瘢痕组织瓣并自体耳软骨移植在单侧唇裂术后继发畸形的鼻槛重建中的应用

目的:探讨一种唇裂术后继发鼻畸形修复过程中鼻槛重建的手术方法。方法:对32例单侧唇裂继发畸形患者进行唇鼻畸形矫正的同时,采用局部瘢痕组织瓣结合自体耳软骨游离移植,重建鼻槛。结果:32例患者,术后3~12个月随访,鼻槛形态稳定,效果满意。结论:对于唇裂术后继发鼻畸形鼻槛的再造,瘢痕组织瓣结合自体耳软骨移植是一种简单、有效的方法。     

强化胰岛素治疗重型颅脑损伤的前瞻性研究

【摘要】〓目的〓比较强化胰岛素治疗与常规胰岛素治疗两种方法在治疗重型颅脑损伤患者上的预后差异。方法〓以2012年1月至2014年6月在我院进行治疗的重型颅脑外伤且合并应激性高血糖的116例患者为研究对象,按病情、年龄、性别等因素配对分成两组,将应用强化胰岛素治疗的58名患者为实验组,将常规胰岛素治疗的58例患者为对照组,并以死亡率、神经功能恢复情况、院内感染率、低血糖发生率为指标分析两组患者的预后差异。结果〓实验组和对照组两组死亡率差别无统计学意义,但实验组院内感染发生率低于对照组,实验组神经功能恢复情况优于对照组,实验组低血糖发生率高于对照组。结论〓强化胰岛素治疗能降低重型颅脑损伤患者院内感染发生率,并利于患者神经功能恢复,但需警惕其可能诱发患者低血糖的风险。     

Impact of Aortic Cross-Clamping Time on Peripheral Nerves: Experimental Model

Purpose: The present study investigated the correlation between extend aortic cross-clamping time and peripheral nerve injury on rats.Methods: 24 male, Sprague Dawley rats were divided into 3 groups; (a) control group: abdomen was directly closed after reached aorta, and followed by 72 hours, (b) short-term ischaemia-reperfusion group: peripheral nerve ischemia was induced in rats by supraceliac aortic occlusion for 20 min followed by 72 h of reperfusion, (c) long-term ischaemia-reperfusion group: peripheral nerve ischemia was induced for 30 min followed by 72 h of reperfusion. Preoperative and postoperative, electromyography (EMG) recordings were done. End of 72 h, the sciatic nerves were harvested from each animal for histopathological and biochemical analysis.Results: The mean compound muscle action potential (CMAP) amplitude of long-term ischaemia-reperfusion group was statically significant reduced when compared to the control group (p <0.01). However, the mean distal latency value of long-term ischaemia-reperfusion group was statically significant increased (p <0.01). On the other hand, there were statically significant differences between the results of malondialdehyde, edema and ischemia fiber degeneration grades on control and long-term ischaemia-reperfusion group (p <0.001).Conclusion: This study demonstrated that the extending cross clamping time directly harms the peripheral nerve of rats.     

高龄患者人工全膝关节置换术的并发症及疗效分析

目的探讨年龄大于75岁的高龄患者进行全膝关节置换术的并发症情况及疗效。方法系统回顾分析2006年8月至2012年12月,共62例(72膝)大于75岁实施全膝关节置换术的患者,记录术前合并症和术后并发症的情况。术后2周,1.5、3、6、12月及之后每年门诊随访,应用HSS评分进行评估。结果所有62例患者中,术中没有死亡和局部并发症。围术期术后系统性并发症31例,并发症发生率为43.1%,共有8例(12膝)失访,54例(60膝)获得随访,随访时间12~72个月,平均(36.9±3.5)个月。HSS评分恢复到平均(86.2±12.8)分,优良率88.3%。结论通过术前合理选择病例,术中、术后密切监护调整,加强出院后的随访和功能康复指导,可以有效地降低术后的各种并发症,使得全膝关节置换术也可以在高龄患者中获得满意的疗效。     

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

Objective

This study aimed to compare the effectiveness and complications between the retropubic and transobturator approaches for the treatment of female stress urinary incontinence (SUI) by conducting a systematic review.

Materials and Methods

We selected all randomized controlled trials (RCTs) that compared retropubic and transobturator sling placements for treatment of SUI. We estimated pooled odds ratios and 95% confidence intervals for intraoperative and postoperative outcomes and complications.

Results

Six hundred twelve studies that compared retropubic and transobturator approaches to midurethral sling placement were identified, of which 16 were included in our research. Our study was based on results from 2646 women. We performed a subgroup analysis to compare outcomes and complications between the two approaches. The evidence to support the superior approach that leads to better objective/subjective cure rate was insufficient. The transobturator approach was associated with lower risks of bladder perforation (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.09-0.32), retropubic/vaginal hematoma (OR 0.32, 95% CI 0.16-0.63), and long-term voiding dysfunction (OR 0.32, 95% CI 0.17-0.61). However, the risk of thigh/groin pain seemed higher in the transobturator group (OR 2.53, 95% CI 1.72-3.72). We found no statistically significant differences in the risks of other complications between the two approaches.

Conclusions

This meta-analysis shows analogical objective and subjective cure rates between the retropubic and transobturator approaches to midurethral sling placement. The transobturator approach was associated with lower risks of several complications. However, good-quality studies with long-term follow-ups are warranted for further research.     

Effects of a novel magnetic orthopedic appliance (MOA-III) on the dentofacial complex in mild to moderate skeletal class III children

Introduction

The objective of this study was to evaluate the changes of skeletal and dental structures in mild to moderate skeletal Class III children following the use of a new magnetic orthopedic appliance (MOA-III).

Methods

A total of 36 patients (14 boys and 22 girls, mean age 9 years and 5 months) who presented with a mild to moderate skeletal Class III jaw discrepancy were treated with MOA-III. Another group of 20 untreated patients (9 boys and 11 girls, mean age 9 years and 2 months) with the same level of deformity served as the control group. The average treatment time was 6.6 months. Radiographs were taken at the same time intervals for both groups. A paired t test was used to determine the significant differences before and after treatment, and a two-sample t test was used to analyze the differences between the treatment and control groups.

Results

The anterior crossbite in all subjects was corrected after MOA-III therapy. The maxillomandibular relationship showed favorable changes (ANB, Wits, overjet increased significantly, P < 0.001). The maxilla was anteriorly positioned (SNA, ptm-A, ptm-S increased significantly, P < 0.001) with clockwise rotation (PP-FH increased, P < 0.001). The mandible showed a slight downward and backward rotation (SNB decreased, P < 0.05, MP-SN, Y-axis increased, P < 0.05). The length of the mandibular body showed no significant changes (Go-Pg, P?>?0.05). Significant upper incisor proclination and lower incisor retroclination were observed (UI-NA increased, P < 0.001, LI-NB, FMIA decreased, P < 0.001). The upper lip moved forward, and the lower lip moved backward (UL-EP increased, P?<?0.001, LL-EP decreased, P?<?0.05). In the control group, most of the parameters showed normal growth, except for some unfavorable mandibular skeletal and soft tissue changes (Go-Pg, Go-Co, MP-SN, N′-SN-Pg′ increased, P < 0.001). Significant positive changes were induced with the MOA-III appliance compared to the untreated group.

Conclusions

The MOA-III was effective for the early treatment of a mild to moderate Class III malocclusion in children.

     

H3K27me3 and VEGF is associated with poor prognosis in patients with synovial sarcoma

Purpose

Previous studies have shown a correlation between the expression of H3K27me3 and pathological characteristics of malignant tumors. This study aimed to investigate the association of H3K27me3 and VEGF expression with clinical outcomes of synovial sarcoma patients.