Objective:To explore and analyze the feasibility and efficacy of the 22G needle-guided suture for orbital septum fat flap fixation on the periosteum.Methods:The retrospective study was conducted. From January 2022 to November 2023, patients with tear trough deformity and eyelid bags underwent surgery of releasing the orbicularis retaining ligament (ORL) complex, orbital septum fat pad combined with 22G needle-guided suture in Department of Burn and Plastic Surgery, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology. Postoperative follow-up was conducted to observe the occurrence of complications. The lacrimal depression deformity was classified according to the Hirmand standard and the degree of lower eyelid bags was graded to evaluate the surgical outcome. Patients were evaluated their satisfaction using the visual analogue scale (very dissatisfied, dissatisfied, average, satisfied, very satisfied).Results:A total of 32 patients (30 females and 2 males) were included in this study. The age range was 31-62 years old with an average of 50.2 years. All patients were followed up for 6 months postoperatively. None of the patients had any severe complications, such as inferior eyelid ectropion, inferior eyelid retraction, scar hyperplasia, and diplopia. Four patients showed mild eyelid-eyeball separation, two patients had conjunctival edema, and all recovered in 1 month. The orbital fat protrusion, tear trough depression deformity, and lower eyelid skin laxity were significantly improved compared to before the operation. Postoperative satisfaction was 22 cases, very satisfied 10 cases, and patient satisfaction rate was 100% (32/32) after surgery.Conclusion:The method of 22G needle-guided suture to fix orbital septum fat pad represents a technically feasible, easy, and suitable for promotion.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective:To explore and analyze the feasibility and efficacy of the 22G needle-guided suture for orbital septum fat flap fixation on the periosteum.Methods:The retrospective study was conducted. From January 2022 to November 2023, patients with tear trough deformity and eyelid bags underwent surgery of releasing the orbicularis retaining ligament (ORL) complex, orbital septum fat pad combined with 22G needle-guided suture in Department of Burn and Plastic Surgery, the First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology. Postoperative follow-up was conducted to observe the occurrence of complications. The lacrimal depression deformity was classified according to the Hirmand standard and the degree of lower eyelid bags was graded to evaluate the surgical outcome. Patients were evaluated their satisfaction using the visual analogue scale (very dissatisfied, dissatisfied, average, satisfied, very satisfied).Results:A total of 32 patients (30 females and 2 males) were included in this study. The age range was 31-62 years old with an average of 50.2 years. All patients were followed up for 6 months postoperatively. None of the patients had any severe complications, such as inferior eyelid ectropion, inferior eyelid retraction, scar hyperplasia, and diplopia. Four patients showed mild eyelid-eyeball separation, two patients had conjunctival edema, and all recovered in 1 month. The orbital fat protrusion, tear trough depression deformity, and lower eyelid skin laxity were significantly improved compared to before the operation. Postoperative satisfaction was 22 cases, very satisfied 10 cases, and patient satisfaction rate was 100% (32/32) after surgery.Conclusion:The method of 22G needle-guided suture to fix orbital septum fat pad represents a technically feasible, easy, and suitable for promotion.

Objective To evaluate the clinical efficacy of stellate ganglion block(SGB)combined with intranasal dexmedetomidine for the treatment of insomnia.Methods A total of 64 patients aged 18 to 75 with insom-nia were randomly assigned to either the experimental group(DS group)or the control group(S group).The S group received SGB treatment for 14 consecutive days,whereas the DS group received an additional intranasal dexmedeto-midine spray at a dose of 100 μg,administered 30 minutes before bedtime on days 1 through 6,in conjunction with SGB.We measured and recorded the Pittsburgh Sleep Quality Index(PSQI),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS)scores,and Psychomotor Vigilance Test(PVT)results for both groups at three time points:baseline(T1),the day after treatment(T2),and one month after treatment(T3).Results Intra-group Com-parison:In both the DS and S groups,PSQI scores and dimensionspecific scores at T2 and T3 were significantly lower compared to T1(P<0.05).SAS and SDS scores in both groups showed a significant reduction at T3 compared to T1 and T2(P<0.05),while PVT results exhibited no significant changes(P>0.05).Inter-group Comparison:The PSQI scores and dimensionspecific scores in the DS group at T2(8.44±2.99)and T3(8.22±2.60)were significantly lower than those in the S group at T2(10.88±2.56)and T3(10.88±2.84)(P<0.05).However,no significant differences were observed in SDS and SAS scores between the DS and S groups at T2 and T3(P>0.05).Conclusion Compared to standalone SGB,the combination of SGB with intranasal dexmedetomidine significantly enhances sleep quality in patients with insomnia,while not impacting their levels of anxiety,depression,or alertness.

Objective:To explore the effect of bidirectional barb absorbable thread in " double ring method" cosmetic surgery for breast ptosis patients.Methods:From June 2016 to September 2019, 85 patients with breast ptosis aged 24-48 (36.28±6.53) years who completed the " double loop method" cosmetic plastic surgery with traditional absorbable sutures were admitted to the Medical Plastic Surgery and Cosmetology Department of Henan University of Science and Technology First Affiliated Hospital New Area as group A. From October 2019 to February 2022, 90 patients with breast ptosis aged 24-50 (35.72±6.43) years who completed the " double loop method" cosmetic plastic surgery with bidirectional barb absorbable thread were selected as group B. The incision suture time and incision healing time were compared between the two groups, and the postoperative incision healing grade, incision scar degree and patient aesthetic satisfaction were compared between the two groups.Results:The incision suture time and incision healing time in group B were (13.78±2.49) min and (7.69±1.27) d, respectively, which were shorter than those in group A (18.23±3.94) min and (10.36±1.78) d ( t=8.98, 11.47, both P<0.05). There was no significant difference in incision healing grade between mild breast ptosis and moderate breast ptosis between the two groups ( P>0.05). There was no significant difference in incision healing grade between the two groups ( P>0.05). There was no significant difference in the degree of incision scar between mild breast ptosis and moderate breast ptosis between the two groups ( P>0.05). The formation rate of superficial scar in group B was 84.44% (76/90), which was higher than 62.35% (53/85) in group A (χ 2=11.01, P<0.05). The formation rates of hyperplastic scar and atrophic scar in group A were 12.22% (11/90) and 3.33% (3/90) respectively, which were lower than 27.06% (23/85) and 10.59% (9/85) in group A (χ 2=4.56, 4.26, both P<0.05). The total aesthetic satisfaction of group B was 93.33% (84/90), which was higher than 81.18% (69/85) in group A (χ 2=5.88, P<0.05). Conclusions:Bidirectional barb absorbable thread can reduce the time of incision suture and incision healing, improve patients′ incision aesthetics and increase the satisfactory rate.

Objective:To compare the effect and biotoxicity of tert-butyl acetate (TBA) and ethyl butyrate (EB) on stone dissolution in vitro.Methods:Ten gallstone samples from patients with multiple gallbladder stones were selected and the cholesterol content was analyzed by HPLC. Stone dissolution tests of TBA and EB were performed on cholesterol gallstone in vitro, and the weight of stone at each time point was recorded, meanwhile, methyl tert-butyl ether (MTBE) was used as the control. The inhibitory effects of MTBE, TBA and EB on proliferation of human normal liver cell line LO2 were analyzed by cell proliferation inhibition assay. Flow cytometry was used to analyze the effects of MTBE, TBA and EB on the early and late apoptosis of LO2 cells, and the changes of reactive oxygen species level in LO2 cells were also analyzed.Results:Of the 10 gallbladder gallstones, 6 were cholesterol gallstones and 4 were non-cholesterol gallstones. Stone dissolution experiment showed that the remaining stones of MTBE, TBA and EB groups were (47.83±3.84)%, (58.12±4.53)% and (75.75±4.61)% 30 minutes later. The remaining stones were (18.38±6.47)%, (33.82±6.22)% and (56.38±3.91)% 90 minutes later. MTBE had the best stone dissolution effect in vitro, the stone dissolution effect of TBA was slightly weaker than MTBE, and the stone dissolution effect of EB was relatively weak in all ( P<0.05). The cell proliferation inhibition experiment showed that the cell viability of the control group, MTBE group and TBA group were (100.00±4.46)%, (96.79±4.32)% and (93.72±3.51)%, respectively, and there were no significant differences among the three groups ( P>0.05). However, the cell viability of EB group (87.57±5.29)% was lower than the above three groups, and the differences were statistically significant ( P<0.001). The early apoptosis and late apoptosis of the control group were (1.67±0.15)% and (1.27±0.06)%, respectively. EB induced early apoptosis (15.90±0.53)% ( P<0.001) and late apoptosis (5.13±0.76)% ( P<0.05). However, MTBE and TBA had no significant effect on cell apoptosis ( P>0.05). Compared with control group, MTBE, TBA and EB all significantly inhibited the level of reactive oxygen species ( P<0.05), and the inhibitory effect of EB was the most obvious. Conclusions:TBA has good stone dissolution effect and biosafety for gallbladder cholesterol stones in vitro, while EB has relatively poor performance. TBA is a potential drug for gallstone dissolution.

Objective To investigate the clinical application and safety of DSA-guided infusion port implantation via internal jugular vein,subclavian vein and axillary vein.Methods A total of 827 patients with malignant tumors,who underwent DSA-guided intravenous infusion port implantation at the Jiangyin Municipal People's Hospital of China between March 28,2016 and June 28,2018,were enrolled in this study.According to the used approach in the port implantation,the patients were divided into internal jugular vein group(group A,n=125),subclavian vein group(group B,n=87),and axillary vein group(group C,n=615).The success rate of puncturing and the incidence of complications were compared between each other among the three groups.Results The success rates of the DSA-guided first-time puncturing in group A,B and C were 98.40％(123/125),94.25％(82/87),and 97.89％(602/615)respectively,the difference was statistically significant(P＜0.05);the success rate of puncturing in group B was lower than that in group C,and among the other groups there was no statistically significant difference(P＞0.05).All patients were followed up for a mean period of(15.56±2.91)months(range of 3-26 months).The overall incidence of postoperative early complications was 3.75％,which in group A was 4.00％(5/125),in group B was 9.20％(8/87),and in group C was 2.93％(18/615),and the incidence of complications in group B was obviously higher than that in group C(P＜0.0167).There was no statistically significant difference in the incidence of various complications between each other among the three groups(P＞0.05).The overall incidence of postoperative long-term complications was 4.72％(39/827),which in group A was 4.80％,in group B was 14.95％,and in group C was 3.25％,and the incidence of complications in group B was strikingly higher than that in group A and group C,the difference was statistically significant(P＜0.05).Comparison of groups for the rates of various complications showed that the incidence of catheter fracture in group B was higher than that in group C,and the clipping syndrome occurred only in group B,the difference was statistically significant(P＜0.0167).There was no significant difference in the incidence of other complications between each other among the three groups(P＞0.05).The abnormal port-taking rate was 1.45％,including 3 patients in group A,7 patients in group B,and 2 patients in group C.The postoperative abnormal port-taking rate in group B was the highest(8.05％),which was significantly different from that in group C(P＜0.0167).Conclusion For intravenous infusion port implantation,axillary vein approach is clinically safe,comfortable,minimally-invasive and highly-efficient method,it is superior to internal jugular vein approach and subclavian vein approach in effectively reducing the incidence of complications and improving the postoperative abnormal port-taking rate of patients.Therefore,this technique can be regarded as a first choice in clinical practice.(J Intervent Radiol,2023,32:1212-1216)

Objective To analyze the CT features in the early stage of asymptomatic active pulmonary tuberculosis (PTB)in adolescence after PTB outbreak.Methods After PTB outbreak in a boarding school of a certain county in northern Jiangsu province,the clinical data, X-ray and CT findings of 47 cases with active PTB were analyzed retrospectively and compared with CT findings after treatment.Results In 47 cases,the incidence of male was higher than that of female,and 27 cases were negative on chest X-ray.The difference of X-ray and CT detection rate in the early stage of active PTB was statistically significant (P<0.001).Of 47 cases,46 patients had pulmonary parenchymal lesions and 1 had pleural effusion on CT.The lesions were found on 58 lobes and 60 lung segments,and 35 cases demonstrate lesions on the upper lobes,22 cases on the lower lobes,1 case on the middle lobe.CT images showed tree-in-bud opacities (68.1%),micronodules (89.4%) and consolidation (21.3%).All of patients got better after antituberculous therapy.Conclusion Active PTB should be considered first when CT scan shows micronodules or tree-in-bud signs in adolescences with PTB exposure.

PURPOSE: Survival of metastatic breast cancer (MBC) patient remains unknown and varies greatly from person to person. Thus, we aimed to construct a nomogram to quantify the survival probability of patients with MBC. MATERIALS AND METHODS: We had included 793 MBC patients and calculated trends of case fatality rate by Kaplan-Meier method and joinpoint regression. Six hundred thirty-four patients with MBC between January 2004 and July 2011 and 159 patients with MBC between August 2011 and July 2013 were assigned to training cohort and internal validation cohort, respectively. We constructed the nomogram based on the results of univariable and multivariable Cox regression analyses in the training cohort and validated the nomogram in the validation cohort. Concordance index and calibration curves were used to assess the effectiveness of nomogram. RESULTS: Case fatality rate of MBC was increasing (annual percentage change [APC], 21.6; 95% confidence interval [CI], 1.0 to 46.3; p < 0.05) in the first 18 months and then decreased (APC, -4.5; 95% CI, -8.2 to -0.7; p < 0.05). Metastasis-free interval, age, metastasis location, and hormone receptor status were independent prognostic factors and were included in the nomogram, which had a concordance index of 0.69 in the training cohort and 0.67 in the validation cohort. Calibration curves indicated good consistency between the two cohorts at 1 and 3 years. CONCLUSION: In conclusion, the fatality risk of MBC was increasing and reached the summit between 13th and 18th month after the detection of MBC. We have developed and validated a nomogram to predict the 1- and 3-year survival probability in MBC.
Breast Neoplasms* ; Breast* ; Calibration ; Cohort Studies ; Humans ; Methods ; Mortality ; Neoplasm Metastasis* ; Nomograms ; Risk Assessment*