the 5 cases received targeted therapy. With a median follow-up of 27 months (3-54 months), 3 patients were alive, 1 alive with tumor recurrence, and 2 died of cancer.Conclusions:Robot-assisted laparoscopic retrohepatic IVC thrombectomy with a single position have the advantage of simple procedure, shorter operative time, less trauma and quicker recovery, and it is a feasible and effective method for renal tumor patients with retrohepatic IVC thrombus.

Objective:To report our technique and outcomes of robotic management of complex pheochromocytoma.Methods:Twelve patients with complex pheochromocytoma underwent robot-assisted surgery from May. 2016 to Sep. 2018. Four patients were male and eight patients were female. The mean patient age was 44 (range, 21-66) years. There were seven right adrenal tumors, two left adrenal tumors and three bilateral tumors. The mean tumor size was 7.8 (range, 2.5-16.0) cm. All surgeries were performed by transperitoneal approach. Three patients underwent synchronous surgery for bilateral pheochromocytoma.Results:All procedures were performed successfully without conversion to open surgery. The mean operative time was 108 (range, 50-195) min and mean blood loss was 105 (range, 20-400) ml. The average postoperative indwelling time of drainage tube was four (range, 3-5) days. The mean postoperative hospital stay was 8.5 (range, 5-23) days. Histopathologic examination of specimen revealed pheochromocytoma arising from adrenal gland. There were no recurrences or metastatic events during the follow-up of 5 to 35 months.Conclusion:Robotic assisted surgery is safe and effective for management of complex pheochromocytoma and provides significant advantages with regard to less blood loss and shorter postoperative hospital stay.