Today, the morbidity and mortality of heart failure are increasing year by year in the world. Mechanical circulatory assist devices has been one of the most effective ways to treat heart failure. The experimental study and clinical application of counterpulsation technique are now becoming more and more popular.Intraaortic balloon pump is representative, and has become the most frequently used shortterm mechanical assist device to treat heart failure. Recently, paraaortic counterpulsation device and other new counterpulsation devices have been developing very rapidly. The principle of counterpulsation and its historical background, as well as the development of various counterpulsation devices are reviewed in this paper.
ObjectiveTo summarize the research progress of ureteral injury in oblique lumbar interbody fusion (OLIF).MethodsThe literature about incidence, clinical manifestations, diagnosis, and treatment of ureteral injury complications in OLIF was reviewed.ResultsOLIF surgery poses a risk of ureteral injury because its surgical approach is anatomically adjacent to the left ureter. Ureteral injuries in OLIF are often insidious and have no specific clinical manifestations. CT urography is a common diagnostic method. The treatment of ureteral injury depends on a variety of factors such as the time of diagnosis, the location and degree of injury, and the treatment methods range from endoscopic treatment to replacement reconstruction.ConclusionSurgeons should pay attention not to damage the ureter and find the abnormality in time during OLIF. High vigilance of abnormalities is conducive to the early diagnosis of ureteral injury. Furthermore, it is important to be familiar with ureter anatomy and gentle operation to prevent ureteral injury.
ObjectiveBased on the method of bibliometrics, to visually analyze the current research status of DNA polymerase epsilon catalytic/DNA polymerase delta catalytic subunit (POLE/POLD1) mutations in colorectal cancer, and further to explore its current hot spots and to look forward to future development trends.MethodsUsed the Web of Science database as the data source to retrieve the published related literatures in the 30 years from the establishment of the database to September 2020, and used VOSviewer 1.6.11 and CiteSpace 5.7 software to analyze the the distribution of research countries/institutions, authors and keywords in the included published literatures. And to perform cluster analysis, time evolution analysis and Burst analysis on keywords, draw corresponding visual maps and analyzed them.ResultsA total of 299 published articles were included. Bibliometric analysis showed that the application of POLE/POLD1 mutations in colorectal cancer had developed steadily in recent years. After 2012, the number of published studies had increased significantly; the journals with the most articles were Familial Cancer and Proceedings of the National Academy of Sciences of the United States of America. The author with the highest number of articles was Tomlinson I. The analysis of countries and regions showed that the United States was the main country for research in this field and had contributed the most to the amount of publications. After analyzed the academic institutions/universities where the researchers were located, it could be seen that the University of Oxford was the research university/institution with the most publications. Keyword cluster analysis and time evolution analysis showed that the research hotspots in this field focus on the impact of this gene mutation on immunotherapy. Burst analysis showed that the current published research in this field started two years after publication and continues to be highly cited.ConclusionsPOLE/POLD1 mutation has undoubtedly become a hot area of current research in colorectal cancer research. Among them, tumor immunotherapy is the focus of research in this field.
ObjectiveTo summarize the research progress on spontaneous facet fusion (SFF) after lumbar spine surgery, and provide reference for further research on SFF. Methods The definition, development, clinical significance, and related influence factors of SFF were throughout reviewed by referring to relevant domestic and foreign literature in recent years. Results SFF is a phenomenon of joint space disappearance and fusion of upper and lower articular processes, which starts in a ring shape from the outermost edges to the central regions. Currently reported SFF occurred after posterior lumbar pedicle screw fixation. SFF may increase the stability of surgical segments and relieve clinical symptoms of patients. SFF is closely related to the method of lumbar internal fixation, facet osteoarthritis, interbody fusion, age, body mass index, type B fracture (according to AO classification), and the operative segment. Conclusion Most reported SFF occur after posterior lumbar pedicle screw fixation, which can increase lumbar stability, but the mechanism and influencing factors remain to be further clarified.
Objective To summarize the effect of cage height on outcomes of lumbar interbody fusion surgery and the importance of the cage height selection. Methods The related literature was widely reviewed to summarize the research progress on the complications caused by inappropriate height of the cage and the methods of selecting cage height. Results Inappropriate height of the cage can lead to endplate injury, cage subsidence, internal fixation failure, adjacent segmental degeneration, over-distraction related pain, insufficient indirect decompression, instability of operation segment, poor interbody fusion, poor sequence of spine, and cage displacement. At present, the selection of the cage height is based on the results of the intraoperative model test, which is reliable but high requirements for surgical experience and hard to standardize. ConclusionThe inappropriate height of the cage may have an adverse impact on the postoperative outcome of patients. It is important to develop a selection standard of the cage height by screening the related influential factors.
Objective To compare the effects of preserving and releasing the inferior pulmonary ligament (IPL) during thoracoscopic right upper lobe apical segment resection for non-small cell lung cancer patients, and to explore appropriate management methods for intraoperative IPL. MethodsAccording to the prospective and open principle, the patients with non-small cell lung cancer who underwent thoracoscopic right upper lobe apical segment resection in the Cardiothoracic Surgery Department of Ningbo Second Hospital from January 2020 to November 2022 were randomly selected and divided into two groups: a release group (receiving IPL release during thoracoscopic right upper lobe apical segment resection) and a retention group (receiving the same right upper lobe apical segment resection, but retaining IPL during operation). The clinical data of the two groups were compared. ResultsA total of 70 patients were included in this study, including 33 males and 37 females, aged 35-76 years. There were 35 patients in the release group with an average age of 57.02±9.25 years; 35 patients in the retention group with an average age of 56.81±9.94 years. The surgical time in the release group was statistically longer than that in the retention group (P=0.017). There was no statistical difference between the two groups in terms of intraoperative bleeding, duration of postoperative air leakage, time to achieve lung recruitment, drainage flow rate of the thoracic duct, retention time of the thoracic duct, incidence of postoperative complications, postoperative hospitalization days, or residual cavity rate one month after the surgery (P>0.05). ConclusionCompared to releasing IPL during thoracoscopic right upper lobe apical segment resection, preserving IPL can simplify surgical procedures, shorten surgical time and reduce trauma, and does not increase postoperative adverse effects. This further reflects the concept of minimally invasive surgery and can be applied to clinical practice.
Objective To systematically evaluate the effectiveness of dasatinib in doses of 140 mg once daily and 70 mg twice daily for chronic myeloid leukemia (CML). Methods The randomized controlled trials (RCTs) were retrieved from Embase (1974 to November 2011), Pubmed (1966 to November 2011), The Cochrane Library (Issue 11, 2011), CBM (1979 to November 2011), VIP (1989 to November 2011), CNKI (1994 to November 2011), Wanfang Data (1997 to November 2011) and references listed in all articles. RCTs meeting inclusive criteria were included, the data were extracted, the quality was evaluated and cross-checked by two reviewers independently according to Cochrane Handbook for Systematic Reviews of Interventions, and then meta-analyses were conducted using RevMan 5.1 software. Results A total of four studies involving two RCTs and 862 patients were included. Results of meta-analyses showed that when dasatinib was used in the long-term treatment of CML, no significant difference was found between 140 mg once daily and 70 mg twice daily in the complete hematologic response (RR=0.97, 95%CI 0.88 to 1.07, P=0.58), complete cytogenetic response (RR=0.94, 95%CI 0.80 to 1.11, P=0.47) and major cytogenetic response (RR=0.99, 95%CI 0.86 to 1.13, P=0.86). In the short-term treatment of CML, there were no significant differences in the complete hematologic response (RR=0.99, 95%CI 0.90 to 1.07, P=0.73), complete cytogenetic response (RR=0.99, 95%CI 0.78 to 1.26, P=0.95) and major cytogenetic response (RR=1.01, 95%CI 0.83 to 1.22, P=0.95). The subgroup analyses on the long-term treatment of CML in both chronic phase and advanced phase showed that there were no significant differences in the complete hematologic response, major cytogenetic response and complete cytogenetic response. Conclusion In the effectiveness of dasatinib for CML, the dose of 140 mg once daily is similar to the dose of 70 mg twice daily. Considering possible moderate selection bias existing in the methodological quality of the included studies which may affect the authenticity of outcomes, this conclusion should be further proved by conducting more high-quality, large-scale and double- blinded RCTs.
Objective To assess the clinical effectiveness and safety of fludarabine and cyclophosphamide (FC) combined with rituximab chemotherapy regimen (FCR regimen) for patients with chronic lymphoblastic leukemia (CLL). Methods The databases such as PubMed, The Cochrane Library, SpringerLink, CNKI, and CBM were searched from 2000 to 2011. The randomized controlled trials (RCTs) on FC regimen versus FCR regimen for CLL were retrieved. The methodological quality of the included studies was assessed according to the Cochrane Reviewer’s Handbook, and meta-analyses were performed using RevMan 5.0 software. Results Three RCTs involving 1 623 patients with CLL were included. The results of meta-analyses showed that significant differences were found in the progression-free survival (PSF)(Plt;0.001), overall response (OR=1.94, 95%CI 1.49 to 2.53, Plt;0.000 01), complete remission (OR=2.54, 95%CI 2.00 to 3.22, Plt;0.000 01), and grade III or IV neutropenia (OR=1.60, 95%CI 1.33 to 1.92, Plt;0.000 01); but no significant differences were found in the partial response (OR=0.74, 95%CI 0.35 to 1.55, P=0.43), grade III or IV thrombocytopenia (OR=0.97, 95%CI 0.74 to 1.27, P=0.83) and autoimmune hemolytic anemia (OR=0.86, 95%CI 0.59 to 1.27, P=0.45) between FCR and FC regimen. Conclusion The FCR regimen can improve the progression-free survival, overall response and complete remission. Meanwhile, it sometimes increases the incidence of Grade III or IV events, such as neutropenia, thrombocytopenia, autoimmune hemolytic anemia and nausea and vomiting.
Objective To explore the feasibility， operation method， and clinical application value of transumbilical single-port laparoscopic cholecystectomy （TUSP-LC） in treatment for children patients with benign gallbladder diseases. Methods The clinical data of 64 patients with benign gallbladder diseases from June 2009 to June 2011 were analyzed retrospectively. The patients were divided into TUSP-LC group （n=41） and convention three-port LC （CTP-LC group， n=23）. The operative time， intraoperative blood loss， conversion to CTP-LC or laparotomy， operative complications， and hospital stay were recorded. The pains were registered at 3，6，12，24，48， and 72h postoperatively using visual analog scale （VAS）. The patients were given satisfaction questionnaires with surgery at 6 time points （1 week， 2 weeks， 1 month， 3 months， 6 months， 12 months） during a 12 months follow-up. Results A total of 64 pediatric LCs were performed successfully， no patients were converted to laparotomy. Except for one case of incision infection in the CTP-LC group 〔4.35%（1/23）〕 and one case of incision infection and one case of ecchymoma in the TUSP-LC group 〔4.88% （2/41）〕， no other complications such as bile duct injury， bile leakage， and incision hernia happened， the total complication rate was not significant difference in two groups （P＞0.05）. The operative time 〔（47.54±18.71） min versus（45.33±10.58） min〕， intraoperative blood loss 〔（18.56±13.34） ml versus （17.28±12.53） ml〕， and hospital stay 〔（1.67±0.36） d versus （1.81±0.38） d〕were not significant differences in two groups （P＞0.05）. The VAS score was not statisticly significant within 24h in two groups （P＞0.05）， but which in the TUSP-LC group was significantly lower than that in the CTP-LC group after 24h postoperatively （P＜0.05）. During a 12 months follow-up， the score of satisfaction in the TUSP-LC group was significantly higher than that in the CTP-LC group （P＜0.05）. Conclusions TUSP-LC is a safe and feasible method in the children patients with benign gallbladder diseases. It can be performed with the same technical exposure and outcomes as multi-port laparoscopy， with the added benefit of relieving postoperative pain and little no scarring.
Objective To present the concept and explore the diagnosis and treatment strategies of secondary appendicitis. To summarize the clinical features of secondary appendicitis caused by different related factors. Methods The clinical data of 660 patients with a presumptive diagnosis of acute appendicitis between November 2003 and November 2008 in The First Affiliated Hospital of Harbin Medical University were collected and analyzed retrospectively. Five hundred and ninetyfour patients with primary appendicitis (primary appendicitis group), and 66 patients with secondary appendicitis (secondary appendicitis group). Clinical parameters such as fever， nausea or vomit, abdominal pain, abdominal distension, change of defecation habits or characters, tenderness in the right lower abdominal quadrant, acute abdomen, abdominal mass, and WBC were compared between two groups. Results Biopsies of appendectomy were taken in all and the results showed inflammation. The pathogenic factors and cases of primary appendicitis: bacterial infection in 171 cases (25.91%), appendix cavity blocked by fecalith in 386 cases (58.48%), appendix cavity stricture in 33 cases (5.00%), and appendix deformity in 4 cases (0.61%). Sixty-six patients resulted from secondary appendicitis: colon carcinoma in 7 cases (1.06%) receiving laparocolectomy including 5 ascending colon and 2 transverse colon; gynecological disease in 20 cases (3.03%), 7 cases of right ovarian cyst accompanying adnexal torsion receiving oophorocystectomy combining with appendectomy, 5 right rupture of corpus luteum of ovary receiving right ovariectomy combining with appendectomy, 4 acute pelvic inflammation and pelvic abscess receiving transvaginal drainage of pelvic abscess combining with appendectomy, 4 extra-uterine pregnancy receiving right ovariectomy and salpingectomy combining with appendectomy; 9 cases (1.36%) of hernia, all to be right oblique hernia, receiving herniorrhaphy combining with appendectomy; Intestinal tuberculosis in 6 cases (0.91%), 4 cases receiving appendectomy, 1 case for resection of ileocecum, and 1 case for right hemicolectomy; parasitic disease in 24 cases (3.64%), all to receive appendectomy. There were significant differences in nausea or vomit, abdominal pain, abdominal distension, changes of defecation habit or character, tenderness in the right lower abdominal quadrant, abdominal mass, and WBC between two groups (Plt;0.05). There was no significant difference in fever or acute abdomen between two groups (Pgt;0.05). InclusionsAppendicitis could be secondary to many diseases. We must attach importance to the diagnosis of secondary appendicitis so that to decrease or avoid the appearance of missed diagnosis and misdiagnosed in the clinical.