AIM: To compare the effectiveness of foldable capsular body(FCB)with traditional scleral buckling(SB)in the treatment of experimental retinal detachment animal models.METHODS: After successfully establishing rhegmatogenous retinal detachment(RRD)animal models, 24 New Zealand white rabbits were randomly divided into three groups(RRD models group, SB group, and FCB group), with 8 rabbits in each group. The FCB and SB groups underwent SB and FCB surgeries for the RRD animal models, while the RRD models group only consists of RRD models without any surgical intervention during the follow-up period. The follow-up duration was 3 mo. Wide-field neonatal fundus imaging system and ophthalmic B-ultrasound were used to assess the fundus conditions before and after surgery. The Icare® TONOVET Plus tonometer was utilized to evaluate intraocular pressure changes before and after surgery. The Eaton and Draize scoring systems were selected to monitor postoperative inflammatory reactions.RESULTS: The retinal reattachment rates in the FCB and SB groups were 87.5% and 75.0%, respectively, with no statistically significant difference between the groups(P>0.05). The intraocular pressure in both the FCB and SB groups increased postoperatively compared to preoperative levels(P<0.01), and there were no significant differences in intraocular pressure at any time points during the follow-up period between the groups(P>0.05). The intraocular pressure in the RRD models group remained at a low level throughout the follow-up period. The average surgical time for the FCB group was 16.87±2.29 min, which was shorter than 46.25±4.74 min in the SB group(t=-15.166, P<0.001). According to the Eaton and Draize scoring systems, the FCB group had lower grades of conjunctival hyperemia and edema in the early postoperative period compared to the SB group, indicating milder inflammatory reactions(P<0.05).CONCLUSION: Both FCB and SB are effective in treating experimental RRD. Compared to SB, FCB is simpler to operate, and also has a shorter surgical time and milder postoperative inflammatory reactions.

Objective To explore the application value of multimodal MRI in the preoperative staging of cervical cancer.Methods The preoperative imaging data of 60 patients with cervical cancer confirmed by surgical pathology or biopsy were analyzed retro-spectively.The results of preoperative staging by multimodal MRI and postoperative pathological staging were compared.The diag-nostic accuracy of multimodal MRI in staging of cervical cancer was evaluated.Results Among the 60 cases,the preoperative staging results of multimodal MRI were 25 ⅠB,20 ⅡA1,9 ⅡA2,and 6 ⅢC.While the postoperative pathological staging results were 27 Ⅰ B,18 ⅡA1,9 ⅡA2,and 6 ⅢC.The staging results achieved by preoperative multimodal MRI and postoperative pathological staging were in good agreement.With the postoperative pathological staging as the gold standard,the diagnostic accuracy of multimodal MRI in preoperative staging was 100.00%(25/25),85.00%(17/20),77.78%(7/9),and 83.33%(5/6),respectively.Conclusion Multimodal MRI has a high accuracy in the preoperative staging of cervical cancer which can be used as a routine evaluation tool for the accurate preoperative staging of cervical cancer in clinical work.

Objective To explore the clinical application of the Shikani optical style(SOS)in guiding nasal tracheal intubation.Methods A retrospective analysis was made on clinical data of 60 patients who underwent selective operation under general anesthesia through nasal tracheal intubation from January 2017 to December 2022.According to the guidance methods of nasal tracheal intubation,the patients were divided into three groups with 20 cases in each group:video laryngoscope guided nasal tracheal intubation group(group V),fiberoptic bronchoscopy guided nasal tracheal intubation group(group F),and SOS guided nasal tracheal intubation group(group S).The grading of glottis exposure and epistaxis during tracheal intubation were recorded,as well as the success rate,completion time,and incidence of postoperative complications related to nasal tracheal intubation.Results The glottis exposure in the group F and group S were both grade Ⅰ.Among the group V,there were 7 cases of gradeⅠ,10 cases of gradeⅡ,and 3 cases of grade Ⅲ.The glottis exposure effect of patients in the group F and S was significantly better than that of the group V(Z =-4.274,P = 0.000;Z =-4.274,P = 0.000).There were 15 and 14 patients in the group F and the group S without epistaxis,and 5 and 6 patients with mild epistaxis,respectively.There were no patients with severe epistaxis in the group F and the group S.In the group V,there were 7 patients without epistaxis,10 patients with mild epistaxis,and 3 patients with severe epistaxis.The degree of epistaxis in the group F and the group S was significantly less than that in the group V(Z =-2.678,P =0.007;Z =-2.402,P =0.016).The median time for tracheal intubation in the group S was 37.5(34.3,41.5)s,significantly shorter than 45.0(39.8,72.5)s in the group V and 89.0(76.0,102.5)s in the group F(Z =15.703,P =0.013;Z =32.050,P =0.000),with the group V being significantly shorter than the group F(Z =-16.347,P =0.009).The nasal tracheal intubation failed in 2 cases in the group V,while was all successfully completed in the group F and the group S.The difference of success rate was not statistically significant among the three groups(P>0.05).There were no statistically significant differences in the rates of postoperative nasopharyngeal pain and nasal congestion among the three groups(P>0.05).Conclusion The method of SOS-guided nasal tracheal intubation can provide good glottis exposure and achieve a satisfactory success rate of tracheal intubation without increasing the risk of adverse reactions,which can be regarded as a safe and effective method of nasal tracheal intubation.

Objective To explore the safety and feasibility of single-segment paravertebral nerve block(PVNB)in elderly patients undergoing inguinal hernioplasty.Methods A retrospective analysis was made on clinical data of 58 elderly patients who underwent open tension-free inguinal hernioplasty from January 2016 to December 2022.According to the anesthesia method,they were divided into two groups with 29 cases in each:single-segment PVNB group(P group)and single subarachnoid block group(S group).Patients in the P group were given L1 single-segment PVNB guided by ultrasound combined with peripheral nerve stimulators or simple peripheral nerve stimulators by using 0.4%ropivacaine 20 ml.Patients in the S group underwent puncture in the interspinous space between L3/4 and received 0.5%bupivacaine 10 mg.The mean arterial pressure and heart rate before anesthesia(T0),at the time of skin incision(T1),at the time of hernia sac dissection(T2),and at the time of wound closure(T3)were recorded,and the block levels,anesthetic effect,remedial rate of fentanyl,local anesthetic toxicity,peripheral nerve injury,urinary retention,delirium,and nausea and vomiting of the patients were recorded.The patient's satisfaction with anesthesia was followed up.Results All the 58 patients underwent surgery smoothly.The difference in block levels was statistically significant between the two groups of patients(Z =-4.144,P =0.000),while the differences in the remedial rate of fentanyl,anesthesia effect,and anesthesia satisfaction were not statistically significant(χ2 =0.269,P =0.604;Z =-1.430,P =0.153;Z =-1.395,P =0.163).There were no statistically significant differences in mean arterial pressure and heart rate changes between the two groups at different time points(F =0.002,P = 0.960;F =0.260,P =0.612).The rate of urinary retention in the P group was significantly lower than that in the S group(0.0%vs.24.1%,Fisher's test,P =0.010).There were no statistically significant differences in rates of dilirium and nausea and vomitting(P>0.05).All the patients did not experience local anesthetic toxicity or peripheral nerve injury during the perioperative period.Conclusion Single-segment PVNB can provide comprehensive anesthesia and analgesia for elderly patients undergoing inguinal hernioplasty,helping to maintain the stability of intraoperative hemodynamics and reducing the risk of postoperative adverse reactions.

Piezo1 is a mechanosensitive ion channel protein widely expressed in mammalian cells with the function of sensing mechanical stimuli and of mediating signaling,and is embedded in the membranes of erythrocytes,the major cellular component of blood.Piezo1 regulates the morphology and function of erythrocytes by mediating the in-flux of Ca2+into the cell in crosstalk with the Gardos channel(KCa3.1),constituting the"Piezo1-Ca2+-Gardos channel axis".However,when Piezo1 is abnormally expressed or over-activated by its specific agonist(Yoda1),it can also lead to abnormal erythrocyte morphology and dysfunction,and even cause the development of related he-reditary diseases.

Objective:To examine the early to mid-term clinical outcomes of aortic valve repair in patients with bicuspid aortic insufficiency.Methods:This is a retrospective cohort study. The clinical data of 124 patients with BAV insufficiency who underwent aortic valve repair from January 2017 to June 2023 in the Department of Cardiovascular Surgery at Fuwai Hospital were analyzed retrospectively. There were 117 males and 7 females with an age of (38.1±12.7) years (range: 14 to 65 years). Depending on whether the aortic sinus was replaced or not, surgical approaches were divided into valve sparing root replacement (reimplantation, remodeling, modified remodeling) and isolated aortic valve repair (annuloplasty, isolated aortic valve leaflet repair). Perioperative and follow-up data were collected. Kaplan-Meier method was used to plot the curves of survival rate, free recurrence rate of massive aortic valve insufficiency and free re-operation rate, and Log-rank test was used for comparison between groups.Results:Among the surgeries, there were 47 cases of reimplantation, 8 cases of remodeling, 8 cases of modified remodeling, 48 cases of aortic annuloplasty (external annuloplasty in 22 cases, CV-0 annuloplasty in 26 cases), and 13 cases of isolated leaflet repair. Leaflet plication was the most used leaflet repair technique, used in 103 patients. The cardiopulmonary bypass time was (133.7±56.9) minutes (range: 48 to 461 minutes), and aortic cross-clamp time was (103.8±47.8) minutes (range: 25 to 306 minutes), with no surgical mortality. All patients underwent outpatient or telephone follow-up. The cumulative follow-up time was 340.3 person-years and the mean follow-up time was ( M (IQR)) 34.0 (25.5) months (range: 3 to 76 months). The 5-year survival rate was 98.4%, the 5-year freedom from significant insufficiency rate was 93.4% and the 5-year freedom from aortic valve reoperation rate was 95.6%. The subgroup analysis revealed a significantly better freedom from the significant insufficiency rate in the aortic valve annular reduction group compared to the non-reduction group ( P<0.01). Conclusions:Aortic valve repair in patients with bicuspid aortic insufficiency could obtain steady early to mid-term outcomes. Aortic annuloplasty can reduce the risk of recurrent aortic valve insufficiency in patients undergoing aortic repair.

Objective:To examine the early to mid-term clinical outcomes of aortic valve repair in patients with bicuspid aortic insufficiency.Methods:This is a retrospective cohort study. The clinical data of 124 patients with BAV insufficiency who underwent aortic valve repair from January 2017 to June 2023 in the Department of Cardiovascular Surgery at Fuwai Hospital were analyzed retrospectively. There were 117 males and 7 females with an age of (38.1±12.7) years (range: 14 to 65 years). Depending on whether the aortic sinus was replaced or not, surgical approaches were divided into valve sparing root replacement (reimplantation, remodeling, modified remodeling) and isolated aortic valve repair (annuloplasty, isolated aortic valve leaflet repair). Perioperative and follow-up data were collected. Kaplan-Meier method was used to plot the curves of survival rate, free recurrence rate of massive aortic valve insufficiency and free re-operation rate, and Log-rank test was used for comparison between groups.Results:Among the surgeries, there were 47 cases of reimplantation, 8 cases of remodeling, 8 cases of modified remodeling, 48 cases of aortic annuloplasty (external annuloplasty in 22 cases, CV-0 annuloplasty in 26 cases), and 13 cases of isolated leaflet repair. Leaflet plication was the most used leaflet repair technique, used in 103 patients. The cardiopulmonary bypass time was (133.7±56.9) minutes (range: 48 to 461 minutes), and aortic cross-clamp time was (103.8±47.8) minutes (range: 25 to 306 minutes), with no surgical mortality. All patients underwent outpatient or telephone follow-up. The cumulative follow-up time was 340.3 person-years and the mean follow-up time was ( M (IQR)) 34.0 (25.5) months (range: 3 to 76 months). The 5-year survival rate was 98.4%, the 5-year freedom from significant insufficiency rate was 93.4% and the 5-year freedom from aortic valve reoperation rate was 95.6%. The subgroup analysis revealed a significantly better freedom from the significant insufficiency rate in the aortic valve annular reduction group compared to the non-reduction group ( P<0.01). Conclusions:Aortic valve repair in patients with bicuspid aortic insufficiency could obtain steady early to mid-term outcomes. Aortic annuloplasty can reduce the risk of recurrent aortic valve insufficiency in patients undergoing aortic repair.

Spine is one of the most important skeletal structures in human body.It has the function of protecting the spinal cord,supporting body weight,slowing impact and allowing flexible movement of the trunk.The study of spinal biomechanics is very important for a comprehensive understanding of the structure and function of the spine and the pathogenesis of spinal diseases.In 2023,scholars at home and abroad have done a lot of researches on spine related biomechanics,including the cognition on basic biomechanics of the spine,the changes in mechanical properties of the spine under pathological conditions,and the design of various treatment methods of spinal diseases based on biomechanical researches.This review focuses on the research progress of spinal biomechanics in 2023,and several typical spinal diseases or pathological states are introduced in detail as examples.

Objective    To summarize the surgical strategy of reoperative aortic root replacement after prior aortic valve replacement (AVR), and analyze the early and mid-term outcomes. Methods    From April 2013 to January 2020, 75 patients with prior AVR underwent reoperative aortic root replacement in Fuwai Hospital. There were 54 males and 21 females with a mean age of 56.4±12.7 years. An emergent operation was performed in 14 patients and an elective operation in 61 patients. The indications were aortic root aneurysm in 38 patients, aortic dissection involving aortic root in 30 patients, root false aneurysm in 2 patients, prosthesis valve endocarditis with root abscess in 2 patients, and Behçet's disease with root destruction in 3 patients. The survival and freedom from aortic events during the follow-up were evaluated with the Kaplan-Meier survival curve and the log-rank test. Results    The operative procedures included prosthesis-sparing root replacement in 45 patients, Bentall procedure in 26 patients, and Cabrol procedure in 4 patients. Operative mortality was 1.3% (1/75). A composite of adverse events occurred in 5 patients, including operative death (n=1), stroke (n=1), and acute renal injury necessitating hemodialysis (n=3). The follow-up was available for all 74 survivors, with the mean follow-up time of 0.5-92.0 (30.3±25.0) months. Four late deaths occurred during the follow-up. The survival rate at 1 year, 3 years and 6 years was 97.2%, 91.4% and 84.4%, respectively. Aortic events developed in 2 patients. The rate of freedom from aortic events at 1 year, 3 years, and 6 years was 98.7%, 95.0% and 87.7%, respectively. There was no difference in rate of survival or freedom from aortic events between the elective patients and the emergent patients. Conclusion    Reoperative aortic root replacement after prior AVR can be performed to treat the root pathologies after AVR, with acceptable early and mid-term outcomes.

ObjectiveTo observe the recovery of proprioception of the affected ankle over time after lateral ankle sprain accepting routine rehabilitation. MethodsFrom June, 2020 to June, 2022, 18 patients with lateral ankle sprain in Kunshan Rehabilitation Hospital underwent routine rehabilitation for twelve weeks. They were measured active and passive position sense of bilateral ankles using an isokinetic dynamometer before treatment, and four, eight and twelve weeks after treatment, respectively. ResultsThe active presentation difference of affected ankle reduced after treatment (F = 22.533, P < 0.001), but it was more than that of the healthy ankle at the same time (t > 4.419, P < 0.001). No significant improvement was found in passive presentation difference of affected ankle after treatment (F = 1.175, P > 0.05), and it was not significantly different from those of the healthy ankle at the same time (|t| < 0.646, P > 0.05). ConclusionProprioception of affected ankle has been impaired after lateral ankle sprain, and it can be recovered after rehabilitation, but cannot achieve the healthy level even after three months of training. Passive position sense as an index of proprioception needs more researches.