1.Finite element analysis of absorbable screws in Bernese periacetabular osteotomy
Hui CHENG ; Xiaoying MA ; Ningtao REN ; Zhendong ZHANG ; Haigang JIA ; Yong LI ; Jianli ZHANG ; Dianzhong LUO ; Hong ZHANG ; Wei CHAI
Chinese Journal of Orthopaedics 2024;44(6):419-426
Objective:To investigate the stability and feasibility of using absorbable screws during Bernese periacetabular osteotomy.Methods:A retrospective analysis was conducted on a 36 year-old woman diagnosed with developmental dysplasia of the hip, who had undergone Bernese periacetabular osteotomy. Finite element analysis was used to simulate the stability of the acetabulum under loads of 10%, 20%, 50%, and 100% of the patient's weight. The structural stiffness of the pelvis and the maximum equivalent stress on the absorbable screws were observed under different conditions, including whether the acetabular bone block and the ilium were in contact, whether 3 or 4 screws were used, and whether a graft (including fibular cortical bone and PEEK grafts) was used.Results:The structural stiffness of the pelvis fixed with four screws increased by 67%-94% compared to that with three screws. After using a graft, the structural stiffness of the pelvis increased by 50%-83%. As the load increased, the maximum equivalent stress on the screws also increased. When the acetabular bone block and the ilium had no contact, no graft was used, and only three screws were used for fixation, the maximum equivalent stress could reach 518.9 MPa, while this value dropped to 61% when four screws were used (318.7 MPa). When the acetabular bone block and the ilium were in contact, the maximum equivalent stress was about 12% of that when there was no contact, regardless of the number of screws used. When a cortical bone graft or a PEEK graft was used, the maximum equivalent stress could drop to 21%-26% of that without a graft. When the screw strength was 130 MPa, a load of 20% of body weight was applied, and only three screws were used without a graft, the equivalent stress could exceed the strength of the screw; if four screws were used, the equivalent stress was slightly higher than the strength of the screw when a load of 50% of body weight was applied. However, when a graft was used (either cortical bone or PEEK), even when a load of 100% of body weight was applied, the equivalent stress was slightly lower than the strength of the screw.Conclusion:Absorbable screws can provide sufficient stability for Bernese periacetabular osteotomy. The contact between the acetabular bone block and the ilium, an increase in the number of screws, and the use of grafts (cortical bone and PEEK grafts) can further improve stability. Therefore, absorbable screws have broad application prospects in Bernese periacetabular osteotomy.
2.Application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy
Yan CHEN ; Xinrui YE ; Lijie LUO ; Zijing ZHANG ; Wenjun XIONG ; Haigang YANG ; Yaohui PENG ; Zeyu LIN ; Zhuoxuan ZHANG ; Wei WANG
Chinese Journal of Gastrointestinal Surgery 2024;27(10):1074-1079
Objective:To explore the application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy.Methods:Overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance is suitable for patients with advanced gastric cancer (clinical stage: cT1b~4aN0~3M0) and esophageal invasion <3 cm, who underwent radical total gastrectomy+ overlap esophagojejunostomy. The main operation procedure was performed as follows: A titanium clip was used for fixation of the full anterior wall of esophagus before overlap esophagojejunostomy, and the side‐to‐side esophagojejunostomy was performed with the linear stapler under the guidance of gastric tube. Then the titanium clip was removed after confirming that the correct cavity was entered. Finally, the common outlet was closed by two barbed sutures. A descriptive case series study was conducted. The clinical data of patients who underwent laparoscopic radical gastrectomy and overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance in Guangdong Provincial Hospital of Chinese medicine and the First Affiliated Hospital of Guangzhou University of Chinese medicine from May 2021 to June 2023 were retrospectively analyzed.Results:A total of 42 patients were collected, and all of them were successfully completed laparoscopic total radical gastrectomy without conversion to laparotomy or perioperative death. The esophagojejunostomy time, operative time, intraoperative blood loss was 17(5‐25) minutes, (258.8±38.0) minutes and 50(20‐200) ml, respectively. The incidence of esophageal false lumen was 0%, and there were no intraoperative complications. The time of gastric tube removal, initial fluid diet intake and the duration of postoperative hospital were 2(1‐5) , 4(1‐8) and 8(4‐21) days, respectively. There were no postoperative anastomotic hemorrhage, anastomotic stenosis and other related complications. One patient (2.38%) developed a Clavien‐Dindo IIIb complication, which was abdominal hemorrhage after operation. The second surgical exploration confirmed that the patient was bleeding due to gastroduodenal artery rupture. After intraoperative suture hemostasis, fluid expansion, blood transfusion and other treatments, the patient was discharged on the 15th day after the operation. Three patients (7.14%) developed Clavien‐Dindo grade II complications, including anastomotic leakage, chylous leakage and pulmonary infection, and were discharged after conservative treatment such as anti‐infection and prolonged retention of drainage tube.Conclusions:Laparoscopic overlap method for intracorporeal esophagojejunostomy with anterior esophageal wall fixation and gastric tube guidance can shorten the time of esophagojejunostomy and prevent the occurrence of false lumen, and do not increase anastomose‐related complications.
3.Application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy
Yan CHEN ; Xinrui YE ; Lijie LUO ; Zijing ZHANG ; Wenjun XIONG ; Haigang YANG ; Yaohui PENG ; Zeyu LIN ; Zhuoxuan ZHANG ; Wei WANG
Chinese Journal of Gastrointestinal Surgery 2024;27(10):1074-1079
Objective:To explore the application of anterior esophageal wall full layer fixation and gastric tube guidance in total laparoscopic overlap method for intracorporeal esophagojejunostomy.Methods:Overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance is suitable for patients with advanced gastric cancer (clinical stage: cT1b~4aN0~3M0) and esophageal invasion <3 cm, who underwent radical total gastrectomy+ overlap esophagojejunostomy. The main operation procedure was performed as follows: A titanium clip was used for fixation of the full anterior wall of esophagus before overlap esophagojejunostomy, and the side‐to‐side esophagojejunostomy was performed with the linear stapler under the guidance of gastric tube. Then the titanium clip was removed after confirming that the correct cavity was entered. Finally, the common outlet was closed by two barbed sutures. A descriptive case series study was conducted. The clinical data of patients who underwent laparoscopic radical gastrectomy and overlap esophagojejunostomy with anterior esophageal wall full layer fixation and gastric tube guidance in Guangdong Provincial Hospital of Chinese medicine and the First Affiliated Hospital of Guangzhou University of Chinese medicine from May 2021 to June 2023 were retrospectively analyzed.Results:A total of 42 patients were collected, and all of them were successfully completed laparoscopic total radical gastrectomy without conversion to laparotomy or perioperative death. The esophagojejunostomy time, operative time, intraoperative blood loss was 17(5‐25) minutes, (258.8±38.0) minutes and 50(20‐200) ml, respectively. The incidence of esophageal false lumen was 0%, and there were no intraoperative complications. The time of gastric tube removal, initial fluid diet intake and the duration of postoperative hospital were 2(1‐5) , 4(1‐8) and 8(4‐21) days, respectively. There were no postoperative anastomotic hemorrhage, anastomotic stenosis and other related complications. One patient (2.38%) developed a Clavien‐Dindo IIIb complication, which was abdominal hemorrhage after operation. The second surgical exploration confirmed that the patient was bleeding due to gastroduodenal artery rupture. After intraoperative suture hemostasis, fluid expansion, blood transfusion and other treatments, the patient was discharged on the 15th day after the operation. Three patients (7.14%) developed Clavien‐Dindo grade II complications, including anastomotic leakage, chylous leakage and pulmonary infection, and were discharged after conservative treatment such as anti‐infection and prolonged retention of drainage tube.Conclusions:Laparoscopic overlap method for intracorporeal esophagojejunostomy with anterior esophageal wall fixation and gastric tube guidance can shorten the time of esophagojejunostomy and prevent the occurrence of false lumen, and do not increase anastomose‐related complications.
4.Effect of Xiaozhongzhitong Mixture on ischemia-reperfusion injury of rat skin flaps and p38MAPK-PPARγ/NF-κB signaling pathway
Yuan SONG ; Haigang WANG ; Zhijun HE ; Tao LIU ; Xudong LIANG ; Yuanxu HE ; Jiaxuan SHEN ; Tuanzhuang ZHANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2023;44(1):126-134
【Objective】 To observe the effect of Xiaozhongzhitong Mixture on ischemia-reperfusion injury of rat skin flaps and p38MAPK-PPARγ/NF-κB signaling pathway. 【Methods】 After flap operation, the survival of rat back flaps and flap survival rate were observed. HE staining, TUNEL staining, and qRT-PCR were used to detect the degree of nuclear destruction, as well as the distribution characteristics and mRNA expression levels of p38MAPK, PPARγ, and Nf-κB in vascular endothelial cells of rat flaps, respectively. 【Results】 The flap survival area in sham operation group was the largest, and it was the smallest in model control group and PPARγ inhibitor group. HE staining and TUNEL staining results showed that the flap tissue cells of rats in model control group and PPARγ inhibitor group were severely damaged and obvious apoptotic cells were seen. In model group, rats’ skin flap tissue cells were arranged in a single layer, and the nucleus was intact and clear. qRT-PCR experiment results showed that compared with model group, the expressions of p38MAPK and Nf-κb in the flap tissue of rats in Xiaozhong Zhicong Mixture group were inhibited (P<0.05), while the expression of PPARγ was increased (P<0.05). When the blocker was added, the expressions of p38MAPK, NF-κB and PPARγ in the flap tissue were further suppressed. 【Conclusion】 Xiaozhongzhitong Mixture can alleviate the infiltration of inflammatory cells in the rat model of skin flap ischemia-reperfusion injury, reduce inflammation and the production of apoptotic cells, thereby alleviating the ischemia-reperfusion injury of skin flaps and promoting the survival of the flaps. The mechanism may be related to the inhibition of p38MAPK-PPARγ/NF-κB signaling pathway.
5.Bidirectional correlation between daily physical activity and emotional state of undergraduates majoring in sports
JIN Haigang, YANG Zhenhao, ZHANG Xiaodan
Chinese Journal of School Health 2023;44(5):742-746
Objective:
To explore the bidirectional correlation between daily physical activity and different emotional states of university students with sports major, and to provide theoretical basis for promoting equality between physical and mental health of college students.
Methods:
The accelerometer and daily emotion scale were used to evaluate 219 physical education major college students recruited from Tianjin University of Sport. Correlation analysis, intra group correlation coefficient analysis and Harman single factor method were used to test the data, and Mplus 7.4 was used to analyze cross hysteria.
Results:
Physical activity was positively correlated with high arousal/low arousal positive emotion, and negatively correlated with low arousal/high arousal negative emotion ( r=0.94, 0.63, -0.28, -0.17, P <0.05). The cross lag model showed that physical activity on Thursday and Friday positively predicted high arousal positive emotion on Friday and Saturday, and high arousal positive emotion on Thursday and Friday positively predicted physical activity on Friday and Saturday( β =0.91, 0.20; 0.88, 0.39, P <0.05). Low arousal positive emotion on Thursday and Friday was a positive prediction of physical activity on Friday and Saturday, but only physical activity on Thursday positively predicted low arousal positive emotion on Friday( β=0.68, 0.35, 0.70, P <0.05). Low arousal negative emotion on Thursdays and Fridays negatively predicted physical activity on Friand and Saturdays( β=-0.37, -0.40, P <0.05).
Conclusion
There is a bidirectional correlation between daily physical activity and positive emotion, but a weak correlation with negative emotion. Attention should be paid to the emotional benefits of physical activity and the increasing physical activity by greater mood improvements.
6.The observation on the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits
Jianbo LIU ; Wei ZHANG ; He HU ; Jiangang CAO ; Chao LIU ; Zeyu ZHAO ; Haigang YANG ; Jiming CHENG
Chinese Journal of Postgraduates of Medicine 2022;45(8):717-720
Objective:To investigate the effect of prospective intervention on emergence agitation and postoperative recovery in patients with chronic sinusitis during preoperative visits.Methods:A total of 80 patients with chronic sinusitis who underwent general anesthesia in Dayi County People′s Hospital of Chengdu City from December 2019 to October 2020 were selected and randomly divided into group D and group G, with 40 patients in each group. Group D received preoperative visit with conventional methods and group G received preoperative visit with prospective intervention methods. The hemodynamic changes of patients in the two groups at 30 min before the operation (T 1) and 1 (T 2), 5 (T 3), 10 (T 4) and 30 min (T 5) after tracheal tube extraction were recorded. The anxiety and depression scores of patients before the intervention and 1 d after the operation were compared between the two groups. The incidence of emergence agitation after the operation and complications during anesthesia awakening period were observed in the two groups, sino-nasal outcome test-20 (SNOT-20) was used to assess the postoperative recovery. Results:The incidence of emergence agitation in group G was lower than that in group D: 7.5%(3/40) vs. 25.0%(10/40), the difference was statistically significant ( χ2 = 4.50, P<0.05). There was no significant difference in systolic blood pressure, diastolic blood pressure and heart rate between the two groups at T 1 and T 5 ( P>0.05), but the level of above indicators in group G at T 2, T 3 and T 4 were significantly higher than those in group D ( P<0.05). The scores of State-Trait Anxiety Inventory(S-AI) and Self-Rating Depression Scale (SDS) in group G at the first day after the operation were significantly lower than those in group D: (35.45 ± 5.32) scores vs. (39.35 ± 4.91) scores, (35.42 ± 7.82) scores vs. (38.76 ± 5.21) scores, the differences were statistically significant ( P<0.05). The incidence of complications during anesthesia awakening period in group G was slightly lower than that in group D ( P>0.05). After the operation, the scores of sinusitis symptoms and nasal symptoms in the two groups were significantly decreased compared with those before the operation, and the scores of group G were significantly lower than those in group D ( P<0.05). Conclusions:Prospective intervention before anesthesia in patients with chronic sinusitis surgery can reduce stress response, improve bad mood, reduce the incidence of emergence agitation, and promote the postoperative recovery.
7.Research on effective teaching influencing factors of basic courses of medical specialty in military university based on the Pharmacology
Xichun PAN ; Haigang ZHANG ; Rongxin QIN ; Yanyan CEN
Chinese Journal of Medical Education Research 2021;20(3):275-278
The basic course of medical specialty is an important part of medical education. There are few studies on effective teaching of basic courses of medical specialty. Based on the course of Pharmacology, this paper discusses the connotation, influencing factors and strategies of effective teaching of basic courses of medical specialty. The factors influencing the effective teaching of basic courses of medical specialty are multiple, that mainly includes four dimensions: students, teachers, course resources and teaching environment. Strategies to improve teaching effect include strengthening the idea of education, positioning goals hierarchically, optimizing curriculum structure, and innovating education platform.
8.Application of effective teaching theory in the small-class teaching of Pharmacology
Yanyan CEN ; Tao LIU ; Haigang ZHANG ; Xichun PAN
Chinese Journal of Medical Education Research 2021;20(4):448-450
Applying the effective teaching theory to the small-class teaching of pharmacology can improve the flexibility of small-class teaching mode under the guidance of the concept of effective teaching and high efficiency. The course chapters were randomly selected for traditional teaching mode or small-class teaching mode based on effective teaching theory in the same class. Practice has proved that the small-class teaching based on AO-AMFM can enhance student analysis and make careful smart objective and teaching frame work before class, and can also reach prompt activation, multi-learning, effective feedback and multi-summary, which can significantly improve students' learning enthusiasm and learning efficiency.
9.Practice and thinking of the X-BL mixed teaching mode of Pharmacology
Hui TAO ; Yanyan CEN ; Haigang ZHANG ; Ya LIU ; Xichun PAN
Chinese Journal of Medical Education Research 2021;20(6):641-643
Objective:To explore the effect of the X-BL mixed teaching mode on Pharmacology course. Methods:In Pharmacology course of the 2017 pharmacy major of our university, 3 teaching units were randomly selected as the control group while the rest 3 teaching units were selected as the experimental group. Traditional teaching mode was carried out in control group. In the experimental group, we designed a X-BL mixed teaching mode composed of web-based learning (WBL), case-based learning (CBL), and team-based learning (TBL). Teaching effects of the two groups were compared using online unit tests and questionnaires. Test scores were analyzed by SPSS 20.0, and differences between groups were analyzed by t test. Results:The test scores of each unit of the experimental group were significantly higher than those of the control group ( P<0.01), and the low scores were all zeroed. The questionnaires showed that the two groups showed similar learning willingness, but the experimental group students were more satisfied with teaching method, teaching quality, classroom atmosphere, teacher guidance and learning effect than the control group. Conclusion:The X-BL mixed teaching mode, which focused on case teaching and group learning, integrated online and offline teaching, and information teaching, has showed a better teaching effect than traditional teaching in the Pharmacology courses. This teaching mode may have certain promotion value in the future teaching applications.
10.A preliminary study on the diagnostic value of infrared thermography in children with idiopathic thrombocytopenic purpura.
Baohong MI ; Cunguo YU ; Jialin SONG ; Wenxue HONG ; Wenzheng ZHANG ; Yue WANG
Journal of Biomedical Engineering 2020;37(4):652-660
Idiopathic thrombocytopenic purpura (ITP) is a common bloody disease with a high incidence in children, but its diagnostic method is exclusive diagnosis, and the existing detection techniques are mostly invasive, which may cause secondary injury to patients and also may increase the risk of disease. In order to make up for the lack of the detection method, this study made a preliminary exploration on the diagnosis of children's ITP from the perspective of infrared thermography. In this study, a total of 11 healthy children and 22 ITP children's frontal infrared thermal images were collected, and the pattern characteristic (PFD), average temperature (Troi) and maximum temperature (MAX) characteristics of 7 target areas were extracted. The weighted PFD parameters were correlated with the platelet count commonly used in clinical diagnosis, and the sensitivity and specificity of the weighted PFD parameters for children's ITP were calculated through the receiver operating characteristic curve (ROC). The final results showed that the difference of the weighted PFD parameters between healthy children and ITP children was statistically significant, and the parameters negatively correlated with platelet count. Under the ROC curve, the area under the curve (AUC) of this parameter is as high as 92.1%. Based on the research results of this paper, infrared thermography can clearly show the difference between ITP children and healthy children. It is hoped that the methods proposed in this paper can non-invasively and objectively describe the characteristics of ITP infrared thermal imaging of children, and provide a new ideas for ITP diagnosis.
Area Under Curve
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Child
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Humans
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Platelet Count
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Purpura, Thrombocytopenic, Idiopathic
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Thermography


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