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find Author "何磊" 5 results
  • RESEARCH PROGRESS OF AXIAL LUMBAR INTERBODY FUSION BY PRESACRAL APPROACH FOR MINIMALLY INVASIVE TREATMENT OF LUMBOSACRAL DEGENERATIVE DISEASES

    Objective To review the progress in the features, early cl inical outcomes, and cl inical appl ication of axial lumbar interbody fusion (AxiaLIF) for the minimally invasive treatment of lumbosacral degenerative diseases. Methods The l iterature about the features, early cl inical outcomes, and cl inical appl ication of AxiaLIF for the minimally invasive treatment of lumbosacral degenerative diseases in recent years was reviewed. Results Almost 9 000 procedures performed globally in recent years, AxiaLIF has shown its safety and effectiveness because of high fusion rates, short hospital ization days, and less iatrogenic compl ications in comparison with standard fusion procedures. ConclusionPostoperative long-term outcomes, biomechanics stabil ity, and extended appl ication of AxiaLIF still need a further study,though it suggests an original minimally invasive treatment of lumbosacral degenerative diseases.

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • 锁定钢板微创内固定治疗老年股骨粗隆间骨折

    目的 总结应用锁定钢板微创内固定治疗老年股骨粗隆间骨折的临床疗效。 方法 2005 年3 月-2010 年3 月,采用骨折闭合复位、小切口肌肉下插入股骨近端外侧锁定钢板,以内固定支架方式治疗老年股骨粗隆间骨折65 例。其中男30 例,女35 例;年龄65 ~ 92 岁,平均70.1 岁。顺粗隆间骨折63 例,按Evans 分型:Ⅰ型 13 例,Ⅱ型16 例,Ⅲ型19 例,Ⅳ型15 例;逆粗隆间骨折2 例。均有不同程度骨质疏松。伤后至手术时间3 ~ 10 d,平均5 d。 结果 所有骨折均手法闭合复位成功。手术时间平均60 min,术中失血量平均80 mL。患者切口均Ⅰ期愈合。术后1 个月发生下肢深静脉血栓形成1 例,经溶栓抗凝治疗后治愈。65 例均获随访,随访时间12 ~ 24 个月,平均15 个月。2 例分别于术后9 个月和14 个月并发全身疾病死亡;余63 例骨折均于术后12 ~ 16 周获骨性愈合。无内固定物脱出及断裂、骨折移位、髋内翻、股骨头坏死等与手术相关的并发症发生。存活患者术后1 年髋关节功能按Harris 评分,获优39 例,良17 例,可5例,差2 例,优良率88.9%。 结论 锁定钢板微创内固定治疗老年股骨粗隆间骨折,手术创伤较小,为骨折提供了足够的稳定性并能促进骨折愈合,可获良好临床疗效。

    Release date:2016-08-31 05:44 Export PDF Favorites Scan
  • IMAGING STUDY ON LUMBAR PLEXUS BY MINIMALLY INVASIVE LATERAL TRANSPSOAS APPROACH

    ObjectiveTo analyze the relative position between lumbar plexus and access corridor of minimally invasive lateral transpsoas approach based on magnetic resonance imaging distribution of lumbar plexus by three dimensional reconstruction technique, so as to evaluate approach safety. MethodsThree-dimensional fast imaging employing steady-state acquisition sequences of lumbar spine were performed on 71 patients with lumbar degenerative diseases between July 2012 and January 2015. The axial image distance between the anterior edge of lumbar plexus and sagittal central perpendicular line (SCPL) of disc was determined using the distance formula at the mid-disc space from L1, 2 to L4, 5 level. SCPL was drawn perpendicularly to the sagittal plane of intervertebral disc and it passed through its central point, which is initial dilator trajectory for transpsoas approach. With respect to the SCPL of disc, the distance with a positive value indicated neural tissue posterior to it whereas anterior to it represented by a negative value. ResultsVarious branches of lumbar plexus which passed through the psoas major anterior to the SCPL of disc were identified in 42 (59.2%), 58 (81.7%), and 70 (98.6%) patients at L2, 3, L3, 4, and L4, 5 levels, respectively. It is possible to infer the presence of genitofemoral nerve in accordance with relevant anatomic research. A ventral migration of intrapsoas nerves is identified from L1, 2 to L4, 5 level. All differences between levels were statistically significant (P < 0.05). ConclusionWith respect to the SCPL of disc, a pass way of guide wire or a radiographic reference landmark to place working channel, lumbar plexus lie posterior to it from L1, 2 to L3, 4 level and shift anteriorly to it at L4, 5 level, while genitofemoral nerve locate anterior to the SCPL from L2, 3 to L4, 5 level. Neural retraction may take place during sequential dilation of working channel especially at L4, 5 level.

    Release date:2016-11-14 11:23 Export PDF Favorites Scan
  • Diagnostic study of machine learning model based on combinatorial optimization to predict postoperative infectious complications of gastric cancer

    Objective To explore the application of combined optimized machine learning algorithm for predicting the risk model of postoperative infectious complications of gastric cancer and to compare the accuracy with other algorithms, so as to find reliable biomarkers for early diagnosis of postoperative infection of gastric cancer. Methods The clinical data of 420 patients with gastric cancer at the Third Affiliated Hospital of Anhui Medical University from May 2018 to April 2023 were retrospectively analyzed and the patients were randomly divided into training set and validation set. Univariate analysis was used to determine the risk factors of postoperative infectious complications. Six conventional machine learning models are constructed using the training set: linear regression, random forest, SVM, BP, LGBM, XGBoost, and MGA-XGBoost model. The validation set was used to evaluate the seven models through evaluation indicators such as ACC, precision, ROC and AUC. Results Postoperative infectious complications were significantly correlated with age, operation time, diabetes, extent of resection, combined resection, stage, preoperative albumin, perioperative blood transfusion, preoperative PNI, LCR and LMR. Among the seven machine learning models, the MGA-XGBoost model performed best. Among the seven machine learning models, the MGA-XGBoost model performed best, with AUC of 0.936, ACC of 0.889, recall of 0.6, F1-score of 0.682, and precision of 0.79 on the validation set. Diabetes had the greatest influence on the internal structure of the model. Conclusion This study proves that the MGA-XGBoost model incorporating comprehensive inflammation indicators can predict postoperative infectious complications in patients with gastric cancer.

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  • The Significance of Abnormal Confluence of Common Bile Duct and Pancreatic Duct

    ObjectiveTo investigate the clinical significance of abnormal confluence of common bile duct (CBD) and pancreatic duct. MethodsFortyfive cases of biliary pancreatic confluence portion of cadavers were dissected and observed with microscope. ResultsThe lower end of CBD inserted normally into the medial posterior portion of descending duodenum with oblique angle (41.4±5.3)° and safeguarded by the sidelong wrinkle formed by mucous membrane of duodenum. In common, pancreatic duct ampulla inserted into CBD with oblique angle (28.5±7.9)° and jointed CBD in the medial wall of dudenum. The length ampulla of Vater was about 0.5-1.5 cm. The Vater’s ampulla was dilated obviously. ConclusionThe result indicates that pancreatic duct and CBD joint with a sharp angle. A number of abnormal anatomic factors may change the relation of oblique angle, and lead to the pancreatitis.

    Release date:2016-08-28 04:49 Export PDF Favorites Scan
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