Objective To review the research of the artificial tracheal prosthesis in the past decade so as to provide theoretical references for the development of the artificial tracheal prosthesis. Methods The l iterature about the artificial tracheal prosthesis was extensively reviewed and analyzed. Results Many new materials are used for the research of artificialtracheal prosthesis which have excellent biocompatibil ity and stabil ity of the structural characteristics. And many compl ications such as migration, obstruction, and infection have been resolved, but so far none of the new materials has been used for cl inical treatment successfully. Conclusion The choice of the materials for artificial tracheal prosthesis is the key to succeed. Biodegradable polymer materials with its unique biological properties become the new direction of the tracheal prosthesis research.
ObjectiveThe study was aimed to further explore risk factors of axillary lymph node metastasis in Luminal A breast cancer and revealed high-risk clinicopathological features.MethodsFrom January 2017 to December 2019, the clinical and pathological data of 237 Luminal A breast cancer patients diagnosed in our hospital were retrospectively analyzed. For the identification of related risk factors of axillary lymph node metastasis in Luminal A breast cancer, χ2 test for univariate analysis and logistic regression model for multivariate analysis were conducted.ResultsAmong the 237 patients with Luminal A breast cancer, 115 patients were associated with lymph node metastasis (48.5%). The univariate analysis indicated that multifocal tumor (P=0.001), p53 mutation (P=0.012), and lymphovascular invasion (P=0.022) were correlated with axillary lymph node metastasis in the Luminal A breast cancer. The multivariate analysis identically showed that multifocal tumor (P=0.009), p53 mutation (P=0.019), and lymphovascular invasion (P=0.021) were independent risk factors of axillary lymph node metastasis.ConclusionMultifocal breast cancer, p53 mutation, and lymphovascular invasion are risk factors of axillary lymph node metastasis in Luminal A breast cancer.
Objective To evaluate the effectiveness and safety of foscarnet sodium in the treatment of chronic hepatitis B. Methods We searched MEDLINE, EMbase, The Cochrane Library and CNKI from 1978 to June 2006. Randomized controlled trials of foscarnet sodium versus other drugs or no drugs in the treatment of chronic hepatitis B were identified. The quality of the included trials was evaluated by two reviewers independently. Meta-analysis was done using The Cochrane Collaboration’s RevMan 4.2.7. Results Seven studies (337 patients) were included; one compared foscarnet sodium versus interferon, and the other six compared foscarnet sodium versus no drugs. All the included studies were graded in terms of the quality of randomization, allocation concealment and blinding. All 7 studies were graded as level C. The meta-analysis showed that: ① foscarnet sodium was not significantly different from interferon in clinical efficacy, liver function, negative-conversion rate of virological markers and side effects. ② compared with the no drugs group, the negative-conversion rate of virological markers was significantly higher for the foscarnet sodium group, HBeAg (RR 6.20, 95%CI 1.76 to 21.79) and HBV-DNA (RR 4.13, 95%CI 1.32 to 12.86); but there were no significant differences in clinical efficacy, liver function and side effects. Conclusions Available evidence shows that: in the treatment of chronic hepatitis B the effectiveness and safety of foscarnet sodium are not significantly different from interferon, but only one trial is included in this review, so the evidence is weak. Compared with no drugs, foscarnet sodium significantly improves the negative-conversion rate of virological markers, but the evidence is insufficient to show whether foscarnet sodium could improve clinical efficacy and liver function, as well as reduce side effects.
The mechanical properties of artificial intervertebral disc (AID) are related to long-term reliability of prosthesis. There are three testing methods involved in the mechanical performance evaluation of AID based on different tools: the testing method using mechanical simulator, in vitro specimen testing method and finite element analysis method. In this study, the testing standard, testing equipment and materials of AID were firstly introduced. Then, the present status of AID static mechanical properties test (static axial compression, static axial compression-shear), dynamic mechanical properties test (dynamic axial compression, dynamic axial compression-shear), creep and stress relaxation test, device pushout test, core pushout test, subsidence test, etc. were focused on. The experimental techniques using in vitro specimen testing method and testing results of available artificial discs were summarized. The experimental methods and research status of finite element analysis were also summarized. Finally, the research trends of AID mechanical performance evaluation were forecasted. The simulator, load, dynamic cycle, motion mode, specimen and test standard would be important research fields in the future.
ObjectiveTo explore the correlation between lipid profile and molecular typing of invasive breast cancer.MethodsThree hundreds and seventy-five patients with primary invasive breast cancer diagnosed from Breast Surgery, Affiliated Hospital of Southwest Medical University from January 2018 to June 2019. The total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), Low-density lipoprotein cholesterol (LDL-C), apolipoprotein A (ApoA), and apolipoprotein B (ApoB) concentrations were detected. Molecular classification based on the results of postoperative immunohistochemistry of breast cancer patients, compared the measured values of each subtype.ResultsThere were no significant difference in serum TG, HDL-C and ApoA among the four subtypes (P>0.05). Differences serum levels of TC, LDL-C, and ApoB among breast cancer patients of various subtypes were statistically significant (P<0.05). Serum TC concentration in the HER2 overexpression type [(5.08±1.00) mmol/L] and the triple negative type [(5.12±0.91) mmol/L] were significantly higher than the Luminal A type [(4.68±1.01) mmol/L] and the Luminal B type [(4.79± 0.93) mmol/L], P<0.05. Serum LDL-C concentration in the triple negative type [(3.14±0.88) mmol/L] was significantly higher than the LuminalA type [(2.77±0.84) mmol/L] and the LuminalB type [(2.87±0.81) mmol/L], P<0.05. Serum ApoB concentration in the Luminal B type [(0.94±0.23) g/L] was significantly lower than the triple negative type [(1.03±0.23) g/L].ConclusionThere are differences in serum TC, LDL-C and apoB concentrations among different subtypes of breast cancer, but TG, HDL-C and ApoA are not related to molecular typing of breast cancer.
ObjectiveTo summarize the research status of mandibular sensory dysfunction after transoral endoscopic thyroidectomy vestibular approach (TOETVA), and explore its potential treatment methods and existing problems, and provide ideas and methods for future clinical treatments or research. MethodThe domestic and foreign literatures about peripheral nerve injury and its treatment after TOETVA were searched and reviewed. ResultsMental nerve injury was considered to be the main cause of mandibular sensory dysfunction after TOETVA. Due to the lack of unified definitions and assessment standards, the true incidence remained unclear. In order to reduce the risk of mental nerve injury, methods such as exposing the mental nerve and combining vestibular approaches during surgery had certain advantages. In terms of treatment, several methods promoting nerve repair were noteworthy, including B vitamins, nerve growth factors, physical therapy and so on. In addition, some auxiliary treatments of Traditional Chinese Medicine also showed effectiveness in promoting nerve regeneration. ConclusionsIt is essential to avoid damage to the mental nerve and mandibular tissues during surgery. For patients with significant complaints postoperatively, active treatment should be pursued. Establishing objective and quantifiable standards for evaluating mandibular sensory dysfunction and seeking effective clinical plans through a multidisciplinary approach may be the direction for future research.
ObjectiveTo observe the clinical effect of unilateral puncture percutaneous kyphoplasty (PKP) through transverse process-pedicle approach (TPA) for the treatment of lumbar osteoporotic vertebral fractures (OVF).MethodsFrom January 2014 to June 2019, a total of 220 OVF patients (321 fractured vertebral bodies) were enrolled, and PKP was performed by unilateral TPA puncture. The distribution of bone cement in vertebral body exceeding the midline of vertebral body was defined as the success of puncture, and the success rates of puncture of different vertebral bodies were recorded. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), anterior and middle heights of the vertebral body, and the local Cobb angle were compared between three time points namely before operation, 1 day after operation, and 6 months after operation. Surgery-related complications were recorded.ResultsThe 220 patients included 57 males and 163 females, with a mean age of (70.3±6.5) years, a mean course of disease of (18.7±17.7) d, and a mean bone mineral density of −3.3±0.6. The success rate of puncture from L1 to L5 was 81.7% (85/104), 95.2% (80/84), 100.0% (69/69), 97.6% (41/42), and 72.7% (16/22), respectively. The mean volume of bone cement injected into the vertebral bodies was (5.8±0.9) mL. Two patients were followed up for less than 6 months because of death or loss to follow-up, and the other 218 patients were followed up for 6-57 months, with an average of (19.6±8.7) months. Before surgery, 1 day after surgery, and 6 months after surgery, the median (lower quartile, upper quartile) of VAS scores was 6 (6, 8), 1 (1, 2), and 2 (1, 2), respectively, with statistically significant differences in all the two-two comparisons (P<0.017). At the three time points, the median (lower quartile, upper quartile) of ODI was 61% (54%, 66%), 26% (22%, 30%), and 25% (24%, 31%), respectively, the mean height of anterior vertebral body was (18.3±2.8), (22.6±3.0), and (22.6±3.1) mm, respectively, the mean height of middle vertebral body was (17.8±2.2), (22.9±2.8), and (22.9±2.7) mm, respectively, the mean local Cobb angle was (19.9±2.6), (14.4±2.8), (14.4±2.8)°, respectively, and the values at 1 day and 6 months after surgery all differed from those before surgery (P<0.017). A total of 32 cases (42 vertebrae) had bone cement leakage, of whom 4 cases had related symptoms. There were 32 re-fractures of the vertebral bodies, including 18 adjacent vertebral body fractures, with an incidence rate of 5.6%. There were 3 vertebral infections after operation, the incidence was 0.9%.ConclusionPatients with OVF of the lumbar spine undergoing unilateral TPA puncture for PKP surgery have a high success rate, definite clinical effect, and satisfactory correction of local deformities.
Zero profile cervical interbody cage is an improvement of traditional fusion products and necessary supplement of emerging artificial intervertebral disc products. When applied in Anterior Cervical Decompression Fusion (ACDF), zero profile cervical interbody cage can preserve the advantages of traditional fusion and reduce the incidence of postoperative complications. Moreover, zero profile cervical interbody cage can be applied under the tabu symptoms of Artificial Cervical Disc Replacement (ACDR). This article summarizes zero profile interbody cage products that are commonly recognized and widely used in clinical practice in recent years, and reviews the progress of structure design and material research of zero profile cervical interbody cage products. Based on the latest clinical demands and research progress, this paper also discusses the future development directions of zero profile interbody cage.
Total lumbar disc replacement is an alternative to interbody fusion for the effective treatment of symptomatic degenerative disc disease. This paper reviewed the history of ball-on-socket type artificial lumbar disc (ALD) prosthesis, which is a typical ALD prosthesis and summarized the ALD prosthesis research progress, according to different materials such as metal-on-metal, metal-on-polymer, and polymer-on-polymer prosthesis. The structural design factors of ball-on-socket type ALD prosthesis were analyzed and its prospect of development was also presented. The purpose of this paper is to provide a theoretical reference for the design of the ball-on-socket ALD prosthesis by reviewing the current state of ball-on-socket type ALD prosthesis.
Objective To compare the effectiveness of Achillon Achilles tendon suture guide combined with circuit suture under the perineural channel and Krachow suture with posterolateral incision of Achilles tendon in the treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture. Methods The clinical data of 38 patients with Kuwada type Ⅱ acute closed Achilles tendon rupture who met the selection criteria between January 2020 and December 2023 were retrospectively analyzed. Krachow suture via posterolateral incision was used in 24 cases (traditional group), and Achillon Achilles tendon suture guide combined with circuit suture via perineural channel was used in 14 cases (minimally invasive group). There was no significant difference in baseline data such as age, gender, body mass index, cause of injury, time from injury to operation, characteristics of Achilles tendon injury (broken end distance, stump length), and preoperative Achilles tendon total rupture score (ATRS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot function score between the two groups (P>0.05). The operation time, incision length, hospital stay, and complications (re-tear, incision infection, sural nerve irritation, deep venous thrombosis) were recorded. ATRS score and AOFAS ankle and hindfoot function score were used to evaluate the effectiveness before operation and at 3 and 6 months after operation. Results All patients successfully completed the operation. The operation time, incision length, and hospital stay in the minimally invasive group were significantly shorter than those in the traditional group (P<0.05). Patients in both groups were followed up 8-16 months, with an average of 12.7 months. There was no sural nerve injury or re-tear of Achilles tendon in both groups. In the traditional group, 1 case had incision infection,1 case had suture rejection, and 1 case had intermuscular venous thrombosis; in the minimally invasive group, no incision healing complication, suture knot discomfort, or thrombosis occurred. There was no significant difference in the incidence of complications between the two groups (P=0.283). The ATRS score and AOFAS ankle and hindfoot function score of the two groups were improved after operation, but there was no significant difference (P>0.05). Except that there was no significant difference in AOFAS ankle and hindfoot function scores between the two groups at 6 months after operation (P>0.05), the ATRS scores and AOFAS ankle and hindfoot function scores in the minimally invasive group were significantly better than those in the traditional group at other time points (P<0.05).Conclusion The treatment of Kuwada type Ⅱ acute closed Achilles tendon rupture with Achillon Achilles tendon suture guide combined with circuit suture via the perineural channel has similar ankle function comparable to traditional operation, but the incision is smaller and the incidenc of incision infection is lower, which is beneficial for patients to recover early ankle function.