Objective:To investigate the efficacy of compression fixation with cross-locking Kirschner wires in the treatment of bicondylar fractures of the phalangeal neck in fingers (toes).Methods:A retrospective study was conducted to analyze the clinical data of 15 patients with bicondylar fractures of the phalangeal neck in fingers (toes) who had been treated from February 2019 to August 2023 at Department of Hand and Foot Surgery, Taizhou Hospital. The patients were all treated by compression fixation with cross-locking Kirschner wires. They were 13 males and 2 females with an age of (43.4±11.0) years and with 9 hands and 6 feet involved. In 2 of them, the fracture line of the bone block was completely located far from the insertion point of the lateral collateral ligament (condylar lateral recess). After surgery, no additional external fixation was used for all but 2 patients whose bone fold line was fixed with plaster for 3 to 4 weeks at a distance from the lateral collateral ligament insertion point. Follow-up records included fracture healing time, visual analogue scale (VAS) pain score at postoperative 3 months, total active motion (TAM) of the finger for hand patients at the final follow-up, and surgical complications.Results:All patients were followed up for (5.4±3.0) months. The VAS pain score for all patients was 0 (0, 0) point at postoperative 3 months. Only 2 patients reported mild pain in the hand at 3 months postoperatively (their VAS pain score was 1 or 2 respectively). At 12-month follow-up, 1 foot patient reported mild pain (1 point of VAS) and the other 5 foot patients experienced no pain while they were carrying weights and walking normally. X-ray evaluations at postoperative 4, 6, and 8 weeks showed nonunion of a middle phalanx intra-articular fracture of the ring finger in 1 case, complicated by bone resorption and joint stiffness which were not further treated. The other cases achieved bony union after an average healing time of (7.1±1.9) weeks. Of the 8 hand patients whose total active motion was measured at the final follow-up using the TAM scoring system, 6 were rated as excellent and 2 as good. No fracture displacement, loosening or withdrawal of Kirschner wires, or no needle tunnel infection occurred.Conclusion:In the treatment of bicondylar fractures of the phalangeal neck in fingers (toes), compression fixation with cross-locking Kirschner wires offers advantages of simplicity in operation, minimal invasiveness, good stability, and facilitation of early postoperative rehabilitation.

Objective:To investigate the efficacy of compression fixation with cross-locking Kirschner wires in the treatment of bicondylar fractures of the phalangeal neck in fingers (toes).Methods:A retrospective study was conducted to analyze the clinical data of 15 patients with bicondylar fractures of the phalangeal neck in fingers (toes) who had been treated from February 2019 to August 2023 at Department of Hand and Foot Surgery, Taizhou Hospital. The patients were all treated by compression fixation with cross-locking Kirschner wires. They were 13 males and 2 females with an age of (43.4±11.0) years and with 9 hands and 6 feet involved. In 2 of them, the fracture line of the bone block was completely located far from the insertion point of the lateral collateral ligament (condylar lateral recess). After surgery, no additional external fixation was used for all but 2 patients whose bone fold line was fixed with plaster for 3 to 4 weeks at a distance from the lateral collateral ligament insertion point. Follow-up records included fracture healing time, visual analogue scale (VAS) pain score at postoperative 3 months, total active motion (TAM) of the finger for hand patients at the final follow-up, and surgical complications.Results:All patients were followed up for (5.4±3.0) months. The VAS pain score for all patients was 0 (0, 0) point at postoperative 3 months. Only 2 patients reported mild pain in the hand at 3 months postoperatively (their VAS pain score was 1 or 2 respectively). At 12-month follow-up, 1 foot patient reported mild pain (1 point of VAS) and the other 5 foot patients experienced no pain while they were carrying weights and walking normally. X-ray evaluations at postoperative 4, 6, and 8 weeks showed nonunion of a middle phalanx intra-articular fracture of the ring finger in 1 case, complicated by bone resorption and joint stiffness which were not further treated. The other cases achieved bony union after an average healing time of (7.1±1.9) weeks. Of the 8 hand patients whose total active motion was measured at the final follow-up using the TAM scoring system, 6 were rated as excellent and 2 as good. No fracture displacement, loosening or withdrawal of Kirschner wires, or no needle tunnel infection occurred.Conclusion:In the treatment of bicondylar fractures of the phalangeal neck in fingers (toes), compression fixation with cross-locking Kirschner wires offers advantages of simplicity in operation, minimal invasiveness, good stability, and facilitation of early postoperative rehabilitation.

AIM: To quantify early changes of macular capillary parameters in type 2 diabetic patients using optical coherence tomography angiography(OCTA).METHODS: Retrospective case study. A total of 49 healthy subjects, 52 diabetic patients without retinopathy(noDR)patients, and 43 mild nonproliferative diabetic retinopathy(mNPDR)patients were recruited. Capillary perfusion density, vessel length density(VLD), and average vessel diameter(AVD)were calculated from macular OCTA images(3 mm×3 mm)of the superficial capillary plexus after segmenting large vessels and the deep capillary plexus. Parameters were compared among control subjects, noDR, and mNPDR patients. The area under the receiver operating characteristic curve estimated the abilities of these parameters to detect early changes of retinal microvascular networks.RESULTS: Significant differences were found in the VLD and AVD among the three groups(P<0.001). Compared with the control group, the noDR group had significantly higher AVD(P<0.05). VLD of both layers in patients of mNPDR group was significant decreased compared with that of noDR group(all P<0.01). Deep AVD had a higher area under the curve(AUC)of 0.796 than other parameters to discriminate the noDR group from the healthy group. Deep AVD had the highest AUC of 0.920, followed by that of the deep VLD(AUC=0.899)to discriminate the mNPDR group from the healthy group.CONCLUSIONS: NoDR patients had wider AVD than healthy individuals and longer VLD than mNPDR patients in both layers. When compared with healthy individuals, deep AVD had a stronger ability than other parameters to detect early retinal capillary impairments in noDR patients.

Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) in patients undergoing replantation of severed fingers, and analyze their influencing factors.Methods:From January 2022 to December 2023, convenience sampling was used to select 335 patients who underwent replantation of severed fingers at the Hand and Foot Surgery of Taizhou Hospital of Zhejiang Province as research subjects. The survey was conducted using the General Information Questionnaire, PTSD Checklist-Civilian Version, Event Related Rumination Inventory, Chinese version of the Perceived Social Support Scale, and the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese. Potential profile analysis was used to explore the potential categories of PTSD in patients undergoing replantation of severed fingers, and ordered Logistic regression was used to analyze the influencing factors of PTSD categories.Results:A total of 335 questionnaires were distributed, and 328 valid questionnaires were collected, with a valid response rate of 97.91%. Potential profile analysis showed that PTSD of 328 patients undergoing severed finger replantation were divided into three latent categories, including low PTSD-high avoidance type ( n=67, accounting for 20.43%), moderate PTSD-high alertness type ( n=178, accounting for 54.27%), and high PTSD-high alertness type ( n=83, accounting for 25.30%). There were statistically significant differences in the number of severed fingers, incidence of postoperative vascular crisis, rumination, perceived social support, and personality trait scores among patients with different types of severed finger replantation ( P<0.05). Taking low PTSD-high avoidance type as a reference, ordered Logistic regression analysis showed that invasive rumination, purposive rumination, and personality types (introversion, neuroticism, psychoticism) were potential influencing factors for the moderate PTSD-high alertness type ( P<0.05). The number of severed fingers, postoperative vascular crisis, invasive rumination, purposive rumination, perceived social support, and personality type (introversion, neuroticism, psychoticism) were potential influencing factors of high PTSD-high alertness type ( P<0.05) . Conclusions:There is significant population heterogeneity in PTSD among patients undergoing severed finger replantation, which can be divided into "low PTSD-high avoidance type", "moderate PTSD-high alertness type", and "high PTSD-high alertness type". Nursing staff should conduct targeted interventions in the early stage based on factors such as the number of severed fingers, whether vascular crisis occurs after operation, level of rumination, personality type, to prevent and improve the occurrence of PTSD.

"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions.
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Objective To explore the feasibility of repairing the skin and soft tissue defect at finger palm side with the reversed free thenar mini-perforator flaps.Methods From October,2010 to October,2016,7 patients were treated with reversed free thenar mini-perforator flap to repair skin and soft tissue defects at finger palm side,including 5 males and 2 females,which the age were between of 17 and 56 (average,35 years old).Cause of injury:1 case of abrasive wear,1 case of machine twist injury,and 5 cases of heavy injury.All cases with varying degrees of phalanx and tendon exposed.The wound size was from 1.3 cm × 2.0 cm to 2.2 cm × 5.0 cm.According to the origin of the artery in the thenar area,3 kinds of reversed free thenar mini-perforator flaps were designed to repair the defective wound.In the middle of the large fish,the width less than 2.5 cm perforating flap was designed,so that the area can be directly sutured.Results All 7 flaps survived.The flap size was from 1.5 cm × 2.4 cm to 2.5 cm × 5.5 cm.All patients were followed-up from 3 months to 17 months (average,9 months).The appearance and skin texture of flaps was close to the normal finger palm side of the skin,with a clear fingerprint.Two-point discrimination was between 9 mm and 15 mm.The sensory recovery to S3 in 3 cases,S4 in 4 cases.Linear scars were left in the donor areas,with no discomfort.Conclusion This technique has the advantages of good appearance,such as good appearance and small damage to the donor area.However,the surgeon is required the super microscopic techniques.

Panax notoginseng (BurK.) F.H.Chen is a traditional Chinese medicinal material with a time-honored history of cultivation.There are a series of problems,such as high pesticide residues,serious disease and pest,and continuous cropping obstacles in the process of the cultivation of notoginseng.Pollution-free cultivation is an effective strategy for the sustainable development of notoginseng industry.We herein summarized three points of the pollution-free cultivation of notoginseng in this review.The standard of lands suitable for the cultivation of notoginseng was established on the basis of the analysis of medicinal plants around global producing areas.The integrated measures of soil improvement were put forward by cfficient rotation and soil disinfection with new varieties breeding combined with the management of water,light and fertilization,and the safe and low-toxic methods of disease and pest control.Additionally,the mode of wild tending should be carried out when the marker-assisted breeding of new varieties was developed,and the platform of comprehensive disease and pest control was founded.Above-mentioned points can effectively perfect and optimize the pollution-free cultivation of notoginseng and promote sustainable development of notoginseng industry.

OBJECTIVETo investigate the clinical effect of Halo-vest head ring in the treatment of replantation of total scalp avulsion.

METHODSWe treated 11 cases of total scalp avulsion with the anastomosis of arteriovenous vessels and Halo-vest head ring from December 2006 to February 2015.

RESULTSOne patient's replanted scalp got necrosis because of serious contusion which was healed without hair growth after free skin graft and dressing. All the scalp flaps in the other 10 patients survived. After 3-96 months follow-up, the wound completely healed, the scalp and hair grew well with satisfactory appearance.

CONCLUSIONSThe use of Halo-vest head ring for replantation of total scalp avulsion can effectively improve the survival rate and survival area.

Anastomosis, Surgical ; methods ; Bandages ; Graft Survival ; Humans ; Lacerations ; surgery ; Necrosis ; etiology ; Prostheses and Implants ; Replantation ; methods ; Scalp ; injuries ; pathology ; surgery ; Skin Transplantation ; methods ; Surgical Flaps

Background and purpose:Laparoscopic retroperitoneal adrenalectomy makes access to the adrenal glands easier and less invasive than open surgery. The aim of this study was to evaluate the clinical efifcacy of laparoscopic retroperitoneal adrenalectomy.Methods:A total of 130 patients who underwent retroperitoneal adrenalectomy for adrenal mass from Jan. 2007 to Dec. 2012 in Fudan University Shanghai Cancer Center were retrospectively assessed. Their clinicopathological factors, perioperative complications and short-term prognostic data were retrieved from the medical records.Results:One hundred and twenty-seven of 130 patients underwent retroperitoneal adrenalectomy successfully, and 3 patients were converted to open surgery due to severe bleeding. Among 130 patients, 63 were male and 67 were female, with the mean age 50.0 years. The pathological results of the 130 patients indicated adrenocortical adenoma in 68, pheochromocytoma in 15, medullary lipoma in 13, adrenal cysts in 10 , ganglioneuroma in 7, metastatic cancer in 5, adrenal hyperplasia in 4, schwannoma in 3, lymphangioma in 2, adrenal hematoma in 1, adrenal cortical carcinoma in 1, adrenal angiosarcoma in 1 and the deputy spleen in 1 (one patient suffering from both pheochromocytoma and ganglioneuroma). The maximum diameters were ranging from 0.5 to 9.0 cm, and mean diameter was 3.48 cm. The average blood loss in surgery was 62.73 mL. Mean length of stay in hospital was 7 d. GradeⅠ complications occurred in 5 patients, including 2 of fever, 1 of food allergy, 1 of drug allergy and 1 of hypokalemia.Conclusion: Retroperitoneal adrenalectomy should be considered as the procedure of choice for the resection of most adrenal tumors in skilled centers with the advantages of minimal invasion, increased safety and faster recovery.

Objective To investigate the medication advancement of gastrointestinal polyposis in patients with Peutz-Jeghers syndrome(PJS).Methods Literatures about the medication advancement on gastrointestinal polyposis of PJS were reviewed and analyzed.The recent development of targeting drugs,especially the data of cyclooxygenase-2 selective inhibitors and rapamycin,were emphatically summarized.Results With the deep investigation of PJS and application of selective drugs,the medication of gastrointestinal polyposis in cases of PJS has got more advancement.The extensive use of synthetic cyclooxygenase-2 inhibitors and rapamycin in clinic developed a new way to treat gastrointestinal polyposis of PJS.Conclusion The cyclooxygenase-2 selective inhibitors and rapamycin have the following features: noninvasive,high selectivity and good curative effects.They have splendid prospects in the clinical treatment of gastrointestinal polyposis in patients with PJS and are bring the treatment of gastrointestinal polyposis in cases of PJS into a targeting therapy phase.