ObjectiveTo investigate whether parecoxib sodium preemptive analgesia reduces inflammatory cytokines and stress hormones production in elderly patients after total hip replacement. MethodSixty patients with American Society of Anesthesiologists Classification Ⅰ-Ⅱ undergoing total hip replacement for femoral neck fracture or aseptic necrosis of the femoral head, aged between 60 and 90 years with a body weight more than 50 kg, were randomly divided into preemptive analgesia group (group P, n=30) and control group (group C, n=30). The patients in group P received parecoxib sodium 40 mg intravenously 30 min before skin incision, and another 20 mg 8 hours after the first administration. All the patients in the two groups received the administration of patient-controlled analgesia sufentanyl. We recorded blood levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), cortisol (COR), adrenaline (AD) and noradrenaline (NAD) 30 min before skin incision, and 1 hour, 6 hours, 12 hours and 24 hours postoperatively. ResultsThe blood levels of IL-6, TNF-α, COR, AD and NAD in group P at 1 hour, 6 hours, 12 hours or 24 hours postoperatively were significantly lower than those in group C (P<0.05). ConclusionsParecoxib sodium preemptive analgesia reduces postoperative inflammatory cytokines and stress hormones production in elderly patients undergoing total hip replacement.
We searched and retrieved literature on the topic of medical image processing published on SCI journals in the past 10 years. We then imported the retrieved literature into TDA for data cleanup before data analysis and processing by EXCLE and UCINET to generate tables and figures that could indicate disciplinary correlation and research hotspots from the perspective of bibliometrics. The results indicated that people in Europe and USA were leading researchers on medical image processing with close international cooperation. Many disciplines contributed to the fast development of medical image processing with intense interdisciplinary researches. The papers that we found show recent research hotspots of the algorithm, system, model, image and segmentation in the field of medical image processing. Cluster analysis on key words of high frequency demonstrated complicated clustering relationship.
ObjectiveTo observe the bladder regeneration by collagen membrane scaffolds for bladder construction to find a new alternative scaffold material. MethodsTwelve healthy adult male Sprague Dawley rats, weighing 300-350 g, were randomly divided into collagen membrane scaffold group (experimental group, n=6), and sham operated group (control group, n=6). Upper hemicystectomy was performed and collagen scaffold was used for reconstruction in experimental group, while the bladder was turned over without bladder resection in control group. At 30 days after operation, the animals were sacrificed and grafts were harvested;HE staining and Masson staining were used to evaluate the bladder regeneration, immunohistochemical staining was performed with α-smooth muscleactin (α-SMA) and von Willebrand factor (vWF) markers to evaluate the percentage of α-SMA positive area and capillary number. ResultsThe rats of 2 groups survived to the end of the experiment, and no urine leakage or infection was observed in experimental group. Histologically, control group presented a pattern of normal bladder structure, experimental group presented a pattern of almost normal urothelium with a small amount of smooth muscle cells and a thin layer of undegraded collagen fibers. Immunohistochemically, experimental group showed ingrowth of smooth muscle fibers and new capillary formation along the collagen membrane scaffolds. The percentage of α-SMA positive area and capillary number in experimental group were significantly lower than those in control group (6.49%±2.14% vs. 52.42%±1.78% and 4.83±0.75 vs. 14.83±1.17, respectively)(t=40.40, P=0.00; t=17.62, P=0.00). ConclusionThe collagen membrane scaffolds could be an effective scaffold material for bladder reconstruction.
Colorectal cancer is one of the most common malignant diseases that threatens human being's health. With researches on microRNAs (miRNAs) getting deeper and wider, more evidences revealed that a great many of miRNAs have been involved in the development of colorectal cancer and have the potential to become the biomarker for early diagnosis, prediction of prognosis and recurrence of colorectal cancer. MiRNA-143/miRNA-145 are significantly reduced in several cancers, including colorectal cancer, showing an antitumorigenic activity. In the present article, we make a brief review on the advances in the researches on miRNA-143/miRNA-145 and colorectal cancer to provide guidance for further explorations of the mechanism and target therapy of this disease.
ObjectiveTo summarize our experience of surgical treatment for right pulmonary artery originated from the ascending aorta by using adult diameter artificial vascular and study the operative indication, design, method, and therapeutic efficacy. MethodsWe retrospectively analyzed clinical data of 11 patients with right pulmonary artery originated from ascending aorta in The Second Affiliated Hospital of Harbin Medical University from May 2008 through December 2013, who were treated by using adult diameter artificial vascular. The patients ranged from 4 months to 25 months old, weighted 4-15 kg. Among of them, 4 patients had persistent truncus arteriosus and 7 had aortopulmonary septal defect. All patients were complicated with moderate pulmonary hypertension. All the patients underwent one stage surgical repair under extracorporeal circulation and cardiac arrest. During the surgery, end to side anastomosis was done between the right pulmonary artery and 16-18 mm diameter artificial blood vessels. And artificial blood vessel was connected to the main pulmonary artery or right ventricle outflow tract incision from the aorta above. ResultsThe average operation time was 179-325 (224±68) min. The average cardiopulmonary bypass (CPB) time was 81-208 (117±54) min. The average aortic clamping time was 29-63(42±21) min. The mean residence time in ICU was 71-197 (109±42) hours. The average assisted mechanical ventilator time was 59-191 (91±26) hours. The average length of stay in hospital was 21-39 (28±11) days. Low cardiac output syndromes caused by pulmonary arterial hypertension occurred in 5 patients including 2 deaths and 3 patients with good recovery by reducing the pulmonary arterial pressure and peritoneal dialysis. The result of postoperative cardiac color ultrasound examination of 9 survival patients showed vascular prosthesis, no distortion, no stenosis of the anastomosis, deformity correction satisfaction. Nine patients were followed up for 3-60 months. The results of echocardiography showed no anastomosis and artificial vascular stenosis, and the pulmonary arterial pressure decreased significantly. ConclusionThe right pulmonary artery originated from the ascending aorta in children should be operated as soon as possible. Compared the adult diameter artificial vascular treatment for one stage repair of right pulmonary artery from the ascending aorta with other operation methods, both short-term and long-term effects are good. Postoperative low cardiac output syndrome is a common complication.
In the development of radio frequency (RF) coils for better quality of the mini-type permanent magnetic resonance imager for using in the small animal imaging, the solenoid RF coil has a special advantage for permanent magnetic system based on analyses of various types of RF coils. However, it is not satisfied for imaging if the RF coils are directly used. By theoretical analyses of the magnetic field properties produced from the solenoid coil, the research direction was determined by careful studies to raise further the uniformity of the magnetic field coil, receiving coil sensitivity for signals and signal-to-noise ratio (SNR). The method had certain advantages and avoided some shortcomings of the other different coil types, such as, birdcage coil, saddle shaped coil and phased array coil by using the alloy materials (from our own patent). The RF coils were designed, developed and made for keeled applicable to permanent magnet-type magnetic resonance imager, multi-coil combination-type, single-channel overall RF receiving coil, and applied for a patent. Mounted on three instruments (25 mm aperture, with main magnetic field strength of 0.5 T or 1.5 T, and 50 mm aperture, with main magnetic field strength of 0.48 T), we performed experiments with mice, rats, and nude mice bearing tumors. The experimental results indicated that the RF receiving coil was fully applicable to the permanent magnet-type imaging system.
Objective To evaluate the effect of total gastrectomy (TG) and proximal gastrectomy (PG) for the treatment of advanced esophagogastric junction cancer. Methods Clinical data of 273 cases of advanced esophagogastric junction cancer who underwent TG and PG in our hospital from Jan. 2004 to Dec. 2010 were reviewed for retrospective analysis. Operation related indexes, 3-year cumulative survival rate, and 5-year cumulative survival rate were compared and evaluated. Results There was no significant difference between TG group and PG group in intraoperative blood loss, operation time, and hospital stay(P > 0.05), but the number of dissected lymph nodes in TG group was obviously more than those of PG group, and the difference was statistically significant(P=0.000). The postoperative complication rates were 10.3%(12/117)in TG group and 21.8%(34/156) in PG group respectively, which was lower in TG group(χ2=6.353, P < 0.05). The 3-year and 5-year cumulative survival rates of TG group were 58.9% and 34.2%, of PG group were 43.4% and 23.6% respectively, and the 3-year and 5-year cumulative survival rates were all lower in PG group(χ2=5.894, P < 0.05;χ2=5.582, P < 0.05). For patients in stage pT4, pN2, and TNMⅢ, whose tumor size were bigger than 3.0 cm, and patients who had accept chemotherapy, the 3-and 5-year cumulative survival rates of TG group were significantly higher than those of PG group(P < 0.05). However, for patients in stage pT2, pT3, pN0, pN1, pN3, TNMⅠ, TNMⅡ, TNMⅣ, whose tumor size were smaller than 3.0 cm, who had not accept chemotherapy, and patients of any pathological type, there was no statistically significant difference between the 2 groups in 3-year and 5-year cumulative survival rates(P > 0.05). Conclusion For the patients who suffered from advanced esophagogastric junction cancer, TG can improve long-term survival rate, and it can significantly reduce the incidence of postoperative complications and improve postoperative quality of life.
ObjectiveTo analyze the pressure change and distribution of the intervertebral disc of upper thoracic spine in vertical pressure and 5° flexion, extension, or lateral bending. MethodsTwelve thoracolumbar spinal specimens were harvested from mini pigs and were divided into 2 groups (n=6). T1, 2, T3, 4, T5, 6, and T7, 8 segments were included in one group, and T2, 3, T4, 5, T6, 7, and T8, 9 segments were included in the other group. The data from both groups represented the complete upper thoracic vertebra data. Biomechanical machine and pressure sensitive film were used to measure the pressure on the vertebral columns under loadings of 100, 150, and 200 N in vertical pressures and 5° flexion, extension, or lateral bending. The pressure change of each intervertebral disc under different loads and in different movement conditions was analyzed. ResultsIn flexion, the anterior annulus pressure of the upper thoracic vertebra increased (P < 0.05), whereas the posterior annulus pressure showed no significant change (P > 0.05) or an increasing trend (P < 0.05). In extension, the anterior annulus pressure of the upper thoracic vertebra decreased (P < 0.05), whereas the posterior annulus pressure decreased (P < 0.05) or had no obvious change (P > 0.05). In lateral bending, the pressure on the concave side of the annulus increased significantly (P < 0.05). ConclusionThe upper thoracic vertebra has unique biomechanical characteristics under different loadings; moreover, the posterior vertebral structure plays an important role in the movement of the upper thoracic vertebral segment and pressure distribution. In lateral bending of the upper thoracic vertebra, the concave side pressure will increase significantly, which suggests that asymmetrical force is an important cause of scoliosis progression. Gravity plays an important role in the progression of scoliosis.
ObjectiveThe Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth (P-POSSUM) modification are used extensively to predict post-operative mortality and morbidity in general surgery. The aim was to analysis the predictive value of these models in patients undergoing hepatobiliary surgery. MethodsEligible articles were identified by searching such electronic databases as PubMed, The Cochrane Library (Issue 10, 2013), Science Citation Index, CNKI, WanFang Data and CBM from 1991 to October 2013. Each study was assessed according to the inclusion and exclusion criteria. Then data were extracted, pooled, and analyzed using Comprehensive Meta Analysis Version 2. ResultsTen studies were included. The morbidity analysis included five studies and 683 patients on POSSUM with a weighted O/E ratio 0.71 (95%CI 0.60 to 0.81). The mortality analysis included seven studies with 1 291 patients on POSSUM and six studies with 1 793 patients on P-POSSUM. Weighted O/E ratios for mortality were 0.42 (95%CI 0.27 to 0.57) for POSSUM and 0.74 (95%CI 0.53 to 0.95) for P-POSSUM. ConclusionPOSSUM significantly overestimates postoperative morbidity in patients undergoing hepatobiliary surgery. Compared with the original POSSUM, P-POSSUM is more accurate for predicting post-operative mortality. Modifications to POSSUM and P-POSSUM are needed for audit in hepatobiliary surgery.
ObjectiveTo investigate the advantages and effectiveness of anterior neurovascular interval approach for fixation of ulna coronoid process fracture. MethodsBetween February 2011 and April 2015, 8 patients with ulna coronoid process fracture were treated with open reduction and internal fixation by anterior neurovascular interval approach. There were 5 males and 3 females, aged from 14 to 62 years (mean, 34 years). Fractures were caused by falling in 5 cases, traffic accident in 2 cases, and crashing in 1 case. The time between injury and operation was 1-6 days (mean, 3.5 days). According to Adams classification, there were 4 cases of type II, 1 case of type III, 2 cases of type IV, and 1 case of type V. In 1 patient with joint instability, lateral collateral ligament repair was given through another incision after fixation of coroniod fracture and the hinged external fixator, and plast splin was used to fix in the other patients; function exercise was done after removal of external fixtion. ResultsAll incisions healed by first intention, and no complications of neurovascular injury and deep infection occurred. All patients were followed up 6-48 months (mean, 22 months). The healing time of fracture was 8-15 weeks (mean, 12.6 weeks). Mild myositis ossificans occurred in 1 case. The flexionextension arc of the elbow was (125.00±7.07)° and the forearm rotation was (135.00±7.07)°, showing no significant difference when compared with those of normal side[(126.88±7.53)° and (139.38±8.21)°] (t=0.469, P=0.654; t=2.198, P=0.054). According to Morrey's scale, the results were excellent in 6 cases, good in 2 cases; the excellent and good rate was 100%. ConclusionAnterior neurovascular interval approach for reduction and internal fixation of ulna coroniod fractures has the advantages of simple operation, less trauma, and larger operative field. It can be used alone or combined with other surgical approaches.