Objective To explore the feasibility and safety of fastest recovery after surgery(FRAS)in laparoscopic surgery of gastrointestinal tumors.Methods The clinical data of patients undergoing laparoscopic surgery for gastrointestinal tumors under FRAS and enhanced recovery after surgery(ERAS)from Jan.2023 to May 2024 were collected,and perioperative safety and medical cost were analyzed.Results A total of 87 patients were enrolled,including 43 in the FRAS group and 44 in the ERAS group.Compared with the ERAS group,the FRAS group had significantly shorter surgical time(3.0[2.5,3.5]h vs 3.0[2.5,4.0]h),first postoperative movement time([2.85±4.29]h vs[20.18±6.13]h),first postoperative oral feeding time(2.0[2.0,3.0]h vs 24.0[15.0,48.0]h),postoperative hospital stay(24.0[20.0,40.0]h vs 192.0[150.0,216.0]h),lower hospitalization costs(50 515.61[46 650.44,56 827.12]yuan vs 65 555.09[58 683.21,86 239.02]yuan),and lower medication costs(2 671.09[2 063.31,3 127.09]yuan vs 7 326.90[5 104.66,10 674.26]yuan)(all P＜0.05).Conclusion It is safe and feasible to use FRAS during the perioperative period of laparoscopic radical gastrectomy for gastrointestinal tumors,and FRAS can also reduce the costs of hospitalization and medications.

Objective:To investigate the effects of vitreomacular traction (VMT) on the efficacy of internal limiting membrane (ILM) removal combined with air tamponade in the treatment of macular holes.Methods:The clinical data of 44 patients with macular holes who underwent ILM removal combined with air tamponade at the Affiliated Hospital of Shaoxing University from January 2019 to December 2022 were collected and analyzed retrospectively. The patients were divided into two groups based on the presence of VMT prior to surgery: the VMT group and the non-VMT group, with 22 cases in each group. The best corrected visual acuity, closure of the macular hole, continuity of the external limiting membrane, and ellipsoid zone integrity were compared between the two groups during the postoperative follow-up.Results:There was no significant difference in the best corrected visual acuity, the rate of visual acuity improvement, or the rate of macular hole closure between the two groups (all P > 0.05). However, the continuity rate of the external limiting membrane [54.5% (12/22)] and the rate of ellipsoid band integrity [36.4% (8/22)] in the VTM group were significantly higher than those in the non-VTM group [9.1% (2/22), 0; χ2 = 10.47, 7.49, both P < 0.05]. Conclusions:Macular holes caused by VMT show better outcomes after vitrectomy to relieve the vitreous traction. However, for macular holes without remarkable VMT, vitrectomy alone may not yield ideal results. In such cases, it may be necessary to expand the area of ILM removal to adequately relieve the tangential traction.

Objective:To investigate the effects of vitreomacular traction (VMT) on the efficacy of internal limiting membrane (ILM) removal combined with air tamponade in the treatment of macular holes.Methods:The clinical data of 44 patients with macular holes who underwent ILM removal combined with air tamponade at the Affiliated Hospital of Shaoxing University from January 2019 to December 2022 were collected and analyzed retrospectively. The patients were divided into two groups based on the presence of VMT prior to surgery: the VMT group and the non-VMT group, with 22 cases in each group. The best corrected visual acuity, closure of the macular hole, continuity of the external limiting membrane, and ellipsoid zone integrity were compared between the two groups during the postoperative follow-up.Results:There was no significant difference in the best corrected visual acuity, the rate of visual acuity improvement, or the rate of macular hole closure between the two groups (all P > 0.05). However, the continuity rate of the external limiting membrane [54.5% (12/22)] and the rate of ellipsoid band integrity [36.4% (8/22)] in the VTM group were significantly higher than those in the non-VTM group [9.1% (2/22), 0; χ2 = 10.47, 7.49, both P < 0.05]. Conclusions:Macular holes caused by VMT show better outcomes after vitrectomy to relieve the vitreous traction. However, for macular holes without remarkable VMT, vitrectomy alone may not yield ideal results. In such cases, it may be necessary to expand the area of ILM removal to adequately relieve the tangential traction.

OBJE CTIVE To explore the rational application and management of antibiotics in burn department of our hospital based on disease diagnosis related groups （DRGs）. METHODS Patients discharged from the burn department of our hospital from July 2020 to June 2021 were selected as the research objects to collect DRG data. The overall application of antibiotics in DRG group with more than 10 cases were analyzed ，and the application of antibiotics in typical disease groups were evaluated horizontally and vertically. RESULTS Among 3 732 discharged cases in the burn department of our hospital ，a total of 3 515 cases were included in 66 DRG groups ，21 DRG groups of which were included in the study. Among 21 DRG groups ，the maximum antibiotics use density （AUD）of antibiotics was 102.20 DDDs/（100 person·d）in AH 11 group，the utilization ratio of antibiotics was 100％，and the combined use rate of antibiotics was 81.82％；case-mix index （CMI）value was 11.49. The minimum AUD was 1.01 DDDs/（100 person·d）in XR 19 group，the utilization ratio of antibiotics was 5.06％，and the combined use rate of antibiotics was 0；CMI value was 0.81. Within the same core group ，AUD increased with the increase of CMI. The horizontal comparison and analysis of WB 11 group showed that there was a large gap in AUD among different physicians. The vertical comparison of AUD in WB11 group showed relatively small changes over time. CONCLUSIONS The horizontal and vertical evaluation of antibiotics based on DRGs can provide new clues for the control of antibiotics and help to realize the fine specialized management of antibiotics.

UNLABELLEDA new kind of Interbody Cage made of multi-amino acid copolymer/tri-calcium phosphate (MAACP/TCP) composite was designed, and the purpose of this study was to evaluate immediate stability of MAACP/TCP Cage in a goat cervical spine model (C3-4). After the motion segment C3-4 was tested intact, 27 goat cervical spines were divided into three groups randomly. There were four groups group A. MAACP/TCP Cage group (n = 9), group B2 titanium Cage group (n = 9), group C2 autologous tricortical iliac crest bone group (n = 9) and group D: intact group (n = 27). Different Cage groups were implanted after complete discectomy (C3-4) was performed. Then they were tested in flexion, extension, axial rotation, and lateral bending with a nondestructive stiffness method. The range of motion (ROM) and relative stiffness were calculated and compared between groups. In comparison to the intact motion segment, MAACP/TCP Cage showed a significantly (P < 0.05) lower ROM and a significantly (P < 0.05) higher relative stiffness in flexion and lateral bending. In comparison to the tricortical iliac crest bone graft, MAACP/TCP Cage showed a significantly (P < 0.05) lower ROM and a significantly (P < 0.05) higher relative stiffness in extension, flexion and lateral bending. There was no significant (P > 0.05) difference in the ROM and relative stiffness between MAACP/TCP Cage and titanium Cage in extension, flexion and lateral bending. In comparison to titanium Cage, MAACP/TCP Cage showed a significantly (P < 0.05) higher ROM and a significantly (P < 0.05) lower relative stiffness in rotation.

CONCLUSIONMAACP/TCP Cage can provide enough immediate stability for cervical interbody fusion in a goat cervical spine model.

Absorbable Implants ; Amino Acids ; chemistry ; Animals ; Biomechanical Phenomena ; Calcium Phosphates ; chemistry ; Cervical Vertebrae ; surgery ; Evaluation Studies as Topic ; Female ; Goats ; Implants, Experimental ; Polymers ; chemistry ; Spinal Fusion ; instrumentation

[Objective]To explore the effects of invigorating the kidney,promoting qi and activating blood method in repairing articular cartilage defects in rabbits with chodrocytes induced by bone marrow matrix stem cell.[Method]The complexes from seeding of chondrocytes and allograft chondrocytes encapsulated in collagen gel and cultured in Guyanding drug serum into CPPf/PLLA scaffolds were cultured in vitro for 3 weeks. Some complexes were observed with the phase-contrast microscope or scanning electron microscope and others were allotransplanted into articular cartilage defects in rabbits.The specimens harvested at 4,8,12 weeks were analyzed by observation,histology and type Ⅱ collagen immunohistochemistry.[Result]The induced chondrocytes were embedded in scaffolds evenly the formation,smoothness of the surface and integration with adjacent tissues of the hyaline cartilage-like tissues,distribution of type Ⅱ collagen in the matrix of the induced chondrocytes group were better than all those in the chondrocyte group.[Conclusion]The method of invigorating the kidney,promoting qi and activating blood has superiority in repairing articular cartilage defects over the traditional method.