OBJECTIVE: Using the mono-energy reconstruction images and X-ray films to investigate whether the ABG Ⅱ short-stem could improve the filling ratio, stability, and alignment in the Dorr type C femur, compared with the Corail long-stem. METHODS: Among patients who were with Dorr type C femurs and treated with total hip arthroplasty between January 2006 and March 2012, 20 patients with a Corail long-stem (Corail group) and 20 patients with an ABG Ⅱ short-stem (ABG Ⅱ group) were randomly selected. The differences in gender, age, body mass index, and preoperative diagnoses between the two groups were not significant ( P>0.05). The ABG Ⅱ group was with a mean follow-up of 142 months (range, 102-156 months), and the Corail group was with a mean follow-up of 107 months (range, 91-127 months). There was no significant difference in the Harris score and subjective satisfaction score between the two groups at last follow-up ( P>0.05). At last follow-up, dual-energy CT scans with mono-energy image reconstruction were used to calculate the prosthetic filling ratio and to measure the alignment of the prosthesis in the coronal and sagittal positions. Stability assessment was performed based on X-ray films, and the subsidence distance was measured using EBRA-FCA software. RESULTS: X-ray film observation showed that the prostheses in the two groups were stable and no signs of loosening was found. The incidence of pedestal sign was significantly lower in the ABGⅡ group than in the Corail group ( P<0.05), and the incidence of heterotopic ossification was significantly higher in the ABGⅡ group than in the Corail group ( P<0.05). The subsidence distance of femoral stem in ABG Ⅱ group was significantly greater than that in Corail group ( P<0.05), and the subsidence speed of femoral stem in ABG Ⅱ group was also greater than that in Corail group, but the difference was not significant ( P>0.05). The overall prosthesis filling ratio was significantly higher in the ABG Ⅱ group than in the Corail group ( P<0.05), while the coronal filling ratio at the lesser trochanter, 2 cm below the lesser trochanter, and 7 cm below the lesser trochanter were not significant ( P>0.05). The results of prosthesis alignment showed that there was no significant difference in the sagittal alignment error value and the incidence of coronal and sagittal alignment error >3° between the two groups ( P>0.05), while the coronal alignment error value in the ABG Ⅱ group was significantly greater than that in the Corail group ( P<0.05). CONCLUSION Although the ABG Ⅱ short-stem avoids the distal-proximal mismatch of the Corail long-stem in the Dorr type C femur and thus achieves a higher filling ratio, it does not appear to achieve better alignment or stability.
Humans ; Arthroplasty, Replacement, Hip/methods* ; Femur/surgery* ; Hip Prosthesis ; Lower Extremity/surgery* ; Prosthesis Design ; Retrospective Studies

Objective To investigate the correlation between TCM syndrome types and solar term of onset in patients with gastric cancer.Methods A total of 359 patients with gastric cancer admitted to the Cancer Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2020 to August 2023 were included in this study,and the frequency distribution method was used to analyze their information such as sex,age,solar term of onset,differentiation,metastasis and TCM syndrome type.The solar term of onset corresponding to the onset date was calculated,and then the association between solar term of onset and TCM syndrome type in gastric cancer was analyzed.The circular distribution method was used to explore the peak of solar term of onset and TCM syndrome type.Results Among the 359 patients with gastric cancer included in this study,male patients were more than female patients(1.69∶1).The age of onset was mainly between 60 and 70 years old(117 cases,32.6%),and male patients(85 cases,72.6%)were more than female patients(32 cases,27.3%)in this age group.The most common TCM syndromes were qi and blood deficiency syndrome(160 cases,44.6%)and phlegm damp condensation syndrome(94 cases,26.2%).The onset of the disease mainly occurred in winter(132 cases,36.8%),and the peaks were light snow(31 cases,23.5%),major cold(25 cases,18.9%),heavy snow(23 cases,17.4%)and the start of winter(22 cases,16.7%).Qi and blood deficiency syndrome and phlegm damp condensation syndrome in patients with gastric cancer were correlated with solar terms and seasons(P<0.05).The 285 patients with gastric cancer were mainly poorly differentiated gastric cancer(175 cases,61.4%),mainly concentrated in winter(66 cases,37.7%).The main route of gastric cancer metastasis is lymph node metastasis,followed by liver and abdominal cavity metastasis.Conclusion Qi and blood deficiency syndrome and phlegm dampness condensation syndrome are common in patients with gastric cancer.The onset time of gastric cancer is mostly in winter,and the syndrome type is significantly correlated with the onset solar term and differentiation degree.

There are still differences in the surgical treatment of children with pulmonary atresia(PA-VSD) with ventricular septal defect. The high rate of postoperative complications and reoperation intervention is still a problem that plagues surgeons. There are few reports on the understanding of the anatomy and physiological functions of MAPCAs. This article systematically reviews and analyzes domestic and foreign literature, and reviews the anatomical classification, surgical management strategies and related complications of PA-VSD patients.

Objective: To investigate the clinical outcomes of selective major aortopulmonary collaterals(MAPCAs) unifocalization and report histopathological findings in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collaterals(PA/VSD/ MAPCAs). Methods: The study enrolled 6 MAPCAs/VSD/PA patients with age ranged from 6 to 96 months and body weight ranged from 5.0 to 23.0 kg. These patients underwent selective MAPCAs unifocalization and primary repairs. Preoperative cardiac catheter, selective arteriography, cardiac CTA and intraoperative pathology were performed to identify different function, anatomic distribution and histopathology of MAPCAs. Results: 6 MAPCAs/VSD/PA patients underwent selective MAPCAs unifocalization and primary repair. No death occurred after operation and at follow-up which lasted for 1 to 20 months. Preoperative cardiac catheter, selective arteriography and intraoperative histopathology demonstrated distribution of functional MAPCAs similar to native pulmonary artery arborization and participating in arterial gas exchange. Functional MAPCAs were classified into elastic arteries according to histopathology. Conclusion There are two histological type of MAPCAs which play different roles. Selective unifocalization to functional MAPCAs which are classified into elastic arteries like native pulmonary artery is a safe and effective treatment approach for PA/VSD/MAPCAs.

A 23-year-old male patient received moxifloxacin, recombinant human interferon α-2b for injection, and lopinavir and ritonavir for 7 days for novel coronavirus pneumonia. There was no abnor-malityof serum potassium. Moxifloxacin was stopped, Qingfei Paidu decoction(清肺排毒汤) was given, and then the patient′s serum potassium began to rise. On day 10 after taking the decoction, laboratory tests showed serum potassium 5.7 mmol/L and the patient was diagnosed with hyperkalemia. Insulin injection 4 U diluted to 5% glucose injection 250 ml was given once by IV infusion, and then the serum potassium decreased to 5.0 mmol/L 6 hours later and 4.6 mmol/L 2 days later. After 5 days, the serum potassium rose again and finally to 5.4 mmol/L on day 17 after taking the decoction. Insulin was given once that day and 2 days later once daily according to the previous method. Then the serum potassium decreased and did not rise again. The patient recovered from novel coronavirus pneumonia and was discharged on day 28 after hospitalization.

A 62-year-old male patient received propacetamol hydrochloride for analgesia, cefuroxime sodium for anti-infection, adenosine cobalamin for nutrition of nerve, and low molecular weight heparin calcium for anticoagulation for burst fracture of the third lumbar vertebra and multiple fractures of transverse process of lumbar spine caused by traffic accident. The patient′s liver function was normal before medication. He underwent the operation under general anesthesia 2 days later. Low molecular weight heparin calcium was stopped before the operation. On day 3 after the operation (on day 5 of medication), the patient developed abdominal distension and pain. The results of laboratory tests showed alanine aminotransferase (ALT) 9 315 U/L, aspartate aminotransferase (AST) 10 760 U/L, gamma glutamyltransferase (γ-GT) 47 U/L, alkaline phosphatase (ALP) 101 U/L, total bilirubin (TBil) 71.3 μmol/L, direct bilirubin (DBil) 48.5 μmol/L, and indirect bilirubin (IBil) 22.8 μmol/L. Drug-induced liver injury was considered. Propacetamol hydrochloride was discontinued and liver-protective drugs were given. The next day, the patient developed yellow staining of his sclera and whole body skin, then followed by confusion, decreased blood oxygen saturation, low blood pressure, and hypoglycemia. The results of reexamination showed ALT 5 975 U/L, AST 3 659 U/L, γ-GT 100 U/L, ALP 141 U/L, TBil 175.2 μmol/L, DBil 101.4 μmol/L, IBil 73.8 μmol/L, and prothrombin time 21.2 s. The patient was diagnosed as acute liver failure. Cefuroxime sodium and adenosine cobalamin were discontinued and symptomatic and supportive treatments such as increasing blood pressure, fluid supplement, and correction of acidosis were given. However, the patient′s condition was not improved. He was transferred to other hospital on the same day. On the 4th day, he died of multiple organ failure.

A 23-year-old male patient received moxifloxacin, recombinant human interferon α-2b for injection, and lopinavir and ritonavir for 7 days for novel coronavirus pneumonia. There was no abnor-malityof serum potassium. Moxifloxacin was stopped, Qingfei Paidu decoction(清肺排毒汤) was given, and then the patient′s serum potassium began to rise. On day 10 after taking the decoction, laboratory tests showed serum potassium 5.7 mmol/L and the patient was diagnosed with hyperkalemia. Insulin injection 4 U diluted to 5% glucose injection 250 ml was given once by IV infusion, and then the serum potassium decreased to 5.0 mmol/L 6 hours later and 4.6 mmol/L 2 days later. After 5 days, the serum potassium rose again and finally to 5.4 mmol/L on day 17 after taking the decoction. Insulin was given once that day and 2 days later once daily according to the previous method. Then the serum potassium decreased and did not rise again. The patient recovered from novel coronavirus pneumonia and was discharged on day 28 after hospitalization.

A 62-year-old male patient received propacetamol hydrochloride for analgesia, cefuroxime sodium for anti-infection, adenosine cobalamin for nutrition of nerve, and low molecular weight heparin calcium for anticoagulation for burst fracture of the third lumbar vertebra and multiple fractures of transverse process of lumbar spine caused by traffic accident. The patient′s liver function was normal before medication. He underwent the operation under general anesthesia 2 days later. Low molecular weight heparin calcium was stopped before the operation. On day 3 after the operation (on day 5 of medication), the patient developed abdominal distension and pain. The results of laboratory tests showed alanine aminotransferase (ALT) 9 315 U/L, aspartate aminotransferase (AST) 10 760 U/L, gamma glutamyltransferase (γ-GT) 47 U/L, alkaline phosphatase (ALP) 101 U/L, total bilirubin (TBil) 71.3 μmol/L, direct bilirubin (DBil) 48.5 μmol/L, and indirect bilirubin (IBil) 22.8 μmol/L. Drug-induced liver injury was considered. Propacetamol hydrochloride was discontinued and liver-protective drugs were given. The next day, the patient developed yellow staining of his sclera and whole body skin, then followed by confusion, decreased blood oxygen saturation, low blood pressure, and hypoglycemia. The results of reexamination showed ALT 5 975 U/L, AST 3 659 U/L, γ-GT 100 U/L, ALP 141 U/L, TBil 175.2 μmol/L, DBil 101.4 μmol/L, IBil 73.8 μmol/L, and prothrombin time 21.2 s. The patient was diagnosed as acute liver failure. Cefuroxime sodium and adenosine cobalamin were discontinued and symptomatic and supportive treatments such as increasing blood pressure, fluid supplement, and correction of acidosis were given. However, the patient′s condition was not improved. He was transferred to other hospital on the same day. On the 4th day, he died of multiple organ failure.

Objective To analyze the clinical characteristics of complete transposition of great arterial with left ventricular outflow tract obstruction(TGA/LVOTO) patients who received arterial switch operation(ASO),and further evaluated the risk factors of postoperative adverse events.Methods Retrospectively evaluated the adverse events(including postoperative mortality,reoperation,aortic valve insufficiency,re-LVOTO and mitral valve insufficiency) and the related risk factors of 39 TGA/LVOTO patients after ASO.Results 39 TGA/LVOTO patients were included,the mean Z value of PV was 0.6,the mean peak LVOT gradient was 31.6 mmHg (1 mmHg =0.133 kPa).The mean follow up time was 15.9 months,during the follow up,1 patient had early mortality,and CPB time(P =0.034) was associated with early mortality;4 patients had early reintervention;15 patients had AVI,and larger PV Z value(P =0.026) was associated with postoperative AVI;7 patients had MVI,and subvalvar level LVOTO(P =0.001) was associated postoperative MVI;6 patients had re-LVOTO,and older age at operation (P =0.029),muhi-level LVOTO (P =0.024) were associated with postoperative re-LVOTO.Conclusion If the obstruction of LVOT can be repaired by surgery,TGA/LVOTO patients had a satisfied prognosis after ASO with relief of LVOTO,the postoperative early mortality was very low,and although the probability of re-LVOTO was increased with time,the long-term reintervention probability was very low.