Objective:To investigate the clinical efficacy of minimally invasive percutaneous internal fixation with double screws for delayed union or nonunion of scaphoid fracture.Methods:A retrospective study was conducted to analyze the 12 patients with delayed union or nonunion of scaphoid fracture who had been treated at Department of Hand and Foot Surgery, The Affiliated Hospital of Jining Medical University from March 2021 to December 2023. They were 11 males and 1 female, with an age of (29.9±13.8) years and an interval from injury to surgery of (5.1±2.6) months. They were all treated by minimally invasive percutaneous internal fixation with 2 hollow compression screws. The visual analogue scale (VAS), grip strength (percentage of the affected side to the healthy side), wrist range of motion, modified Mayo wrist score and other data were recorded and compared between pre-surgery and the last follow-up. The incidence of complications was recorded.Results:Follow-up for all patients lasted for (20.8±8.9) months. All patients achieved bony union after (10.1±3.2) weeks with no complications like infection. No post-surgery imaging revealed screw misplacement or penetration. At the last follow-up, the VAS pain score was 0 (0, 1) point, the wrist grip strength 100.6%±7.2%, the wrist flexion 88.3°±2.5°, the wrist dorsiflexion 88.5°±2.2°, and the modified Mayo wrist score (98.3±2.5) points, all significantly better than the pre-surgery values [4 (4, 5) points, 69.1%±16.0%, 61.3°±13.5°, 64.7°±9.1°, and (61.7±10.1) points] (all P < 0.05). Conclusion:In the treatment of delayed union or nonunion of scaphoid fracture, minimally invasive percutaneous internal fixation with double screws shows advantages of minimal invasion, quick fracture healing, fine functional recovery, and no need of bone grafting.

Objective:To investigate the clinical efficacy of minimally invasive percutaneous internal fixation with double screws for delayed union or nonunion of scaphoid fracture.Methods:A retrospective study was conducted to analyze the 12 patients with delayed union or nonunion of scaphoid fracture who had been treated at Department of Hand and Foot Surgery, The Affiliated Hospital of Jining Medical University from March 2021 to December 2023. They were 11 males and 1 female, with an age of (29.9±13.8) years and an interval from injury to surgery of (5.1±2.6) months. They were all treated by minimally invasive percutaneous internal fixation with 2 hollow compression screws. The visual analogue scale (VAS), grip strength (percentage of the affected side to the healthy side), wrist range of motion, modified Mayo wrist score and other data were recorded and compared between pre-surgery and the last follow-up. The incidence of complications was recorded.Results:Follow-up for all patients lasted for (20.8±8.9) months. All patients achieved bony union after (10.1±3.2) weeks with no complications like infection. No post-surgery imaging revealed screw misplacement or penetration. At the last follow-up, the VAS pain score was 0 (0, 1) point, the wrist grip strength 100.6%±7.2%, the wrist flexion 88.3°±2.5°, the wrist dorsiflexion 88.5°±2.2°, and the modified Mayo wrist score (98.3±2.5) points, all significantly better than the pre-surgery values [4 (4, 5) points, 69.1%±16.0%, 61.3°±13.5°, 64.7°±9.1°, and (61.7±10.1) points] (all P < 0.05). Conclusion:In the treatment of delayed union or nonunion of scaphoid fracture, minimally invasive percutaneous internal fixation with double screws shows advantages of minimal invasion, quick fracture healing, fine functional recovery, and no need of bone grafting.

Objective To investigate the mechanism by which CDHR2 overexpression inhibits breast cancer cell growth and cell cycle pragression via the PI3K/Akt signaling pathway.Methods Bioinformatic analysis was performed to investigate CDHR2 expression in breast cancer and its correlation with survival outcomes of the patients.Immunohistochemistry was used to examine CDHR2 expressions in surgical specimens of tumor and adjacent tissues from 10 patients with breast cancer.CDHR2 expression levels were also detected in 5 breast cancer cell lines and a normal human mammary epithelial cell line using qRT-PCR and Western blotting.Breast cancer cell lines MDA-MB-231 and MCF7 with low CDHR2 expression were transfected with a CDHR2-overexpressing plasmid,and the changes in cell proliferation and cell cycle were evaluated using CCK-8 assay,EdU assay,and cell cycle assay;the changes in expressions of PI3K/Akt signaling pathway and cell cycle pathway proteins were detected with Western blotting.Results Bioinformatic analysis showed low CDHR2 expression level in both breast cancer and adjacent tissues without significant difference between them(P>0.05),but breast cancer patients with a high expression of CDHR2 had a more favorable prognosis.Immunohistochemistry,qRT-PCR and Western blotting showed that the expression of CDHR2 was significantly down-regulated in breast cancer tissues and breast cancer cells(P<0.01),and its overexpression strongly inhibited cell proliferation,caused cell cycle arrest,and significantly inhibited PI3K and Akt phosphorylation and the expression of cyclin D1.Conclusion Overexpression of CDHR2 inhibits proliferation and causes cell cycle arrest in breast cancer cells possibly by inhibiting the PI3K/Akt signaling pathway.

Objective To investigate the mechanism by which CDHR2 overexpression inhibits breast cancer cell growth and cell cycle pragression via the PI3K/Akt signaling pathway.Methods Bioinformatic analysis was performed to investigate CDHR2 expression in breast cancer and its correlation with survival outcomes of the patients.Immunohistochemistry was used to examine CDHR2 expressions in surgical specimens of tumor and adjacent tissues from 10 patients with breast cancer.CDHR2 expression levels were also detected in 5 breast cancer cell lines and a normal human mammary epithelial cell line using qRT-PCR and Western blotting.Breast cancer cell lines MDA-MB-231 and MCF7 with low CDHR2 expression were transfected with a CDHR2-overexpressing plasmid,and the changes in cell proliferation and cell cycle were evaluated using CCK-8 assay,EdU assay,and cell cycle assay;the changes in expressions of PI3K/Akt signaling pathway and cell cycle pathway proteins were detected with Western blotting.Results Bioinformatic analysis showed low CDHR2 expression level in both breast cancer and adjacent tissues without significant difference between them(P>0.05),but breast cancer patients with a high expression of CDHR2 had a more favorable prognosis.Immunohistochemistry,qRT-PCR and Western blotting showed that the expression of CDHR2 was significantly down-regulated in breast cancer tissues and breast cancer cells(P<0.01),and its overexpression strongly inhibited cell proliferation,caused cell cycle arrest,and significantly inhibited PI3K and Akt phosphorylation and the expression of cyclin D1.Conclusion Overexpression of CDHR2 inhibits proliferation and causes cell cycle arrest in breast cancer cells possibly by inhibiting the PI3K/Akt signaling pathway.

Objective To evaluate the surgical treatments of refractory sclerosing peritonitis related peritoneal dialysis.Methods Clinical data of 15 patients with refractory sclerosing peritonitis related to peritoneal dialysis treated in the General Surgery Department of the 900th Hospital of the Joint Logistics Support Force of the People's Liberation Army from June 30,2014 to May 30,2018.Among them,5 cases underwent"open abdomen peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",4 cases underwent"laparoscopic peritoneal catheter removal+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter",3 cases underwent"laparoscopic peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",2 cases underwent"open abdomen peritoneal dialysis catheter removal+abdominal infection flushing and drainage with catheter",and 1 case underwent"laparoscopic examination combined with laparotomy exploration and removal of lower abdominal catheter+intestinal adhesiolysis+abdominal infection flushing and drainage with catheter".Age,gender,clinical symptoms,abdominal CT examination,peripheral blood routine,blood biochemistry,blood C-reactive protein(CRP),white blood cells,biochemistry,and aetiology of peritoneal dialysis fluid were collected and followed up,and the therapeutic effect was evaluated.Results 15 patients were transferred to the Department of Surgery after ineffective treatment in the Department of Internal Medicine.Preoperatively(after 5 days of antibiotic treatment)compared to before antibiotic treatment,there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Laparoscopic exploration or laparotomy exploration was performed,during which the peritoneal dialysis catheter was removed and the abdominal infection focus was cleared.A pelvic cavity washout drainage tube was left in place postoperatively.Fourteen patients had a good recovery after surgery,with effective control of peritonitis symptoms and no complications such as intestinal obstruction or enterocutaneous fistula.After the removal of the peritoneal dialysis catheter,all patients switched to hemodialysis.A comparison of inflammatory markers before and after surgery showed a significant decrease after surgery.Three days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there were no significant changes in blood WBC,blood NEUT％,CRP,and peritoneal fluid WBC(P＞0.05).Seven days postoperatively compared to before surgery(after 5 days of antibiotic treatment),there was a significant decrease in blood WBC[(7.43±2.65)× 109/L VS(10.17±5.24)× 109/L],blood NEUT％[(88.23±9.02)％VS(85.07±11.57)％],and CRP[(152.88±113.01)mg/L VS(114.49±92.97)mg/L](P＜0.05);the peritoneal fluid WBC at 7 days postoperatively showed no significant change compared to before surgery(after 5 days of antibiotic treatment)(P＞0.05).The cases were followed up for at least 22 months,and 13 patients did not experience peritonitis or intestinal obstruction again.One patient died 39 days after surgery due to multiple organ failure,and one patient died from other causes after a 2-year follow-up.Conclusion For refractory sclerosing peritonitis related peritoneal dialysis that is ineffective in medical conservative treatment,On the basis of reasonable and effective antibiotics to control infection,surgical intervention should be actively carried out and surgical methods such as surgery should be used to control the progress of peritonitis,reduce mortality and improve the cure rate.

Objective:This study aimed to reveal the distribution and course of the branches of the infraorbital nerve(IN),its communication relationship between the branches of the infraorbital nerve and facial nerve,so as to provide morphological basis for clinical implementation of accurate infraorbital nerve trunk in the infraorbital canal,regional facial anesthesia and facial surgery,so as to improve the success rate of maxillofacial surgery.Methods:25 adult cada-vers with formalin immobilized semi-face were selected.Exclude facial defect samples caused by tumor,trauma,deformity,surgery,etc.The length and diameter of the trunk of the infraorbital nerve and the length of the infraorbital canal were measured.The total number of infraorbital nerve and the number of branches were counted,and the course,distribution and communication relationship between infraorbital nerve and facial nerve were investigated.Results:The length of infraorbital nerve trunk ranged from 19.61 to 44.47 mm,with an average length of(23.33±4.95)mm.The length of infraorbital canal ranged from 9.49 to 31.21 mm,with an average length of(12.87±3.99)mm.The number of infraorbital nerve branches ranged from 5 to 12,and the average number was(7.29±2.29).The number of upper labial branches was the widest,ranging from 1 to 5,while the distribution area of eyelid branches was the narrowest.There are(were)a large number of intersections and anastomoses between the infraorbital nerve and the facial nerve,forming a complex multi-layer network structure.Conclusion:The infraorbital nerve trunk and the infraorbital canal va-ry in length.The number and distribution range of infraorbital nerve branches are not constant,and the communication relationship between infraorbital nerve and facial nerve is complicated.

Objective To explore the presentation of T2 weighted magnetic resonance imaging(T2WI)and dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)parameters in patients with prostate cancer and their correlations with prostate specific antigen(PSA)level and International Society of Urological pathology(ISUP)grading.Methods A total of 82 patients with prostate diseases who were admitted to Yixing Traditional Chinese Medicine Hospital between March 2019 and June 2023 were selected as research objects,including 52 patients with prostate cancer and 30 patients with benign prostatic hyperplasia.T2WI and DCE-MRI parameters of these patients were compared.Results The proportion of prostate cancer patients with T2WI score≥4 was 50.00%,which was higher than that of the benign prostatic hyperplasia patients(P<0.05).The peak time(Tmax)of prostate cancer patients was 70 541.44(45 035.20,90 655.41)ms,which was shorter than that of the patients with benign prostatic hyperplasia(P<0.05).The fastest enhancement rate(Rmax)of prostate cancer patients was 36.60±14.41,which was higher than that in patients with benign prostatic hyperplasia(P<0.05).The proportions of patients with T2WI score≥4 in stages Ⅲ-Ⅳ,ISUP grading≥4,and PSA≥50 ng/ml were 62.50%,75.00%and 63.16%,respectively,which were significantly higher than those in stages Ⅰ-Ⅱ,ISUP grading≤3,and PSA level<50 ng/ml(all P<0.05).The Tmax of patients in stages Ⅲ-Ⅳ was 68 405.44(43 506.43,82 204.32)ms,which was lower than that of stagesⅠ-Ⅱpatients(all P<0.05).The Rmax of patients in stages Ⅲ-Ⅳ was 39.16±9.50,which was higher than that of stages Ⅰ-Ⅱ patients(all P<0.05).The Tmax of patients with ISUP grading≥4 was 66 504.32(43 506.43,84 053.12)ms,which was lower than that of patients with ISUP grading≤3(P<0.05).The Rmax of patients with ISUP grading≥4 was 40.38±9.75,which was higher than that of patients with ISUP grading≤3(P<0.05).The Tmax of patients with PSA≥50 ng/ml was 63 044.22(45 035.20,82 204.32)ms,which was shorter than that of patients with PSA<50 ng/ml(P<0.05).The Rmax of patients with PSA≥50 ng/ml was 39.15±9.05,which was higher than that of patients with PSA<50 ng/ml(P<0.05).Tmax was negatively correlated with PSA(P<0.05),while Rmax was positively correlated with PSA(P<0.05).T2WI manifestations and Rmax were positively correlated with ISUP grading(all P<0.05),while Tmax was negatively correlated with ISUP grading(P<0.05).Conclusion T2WI and DCE-MRI parameters are correlated with clinical staging,ISUP grading,and PSA level of prostate cancer,which is worthy of further clinical research.

Objective:To investigate the safety and efficacy of excimer laser ablation (ELA) combined with drug-coated balloon (DCB) for the below-the-knee (BTK) artery lesions.Methods:From Jun 2019 to Nov 2022, 22 patients receiving ELA combined with DCB in atherosclerotic lesions of BTK artery at these two centers were retrospectively analyzed.Results:In these 22 patients there were 3 (13.6%) suffering from stenosis and 19 (86.4%) from chronic total occlusion (CTO) lesions. The mean length of lesion was (25.6±5.7) cm. The technical success rate was 95.5%. Flow-limiting dissection was found in 1 (4.5%) patient and a bailout stent was deployed. The mean ankle-brachial index (ABI) significantly improved during the follow-up period compared with that before the treatment. The median follow-up time was 21.5 months. The 1-year primary patency rate was 80.3%Conclusion:ELA combined with DCB was safe and effective in the treatment of atherosclerotic lesions of BTK artery, improving the primary patency.

OBJECTIVES: Stroke has become the leading cause of death and disability among adults in China. This study aims to analyze the disease burden based on gender and age and the risk factors for stroke subtypes in China 2019, and to provide reference for targeted stroke prevention and control. METHODS: Based on 2019 data of the Global Burden of Disease (GBD), the gender and age in patients with different stroke subtypes (ischemic stroke, intracranial hemorrhage, subarachnoid hemorrhage) in China 2019 was described by using disability-adjusted life years (DALY), and attributable burden of related risk factors was analyzed. RESULTS: In 2019, the burden of intracranial hemorrhage was the heaviest one in China, resulting in 22.210 6 million person years of DALY, following by ischemic stroke and subarachnoid hemorrhage, resulting in 21.393 9 and 2.344 7 million person years of DALY, respectively. Among them, except the 0-14 age group, the disease burden of different subtypes of stroke in men was higher than that in women. The disease burden of ischemic stroke was increased with age in both men and women, with the heaviest disease burden in ≥70 years group. The disease burden of intracranial hemorrhage and subarachnoid hemorrhage was the heaviest in males aged 50-69 years old, and in females aged ≥70 years and 50-69 years, respectively. Metabolic factors were the main risk factors in all ages of different stroke subtypes, and the most important risk factor was high systolic blood pressure. Other risk factors were different between men and women. Smoking, high body mass index, high low-density lipoprotein, and outdoor particulate matter pollution were the main risk factors for stroke in men, while high body mass index, outdoor particulate matter pollution, and high fasting blood glucose were the main risk factors of stroke in women. The main risk were different among different age groups. CONCLUSIONS The burden and attributable risk factors for different stroke subtypes are discrepancy in different gender and age groups. Targeted interventions should be conducted in the future to reduce the burden of stroke.
Male ; Adult ; Humans ; Female ; Infant, Newborn ; Infant ; Child, Preschool ; Child ; Adolescent ; Middle Aged ; Aged ; Subarachnoid Hemorrhage/epidemiology* ; Quality-Adjusted Life Years ; Cost of Illness ; Stroke/etiology* ; Risk Factors ; China/epidemiology* ; Particulate Matter ; Ischemic Stroke ; Intracranial Hemorrhages/etiology*

Objective:To explore the efficacy of a flat ground exoskeleton robot in improving the walking ability of stroke survivors.Methods:Fifty-eight stroke survivors with mobility difficulties were randomly divided into a robot group ( n=29) and a control group ( n=29). In addition to routine rehabilitation, the control group received conventional walking training, while the robot group underwent exoskeleton robot-assisted gait training. The 30-minute training sessions were held twice a day, 5 days per week for 5 weeks. Before as well as after 2 and 4 weeks of treatment, everyone′s walking ability was tested using the 6-minute walk test (6MWT) and functional ambulation scale (FAC). General lower limb motor function was quantified using the Fugl-Meyer Lower Extremity assessment (FMA-LE). Moreover, gait analysis was conducted before and after 4 weeks of treatment. Results:After 2 and 4 weeks of treatment, the average 6MWT times of both groups were significantly better than before the treatment, with the improvement of the robot group significantly greater than that of the control group after 2 weeks. After 2 and 4 weeks the average FMA-LE and FAC scores of both groups had improved significantly compared with before treatment. After 4 weeks the stride frequency and gait cycle of both groups had improved significantly.Conclusions:Exoskeleton robot-assisted gait training can improve walking ability and lower limb motor function of stroke survivors about as well as conventional walking training.