Objective To review the methods and progress of arthroscopic reconstruction of anterior cruciate l igament (ACL) with the remnant preservation technique. Methods Recent l iterature about arthroscopic reconstruction of ACL with the remnant preservation technique was reviewed and analyzed. Results The preserved ACL after injuries could be single-bundle or remnant. The preserved remnant provided synovium for the reconstructed ACL, and it could accelerate revascularization of the graft, and it was benefit for the proprioception too, and certain kinds of remnant could contribute to the stabil ity of the joint. The preserved remnant could prevent the washing-effect of the joint fluid, then prevent the enlargement of the tibial tunnel. Cyclops or impingement may occurred in remnant preservation technique. Conclusion Remnant preservation in ACL reconstruction can provide good cl inical result. But remnant preservation is a skill demanded technique. There should be more research and cl inical trials about remnant preservation in ACL reconstruction about its necessity and advantage, also disadvantage.
Vascular endothelial cell(VEC) is a kind of simple squamous epithelium lined on the inner surface of blood vessels. VEC is an important barrier between the blood and tissue and it also plays a key role in regulating inflammation, thrombosis, endothelial cells mediated vasodilatation and endothelial regeneration. These processes should be controlled by a variety of complex mechanism which requires us to find out. With results of the researches in vascular endothelial cell function, the important roles that microRNA in vascular endothelial cell function draws more and more researchers' attention. MicroRNAs control gene expression in post-transcriptional level and affect the function of endothelial cells. This review focuses on the research progress on regulatory mechanism of microRNA to endothelial cell inflammation, thrombosis, vasodilation and endothelium regeneration.
ObjectiveTo observe the clinical effect of clopidogrel combined with Suxiao Jiuxin Pills on patients with acute coronary syndrome (ACS). MethodsNinety-seven patients with ACS diagnosed between January 2010 and December 2011 were divided into the treatment group (treated with clopidogrel combined with Suxiao Jiuxin Pills) (n=48) and the control group (treated with single clopidogrel) (n=49). One month was regarded as a treatment course. After one month, we observed the clinical effect, heart attacks frequency, ST segment changes and adverse reactions for the patients. ResultsThe total effective rate was 79.2% in the treatment group and was 51.0% in the control group. There was significant difference between the two groups (P<0.05). Heart attacks frequency and ST segment were reduced significantly in both the two groups after treatment (P<0.05). The curative effect in the treatment group was significantly better than that in the control group after treatment (P<0.05). ConclusionClopidogrel combined with Suxiao Jiuxin Pills have a better clinical effect in the treatment of ACS than single clopidogrel.
Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Based on the practice of large tertiary hospitals in clinical pathway (CP) entrance management, we implemented a fine CP management model with standardized clinical diagnosis and treatment, and encouraged the department to continuously optimize the path form, expand CP coverage and improve the entry rate in a flexible path. Combining PDCA cycles with CP management, it can promote the realization of management goals and achieve continuous improvement, while providing operable (repeatable) methods to the practice of hospital CP management.
ObjectiveTo assess the causes and risk factors of multiple-intervention in endovascular aortic repair (EVAR) for type B aortic dissection (TBAD). MethodsWe retrospectively analyzed the clinical data of 347 TBAD patients initially treated with EVAR in our hospital between January 1999 and December 2013. The patients were stratified into a multiple-intervention group (34 patients) and a single-intervention group (313 patients). We analyzed the differences of clinical data of the two groups. ResultsThere were 9 patients with endoleak, 10 patients with new dissection, 8 patients with incomplete thrombosis of the false lumen, 4 patients with new aneurysm, 2 patients with retrograde dissection, and 1 patient with iliac artery occlusion in the multiple-intervention group. Higher proportions of chronic dissection and smoking occurred in the multiple-intervention group (79.4% versus 50.8%, 61.8% versus 40.3%, P=0.002, 0.018, respectively). Both of the degree and proportion of hyperglycemia were higher in the multiple-intervention group (6.9±2.3 mmol/L versus 5.7±1.8 mmol/L, P=0.027; 44.1% versus 22.7%, P=0.011). There were statistical differences in oversizing rate of grafts (14.6%±3.2% versus 11.3%±2.5%, P<0.001), operation time (172 min versus 82 min, P<0.001), and blood loss (280 ml versus 100 ml, P=0.006) between the two groups. ConclusionEndoleak, new dissection, and incomplete thrombosis of the false lumen are the main causes of multiple-intervention. While in chronic phase, smoking, hyperglycemia, too big oversizing, and complicated lesion or operation are the potential risk factors.
With high morbidity, branch retinal vein occlusion (BRVO) is a common retinal vascular disease in the clinic. Although the classic characteristics of BRVO have been recognized for a long time, the traditional understanding of BRVO has been challenged along with development and application of new imaging technologies, including the reasonable classification and staging of the disease, and the vascular characteristics at the occlusive site via multimodal imaging, etc. Thus, re-summarizing and refining these features as well as further improving and optimizing traditional imaging evaluation, can not only deepen the correct acknowledge of the entity, but also find biomarkers of prognosis of visual function, which is helpful to establish better diagnosis and treatment strategy. In the meanwhile, it is necessary that clinical characteristics of BRVO on imaging and the reliability of these imaging techniques are worth correct understanding and objective assessment.
Objective To investigate the inhibition effect of salazosulfapyridine (SF) on the formation of post-operative abdominal adhesion and its possible mechanism. Methods Forty male Sprague-Dawley rats were randomly divided into five groups: sham operation group (Sham group), blank control group (BC group), sodium hyaluronate (HA) group, low dose of SF group (LSF group), and high dose of SF group (HSF group). Except the Sham group, all the rats in other 4 groups were created abdominal adhesion model by abrasion of caecum and its opposite abdominal wall. Rats of the BC group didn’t received any treatment after model establishment. Before closing the abdominal wall, the rats of the HA group were treated by 2 mL HA. After the operation, the rats of the LSF group and the HSF group were daily orally administrated with different dose of SF (50 mg/kg for the LSF group and 100 mg/kg for the HSF group), while the other 3 groups treated with same dose of normal saline. Seven days after operation, the rats of 5 groups were killed and abdominal adhesion conditions was evaluated by Nair’s score system. Then the abdominal adhesion tissues or blood were collected to underwent HE staining, immunohistochemistry staining, and enzyme linked immunosorbent assay (ELISA) test. The HE staining was used to assess the inflammation score and fibrillation score of rats in 5 groups and immunohistochemistry staining was used to evaluate expression of the α-smooth muscle actin(α-SMA) in adhesion tissues. The ELISA test was used to detect the concentration of serum interleukin-1β (IL-1β) and transforming growth factor-β1 (TGF-β1) in rats of 5 groups. Results ① The gross evaluation of adhesion condition:3 rats of the Sham groups had incision adhesion; in the BC group, 4 rats had incision adhesion, 8 rats had cecum to the abdominal wall adhesion, 2 rats had viscera to viscera adhesion; in the HA group, 2 rats had incision adhesion and5 rats had cecum to the abdominal wall adhesion; in the LSF group, 2 rats had incision adhesion, 6 rats had cecum to the abdominal wall adhesion, and 1 rat had viscera to viscera adhesion; in the HSF group, 2 rats had incision adhesion and 4 rats had cecum to the abdominal wall adhesion. Compared with the Sham group, the Nair’s scores of the other4 groups were higher (P<0.05); compared with the BC group, the Nair’s scores of the HA group, the LSF group, and the HSF group were all lower (P<0.05), but there was no significant difference on the Nair’s scores among the HA group, the LSF group, and the HSF group (P>0.05). ② Inflammation score and fibrillation score: on the inflammation score, compared with the Sham group, the inflammation scores of the others 4 groups were higher (P<0.05); compared with the BC and HA group, the inflammation scores of the LSF group and the HSF group were both lower (P<0.05); compared with the LSF group, there was no significant difference on the inflammation score of the HSF group (P>0.05). On the fibrillation score, compared with the Sham group, the fibrillation scores of the others 4 groups were higher (P<0.05); compared with the BC group, the fibrillation scores of the HA group, the LSF group, and the HSF group were all lower (P<0.05), but there was no significant difference on the fibrillation scores among the HA group, the LSF group, and the HSF group (P>0.05). ③ The expression scores of α-SMA: compared with the Sham group, the expression scores of α-SMA in the others 4 groups were higher (P<0.05); compared with the BC group, the expression scores of α-SMA in the HA group, the LSF group, and the HSF group were all lower (P<0.05), but there was no significant difference on the expression scores of α-SMA among the HA group, the LSF group, and the HSF group (P>0.05). ④ Concentration of serum IL-1β and TGF-β1: on the concentration of serum IL-1β, compared with the Sham group, the concentrations of serum IL-1β in the others 4 groups were higher (P<0.05); compared with the BC group, the concentrations of serum IL-1β in the HA group, the LSF group, and the HSF group were all lower (P<0.05); compared with the HA and the LSF group, the concentration of serum IL-1β in the HSF group was lower (P<0.05). On the concentration of serum TGF-β1, compared with the Sham group, the concentrations of serum TGF-β1 in the others 4 groups were higher (P<0.05); compared with the BC group, the concentrations of serum TGF-β1 in the HA group, the LSF group, and the HSF group were all lower (P<0.05); compared with the HA group, the concentrations of serum TGF-β1 in the LSF group and the HSF group were both lower (P<0.05), but there was no significant difference between the LSF group and the HSF group (P>0.05). Conclusion SF can reduce the formation of postoperative abdominal adhesion in rat models via inhibiting inflammation and fibrillation.
In the research of non-invasive brain-computer interface (BCI), independent component analysis (ICA) has been considered as a promising method of electroencephalogram (EEG) preprocessing and feature enhancement. However, there have been few investigations and implements about online ICA-BCI system up till now. This paper reports the investigation of the ICA-based motor imagery BCI (MIBCI) system, combining the characteristics of unsupervised learning of ICA and event-related desynchronization (ERD) related to motor imagery. We constructed a simple and practical method of ICA spatial filter calculation and discriminate criterion of three-type motor imageries in the study. To validate the online performance of proposed algorithms, an ICA-MIBCI experimental system was fully established based on NeuroScan EEG amplifier and VC++ platform. Four subjects participated in the experiment of MIBCI testing and two of them took part in the online experiment. The average classification accuracies of the three-type motor imageries reached 89.78% and 89.89% in the offline and online testing, respectively. The experimental results showed that the proposed algorithm produced high classification accuracy and required less time consumption, which would have a prospect of cross platform application.