To evaluate the safety and efficacy of one-level posterior lumbar interbody fusion(PLIF) combined with Prospace and facet fusion using local autograft. Methods Clinical and radiographic data of 76 patients treated by this technique was reviewed from May 2002 to December 2004. Of them, there were 52 males and 24 females, with an average age of 53.2 years (2381 years), including 60 cases of degenerative disc disease, 9 cases of failed back surgery syndrome and 3 cases of spondylolysis. The disese courses were 1.2-8.7 years (mean 3.6 years). The levels of PLIF were:L 2,3 in 2 cases, L 3,4 in 7, L 4,5 in 54, L 5/S 1 in 10, L 4/S 1 in 1 and L 5,6 in 2. After decompression，Prospace was inserted into interbody space bilaterally，and located in disc space 4 mm beyond the rear edge ofthe vertebral body. Local laminectomy autograft was packed both laterally into and between 2 implants. Then the remanent local autograft was placed over facet bed. Pedicle screws were used after insertion of Prospace. Clinical results wereevaluated by the JOA score. Disc height ratio and lumbar lordosis angles were measured on lateral radiographs. Fusion status was determined by evidence of bridge trabeculae across facet joint and interbody space on CT scan without mobility in lateral dynamic X-rays, and no radiolucent gap between Prospace and endplate. Paired t test was used for statistical analysis. Results Mean blood loss and operative time was 384 ml and 178 minutes, respectively. The average JOA score at final follow-up (26.1±2.7) was significantly improved when compared with that of preoperation (14.5±4.0, P＜0.05), with a mean recovery rate of JOA score 81.1% (37.5%-100.0%). The fusion rate was 974%(74/76). Mean disc height ratio and the involved segmental lordosis angle were increased from preoperative 0.27± 0.07 and 5.8±2.2° to 0.33±0.06 and 11.3±2.0° respectively at the final followup, and the differences were significant (P＜0.05). There were no devicerelated complications. Conclusion This surgical technique combined with Prospace interbody device is a safe and effective surgical option for patients with onelevel lumbar disorders when PLIF is warranted.
ObjectiveTo realize the current status and hot issues in the field of gastric cancer imaging research, and to provide references for radiologists and gastrointestinal surgeons to grasp the overall overview of gastric cancer imaging.MethodWe downloaded the relevant literatures of gastric cancer imaging published in 2010–2020 in the Web of Science database, and used Citespace 5.7.R3 software for related visual analysis.ResultsA total of 726 articles in the field of gastric cancer imaging research were retrieved and screened. The number of gastric cancer imaging studies published from 2010 to 2020 was on the rise, with the top three countries published in China, Japan, and the United States. The clusters of co-cited literature on gastric cancer imaging: confocal laser microendoscopy, gastric cancer, gastric mucosal intestinal metaplasia, preoperative T staging, convolutional neural network, deep learning, advanced gastric cancer, in vivo differentiation, early stage gastric cancer, surgical treatment, perigastric lymph nodes, nearest neighbor algorithm, and so on. Hot words in recent research fields included: risk factors, characteristics, deep learning, chemotherapy, and neural networks.ConclusionThe imaging diagnosis of early gastric cancer and the application of artificial intelligence are the research hotspots in this field.
Objective
To review the research progress of midfacial fat compartments, and to thoroughly understand its current state of the anatomy and the aging morphologic characters of midfacial fat compartments, as well as the current status of clinical applications.
Methods
The recent literature concerning the midfacial fat compartments and related clinical applications were extensively reviewed and analyzed.
Results
Midfacial fat layer has been considered as a fusion and a continuous layer, experiencing a global atrophy when aging. As more anatomical researches have done, recent studies have shown that midfacial fat layer is broadly divided into superficial and deep layers, which are both divided into different fat compartments by fascia, ligaments, or muscles. Midfacial fat compartments tend to atrophy with age, specifically in the deep fat compartments while hypertrophy in the superficial fat compartments. Clinical applications show that fat volumetric restoration with deep medial cheek fat and Ristow’s space can restore the appearance of midface effectively.
Conclusion
In recent years, the researches of midfacial fat compartments have achieved obvious progress, which will provide new ideas and basis for fat volumetric restoration. Corresponding treatments are selected based on different sites and different layers with different aging changes, reshaping a more youthful midface.
The suprachoroidal space (SCS) is the potential space between the sclera and choroid. Drugs delivered through SCS can bypass the sclera, avoiding clearance by conjunctival and scleral blood vessels and lymphatic circulation, so that more drugs can reach the disease tissues such as choroid and retina. SCS drug delivery does not disrupt the ocular integrity, is safer than the intravitreal drug injection and more effective than trans-scleral drug delivery. In addition, SCS delivery only needs a very small volume of drug, which makes it possible to be carried out in multiple parts of the sclera, and the specific disease area can be more precisely targeted. SCS drug delivery is suitable for the treatment of choroidal and retinal diseases. However, currently SCS drug delivery is still a novel field and many aspects need to be more in-depth studied, including its safety, delivery methods, drug formulation and effectiveness.
Objective
To investigate the effect of axial stress stimulation on tibial and fibular open fractures healing after Taylor space stent fixation.
Methods
The data of 45 cases with tibial and fibular open fractures treated by Taylor space stent fixation who meet the selection criteria between January 2015 and June 2016 were retrospectively analysed. The patients were divided into trial group (23 cases) and control group (22 cases) according to whether the axial stress stimulation was performed after operation. There was no significant difference in gender, age, affected side, cause of injury, type of fracture, and interval time from injury to operation between 2 groups (P>0.05). The axial stress stimulation was performed in trial group after operation. The axial load sharing ratio was tested, and when the value was less than 10%, the external fixator was removed. The fracture healing time, full weight-bearing time, and external fixator removal time were recorded and compared. After 6 months of external fixator removal, the function of the limb was assessed by Johner-Wruhs criteria for evaluation of final effectiveness of treatment of tibial shaft fractures.
Results
There were 2 and 3 cases of needle foreign body reaction in trial group and control group, respectively, and healed after symptomatic anti allergic treatment. All the patients were followed up 8-12 months with an average of 10 months. All the fractures reached clinical healing, no complication such as delayed union, nonunion, or osteomyelitis occurred. The fracture healing time, full weight-bearing time, and external fixator removal time in trial group were significantly shorter than those in control group (P<0.05). After 6 months of external fixator removal, the function of the limb was excellent in 13 cases, good in 6 cases, fair in 3 cases, and poor in 1 case in trial group, with an excellent and good rate of 82.6%; and was excellent in 5 cases, good in 10 cases, fair in 4 cases, and poor in 3 cases in control group, with an excellent and good rate of 68.2%, showing significant difference between 2 groups (Z=–2.146, P=0.032).
Conclusion
The axial stress stimulation of Taylor space stent fixation can promote the healing of tibial and fibular open fractures and promote local bone formation at fracture site.
Abstract： Objective To investigate the change of tissue structure and epithelial barrier function of excluded esophagus after esophageal exclusion surgery for tracheoesophageal fistula (TEF). Methods Twentyeight hybrid dogs were divided into 3 groups with random number method. For group A (n=12), fistula was excluded; for group B (n=12), only the esophagus was excluded; and group C (n=4) was the control group. The normal and excluded esophagus of the three groups were observed through general sampling, HE staining, transmission electron microscope (TEM), scanning electron microscope (SEM) and Lanthanum trace labeling. The interstitial space dilation (ISD) of the cells on the esophageal mucosa was measured and the number of desmosome in the intercellular space was calculated. Results The changes of tissue structure and epithelial barrier function of the excluded esophagus were similar between group A and group B. Compared with group C, group A and B showed the following changes: esophageal structure changed, submucous glandular tissues reduced or disappeared; the interstitial space increased, the number of desmosome decreased, and the epithelial barrier function attenuated, but the basal lamina did not changed and lanthanum did not break through it. For the dogs in group C, esophageal mucosa could be observed, submucosa was complete and a large number of gland tissues and micrangiums could be seen in it. The number of desmosome for group A, B and C was 0.21±0.03 entries/μm2, 0.22±0.05 entries/μm2, and 0.32±0.03 entries/μm2 respectively, which showed a significant difference between group A, B and group C (Plt;0.05), while there was no significant difference between group A and group B (Plt;0.05). The average interstitial space for group A, B and C was 2.11±0.56 μm, 2.04±0.77 μm, and 1.84±0.49 μm respectively. There was no significant difference between group A and B, while there was significant difference between group A, B and group C. Conclusion The esophageal exclusion surgery for refractory TEF is safe, feasible, and effective with few complications, and deserved to be popularized.
ObjectiveTo explore the fusion effect of allograft Cages on transforaminal lumbar interbody fusion (TLIF).MethodsThe clinical data of 30 patients (38 vertebral segments) who underwent TLIF with allograft interbody fusion Cages between January 2015 and January 2017 were retrospectively analysed. There were 25 males and 5 females with an average age of 56.9 years (range, 44-72 years). The lesions included 20 cases of lumbar disc herniation, 7 cases of lumbar spondylolisthesis, and 3 cases of lumbar spinal stenosis. The operation section included 4 cases of L3, 4, 13 cases of L4, 5, 5 cases of L5, S1, 6 cases of L4, 5-L5, S1, and 2 cases of L3, 4-L4, 5. The disease duration was 6-36 months (mean, 12 months). The clinical effectiveness was evaluated by visual analogue scale (VAS) score, Oswestry disability index (ODI), and Japanese Orthopaedic Association (JOA) score at preoperation, 3 months and 6 months after operation, and last follow-up. The fusion rate was evaluated by anteroposterior and lateral X-ray films and CT three-dimensional reconstruction at 3 and 6 months after operation. The intervertebral space height was measured on anteroposterior and lateral X-ray films at preoperation, 3 days, 3 months, and 6 months after operation.ResultsThe operation time was 2.1-4.3 hours (mean, 3.1 hours), and the intraoperative blood loss was 150-820 mL (mean, 407.5 mL). The follow-up time was 8-25 months (mean, 16.4 months). One Cage split at 6 months after operation without Cage movement and neurologic symptoms; none of the other patients had Cage prolapse, displacement, and fragmentation. No local or systemic allergy or infection signs was found in all patients. No nerve compression or symptoms was observed during the follow-up. The postoperative VAS score, ODI score, and JOA score improved significantly when compared with preoperative scores (P<0.05); and the scores at 6 months and at last follow-up were significantly improved when compared with those at 3 months after operation (P<0.05); but no significant difference was found between at 6 months and at last follow-up (P>0.05). The fusion rate was 55.3% (21/38), 92.1% (35/38), and 100% (38/38) at 3 months, 6 months, and last follow-up postoperatively. The intervertebral space height was increased significantly at 3 days, 3 months, 6 months, and last follow-up postoperatively when compared with preoperative ones (P<0.05); and the loss of intervertebral space height was significant at last follow-up when compared with postoperative at 3 days (P<0.05).ConclusionThe allograft interbody fusion Cage contributes to the spine interbody fusion by providing an earlier stability and higher fusion rate.
【Abstract】ObjectiveBy using multidetectorrow spiral CT (MDCT), to investigate the CT imaging features of inflammatory diseases in retroperitoneal space with correlation of radiological anatomy.MethodsThe clinical and laboratory dada of 30 patients with proven inflammatory diseases of retroperitoneal space were collected. All patients underwent MDCT plain scanning and portal venous acquisition. CT imaging data generated at portal venous phase were processed with coronal, sagittal and oblique multiplanar reformation (MPR) technique.ResultsAcute pancreatitis and various types of renal infection were the two main sources of retroperitoneal inflammation. Depending on the specific anatomic locations, retroperitoneal inflammation of different subspaces demonstrated characteristic imaging features. Spreading of inflammatory process across subspaces was also quite common.ConclusionMDCT is the imaging method of choice to depict comprehensively and clearly the inflammatory diseases of various retroperitoneal spaces.
An auxiliary dining robot is designed in this paper, which implements the humanoid feeding function with theory of inventive problem solving (TRIZ) theory and aims at the demand of special auxiliary nursing equipment. Firstly, this robot simulated the motion function of human arm by using the tandem joints of the manipulator. The end-effector used a motor-driven spoon to simulate the feeding actions of human hand. Meanwhile, the eye in hand installation style was adopted to instead the human vision to realize its automatic feeding action. Moreover, the feeding and drinking actions of the dining robot were considered comprehensively with the flexibility of spatial movement under the lowest degree of freedom (DOF) configuration. The structure of the dining robot was confirmed by analyzing its stresses and discussing the specific application scenarios under this condition. Finally, the simulation results demonstrate high-flexibility of the dining robot in the workspace with lowest DOF configuration.
Intrahepatic ectopic splenosis is rare and lacks typical clinical and imaging features. We analyzed the clinical, pathological, and imaging characteristics of a patient with intrahepatic ectopic splenosis admitted to the Guangzhou First People’s Hospital in combining with literature review. The aim of case analysis is to enhance comprehension of the disease and provide a reference for clinical doctors in diagnosis.
