To discuss renovascular reconstruction during l iving related donor kidney transplantation (LDKT). Methods Seventy-seven cases of LDKT from April 2006 to March 2008 were retrospectively analyzed, including 63 cases in single renal artery group and 14 cases in multi ple artery group. In multi ple artery group, there were 3 cases of three arteries and 11 cases of double arteries; 9 cases of donated left kidneys and 5 cases of donated right kidneys. Potential donors underwent fully medical evaluation before operation, including donor-reci pient human leucocyte antigen matchingand a cross match test. The donor’s operation of the incision either underneath the 12th rib approaching the dorsal lumbar was performed and the transplantation operation adopted the extraperitoneal approach in the contralateral fossa il iac. The arteries in the multiple artery group were implanted onto the external (or common) il iac artery different from the orthodox method. Results In multiple artery group, no blood transfusion during operation was performed, no compl ication occurred after operation and all donors were discharged after 7-9 days of postoperation. After a follow-up of 3 months to 1 year, all the recipients kept normal kidney function without renal tubule necrosis, renal artery embol ism, vascular stenosis, urinary fistula and ureter necrosis. The ultrasound examination showed that the transplanted kidney had good blood supply. There was no significant difference in the time of urine secretion, serum creatinine level after 1 week of operation, length of hospital ization between the multiple artery group and the single artery group (P gt; 0.05). Conclusion The accurate treatment of multiple artery anastomosis are critical for the safety of the LDKT.
The material properties and volume proportion of the fibers as well as the cross-sectional area proportion of nucleus pulposus vary greatly in different studies. The effect of these factors on the mechanical behavior of intervertebral discs (IVDs) are uncertain. The IVDs finite element models with different parameters were created to investigate the pressure, height, rotation, stress, and strain of the IVDs under loads: pure compression, rotation after compression or axial moment after compression. The results showed that the material properties of fibers had great impact on the mechanical behavior of IVDs, especially on the rotation angle. When the fiber volume ratio was small, its changes had a significant impact on the rotation angle of the IVDs. The area proportions of nucleus pulposus had relatively little effect on the mechanical behavior of IVDs. The IVDs rotation should be observed when validating the model. By adjusting the elastic modulus or volume ratio of fibers within a reasonable range, a model that could simulate the mechanical behavior of normal IVDs could be obtained. It was reasonable to make the area proportion of nucleus pulposus within 25%–50% for the IVDs finite element model. This study provides guidance and reference for finite element modeling of the IVDs and the investigation of the IVDs degeneration mechanism.
Objective To retrospectively analyze the clinical information of a series of patients with atypical adrenal phaeochromocytoma in order to improve the diagnosis of atypical phaeochromocytoma. Methods Ninety patients diagnosed pathologically as adrenal phaeochromocytoma from January 1998 to December 2004 in the Affiliated Hospital of Inner Mongolia Medical College were included in the study. Patients with phaeochromocytoma were classified into the typical group and atypical group based on their clinical manifestations. The differences were analyzed between the two groups in terms of patient age, tumor location and maximal diameter, incidence of hypertension, and plasma catecholamine level. Results About 24.4% (22/90) of the patients with phaeochromocytoma were classified as atypical. There was no significant difference in the maximal tumor diameter between the two groups. The plasma norepinephrine level of the atypical group was significantly lower than that of the typical group (P=0.001), and the positive rate of plasma norepinephrine of the atypical group was also lower than that of the typical group (P=0.003). Conclusion Compared with typical phaeochromocytoma, atypical phaeochromocytoma is associated with a lower plasma norepinephrine level. The size of adrenal tumor cannot contribute to the diagnosis of atypical phaeochromocytoma. Based on atypical manifestations, CT examination results, and plasma catecholamine level, most atypical phaeochromocytoma should be diagnosed correctly.
Objective To investigate the effect of lower limb rehabilitation robot combined with virtual reality training on walking ability after anterior cruciate ligament reconstruction (ACLR). Methods Patients after ACLR treated in the Rehabilitation Medical Center of the Second Hospital of Jiaxing between May 2019 and July 2021 were selected. The patients were randomly divided into two groups. The patients with conventional ACLR rehabilitation training + lower limb rehabilitation robot combined with virtual reality training were used as the treatment group, and only the patients with conventional ACLR rehabilitation training were used as the control group. The rehabilitation training lasted for 8 weeks. After 4 and 8 weeks of treatment, the two groups were evaluated by Lysholm knee score scale (LKSS), Holden walking score and Gait watch gait analysis. Results A total of 40 patients were included, with 20 patients in each group. There was no significant difference between the two groups in LKSS score, Holden walking score and Gait watch gait analysis dynamic data at 4 weeks of treatment (P>0.05). After 8 weeks of treatment, the LKSS score [(77.74±5.53) vs. (69.53±5.26) points], Holden walking score [(4.79±0.34) vs. (4.45±0.39) points] and Gait watch gait analysis dynamic data [step size: (78.35±2.43) vs. (73.64±3.35) cm, step frequency: (115.10±4.49) vs. (107.71±5.14) step/min, step speed: (108.63±8.55) vs. (96.78±8.47) cm/s] of the treatment group were better than those of the control group (P<0.05), The above indexes of the two groups were improved compared with those at 4 weeks of treatment (P<0.05). Conclusion Lower limb rehabilitation robot combined with virtual reality training can effectively improve walking ability after ACLR.
