计算机辅助设计与解剖定位在卵圆孔穿刺规划中的对比研究

目的研究利用计算机辅助设计技术(computer-assisted design, CAD)规划三叉神经毁损术卵圆孔穿刺路径与解剖定位法在穿刺参数方面的差异,提出解剖定位法的优化方案。方法选择2014年1月至2017年6月接受3D导航模板引导下半月神经节射频热凝术的原发性三叉神经痛患者57例,男22例,女35例。回顾分析每例患者的穿刺方案(CAD法),并与模拟的传统前入路定位方案(解剖定位法,取口角外2.5 cm作为进针点)进行对比分析,观察穿刺路径被遮挡情况。结果与传统解剖定位法比较,基于三维影像的CAD路径规划明显降低穿刺路径被遮挡率(P0.05),该方法在穿刺方向上的可获得卵圆孔面积及短径明显大于传统解剖定位法(P0.05)。91.2%患者通过CAD三维影像法规划的进针点分布在口角外2.5 cm进针点的内下方。结论将传统解剖定位法进针点向内下方调整,可以减少穿刺过程遮挡,获得一定的针道调整空间,有助于提高穿刺成功率。     

喙突入路锁骨下臂丛神经阻滞——改良法与经典法的比较

目的 探讨改良(或修正)喙突入路和经典喙突入路定位对锁骨下臂丛神经阻滞的影响.方法 对80例择期行臂丛神经阻滞手术的患者,随机分为2组,采用神经刺激器定位臂丛神经:A组以喙突内下2 cm为穿刺点(经典组);B组穿刺点参考喙突内下2 cm,并用臂丛神经体表的 投影对该穿刺点进行修正(改良组).记录两组患者操作时间、穿刺次数、阻滞成功率、并发症及患者的满意度.结果 改良组的操作时间明显少于经典组(P＜0.01),且改良组无需调整阻滞针即可定位到臂丛神经的比例明显高于经典组(P＜0.05).结论 改良喙突入路可以明显提高单次穿刺定位到神经的概率,且可减少操作时间,提高了穿刺点体表定位的准确性.     

经皮颈椎后路内窥镜术安全性的应用解剖学

[目的]通过应用解剖学方法探讨经皮颈椎后路内窥镜下颈椎间盘切除术的安全性因素,为临床手术提供理论依据。[方法]选取5具成人尸体标本,观测侧块高度(a)、宽度(b);以关节突关节间隙后内侧缘交点(O点)为中心,建立平面直角坐标系,观测O点与对应节段神经根下缘和硬脊膜外侧缘交点(A点)、下一节段神经根上缘与硬脊膜外侧缘交点(B点)的位置关系及各象限重要结构的毗邻关系;O点与硬脊膜外侧缘的水平距离(e)、与椎动脉前壁的垂直距离(g)以及内侧壁的水平距离(j);椎动脉内侧壁与硬脊膜外侧缘的水平距离(d);神经根与下关节突交点和硬脊膜外侧缘的水平距离(c);上位椎弓根内下缘(G点)与下位椎弓根内上缘(H点)连线与O点的水平距离(f);AB间的距离(k)。所得数据行统计学分析。[结果]a为(10.17±0.66)mm~(11.69±0.97)mm;b为(10.30±0.89)mm~(12.29±0.47)mm;e为(5.66±0.51)mm~(7.57±0.44)mm;g为(3.79±0.44)mm~(4.29±0.47)mm;d为(5.73±0.47)mm~(8.29±0.70)mm;c为(6.90±0.60)mm~(8.27±0.44)mm;f为(1.69±0.87)mm~(4.83±0.96)mm;j为(4.81±0.90)mm~(7.40±0.79)mm;k为(18.12±1.11)mm~(20.87±1.19)mm。[结论]PPECD中O点是更具临床意义的定位点,可作为手术入点标示开骨窗安全范围、准确定位病变部位并避免损伤椎管内外重要结构。     

改良旁正中穿刺法在老年腰椎间盘突出伴椎管狭窄患者硬膜外封闭时的应用

目的比较老年腰椎间盘突出伴椎管狭窄患者硬膜外封闭时2种穿刺方法的效果。方法回顾性分析2014-09-2017-05在我院行硬膜外封闭治疗的老年腰椎间盘突出伴椎管狭窄患者60例,随机分为旁正中法组(A组)和改良旁正中法组(B组),每组30例。A组采用棘突间隙中点旁开1.5cm处为穿刺点,穿刺针与皮肤呈约75°穿刺,当穿刺针进入硬膜外腔时,在注射器活塞上的压力使溶液无阻力地进入硬膜外腔。B组与A组的不同是穿刺针向头侧约倾斜45°进针。比较2组病人1次穿刺的成功率和术后腰痛的发生率。结果 B组中1次穿刺成功率高于A组(P0.01),而术后腰部疼痛的发生率低于A组(P0.01)。结论对于老年腰椎间盘突出伴椎管狭窄患者硬膜外封闭,改良旁正中法明显优于旁正中法。     

多沙唑嗪对兔膀胱出口部分梗阻致膀胱顺应性减低的影响

目的 探讨多沙唑嗪对兔膀胱出口部分梗阻后膀胱顺应性改变的影响.方法 成年雄性新西兰兔40只随机分为4组,每组10只,A组为假手术对照组,B组为膀胱出口部分梗阻组,C组为膀胱出口部分梗阻后口服多沙唑嗪组,D组为假手术后给予多沙唑嗪组.各组于14周行尿动力学检测,检测完成后处死并留取膀胱标本,行膀胱称重.结果 4组膀胱标本质量分别为(3.2±0.9)、(14.1±2.3)、(5.0±2.0)、(2.9±0.5)g;B、C组均高于A、D组,B组高于C组,差异均有统计学意义(P＜0.01);A、D组间比较差异无统计学意义(P＞0.05).4组逼尿肌漏尿点压分别为(10.2±2.5)、(18.8±6.1)、(13.5±4.7)、(11.6±3.6)cm H2O(1 cm H2O=0.098 kPa),B组高于A、D组,差异有统计学意义(P＜0.01),且高于C组,差异有统计学意义(P＜0.05);A、C、D组间差异无统计学意义(P＞0.05).膀胱顺应性分别为(2.86±0.56)、(1.22±0.39)、(4.25±2.19)、(2.90±0.53)ml/cm H2O,B组与A、D组相比明显下降,差异有统计学意义(P＜0.01);C组高于A、D组,差异有统计学意义(P＜0.05);A、D组间差异无统计学意义(P＞0.05).结论膀胱出口部分梗阻后早期应用多沙唑嗪治疗能够延迟梗阻对膀胱顺应性的损害,保护膀胱储尿功能.

Abstract：

Objective To explore the effect of doxazosin on rabbit bladder compliance after partial bladder outlet obstruction. Methods A total of 40 male New Zealand white rabbits were randomized into 4 groups, with 10 rabbits in each group. Partial bladder outlet obstruction was established in groups B and C, while groups A and D underwent the same operation but without partial bladder outlet obstruction. On the day after the operation, groups C and D received oral administration of doxazosin. After 14 weeks, urodynamic examinations were carried out in all groups, and the bladder was weighted after cystectomy. Results Bladder weight was (3.2±0.9) g in group A, (14.1±2.3) g in group B, (5.0±2.0) in group C,and (2.9±0.5) g in group D. The bladder weight in groups B and C increased significantly compared to groups A and D (P＜0.01), group B increased significantly over group C (P＜0.01), and there was no significant difference between groups A and D (P＞0.05).The detrusor leak point pressure was (10.2±2.5) cm H2O in group A, (18.8±6.1) cm H2O in group B, (13.5±4.7) cm H2O in group C,and (11.6±3.6) cm H2O in group D. The detrusor leak point pressure in group B was significantly higher than group A, group D (P＜0.01) and group C (P＜0.05). There was no significant difference between group A, group C and group D (P＞0.05). The bladder compliance was (2.86±0.56) ml/cm H2O in group A, (1.22±0.39) ml/cm H2O in group B, (4.25±2.19) ml/cm H2O in group C,and (2.90±0.53) ml/cm H2O in group D. The bladder compliance was significantly decreased in group B compared to groups A and D (P＜0.01). Bladder compliance in group C was significantly higher than in groups A and D (P＜0.05), and there was no significant difference between group A and group D (P＞0.05). Conclusion Early use of doxazosin can delay the occurrence of lower bladder compliance after partial bladder outlet obstruction, thus protecting the storage function of bladder.     

颈椎后路经皮内镜开窗安全性3D-CT分析

[目的]通过三维CT成像(three-dimensional computed tomography,3D-CT)方法探讨颈椎后路经皮内镜颈椎间盘切除术(percutaneous posterior endoscopic cervical discectomy,PPECD)精准开窗范围。[方法]8例颈椎病患者行头颈CTM,Mimics16.0重建颈椎3D图像。经各点建立矢状面:侧块内下端与椎板外下缘交点(O点)、相邻上下椎板交点(V点)、硬脊膜外侧缘、下位椎弓根峡部内侧缘M_((内))及外侧缘M_((外))、棘突中线。横断面测量距离:侧块横径(a),V点与硬脊膜外侧缘(b),O点与M_((内))(c),O点与M_((外))(d),O点与V点(e),O点与硬脊膜外侧缘(f),棘突中线与硬脊膜外侧缘(g),O点上、下关节突重叠厚度(h)。矢状面测量距离:O点与相邻上位M_((下))(i)及下位M_((上))(j),计算d/a(k)。统计学分析数据。[结果]C_3-C_4~C_7-T_1的f值[(4.03±1.67)mm~(4.72±1.98)mm)、h值[(6.06±2.07)mm~(7.20±1.93)mm]差异无统计学意义(P0.05)。但C_3-C_4~C_5-C_6与C_7-T_1的b值[(-0.17±1.74)mm~(2.42±1.41)mm](P0.001);d值[(-0.75±1.27)mm~(2.85±1.69)mm](P0.001);i值[(6.79±1.04)mm~(9.57±1.27)mm](P0.001);j值[(0.19±2.04)mm~(2.36±1.39)mm](P0.01)差异有统计学意义。[结论]O点将术区分为中央椎管区、腋下区、肩上区及椎间孔区,各区减压范围恒定,各有其开窗入点、开窗安全范围和重要结构;显露腋下区、肩上区无需破坏关节突关节,显露椎间孔区对关节突关节影响甚小。     

3D打印个性化经皮肾镜穿刺导板的临床应用

目的利用CT尿路造影(CTU),结合3D打印技术,数字化设计,研制个体化经皮肾镜碎石取石术(PCNL)穿刺导板,初步探讨其应用于PCNL穿刺定位的可行性。方法选取2017—2018年徐州医科大学附属医院22例拟行经PCNL的肾结石患者,其中实验组10例,利用3D打印技术制作导向器(穿刺导板),在体外进行模拟穿刺,明确进针角度后对10例患者进行PCNL;对照组12例,利用彩超定位穿刺点进行PCNL。比较两组穿刺定位的准确性、穿刺时间、术中出血量。结果实验组10例患者术中穿刺导板与患者皮肤均贴合良好,在导板引导下行穿刺针穿刺并且经过彩超的验证1针穿刺成功率100.00%(10/10),进针点的定位及穿刺的深度、角度均与术前设计的方案一致;对照组12例彩超定位穿刺1针穿刺成功率75.00%(9/12),两组比较无统计学意义(P0.05);实验组穿刺时间、术中出血量分别为(7.78±0.94)min、(49.31±6.43)mL,对照组分别为(9.04±1.09)min、(60.08±12.18)mL,两组比较有统计学意义(P0.05)。结论 3D打印个性化经皮肾镜穿刺导板能够提高PCNL肾脏穿刺通道定位的准确性,缩短了穿刺时间减少了术中出血量,为PCNL的肾脏穿刺定位提供了一种新的方法,值得临床进一步探讨研究。     

超声引导桡动脉穿刺置管的临床应用效果

目的评价超声引导桡动脉穿刺置管的临床效果。方法择期肝脾切除术患者160例,随机均分为两组,触摸组(A组)采用触摸法定位,超声组(B组)使用便携式超声仪定位,两组均在局麻下进行桡动脉穿刺置管。记录穿刺情况及并发症。结果 A组有9例(11.2%)穿刺失败,B组全部穿刺成功,A组穿刺成功率明显低于B组(P0.01)。B组操作时间(9.8±7.4)s,明显短于A组的(18.7±14.6)s(P0.05)。A组有4例发生血肿,B组仅有1例。结论超声引导桡动脉穿刺成功率高,并发症少。     

气道加压对全麻患者右颈内静脉穿刺置管术的影响

目的 探讨气道加压对全麻患者右颈内静脉穿刺置管术的影响.方法 需要进行右颈内静脉穿刺置管的全麻患者125例,随机分为对照组(C组,n=60)和气道加压组(P组,n=65).超声引导下于环状软骨平面,C组在暂停机械通气时、P组手控呼吸维持气道压力20 cm H2O时进行右颈内静脉穿刺置管.暂停机械通气时测定两组右颈内静脉横截面积和穿刺成功后CVP,P组患者气道压力20 cm H2O时测定颈内静脉横截面积和CVP,记录穿刺次数、颈内静脉管壁至皮肤的最短距离、进针深度、进针和退出过程中回抽血液通畅情况,气道加压前测定HR和MAP,并记录气道加压过程中的最低值,观察两组患者的穿刺置管情况.结果 P组气道压力20 cm H2O时颈内静脉横截面积和CVP较气道加压前增加(P＜0.01);与C组比较,P组进针深度降低,1次穿刺成功率、30 s内穿刺成功率、进针过程中回抽血液通畅率升高(P＜0.01),心动过缓、低血压发生率升高(P＜0.05).结论 气道加压有助于超声引导下右颈内静脉穿刺置管术的成功.     

颈胸段前路椎弓根螺钉固定技术的影像学研究

目的:研究颈胸段前路椎弓根螺钉置入的进钉位置及进钉方向,并探讨颈胸段前路椎弓根置钉的可行性。方法:选取50例2014年1月~2014年6月行颈胸段螺旋CT扫描无生理曲度异常、骨质破坏患者的影像学资料,其中男性29例,女性21例,年龄22~60岁,平均36.4岁。应用Advantage Workstation 4.2对原始连续横断面图像进行多平面重建,测量C6~T2椎弓根轴线的外倾角和头/尾倾角、横向进针点距离、矢状面进针点距离和椎弓根轴线长度,记录C6~T2椎弓根轴线在胸骨柄上区(A区)、胸骨柄区(B区)及胸骨柄下区(C区)的分布情况,并进行比较分析。结果:C6~T2外倾角、尾倾角在性别差异上无统计学意义,合并两性数据示C6~T2外倾角逐渐减小(46.77°~20.02°);椎弓根轴线在矢状位上均尾倾,C6~T1尾倾角逐渐减小(18.10°~14.54°),而T2尾倾角最大(20.62°±5.04°);C6~T2外倾角、尾倾角在不同椎节的差异有统计学意义(P0.05)。C6~T2横向进针点距离、矢状面进针点距离、椎弓根轴线长度两性差异有统计学意义(P0.05)。C6~T2横向进针点距离逐渐增大(-0.34~4.75mm);C6矢状面进针点距离最小(5.18±1.02mm),T2矢状面进针点距离最大(9.82±2.28mm)。C6~T2椎弓根轴线长度为31.01~34.21mm。相同性别的横向进针点距离、矢状面进针点距离在不同椎节的差异有统计学意义(P0.05)。C6、C7椎弓根轴线穿经A区;T1椎弓根轴线主要穿经A区和B区,在位于A区者中仅3例穿经两侧胸骨锁骨端上缘连线之上;T2椎弓根轴线穿经B区和C区。A、B、C分区结果在性别差异上无统计学意义(P0.05)。结论:理论上前方入路可完成C6、C7前路椎弓根螺钉置入,而绝大部分T1、T2因受限于其前方骨性结构的阻挡,无法经下颈椎前方入路完成前路椎弓根螺钉的置入。     

Urodynamic parameters in patients with slight and severe genuine stress incontinence: Is the stress profile useful?

This study evaluates the usefulness of the urethral pressure profile (UPP) parameters in assessing the severity of genuine stress incontinence (GSI). Functional length (FL), maximum urethral closure pressure (MUCP), pressure transmission ratio (PTR), residual area at stress (RAS), number of patients with incontinent spikes (IS), and distribution of IS on UPP were determined in supine and standing position for 54 patients (group I) with a 1 -hour pad test < 2 g and compared with the values of 63 patients (group 2) with a 1 -hour pad test > 2 g. The results were similar: FL (supine: 24 mm ± 6/26 mm ± 7 [P:0.2]; standing: 26 mm ± 8/24 mm ± 11 [P:0.5]); MUCP (supine: 51 cm H₂O ± 23/47 cm H₂O ± 20 [P:0.3]; standing: 45 cm H₂O ± 21/38 cm H₂O ± 18 [P:0.1]); and PTR (supine: 83% ± 27/84% ± 31 [P:0.9]; standing: 81% ± 25 and 88% ± 27 [P:0.3]). But the RAS was lower (supine: 502 mm² ± 497/246 mm² ± 268 [P < 0.009]; standing: 500 mm² ± 534/271 mm² ± 306 [P < 0.05]) in group 2. If the percentage of patients with IS was higher (supine: 57/93% [P < 0.001 ]; standing: 54/84% [P] < 0.011) in group 2, the distribution of IS over the entire FL demonstrated no differences between group 1 and 2. In conclusion, except for the RAS, standard UPP parameters cannot be considered determinant in assessing the severity of GSI. © 1994 Wiley-Liss, Inc.     

基于标准臀肌注射点相对安全区的微创臀肌挛缩症皮下松解术初探

目的：探索一种基于标准臀肌注射点的臀肌挛缩症经皮挛缩松解切口部位选择方案。方法：2008年9月至2010年8月,对25例臀肌挛缩症进行研究,男14例,女11例;年龄12～26岁,平均16.5岁;病程6～12年。所有患者可在臀部触及明显挛缩束带,体表描出髂前上棘-尾骨连线（AD线）和挛缩束带的前后两边缘线（a线,p线）,以连线法定出标准臀肌注射点（即AD连线中外1/3处的O点）,测量a、p两线与AD线交点（B、C点）到O点的距离。并试以C点为皮肤入口点行经皮挛缩松解术。结果：OB距离（0±0.76）cm,OC距离（2.86±0.78）cm,BC距离（2.86±1.01）cm,术后平均手术引流量小于10ml,无神经损伤、术后血肿等并发症,患者4～6d可以良好进行并膝下蹲,康复出院。结论：基于标准臀肌注射点的臀肌挛缩症经皮微创治疗方案,定位准,易掌握,安全可靠。     

HIFU“帽式”消融方法的可行性研究

目的探索高强度聚焦超声"帽式"消融兔肝组织的可行性。方法将60只健康新西兰白兔分为A、B两组,每组30只,A组根据采用功率的不同分为A1(200 W,10只)、A2(250 W,10只)、A3(300 W,10只)3个亚组;B组根据两个辐照面的夹角不同分为B1(55°,10只)、B2(90°,10只)、B3(125°,10只)三个亚组,分别辐照兔肝组织。计算总辐照时间和超声能量,观察凝固性坏死体积大小、形态变化。结果 A2亚组能形成连续线状坏死,并能组成均匀规则的椭球形坏死体;B1亚组凝固性坏死体积为(3907.85±565.53)mm3,沿近声场形成的长轴与垂直于近声场所形成的短轴(长/短轴)之比为2.14±0.25;B2亚组凝固性坏死体积为(4431.49±721.36)mm3,其长/短轴比值为1.47±0.26;B3亚组产生的凝固性坏死大小为(3729.46±1049.29)mm3,长/短轴比值为1.06±0.12。结论 "帽式"消融方法能有效缩短辐照时间,减少能量的过度投放,降低或减少副反应的发生。     

食管超声心动图构建右颈内中心静脉置入导管深度的简易预测公式

目的 经右颈内静脉置入中心静脉导管,采用经食管超声心动图(TEE)准确定位导管位置,构建置入导管深度简易预测公式.方法 选择择期行心脏手术患者172例,男101例,女71例,年龄>18岁.于麻醉诱导后放置TEE探头,经右颈内静脉穿刺置入导丝,初次导丝置入深度为Peres公式计算深度(身高÷10 cm),TEE观察导丝尖...     

Does femoral offset recover and affect the functional outcome of patients with displaced femoral neck fracture following hemiarthroplasty?

BackgroundRestoring preoperative horizontal femoral offset (FO) promised good functional outcome in patients receiving total hip arthroplasty. However, relatively little was known regarding the clinical relevance of restoring the offset in patients with bipolar hemiarthroplasty to treat displaced femoral neck fracture. Therefore, the objective of this study was to evaluate postoperative FO accurately and verify its relation with functional outcome.MethodsOne hundred elderly patients who received bipolar hemiarthroplasty to treat displaced femoral neck fracture were identified. Preoperative CT scanning of contralateral hip joint and reconstruction of images led to rotation-free FO. By referencing postoperative implant specification and comparing to measured values in Picture Archive and Communication System, rotation-free postoperative FO and the amount of change were acquired. Postoperative Harris Hip Score (HHS) and Modified Barthel Index (MBI) were evaluated to measure functional outcome at 12-month after the surgery. Patients with significant FO change were identified. Multiple regression analysis was conducted to determine if the FO change might independently affect the outcome regardless of confounding factors.ResultsThe mean preoperative offset was 37.4 ± 2.5 increased by 12.7 ± 9.6% after the surgery. Only 25.0% of postoperative offset after hemiarthroplasty was changed within ±5% of preoperative offset. A total of 45.0% of postoperative offset changed within ±10% while 77.0% of postoperative offset changed within ±20%. 23% of patients whose FO changed more than 20% showed significantly worse outcome score than the patients whose FO change remained within ±20% of initial value. Mean MBI and HHS were negatively correlated with FO change. After adjusting for confounding factors, significant correlation remained between modification of FO and MBI, but not between FO change and HHS (B = 4.576; β = 0.235; 95% confidence interval of B: 0.534 to 8.135).ConclusionsFO was not properly restored in 23% of subjects receiving bipolar hemiarthroplasty due to femoral neck fracture. FO restoration independently predicted fair MBI after the surgery. Therefore, surgeons should pay attention to restoring FO with meticulous templating.     

Computed tomography comparison study of two Axis-based C1 transpedicular screw trajectory designs

BACKGROUND CONTEXTTo our knowledge, there is no comparison study of two different Axis-based C1 transpedicular screw trajectory (TST) designs.PURPOSETo compare two different Axis-based C1 TST designs.STUDY DESIGNThe computed tomography (CT) morphologic analysis of the two different C1 Axis-based TST designs.METHODSFirstly, the design of Axis C/M and related measurements were made on a work station by using neck computed tomography angiography (CTA) data of 62 patients. The central axes (Axis M and Axis C) of C1 TST were designed by multiplanar reconstruction (MPR) technique. Based on Axis M and Axis C, the following parameters were measured: (A, A’), distance between the insertion point (IP) and the midline. (B, B’), distance between IP and the inferior aspect of C1 posterior arch. (C, C’), distance between IP and the C1 anterior cortex of the lateral mass along Axis M/C. (D, D’), insertion angle (IA) based on Axis M/C. (E, E’), the narrowest width of the inner medullary cavity (IMC) along Axis M/C.RESULTThe C1 TST can be designed by MPR technique based on CT volume scan. The design of Axis C trajectory was easier to Axis M trajectory. A, A’ were 20.7±1.6mm and 20.6±1.9mm. Both B, B’ were 2.0±0.6mm. C, C’ were 27.2±2.1mm and 27.5±2.1mm. D, D’ were 9.9±5.0°and 10.4±7.7°. E, E’ were 5.0±1.3mm and 5.4±1.4mm. Among 62 patients (124 sides), Axis C can be achieved by medial inclination, perpendicular, lateral inclination method in 81.5%, 13.7%, 4.8% sides, respectively; Axis M can be achieved by medial inclination, perpendicular, lateral inclination method in 90.3%, 8.9%, 0.8% sides, respectively.CONCLUSIONAxis C can be a reliable trajectory for C1 transpedicular screw insertion as long as there is no displaced fracture in the C1 pedicle and lateral mass. Because of the individual differences, the ideal C1 TST can be achieved by medial inclination, perpendicular or even lateral inclination method, although its inclination direction is medial in the majority of patients.     

Comparison of the intraoperative efficacy of the powered rasp and conventional burr in arthroscopic resection of anterior ankle osteophytes

BackgroundThe efficacy of the powered rasp, a new reciprocating motion device for arthroscopic resection of osteophytes, has not been verified. The aim of this study was to compare the intraoperative efficacy of the powered rasp in arthroscopic resection of anterior ankle osteophytes to that of the conventional burr.MethodsA total of 49 consecutive patients who underwent arthroscopic resection of anterior ankle osteophytes (26 patients with the conventional burr and 23 patients with the powered rasp) were retrospectively reviewed. The preoperative volume of each osteophyte was measured using computerized tomography scan and three-dimensional software. The resection time was measured by review of the individual arthroscopy video, and the estimated resection rate was calculated as the volume of osteophytes/resection time.ResultsThe preoperative volume of osteophytes was not different between the two groups (847.8 ± 685.3 mm³ in the conventional burr and 913.3 ± 605.8 mm³ in the powered rasp, p = 0.726). The resection time was 442.4 ± 216.6 s (seconds) in the conventional burr and 386.4 ± 186.3 s in the powered rasp, and the estimated resection rate was 1.8 ± 1.0 mm³/s with the conventional burr and 2.4 ± 1.3 mm³/s with the powered rasp. These measurements were not significantly different between the two groups (p = 0.340 and 0.083, respectively).ConclusionThe intraoperative efficacy of the powered rasp did not show superiority to that of the conventional burr in arthroscopic resection of anterior ankle osteophytes.Level of evidenceLevel III, retrospective comparative study.     

Omega-3 fatty acids are protective in hepatic ischemia reperfusion injury in the absence of GPR120 signaling

BackgroundA single dose of IV fish oil (FO) before hepatic ischemia reperfusion injury (HIRI) increases hepatocyte proliferation and reduces necrosis in wild type (WT) mice. It has been suggested that the GPR120 receptor on Kupffer cells mediates FO's ability to reduce HIRI. The purpose of this study was to determine whether GPR120 is required for FO to reduce HIRI.MethodsSixty-four (n = 8/group) adult male WT (C57BL/6) and GPR120 knockout (KO) mice received IV FO (1 g/kg) or saline 1 h prior to HIRI or sham operation. Mice were euthanized 24 h postoperatively for analysis of hepatic histology, NFκB activity, and serum alanine transaminase (ALT) levels.ResultsFO pretreated livers had less necrosis after HIRI than saline pretreated livers in both WT (mean ± SEM 25.9 ± 7.3% less, P = 0.007) and KO (36.6 ± 7.3% less, P < 0.0001) mice. There was no significant difference in percent necrosis between WT-FO and KO-FO groups. Sham groups demonstrated minimal necrosis (0–1.9%). Mean [95% CI] ALT after HIRI was significantly higher (P = 0.04) in WT-Saline mice (1604 U/L [751–3427]) compared to WT-FO (321 U/L [150–686]) but was not significantly higher in KO-Saline mice compared to KO-FO. There were no differences in ALT between WT-FO and KO-FO mice who underwent HIRI or between groups who underwent sham surgery. There were no differences in NFκB or IKKβ activation among groups as measured by Western blot analysis.ConclusionsIV FO pretreatment was able to reduce HIRI in GPR120 KO mice, suggesting the hepatoprotective effects of FO are not mediated by GPR120 alone.     

脓毒症相关性脑病大鼠静息态神经网络功能改变

目的采用静息态功能磁共振(rs-fMRI)观察脓毒症相关性脑病(SAE)大鼠神经网络功能改变。方法健康雄性SD大鼠30只,随机分为对照组和SAE组。SAE组大鼠采用腹腔注射脂多糖(LPS)1mg/kg建立SAE模型,对照组大鼠腹腔注射等容量生理盐水。使用区域一致性(Re-Ho)方法检测大鼠异常脑区并将其作为种子点进行全脑功能连接分析,并在LPS腹腔注射48h后进行行为学测试。结果与对照组比较,SAE组在强迫游泳实验不动时间明显延长[(38.93±13.84)s vs(22.06±6.75)s,P0.05];前扣带回皮质(ACC)及右侧尾状核(CPu)ReHo值明显增加,分别为(1.21±0.07vs 0.97±0.12,P0.05)及(1.34±0.09vs 1.17±0.16,P0.05);将ACC作为种子点,其与后扣带回皮质(RSC)的功能连接明显增强(0.45±0.06vs 0.11±0.02,P0.05);将右侧CPu作为种子点,其与左侧CPu的功能连接明显增(0.33±0.07vs 0.07±0.01,P0.05);抑郁样行为与ACC(r2=0.357 3,P=0.018 6)及右侧CPu(r2=0.5036,P=0.003 0)升高的ReHo值以及双侧CPu之间增强的功能连接(r2=0.315 9,P=0.029 2)呈现一定的相关性。结论ACC和右侧CPu ReHo值的增高及双侧CPu功能连接的增强可能参与大鼠SAE的情感损害。