Objective:To analyze the clinical efficacy of three-dimensional (3D) navigation-assisted percutaneous sacroiliac screw fixation in the treatment of Tile C1 pelvic fractures.Methods:A total of 12 patients with Tile C1 pelvic fractures who underwent percutaneous sacroiliac screw fixation assisted by 3D navigation in Liuzhou People's Hospital Affiliated to Guangxi Medical University from September 2019 to March 2022 were retrospectively analyzed. There were 8 males and 4 females, aged 43.08±16.93 years (range, 21-72 years). 24 patients with Tile C1 pelvic fractures who underwent fluoroscopy-assisted percutaneous sacroiliac screw internal fixation during the same period were selected as controls by pairing them according to age and sex in a ratio of 1:2. There were 15 males and 9 females, aged 45.75±11.69 years (range, 32-75 years). The operation time, intraoperative blood loss, number of screws, intraoperative fluoroscopy times, guide pin drilling times and pelvic function scores were compared between the two groups. The quality of pelvic fracture reduction was evaluated based on the Matta scoring criteria, the screw cut-out rate was calculated according to the Lonstein evaluation criteria, and the degree of postoperative heterotopic ossification was evaluated according to the Brooker grading system.Results:All patients were followed up for 18.1±4.7 months (range, 12-30 months). In the 3D navigation group, the operation time was 110.67±44.85 min, the number of intraoperative fluoroscopies was 24.42±9.94, and the number of guided needle drilling was 7.33±4.70, which was lower than 145.00±48.51 min, 75.75±29.47, and 13.92±5.78 in the fluoroscopically-assisted group, and the differences were statistically significant ( P<0.05). At the last follow-up, the Majeed pelvic function score of 3D navigation group was 89.08±3.89, and the excellent and good rate was 100% (12/12). The score of fluoroscopy-assisted group was 74.00±10.71, and the excellent and good rate was 79% (19/24). The difference was statistically significant ( χ2=10.23, P<0.001). The excellent and good rate of Matta grading was 92% (11/12) in the 3D navigation group and 79% (19/24) in the fluoroscopic assisted group, showing no significant difference between the two groups ( χ2=2.93, P=0.403). The screw cut-out rate and heterotopic ossification rate in the 3D navigation group were 17% (2/12) and 8% (1/12), which were lower than 71% (17/24) and 13% (3/24) in the fluoroscopy-assisted group, and the differences were statistically significant ( χ2=9.76, P=0.021; χ2=31.71, P<0.001). Conclusion:3D navigation-assisted percutaneous sacroiliac screw fixation for Tile C1 pelvic fractures can reduce the operation time and radiation exposure, improve the postoperative pelvic function, and reduce the incidence of screw cut-out and heterotopic ossification.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Objective:To evaluate the efficacy and safety of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) in the treatment of pseudomyxoma peritonei (PMP).Methods:In this descriptive case series study, we retrospective analyzed the records of PMP patients treated with CRS and HIPEC between January 2013 and June 2023 at Affiliated Cancer Hospital and Institute of Guangzhou Medical University. The inclusion criteria were as follows: (1) Aged 18 to 75 years and nonpregnant women. (2) Histologically confirmed diagnosis of pseudomyxoma peritonei. (3) Karnofsky Performance Scale (KPS)>70. (4) The functions of major organs such as the heart, liver, lungs, and kidneys can tolerate major surgery for long periods of time. (5) No evidence of extra-abdominal metastasis. Patients with extensive intra-abdominal adhesions or severe infectious diseases were excluded. The main outcomes were overall survival (OS) and postoperative major complications. The postoperative major complications were graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (version 5.0). We used the peritoneal cancer index (PCI) score to quantitatively assess the peritoneal metastases and the completeness of cytoreduction (CCR) score at the end of surgery (CCR-0 and CCR-1 considered to be complete CRS).Results:A total of the 186 PMP patients with a median age of 56 (interquartile range extremes (IQRE), 48-64) years were included, 65 (34.9%) males and 121 (65.1%) females. The median peritoneal cancer index (PCI) score was 28 (20-34). Appendiceal origin accounted for 91.4%. Histological types were low grade in 99 patients (53.2%), high grade in 57 patients (30.6%), and 55 patients (29.6%) received complete cytoreduction (CCR-0/1). The median operative duration was 300 (211-430) minutes for all patients. Treatment-related 30-day mortality was 2.7%; 90-day mortality 4.3%; reoperation 1.6%; and severe morbidity 43.0%. Within the entire series, anemia(27.4%), electrolyte disturbance(11.6%), and hypoalbuminemia(7.5%) were the most frequent major complications (grade 3-4). The incidences of gastrointestinal anastomotic leakage, abdominal bleeding, and abdominal infection were 2.2%, 2.2%, and 4.3%, respectively. After a median follow-up of 38.1 (95%CI:31.2-45.1) months, the 5-year OS was 50.3% (95%CI: 40.7%-59.9%) with a median survival time of 66.1 (95%CI: 43.1-89.1) months. The survival analysis showed that patients with pathological low grade, low PCI, and low CCR score had better survival with statistically significant differences (all P<0.05). Further stratified into complete and incomplete CRS subgroups, the 5-year OS of the CCR-0 and CCR-1 subgroups was 88.9% (95%CI: 68.3%-100.0%) and 77.6% (95%CI: 62.7%-92.5%), respectively; and 42.0% (95%CI: 29.5%-54.5%) in the CCR-2/3 subgroup. Conclusions:CRS and HIPEC may result in a long-term survival benefit for PMP patients with acceptable perioperative morbidity and mortality. This strategy, when complete CRS is possible, could significantly prolong survival for strictly selected patients at experienced centers.

Objective:To evaluate the efficacy and safety of lactulose combined with polyethylene glycol for bowel preparation before colonoscopy in patients of different risks.Methods:A total of 208 patients undergoing colonoscopy were enrolled, including 108 high-risk and 100 low-risk patients. The high-risk patients were divided into group A (54 taking lactulose + polyethylene glycol) and group B (54 taking polyethylene glycol), and the low-risk patients were divided into group C (49 taking lactulose + polyethylene glycol) and group D (51 taking polyethylene glycol). The Boston bowel preparation score, cecal intubation time, withdrawal time, the detection rate of colonic polyps and adenoma, and the incidence of adverse reactions were observed.Results:Among the high-risk patients, the Boston bowel preparation score and adenoma detection rate in group A [(6.35±1.15) scores, 46.3%] were significantly higher than those in group B [(5.76±0.89) scores, 22.2%, both P<0.05], and the first defecation interval in group A was significantly shorter than that in group B [(1.20±0.85) h VS (3.29 ± 2.93) h, P<0.05]. There was no significant difference in adequate bowel preparation rate, polyp detection rate, frequency of defecation or incidence of adverse reactions between group A and B. In the low-risk patients, the first defecation interval in group C was significantly shorter than that in group D [(1.65 ± 1.35) h VS (3.42 ± 2.64) h, P<0.05], and the incidence of adverse reactions was significantly lower than that in group D (44.9% VS 64.7%, P<0.05). There was no significant difference in adequate bowel preparation rate, Boston bowel preparation score, adenoma detection rate, polyp detection rate or frequency of defecation between group C and D. Conclusion:For the high-risk patients, the effect of lactulose combined with polyethylene glycol for bowel cleansing is better than that of traditional polyethylene glycol in the improvement of the Boston bowel preparation score, adenoma detection rate, and the first defecation interval. For low-risk patients, lactulose combined with polyethylene glycol regimen has few advantages over traditional polyethylene glycol regimen.

Objective:To investigate the efficacy and safety of different endoscopic treatment strategies for grade Ⅰ-Ⅲ internal hemorrhoids.Methods:Clinical data of 107 internal hemorrhoid patients who received endoscopic sclerotherapy or band ligation in Renmin Hospital of Wuhan University from December 2018 to December 2020 were retrospectively studied. Postoperative adverse events, efficacy, and satisfaction were followed up.Results:Among the 107 patients, there were 45 patients (42.06%) with grade Ⅰ, 55 (52.34%) with grade Ⅱ, and 6 (5.60%) with grade Ⅲ. At the same time, 94.39% (101/107) patients underwent other gastrointestinal endoscopic treatment. The postoperative follow-up time ranged from 3 to 25 months, with a median of 5 months. A total of 84 patients underwent routine endoscopic injection sclerotherapy, and 8 had adverse events after the surgery. The overall effective rate was 97.61% (82/84), and satisfaction rate was 95.24% (80/84). Nine underwent endoscopic foam sclerotherapy, and no postoperative adverse events were observed. The overall effective rate and the satisfaction rate were both 100.00% (9/9). Among the 11 patients undergoing endoscopic band ligation, 2 had adverse events after the surgery. The overall effective rate was 81.82% (9/11), and the satisfaction rate was 72.73% (8/11). Three patients underwent sclerotherapy combined with ligation, and 2 had postoperative adverse events. The overall effective rate was 100.00% (3/3), and the satisfaction rate was 66.67% (2/3). Sclerotherapy was generally superior to ligation in operation cost. Further subgroup analysis for grade Ⅰ-Ⅱ patients showed that for grade Ⅰ patients, sclerotherapy was better than band ligation in the incidence of postoperative pain ( P<0.05), and for grade Ⅱ patients, no statistically significant differences were observed in adverse events, effective rate and satisfaction rate ( P>0.05). Conclusion:Both endoscopic injection sclerotherapy and band ligation for internal hemorrhoids are safe and effective, and may not increase the risk of adverse events when simultaneously completed with other gastrointestinal endoscopic treatment.

Objective To review the clinical features of the patients received massive transfusion (MT) in plastic surgery department.Methods Ten cases were reviewed.The reason of massive transfusion,the type and dosage of transfusion,the reaction of patients were included.For all the patients,consultation of related department preoperatively was necessary.Based on the through and detailed analysis of the patients' condition,necessary blood product should be prepared ahead of operation.During the therapy,adjustment of treatment plan was made from time to time,according to the patient's condition.Therefore efficient and prompt therapeutic result was achieved.Results In all the 10 MT cases suffered from acute blood loss,2 of them were in hemorrhagic shock before administration.Coagulation disorders happened in 2 patients,and recovered after appropriate treatment.RBC,which was 58.3％ of total amount of transfusion,used most commonly;the second was fresh frozen plasma (FFP),which was 38.6％ according to the total amount.All the patients had satisfactory recovery,without hemolysis or any other functional disorder.Conclusions For MT patients in the Department of Plastic Surgery,the main proposes are to restore and maintain an effective circulatory blood volume,while preventing the coagulation disorder.Also,detailed analysis,through consultation and timely adjustment are of great importance for the MT patients.It is also the essential of an effective perioperative management.

BACKGROUND:WIF-1 is a tumor suppressor gene. Promoter hypermethylation causes WIF-1 down-regulationin most tumors. DNA methylation inhibitor can lead to gene demethylation and restore its expression. OBJECTIVE:To observe the differences of tumor pathology and, WIF-1 mRNAand proteinchanges using WIF-1 or 5-aza-2'-deoxycytidine demethylation in animalmodels of osteosarcoma.
METHODS:Murine osteosarcoma models were established and divided into three groups. In the control group, no treatment was given. In the 5-aza-2'-deoxycytidine group, an appropriate amount of 5-aza-2'-deoxycytidine was injected ineach mouse daily. In the WIF-1 group, an appropriate amount of Wnt/β-catenin signal transduction pathway inhibitor WIF-1 was injected in each mouse daily. Seven days after medication, the weight of nude mouse was weighed every 7 days. Short tumor diameter (a) and the long diameter (b) were measured. Therelative tumor volume was calculated. The relative growth rate of tumor was calculated at 7, 14, 21, 28 and 56 days. Four nude mice from ach group were sacrificed by puling the neck at 7, 14, 21, 28 and 56 days after medication. Tumor tissues were stripped and the weight of them was weighed. Pathological analysis of the tumor was conducted. The expression of WIF-1protein and WIF-1 mRNA was detected in osteosarcoma at 56 days after medication in the three groups.
RESULTS AND CONCLUSION:(1) Compared withthe medication and control groups, the weight of nude mice was increased at 7, 14, 21, 28 and 56 days in the treatment group. No significant difference was found between the medication and control groups. (2) The tumor size was significantly smaler in themedication group than in the control group. WIF-1 mRNA and WIF-1 protein expression was increased in the medication group compared with the control group to different degrees. (3) Results suggested that WIF-1 gene promoter methylation is one of the mechanisms of the development of osteosarcoma. Use of WIF-1 or 5-aza-2'-deoxycytidine demethylation can inhibit tumor growth in animal models of osteosarcoma.

OBJECTIVETo investigate the effects of Dragon' s blood extract on proliferation and secret extracellular matrix function of fibroblasts in vitro.

METHODSDragon' s blood was extracted by chloroform, acetoacetic ester, alcohol. Human fibroblast were cultured in vitro in media containing gradient dilutions of Dragon' s blood extracts (0.002, 0.02, 0.2, 2, 20 mg/ml) , which was followed by cell proliferation assessed with MTT assay on 0, 12, 24, 36, 48, 60, 72 h. Under the optimal concentration, the cell growth curves were drawn and the flow cytometry (FCM) was used to determine the changes of cell cycle. On 0, 12, 24, 36, 48, 60, 72 h, the concentration of hyaluronic acid in the supernatant of fibroblast culture was measured by radioimmunoassay.

RESULTS0.2-2 mg/ml Dragon' s blood extracts enhanced the proliferation of fibroblasts in a dose-dependent manner. 2 mg/ml was the optimal dilution of Dragon's blood extract, and it increased the ratio of S cells in cell cycle [(25.80 ± 3.10)%] than control group [(7.50 ± 0.70)%, P < 0.01]. From 12 h to 72 h, in 2 mg/ml Dragon's blood group, concentration of Hyaluronic acid secreted by fibroblasts gradually increased, but were less than control (P < 0.01).

CONCLUSIONSDragon's blood acetoacetic ester extract improved the proliferation of cultured human fibroblasts in vitro, might be beneficial to promote wound healing.

Cell Cycle ; Cell Proliferation ; drug effects ; Culture Media ; chemistry ; Dose-Response Relationship, Drug ; Extracellular Matrix ; Fibroblasts ; cytology ; drug effects ; secretion ; Flow Cytometry ; Humans ; Hyaluronic Acid ; analysis ; secretion ; Plant Extracts ; pharmacology ; Resins, Plant ; Time Factors

Objective To study the construction of training bases for three tumor therapies. Methods Eight training bases in six third-level first-class hospitals with score of technology assessment higher than 90 were investigated. Results There were good hardware in all training bases and qualified teaching staff in six of them. Annual operative quantity of hyperthermia and radioactive particles implantation technology of all training bases were up to the standard , while the coincidence rate of ablation technology was 80%. Besides , quantity of ablation technology and radioactive particles implantation technology trainees participated in during training met the standard, but that of hyperthermia not. There were significant difference in theory and operational test results before and after training (P < 0.01). Conclusions Management system, operative quantity and teaching staff construction need to be improved. Clinical skills training and standardized training assessment should be strengthened in base construction.

Objective To compare the cumulative analgesic effects of electroacupuncture at Sanyinjiao (SP6), Xuanzhong (GB39) and non-acupoint in treating primary dysmenorrhea. Method By adopting a multi-centered randomized controlled study method, 501 patients recruited from Dongzhimen Hospital of Beijing University of Chinese Medicine, China-Japan Friendship Hospital, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Huguosi Hospital of Chinese Medicine of Beijing University of Chinese Medicine and the Outpatient of Shandong University of Traditional Chinese Medicine were randomized into a Sanyinjiao group, a Xuanzhong group, and a non-acupoint group, 167 subjects in each group. The electroacupuncture intervention was applied when dysmenorrhea flared up and the Visual Analogue Scale (VAS) ≥40 mm, with frequency at 2/100 Hz and intensity during patient’s endurance, 30 min each time, once a day, and for successive 3 d. Before the first treatment, 30 min after the first treatment, and respectively prior to the second and third treatment, VAS was used to measure the pain intensity. Meanwhile, the Retrospective Symptom Scale (RSS-COX 2) was investigated before the first treatment, right after the removal of needles for the first treatment, before the second and third treatment. Result The decrease of VAS in Sanyinjiao group was more significant than that in Xuanzhong group and non-acupoint group (MD=﹣2.92 mm, P=0.028; MD=﹣3.47 mm, P=0.009), while there was no significant difference between Xuanzhong group and non-acupoint group (MD=﹣0.56 mm, P=0.674); there were no significant differences in comparing the RSS-COX2 total score among the three groups (P=0.086). Conclusion Sanyinjiao (SP6) can produce a more significant cumulative analgesic effect for primary dysmenorrhea patient than Xuanzhong and non-acupoint, and the effects of Xuanzhong and non-acupoit are equivalent.