Table of Content

28 March 2022, Volume 11 Issue 1 Previous Issue    Next Issue

Commentary

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Clinical prospects and opportunities for nanotechnology applied to imaging of osteoarthritis LU Rong, CHEN Shuang 2022, 11 (1):  1-8.  doi: 10.3969/j.issn.2095-378X.2022.01.001 Abstract ( 187 )   PDF (678KB) ( 702 )   Save Osteoarthritis （OA） is the most common bone and joint disease. At present, it is considered no longer just a degenerative disease, but a systemic, metabolic, and inflammatory disease. OA is the main cause of disability of the elderly and one of the sources of social costs. Many new technologies and materials are under preclinical development to address this multifactorial disease. In terms of diagnosis, nano contrast agents for MRI, CT, and PA provide a lot of qualitative and quantitative information about cartilage structure and lesions, which are known biomarkers of OA. The opportunities for the development of nano medicine and the prospects of imaging and diagnosis based on nanotechnology are extremely broad. References | Related Articles | Metrics

Original article

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Application of free and pedicled skin flaps to repair lower leg skin defects CHEN Xingyuan, WU Junfu, ZHANG Shijin, YU Enting 2022, 11 (1):  9-13.  doi: 10.3969/j.issn.2095-378X.2022.01.002 Abstract ( 134 )   PDF (753KB) ( 293 )   Save Objective To explore the clinical application of free and pedicled skin flaps in the repair of lower leg skin defects. Methods A retrospective analysis of 110 cases of lower leg skin defects repaired by skin flap from September 2017 to September 2020 were conducted. According to the type of skin flap, the patients were divided into a free group and a pedicled group. The intraoperative and postoperative conditions of the patients were analyzed respectively to understand the difference between the two groups of patients after receiving treatment. Results The operation time of the free group was longer than that of the pedicled group by more than 5 h, and the amount of intraoperative blood loss was more than that of the pedicled group （P<0.05）. In addition, the incidence rate of postoperative contractures in the free group was higher than that in the pedicled group, and the difference between the groups was statistically significant （P<0.05）. At the same time, the postoperative sensory recovery in the treated area of the lower leg was good in the two groups, with no big deviation. It could be seen from the survival curve that the flap survival rates of the two groups of patients were high, and the survival rate of the pedicled group was slightly higher than that of the free group. Conclusion Both flap repairing methods for lower leg skin defects are effective. Free flap is more adaptable, while pedicled flap is more manipulative and more effective. References | Related Articles | Metrics

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Risk factors for secondary surgery at distant sites after craniotomy in patients with severe traumatic brain injury DU Haiping, GAO Feng 2022, 11 (1):  14-18.  doi: 10.3969/j.issn.2095-378X.2022.01.003 Abstract ( 98 )   PDF (604KB) ( 333 )   Save Objective To analyze the risk factors for secondary surgery at distant sites after craniotomy in patients with severe craniocerebral trauma, so as to provide reference for perioperative monitoring and treatment. Methods A retrospective analysis was conducted. A total of 163 cases of severe traumatic brain injury （TBI） were selected from from January 2016 to March 2019, and according to whether secondary surgery was performed at distant sites, they were divided into a secondary surgery group （n=37） and a control group （n=126）. Comparisons were made in trauma site, hematoma site, preoperative Glasgow Coma Scale （GCS） score, and other factors may cause secondary surgery at distant sites, and significant factors were assigned a value based on weight. A multiple logistic regression analysis was also conducted. Results In the secondary surgery group, the good and moderate disability rate was 45.94%, lower than 65.87% in the control group, and the difference was statistically significant （P<0.05）. In the secondary surgery group, the proportions of patients with occipital impact, hematoma on the contralateral or bilateral position, associated injury, decompression by bone flap removal, preoperative PLT < 80×109/L, midline displacement, and distal fracture were higher than those in the control group, and the differences were statistically significant （P<0.05）. Logistic regression analysis results showed that occipital impact + contralateral hematoma, preoperative PLT < 80×109/L, decompression by bone flap removal, and distal fracture were risk factors for secondary surgery of distal part in patients with severe TBI （OR=0.704, 1.573, 4.251, 5.092; 95%CI： 0.517-1.296, 1.106-4.821, 2.592-6.281, 3.702-13.173）. Conclusion Occipital impact + contralateral hematoma, preoperative PLT < 80×109/L, decompression by bone flap removal, and distal fracture are risk factors for secondary surgery at distant sites in patients with severe TBI. Patients with a combinition of these factors should be closely monitored after craniotomy. Once there is an increase in intracranial pressure or change in consciousness, a cranial CT examination should be performed promptly, and an operation should be performed promptly if the indication for secondary surgery in the distal compartment is met. References | Related Articles | Metrics

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Clinical evaluation of laparoscopic-assisted transanal total mesorectal excision for rectal cancer TAN Zhanhai, CHEN Jianrong, ZHANG Jifa, ZHOU Lianming, ZHANG Guangjun, SHAN Yuanzhou 2022, 11 (1):  19-21.  doi: 10.3969/j.issn.2095-378X.2022.01.004 Abstract ( 163 )   PDF (560KB) ( 395 )   Save Objective To investigate the clinical efficacy of laparoscopic-assisted transanal total mesorectal excision （laparoscopic-assisted taTME） on rectal cancer. Methods From May 2019 to May 2021, 34 cases of rectal cancer who underwent laparoscopic total mesorectal excision （TME） were selected as control group, and 46 cases of rectal cancer with taTME were selected as observation group. The clinical data were retrospectively analyzed. Results The operation time, blood loss, length of hospital stay, and incidence rate of postoperative complications in the observation group were significantly less than those in the control group （P<0.05）, and the quality of life in the observation group was better than that in the control group （P<0.05）. There were no significant differences in the total number of lymph nodes dissected, success rate of anal preservation, rate of positive margin resection, time of first postoperative eating, and time of first anal exhaust between the two groups （P>0.05）. Conclusion Laparoscopic-assisted taTME surgery in the treatment of rectal cancer can significantly shorten operation time, reduce important neurovascular injury and postoperative complications, while ensure surgical effect, which is worthy of clinical promotion. References | Related Articles | Metrics

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Effect of kyphoplasty on osteoporotic vertebral compression fracture LIU Guangpeng, ZHU Yanlin, TIAN Deyu 2022, 11 (1):  22-24.  doi: 10.3969/j.issn.2095-378X.2022.01.005 Abstract ( 77 )   PDF (549KB) ( 522 )   Save Objective To observe the clinical effect of percutaneous kyphoplasty （PKP） on osteoporotic vertebral compression fracture （OVCF）. Methods A total of 120 patients with OVCF from April 2018 to March 2021 were selected as study subjects and randomly divided into an observation group （n=60, receiving PKP） and a control group （n=60, receiving conservative treatment）, and the efficacy of the two groups was observed. Results After treatment, the average height of injured vertebrae, kyphosis angle, and VAS score in both groups were significantly improved （P<0.05）, the average height of injured vertebrae and kyphosis angle in the observation group were significantly higher than those in the control group （P<0.05）, and the VAS score in the observation group was significantly lower than that in the control group （P<0.05）. FIM score of the observation group was significantly higher than that of the control group （P<0.05）. Conclusion PKP has a significant effect on OVCF, which can significantly alleviate pain symptoms, restore the height of injured vertebra, and correct kyphosis deformity angle, improve the quality of daily life of patients, and can be promoted in clinical application. References | Related Articles | Metrics

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Clinical efficacy of laparoscopic hepatectomy on primary liver cancer ZHOU Kai, LIU Shuguang 2022, 11 (1):  25-27.  doi: 10.3969/j.issn.2095-378X.2022.01.006 Abstract ( 105 )   PDF (555KB) ( 351 )   Save Objective To investigate the clinical efficacy of laparoscopic hepatectomy on primary liver cancer. Methods A total of 68 patients with primary liver cancer from October 2019 to November 2020 were divided into a control group （n=28） and an observation group （n=40） according to different surgical methods. The control group received open hepatectomy and the observation group underwent laparoscopic hepatectomy. Perioperative indexes, liver function, postoperative recovery, and complications were compared between the two groups. Results The observation group showed shorter operation time, less amount of intraoperative bleeding, shorter postoperative ICU time, hospital stay, and gastrointestinal function recovery time than the control group （P<0.05）. The indexes of liver function such as aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, and total bilirubin （TBIL） in the observation group were better than those in the control group （P<0.05）. The incidence rates of complications such as pleural effusion, ascites, bile leakage, incision infection, and liver failure in the observation group were lower than those in the control group （P<0.05）. Conclusion Laparoscopic hepatectomy has an ideal and safe effect on primary liver cancer. References | Related Articles | Metrics

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Ultrasound-guided supraclavicular brachial plexus block in operation of upper limb fractures in elderly patients YANG Tao, LI Yanhua, ZHOU Ying 2022, 11 (1):  28-30.  doi: 10.3969/j.issn.2095-378X.2022.01.007 Abstract ( 110 )   PDF (575KB) ( 441 )   Save Objective To explore the effect of ultrasound-guided supraclavicular brachial plexus block on elderly patients with upper limb fracture surgery. Methods A total of 100 elderly patients with upper limb fracture surgery from January 2019 to January 2021 were selected as study subjects. They were divided into a traditional method group （n=50） and an ultrasound-guided group （n=50）. Comparisons were made in anesthesia effect, block onset time of the main brachial plexus branches, complete block rate within 30 min, and the occurrence of complications between the two groups. Results The excellent and good rate of anesthesia in the ultrasound-guided group was higher than that in the traditional method group （P<0.05）. The ultrasound-guided group showed shorter block onset time of the ulnar nerve, median nerve, musculocutaneous nerve, and radial nerve block than the traditional method group （P<0.05）, and higher complete block rates of the ulnar nerve and median nerve within 30 min （P<0.05）. No significant difference was found in the complication rate between the two groups （P>0.05）. Conclusion The effect of ultrasound-guided supraclavicular brachial plexus block for elderly patients with upper limb fracture surgery is better than the block with acupuncture positioning. The former method can shorten the onset time of anesthesia block, increase complete block rate within 30 min, and has high safety. References | Related Articles | Metrics

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Effects of different anesthesia methods on postoperative cognitive function and recovery of elderly patients with hip fracture WU Tie, CHEN Jiachen 2022, 11 (1):  31-34.  doi: 10.3969/j.issn.2095-378X.2022.01.008 Abstract ( 112 )   PDF (664KB) ( 382 )   Save Objective To explore the effects of different anesthesia methods on postoperative cognitive function and recovery of elderly patients with hip fracture. Methods A total of 100 elderly hip fracture patients admitted to the People's Hospital of Yangdong District, Yangjiang City from April 2018 to April 2021 were selected and divided into a control group and an observation group （50 cases in each group） by lottery method. The control group was treated with traditional intravenous anesthesia, while the observation group was given local infiltration anesthesia on the basis of the control group. Comparisons between the two groups were made in the onset time of pain block, operation time, Ramsay sedation scores at different time points, cognitive function, postoperative time to get out of bed, and postoperative eating time. Results There was no significant difference in the onset time of pain block and operation time between the two groups （P>0.05）. The Ramsay sedation score of the observation group was higher than that of the control group at 5 min after awakening （P<0.05）. There was no significant difference in the scores of Montreal Cognitive Assessment before or after the surgery （P>0.05）. The observation group’s postoperative time to get out of bed and postoperative eating time were shorter than those of the control group （P<0.05）. Conclusion Comparing with intravenous anesthesia, intravenous anesthesia combined with local infiltration anesthesia for elderly patients with hip fracture has a more stable postoperative sedative effect, and it can shorten the postoperative time to get out of bed and and eating without affecting the postoperative cognitive function of the patients. References | Related Articles | Metrics

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Observation on effect and complications of laparoscopic inguinal hernia repair with ultrasound-guided transversus abdominis plane combined with iliohypogastric nerve block ZHANG Guoqiang, ZHAO Chunjiang, WU Haibin, OU Jianying, HUANG Zhongyang, LI Guangxiang 2022, 11 (1):  35-38.  doi: 10.3969/j.issn.2095-378X.2022.01.009 Abstract ( 103 )   PDF (626KB) ( 352 )   Save Objective To study the effect of laparoscopic inguinal hernia repair with ultrasound-guided transversus abdominis plane （TAP） combined with iliohypogastric nerve block and to analyze the complications. Methods From August 2019 to July 2021, a total of 80 patients who planned to undergo laparoscopic inguinal hernia repair were included in this study. The patients were divided into a combined treatment group and a control group, with 40 cases in each group. The control group received ultrasound-guided TAP block, while the combined group received ultrasound-guided TAP combined with iliohypogastric nerve block. The mean arterial pressure （MAP）, heart rate （HR）, and blood oxygen saturation （SpO2） levels at different time points during perioperative period were compared between the two groups, as well as the pain and complications at different time points after block. Results The MAP levels of the combined treatment group at 10 min after anesthesia and at pulling the hernia were higher than the levels of the control group （P<0.05）, and there were no significant differences in HR and SpO2 levels between the two groups at different time periods （P>0.05）. The VAS scores of the combined treatment group at 2 h, 6 h, 12 h, 24 h, and 48 h after block were lower than the scores of the control group （P<0.05）. The incidence rates of nausea and vomiting, heart rate increase, and blood pressure increase in the combined treatment group were 2.50%, 0.00%, and 0.00%, respectively, which were all lower than those of the individual treatment group （17.50%, 10.00%, and 10.00%; P<0.05）. Conclusion Laparoscopic inguinal hernia repair with ultrasonic-guided TAP combined with iliohypogastric nerve block is beneficial to maintain hemodynamic stability, has significant analgesic effects, and can effectively reduce the incidence of complications. References | Related Articles | Metrics

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Factors associated with isolated calf deep vein thrombosis after spine surgery ZHU Mengying 2022, 11 (1):  39-43.  doi: 10.3969/j.issn.2095-378X.2022.01.010 Abstract ( 118 )   PDF (583KB) ( 578 )   Save Objective To investigate influencing factors for isolated calf deep vein thrombosis （ICDVT） after spine operation, in order to provide a theoretical basis for early prevention and treatment of ICDVT cases. Methods Inpatients with spinal diseases from June 2017 to June 2019 were selected and analyzed. Their general information, disease history, diagnosis code, and operation information were collected. Results The results of single-factor analysis and binary logistic regression analysis showed that age, diabetes mellitus history, body mass index（BMI）, bedridden time, operative method, the use of dehydrants, and periopeartive blood transfusion were the risk factors of ICDVT, while anticoagulation was a protective factor. Conclusion ICDVT after spine surgery may increase the risk of pulmonary embolism, Preoperative blood glucose control and early mobilization, patients with a high risk of venous thrombosis may receive anticoagulant therapy to reduce the incidence rates of ICDVT. References | Related Articles | Metrics

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Effect of single-channel minimally invasive percutaneous nephrolithotomy plus retrograde intrarenal surgery on complex renal calculi MO Xun, WU Shijie, LIANG Zhiqiang, FENG Shisen 2022, 11 (1):  44-47.  doi: 10.3969/j.issn.2095-378X.2022.01.011 Abstract ( 86 )   PDF (623KB) ( 376 )   Save Objective To explore the effect of single-channel minimally invasive percutaneous nephrolithotomy plus retrograde intrarenal surgery on complex renal calculi. Methods A total of 56 complex renal calculi patients treated from January 2017 to January 2020 were selected and randomly divided into a control group and an observation group, with 28 cases in each group. The control group received multi-channel minimally invasive percutaneous nephrolithotomy; the research group received single-channel minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery. Operation conditions, pain and comfort scores, micturition conditions, life quality, and postoperative complications of the two groups were observed. Results There were no significant differences in operation time,preoperative International Prostate Symptom Score （IPSS）, maximum flow rate （Qmax）, and life quality between the two groups （P>0.05）. After surgery, the operation conditions in the research group were better than those in the control group; after 5 h and 48 h of surgery, the pain scores of the research group were lower than those of the control group, and the comfort scores were higher; after 3 months of surgery, the IPSS and Qmax of the research group were better than those of the control group; the life quality score at discharge of the research group was higher than that of the control group; the postoperative complication rate in the research group （10.71%） was lower than that in the control group （28.57%） （P<0.05）. Conclusion The single-channel minimally invasive percutaneous nephrolithotomy combined with retrograde intrarenal surgery can shorten hospital stays, reduce postoperative pain and postoperative complication rate, and improve life quality, treatment safety, and comfort degree. References | Related Articles | Metrics

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Clinical efficacy and safety analysis of maxillary sinus life with oral implant on maxillary posterior tooth loss LI Yan, NING Weimin, YANG Gang 2022, 11 (1):  48-50.  doi: 10.3969/j.issn.2095-378X.2022.01.012 Abstract ( 172 )   PDF (581KB) ( 361 )   Save Objective To analyze the clinical efficacy and safety of maxillary sinus lift with oral implant on maxillary posterior tooth loss. Methods The clinical data of 98 patients with maxillary posterior tooth loss who received treatment from January 2018 to February 2021 were retrospectively analyzed. According to restoration methods, the patients were divided into a control group and a study group, with 49 cases in each group. The control group was fixed by conventional porcelain-fused-to-metal bridge, while the study group was fixed by maxillary sinus lift and implant. Clinical efficacy, retention function, masticatory function, aesthetic appearance, comfort, and incidence of complications （gingivitis, internal crown release, and bleeding） were compared between the two groups. Results The total effective rate of the study group was 100.00%, which was higher than that of the control group （91.84%）, and the difference was statistically significant （P<0.05）. The retention function, masticatory function, aesthetic appearance, and comfort scores of the study group were significantly higher than those of the control group, and the differences were statistically significant （P<0.05）. The incidence rate of complications in the study group （2.04%） was lower than that in the control group （12.24%）, and the difference was statistically significant （P<0.05）. Conclusion Maxillary sinus lift in the treatment of maxillary posterior tooth loss can improve the retention function, masticatory function, aesthetic appearance, and comfort, and reduce the incidence of complications. References | Related Articles | Metrics

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Lymphoepithelioma-like carcinoma of the skin： A case report and literature review WANG Qian, ZHU Xuyou, ZHANG Haoyang, SUN Heguo, LI Jia, GAO Qingyun, YI Xianghua 2022, 11 (1):  51-55.  doi: 10.3969/j.issn.2095-378X.2022.01.013 Abstract ( 116 )   PDF (12315KB) ( 332 )   Save Objective To investigate the clinical and pathological features of lymphoepithelioma-like carcinoma of the skin （LECS） and improve clinical diagnosis and treatment of the disease. Methods The clinical manifestations, gross pathological morphology, histological features, and immunohistochemical phenotype of a patient with LECS were analyzed, and the related literature was reviewed. Results The patient was an elderly male with a 1.3 cm dark red hard nodular lesion on the left cheek. The nodule was solid and without obvious capsule. Immunohistochemical results showed that the tumor cells were stained positive for P-CK, CK5/6, EMA, S100 and CD1α （partial positive expression）, Ki-67 （40%）, and PD-L1 （50%）, and negative for P40, Melan-A, and CEA. The proliferative lymphocytes around the tumor cells were diffuse positive for LCA, and the lymphocytes in and around the cancer nest were mainly CD3 positive T lymphocytes. EBER in situ hybridization of tumor cells was negative. Conclusion LECS on the check is very rare, and its pathological morphology and immunohistochemical phenotype are similar to those in other sites. EBER examination is valuable in differential diagnosis. Local complete resection is the first choice for the treatment of the tumor, and the prognosis is relatively good. References | Related Articles | Metrics

Review

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Application and development of digital medicine in orthopedic surgery CAO Zhiyou, WU Weiwei, MO Fengbo, QUAN Kun, DAI Min 2022, 11 (1):  56-59.  doi: 10.3969/j.issn.2095-378X.2022.01.014 Abstract ( 167 )   PDF (497KB) ( 550 )   Save In today’s society, with the popularity of the Internet, information technology has developed rapidly and has been applied to various fields. Among them, digital medicine is the full embodiment of how well information technology is being applied and developed in medical field. Digital orthopedics is a discipline developed by combining digital medical technology with clinical orthopedics, which enables digital technologies such as orthopedic sensors, computer-aided orthopedic navigation technology, as well as robotic surgery system to be fully utilized in the field of orthopedics, and has greatly improved the orthopedic surgery techniques. This paper summarized the application and development of digital medicine in orthopedic surgery. References | Related Articles | Metrics

Medical instrument

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Remote teaching of digestive endoscopy based on 5G network WU Xiaofen, DONG Ningxin, SHAO Lei 2022, 11 (1):  60-63.  doi: 10.3969/j.issn.2095-378X.2022.01.015 Abstract ( 171 )   PDF (7283KB) ( 275 )   Save Objective To provide cross-regional remote medical services hospitals in border cities of the Belt and Road Initiative and to build seamless transmission and sharing of information and expert resources. Methods Based on the 5G network rolled out between Tongji Hospital Affiliated to Tongji University and Karamay Central Hospital, a video conference system was built, and a transformed medical trolley was connected. Results Remote video connection and operation teaching of digestive endos copy between Tongji Hospital and Karamay Central Hospital were realized. Conclusion The remote operation teaching based on 5G network solves the problems of time, space, and safety, realizes the sharing of high-quality medical resources, greatly improves teaching effect and training efficiency, and reduces training cost. References | Related Articles | Metrics

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Feasibility of a new cryoprobe for cryobiopsy QIAN Kun, LI Huan, ZHANG Lei, YANG Jia, LIU Bin 2022, 11 (1):  64-68.  doi: 10.3969/j.issn.2095-378X.2022.01.016 Abstract ( 151 )   PDF (773KB) ( 423 )   Save Objective To explore the feasibility of a new cryoprobe for cryobiopsy. Methods A new type of cryoprobe and two types of traditional cryoprobe were used for in vitro transbronchial cryobiopsy. The size of biopsy tissues obtained by different specifications of cryoprobes was measured and compared. Results In most cases, the size of biopsy tissues was positively correlated with the freezing time, and the diameter of cryoprobe was positively correlated with the size of tissues over the same freezing time. There was no significant difference in the mass and diameter of biopsy tissues with or without adoptor. At different freezing time, the tissue size by the new cryoprobe was similar to that by the traditional cryoprobes. Conclusion The significant advantages of the new type of cryoprobe are its smaller diameter and flexibility which allow it easily to reach the upper lobe of the lung and other lesions which are difficult by conventional cryoprobes, and at the same time reduce the occurrence of bleeding; although the size of tissues obtained in a single time by the new cryoprobe is not comparable with the traditional types, it can still achieve the similar amount through adjusting freezing time as appropriate. References | Related Articles | Metrics

Nursing

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Nursing management strategy in general wards under the background of regular prevention and control of COVID-19 epidemic SUN Xiaomin, LIN Yan, XU Fanglei 2022, 11 (1):  69-72.  doi: 10.3969/j.issn.2095-378X.2022.01.017 Abstract ( 157 )   PDF (529KB) ( 282 )   Save Under the background of regular prevention and control of COVID-19 epidemic, the management of general wards has gradually changed from short-term passive emergency measures to regular prevention and control. In view of occasional small-scale rebound of the epidemic in some areas of China, strengthening epidemic prevention and control management in general wards is still one of the key tasks of ward management. This paper summarized the nursing management strategies in general wards under the background of regular prevention and control of COVID-19 epidemic from aspects of nursing management in general wards, the setting and management of emergency isolation wards, and the closed-loop management for epidemic prevention and control, aiming to provide reference for clinical nursing managers. References | Related Articles | Metrics

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Effect of pain nursing intervention on the quality of life of patients with craniocerebral trauma in neurosurgery department WEI Baozhen 2022, 11 (1):  73-76.  doi: 10.3969/j.issn.2095-378X.2022.01.018 Abstract ( 107 )   PDF (573KB) ( 433 )   Save Objective To explore the effect of pain nursing intervention on improving the quality of life of patients with craniocerebral trauma in neurosurgery department. Methods From January 2018 to March 2020, 90 cases of patients with craniocerebral trauma were randomly divided into two groups, with 45 cases in each group. The control group received routine nursing, and the observation group received pain nursing on the basis of routine nursing. The scores of pain, comfort, bad mood, and life quality were compared between the two groups. Results At 12-48 h after operation, the pain score in the observation group was lower than that in the control group （P<0.05）, and the comfort score in the observation group was higher than that in the control group （P<0.05）. After nursing, the scores of anxiety and depression in the observation group were lower than those in the control group （P<0.05）, and the score of life quality in the observation group was higher than that in the control group （P<0.05）. Conclusion The application of pain nursing in patients with craniocerebral trauma in neurosurgery department can reduce postoperative pain, improve postoperative comfort, improve psychological status, and improve their quality of life. References | Related Articles | Metrics