Safety and efficacy of ultrasound-guided low-pressure perfusion mini-percutaneous nephrolithotomy in children aged 1–7 years: a retrospective observational study

International Urology and Nephrology - This article analyzed the safety and efficacy of ultrasound-guided mini-percutaneous nephrolithotomy (MPCNL) with low-pressure perfusion for the treatment of...     

Effect of photobiomodulation on CCC-ESF reactive oxygen species steady-state in high glucose mediums

Lasers in Medical Science - Delayed wound healing is one of the most challenging complications of diabetes mellitus (DM) in clinical medicine, and it is related to the excessive generation of...     

完全神经内镜下经Poppen锁孔入路松果体区手术的应用解剖学研究

目的 解剖观察完全神经内镜下经Poppen锁孔入路开颅松果体区手术的相关解剖结构及其特征,并探讨该术式的可行性。方法 选取12具经10%甲醛固定、红蓝乳胶灌注的成人尸头湿标本进行实验观察,其中男7例、女5例,年龄34~71岁。应用随机数字表法将12具标本随机分为内镜组和显微组,每组6具,分别采用完全神经内镜Poppen锁孔入路和显微镜常规Poppen入路进行模拟开颅手术松果体区手术。模拟手术中,利用神经导航对松果体区以及手术间隙进行观察测量：（1）观察2组松果体区重要解剖结构;（2）内镜组术中,于剪开小脑幕前后,分别测量松果体区暴露面积,并采用配对t检验进行比较;（3）内镜组与显微镜组术中,分别测量第1、2、3手术间隙的暴露面积,并采用独立样本t检验进行组间比较;（4）其他重要解剖结构间距的神经内镜测量。结果 （1）2种入路均可观察到双侧基底静脉、小脑中脑裂静脉、大脑内静脉、大脑后动脉、小脑上动脉等重要血管,以及滑车神经、四叠体、胼胝体压部和松果体等重要解剖结构,但显微镜常规Poppen入路的手术通道狭窄、倾斜,视野局限。（2）内镜组模拟手术中,剪开小脑幕前后松果体区显露面积分别为（73.14±3.38）mm²和（127.77±7.90）mm²,剪开后明显大于剪开前,差异有统计学意义（t=28.84,P<0.001）。（3）内镜组和显微镜组模拟手术中,第1、2、3手术间隙的暴露面积分别为（20.93±2.49）mm²、（72.55±4.18）mm²、（208.57±11.79）mm²和（9.12±1.12）mm²、（53.45±3.17）mm²、（175.29±9.98）mm²,内镜组均大于显微镜组,差异均有统计学意义（t=14.92、12.61、7.41,P值均<0.001）。（4）神经内镜测量显示：双侧基底静脉最大距离为（14.41±0.94）mm,双侧小脑中脑裂静脉最大距离为（8.23±0.84）mm,双侧大脑内静脉最大距离为（8.41±0.96）mm,双侧大脑内静脉最小距离（第1间隙最窄长度）为（2.58±0.22）mm,松果体中心点至丘脑枕部中心点距离为（16.83±1.16）mm。结论 完全神经内镜下经Poppen锁孔入路模拟手术中间隙恒定,可安全到达松果体区;与显微镜常规Poppen入路相比,完全神经内镜Poppen锁孔入路的手术操作空间更大,松果体区显露得更充分。     

Concomitant Distal Tibia-Fibula Fractures Treated with Intramedullary Nailing,With or Without Fibular Fixation: A Meta-Analysis

There is no consensus on whether a fibular fracture should be fixed when a concurrent extra-articular distal tibia fracture is managed with intramedullary nails. We evaluated the use of fibular fixation in a meta-analysis of randomized trials and observational studies. Two researchers independently assessed the quality of eligible studies and extracted the data. We analyzed 4 trials with a pooled sample of 283 patients (mean age, 24 to 43 years; 141 men), 94 who had undergone fibular fixation and 189 who had not. Two randomized trials assessed on the Cochrane risk-assessment criteria were determined to have a moderate risk of bias, and 2 retrospective cohort studies evaluated with the Newcastle-Ottawa Scale were considered to be high quality. Tibia malalignment at follow-up times ranging from 12 to 72 weeks was reported in 20% (19/94) of patients in the fibular-fixation group and 67% (126/189) of patients in the nonfixation group, indicating that fibular fixation was significantly associated with a lower risk of malalignment (risk ratio, 0.34; 95% confidence interval [CI] 0.13 to 0.92; p = .03). The groups did not differ in the proportion of patients with malalignment immediately after surgery, delayed union, nonunion, or infection. When distal extra-articular tibia-fibular fractures are treated with intramedullary nails, fibular fixation may decrease the risk of late malalignment. Further randomized controlled trials with higher quality are required to verify the result.     

Mechanical dilation to remove incarcerated laminaria during a second trimester abortion

Cervical preparation with laminaria reduces complications with 2nd trimester dilation and evacuation. During a surgical abortion at 22 weeks, we could not remove laminaria manually or with ring forceps due to laminaria “dumbbelling” [1]. Without pushing laminaria into the uterus, we mechanically dilated the cervix and removed the incarcerated laminaria.     

几丁糖电纺膜对大鼠皮肤创面的病理学影响

目的观察本课题组自行研制的几丁糖电纺膜对大鼠创面的病理学变化的影响。方法取健康SD大鼠25只,体重240~300g,于脊柱两侧切取直径1.8cm圆形创面,制作皮肤创面模型,左侧为实验组,右侧为对照组。实验组采用几丁糖电纺膜外敷,对照组用无菌纱布外敷,每日进行大体观察并记录创面愈合时间;术后3、5、7、9、12天切取包括创面在内直径为2.0cm的皮肤标本,行HE染色观察创面的组织学改变,计算实验组及对照组组织病理学评分。结果实验组创面无红、肿、热等局部炎性征象,从第3天开始观察到明显的创面收缩,残余面积第4天接近55%,第7天时达30%;对照组创面结痂迟,创缘收缩较慢,第4天开始观察到明显的创面收缩,第5天残余面积接近65%,第7天接近40%。实验组创面完全愈合时间为(272.87±11.74)小时,对照组为(303.80±12.15)小时,愈合时间有统计学意义(P0.01)。病理学观察实验组自手术后第3天开始依次出现肉芽组织增生及细胞浸润,胶原组织增生、创面皱缩及上皮化,到术后9天,胶原组织已排列整齐,上皮化过程基本完成,可见皮肤附件;对照组相应时间点观察到细胞浸润出现晚,且部分创面出现肉芽组织伴溃疡,上皮化过程较晚。实验组及对照组组织病理学评分有统计学意义(P0.01)。结论几丁糖电纺膜能减轻创面炎症反应,缩短创面愈合时间,促进创面上皮化,提高创面愈合质量,具有显著的促进愈合作用。     

细胞膜和细胞骨架在细胞受力过程中的保护作用

力作用下的细胞保护反应是细胞机械力转导研究中的一个重要领域。细胞膜维持细胞内离子平衡，并通过牵张活化离子通道和机械力敏感酶调控力诱导的细胞骨架重排对细胞骨架产生保护作用；而细胞骨架给细胞膜提供结构支撑、加强受力部分的皮层网络结构、调控机械力敏感离子通道，在受力破坏后的细胞膜重新封闭的过程中也发挥着潜在的作用。就细胞膜和细胞骨架在细胞受力过程中的保护作用进行综述。     

干牛骨拉伸弹性模量沿径向的分布

本文研究了干牛胫骨骨干密质骨部分沿生长轴方向的拉伸弹性模量沿径向的分布，发现此弹性模量沿径向呈非均匀分布，内外两侧的弹性模量值低于中间部分；提出了一种骨内疲劳裂纹的分布假设，并据此对测试结果进行了初步性的分析。     

髋关节外固定器对股骨头压力影响的三维有限元分析

目的从三维有限元分析的角度,探讨髋关节外固定器对股骨头压力的影响。方法建立正常的髋关节三维有限元模型、安装单轴髋关节外固定器(A型)髋关节三维有限元模型、安装双轴髋关节外固定器(B型)的髋关节三维有限元模型,应用接触压力分析的方法,观察并分析髋关节双足站立位、单腿站立髋关节中立位股骨头的峰值压力,并进行统计学分析。结果髋关节外固定器均能减少股骨头的接触压力(P<0．05),髋关节外固定器在双腿站立时减少最明显,B型髋关节外固定器组较A型髋关节外固定器的股骨头接触压力减小。结论髋关节外固定器可减少股骨头的压力,可辅助治疗髋关节疾病。