Objective The hypoxic-ischemic(HI) cardio-cerebral damage caused by cardiac arrest in perioperative period is the main cause of acute and chronic disability in children patients.To investigate role of mitochondrial dysfunction in hypoxic-ischemic brain damage of mice.Methods The hypoxic-ischemic mice model was established by the bilateral carotid artery occlusion and hypoxia treatment.The neurobehavior of mice in HI model group,sham-operated group,and comparative group were evaluated within 48 hours after operation.After 48 hours,the mice were killed to evaluate the brain water content,mitochondria content,swelling,antioxidant capacity,and respiratory function.Results Within 0,24 hours after operation,the abnormal rate of the neurobehavior of HI model mice was 83.33％,which was significantly higher than comparative and sham-operated groups.The water content of right brain was significantly increased evidently compared to the other two groups (P ＜ 0.05).The content and swelling of mitochondria in brain were increased.The activity of superoxide dismutase (SOD),the glutathione (GSH) content,respiratory state 3 (ST3),and respiration control of rate (RCR) were significantly decreased; while the content of malondialdehyde (MDA) and ST4 were significantly increased (P ＜ 0.05).Conclusions The brain tissue showed different swelling,the mitochondrial function occurred disorder,which might play an important role in hypoxic-ischemic brain damage of mice.

Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI)in diagnosis of extramural vascular invasion (EMVI)of rectal cancer.Methods 33 patients with rectal cancer were reviewed preoperatively.The MRI findings of EMVI of all cases were scored and compared with the postoperative pathological results.Results The MRI EMVI scores were consistent with histopathology findings (k=0.324,P=0.039).The accuracy rate of MRI in diagnosis of EMVI was 66.7% (22/33).The MRI EMVI scores rose up with increased pT stage,meanwhile there was a high correlation between both (r=0.546).The percentage of MRI EMVI positive number was increased with elevated pT stage,and there was also a high correlation between both (r=0.469). ROC curve showed that MRI EMVI scoring was an effective method in diagnosis of rectal cancer EMVI (AUC=0.757).Conclusion HRMRI is a valuable method in diagnosis of EMVI of rectal cancer.

OBJECTIVEThis study aimed to evaluate the effort of applying frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater in the treatment of sagittal synostosis.

METHODSFrom April 2008 to June 2013, sixty-three children with sagittal synostosis, aged 5 months to 3 years, were included in the study. The frontal bone flap was removed using an air drill. The occipital and bilateral temporal bone flaps were cut open but not detached from the dura mater or fixed to produce floating bone flaps. The skull bone was cut into palisade-like structures. Brain compression from both sides and the base of the skull was released and the brain expanded bilaterally through the enlarged space. Only a long strip-shaped bone bridge remained in the central parietal bone. Subsequently, the frontal bone flaps and occipital bone flap were pushed towards the midline and fixed with the parietal bone bridge to shorten the anteroposterior diameter of the cranial cavity and allow the brain to expand bilaterally to correct scaphocephaly. The CT images showed that both sides of the parietal bone of artificial sagittal groove gradually merged postoperative 1 year, and skull almost completely normal healing after operation 2 or 3 years, without deformity recurrence within 5 years. Among them all, 61 children's intelligence is normal and 2 children's lagged behind normal level, no further improvement.

RESULTSPatients were followed up 1 - 5 years (an average of 43 months). Skull growth was excellent in all patients, the anteroposterior diameter was shortened by 14.6 mm averagely, the transverse diameter was increased by 12.3 mm averagely, the prominent forehead was corrected, and scaphocephaly improved significantly. There were no complications such as death and skull necrosis.

CONCLUSIONSThe application of frontal and occipital bones in extensive cranioplasty and preserving multiple cranial bone flaps adhered to the dura mater can be used in the treatment of sagittal synostosis. Surgery without removing bone flaps is less traumatic and results in no massive bleeding. It can effectively relieve brain compression and promotes transversal expansion of the brain during surgery and subsequent normal brain development.

Bone and Bones ; Brain ; growth & development ; Child, Preschool ; Craniosynostoses ; surgery ; Dura Mater ; Frontal Bone ; surgery ; Humans ; Infant ; Parietal Bone ; surgery ; Recurrence ; Surgical Flaps ; Temporal Bone ; surgery

Differentiated thyroid cancer is one of the most common endocrine malignant tumors, and thyroidectomy is its basic treatment measures. Insufficient attention is paid to its postoperative bone hungry syndrome and parathyroid hyperfunction or hyperparathyroidism, which will seriously affect the patient’s life quality and prognosis. This paper will explore the etiology, dangers, diagnosis, prevention, and treatment for hungry bone syndrome, parathyroid hyperfunction and hyperparathyroidism of thyroid cancer patients after thyroidectomy.

Objective:To evaluate the clinical feasibility, safety, and advantages of small lateral cervical incision for parathyroid exploration and resection.Methods:A total of 31 consecutive patients who underwent parathyroidectomy with a small lateral cervical incision, in the Department of Endocrinology and Breast Surgery of the First Affiliated Hospital of Chongqing Medical University from Apr. to Nov. 2021, including 11 males and 20 females, aged (49.32±13.79) years, ranging from 28 to 86 years, were selected to make retrospective statistical analysis of the surgical time, hospital stay, intraoperative blood loss, postoperative drainage and postoperative complications of the patients. All patients were injected with carbon nanoparticles suspension injection guided by color ultrasound to locate the enlarged parathyroid gland before surgery. EXCEL 2019 software was used for statistical analysis.Results:Thirty-one patients underwent parathyroidectomy through a small lateral cervical incision. Primary hyperparathyroidism was performed in 19 cases (including 2 cases with bilateral small lateral cervical incision, 2 cases with unilateral excision of thyroid mass combined with parathyroidectomy, 1 case with resection of huge parathyroid adenoma, and 1 case with local anesthesia) . Twelve patients with secondary hyperparathyroidism underwent total parathyroidectomy through bilateral small lateral cervical incision and forearm autogenous parathyroid transplantation (including bilateral thyroid mass resection combined with bilateral total parathyroidectomy and forearm autogenous parathyroid transplantation in 2 cases, local anesthesia and cervical plexus nerve block in 2 cases, and ectopic parathyroid gland in thyroid in 1 case) . Among them, the average operative time of patients with primary hyperparathyroidism was (54.74±27.71 & 74.14±31.73) min, the average intraoperative blood loss was (8.11±5.05 & 14.43±10.94) ml, the average postoperative drainage was (14.37±24.64 & 26.36±32.87) ml, the average postoperative parathyroid hormone was (11.59±16.46 & 26.65±56.38) pg/ml, the average hospital stay was (10.00±5.09 & 10.96±4.55) d, and the postoperative complication rate was (3.2% & 0%) .Conclusions:Parathyroid gland exploration and resection through small lateral cervical incision is a safe and effective surgical method and can also complete thyroid exploration and parathyroidectomy at the same time. Appropriate anesthesia should be selected after a full assessment of the patient’s basic condition.