Objective::Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.Methods::Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.Results::Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons risk score (odds ratio 0.760, 95% confidence interval (CI): 0.584-0.989; P = 0.041) and annulus perimeter (odds ratio 0.888, 95% CI: 0.796-0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not Society of Thoracic Surgeons risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio 2.223, 95% CI: 1.060-4.659; P = 0.028). Conclusions::TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.

Objective::Patients with untreated severe aortic regurgitation (AR) have a high risk of mortality. Transfemoral transcatheter aortic valve replacement (TF-TAVR) is a treatment option for AR; however, the safety and efficacy of this technique have not been sufficiently established. This study aimed to evaluate the clinical and anatomical variables correlating with device success of TF-TAVR using a self-expanding valve system for pure AR.Methods::Patients with pure native severe AR who underwent TF-TAVR using a self-expanding valve system were registered at 5 Chinese centers. The primary endpoint was device success at 1 month after TAVR. The secondary endpoint was the composite of major adverse cardiovascular events (MACE) at 6 months, including all-cause death, ischemic stroke, emergency conversion to cardiac surgery, and permanent pacemaker implantation. Echocardiography was used to analyze the left ventricular function before the TAVR procedure and during follow-up. Multivariable logistic regression and Cox regression analyses were performed to find relevant independent risk factors.Results::Between September 2019 and February 2022, 79 patients with AR were enrolled in the study. At 1 month, device success was achieved in 60 (75.9%) patients. By 6 months, 29 (36.7%) patients had MACE. Echocardiography revealed improved left ventricular function after TAVR. Multivariate regression analysis demonstrated that the Society of Thoracic Surgeons risk score (odds ratio 0.760, 95% confidence interval (CI): 0.584-0.989; P = 0.041) and annulus perimeter (odds ratio 0.888, 95% CI: 0.796-0.992; P = 0.035) were 2 predictors of device success. Moreover, annulus perimeter (<80.2 mm), but not Society of Thoracic Surgeons risk score, was associated with a significant reduction in MACE at 6 months (hazard ratio 2.223, 95% CI: 1.060-4.659; P = 0.028). Conclusions::TF-TAVR using a self-expanding valve system appears to be a safe and feasible treatment for patients with pure native severe AR, particularly those with a less enlarged annulus.

Objective This study aimed to analyze the use of various virtual surgical planning and 3D printing templates in mandibular angle ostectomy.Methods Twelve patients with mandibular angle prominence were selected from the Affiliated Stomatological Hospital of Guizhou Medical University between January 2022 and January 2023.Preoperative craniofacial CT scans were used to create three-dimensional models.Two types of virtual surgical planning and templates were designed:ascend-ing branch-fixed templates on the ramus(Group Ⅰ)and inferior border-fixed templates on the excised mandibular angle(GroupⅡ).Patients were divided into two groups based on the template used during surgery.The changes in the mandibular angle be-fore and two weeks after surgery were compared between the groups,and deviations between the surgical plans and postopera-tive results were measured.Results All patients healed successfully with satisfactory cosmetic outcomes.Lateral mandibular angles were observed in all patients of Group Ⅰ.In Group Ⅱ,one patient presented with a lateral angle,while the others showed medial angles.An increase in the mandibular angle(P＜0.01)was noted with no significant difference between the bilateral an-gles(P＞0.05).The deviation from the surgical planning was also not significantly different between the groups(P＞0.05).Conclusion Virtual surgical planning and 3D printed templates in mandibular angle ostectomy result in high accuracy and favor-able cosmetic outcomes.Ramus-fixed template is suitable for lateral mandibular angle type,while lower edge-fixed template is better for medial mandibular angle type.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Objective To investigate the efficiency and cost-effectiveness of multi-station drug dispensing robots.Methods The study selected 4 pharmacists with comparable experience and skills,and 3 commonly used medications from our hospital's pharmacy intravenous admixture service.A crossover design was employed to compare the manual and robotic dispensing efficiency.Cost-effectiveness analysis was conducted for the economic evaluation,comparing the costs,benefits,and net profits of both dispensing modes,and sensitivity analysis was performed on the evaluation results.Results The dispensing efficiency,cost and net profits of the robotic dispensing were significantly higher than manual dispensing(P＜0.001).Sensitivity analysis results revealed that even after adjusting labor and material costs,the net profit of robotic dispensing was still significantly higher than that of manual dispensing(P＜0.001),indicating strong robustness.Conclusion Compared to manual dispensing,multi-station drug dispensing robots exhibit significant advantages in dispensing efficiency and cost-effectiveness,showing broad clinical application prospects.

Objective:To investigate the results of coryoint flap harvested from lower abdominal wall for covering extremely soft tissue circular defects on limbs.Methods:From March 2018 to June 2020, 15 patients who suffered from severe degloved injury were admitted into the Department of Hand Surgery, The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University. The injuries were characterised as extreme circular defects on limbs. The dimension of defects ranged from 25.0 cm×9.0 cm to 30.0 cm×18.0 cm. All wounds were taken through emergency debridement and managed by VSD. Using lower abdomen as a donor site, a conjoined flap was dissected when the wound surface became granulating. The perforator vessels of the flaps included vessels of deep inferior epigastric artery(DIEA), superficial inferior epigastric artery(SIEA) and superficial circumflex iliac artery(SCIA). The donor sites were primary closed. Postoperative follow-ups were conducted by the surgeons in the same surgical team at outpatient clinic.Results:Fourteen flaps survived completely without significant complications. Distal necrosis occurred in 1 flap, which healed with a skin graft in the second stage surgery. All flaps were reviewed during the postoperative follow-up that lasted for 18-24(mean 20) months. The aesthetic outcomes were achieved on the recipient site without hairy nor hyper-pigmentation. A concealed linea scare left at the donor sites without hernia and limited function. At the last follow-up, 5 patients were in excellent and 2 in good evaluated by following the Disabilities of the arm, shoulder and hand(DASH). With the Lower extremity functional scale(LEFS), 5 patients were in excellent and 3 in good.Conclusion:The simultaneous reconstruction of extremely large soft tissue circular defects on limbs with best possible salvage surgery can be achieved by a conjoined flap. A conjoined flap offers a concealed donor site, easy to design, flexible perforators design and larger size of soft tissue.

Objective:To investigate the curative effects of bi-pedicled deep inferior epigastric perforator (DIEP) flap in repairing large soft tissue defects in the lower limbs.Methods:A retrospective observational study was conducted. From February 2016 to June 2020, 16 patients with large soft tissue defects in the lower limbs caused by trauma or after tumor/scar resection were admitted to the Department of Hand Surgery of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, including 9 males and 7 females, aged 25-58 years, with the area of soft tissue defects ranging from 14.0 cm×8.0 cm to 32.0 cm×18.0 cm. Using the abdomen as the donor site, the conjoined abdominal wall flap, i.e., the bi-pedicled DIEP flap (with an area ranging from 15.0 cm×9.0 cm to 32.0 cm×20.0 cm) carrying two sets of the trunk of the deep inferior epigastric artery was designed and resected to repair the wound. The donor site wound was sutured directly. The flap survival and wound healing in the donor and recipient areas were observed after operation. The curative effect was evaluated during the follow-up. At the last follow-up, the American Knee Society score and lower extremity functional scale were used to assess the functions of knee joint and lower limb, respectively.Results:The flaps of 15 patients survived after operation; the flap of one patient had partial infection at the edge after operation but healed after debridement and dressing change. The wounds in the donor and recipient areas of 16 patients all healed well. Follow-up of 16-28 months showed that the recipient area had a good shape and pliable texture, and there was no obvious swollen appearance, hyperpigmentation, or abnormal hair growth; the donor site had linear scar only, with no complications such as abdominal hernia or hyperplastic scar; the functions of knee joint and lower limb were well reconstructed, with no recurrence of tumor. At the last follow-up, among the 4 patients with knee joint injury, 3 cases were excellent and 1 case was good in the evaluation of knee joint function; among the 12 patients with lower limb injury, 9 cases were excellent and 3 cases were good in the evaluation of lower limb function.Conclusions:The donor site of bi-pedicled DIEP flap is concealed with abundant tissue and large area for resection, with which can be used to repair large soft tissue defects in the lower limbs, achieving good short-term results of appearance and function restoration.

Objective:To investigate the clinical characteristics and surgical treatment of enteric Behcet′s disease with acute abdomen.Methods:The clinical data and follow-up results of 9 patients with enteric Behcet′s disease with acute abdomen treated surgically were analyzed retrospectively.Results:All patients in this group had abdominal pain, with bloody stool in one case, failure to exhaust and defecation in 1 case. Physical examination revealed abdominal mass in 2 cases, peritonitis sign in 5 cases and tenderness of the right lower abdomen in 1 case. The causes of operation were pathological perforation of ileocecal region, pathological perforation of small intestine, acute appendicitis, ileum fistula, intestinal stenosis and obstruction and massive hemorrhage of lower digestive tract.In this group, laparotomy or laparoscopy were done in these cases, including ileocecal resection in 2 cases, partial resection of small intestine in 3 cases, laparoscopic appendectomy in 1 case and right colon colectomy in 3 cases. Incision infection occurred in 1 case, anastomotic leakage in 1 case and adhesive intestinal obstruction in 1 case occurred after operation. The median follow-up time of 8 cases was 7.5 years, and Behcet′s disease recurred in 4 cases, but no recurrence of enteric Behcet disease was found.Conclusions:Intestinal perforation, bleeding and obstruction are the main causes of intestinal Behcet′s disease with acute abdomen, and emergency surgery is an important means of treatment, moreover, nutrition support and drug therapy are the important supportive therapy to control this disease.

Objective To investigate the clinical characteristics,diagnosis and treatment of primary abdominal cocoon.Methods The clinical data of 16 cases of primary abdominal cocoon were reviewed and analyzed.Results Only in 2 cases in which correct preoperative diagnosis was estabished by CT scan.The other 14 cases were diagnosed during operation.Parts or all small intestines were covered with a layer of milky white dense fibrous thin membrane,formed mass-likely adhesion,and fibrous film attached to the mesenteric roots.Extensive adhesion existed in between intestines.The operation included lysis of peritoneal adhesion plus fibrous membrane excision in 14 cases,lysis of peritoneal adhesion plus fibrous membrane excision and segmental enterectomy in 2 cases,and in 2 cases appendectomy was done.There was no anastomotic leakage or other major complications except for wound infection in 1 case.All the patients were followed up from 3 months to 7 years with a median follow-up time of 3.6 years,and no recurrent cases were found.Conclusions Surgery is the main method for the treatment of abdominal cocoon with evident clinical symptoms,and the prognosis is largely fair.

Objective To investigate the clinicopathological features of abdominal lymphangioma and its diagnosis and treatment.Methods The clinical data of 37 patients with abdominal lymphangioma were analyzed retrospectively.Results The clinical presentations were slight abdominal distention and discomfort in 6 cases (16％),abdominal pain or lumbago in 13 cases (35％),found by health screening in 14 cases (38％) and abdominal mass in 4 cases (11％).Tumor located in retroperitoneal space in 20 cases,small bowel in 7 cases,colon mesentery in 4 cases,small mesentery in 2 cases,duodenum in 2 cases,stomach in one case and pancreas in one case.The surgical procedures were complete resection in 31 cases and incomplete resection in 6 cases.Except 3 cases lost to fol]ow-up,no recurrence was found during the postoperative follow-up period.Conclusions It is difficult to diagnose abdominal lymphangioma before operation,and complete resection of tumor is the first choice.