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Clinical application of external ventricular drainage for ruptured anterior communicating artery aneurysms

Heng ZHANG ; man Xiao ZHOU ; Xing YANG ; Shuo WEI ; chang Wen GAO

Journal of Regional Anatomy and Operative Surgery.2017;26(10):764-767. doi:10.11659/jjssx.04E017034

Objective To investigate the clinical effect of external ventricular drainage on the prognosis of anterior communicating artery aneurysms.Methods Retrospectively collected and analyzed 96 patients of anterior communicating artery aneurysms who were treated in our hospital from June 2013 to October 2015,and they were divided into the observation group which was given external ventricular drainage treatment and the control group which was not given external ventricular drainage treatment.These patients were followed up for 6 months to 2 years,and the results of the 2 groups were graded according to the analysis of postoperative complications and the Glasgow prognostic score (GOS).Meanwhile,evaluated the general function of the patients according to the KPS score.Results The the incidence rate of complications after treatment in observation group was 54.17％,which was lower than 86.96％ in the control group,and the difference was statistically significant(P ＜ 0.05).The cure rate of observation group was 79.16％,which was higher than 50％ in the control group,and the difference was statistically significant (P ＜ 0.05).The postoperative KPS score in the observation group was (79.68 ± 13.24) points,which was higher than (62.57 ± 12.72) points in the control group,and the differences were statistically significant (P ＜ 0.05).Conclusion External ventricular drainage can reduce the compression injury of the brain tissue to a minimum degree,reduce intracranial pressure,relieve cerebral edema caused by intracranial pressure,reduce complications,and improve the prognosis of patients and the cure rate.

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3D visualization assisted proximal femoral nail anti-rotation surgery in the treatment of elderly intertrochanteric fracture

jun Ai LIANG ; yi Jia LI ; yu Chen HUANG ; Shuai LIU ; Yan XU ; qiang Qing YAO ; ming Li WANG

Journal of Regional Anatomy and Operative Surgery.2017;26(10):759-763. doi:10.11659/jjssx.05E017095

Objective To investigate the application of 3 D visualization (3 DV) assisted proximal femoral nail anti-rotation (PFNA) surgery in the treatment of elderly intertrochanteric fracture (ITF).Methods Totally 11 cases of elderly unstable ITF were treated with 3DV assisted PFNA fixation surgery.All these patients were examined with multi-row spiral CT volume scan,and the anatomical data of Dicom was reconstructed through M3 D software.Computer aided design (CAD) was performed based on 3 D reconstruction data,including anatomical data measurement,fracture reduction simulation,and proximal femoral head nail (PFNA) implant parameter design.And the CAD data were showed by S-3DV system during operation to guide the operation.Time of operation,intra-operative blood lose,post-operative drainage volume,hospital stay time and Harris hip score were recorded and compared to the non-3DV assisted PFNA procedure.Results In 3 DV-PFNA surgery,there was no significant difference between the preoperative planned average PFNA size and the implanted average PFNA size (P ＞ 0.05).Compared to the non-3DV-PFNA surgery,3 DV-PFNA surgery has less intra-operative blood lose and post-operative drainage volume,shorter time of preoperative traction reduction and operation (P ＜ 0.05).Harris hip function score of 3 DV-PFNA surgery was better than the conventional surgery 1 week after operation,and there was no significant difference in VAS score I month after operation.The 11 cases treated with 3DV-PFNA technology were healed well,and the rate of complications was lower than the conventional surgery.Conclusion 3DV technique can show accuracy CAD model of ITF,which may play an important role to improve efficiency and accuracy of PFNA surgery.

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Clinical application of Acrysof Toric intraocular lens based on Sirius measurement data

Xi LIU ; wen Jia LI ; liang Fu LI ; Ping DUAN ; Hui LIU ; Yu WANG

Journal of Regional Anatomy and Operative Surgery.2017;26(10):754-759. doi:10.11659/jjssx.04E017059

Objective To evaluate the effect of corneal curvature based on Sirius measurement on the accuracy of implantation of Acrysof Toric intraocular lens (IOL) and astigmatism correction.Methods In this prospective study,23 patients (36 eyes) with cataract and mild to moderate corneal astigmatism were recruited and underwent phacoemulsification and Acrysof Toric IOL implantation.In the observation group,the corneal curvature value of 19 eyes measured by Sirius was used as the basis for calculating Acrysof Toric intraocular lens power.In the control group,the corneal curvature value of 17 eyes measured by manual corneal curvature was used as the basis for calculating Acrysof Toric intraocular lens power.Main outcome measurements including uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA) surgically induced astigmatism(SIA),deviation of lens axis (LAD),index of corrected astigmatism (CAI) at 3 months postoperatively were observed.Results At 3 months postoperatively,the average UCVA of the observation group was (0.8 ± 0.11) and the average UCVA of the control group was (0.7 ± 0.73),there was no statistically significant differences (Z =1.277,P =0.372).The average BCVA of the observation group was (0.8 ± 0.21),and the average BCVA of the control group was (0.8 ± 0.41),there was no statistically significant differences (z =0.962,P =0.329).The deviation of lens axis of the observation group was (2.81 ± 1.72) ° and it was (3.12 ± 1.56)°in the control group,and there was no statistically significant differences (t =0.481,P =0.631).The index of corrected astigmatism of the observation group was (1.01 ± 0.21) and it was (1.03 ±0.32) in the control group,with no statistically significant differences (t =0.581,P =0.615).Conclusion Compared with the manual keratometer,Acrysof Toric IOL calculation based on Sirius measurement data is accurate and reliable.Meanwhile,Sirius has obvious advantages such as high resolution,non-contact,non-invasive and easy to operate.

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Effects and safety analysis of patient controlled brachial plexus nerve block analgesia after pediatric upper limb operation

hua Jia SHI ; ming Jian CHEN ; ping Xin YANG ; wen Yu KE

Journal of Regional Anatomy and Operative Surgery.2017;26(10):750-753. doi:10.11659/jjssx.12E016017

Objective To investigate the effect and safety of patient controlled intravenous analgesia and patient controlled brachial plexus block in the prevention of postoperative pain in children with upper limb operation.Methods Totally 80 children with upper limb surgery were randomly divided into two groups:patient controlled intravenous analgesia group (PI group) and patient controlled brachial plexus block group(PN group),with 40 patients in each group.The dynamic pain score,static pain score,sedation score,sleep quality score,parent satisfaction score,and adverse reaction of the two groups were recorded.Results There was no significant difference between the two groups in the static pain score(P ＞ 0.05).The dynamic pain score of PN group was better than that of PI group within 24 hours,and the difference was statistically significant(P ＜ 0.05).The difference was statistically significant in the comparison of sedation score between the two groups within 6 hours (P ＜ 0.05),but the difference was not statistically significant after 6 hours (P ＞ 0.05).PN group was better than PI group in terms of sleep quality,parent satisfaction and adverse reaction incidence,and the difference was statistically significant (P ＜ 0.05).Conclusion Patient controlled brachial plexus block can provide a more satisfactory analgesic effect for children after surgery with low incidence of adverse reactions and higher safety,which is conducive to early functional exercise in children.

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Slide asymmetry of corresponding neurapophysis with major gyrus on telencephalic sectional planes

peng Xue LI ; hui Ye ZHANG ; qing Qing NA ; sheng Yan LIN ; kai Jian ZHANG

Journal of Regional Anatomy and Operative Surgery.2017;26(10):703-706. doi:10.11659/jjssx.05E017067

Objective To study the asymmetry of medulla on the sectional plane to support the way of localizing gyris by the neurapophysis,and to enrich the anatomical knowledge about the telencephalic sectional plane.Methods Slected 30 adult normal head specimens.Head specimens saw cutting were made through the planum sphenoidale till the surface of the brain were marked.Colored the different gyris with different colors so as to distinguish.Then cut the brain parallel to the marked line to make brain slices of 6 mm.Observed the corresponding neural process by different staining of brain slices.The number and direction of neurapophysis branches of the corresponding neurapophysis were observed.And these data were statistically analyzed and processed.Results On the telencephalic sectional planes,most of the corresponding neurapophysis of gyrus were symmertrical in the number and direction of neurapophysis branches.Conclusion It is reliable and practical to localize gyris with neurapophysis on telencephalic sectional planes.

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Efficacy analysis of radiofrequency ablation for atrial fibrillation in patients with cardiac valve disease

dong Ye MI ; fei Lin ZHANG ; mei Li SHAN ; xiang Xiang ZHENG ; Zhi LI ; jun Chen HUANG ; wei Jian QIN

Journal of Regional Anatomy and Operative Surgery.2017;26(10):738-741. doi:10.11659/jjssx.05E017080

Objective To investigate the clinical efficacy and prognosis of bipolar radiofrequency ablation for atrial fibrillation in patients with cardiac valve disease.Methods Sixty patients with atrial fibrillation and valvular heart diseases who merely underwent cardiac valve surgery were selected as the control group,and seventy-five patients who underwent bipolar radiofrequency ablation modified Maze procedure along with concomitant cardiac valve surgery were selected as the observation group.The perioperative technological characteristics and postoperative restoration of sinus rhythm in different time-points of the two groups were retrospectively analyzed.Results There was no significant differences in terms of the surgical pathway and types of replaced cardiac valves (P ＞ 0.05),but the cardiopulmonary bypass time and aortic-cross clamping time of the observation group were significantly longer than those in the control group(P ＞ 0.05).Successful restoration of sinus rhythm in the observation group was significantly higher than that of the control group 3 months,6 months,and 1 year after operation respectively.Conclusion Bipolar radiofrequency ablation modified Maze procedure along with concomitant cardiac valve surgery is clinically effective during the short term for the patients with atrial fibrillation and valvular heart diseases.

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Early diagnosis and surgery timing of strangulated intestinal obstruction

hua Wen ZHANG ; xiong Zhi LIU ; Song ZHOU ; Jing LIU ; guo Ai YANG ; xiang Yao ZOU ; Kai NIE

Journal of Regional Anatomy and Operative Surgery.2017;26(10):735-738. doi:10.11659/jjssx.07E017021

Objective To investigate the early diagnosis and surgery timing of strangulated intestinal obstruction.Methods The clinical data of 90 patients with strangulated intestinal obstruction who were admitted into our hospital from January 2013 and January 2016 were retrospectively analyzed.And these patients were divided into the early stage group (28 cases) and the later stage group (62 cases).The rate of mortality and the rate of necrotic bowel resection of the two groups were analyzed.Results Among the 90 patients underwent emergency surgery,there were 88 cases cured and 2 cases died,and there were 10 cases (11.11％) of necrotic bowel resection among the survivor.In the early stage group,there were 8 cases of necrotic bowel resection and 1 case of death.In the later stage group,there were 2 cases of necrotic bowel resection and 1 case of death.Conclusion Early diagnosis and prompt surgical treatment can reduce the mortality of strangulation obstruction and necrosis of bowel resection.

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Vit D promotes proliferation and differentiation of mesenchymal stem cells through regulates extracts of plastrum testudinis

feng Jin CHEN ; ling Hai ZHANG ; gou Chun XIAO ; sheng Mao YE ; lai Er ZHENG ; feng Dong CHEN

Journal of Regional Anatomy and Operative Surgery.2017;26(10):714-718. doi:10.11659/jjssx.05E017005

Objective To explore the effect and the mechanism of vitamin D(Vit D) promotes proliferation and differentiation of mesenchymal stem cells (MSCs) through regulates extracts of plastrum testudinis (PTE).Methods Established the PGL3-Id1 promoter and transfered rat MSCs.PTE combined with 10-6,10-7,10-8mol/L Vit D respectively were acted on the transfected MSCs for 36 hours.The level of Id1 promoter were detected by luciferase activity measurement.1,3,30,100 pg/mL PTE combined with Vit D of 10-7 mol/L were acted on MSCs for 36 hours,3 days and 7 days,and the VDR expression were detected by RT-PCR test.Results PTE promoted the expression of Id1 in MSCs,the expression of Id1 was inhibited when PTE combined with Vit D (P ＜ 0.01),and it was significantly different among different dosis of Vit D(P ＜0.01).The expression of VDR was inhibited in different degree when PTE combined with Vit D for 36 hours,3 days and 7 days.PTE combed with large dose of Vit D for 36 hours had significant effect of inhibition,and the difference was statistically significant (P ＜ 0.05).The inhibiting effect was more obvious when PTE combined with large dose of Vit D for 3 days and 7 days.When different doses of PTE combined with Vit D for a same duration,the difference of VDR expression was statistically significant (P ＜ 0.05).Meanwhile,when same doses of PTE combined with Vit D for different durations,the difference of VDR expression at 7 days and 36 hours was statistically significant (P ＜ 0.05).Conclusion The proliferation of MSCs which promoted by PTE was inhibited by Vit D,and the nuclear receptor VDR may be one of the targets of drug action for PTE regulating proliferation and differentiation of MSCs.

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Study in L-carnosine on the proliferation and apoptosis of human hepatocellular carcinoma HepG2 cells

Qiang LIU ; ping Yu PENG ; jiao She DAI ; bin Xiao MA

Journal of Regional Anatomy and Operative Surgery.2017;26(10):710-714. doi:10.11659/jjssx.06E017063

Objective To study the L-carnosine induced apoptosis of human hepatocellular carcinoma HepG2 cells and its mechanism.Methods Human hepatocellular carcinoma HepG2 cells were cultured in vitro,then the cells in logarithmic phase were divided into 5 mM,20 mM,50 mM L-carnosine group and control group,treated with 5 mM,20 mM,50 mM L-carnosine and saline respectively.The proliferation of HepG2 cells was measured by CCK-8 assay after 24 hours and 48 hours treatment.The cell apoptosis and cell cycle were detected by flow cytometry after 48 hours treatment.The protein expression of Caspase-8,PI3K and Akt were detected by Western blot in each group after 48 hours treatment.Results CCK-8 and flow cytometry assay showed that both 20 mM and 50 mM L-carnosine treated group significantly inhibited the proliferation of HepG2 cells after 24 hours and 48 hours,and the inhibition were in a time and dose-dependent manner.Western blot revealed that the expressions of PI3K and Akt were down-regulated with the increase of L-carnosine concentration,while the expression of Caspase-8 was increased.Conclusion L-carnosine exhibits an inhibitory effect of the proliferation and promote apoptosis of human liver cancer cell line HepG2.The mechanism may be associated with the inhibition of the PI3K/Akt signaling pathway and activation of Caspase-8 signaling pathway.

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Establishment of pleural effusion model of SD rats with hypothermia

bo Jian HUAN ; na Li CHEN ; he Cheng SHI ; Wei DAI ; feng Dan YUAN ; hong Ji ZHOU ; hai Zhi HAN

Journal of Regional Anatomy and Operative Surgery.2017;26(10):706-709. doi:10.11659/jjssx.05E017094

Objective To establish a hypothermic pleural effusion model with SD rats,and to observe the relationship between hypothermic pleural effusion production and cold water immersion duration.Methods Sixty male Sprague-Dawley rats of(290.3 ± 7.5) g were randomly divided into experimental group(n =50) and control group(n =10).The experimental group was divided into group A1,A2,A3,A4 and A5 according to the different immersion time with 10 rats in each group.The experimental group was placed in a self-made cylindrical erected rat holders and then immersed in cold water at (20 ±0.2) ℃.The soaking depth was the level of clavicle of the rats.Group A1 and A2 were respectively removed and anesthetized after immersing 12 hours and 24 hours,and the serum and pleural effusion were collected to detect total protein and lactate dehydrogenase concentration.The remaining rats of experimental group were rewarmed by incubating at 37 ℃ for 1 hour.Group A3,A4 and A5 were respectively anesthetized at 12 hours,24 hours and 36 hours after the initiation of rewarming for detecting the serum and pleural effusion.The control group was directly anesthetized to collect serum to detect total protein,lactate dehydrogenase concentration.The pleural effusion quality was analyzed by Light standard.Results There was no obvious pleural effusion in normal rats.The amount of pleural effusion in the group A2 was higher than that in the group A1.After the rewarming,the amount of pleural effusion gradually decreased with the prolongation of time,and disappeared 36 hours later.Pleural effusion total protein/serum total protein was about 50％ in group A1,while it was more than 50％ in the group A2,A3 and A4.Pleural effusion lactate dehydrogenase/serum lactate dehydrogenase were all less than 60％ in each experimental group.The pleural effusion lactate dehydrogenase of experimental group was 2 times greater than that of the control group.Conclusion The method of establishing hypothermia pleural effusion SD rats model by immersing in 20 ℃ water is stable and reliable.The pleural effusion increased with the prolongation of the cold water immersing.After rewarming,the pleural effusion was gradually absorbed and then dispeared.

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