Deep brain stimulation (DBS), as a major branch of functional neurosurgery, has been widely used in the treatment of diseases such as Parkinson disease, primary tremor, and muscle tone disorder. It can effectively alleviate patients’ symptoms, reduce drug dependence, and minimize adverse drug reactions. In recent years, with the rapid development of artificial intelligence (AI) in the medical field, it has gradually penetrated into multiple aspects of DBS. This article reviews the current application status of AI technology in DBS therapy and explores its future development prospects, providing new solutions for significant improvement in patients’ quality of life.
ObjectiveTo investigate the CT presenting rate and features of gastric bare area (GBA, including the area posterior to GBA and the adipose tissue in the gastrophrenic ligament) without pathologic changes.MethodsThirty cases with superior peritoneal ascites, but without pathological involvement of GBA were included into the study to show the normal condition of GBA, including the presenting rate and CT features. We selected some cases with GBA invasion by inflammation or neoplasm to observe their CT features. ResultsAll cases with superior peritoneal ascites showed the GBA against the contrast of ascites with the presenting rate of 100%. The GBA appeared at the level of gastricesophageal conjunction and completely disappeared at the level of hepatoduodenal ligament and Winslow’s foramen. The maximum scope of GBA presented at the level of the sagital part of the left portal vein with mean right to left distance of （4.39±0.08）cm (3.8~5.7 cm) (distance between the left and right layer of the gastrophrenic ligament). In acute pancreatitis, the width of GBA increased, in which local hypodensity area could be seen. In gastric leiomyosarcoma invading GBA, the mass could not separate from the crus of the diaphragm. In lymphoma and metastasis invading GBA, the thickness of GBA increased and the density was heterogeneous, in which lymph nodes presenting as small nodes or fused mass. ConclusionThe results of this study show that it is helpful to use contrast enhanced spiral CT scanning to observe the change of GBA and to diagnose retroperitoneal abnormalities that involving GBA comprehensively and accurately.
Objective To retrospectively compare short-term outcomes and health economics of PHS versus UHS for inguinal hernia repair. Methods We included 105 patients suffering from reducible inguinal hernia hospitalized in the First Affiliated Hospital of Lanzhou University from September, 2007 and September, 2012. The referred hernia types involved direct and indirect hernia (unilateral and bilateral). Based on different repair materials, the patients were divided into two groups, PHS group (n=53) and UHS group (n=52). Outcome parameters for comparison included incidences of seroma and scrotum edema, hospital duration, costs, etc. Results There were no differences in age, sex, hernia type, incidences of seroma and scrotum edema after surgery, hospital duration and costs between the two groups. However, the patients in the PHS group spent less money than those in the UHS group regarding the costs of materials and hospitalization, with significant differences. Conclusion For inguinal hernia repair, PHS and UHS are alike in reducing short-term complications, but PHS can significantly reduce patients’ economic burden due to less costs.
Objective To evaluate the short-term results of discectomy combined with Isobar non-fusion internal fixation. Methods Between May 2006 and May 2008, 65 cases of single segment lumbar disc protrusion were random surgically treated by discectomy combined with Isobar non-fusion internal fixation (34 cases, group A) and single discectomy (31 cases, group B), respectively. In group A, there were 18 males and 16 females with an average age of 38.8 years (range, 23-51 years); the involved segments were L2,3 (1 case), L3,4 (4 cases), L4,5 (20 cases), and L5, S1 (9 cases), including 11 cases of protrusion type, 16 cases of prolapsed-type, and 7 cases of sequestered type; and the mean disease duration was 7.2 months (range, 1-66 months). In group B, there were 19 males and 12 females with an average age of 39.2 years (range, 21-49 years); the involved segments were L3,4 (2 cases), L4,5 (24 cases), and L5, S1 (5 cases), including 13 cases of protrusion type, 15 cases of prolapsed-type, and 3 cases of sequestered type; and the mean disease duration was 6.5 months (range, 3 weeks to 72 months). There was no significant difference in the general data between 2 groups (P gt; 0.05). The surgical results were assessed by visual analogue scale (VAS) for back/leg pain and the Oswestry disabil ity index (ODI). The height of involved intervertebral space was measured dynamically after operation. Results The patients of two groups were followed up 32 months on average (range, 24-49 months). All cl inical symptoms of the patients were notably improved in 2 groups. One patient in group B experienced postoperative cerebral fluid leakage, and was cured after extubation, changing posture, and other measures. There was no implant failure, such as pedicle fracture, screw loosening, or screw malposition during the follow-up. The ODI and VAS were significantlyimproved after operation. The back and leg pain VAS scores at each time point were decreased significantly when compared with
Objective To investigate the clinical characteristics and death risk factors of patients with community acquired pneumonia and sepsis. Methods Data of 350 patients with community-acquired pneumonia and sepsis admitted to the Intensive Care Unit of Third Xiangya Hospital of Central South University from January 2015 to October 2021 were retrospectively analyzed, and their basic characteristics, laboratory results and treatment were analyzed. Results The absolute value of white blood cell, neutrophil ratio, absolute value of neutrophil, inflammatory index, liver and kidney function, coagulation function, cardiac enzymology, lactic acid and sequential organ failure evaluation score of patients with community acquired pneumonia sepsis in the non-survival group were higher than those in the survival group. Logistic regression analysis showed that respiratory rate, heart rate, mean arterial pressure, blood oxygen saturation, C-reactive protein, D-dimer, lactic acid, creatinine and lymphocyte ratio may be independent risk factors for 28-day death in patients with community-acquired pneumonia and sepsis.The receiver operating characteristic curve shows that the combination of the above indicators to predict the risk of death of patients has the best sensitivity, specificity and maximum area under the curve, which is superior to the prediction value of individual variables. Conclusions Patients in the non-survivor group of community-acquired pneumonia sepsis had more severe inflammatory response and organ function impairment. Respiratory rate, heart rate, mean arterial pressure, blood oxygen saturation, C-reactive protein, D-dimer, lactic acid, creatinine, lymphocyte ratio and other indicators are independent risk factors for death of patients with community-acquired pneumonia and sepsis, which have better prognostic value when combined.
ObjectiveTo investigate effect of coronal plane alignment of the knee (CPAK) phenotype alteration on patient-reported outcome measures (PROMs) and functional outcomes in patients undergoing robot-assisted total knee arthroplasty (RA-TKA). MethodsThe clinical data of 108 patients who underwent unilateral RA-TKA between December 2024 and June 2025 and met the inclusion criteria were retrospectively analyzed. The cohort included 34 males and 74 females, with an average age of 68.8 years (range, 54-83 years). General data including age, gender, body mass index (BMI), and operative side were collected. PROMs included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), Knee Society Score (KSS), and Forgotten Joint Score-12 (FJS-12). Functional outcomes included range of motion (ROM) and angle of knee extension lag. Based on full-length lower extremity X-ray films, the mechanical lateral distal femoral angle (mLDFA) and mechanical medial proximal tibial angle (mMPTA) were measured, and the arithmetic hip-knee-ankle angle (aHKA) and joint line obliquity (JLO) were calculated. The CPAK phenotype was determined according to the classification proposed by MacDessi et al. Patients were grouped into a CPAK consistent group and a CPAK changed group based on pre- and post-operative CPAK phenotypes, and the PROMs, functional outcomes, and radiographic parameters were compared. Multiple linear regression analysis was used to examine the independent association between CPAK phenotype change and the improvement in WOMAC scores. Results Among the 108 patients, the CPAK phenotype remained unchanged in 70 cases (64.8%, CPAK consistent group) and changed in 38 cases (35.2%, CPAK changed group). There was no significant difference between the two groups in age, gender, BMI, operative side, or preoperative WOMAC score, KSS score, ROM, and aHKA (P>0.05), whereas preoperative JLO showed a significant difference between groups (P<0.05). Univariate analysis demonstrated significant differences between groups at 3 months postoperatively in WOMAC, KSS, and FJS-12 scores, as well as in the changes of WOMAC score, KSS score, and ROM (P<0.05); moreover, the improvements in these parameters were superior in the consistent group compared to the changed group. There was no significant difference in postoperative ROM, angle of knee extension lag, mLDFA, mMPTA, JLO, aHKA, and the change of aHKA between groups (P>0.05). Multiple linear regression analysis revealed that CPAK phenotype change was a risk factor for improvement in WOMAC scores at short-term stage (P<0.05). ConclusionPreservation of the preoperative CPAK phenotype after RA-TKA is associated with superior improvement in PROMs at short-term stage.
目的 分析和總結采用雙靶點伽瑪刀治療三叉神經痛術后疼痛緩解時間規律，為伽瑪刀的臨床治療提供參考。 方法 2005年1月－2011年1月，共147例原發性三叉神經痛患者于四川大學華西醫院接受Leksell C型伽瑪刀治療。使用4 mm準直器在三叉神經根制作2個等中心靶點，中心劑量80~90 Gy，控制腦橋照射劑量＜20 Gy。術后定期對患者進行隨訪，對疼痛緩解時間進行統計分析。 結果 130例患者獲得隨訪，隨訪時間11～64個月，平均28.7個月。術后疼痛完全緩解95例（73.1%），部分緩解29例（22.3%），無效6例（4.6%）。疼痛緩解時間4 h～12個月，平均3.6周，其中疼痛完全緩解患者的疼痛緩解時間明顯短于部分緩解患者（P＜0.05）。53例（40.8%）患者于術后出現術側輕度面部麻木。 結論 患者術后疼痛緩解時間可能是預測伽瑪刀治療效果的重要因素，但疼痛緩解時間個體差異大，應進行長期隨訪觀察。
Objective To explore the value of endoscopic retrograde cholangiopancreatograph (ERCP) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of pancreatic duct stones. Methods A retrospective collection of 28 patients with chronic pancreatitis and pancreatic duct stones admitted to the Department of Gastroenterology from January 2010 to August 2021 was performed. According to the treatment of patients, they were divided into ERCP direct stone extraction group and ESWL combined ERCP stone extraction group. We compared the treatment effects of the two groups of patients, including the success rate of stone extraction, postoperative complications of ERCP, postoperative symptom improvement, and so on. Results Among the 28 patients, 19 cases underwent ERCP direct stone extraction, and 9 cases underwent ESWL combined with ERCP stone extraction. In the ERCP direct stone extraction group, 7 cases (36.84%) were completely extracted, 1 case was partially extracted (5.26%), and 11 cases (57.89%) failed to extract and only placed stents and drained; 5 cases (26.32%) had elevated white blood cells at 6 hours postoperatively, C-reactive protein increased in 4 cases (21.05%), 3 cases (15.79%) were diagnosed as ERCP-related pancreatitis, and 2 cases (10.53%) were diagnosed as hyperamylaseemia. The abdominal pain symptoms were completely relieved in 14 cases (73.68%) during a follow-up period of 3 to 6 months. The body mass of 17 cases (89.47%) increased in the 6 months after stone extraction. ESWL combined with ERCP had complete stone extraction in 5 cases (55.56%), partial stone extraction in 3 cases (33.33%), and failure in stone extraction and only stent drainage in 1 case (11.11%). One case (11.11%) had elevated white blood cells at 6 hours postoperatively, and 1 case (11.11%) had elevated C-reactive protein . One case (11.11%) was diagnosed with ERCP-related pancreatitis. One case (11.11%) got abdominal pain and transient hematuria during ESWL, which resolved spontaneously 3 days later. After 3 to 6 months of follow-up, 9 patients (100%) had complete relief of abdominal pain symptoms, and the body mass of 9 patients (100%) increased in the 6 months after stone extraction. The stone clearance rate of the ESWL combined with ERCP stone extraction group was higher than that of the ERCP direct stone extraction group (P=0.033), but there was no statistically significant difference between the two groups in terms of ERCP-related complications, relief of abdominal pain, and weight gain (P>0.05). Conclusion ESWL combined with ERCP in the treatment of chronic pancreatitis complicated with pancreatic duct stone extraction is more effective than ERCP direct stone extraction.
方法 2008年9月-2009年11月，將20例顱腦外傷后顱內感染患者分為腦脊液外引流組和抗生素組各10例，外引流組進行持續腰池置管腦脊液外引流，定期取引流腦脊液進行常規和生化檢查；抗生素組采用靜脈抗生素治療。對兩組顱內感染情況進行對比分析。 結果 外引流組經持續腰池置管腦脊液外引流治療后，顱內感染臨床癥狀明顯緩解，腦脊液有核細胞數和腦脊液微量蛋白含量顯著降低、腦脊液葡萄糖和氯化物濃度升高（Plt;0.05）。治療10 d后，外引流組體溫、腦脊液有核細胞數、腦脊液微量蛋白含量、腦脊液葡萄糖和氯化物濃度的改善程度明顯優于抗生素組（Plt;0.05）。 結論 持續腰池置管腦脊液外引流治療顱內感染具有安全性高、操作簡便、觀察顱內感染情況方便的優點，可作為顱內感染可靠治療手段。【Abstract】 Objective To observe the efficacy of continuous lumbar drainage of cerebrospinal fluid via a lumbar catheter in treating intracranial infection. Methods From September 2008 to November 2009, 20 patients with intracranial infection after head trauma were enrolled in this study. Ten of them, classified as the external drainage group, sustained continuous external lumbar drainage of cerebrospinal fluid. The cerebrospinal fluid was obtained regularly for routine and biochemical examination. The other 10 patients were categorized as the antibiotics group. They only accepted intravenous antibiotic therapy. Results For the patients in the external drainage goup, after continuous external lumbar drainage of cerebrospinal fluid, their clinical symptoms of intracranial infection were significantly alleviated and the number of nucleated cells and protein content in the cerebrospinal fluid decreased significantly, while the glucose and chloride concentrations increased significantly (Plt;0.05). After 10 days of treatment, the patients in the external drainage group were superior to those in the antibiotics group in improvement of the body temperature, the number of nucleated cells and protein content, glucose and chloride concentrations in the cerebrospinal fluid (Plt;0.05). Conclusion Continuous lumbar drainage of cerebrospinal fluid is simple and safe. It provides an easy way of monitoring the intracranial infection and can be a reliable treatment.
ObjectiveTo evaluate the surgical technique and the effectiveness of the free superficial palmar branch of the radial artery flap to repair soft tissue defect of fingers.MethodsBetween June 2014 and June 2017, 10 cases (10 fingers) of soft tissue defects of fingers were repaired with the free superficial palmar branch of the radial artery flaps. There were 8 males and 2 females with an average age of 29.8 years (range, 23-42 years). The causes of injury included the chainsaw cutting injury in 6 cases, the machine crush injury in 2 cases, and the glass scratching in 2 cases. The time from injury to admission was 1-8 hours with an average of 3 hours. The locations were the volar of the middle of index finger in 3 cases, the volar of the distal of index finger in 1 case, the volar of the distal of middle finger in 3 cases, the ulnar side of distal interphalangeal joint of ring finger in 1 case, and the volar of the distal of the little finger in 2 cases. The area of soft tissue defect ranged from 1.8 cm×0.9 cm to 2.8 cm×2.1 cm, and the area of flap ranged from 2.0 cm×1.0 cm to 3.0 cm×2.3 cm. The donor sites were sutured directly.ResultsAll flaps survived after operation, and the wounds healed by first intention. The incisions of donor site also healed by first intention with a linear scar. All cases were followed up 6-12 months (mean, 9 months). The appearance and texture of the flaps were satisfactory. The pain sensation, warm sensation, and touch sensation of the flap recovered. At last follow-up, the two-point discrimination of the flap was 6-13 mm (mean, 7.5 mm). According to the assessment of the upper limb function issued by tha Hand Surgery Society of Chinese Medical Association, the results were graded as excellent in 8 cases and good in 2 cases.ConclusionThe free superficial palmar branch of the radial artery flap is easy to harvest and anastomose and has small injury. It is an ideal method in repairing of soft tissue defects of fingers.