Objective:To compare the clinical efficacy and safety of different myotomy procedures during peroral endoscopic myotomy (POEM) for achalasia (AC).Methods:A retrospective study was conducted involving patients diagnosed as having achalasia and underwent POEM at Peking Union Medical College Hospital from April 2020 to October 2023. Patients were divided into conventional myotomy group, short myotomy group and full-thickness myotomy group according to myotomy length and depth. Outcomes including operation duration, procedure-related complications, efficacy and incidence of postoperative reflux esophagitis were compared between conventional vs. short, and conventional vs. full-thickness groups.Results:Among 70 patients, 26 underwent conventional myotomy, 19 short myotomy, and 25 full-thickness myotomy. The short myotomy group demonstrated significantly shorter procedure duration (72.89±20.57 min) compared to the conventional group (91.81±36.70 min, t=2.197, P=0.034). There were no statistically significant differences in procedure-related complications [26.3% (5/19) VS 34.6% (9/26), χ2=0.353, P=0.553], treatment efficacy [94.7% (18/19) VS 96.2% (25/26), χ2=0.052, P=0.820], or incidence of postoperative reflux esophagitis [50.0% (5/10) VS 41.7% (5/12), χ2=0.306, P=0.580] between the short and conventional myotomy groups. No statistically significant differences were observed between the conventional and full-thickness myotomy group in procedure duration (99.64±29.13 min VS 91.81±36.70 min, t=0.336, P=0.404), procedure-related complications [28.0% (7/25) VS 34.6% (9/26), χ2=0.259, P=0.611], treatment efficacy [96.0% (24/25) VS 96.2% (25/26), χ2=0.001, P=0.977], or incidence of postoperative reflux esophagitis [35.7% (5/14) VS 41.7% (5/12), χ2=0.022, P=0.883]. Conclusion:Short myotomy POEM achieves comparable efficacy to conventional myotomy with reduced operative time and no increased complication risk. Full-thickness myotomy demonstrates similar efficacy, operative duration, and safety to conventional myotomy.

Objective:To compare the clinical efficacy and safety of different myotomy procedures during peroral endoscopic myotomy (POEM) for achalasia (AC).Methods:A retrospective study was conducted involving patients diagnosed as having achalasia and underwent POEM at Peking Union Medical College Hospital from April 2020 to October 2023. Patients were divided into conventional myotomy group, short myotomy group and full-thickness myotomy group according to myotomy length and depth. Outcomes including operation duration, procedure-related complications, efficacy and incidence of postoperative reflux esophagitis were compared between conventional vs. short, and conventional vs. full-thickness groups.Results:Among 70 patients, 26 underwent conventional myotomy, 19 short myotomy, and 25 full-thickness myotomy. The short myotomy group demonstrated significantly shorter procedure duration (72.89±20.57 min) compared to the conventional group (91.81±36.70 min, t=2.197, P=0.034). There were no statistically significant differences in procedure-related complications [26.3% (5/19) VS 34.6% (9/26), χ2=0.353, P=0.553], treatment efficacy [94.7% (18/19) VS 96.2% (25/26), χ2=0.052, P=0.820], or incidence of postoperative reflux esophagitis [50.0% (5/10) VS 41.7% (5/12), χ2=0.306, P=0.580] between the short and conventional myotomy groups. No statistically significant differences were observed between the conventional and full-thickness myotomy group in procedure duration (99.64±29.13 min VS 91.81±36.70 min, t=0.336, P=0.404), procedure-related complications [28.0% (7/25) VS 34.6% (9/26), χ2=0.259, P=0.611], treatment efficacy [96.0% (24/25) VS 96.2% (25/26), χ2=0.001, P=0.977], or incidence of postoperative reflux esophagitis [35.7% (5/14) VS 41.7% (5/12), χ2=0.022, P=0.883]. Conclusion:Short myotomy POEM achieves comparable efficacy to conventional myotomy with reduced operative time and no increased complication risk. Full-thickness myotomy demonstrates similar efficacy, operative duration, and safety to conventional myotomy.

Objective:To evaluate the screw placement assisted by robotic navigation in cannulated screw fixation for treatment of fracture of scapular coracoid process.Methods:A retrospective study was conducted to analyze the data of 24 patients with fracture of scapular coracoid process who had been treated by cannulated screw fixation at Department of Orthopaedics and Trauma, Red Cross Hospital Affiliated to Xi'an Jiaotong University from January 2020 to December 2023. According to whether the intraoperative screw placement was assisted by robotic navigation or not, the patients were divided into 2 groups. In group A of 11 cases, there were 6 males and 5 females with an age of (47.4±3.4) years whose screw placement was assisted by robotic navigation during the internal fixation with cannulated screws. In group B of 13 cases, there were 10 males and 3 females with an age of (43.5±4.9) years whose screw placement was assisted by conventional C-arm X-ray fluoroscopy during the internal fixation with cannulated screws. The operative time, intraoperative blood loss, fracture healing time, intraoperative fluoroscopy frequency, intraoperative adjustments of guide wire, Constant-Murley score of shoulder function at the last follow-up and postoperative complications were compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, indicating comparability ( P>0.05). The follow-up time was (25.3±9.1) months for group A and (27.6±10.8) months for group B, showing no statistically significant difference ( P>0.05). The intraoperative blood loss [(51.8±35.7) mL], intraoperative fluoroscopy frequency [(5.7±1.0) times] and intraoperative adjustments of guide wire [(1.6±0.7) times] in group A were significantly less than those in group B [(123.8±73.9) mL, (12.5±2.7) times, and (5.3±1.0) times] ( P<0.05). There were no significant differences in operative time [(88.2±21.3) min versus (80.4±31.1) min], fracture healing time [(10.0±1.3) weeks versus (11.5±2.7) weeks] or Constant Murley score of shoulder function at the last follow-up [(86.7±6.1) points versus (91.1±10.0) points] between group A and group B ( P>0.05). No patient reported such complications as wound infection, fracture nonunion, or failure of internal fixation during the follow-up period. Conclusions:In the treatment of fracture of scapular coracoid process by cannulated screw fixation, robotic navigation can be used to assist screw placemen to achieve good efficacy comparable to conventional C-arm X-ray fluoroscopy. Moreover, assistance by robotic navigation can help reduce intraoperative blood loss and radiation, and improve surgical accuracy.

Humans ; Lung Neoplasms ; Pulmonary Blastoma

A direct current glow discharge mass spectrometry ( GD-MS) for the determination of Li, Be, Na, Mg, Si, P, K, Ca, Ti, V, Cr, Mn, Co, Ga, Sr, Mo, Ag, Cd, Sn, Sb, W and Pb in nickel-zinc ferrites was developed. Copper powder as the conductive medium was evenly mixed with nickel-zinc ferrites powder for tableting, and then the impurity elements in nickel-zinc ferrites were determined by GD-MS. The influence of sample preparation and the glow discharge conditions including discharge current, discharge voltage, discharge gas flow rate and pre-sputter time on discharge stability and analysis sensitivity were investigated. The mass spectrometry interferences of analytes were investigated, as well as appropriate isotopes were selected. Most of the mass spectrometry interferences were avoided by measuring in medium resolution mode and high resolution mode. Total signal of Fe, Ni, Zn, O and Cu normalization was adopted, and the impurity elements in nickel-zinc ferrites were calculate in subtraction. The results showed that the detection limits for the investigated elements were in the range of 0. 001-0. 29 μg/g, the relative standard deviations of each element were within 3 . 5%-18 . 6%. The analysis results were consistent with those obtained by inductively coupled plasma mass spectrometry.

Carotid Body Tumor ; surgery ; Humans ; Hypertension ; Pressoreceptors

BACKGROUND:Surface modification of orthopedic implants can reduce or prevent bacterial adhersion. Bacteriostatic and bactericidal ingredients released from special coating of metal surfaces prevent orthopedic surgery infection. OBJECTIVE:To prepare hydroxyapatite/nano-silver composite coating on the surface of medical titanium based on different preparation parameters and to observe the release properties of silver ions on the composite material surface in the simulated body fluid. METHODS:Using pulse electrochemical methods, hydroxyapatite and nano-silver were deposited in the solution containing silver, calcium and phosphate ions. Scanning electron microscopy, X-ray diffraction and energy dispersive spectroscopy were used to characterize its morphology and composition. The composite titanium materials containing 0.5, 1 mmol/L silver were immersed in the simulated body fluid, and Ag+concentration was detected by atomic absorption spectrometry at the different time points. RESULTS AND CONCLUSION:Nanoparticles were uniformly distributed in the coating which was interwoven with the nano needle-like hydroxypatite and dot-like silver particles. After high temperature processing, the coating became denser, and hydroxypatite became more crystal and silver particles exhibited no agglomeration. In the simulated body fluid, Ag+release was maximal at 1-7 days and became stable at 7-30 days which maintained an effective antimicrobial concentration. The material containing 0.5 mmol/L Ag+showed a lower amount of Ag+released than cytotoxic concentration at 30 days, but the material containing 1 mmol/L Ag+could release the total of Ag+close to the critical value of celltoxicity at 30 days. Above al , the material containing 0.5 mmol/L Ag+is more secure in the clinical application.

To investigate the effects of Astragalus membranaceus and Potentilla discolor mixture (APM) on insulin resistance (IR) and mRNA expressions of IR-related genes, including phosphatidylinositol 3-kinase (PI3-K), phosphoenolpyruvate carboxykinase (PEPCK) and peroxisome proliferator-activated receptor γ coactivator 1 (PGC1) in KKAy mice with early type 2 diabetes and to explore the gene regulation mechanisms of AMP.

Objective To investigate the effects of insulin-like growth factor-1（IGF-1）on the cell proliferation of human non-small-cell lung cancer（NSCLC） and the possible molecular mechanism.Methods MTT assay was used to examine the effects of IGF-1 （0.1,1,10,100 ng/mL）on the cell proliferation of NSCLC cell lines（A549,LK2,H460）,Flow cytometry（FCM）and Western blot to ana-lyze the cell cycles and the protein expression of S-Phase Kinase-Associated Proteins 2（Skp2）and CDC20 homolog 1（CDH1）,respectively.Results The cell proliferation of NSCLC cell lines（A549,LK2,H460）could be promoted by the IGF-1 at different concentrations and the proliferation rate peaked when the cells were treated with 1 ng/mL IGF-1.Compared with control,the percentage of the S-phase cell population was significantly increased after the treatment of IGF-I（P 〈 0.01）and the protein expression of SKP2 also increased obviously（P 〈0.05）.However,there was no change in the CDH1 protein expression（P 〉 0.05）.Conclusion IGF-1 may accelerate the cell-cycle pro-gression of NSCLC cells by negatively modulating p27 protein via the up-regulation of SKP2 protein expression.

Objective To study the changes in the percentage of CD+4 CD+25 regulatory T (Tr) cells in peripheral blood and deciduas in unexplained recurrent spontaneous abortion (URSA) patients, normal non-pregnant and pregnant women respectively. Methods The percentage of CD+4 CD+25 Tr cells in deciduas and peripheral blood from 25 URSA patients, 22 normal non-pregnant (NNP) women, and 34 normal early pregnant (NP) women were measured by double-staining followed by flow cytometric analysis. Results (1) The percentage of CD+4 CDbright25 T cells in peripheral blood in both URSA and NP [ ( 1.55±0.77 ) %, (2. 65±1.10)%, respectively] women were increased significantly than that in NNP women [ (0. 39± 0.14)% P<0.05]. The percentage of CD+4 CDbright25 T cells in peripheral blood in URSA women was significantly lower than that in NP women (P<0.05 ). (2) The percentage of CD+4 CDbright25 T cells in decidua in URSA women was significantly lower than that in NP women [ ( 0. 59±0. 23 ) %, ( 1.24 ± 0. 55)%, respectively, P <0. 01 ]. There was no significant difference in the percentage of CD+4 CDdim25 T cells in decidua between URSA women and NP women [ (4. 23±1.52)%, (3.75±1.88)%, respectively, P>0.05]. (3) The proportion of CD+4 CDbright25/CD+4 cells in deeiduas was significantly higher than that in peripheral blood in NP women [(13. 10±10. 25 ) %, ( 5.59±2.62 ) %, respectively, P < 0. 05 ] . However, a significant difference in the proportion of CD+4 CDbright25/CD+4 between decidua and peripheral blood was not found in URSA patients [ (5. 16±2. 83 ) %, ( 4. 64±2. 07 ) %, respectively, P>0.05)].Conclusions The number of CD+4 CD+25 Tr cells is increased in normal pregnancy and decreased in URSA. Therefore, CD+4 CD+25 Tr cells may play an important role in maintaining maternal-fetal tolerance and may be involved in the pathogenesis of URSA.