Objective To refine the technique of portal inflow occlusion and parenchymal transection for laparoscopic hepatectomy in the porcine model. Methods Ten pigs were used. The portal inflow complete or selective occlusion was carried out with portal triad clamping or dissection and division of the left portal pedicle. The sequential laparoscopic local hepatectomy, left lateral lobectomy, and left medial lobectomy were performed without portal inflow occlusion. Parenchymal transection was performed with harmonic scalpel, LigaSure, microwave dissector, bipolar electrocautery, surgical clips, and endoscopic stapler. The efficacy and safety of different techniques in laparoscopic parenchymal transection of the liver were compared. Results The ischemic liver was darken with complete or selective portal triad clamping. The ischemic demarcation line between left and right lobe was obvious with the dissection and division of the left portal pedicle. There was an applicable scope of each hepatic parenchymal transection apparatus. The optimal combination of different techniques could increase efficacy and reduce hemorrhage in laparoscopic parenchymal transection of the liver. Conclusion Technical refinements of portal inflow occlusion and parenchymal transection in porcine models could provide evidences to clinical appliance of laparoscopic anatomic major hepatectomy.
Objective To analyze the characteristics of intestinal flora in patients with allergic asthma, so as to provide a theoretical basis for the development of new clinical treatment methods. Methods Fecal samples were collected from 14 patients with allergic asthma and 15 healthy people between January 2021 and December 2021, and 16S rRNA was used to analyze the composition and diversity of intestinal flora of the participants. Results There was no statistically significant difference in age, gender, BMI, or smoking history between the allergic asthma group and the control group (all P>0.05). Alpha diversity results showed that there was significant difference in the abundance of intestinal flora between the two groups, but there was no significant difference in the diversity of intestinal flora between the two groups. The results of β diversity analysis indicated that there were significant differences in the composition of bacterial flora between the allergic asthma group and the control group. The difference bacteria between the two groups at the genus level are Faecalibacterium, Roseburia, Alistipes, Sphingomonas, Dorea, Ruminococcaceae_UCG-002, Streptomyces, [Eubacterium]_venturiosum_group, Butyriococcus and Agathobacter. Conclusion Compared with healthy individuals, patients with allergic asthma have undergone significant changes in the composition of their gut microbiota, with various differential bacteria present. Among them, Roseburia and Eubacterium may be involved in the pathogenesis of allergic asthma through changes in short chain fatty acids.
A micro silicone oil liquid spring was designed and manufactured in this article. The performance of the liquid spring was studied by simulation analysis and mechanical test. A self-force source power-assisted knee orthosis was designed based on the liquid spring. This power-assisted knee orthosis can convert the kinetic energy of knee flexion into the elastic potential energy of liquid spring for storage, and release elastic potential energy to generate assisted torque which drives the knee joint for extension. The results showed that the average maximum reset force of the liquid spring was 1 240 N, and the average maximum assisted torque for the knee joint was 29.8 N·m. A musculoskeletal multibody dynamic model was used to analyze the biomechanical effect of the knee orthosis on the joint during knee bending (90°knee flexion). The results showed that the power-assisted knee orthosis could effectively reduce the biomechanical load of the knee joint for the user with a body weight of 80 kg. The maximum forces of the femoral-tibial joint force, patellar-femoral joint force, and quadriceps-ligament force were reduced by 24.5%, 23.8%, and 21.2%, respectively. The power-assisted knee orthosis designed in this article provides sufficient assisted torque for the knee joint. It lays a foundation for the subsequent commercial application due to its small size and lightweight.
Objective To investigate the effectiveness of three-dimensional strapping reduction in treatment of patellar fracture. Methods Between January 2015 and June 2015, thirty-two patients were randomly allocated to three-dimensional strapping reduction group (trial group) and towel clamp reduction group (control group). There was no significant difference in age, gender, damage side, interval from injury to opreration, fracture pattern, and cause of injury (P>0.05). The operation time, fluoroscopy time, fracture healing time, postoperative Hospital for Special Surgery (HSS) scores, and complications were collected and analysed. Results All incisions healed at stage I. All patients of 2 groups were followed up 10-14 months (mean, 12.4 months). The operation time and fluoroscopy time of trial group were both shorter than those of control group (t=6.212, P=0.000; t=6.585, P=0.000). X-ray films showed that the fractures in both groups healed successfully and there was no significant difference in healing time between groups (t=1.973, P=0.058). Bone nonunion, infection, and failure fixation were not found in both groups. HSS scores of trial group (91.6±3.8) was higher than that of control group (86.4±5.5) (t=–3.105, P=0.004). Conclusion Compared with towel clamp reduction, the three-dimensional strapping reduction in treatment of patellar fracture has the advantages of shorter operation time and fluoroscopy time, better knee function after operation, and satisfactory fracture healing.
ObjectiveTo analyze the incidence and risk factors of tuberculosis in the city of Mianyang based on data from active cases.MethodsFrom March 2018 to April 2019, 199 182 residents were selected for the study. Data were collected using a questionnaire, digital radiography (DR), physical examination and laboratory tests. The incidence of tuberculosis was estimated, and multivariate logistic regression was used to identify factors associated with the disease.ResultsThroughout the process, 103 residents were diagnosed with active tuberculosis, corresponding to an incidence of 51.71 per 100 000. Risk of tuberculosis was significantly higher among individuals who were over age 60 (OR=1.74, 95%CI 1.11 to 2.73, P=0.02), males (OR=4.39, 95%CI 2.74 to 7.04, P<0.001), medical workers (OR=11.18, 95%CI 2.99 to 41.84, P<0.001), and those with a history of tuberculosis (OR=16.43, 95%CI 8.10 to 33.33, P<0.001). Conversely, individuals with higher levels of education were associated with lower risk of tuberculosis: compared to those with primary school or less, those with a junior high school education had an OR of 0.53 (95%CI 0.30 to 0.88, P=0.02); high school/technical school had an OR of 0.36 (95%CI 0.15 to 0.92, P=0.03); junior college or above had an OR of 0.23 (95%CI 0.06 to 0.88, P=0.04).ConclusionsAnalyzing tuberculosis epidemiology based on active cases can help detect the disease as well as control or even prevent epidemics. Individuals who are more senior, males, medical workers, with a history of tuberculosis, and those with lower levels of education may be at higher risk of the disease. These results may improve screening efforts and allow timely intervention.
Objective we want to construct a rating scale for the key technique using the inhaler device for patients with chronic airway disorder and to provide a reference tool for the scientific evaluation of patients’ techniques in the use of inhaler devices. MethodsThrough literature review and Delphi expert consultation, the items of the rating scale were determined, and the weights and assignments of the items were determined through the analytic hierarchy process. The resulting evaluation form was used for clinical assessment of patients, and the differentiation of each item was tested by the critical ratio method.ResultsAfter the two rounds of consultation, the positive coefficients of experts were 95.24% and 100%, the expert authority coefficients were 0.988 and 0.990, and the Kendall-W coefficients were 0.371 (P<0.001) and 0.654 (P<0.001), respectively. The final form, consisting of 10 operational items for evaluating key inhaler techniques for patients with chronic airway disorder, was finalized. The results of the hierarchical analysis showed that the consistency ratio CR was 0.088<0.10, which satisfied the consistency test. The top 5 key operational steps were medication preparation, exhalation, holding the mouthpiece, inhalation, and breathholding. Used for clinical patient assessment showed better discrimination of items (t ≥ 3, P<0.05).ConclusionThe rating scale for the technique using the inhaler device for chronic airway disorder constructed in this study is scientifically reliable, convenient, and practical, which can be used as an objective evaluation tool to assess patients’ skill in inhaler device use.