Objective:To study the application effect of perioperative management based on enhanced recovery after surgery(ERAS)philosophy in the robot-assisted surgery for thoracolumbar fracture.Methods:This was a prospective random control trial(RCT).A total of 80 patients with thoracolumbar fracture admitted to Jiangsu Provincial People's Hospital from January 2020 to January 2025 were selected.They were divided into control group and ERAS group according to random number method,with 40 cases in each group.All of them adopted robot-assisted surgery for thoracolumbar fracture as the main therapeutic scheme.After surgery,the control group adopted routine perioperative management,and the ERAS group adopted perioperative management based on the ERAS philosophy.The postoperative recovery time of physiological function(the time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay)between two groups were compared.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to assess the levels of anxiety and depression of the patients in two groups before surgery and at the 1st d,5th d and 7th d after surgery.In addition,the pain score of visual analogue scale(VAS),the incidence of postoperative complication,the scores of psychological state before and at the 7th day after surgery,and patient's satisfaction for diagnosis and treatment during the length of hospital stay as the evaluation of Nursing Scale for Nursing Staff(NSNS)before discharge were compared between the two groups.Results:The time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay of ERAS group were shorter than those of control group,and the differences were significant(t=3.508,9.171,5.423,10.983,6.675,P<0.05).Before surgery,there were not significant differences in VAS score,SAS score and SDS score between the two groups(P>0.05).The VAS scores at the 1st d,5th d and 7th d after surgery in ERAS group were significantly lower than those in control group(t=5.433,5.882,5.060,P<0.05).At the 7th d after surgery,the scores of SAS and SDS in ERAS group significantly decreased,which were significantly lower than those in control group(t=14.327,13.390,P<0.05).The incidence of postoperative complications in ERAS group was 7.50%(3/40),which was lower than 32.50%(13/40)in control group(x2=7.812,P<0.05).Satisfaction of patients in ERAS group was 95.00%,which was significantly higher than 77.50%in control group(x2=5.165,P<0.05).Conclusion:The perioperative management based on ERAS philosophy can contribute to promote the recovery of postoperatively physiological function,and relieve postoperative pain,and improve postoperatively negative emotional state,and reduce the incidence of postoperative complications,and enhance patient's satisfaction.

Objective Based on multi-objective optimization,a design method for Voronoi bionic porous scaffolds tailored to different degrees of bone defects was proposed.Methods First,the effects of design parameters on mechanical and biological properties of the scaffolds were investigated.The response surface models were then established respectively for the design parameters and performance indicators(specific surface area,elastic modulus,yield strength,and permeability).Using a cubic scaffold with side length of 15 mm as an example(assuming a corresponding bone defect of the same dimension),multi-objective optimization of the scaffold was finally conducted using the non-dominated genetic algorithm-Ⅱ algorithm,while considering the elastic modulus and permeability ranges of bone tissues as performance constraints.Results The degree of anisotropy in Voronoi scaffolds was influenced by the number of seed points,while the size and scaling factors of the scaffolds exclusively impacted the rod diameter and rod length.Using the design method of this study,the optimal scaffold with specific defect size satisfying mechanical and biological properties was designed.The optimal scaffold meeting different strength requirements was designed by adjusting the yield strength to change the utopia point.Conclusions A design method for Voronoi bionic porous scaffolds based on multi-objective optimization is proposed.This method can be applied to bone defects at varying degrees and provides a new idea for the personalized design of bone tissue engineering scaffolds.

Objective Based on multi-objective optimization,a design method for Voronoi bionic porous scaffolds tailored to different degrees of bone defects was proposed.Methods First,the effects of design parameters on mechanical and biological properties of the scaffolds were investigated.The response surface models were then established respectively for the design parameters and performance indicators(specific surface area,elastic modulus,yield strength,and permeability).Using a cubic scaffold with side length of 15 mm as an example(assuming a corresponding bone defect of the same dimension),multi-objective optimization of the scaffold was finally conducted using the non-dominated genetic algorithm-Ⅱ algorithm,while considering the elastic modulus and permeability ranges of bone tissues as performance constraints.Results The degree of anisotropy in Voronoi scaffolds was influenced by the number of seed points,while the size and scaling factors of the scaffolds exclusively impacted the rod diameter and rod length.Using the design method of this study,the optimal scaffold with specific defect size satisfying mechanical and biological properties was designed.The optimal scaffold meeting different strength requirements was designed by adjusting the yield strength to change the utopia point.Conclusions A design method for Voronoi bionic porous scaffolds based on multi-objective optimization is proposed.This method can be applied to bone defects at varying degrees and provides a new idea for the personalized design of bone tissue engineering scaffolds.

Objective:To study the application effect of perioperative management based on enhanced recovery after surgery(ERAS)philosophy in the robot-assisted surgery for thoracolumbar fracture.Methods:This was a prospective random control trial(RCT).A total of 80 patients with thoracolumbar fracture admitted to Jiangsu Provincial People's Hospital from January 2020 to January 2025 were selected.They were divided into control group and ERAS group according to random number method,with 40 cases in each group.All of them adopted robot-assisted surgery for thoracolumbar fracture as the main therapeutic scheme.After surgery,the control group adopted routine perioperative management,and the ERAS group adopted perioperative management based on the ERAS philosophy.The postoperative recovery time of physiological function(the time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay)between two groups were compared.The self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were applied to assess the levels of anxiety and depression of the patients in two groups before surgery and at the 1st d,5th d and 7th d after surgery.In addition,the pain score of visual analogue scale(VAS),the incidence of postoperative complication,the scores of psychological state before and at the 7th day after surgery,and patient's satisfaction for diagnosis and treatment during the length of hospital stay as the evaluation of Nursing Scale for Nursing Staff(NSNS)before discharge were compared between the two groups.Results:The time for removing urinary catheter,time for eating,time for exhaling,time for getting out of bed,and length of hospital stay of ERAS group were shorter than those of control group,and the differences were significant(t=3.508,9.171,5.423,10.983,6.675,P<0.05).Before surgery,there were not significant differences in VAS score,SAS score and SDS score between the two groups(P>0.05).The VAS scores at the 1st d,5th d and 7th d after surgery in ERAS group were significantly lower than those in control group(t=5.433,5.882,5.060,P<0.05).At the 7th d after surgery,the scores of SAS and SDS in ERAS group significantly decreased,which were significantly lower than those in control group(t=14.327,13.390,P<0.05).The incidence of postoperative complications in ERAS group was 7.50%(3/40),which was lower than 32.50%(13/40)in control group(x2=7.812,P<0.05).Satisfaction of patients in ERAS group was 95.00%,which was significantly higher than 77.50%in control group(x2=5.165,P<0.05).Conclusion:The perioperative management based on ERAS philosophy can contribute to promote the recovery of postoperatively physiological function,and relieve postoperative pain,and improve postoperatively negative emotional state,and reduce the incidence of postoperative complications,and enhance patient's satisfaction.

Objective To investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma(HCC).Methods A total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients.The patients in the control group received percutaneous argon-helium cryoablation,and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody.The two groups were compared in terms of short-term response,changes in T lymphocyte subsets after treatment,changes in liver function and alpha-fetoprotein(AFP)after treatment,and progression-free survival and overall survival during follow-up.The t-test was used for comparison of normally distributed continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.The Kaplan-Meier method was used to plot survival curves,and the log-rank test was used for comparison of survival time between the two groups.Results The combined treatment group had significantly higher overall response rate and disease control rate than the control group(χ2=4.156 and 4.348,P=0.042 and 0.037).After treatment,the combined treatment group had significant increases in the percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(P＜0.05)and a significant reduction in the percentage of CD8+T lymphocytes(P＜0.05),while the control group had no significant changes in T lymphocyte subsets after treatment(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly higher percentages of CD3+and CD4+T lymphocytes and CD4+/CD8+ratio(all P＜0.05)and a significantly lower percentage of CD8+T lymphocytes(P＜0.05).After treatment,both groups had significant reductions in the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),and AFP(all P＜0.05)and a significant increase in the level of albumin(Alb)(P＞0.05),and compared with the control group after treatment,the combined treatment group had significantly lower levels of ALT,AST,and AFP(all P＜0.05)and a significantly higher level of Alb(P＜0.05).There were no significant differences in the incidence rates of grade Ⅲ—Ⅳ(moderate to severe)adverse reactions between the two groups(P＞0.05).Compared with the control group,the combined treatment group had significantly better median progression-free survival(21.32 months vs 15.31 months,χ2=4.689,P=0.030)and median overall survival(28.36 months vs 20.75 months,χ2=5.030,P=0.025).Conclusion Argon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response,enhance immune function,and prolong survival time,with a favorable safety profile.

Objective:To investigate whether the bladder neck descent and the area of levator ani hiatus obtained on the maximum Valsalva were consistent at the lithotomy position and separating-legs-holding-knees position.Methods:Forty four subjects who underwent perineal pelvic floor four-dimensional ultrasound at 6-8 weeks postpartum in Third Hospital of Longgang Shenzhen from November 2019 to January 2020 were enrolled in this study. All subjects were able to effectively complete the maximum Valsalva maneuver both at the lithotomy position and the separating-legs-holding-knees position. The bladder neck descent and hiatus area of the levator Ani on the maximum Valsalva at these two positions were measured and compared.Results:The bladder neck descent at the separating-legs-holding-knees position was higher than that at the lithotomy position [(41.06±8.25)mm vs (39.96±8.10)mm; t=-2.965, P=0.005], and the hiatus area of levator Ani at the separating-legs-holding-knees position was larger than that at the lithotomy position[(27.55±4.90)cm 2 vs (26.32±4.76)cm 2; t=-3.820, P<0.001]. Conclusions:The bladder neck descent and the area of levator Ani hiatus on the maximum Valsalva at separating-legs- holding-knees position are larger than those on the maximum Valsalva at the lithotomy position.

Objective: To investigate the effect of hypertensive disorder complicating pregnancy (HDCP) on the mortality and early complications of premature infants. Methods: The general clinical data of preterm infants with gestational age 24-36^{+ 6} weeks were collected from the cooperative units in the task group from January 1, 2013 to December 31, 2014.According to the severity of HDCP, the infants were divided into 4 groups: HDCP group, preeclampsia group, eclampsia group and non HDCP group, the mortality and major complications of preterm infants were compared, and the influencing factors were analyzed. Results: The mortality rate of preterm in the HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=9.970, P=0.019). Eclampsia had a highest fatality rate (4.8%) in the early stage, compared with non HDCP group (2.2%), and the difference was statistically significant.Comparison of HDCP group (1.8%) and eclampsia group (3.2%) suggested that there was no statistically significant difference.The incidence of respiratory distress syndrome (RDS) in preterm in HDCP group was significantly higher than that of non HDCP group, and there was statistical significance (χ²=13.241, P=0.004). Eclampsia group showed the highest incidence (35.4%), compared with non HDCP group (16.2%), the difference was statistically significant, but compared with HDCP group (19.9%), preeclampsia group (17.1%), there was no significant diffe-rence.The incidence of bronchopulmonary dysplasia (BPD) in preterm in HDCP group was significantly higher than that of non HDCP group (χ²=9.592, P=0.022), the highest incidence showed up in eclampsia group (9.7%), compared with non HDCP group (2.0%) and HDCP group (1.7%), the difference was statistically significant.But there was no statistically significant difference, compared with preeclampsia group.As the degree of HDCP aggravated, the incidence of BPD gradually rose.There was no significant impact on necrotizing enterocolitis (NEC), retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH) and sepsis of HDCP (χ²=7.054, 7.214, 0.358, 3.852; P=0.070, 0.065, 0.949, 0.278). Considering the overall outcome of the child, that was, whether the child died or survived, he had at least one complication, and HDCP had an effect on it (χ²=15.697, P=0.001), so the incidence increased while the degree of HDCP rose gradually.After adjusting gestational age, birth weight, sex, way of delivery, placental abruption and front placenta, prenatal hormonal, gestational diabetes, neonatal asphyxia and other factors, the results displayed that HDCP was the factor leading to the death of premature baby (OR=2.159, 95%CI: 1.093-4.266), and comparison between preeclampsia and eclampsia showed no statistical difference (P=0.714, 0.389); HDCP had no significant influence on RDS, BDP, ICH, NEC, ROP and sepsis. Conclusions HDCP leads to increased risk of premature death, but also leads to the increased incidence of RDS and BPD, but it had no obvious effect on NEC, ROP, IVH, sepsis and other complications.

Objective To determ ine the norm al reference values of 33 elem ents, Ag, Al, As, Au, B , B a, Be, Ca, Cd, Co, Cr, Cs, Cu, Fe, G a, H g, Li, Mg, Mn, Mo, N i, Pb, Rb, Sb, Se, Sr, Th, Ti, Tl, U , V , Zn and Zr, in the blood and urine sam ples from the general population in Sanm en County of Zhejiang province, a typical coastal area of eastern China. Methods The 33 elem ents in 272 blood and 300 urine sam ples w ere determ ined by inductively coupled plasm a-m ass spectrom etry (ICP-MS ). The norm ality test of data w as conducted using SPSS 17.0 Statistics.The data w as com pared w ith other reports. Results The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County w ere obtained, w hich of som e elem ents w ere found to be sim ilar w ith other reports, such as Co, Cu, Mn and Sr, w hile As, Cd, H g and Pb w ere generally found to be higher than those previously reported. There w as a w ide variation betw een the reports from different countries in blood B a. Conclusion The norm al reference values of the 33 elem ents in the blood and urine sam ples from the general population in Sanm en County are established, and successfully applied to tw o poisoning cases.

Objective T o determine the normal range of the 33 elements (Li, Be, B, mg, Al, Ca, Ti, V , Cr, mn, Fe, Co, Ni, Cu, Zn, Ga, As, Se, Rb, Sr, Zr, mo, Ag, Cd, Sb, Cs, Ba, Au, Hg, Tl, Pb, Th and U ) in human whole blood of general population in Hunan province. Methods Blood samples were ana-lyzed by inductively coupled plasma-mass spectrometry (ICP-mS ) to determine the normal range. T he influences of district, gender and age to the element content in blood samples were also observed. Re-sults T he normal range of 33 elements in blood samples fromgeneral population in Hunan province were obtained. Gender was shown to statistically influence the concentrations of B, mg, Ca, Ti, mn, Fe, Co, Cu, Zn, As, Se, Rb, Sr, Ag, Cd, Cs, Hg and Pb (P<0.05), while age was shown to influence the concentrations of Co, Ni, Cs and Hg in women (P<0.05) as well as Cu, Se and Hg in men(P<0.05). Conclusion Although there are variables in different districts, the normal ranges of trace element in blood of the four cities in Hunan province are established.

OBJECTIVE: To build up a simple and effective comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. METHOD: One hundred and twenty cases of laryngeal tubor were selected. Using Logistic regression method to analyse relative factors, including weight, height, BMI, neck girth, neck upward degree, upper-lower incisor teeth distance, thyroid-mentum distance, thyroid-sternum distance, Mallampati test, Yamamoto test and Upper lip bite test. Build data-base to construct a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. RESULT: The relative factors of difficult laryngeal exposure were BMI, neck girth, upper-lower incisor teeth distance, neck upward degree, thyroid-mentum distance, Mallampati test and Yamamoto test (P < 0.05). To build up a comprehensive system for predicting difficult laryngeal exposure under suspension laryngoscopy. The predicting standards included the seven relative factors, each factor has 1 score, 2 score, 3 score. Higher score means more risk. Eight score was designed as minimum, under the premise,the sensibility, misdiagnosis rate, missed misdiagnosis rate, specificity of the experiment were 95.5%, 5.3%, 4.5%, 94.7%. CONCLUSION The comprehesive system is an effective method for predicting difficult intubation. It can help to identify difficult cases according to the results of this predicting system.
Anthropometry ; Chin ; Humans ; Intubation, Intratracheal ; methods ; Laryngoscopy ; methods ; Larynx ; Lip ; Neck ; Thyroid Gland