Managing three-column injuries in the subaxial cervical spine in patients with prior spinal fusion surgery is complex. Current treatment algorithms generally advocate that an anterioronly approach is adequate for reducible subaxial cervical spine injuries. However, comprehensive studies on cervical trauma in patients with previously fused spines are lacking. We report a case of a 62-year-old male with a history of C4 to C6
anterior cervical spine fusion. The patient sustained a C6–C7 translational injury from a fall. Despite successful intraoperative reduction and anterior instrumentation, instrument failure occurred within a month without further trauma. This complication may be due to increased mechanical load from the fused segments above the injury site. This case underscores the need for customized treatment strategies for patients with prior spinal fusion surgery. Initial circumferential stabilization might be crucial to distribute mechanical loads effectively and prevent instrument failure. Further research is necessary to develop definitive management protocols for these challenging cases.Abstract
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Lasers for Pulmonary Resections
Our goal is to evaluate the effectiveness and safety of lasers compared with mechanical staplers in pulmonary resections using a qualitative and systematic manner. Laser technique is effective in pulmonary resections among patients with pulmonary disease. However, systematic review of this technique need to be made toascertain its key role in thoracosurgery domain. For randomized controlled trials (RCTs) published in Medline, Web of Science, Cochrane Controlled Trials Register (CCTR), and clinical trial databases from June 1979 to October 2022, we identified and synthesized three studes to compare the efficacy and safety of lasers and mechanical staplers in pulmonary resections based on selection criteria. Two reviewers independently assessed trial bias and extracted data to make a using a qualitative systematic review. The three RCTs were obtained using surgery approach of
video-assisted thoracoscopic surgery (VATS). The operating time of the laser group was longer than that of the staple group in Marulli study (WMD = 12.00 min, 95% CI -11.66 to 35.66 for McKenna, WMD = 39.00 min, 95% CI 21.82 to 56.18 for Marulli and WMD = 2.00 min, 95% CI -15.10 to 19.10 for Scanagatta), while the hospital stay of the laser group was comparative with that of the staple group (WMD = -2.00d, 95% CI -7.36 to 3.36 for McKenna, WMD = -3.00d, 95% CI -6.29 to 0.29 for Marulli and WMD = 0.00d 95% CI -1.69 to 1.69 for Scanagatta). Risk ratio (95%CI), expressed as the persistent air leaks of the laser group vs the staple group, was RR = 0.68 (95%CI 0.38 to 1.22) for McKenna, RR = 0.67 (95%CI 0.12 to 3.61) for Marulli, RR = 1.07 (95%CI 0.53 to 2.16) for Scanagatta, respectively and expressed as pneumothorax, RR = 7.09 (95%CI 0.90 to 55.95) for McKenna, RR = 0.33 (95%CI 0.01 to 7.76) for Marulli, RR = 6.28 (95%CI 0.34 to 117.39) for Scanagatta, respectively. At the 6th month follow-up, the mean postoperative forced expiratory volume in 1 second of the staple group was significantly improved compared with that of the laser group. The clinical symptoms and dyspnea index were improved by more than one grade 8 of 33 (24%) patients in the laser group and 26 of 39 (66%) patients in the staple group (p = 0.003). The lasers are effective and comparable with mechanical stapler technique in pulmonary resections except for the improved for dyspnea index.Abstract
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The aim of this study was to investigate the effect of miR-135a/BACH1/GATA3 signaling on the proliferation, apoptosis, invasion, and migration of gastric cancer cells. Sixty specimens of cancer tissues and sixty specimens of corresponding adjacent tissues in gastric cancer patients were collected. qPCR and immunohistochemistry were used to detect the expression levels of miR-135a, BACH1 and GATA3 in cancer tissues and adjacent tissues. miR-135a inhibitor, miR-141 mimic, BACH1 inhibitor and GATA3 inhibitor carriers were established. Cell proliferation was detected by CCK8, the invasion ability of cells in vitro was evaluated by MTT, and the cell apoptosis of each group was detected by flow cytometry. The results of RT-PCR showed that the expression levels of miR-135a in gastric cancer tissues were significantly higher than those in adjacent tissues, while the expression levels of BACH1 and GATA3 in gastric tissues were significantly lower than those in adjacent tissues (P<0.05). Interfering with miR-135a increased both BACH1 and GATA3 expression levels; overexpression of miR-135a significantly reduced BACH1 and GATA3 expression levels. Interference with BACH1 and GATA3 significantly enhanced the proliferative capacity of gastric cancer cells. Overexpression of miR-135a significantly increased apoptosis, whereas interference with BACH1 and GATA3 increased apoptosis. miR-135a participates in the development of gastric cancer by regulating gastric cancer cell proliferation and apoptosis by targeting BACH1 and GATA3.Abstract
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Direct Anterior Approach (DAA) is a nervous muscle space approach, which theoretically does not damage muscles and nerves, with less intraoperative bleeding, quick postoperative recovery and low dislocation rates and without contraindicated positions. It is considered as a truly minimally invasive approach for hip arthroplasty. 134 elderly patients with intertrochanteric fractures hospitalized from February 2019 to August 2023 were chosen for hip arthroplasty using DAA, including 70 women and 64 men aged 70-94, with an average age of 79.40 ± 4.80. The incision length for hip replacement surgery was 10.14 ± 2.34 cm in length, the duration of surgery was 74.72 ± 12.54 min, intraoperative blood loss was 125.27±17.29 ml, the volume of postoperative drainage fluid was 122.43± 163.45 ml, the time of postoperative ambulation was 1.41±0.65 d, and the Harris hip score at six months after surgery was 93.57±4.85 points. There were three patients who experienced local numbness in the lateral thigh and no patients that suffered dislocations. Hip replacement for elderly patients with intertrochanteric fractures using DAA causes less damage to soft tissues with low complications, and contributes to early-stage functional exercise. It is a reliable minimally invasive therapy.Abstract
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To compare the efficacy of percutaneous transhepatic biliary drainage (PTCD) combined with local litholytic therapy versus endoscopic retrograde cholangiopancreatography (ERCP) alone for treating intrahepatic bile duct stones. A retrospective study of 160 patients divided into joint group (JG, n=80; PTCD with litholytic therapy) and ERCP group (EG, n=80). Parameters compared included surgical metrics, short-term efficacy indicators, liver function tests, inflammatory markers, complications, and recurrence rates. The JG showed significantly shorter operative times, less blood loss, shorter hospital stays, lower costs, and faster recovery than the EG (all P<.05). At 3 months postoperatively, liver function indicators (TBIL, ALT, AST, ALP) and inflammatory markers (CRP, PCT) were significantly improved in the JG compared to the EG. Perioperative complication rates (7.5% vs. 18.75%) and 12-month recurrence rates (7.5% vs. 18.8%) were lower in the JG (P=.035). Combined PTCD with local litholytic therapy offers advantages over ERCP alone, including reduced trauma, faster recovery, improved liver function, and lower complication and recurrence rates.Abstract
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Patient satisfaction significantly influences healthcare outcomes, including compliance and loyalty, particularly in competitive private healthcare markets. While extensively studied in chronic care, patient satisfaction in emergency abdominal surgeries remains underexplored. This study investigates factors influencing patient experience and satisfaction following emergency abdominal procedures and identifying key influencing factors. A prospective observational study was conducted on adult patients who underwent emergency abdominal surgeries at Dr. Sulaiman Al-Habib, Al-Suwaidi Hospital. Data were collected within seven days post-discharge using validated Patient-Reported Experience Measures (PREMs). Statistical analysis included the Mann-Whitney U test and multivariable linear regression. Among 102 patients, higher satisfaction was associated with pain control, sufficient information, effective communication, assistance at mealtimes, adequate nurse staffing, and confidence in nursing care. Multivariable analysis indicated that lack of threatening behavior (B = 1.33, p = 0.001), emotional support from staff (B = 1.36, p = 0.002), and timely responses to questions by nurses (B = 1.32, p = 0.002) were independently linked to higher satisfaction. Effective pain management, empathetic care, and timely communication are pivotal to enhancing satisfaction in emergency surgeries. Future research should validate these findings and refine strategies for improving patient experience.Abstract
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The purpose of this study was to summarize the knowledge structure of pulmonary ultrasound through bibliometric analysis, and to discuss potential research trends and priorities. Publications related to pulmonary ultrasound were selected from the Science Core Collection website before March 2, 2023. Use VOSviewer(version 1.6.18), CiteSpace(version 6.1.3), and Rstudio's free online platforms (http://bibliometric.com) for co-write, co-cite, and co occurrence analysis of countries, institutions, authors, references, and keywords in the field. And the visual analysis is carried out. A total of 1057 papers were included. Since 2013, research papers based on lung ultrasound have increased. In terms of published articles, Italy has contributed the most in this area. The institutions and authors we think have been most productive are the University of Milan and Luna Gargani. The top three journals with the most published articles are the 《JOURNAL OF ULTRASOUND IN MEDICINE》, 《DIAGNOSTICS》 and 《PEDIATRIC PULMONOLOGY》. According to the results of literature and keyword analysis, "covid-19", "SARS-CoV-2", "PoCUS", "deep learning" and "lung ultrasound score" have been identified as the main research directions in the future. Pulmonary ultrasound is in the stage of vigorous development and has a broad prospect. The development of pulmonary ultrasound will be the focus of future research.Abstract
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Chlorogenic acid, a natural polyphenol found abundantly in plants like honeysuckle and eucommia, possesses broad-spectrum antimicrobial properties with complex mechanisms. Its efficacy in combating biofilms formed by pathogenic bacteria during Prosthetic Joint Infection (PJI) warrants further investigation. This study aimed to establish an in vitro model of PJI, extract RNA eluate samples treated with specific concentrations of chlorogenic acid, perform eno gene detection via PCR, and assess chlorogenic acid's ability to disrupt biofilms formed by PJI pathogens by analyzing detection rates and efficiency. Five common PJI pathogens were cultured at 37°C in monoclonal TSB broth. Glass slides were incubated in a shaker at 37°C for 48 hours to simulate biofilm formation. Samples were divided into distilled water control and chlorogenic acid treatment groups. RNA eluates were extracted using ultrasonic disruption and subjected to eno gene PCR testing. Differences in eno gene detection rates and efficiency between the groups were analyzed. In the distilled water control group, eno gene detection rate was 44.4% with 53.8% accuracy. In the chlorogenic acid group, eno gene detection rate increased to 66.6% with 73.3% accuracy. Chlorogenic acid treatment significantly improved detection rates and efficiency. Compared to the control, chlorogenic acid-treated samples consistently showed robust positive results less prone to confusion or interference. Biofilm formation by pathogenic bacteria closely correlates with PJI development, influencing the detection of specific eno genes. Chlorogenic acid effectively disrupts PJI pathogen biofilms, markedly enhancing eno gene detection rates and accuracy. Post-treatment, positive results demonstrate strong and reliable outcomes less susceptible to interference.Abstract
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Online video-hosting platforms are important sources of information for various fields. Surgical trainees are actively using YouTube as an adjunct to their training. In this study, we assessed the accuracy of the information available on laparoscopic splenectomy, in regard to quality, medical accuracy, and feasibility as a surgical training tool. On March 23, 2022, YouTube was searched using the keyword ‘laparoscopic splenectomy.’ The video quality was scored using an authordeveloped arbitrary scoring system. Videos were classified as private practice (PP), secondary hospital (SH) and academic institution (AI). Of 100 videos selected, 34 were excluded, and 66 were included in the study. Of the 66 videos, 4 (6.1%) were classified as good, 51 (77.3%) as moderate, and 11 (16.7%) as poor. The mean views, likes, and dislikes did not show any significant differences among the three groups. Videos in the good and moderate groups were significantly longer than those in the poor group. More videos were uploaded from PP than SH or AI [45 (68.2%) vs 5 (7.6%) from SH vs 16 (24.2%) from AI]. The mean score of AI videos were significantly higher than that of PP or SH videos (AI 11.7 ± 0.5 vs PP 10.2 ± 0.4, P=0.034, AI 11.7 ± 0.5 vs SH 8.2 ± 0.9, P=0.004). AI videos had higher educational value than PP or SH videos, but this difference was not recognized by viewers. AI videos can be referred to by surgical trainees as adjuncts to the training program.Abstract
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Intravenous leiomyomatosis invasion of the inferior vena cava is a rare disease, and there are no guidelines for the diagnosis and treatment of this disease. This study reported the diagnosis and treatment process of a case of intravenous leiomyomatosis invading the inferior vena cava, which provides clinical reference experience for the diagnosis and treatment of IVL. A 59-year-old woman, because of "physical examination found inferior vena cava thrombosis one month" admitted to hospital, 4 years before left ovarian+right fallopian tube+myomectomy, after admission line chest and abdominal enhanced CT prompt: inferior vena cava vein (renal vein level) filling defect, the following lumen and branches without visible, considering thrombus or tumor thrombus formation, the cervix left visible 1 about 8cm diameter fat density mass, enhanced scanning period is not strengthening. A multidisciplinary team performed laparotomy+resection of intravena cava tumor+total hysterectomy+right oophorectomy+repair of inferior vena cava and left iliac vein. Postoperative pathology suggested: spindle cell tumor, leiomyomatosis. IVL is a special type of benign tumor in the mesoderm lobe.Surgical resection is the main mode of treatment. Intravenous vascular leiomyoma onset is insidious, lack of clinical manifestations of specificity, and easy to misdiagnosis and miss diagnosis. Accurate preoperative evaluation, multidisciplinary team cooperation, and appropriate surgical plan are the important factors for obtaining the best treatment results. The possibility of leiomyoma in the vein should be considered in female patients with uterine fibroids combined with pelvic compression, venous return dysfunction and right heart insufficiency.Abstract
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The purpose of this study was to investigate the safety and clinical effectiveness of endoscopic unilateral laminectomy with bilateral decompression (END-ULBD) in patients with adjacent segment disease (ASD) after lumbar fusion. We conducted a retrospective study and collected data on 9 patients with adjacent segment disease (ASD) after lumbar fusion who were hospitalized in our hospital from January 2021 to January 2022. All 9 patients, aged 54 to 77 years, received Endo-ULBD treatment, with an average age of 59.2±3.6 years. The ASD segments are L2/3 segment 1, L3/4 segment 5, and L5/S1 segment 3. The operation time and blood loss were recorded intraoperatively. For analysis, the visual analog scale (VAS), Oswestry Disability Index (ODI), and modified MacNab Lower Extremity Pain Criteria score were recorded at the last follow-up visit. The surgery was successful in 9 patients. There was no neurological injury or dural rupture resulting in cerebrospinal fluid leakage. The average operation time was (90.25±118.0) minutes, the average blood loss was (35.3±5.3) ml, and the average hospitalization time was (14.4±2.1) days. The results also showed that ODI and VAS scores decreased significantly 1 week after surgery. All indicators were statistically improved 1 month after surgery (p<0.05). There was no statistically significant difference in ODI and VAS scores 1 month and 3 months after surgery. At the final follow-up, according to the modified MacNab criteria, 7 cases had excellent curative effect and 2 cases had good curative effect. In clinical practice, we found that Endod-Ulbd can be combined with a single portal vein endoscopy for ASD patients with bilateral lower limb symptoms after lumbar fusion, providing a new option for patients.Abstract
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The COVID-19 pandemic has created significant effects both psychologically and physiologically around the world. Since obesity causes respiratory disorders, psychological disorders, and comorbidities, obese individuals are at higher risk for complications of the COVID-19 virus. The aim of this study is to compare the physiological and psychological effects against COVID 19 infection between patients who underwent BS during the pandemic period and patients who did not. A total of 307 participants were included in this study. The COVID-19 Psychological Distress Scale and a survey consisting of 40 questions were administered to the participants. Patients were divided into two groups: those who underwent bariatric surgery (Group BS) and those who did not undergo surgery (Group NBS). Data were analyzed using SPSS (Statistical Package for Social Sciences). In this study, it was found that bariatric surgery significantly reduced the severity of physiological and psychological symptoms associated with Covid 19 (p=0.00). It was also seen to reduce the presence of obesity-related diabetes, hypertension, sleep apnea, asthma and insulin resistance. The use of vitamin D, vitamin C, multivitamin, protein powder, iron, vitamin B12 and zinc was found to be statistically significantly higher in patients who underwent bariatric surgery (p<0.05). According to the results of this study, the bariatric surgery group has a lower risk of physiological and psychological symptoms against the COVID-19 virus compared to the non-surgery group, thanks to the management of chronic diseases and improvement of some psychological symptoms.ABSTRACT
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The relationship between surgery and gut microbiota has recently attracted attention, however changes of gut microbiota and the composition are still unclear. The aim of this study was to investigate altered gut microbiota in patients with colorectal cancer in perioperative period. This prospective, single-center, observational cohort study included 48 patients with colorectal cancer who underwent radical surgery at the Oita University Hospital. Stool samples were collected on the day of and 2 days before surgery, and on postoperative days 1, 3, 7, and after 1 month and 1 year. The primary endpoint of this study was to elucidate gut microbiota composition using 16S rRNA gene sequencing, and the secondary endpoint was to elucidate its association with surgical outcomes. Forty-eight patients were enrolled over a 2-year period from November 2016 to October 2018. Diversity of the gut microbiota decreased to approximately 30% of the preoperative level on the third postoperative day. It recovered to 60% of the preoperative state in the first month and to 80% in the first year. The preoperative gut microbiota was dominated by commensal bacteria (26%), whereas on the first postoperative day, the proportion of facultative anaerobes (46%) increased. Significant differences were not observed between the changes in the gut microbiota and any surgical outcomes. Among gut microbiota composition, facultative anaerobes changed to dominant during the perioperative period of colorectal cancer surgery. The results would provide microbial approaches to maintain gut microbiota composition in practice.ABSTRACT
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Laryngotracheobronchial endoscopy techniques and equipment have rapidly advanced since the mid 1800's. Techniques and equipment continue to evolve as do the endoscopists. Older rigid equipment and endoscopy techniques have been rapidly replaced by the current modern flexible and video equipment training programs. Historically, sitting bronchoscopy has been utilized in both diagnostic and treatment situations. Upright positioning was more common when rigid bronchoscopy was the only option. As with many medical advances, older diagnostic and therapeutic techniques frequently are discarded and forgotten. Modifications in equipment have greatly reduced both the need for rigid and the need for the sitting position bronchoscopy. However, sitting or upright bronchoscopy utilization, usually flexible, continues on a limited basis at this time.
Abstract
The effect of perioperative antibiotics on postoperative infection (PI) in laparoscopic cholecystectomy (LC) remains unclear. This study aimed to assess the effectiveness of prophylactic antibiotics in preventing postoperative infection and to identify related risk factors. This retrospective study included 464 patients who underwent LC. Patients were divided into the antibiotic group (260 patients, received cephalosporins after anesthesia induction) and the no-antibiotic group (204 patients). Demographic data and infection rates were compared using chi-squared and t-tests, and binary logistic regression was applied to identify risk factors, with results presented as Odds Ratios and Confidence Intervals. The overall PI rate was 2.4% (11 of 464 patients), with no statistically significant difference between the antibiotic group (2.0%, 5 of 260 patients) and the noantibiotic group (3.0%, 6 of 204 patients; P-value = 0.474). Risk factors significantly associated with PI included advanced age (P = 0.001), low albumin levels (P = 0.010), long hospital stay (P < 0.001), and prolonged operation time (P = 0.002). Logistic regression analysis revealed that advanced age (odds ratios = 1.08, 95% confidence intervals: 1.00-1.16)and extended hospital stay (odds ratios = 1.33, 95% confidence intervals: 1.14-1.56) significantly increased the risk of postoperative infection. Routine prophylactic antibiotics may not be necessary for all patients undergoing LC; however, older patients and those with extended hospitalizations should be carefully evaluated, as they may be at higher infection risk. Further prospective studies are warranted to confirm these findings and optimize antibiotic use in this context.Abstract
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Male breast cancer is a sporadic disease and only one in every 100 new breast cancer patients is male. There are few satisfactory clinical studies on male breast cancers in the literature. We aim to share the clinicopathologic and demographic characteristics of male breast cancer patients admitted to our clinic in the last 12 years and our experience in the treatment of these patients. The data of patients who were referred to our clinic with a diagnosis of breast cancer, suspicion of breast cancer, or who presented to our outpatient clinic with symptoms of breast discharge, palpable mass in the breast and were diagnosed with breast malignancy or suspicion of malignancy between 2010 and 2022 were retrospectively evaluated from the data bank records of our hospital. 28 patients were included in the study. Patients' clinical and pathologic data, treatment options, approach to the axilla, pathology results, and survival were evaluated. There were 28 patients in the research. 22 had mastectomies. No surgical intervention was carried out for the five patients who had metastases. One of these patients died during follow-up due to advanced comorbidities and metastatic disease. Another patient declined surgery following neoadjuvant chemotherapy and passed away during follow-up (ex). The third patient passed away during neoadjuvant chemotherapy, and two patients are still undergoing neoadjuvant treatment. Male breast cancers are rare diseases. RT after mastectomy increases survival in male patients as well as in female patients. However, RT in male patients is not standardized today. In our study, 15 patients received adjuvant RT.Abstract:
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While a potential connection between epilepsy and frailty has been proposed in past research, the causal nature of this relationship requires additional study. This research was designed to evaluate the bidirectional causality between epilepsy and frailty index (FI) through two-sample Mendelian randomization (MR). In this study, we applied genome-wide association studies (GWAS) to perform forward and reverse MR within a two-sample context to explore the potential bidirectional causality between FI and epilepsy. The main analysis approach was the inverse variance weighted (IVW), used to assess the potential influence of causal relationships and to carry out sensitivity checks. MR analysis has revealed a positive correlation between FI and the heightened risk of epilepsy (ORIVW = 1.2126, 95% CI: 1.0143-1.4497, P = 0.0343). This correlation persists in MR analysis that excluded aberrant single nucleotide polymorphisms (SNPs)(ORIVW = 1.1862, 95% CI: 1.0236-1.3746, P = 0.0232). Reverse MR analysis corroborated a significant positive relationship between epilepsy and FI (ORIVW =1.0896, 95% CI: 1.0242-1.1592, P = 0.0066), which was confirmed in subsequent replication analysis (ORIVW =1.0975, 95% CI: 1.0532-1.1436, P = 9.69e-06). Sensitivity analysis further supported the hypothesis of a causal link between FI and epilepsy. There is an evident bidirectional causal relationship between FI and epilepsy.Abstract
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To investigate the clinical effect of internal fixation combined with anterior ligament repair of lower tibiofibular syndesmosis in the treatment of ankle fracture with lower tibiofibular syndesmosis injury. From November 2017 to December 2021, 94 patients with ankle fracture and lower tibiofibular syndesmosis injury were selected as the research objects. According to the random number table generated by statistical software, the patients with ankle fracture and lower tibiofibular syndesmosis injury were divided into combined group and control group, with 47 cases in each group. The patients in the combined group were treated with internal fixation combined with anterior ligament repair of lower tibiofibular syndesmosis, while the patients in the control group were treated with internal fixation combined with lower tibiofibular syndesmosis fixation. The operation time, bleeding volume, hospitalization time and fracture healing time of the two groups were compared. The operation time of the combined group was longer than that of the control group (P<0.05). The amount of bleeding, hospitalization time and fracture healing time of the two groups were compared and analyzed (P>0.05). The parameters of the lower tibiofibular space and the parameters of the lower tibiofibular overlap were compared between the combined group and the control group before operation, 3 months and 6 months after operation. The parameters of the lower tibiofibular space in the combined group were lower than those in the control group at 3 months and 6 months after operation, and the parameters of the lower tibiofibular overlap at 3 months after operation were higher than those in the control group (P<0.05) Internal fixation combined with anterior ligament repair of lower tibiofibular syndesmosis in the treatment of ankle fracture with lower tibiofibular syndesmosis injury. Although the operation time is prolonged, it has a considerable effect on improving the reduction effect, promoting the recovery of joint function and reducing surgical complications.Abstract:
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To observe the effect of dexamethasone complex ropivacaine on reducing lateral side pain in patients undergoing total hip arthroplasty. 120 patients aged 45 to 75 years who were proposed to undergo unilateral total hip replacement, ASA ∼grade, and L2-3Gap for puncture. The 120 patients were randomly divided into four groups of 30 each. In group A, 5 μ g sufentanyl injection was injected before lumbar anesthesia; in the other three groups; in group 1, ropivacaine and saline in group B; dexmedetomidine combined with ropivacaine in group C; dexamethasone plus ropivacaine in group D. After entering the operating room, electrocardiogram and pulse oxygen saturation were routinely monitored (SpO2), Invasive mean arterial pressure (MAP), heart rate (HR), and pain visual analogue score (VAS). Monitoring and recorded into the operating room (T0), The iliac fascia lacuna block or vein, 5min after administration (T1), 10min after iliac fascia space block (T2), 15min after iliac fasspace block (T3, When SA changes the body position) of HR, SpO2, MAP, and VAS score values. The operation duration, anesthesia operation duration, intraoperative bleeding volume, patient anesthesia satisfaction, adverse reactions of hypotension, bradycardia, chills and nausea and vomiting, and the number of postoperative intravenous analgesia pump dosage presses were recorded. Sex, age, height, weight, and bleeding conditions (P> 0.05).(1) Comparison of the hemodynamic changes between the groups: in T2The fluctuations in heart rate and arterial blood pressure in group D (10min after dose) were smaller than those of the other three groups, with statistically significant differences (P <0.05); in T3The arterial blood pressure and heart rate fluctuations in groups B, C and D were smaller than those in group A, with A statistically significant difference (P <0.05).(2) Comparison of VAS scores: change within ①group: four groups of patients, T2, T3Time points with T0 Significant changes in VAS scores were statistically significant (P <0.05); where D group T1Time point VAS score with T0Comparison, statistically significant (P <0.05); change between ②groups: Group D compared to groups A, B and C in T1The changes in VAS scores were statistically different (P <0.05); compared with group A, groups B and C were in T1The difference in VAS score change at time points was not statistically significant (P> 0.05); in T2, T3VAS scores, but in groups B, C and D, were statistically lower (P <0.05); (3) Comparison of intraoperative complications: the incidence of hypotension, bradycardia, nausea and vomiting, and local anesthetic poisoning (P> 0.05). In groups C and D, the number of postoperative analgesic pump dosage presses was significantly less than that in groups A and B, with a significant difference (P <0.05). Ultrasound-guided dexamethasone compound ropivacaine iliac cia space block can significantly reduce the pain caused by lateral lumbar anesthesia in total hip replacement surgery, and facilitate the hemodynamic stability of patient, better patient comfort and higher satisfaction with anesthesia. Combined dexmedetomidine and dexamethasone had better postoperative analgesia and less opioid use in the analgesic pump. Compared with the dexamethasone compound ropivacaine group, the nerve block was faster and patients were more satisfied with anesthesia, which was conducive to postoperative rehabilitation and worthy of clinical promotion and application.Abstract:
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The incidence of double primary malignancies is very low, particularly, a case of synchronous carcinomas of the ipsilateral breast and lung. Determining whether to have a one-stage operation for ipsilateral breast cancer and lung cancer is a challenge for the surgeon. The current study presents a case of a 56-year-old female, with a rigid textured mass measuring approximately 18×20 mm above the areola of the right breast and chest CT showing a mass of 20 × 14 mm at the tip segment of right upper lobe of the lung. A diagnosis of a synchronous dual primary carcinoma of the right lung (cT1N0M0) and right breast (cT1N0M0) was made. The patient underwent a right breast-conserving surgery, sentinel node biopsy, and right upper lobectomy and lymphadenectomy with a video-assisted thoracoscopic technique simultaneously. To our knowledge, in the previous literature, there was no one-stage operation for ipsilateral, synchronous carcinomas of the breast and lung and only one reported case with left breast and right lung cancer underwent a one-stage operation. This report first presents the successful treatment of a case with synchronous primary breast and lung carcinomas on the same side of the body with a one-stage operation and therefore is educational.Abstract
Objective: Presenting our experience with chondrocutaenous flap reconstruction of the ear to obtain more aesthetic results with fewer complications. Background: Satisfactory reconstruction of the ear following a resection of the helix, scapha and anti-helix remains an ongoing problem in plastic surgery. Many techniques had been developed to approach this issue and to minimise the complications raised from resection of tumours as well. However, no studies have yet mentioned specific details of aesthetic outcomes. Methodology: The study is retrospective in design, with accurate description of the ear reconstruction technique and outcomes in series of cases that were performed by the same surgeon on all patients. Twenty patients were included in this study. The collected data included demographics, any post-operative complications, and post-operative measurements of both reconstructed and normal ears. Results: In all cases, all tumours were completely excised with no known post-operative complications such as flap loss, wound infection, dehiscence or haematoma were reported. The mean residual defect was 21.8 mm ranging from 14 mm to maximum of 30 mm in size. The differences in height, width and projection carried the means of 6.8, 4.3 and 3.8 mm respectively. Conclusion: The modified Antia-Buch technique allows preservation of anatomical landmarks and contour of the ear and therefore maintaining normal overall three-dimensional appearance of the reconstructed ear. Reconstruction of 10 mm defects can be confidently performed using this technique with no loss in size. However, due to the potential lobule distortion, we recommend applying this technique to defects only up to 25 mm.Abstract
Objectives: Fragment removal and internal fixation are the principle treatments for Pipkin type I femoral head fractures. The aim of this study was to compare, using a finite-element method, changes in stress on the femoral head after two different operation types. Materials and Methods: A three-dimensional finite-element model of a Pipkin type I femoral head fracture was generated with MIMICS and ABAQUS software. A three-dimensional numerical screw model was reconstructed based on data from BIOFIX and using SOLIDWORKS software. The screw was implanted in the fragment and femoral head to reconstruct the implantation. Stress changes on the femoral head after removal of the fragment and internal fixation were investigated. Results: Mean stresses along 13 points were 16.94 �± 16.79 MPa in the fragment removal group and 14.17 �± 14.08 MPa in the internal fixation group (P < 0.05). Random tests indicated that the mean stresses along 50 randomly determined points were 25.41 �± 12.12 MPa in the fragment removal group and 19.45 �± 14.62 MPa in the internal fixation group (P < 0.05). Conclusion: Compared to internal fixation, fragment removal led to greater stress that was more concentrated in the femoral head. This finding may help surgeons in choosing an appropriate treatment from a biomechanical perspective.Abstract
Inadequacy of anterior-only fixation for reducible three-column injury of the subaxial cervical spine: case report
Lasers for Pulmonary Resections
miR-135a promotes tumor invasion by targeting BACH1 and GATA3 in gastric cancer
Treatment of Intertrochanteric Fractures in the Elderly with Minimally Invasive DAA for Hip Arthroplasty
eISSN: 2520-2456
ISSN: 0020-8868