ObjectiveTo summarize the research progress in creep characteristics of lumbar intervertebral disc.MethodsThe relevant literature at home and abroad was systematically searched. Then, the concept and structural basis of lumbar disc creep, the description of creep characteristics, and the latest progress of its influencing factors were summarized and analyzed.ResultsThe intervertebral disc is viscoelastic. After loading, the deformation increases with time. However, the degree of increase is not linear with time. That is creep, which plays an important role in buffering the load generated by human activities and absorbing energy in order to maintain stable movement of the spine. Both experimental and simulation studies can well describe the creep behavior of intervertebral disc. Various models including standard linear solid model and corresponding constitutive equations can quantify and compare the creep characteristics, which can be obviously changed by the degeneration of intervertebral disc and the mode of loading stress.ConclusionCreep is an important mechanical properties of intervertebral discs, and an in-depth understanding of the creep characteristics of lumbar intervertebral discs is of great guiding significance for the intervention and treatment of low back pain.
目的:探討骨髓細胞形態學變化特征在鑒別診斷骨髓增生異常綜合征(MDS-RA)及巨幼紅細胞性貧血(MA)中的意義。方法:骨髓片瑞氏染色,記數骨髓中有核細胞200個,并觀察其形態。結果:(1)MDS的骨髓象除巨幼樣變外,還有形態的異常。以淋巴樣小巨核細胞最具有診斷意義。(2)巨幼紅細胞性貧血三系血細胞的巨變程度比MDS-RA明顯.結論:MDS-RA與MA細胞形態學既具有相似性,又具有各自不同特征。
ObjectiveTo conclude the effect of surgery in the treatment of primary gastrointestinal lymphoma (PGIL) and provide evidence in subsequent studies and treatments in PGIL.MethodThe relevant literatures at home and abroad in recent years about the role of surgery in the treatment of PGIL were reviewed.ResultsCommon clinical strategies included surgery, chemotherapy, radiotherapy, and so on. Due to the low incidence, there were few large sample, multi-center, and prospective studies. The surgery was beneficial on relieving the potential risk of complications such as bleeding, perforation, and obstruction. In addition, the surgery provided easy access for direct observation and biopsy. Furthermore, specific pathological stage was necessary for subsequent therapy. For certain PGIL, the indications of surgery became increasingly clear. But it was controversial about treatment strategy of PGIL, especially the effect of surgery.ConclusionThe treatment strategy should be individualized according to the lesion site, pathological type, and clinical stage.
Objective To investigate the clinical value of occlusal guide plate combined with intermaxillary fixation screw in mandibular defect repair with free fibular flap. Methods Between August and December 2011, 7 patients with mandibular tumor were treated, including 5 cases of ameloblastoma and 2 cases of gingival cancer. Of 7 patients, 4 were males and 3 were females, aged 32-65 years (median, 50 years). Occlusal guide plate was prepared and the implanted position of intermaxillary fixation screws was determined preoperatively. Hemimandibulectomy was performed in 5 cases, half mandibular segmental resection with condyle reservation in the other 2 cases. The free fibular flaps of 11-13 cm in length were harvested for repairing mandibular defects. When the free fibular flaps were fixed, the occlusal guide plate and intermaxillary fixation screws were utilized to restorate the occlusal relation. The donor site was sutured directly. Results The average operation time was 9.5 hours (range, 7-12 hours). All free fibular flaps survived completely. All incisions at the donor site and recipient site healed by first intention. All patients were followed up 10-14 months with an average of 12.3 months. All patients had symmetrical face, good occlusal relation, normal mouth opening, and normal mandibular lateral movement, and no pain of bilateral temporomandibular joints occurred. Panoramic tomography showed good mandibular contour and the suitable emplacement of fibular flaps postoperatively. No tumor recurrence occurred during follow-up period. Conclusion When repairing the mandibular defect with free fibular flap, occlusal guide plate with intermaxillary fixation screw contributes to simplifying operation, accurate recovery of the appearance and occlusal relation, and improving the oral comfort level postoperatively.
ObjectiveTo evaluate the diagnostic value of monitoring 1,3-beta-D-glucan (G test) in patients with autoimmune disease complicated with invasive fungal disease (IFD). MethodsA retrospective study was performed in hospitalized patients in the First Affiliated Hospital of Zhengzhou Universisty who were diagnosed as autoimmune disease with lung infection during the immunosuppressive therapy between January 2014 and January 2016. A total of 372 patients were enrolled in this study. All subjects were classified according to the 2006 diagnostic criteria and treatment of invasive pulmonaary fungal infection, with serum 1,3-β-D-glucan results not included in the diagnosis. There were 18 cases with proven IFD, 35 cases with probable IFD, and 70 ceses with possible IFD. Fifty-three patients with proven IFD or probable IFD were as a case group, and another 249 patients with no evidence for IFD were as a control group. The value of the G test for diagnosis of automimmune disease with IFD was analyzed by ROC curve. ResultsThe serum 1,3-β-D-glucan level was significantly higher in the case group when compared with the control group [median (interquartile range): 135.0 (63.1 to 319.0) pg/ml vs. 75.9 (41.2 to 88.1) pg/ml, P<0.05]. When the cut-off value of serum 1,3-β-D-glucan level was set at 93.8 pg/ml, the sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of autoimmune disease with IFD were 0.65 (95% CI 0.56 to 0.73), 0.87 (95% CI 0.83 to 0.92), 0.70 (95% CI 0.64 to 0.81), and 0.83 (95% CI 0.79 to 0.88), respectively. ConclusionThe 1,3-beta-D-glucan test is a valuable method for diagnosis of IFD in patients with autoimmune disease.
Objective To summarize recent progress of microwave ablation combined with endoscopic technique for liver cancer. Method The literatures relevant to treatment of microwave ablation combined with endoscopic technique for liver cancer in recent years were identified by searching PubMed and CNKI, then summarized and reviewed. Results The treatment of endoscopic microwave ablation or it combined with hepatectomy, interventional embolization, neoadjuvant chemotherapy, and two-step hepatectomy could expand the treatment indications for liver cancer, increase the cure rate, and reduce the intraoperative bleeding, postoperative complications and recurrence. Conclusions Microwave ablation combined with endoscopic technique has less invasion and fast recovery for patient with liver cancer. Multi-disciplinary team collaboration and rational use of varied therapeutic methods in treatment of liver cancer could help to improve treatment effect and prolong survival time of patient.
Transcranial direct current stimulation (tDCS) is a brain stimulation intervention technique, which has the problem of different criteria for the selection of stimulation parameters. In this study, a four-layer real head model was constructed. Based on this model, the changes of the electric field distribution in the brain with the current intensity, electrode shape, electrode area and electrode spacing were analyzed by using finite element simulation technology, and then the optimal scheme of electrical stimulation parameters was discussed. The results showed that the effective stimulation region decreased and the focusing ability increased with the increase of current intensity. The normal current density of the quadrilateral electrode was obviously larger than that of the circular electrode, which indicated that the quadrilateral electrode was more conducive to current stimulation of neurons. Moreover, the effective stimulation region of the quadrilateral electrode was more concentrated and the focusing ability was stronger. The focusing ability decreased with the increase of electrode area. Specifically, the focusing tended to increase first and then decrease with the increase of electrode spacing and the optimal electrode spacing was 64.0–67.2 mm. These results could provide some basis for the selection of electrical stimulation parameters.
ObjectiveTo explore the mid-term effectiveness of large-head metal-on-metal total hip arthroplasty (THA).MethodsA retrospective analysis was made on the clinical date of 40 patients (43 hips) who were treated with the large-head metal-on-metal THA between April 2009 and June 2010. There were 18 males (20 hips) and 22 females (23 hips) with an average age of 55.1 years (range, 20-85 years). Unilateral hip was involved in 37 cases and bilateral hips in 3 cases. The disease causes included osteonecrosis of the femoral head in 14 cases (15 hips), osteoarthritis in 6 cases (7 hips), rheumatoid arthritis in 4 cases (4 hips), femoral neck fracture in 4 cases (4 hips), and developmental dysplasia of the hip in 12 cases (13 hips). Before operation, the Harris score and University of California Los Angeles (UCLA) score were 38.51±5.62 and 4.21±1.43, respectively. The visual analogue scale (VAS) score was 6.78±0.95.ResultsAll patients were followed up 6.7-8.3 years (mean 7.5 years). All incisions healed primarily and no neurovascular injury, infection, and hip dislocation occurred. At last follow-up, the Harris score and UCLA score were 93.33±3.21 and 7.32±1.45, respectively, showing significant differences when compared with preoperative scores (t=51.753, P=0.000; t=23.232, P=0.000). The thigh pain occurred in 3 cases (3 hips) in whom the inflammatory pseudotumor of soft tissues was found in 1 case (1 hip). Postoperative X-ray films showed that the acetabular abduction angle and anteversion angle were (46.5±3.2)° and (14.8±3.6) °, respectively. The initial stability of femoral stem prosthesis was excellent in 39 hips and good in 4 hips according to Mulliken standard. Osteolysis occurred in 2 hips and revision was performed in 1 hip of secondary loosening of prosthesis. The rest patients had no prosthesis loosening or sinking.ConclusionThe mid-term effectiveness of large-head mental-on-mental THA in treatment of the terminal diseases of hips are good.