OBJECTIVE: To investigate the effectiveness of three-dimentional (3D) printed personalized guide plate-assisted wrist arthroscopic repair for Palmer type ⅠB triangular fibrocartilage complex (TFCC) injury. METHODS: A retrospective analysis was conducted on the clinical data of 20 patients with Palmer type ⅠB TFCC injuries admitted between January 2023 and March 2024 who met the selection criteria. Among them, 13 were male and 7 were female; ages ranged from 23 to 35 years, with a mean age of 30.3 years. All patients had a history of trauma, 12 cases involved falls and 8 cases involved sprains. All patients demonstrated a positive "piano key sign". MRI revealed deep ulnar-side tears of the TFCC. Conservative treatment for 6 weeks yielded poor or no clinical improvement. The interval from injury to surgery ranged from 2 to 9 months, with a mean of 5.0 months. Patients underwent wrist arthroscopic repair assisted by 3D printed personalized guide plate. Functional recovery was assessed preoperatively and postoperatively using the visual analogue scale (VAS) score for pain, modified Mayo wrist score, and range of motion (ROM) measurements for wrist flexion-extension, ulnar-radial deviation, and pronation-supination. At last follow-up, MRI was performed to evaluate the healing of TFCC. RESULTS: All 20 patients underwent successful surgery without complications such as vascular or nerve injury, fracture, incisional infection, or joint stiffness. All patients were followed up 9-18 months (mean, 12.4 months). At last follow-up, patients demonstrated significant improvements in VAS scores, modified Mayo wrist scores, wrist flexion-extension ROM, ulnar-radial deviation ROM, and pronation-supination ROM compared to preoperative levels ( P<0.05). MRI at last follow-up showed preserved TFCC continuity, excellent healing, and secure fixation. CONCLUSION 3D-printed personalized guide plate significantly improve outcomes in wrist arthroscopic TFCC repair for Palmer type ⅠB injuries. They enable high-quality suturing, facilitate anatomical reconstruction, and markedly enhance wrist function.
Humans ; Arthroscopy/methods* ; Male ; Adult ; Triangular Fibrocartilage/diagnostic imaging* ; Female ; Retrospective Studies ; Printing, Three-Dimensional ; Wrist Injuries/diagnostic imaging* ; Young Adult ; Bone Plates ; Treatment Outcome ; Wrist Joint/surgery* ; Magnetic Resonance Imaging ; Range of Motion, Articular

Objective To explore the clinical efficacy of endoscopic electrocoagulation resection and cold resection techniques in the treatment of elderly patients with complex colonic polyps.Methods A retrospective selection was made of 100 elderly patients with colonic polyps who underwent endoscopic electrocoagulation resection and cold resection of colonic polyps in the Department of Gastroenterology of Yiwu Central Hospital from August 2021 to August 2023.According to the different surgical methods,the patients were divided into the electrocoagulation group(50 cases)and the cold resection group(50 cases).The polyp resection status,intraoperative and postoperative treatment conditions,postoperative pain degree,gastrointestinal quality of life index(GIQLI)score,length of hospital stay,total treatment cost,and recurrence situation after 1-year follow-up of the elderly patients with colonic polyps in the two groups were statistically analyzed.Results 108 polyps were resected in the electrocoagulation group and 113 in the cold resection group.The complete resection rate of polyps in the cold resection group was higher than that in the electrocoagulation group,the specimen damage rate was lower than that in the electrocoagulation group,the differences were statistically significant(P<0.05).There were no statistically significant difference in the average number of polyps removed and the recovery rate of polyp specimens between the two groups(P>0.05).The operation time and hospital stay of the cold resection group were shorter than those of the electrocoagulation group,the total treatment cost was less than that of the electrocoagulation group,and the usage rate of titanium clips during the operation was lower than that of the electrocoagulation group.The differences were all statistically significant(P<0.05).The incidences of intraoperative bleeding,delayed bleeding,perforation and abdominal pain in the electrocoagulation group were 6.00%,2.00%,2.00%and 6.00%respectively,which were higher than those in the cold resection group(2.00%,0.00%,0.00%and 2.00%),and there was statistically significant difference in the total incidence of complications between the two groups of patients(P<0.05).The visual analogue scale(VAS)scores of the cold resection group at 24 and 48 h after surgery were lower than those of the electrocoagulation group,and the differences were statistically significant(P<0.05).The GIQLI score of the cold resection group 3 months after the operation was higher than that of the electrocoagulation group,and the difference was statistically significant(P<0.05).The recurrence rate of the cold resection group at 1 year was lower than that of the electrocoagulation group,but the difference was not statistically significant(P>0.05).Conclusion The clinical efficacy of endoscopic cold resection technique in the treatment of elderly complex colonic polyps patients is better than that of electrocoagulation resection,and it has high safety and low treatment cost.It is worthy of clinical promotion and application.

Objective To explore the clinical efficacy of endoscopic electrocoagulation resection and cold resection techniques in the treatment of elderly patients with complex colonic polyps.Methods A retrospective selection was made of 100 elderly patients with colonic polyps who underwent endoscopic electrocoagulation resection and cold resection of colonic polyps in the Department of Gastroenterology of Yiwu Central Hospital from August 2021 to August 2023.According to the different surgical methods,the patients were divided into the electrocoagulation group(50 cases)and the cold resection group(50 cases).The polyp resection status,intraoperative and postoperative treatment conditions,postoperative pain degree,gastrointestinal quality of life index(GIQLI)score,length of hospital stay,total treatment cost,and recurrence situation after 1-year follow-up of the elderly patients with colonic polyps in the two groups were statistically analyzed.Results 108 polyps were resected in the electrocoagulation group and 113 in the cold resection group.The complete resection rate of polyps in the cold resection group was higher than that in the electrocoagulation group,the specimen damage rate was lower than that in the electrocoagulation group,the differences were statistically significant(P<0.05).There were no statistically significant difference in the average number of polyps removed and the recovery rate of polyp specimens between the two groups(P>0.05).The operation time and hospital stay of the cold resection group were shorter than those of the electrocoagulation group,the total treatment cost was less than that of the electrocoagulation group,and the usage rate of titanium clips during the operation was lower than that of the electrocoagulation group.The differences were all statistically significant(P<0.05).The incidences of intraoperative bleeding,delayed bleeding,perforation and abdominal pain in the electrocoagulation group were 6.00%,2.00%,2.00%and 6.00%respectively,which were higher than those in the cold resection group(2.00%,0.00%,0.00%and 2.00%),and there was statistically significant difference in the total incidence of complications between the two groups of patients(P<0.05).The visual analogue scale(VAS)scores of the cold resection group at 24 and 48 h after surgery were lower than those of the electrocoagulation group,and the differences were statistically significant(P<0.05).The GIQLI score of the cold resection group 3 months after the operation was higher than that of the electrocoagulation group,and the difference was statistically significant(P<0.05).The recurrence rate of the cold resection group at 1 year was lower than that of the electrocoagulation group,but the difference was not statistically significant(P>0.05).Conclusion The clinical efficacy of endoscopic cold resection technique in the treatment of elderly complex colonic polyps patients is better than that of electrocoagulation resection,and it has high safety and low treatment cost.It is worthy of clinical promotion and application.

Purpose To verify the safety and effectiveness of the Insight NM/CT Pro SPECT/CT Imaging System in clinical applications is verified through clinical validation of the acceptable rate of clinical image quality,commonly use features of the device,ease of use of the machine,satisfaction with the stability of the entire machine and safety evaluation.Materials and Methods A total of 79 subjects who voluntarily participated in the trial from July to October 2022 in the Affiliated Hospital of Inner Mongolia Medical University,were selected to undergo endocrine,circulatory,skeletal,respiratory and urological imaging for multiple systems using the Insight NM/CT Pro SPECT/CT,respectively.The quality of the images,the machine operation and safety were evaluated.Results The image quality of all 79 patients were evaluated.Of 36 cases,there were 35 cases of planar imaging were acceptable;Of 43 cases,there were 42 cases of tomographic imaging were acceptable,with an acceptability rate of 97.22%and 97.67%,respectively,and a lower limit of 95%CI of 85.47%and 87.71%,respectively,which were both higher than those of the target value(83.00%).When the operators performed imaging operations on 79 patients,the common functions of the equipment,the ease of use of the equipment and the stability of the whole machine were evaluated as a satisfaction rate of 100%,with no adverse events.Conclusion Insight NM/CT Pro SPECT/CT effectiveness fully meets the requirements of clinical applications,with clear images of tissue structure,full range of commonly used equipment features,stable system,and superior safety and reliability.

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.

Objective : To explore the effect of negative pressure sealing drainage on the treatment of maxillofacial-neck-mediastinal infection in multiple spaces. Methods: Vacuum sealing drainage (VSD) was applied in five patients with maxillofacial-neck-mediastinal infection caused by odontogenic infection accompanied by diabetes or renal failure and other systemic diseases. After extensive debridement, a negative pressure drainage sponge was placed in the pus cavity and then the wound was closed. Continuous negative pressure drainage was continued after the operation. At the same time, multidisciplinary consultation was applied to control basic diseases and, strengthen anti-inflammatory responses, and nutrition and other systemic treatments were applied. Results: Four patients underwent continuous negative pressure drainage and successful removal of the negative pressure sponge after inflammatory symptoms subsided. One patient′s inflammatory symptoms became more serious after the operation, and we performed another operation to change the placement of the negative pressure sponge. All 5 patients underwent VSD with negative pressure sponge replacement ranging from 1 to 3 times during treatment. After multidisciplinary consultation, they were all cured and discharged from the hospital. Conclusion For infection of the mediastinum, maxillofacial region and neck, local treatment and systemic treatment are emphasized, as well as the treatment of infected lesions and basic diseases. Negative pressure closure and drainage technology promotes the alleviation of inflammation, and multidisciplinary combined treatment is beneficial for the control of basic diseases.

Objective:To investigate the effects of different frequency sling exercise therapy (SET) on the balance of trunk control and walking ability in stroke patients.Methods:A total of 90 patients with stroke who were admitted to the Department of Rehabilitation Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, from January 2018 to December 2018, received sling exercise therapy on a routine basis and were divided into 1 time/Day low frequency group, 2 time/Day medium frequency group, 3 time/Day high frequency group, 20 min/time, for a total of 3 months.After 1, 2 and 3 months, trunk control test (TCT), Berg balance scale(BBS), functional ambulation classification (FAC) and modified Barthel Index (MBI) were used to evaluate the three groups of patients.Results:There were significant differences in TCT, BBS, FAC and MBI between the low, middle and high frequency groups (all P < 0.05). The scores of TCT in the low, middle and high frequency groups were (36.21±6.31), (42.51±4.33), (49.52±4.90) and (41.23±6.31), (50.32±8.32), (58.12±7.23) respectively, and the scores of BBS were (15.11±4.31), (19.69±5.86), (24.56±8.74) and (21.43±5.37), (27.61 ± 7.50), (33.81±6.99) respectively, compared with those before treatment )The scores of (24.69±9.33), (22.84 ± 10.11) and (9.32 ± 3.11), (9.504.10), (9.47 ± 3.73) were significantly improved, and the differences between the high frequency group and the low frequency group and the medium frequency group were statistically significant (all P< 0.05), but there was no statistically significant difference between the three groups after three months of training ( P> 0.05). There was no significant difference between fAC and MBI in the low, medium and high frequency group, but there was no significant difference between the two groups after training for 2 and 3 months There were significant differences between fAC ((1.84±0.41), (2.39±0.44), (3.29 ± 0.33) and MBI ((27.32 ± 9.33), (34.45 ± 9.21), (44.77 ± 10.27) and (41.33±11.21), (52.73±12.31), (75.94±13.22)). There was significant difference between the high frequency group and the low frequency group ( P< 0.05). Conclusion:Multiple sling exercise therapy in one day can further improve the balance of trunk control and walking ability of stroke patients, and shorten the course of disease.

Objective To investigate the Toxoplasma gondii infection situation and relative factors in reproductive women in Shandong area,so as to provide the evidences for establishing strategies for reducing the birth defects and improving the quality of population. Methods A total of 5 386 reproductive women who visited hospitals at county and city levels in Shandong region from January 2013 to December 2015 were treated as the research objects,and their venous blood samples were collected to de?tect the antibodies(IgG and IgM)against T. Gondii in serum. Meanwhile,the related risk factors of T. gondii infection were sur?veyed by questionnaires. Results Among the 5 386 reproductive women,623 ones were positive for IgG antibody and the posi?tive rate was 11.56%,and 328 ones were positive for IgM antibody and the positive rate was 6.21%. The single factor analysis showed that the pregnant status(χ2 =13.12,P<0.01),whether the residences were in downtowns or counties(χ2 =6.27, P<0.05),whether having animal contact history(χ2=10.46,P<0.01),and whether eating half?baked foods(χ2=21.19, P < 0.01)were related to T. gondii infection. Conclusions The T. gondii infection rate of reproductive women in Shandong Province is high;the related risk factors include pregnant status,residence,degree of intimate contact with animal,and wheth?er eating half?baked foods. It suggests that the detection of T. gondii infection and health education in reproductive women should be strengthened.

Objective To analyze the epidemiological characteristics and disease control of epi-demic cerebrospinal meningitis (meningitis) in Xi′an in order to optimize the measurement for disease con-trol and prevention .Methods The reported cases , pathogen surveillance data and immunization coverage for meningitis were analyzed to evaluate the epidemic status , the number of healthy carriers and the disease control efficacy.Results The incidence of meningitis was 22.51/100 000 from 1951 to 1984 in Xi′an. Since the implementation of Expanded Immunity Program in 1984 , the incidence dropped significantly from the average incidence of 4.87/100 000 in 1980′s to 0.59/100 000 in 1990′s.The average incidence of men-ingitis was 0.095/100 000 from 2001 to 2011 and then showed a dramatic downtrend with no cases reported during 2012 to 2013 .Conclusion The analysis suggested that an expanded coverage of vaccine immuniza -tion and an enhanced disease surveillance system for meningitis should be used as the comprehensive meas -urements for the prevention and control of disease .

Objective To explore the shape change characteristics of Oncomelania hupensis snail shell after the snails being passively migrated into Shandong intake area of the South-to-North Water Diversion Project. Methods The snails raised on the Dushan island in Weishan Lake region were captured,and 115 the first filial generation snails and 107 the second filial generation ones were selected. The length and width of shells and apertures,and the labial ridge thickness of those snails were measured,the longitudinal rib number of snail spiral was counted,and 107 parental snails were chosen as controls. Results The labial ridge thickness of the filial generation snail was significantly reduced with the increase of algebras,and the labial ridge thickness among the 3 generations had a significant difference(P<0.01). Both the length of snail shell and the width of snail apertures were de-creased,while the width of snail shell,the length of snail apertures,the multiplication product of snail aperture’s length and width and the longitudinal rib number of snail spiral were all increased. Conclusion The body size of Oncomelania snails in Weishan Lake region becomes smaller,and their shells become thinner,which indicates that the environment of the lake region is not suitable for snail breeding,and the snails have natural decay tendency with the extension of time.