Objective To summarize the basic research and the cl inical use of small intestinal submucosa (SIS), which is used as a degradable material for tissue repair. Methods Recent l iterature concerning SIS at home and abroad was extensively reviewed, and current developments of the basic research and the cl inical use of SIS were investigated. Results SIShad many biological advantages in tissue repair, and was used to repair various tissue defects in animal trials. It had successful outcomes in many cl inical trials to repair hernia, anal fistula and Peyronie diseases. And it also had good results at the early stage to treat dilation of the anastomosis, urethroplasty, hypospadias, and other diseases, however, the long-term follow-up was needed. Conclusion SIS is one kind of good material for tissue repair, and has promising future in the cl inical use.
Objective To investigate the therapeutic effects of endovascular covered stent on vertebral dissecting aneurysm and carotid-cavernous fistula (CCF). Methods From March 2006 to May 2007, Jostent coronary stent grafts were used to treat 4 patients with vertebral dissecting aneurysm and 3 patients with CCF. The patients of vertebral dissecting aneurysmwere male and 37-57 years old, the lesion was located on the left vertebral artery in 3 patients and on the right vertebral artery in 1 patient, with the primary symptoms of sudden headache and vomiting; CT scan demonstrated subarachnoid hemorrhage; and the medical history varied from 2 days to 10 years. The patients of CCF were male and 35-51 years old, the lesion was located on the left carotid artery in 2 patients and on the right carotid artery in 1 patient, with the primary symptoms of headache, lateral exophthalmos, eyeball distending pain, conjunctive hyperemia and impaired eyesight; all 3 patients got head injury 2 days to 1 month before the appearance of symptoms and 1 of them had a history of severe nosebleed; and the medical history ranged from 1 week to 2 months. Results For the patients with vertebral dissecting aneurysm, complete obl iteration of aneurysms was achieved, the circulations of the vertebral artery, the adjacent posterior inferior cerebellar artery and the adjacent anterior inferior cerebellar artery were smooth, no compl ications relative to operation occurred, and no recurrence of symptoms and intracranial rehaemorrhagia were observed during the follow-up period of 8 months-2 years. For the patients with CCF, the fistula were completely obl iterated, the circulation of carotid artery was smooth, the exophthalmus and conjunctiva hyperemia were improved obviously 3 days after operation, the eyesight of patient was improved at different levels over the follow-up period of 1-3 months. Conclusion Endovascular covered stent is a new and useful tool for the treatment of vertebral dissecting aneurysm and CCF .
Objective To assess the results of microvascular decompression (MVD) in treating cranial nervehyperactive dysfunction. Methods From October 2002 to January 2007, 106 patients with cranial never hyperactivedysfunction were treated with MVD. Among them, there were 47 males and 59 females with an average age of 62 years (42-85 years), including 56 cases of trigeminal neuralgia, 33 cases of hemifacial spasm and 17 cases of spasmodic torticoll is. MRI showed obvious nerve root compression in 60 patients (56.6%), suspected nerve root compression in 33 patients (31.1%) and no nerve root compression in 13 patients (12.3%). The disease course was 2-300 months with median course of 54 months. The typical manifestations before operation were pain and myospasm in corresponding innervation region. Results The superior cerebellar artery was the most common offending vessel in trigeminal neuralgia (44.6%, 25/56), the anterior inferior cerebellar artery in hemifacial spasm (33.3%, 11/33), and the vertebra-basilar artery in spasmodic torticol is (82.4%, 14/17). Compl ications of facial paralysis, hypoacusia, facial numbness, dizziness, pain of neck and shoulder, muscles weakness of neck and subcutaneous dropsy occurred in 31 patients (29.2%). All patients were followed up for 6-42 months. The total response rate was 90.6%. The curative rate of MVD was 83.9% (47/56) in trigeminal neuralgia, 81.8% (27/33) in hemifacial spasm and 41.2% (7/17) in spasmodic torticol is, respectively. Five patients failed to response (4.7%), 2 of them were cured after re-operation and 3 abandoned further treatrment. Five patients suffered recurrence 3-8 months after operation (4.7%), 2 of them recovered after re-operation, 1 got rel ief by Gamma-knife treatment, and 2 abandoned further treatment. Conclusion MVD has a good therapeutic effect on the disease caused by vascular compression of cranial nerve. Comprehensive preoperative evaluation, skillful operational technique and intraoperative electrophysiological monitoring should be implemented to enhance the therapeutic effects of MVD and to prevent possible compl ications.
Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
Objective To investigate the cl inical features of mal ignant melanoma (MM) in the central nervous system (CNS) and to improve the diagnosis and treatment of this disease. Methods Seven MM-in-CNS patients’ records between September 1996 and April 2007 were analyzed retrospectively, including 6 males and 1 female aged 18-74 years. The 5 cases were located in the supra-tentorial area, 1 in the spinal cord and 1 in the whole brain. CT or MRI scan was appl ied. The lesion was in the right frontal area in 4 cases, in the right temporal are in 1 case, in the left temporal area in 1 case, in the left apex area in 1 case and in the cervical spinal cord of C5-7 in 1 case. Six patients underwent neurosurgical operation and1 patient received the Gamma Knife therapy. The pathological examination revealed that 2 cases were metastatic MM and 5 were primary. Results One patient with primary MM received no follow-up, and the rest 6 patients were followed up for 2 weeks to 2 years with the time of median 8 months. One patient with metastatic MM died 2 months after operation, 1 patient to with metastatic MM died 2 weeks after Gamma-Knife treatment, 1 patient with metastatic MM with primary MM died 2 years after operation, and 3 patients with primary MM were still al ive and self-independent 6, 10 and 24 months after operation, respecti vely. Conclusion Since MM-in-CNS is short of specificity in cl inical symptoms and signs, its diagnosis mainly rel ies on the pathological examination and is assisted by MRI. The combined therapy giving priority to operation is recommended.
Objective To investigate the effectiveness of LARS ligament and three-dimensional (3D) printed prosthesis on the combined reconstruction of radial hemicarpal joint after distal radius tumor resection. Methods The clinical data of 12 patients with combined reconstruction of radial hemicarpal joint with LARS ligament and 3D printed prosthesis after distal radius tumor resection between September 2017 and March 2021 were retrospectively analyzed. There were 7 males and 5 females with an average age of 41.8 years (range, 19-63 years). There were 8 cases on the left side and 4 cases on the right side, and 10 cases of giant cell tumor of bone and 2 cases of osteosarcoma. The disease duration ranged from 1 to 20 months, with an average of 8.1 months. The osteotomy length, operation time, and intraoperative blood loss were recorded, and the wrist function was evaluated by Mayo wrist score and Musculoskeletal Tumor Society (MSTS) score before and after operation. The grip strength of the affected limb was expressed by the percentage of grip strength of the healthy upper limb, and the range of motion (ROM) of the wrist joint was measured, including extension, flexion, radial deviation, and ulnar deviation; the bone ingrowth and osseointegration at the bone-prosthesis interface of the wrist joint were observed by radiographic follow-up; the possible wrist complications were recorded. ResultsAll 12 patients successfully completed the operation. The osteotomy length was 5.0-10.5 cm (mean, 6.8 cm), and the operation time was 180-250 minutes (mean, 213.8 minutes). The intraoperative blood loss was 30-150 mL (mean, 61.7 mL). All patients were followed up 11-52 months (mean, 30.8 months). Radiographic follow-up showed that bone ingrowth and osseointegration at the bone-prosthesis interface were observed in all patients, and biological fixation was gradually achieved. During the follow-up, the stability, motor function, and ROM of the wrist joint were good. There was no complication such as arthritis, subluxation, prosthesis loosening, and infection, and no tumor recurrence and metastasis. At last follow-up, the Mayo score was 82.1±5.4, and MSTS score was 27.5±1.5, which were significantly improved when compared with those before operation (48.8±13.5, 16.4±1.4; t=−10.761, P<0.001; t=−26.600, P<0.001). The grip strength of the affected side was 59%-88% of that of the healthy side, with an average of 70.5%. The ROM of wrist joint were 55°-80° (mean, 65.42°) in extension, 35°-60° (mean, 44.58°) in flexion, 10°-25° (mean, 17.92°) in radial deviation, 10°-25° (mean, 18.33°) in ulnar deviation. Conclusion The combined application of LARS ligament and 3D printed prosthesis is an effective way to reconstruct bone and joint defects after distal radius tumor resection. It can improve the function of wrist joint, reduce the incidence of complications, and improve the stability of wrist joint.
At present, the incidence of Parkinson’s disease (PD) is gradually increasing. This seriously affects the quality of life of patients, and the burden of diagnosis and treatment is increasing. However, the disease is difficult to intervene in early stage as early monitoring means are limited. Aiming to find an effective biomarker of PD, this work extracted correlation between each pair of electroencephalogram (EEG) channels for each frequency band using weighted symbolic mutual information and k-means clustering. The results showed that State1 of Beta frequency band (P = 0.034) and State5 of Gamma frequency band (P = 0.010) could be used to differentiate health controls and off-medication Parkinson’s disease patients. These findings indicated that there were significant differences in the resting channel-wise correlation states between PD patients and healthy subjects. However, no significant differences were found between PD-on and PD-off patients, and between PD-on patients and healthy controls. This may provide a clinical diagnosis reference for Parkinson’s disease.
Esophageal squamous cell carcinoma can easily penetrate into the esophageal wall and invade adjacent organs due to the lack of serosa. Stage cT4b tumors involving organs adjacent to the aorta, vertebral body, trachea, or bronchus were considered unresectable. For unresectable esophageal squamous cell carcinoma, radical chemoradiotherapy or chemotherapy is recommended. However, the therapeutic effect is poor. With the advent of conversion surgery, surgical resection is feasible after induction therapy for patients with esophageal tumors that are initially unresectable due to adjacent organ invasion or distant metastasis. This article reviews the research on conversion surgery for unresectable esophageal squamous cell carcinoma in recent years in order to explore the clinical application prospects of conversion surgery.
【摘要】 目的 探讨瑞舒伐他汀对慢性肾病患者抗炎疗效。 方法 选取2009年11月-2010年12月90例慢性肾病患者，随机分为A、B两组，A组50例，给予瑞舒伐他汀钙10 mg/d；B组40例，给予阿托伐他汀钙10 mg/d，两组患者的年龄和性别相匹配。分别测定其治疗前及治疗后12周时血白细胞、高敏反应蛋白、纤维蛋白原、白介素-6、肿瘤坏死因子-α。 结果 两组治疗前各炎症指标水平差异无统计学意义（Pgt;0.05）。与治疗前相比，两组患者治疗12周后炎症指标水平均较前明显下降（Plt;0.01），瑞舒伐他汀钙组比阿托伐他汀钙组炎症指标下降更为明显。 结论 瑞舒伐他汀可有效改善慢性肾病患者的炎症反应。【Abstract】 Objective To explore the anti-inflammatory effect of rosuvastatin on chronic kidney disease (CKD) patients. Methods Ninety CKD patients treated in our hospital between November 2009 and December 2010 were randomly divided into two groups. One group was given rosuvastatin calcium 10 mg/d, which the other group was given atorvastatin calcium 10 mg/d. The two groups matched in terms of age and gender. We determined blood leukocyte (WBC), high sensitivity reactive protein (hs-CRP), fibrinogen (FIG), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) of the patients before and after treatment for 12 weeks. Results The inflammatory marker levels of both groups before treatment had no significant difference (Pgt;0.05). The inflammatory marker levels of two groups after treatment for 12 weeks were significantly decreased compared with the levels before treatment (Plt;0.01), and rosuvastatin calcium group decreased more apparently than atorvastatin calcium group. Conclusion Rosuvastatin can improve the anti-inflammatory response in CKD patients.