Objective To establish preoperative and postoperative femoral-pelvic-lumbar spine models of patients with developmental dysplasia of the hip(DDH)and healthy volunteers and to study the biomechanical effects of curved periacetabular osteotomy on the lumbar spine.Methods Preoperative and postoperative femoral-pelvic-lumbar spine DICOM data from four patients with DDH and one healthy volunteer were acquired using CT scanning technology,and a three-dimensional finite element model was constructed.The offset method was used to divide the cortical and cancellous bones in Geomagic and the lumbar cartilage,sacroiliac joint,pubic symphysis,and other cartilages were added to SolidWorks.The model was analyzed using ANSYS for finite element analysis,and the gait was the mid-stage of single-leg support during slow walking.The biomechanical changes in the lumbar spine of patients with DDH before and after surgery were analyzed and compared,and the biomechanical data of the lumbar spine of patients after surgery were compared with those of healthy volunteers.Results The femoral-pelvic-lumbar spine models of four patients and a healthy volunteer were established.The results obtained by the established models under each working condition were within the range of the referenced literature,and the validity of the models was proved.The postoperative stresses on the lumbar spine,femoral neck,annulus fibrosus,and nucleus pulposus were much smaller than those of the patients in the preoperative state,and the postoperative stresses on the lumbar spine,femoral neck,annulus fibrosus,and nucleus pulposus of the patients were similar to those of healthy volunteers.Conclusions Curved periacetabular osteotomy significantly reduced the stresses on the lumbar spine and intervertebral discs.Additionally,the stresses on the annulus fibrosus were more uniform after surgery,which indicated that curved periacetabular osteotomy will adjust patients to a healthy state.This study provides a biomechanical basis for the clinical treatment of DDH and helps optimize surgical plans.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

Objective:In this study, we aimed to compare the short-term safety of two digestive tract reconstruction techniques, laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis, following radical resection of Siewert Type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 139 patients who had undergone radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. These included 89 patients treated at the First Affiliated Hospital of Air Force Medical University from November 2021 to July 2023, 36 patients treated at the First Affiliated Hospital of Xi'an Jiaotong University from December 2020 to June 2021, and 14 patients treated at the Yuncheng Central Hospital in Shanxi Province from September 2021 to November 2022. The group consisted of 107 men (77.0%) and 32 women (23.0%) of mean age 62.5±9.3 years. Forty-eight patients underwent laparoscopic total abdominal overlap anastomosis (overlap group), and 91 laparoscopic-assisted end-to-side anastomosis (end-to-side group). Clinical data, surgical information, pathological findings, postoperative recovery, and related complications were compared between the two groups.Results:There were no significant differences in general clinical data between the overlap and end-to-side anastomosis groups (all P>0.05), indicating comparability. There was no significant difference in operation time (267.2±60.1 minutes vs. 262.8±70.6 minutes, t=0.370, P=0.712). However, the intraoperative blood loss in the overlap group (100 [50, 100] mL) was significantly lower compared to the end-to-side group (100[50, 175] mL, Z=2.776, P=0.005). Compared to the end-to-side group, longer distances between the tumor and distal resection margin proximal(1.7±1.0 cm vs. 1.3±0.9 cm, t=2.487, P=0.014) and the tumor and distal resection margin (9.5±2.9 cm vs. 7.9±3.5 cm, t=2.667, P=0.009) were achieved in the overlap group. Compared with the end-to-side group, the overlap group achieved significantly earlier postoperative ambulation (1.0 [1.0, 2.0] days vs. 2.0 [1.0, 3.0] days, Z=3.117, P=0.002), earlier time to first drink (4.7±2.6 days vs. 6.2±3.0 days, t=2.851, P=0.005), and earlier time to first meal (6.0±2.7 days vs. 7.1±3.0 days, t=2.170, P=0.032). However, the hospitalization costs were higher in the overlap group (113, 105.5±37, 766.3) yuan vs. (97, 250.2±27, 746.9) yuan; this difference is significant ( t=2.818, P=0.006). There were no significant differences between the two groups in postoperative hospital stay, total number of lymph nodes cleared, or time to first postoperative flatus (all P>0.05). The incidence of surgery-related complications was 22.9%(11/48) in the overlap group and 19.8% (18/91) in the end-to-side group; this difference is not significant (χ2=0.187, P=0.831). Further comparison of complications using the Clavien-Dindo classification also showed no significant differences ( Z=0.406, P=0.685). Conclusions:Both laparoscopic total abdominal overlap anastomosis and laparoscopic-assisted end-to-side anastomosis are feasible for radical surgery for Siewert Type II esophagogastric junction adenocarcinoma. Laparoscopic total abdominal overlap anastomosis achieves longer proximal and distal resection margins and better postoperative recovery; however, end-to-side anastomosis is more cost-effective.

Sacral neuromodulation (SNM) procedure has become a new therapy to treat chronic constipation and fecal incontinence. The surgical procedure is easy and safe. It has a small incision compared with traditional surgery and is mainly used in patients whose traditional treatment was unsuccessful. Chronic constipation is one of the most common digestive symptoms. The quality of life in patients with severe constipation has decreased greatly. Although the incidence of fecal incontinence in China is not as high as that of constipation, it also seriously affects the life of the patients, resulting in a decline in the quality of life. Although the mechanism of SNM is uncertain, with more studies conducted, understanding has become more profound, and the curative effect has been recognized. SNM can improve the symptoms and the quality of life. Many studies have reported SNM treatment. Furthermore, some trials on SNM have been conducted. It is used after colorectal resections to promote symptoms of bowel dysfunction. However, few studies reported regarding SNM for constipation and fecal incontinence in China, and knowledge regarding SNM is limited. In this article, we will mainly discuss SNM in the treatment of chronic constipation and fecal incontinence, and its research progress on the mechanism and method, surgical procedure, effectiveness, complications, postoperative contraindications, and the population who need to pay attention, in order to provide reference for the treatment of SNM in China.

OBJECTIVETo assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation.

METHODSA total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs.

RESULTSThe constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ± 0.5 to 8.0 ± 2.5 per week (P<0.01), and the defecation time decreased from (22.9 ± 11.5) to (3.7 ± 0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6 ± 4.2 to 9.0 ± 0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1 ± 0.9 to 82.5 ± 5.2 (P<0.01).

CONCLUSIONSNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment, especially for the patients refractory to traditional operations.

Objective To assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation. Methods A total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs. Results The constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ±0.5 to 8.0 ±2.5 per week (P<0.01), and the defecation time decreased from (22.9 ±11.5) to (3.7 ±0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6±4.2 to 9.0±0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1±0.9 to 82.5±5.2(P<0.01). Conclusion SNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment , especially for the patients refractory to traditional operations.

Objective To assess the efficacy of sacral neuromodulation (SNM) in patients with intractable constipation. Methods A total of 7 patients with intractable constipation were treated with pereutaneous test stimulation of the S3 nerve root and were assessed by sacral never stimulation system in our department from January 2013 to January 2014. Four of these 7 patients received operation for constipation before. The efficacy was assessed by bowel habit diary, clinic constipation scores, subjective questionnaire and clinical signs. Results The constipation symptoms were improved significantly in all the 7 patients. The frequency and volume of defecation per week were increased obviously, and the average urine was increased. Six patients underwent permanent implantation of the SNS system. After a median 4 months follow-up, the defecation frequency increased from 0.6 ±0.5 to 8.0 ±2.5 per week (P<0.01), and the defecation time decreased from (22.9 ±11.5) to (3.7 ±0.8) min (P<0.01). The Cleveland clinic constipation score decreased from 24.6±4.2 to 9.0±0.9 (P<0.01), and the visual analogue scale(VAS) score increased from 8.1±0.9 to 82.5±5.2(P<0.01). Conclusion SNM is a clinically efficacious, minimally invasive and safe new technique, which offers an alternative treatment for the patients with intractable constipation resistant to conservative treatment , especially for the patients refractory to traditional operations.

The process flow and the main devices of a new two-stage dry-fed coal gasification pilot plant with a throughout of 36 t/d are introduced in this paper. For comparison with the traditional one-stage gasifiers, the influences of the coal feed ratio between two stages on the performance of the gasifier are detailedly studied by a series of experiments. The results reveal that the two-stage gasification decreases the temperature of the syngas at the outlet of the gasifier, simplifies the gasification process, and reduces the size of the syngas cooler. Moreover, the cold gas efficiency of the gasifier can be improved by using the two-stage gasification. In our experiments, the efficiency is about 3%-6% higher than the existing one-stage gasifiers.

Objective: To evaluate the effects of stent implantation for treatment of Budd-Chiari syndrome. Methods:A total of 16 patients with pasthepatic inferior vena cave (IVC) obstruction syndrome were treated by balloon catheters ( Polythene and Inoue ) in percutaneous transluminal angioplasty (PTA) , then stent were inserted into the obstruction. Results: The residual pressure gradient after PTA and stent implantation was decreased from (4.6?0. 3 ) kPa to (2. 1?0. 1) kPa. The diameter of IVC after PTA and stent implantation was increased from (3.8?1. 7)mm to (14. 9?2. 0)mm. Conclusion : PTA and stent implantation are effective treatment for pasthepatic inferior vena cave obstruction.

Objective:To investigate the couse of 24 cases AVB during RFCA and 5 cases after RFCA in total 94 AVNRT patients. Methods:94 AVNRT patients received RFCA in which time, the energy and power were gradually discussed. The correlation among AVB and both different anatomical positions (upper, middle and lower zone) and A/V, H-value in intraventricular ablation mapping were studied respectively. Results: With the elevation of ablation zone, the AVB risk was also increased. The intraventricular ablation mapping showed that:①Increase of A/V and H-value means higher AVB risk;② Simultaneous increase of A/V and H-value would lead to the most dangerous result. Conclusion:It is of great importance to perform RFCA under such situation:middle and lower zone as ablation positions multiple-peak A wave, A/V(0.1-0.25) and no H or slightest H(≤0.02?0.03)mV are present in intraventricular ablation mapping, which could significantly lower the risk of RFCA-related AVB.