Objective To review the progress in the cl inical treatment of Kienbouml;ck’s disease. Methods Related l iterature concerning the treatment of Kienbouml;ck’s disease was reviewed, and comprehensive analysis was done. Results The treatment methods of Kienbouml;ck’s disease include non-surgical treatment and surgical treatment, which are primarily guided bythe anatomic factor and Lichtman stage. Non-surgical treatment methods should be selected in patients of children and at stage I. Surgical treatment methods include vascularized bone graft transfer into the cored-out lunate, radial shortening osteotomy, radial lateral wedge osteotomy, etc. All surgical treatment methods have advantages and disadvantages. Conclusion For the treatment of Kienbouml;ck’s disease, none of procedure is superior to another. In short, choosing different treatment strategies based on different patients can achieve the desired outcome.
Avoidable mortality (AM) is an important indicator of health system performance. It is also an effective tool for evaluating the effectiveness of health measures and allocation of health resources. The concept development, analytical methods, and research contents of avoidable mortality are introduced in this study. This study investigated the applicability of avoidable mortality analysis in determining priority health-service intervention areas, determining priority health-service intervention populations and evaluating the quality of those services. This paper also discussed the significance and limitations of avoidable mortality analysis. The investigation provided references for further research and application of avoidable mortality analysis.
Objective To review the research progress of osteoblastextracellular matrix(ECM) and its application in bone tissue engineering. Methods The recentrelated literatures were extensively reviewed. Results The ECM was complex in its components. The configuration of cell and cell’s adhesion, migration, proliferation, and differentiation were subject to the ECM. The bioactivity of the tissue engineering products was revealed by ECM, which predicted the product’s efficiency in clinic application. Conclusion ECM has the potential to become the effective index in evaluating tissue engineered products.
Objective To review the study progress of mesenchymal stem cells induced to differentiate intervertebral disc cells Methods The recent related literature was reviewed. The theorical and experimental studies were summarized. Results MSCs had the potential of multidirectional differentiation.International experimental studies indicated the potential of MSCs induced to differentiate intervertebral disc cells. Conclusion MSCs induced to differentiate intervertebral disc cells has the fine prospect.
Objective To evaluate the clinical relationship between serum carcinoembryonic antigen (CEA) and mortality of anti-melanoma differentiation associated gene 5 (MDA5) antibody positive dermatomyositis with interstitial lung disease (ILD). MethodsThe consecutive clinical data of 214 patients with anti MDA5 antibody positive dermatomyositis from West China Hospital of Sichuan University from February 2017 to September 2019 were collected retrospectively, including demographic, laboratory examination and imaging examination data. Patients were divided into CEA elevated group (CEA≥4.63 ng/mL) and CEA normal group (CEA<4.63 ng/mL) according to CEA level. R4.1.2 software was used for statistical analysis of all data, and Kaplan Meier method was used to draw the survival curve. Cox proportional hazard model was used to analyze the survival of patients with ILD, and to explore the risk factors associated with the survival of patients with anti-MDA5 antibody positive dermatomyositis with ILD. Results There were 180 patients with ILD who met the inclusion and exclusion criteria, 57 patients with rapidly progressive pulmonary interstitial fibrosis (RPILD), and 123 patients without RPILD; 121 women and 59 men, with an average age of 50.2±10.7 years; The average follow-up was 23.5 months, and 52 patients died. Univariable analysis suggested that CEA≥4.63 ng/mL, smoking, RPILD, lactate dehydrogenase (LDH) ≥321 IU/L, albumin<30 g/L and dyspnea were risk factors associated with death in patients with anti MDA5 dermatomyositis combined with ILD. Multivariable Cox regression analysis showed that CEA≥4.63 ng/mL [hazard ratio (HR) =3.01, 95% confidence interval (CI) 1.23 - 7.32, P=0.015], RPILD (HR=3.87, 95%CI 2.09 - 7.19, P<0.001), smoking (HR=2.37, 95%CI 1.25 - 4.47, P=0.008), LDH≥321 IU/L (HR=2.47, 95%CI 1.23 - 4.96, P=0.011), albumin<30 g/L (HR=2.57, 95%CI 1.38 - 4.78, P=0.003) were independent predictors for mortality. ConclusionsSerum CEA level can be used as a clinical prognostic predictor in patients with anti-MDA5 positive dermatomyositis and ILD. RPILD, smoking, LDH≥321 IU/L, and albumin<30 g/L are independent predictors for mortality.
With the development of three-dimensional (3D) printing technology, more and more researches have focused on its application in the region of intervertebral fusion materials; the prospects are worth looking forward to. This article reviews the researches about 3D printing technology in spinal implants, and summarizes the materials and printing technology applied in the field of spinal interbody fusion, and the shortcomings in the current research and application. With the rapid development of 3D printing technology and new materials, more and more 3D printing spinal interbodies will be developed and used clinically.
ObjectiveTo summarize the latest research progress in active surveillance of low-risk papillary thyroid microcarcinoma at home and abroad, and provide some reference for future clinical work. MethodRetrieved and reviewed relevant literatures about prospective studies on active surveillance of papillary thyroid microcarcinoma.ResultsIn recent years, the incidence of papillary thyroid microcarcinoma had increased sharply, but most of the biological activities were inert, tumor-specific mortality was very low, and only a few had progressed. For patients with papillary thyroid microcarcinoma, surgery was a safe and effective treatment method, but due to changes in the epidemiological characteristics of the disease, people were reconsidering whether there was overtreatment in patients without high-risk characteristics. Expert consensus and guidelines no matter at home or abroad mentioned that active monitoring can be considered as an alternative to surgery. For suitable patients, active monitoring might be a better choice.ConclusionsActive surveillance for low-risk papillary thyroid microcarcinoma is basically considered to be a safe and feasible treatment option, but large numbers of clinical trials are still needed to provide evidence for the conversion of conventional clinical treatment models. In the future, by more accurately assessing the tumor progression of patients with low-risk papillary thyroid microcarcinoma, active surveillance is promising to alternate surgical treatments.
Choroidal metastasis of lung cancer is rare in clinical, which is easy to missed diagnosis or misdiagnosis, special research and discussion are not much. This article mainly introduces the current situation of choroidal metastasis of lung cancer in China, the characteristics of clinical and ophthalmoscopic examination, angiography and imaging, the methods of early detection, early diagnosis and the progress of individualized comprehensive treatment. It is expected to attract the attention of thoracic surgeons, conducive to improve the quality of life and prognosis of patients.
Objective To summarize the recent advance in the research of tissue engineered nerve grafts. Methods The cl inical and experimental research papers about tissue engineered nerve grafts were extensively reviewed and analyzed. Results The porosity, mechanical property and surface topography of a nerve scaffold, which was either made up of natural biodegradable polymers or synthetic polyesters, were pivotal factors that influenced the capacity of the scaffold in supporting nerve regeneration. Of various candidate supporting cells for nerve tissue engineering, the bone marrowmesenchymal stem cells had been paid more attention because of their advantages. Several model designs of drug del ivery systems for controlled release of growth factors had been attempted. In cl inical settings, short nerve gaps were demonstrated to be treatable with several nerve conduits which were commercially available, with functional recovery approximating tonerve autografting. Conclusion The field of nerve tissue engineering has witnessed a rapid development not only in experimental research but also in cl inical appl ication.
In recent years, flap surgery has been well-developed, and many theories and techniques of flap surgery have been updating. The purpose of manuscript which is based on the flap-related literature is to summarize recent developments of basic and clinic researches, indicate the future of the flap surgery, and show the consensus and guidelines of flap surgery made by Chinese experts.