Zhonghua yi xue za zhi最新文献

{"title":"[Entry point and screw path study of second sacral alar-iliac screw trajectory in spinal pelvic fixation under O-arm navigation].","authors":"C S Fan, J Li, Z S Hu, B H Liang, C Ling, H Xu, Y Qiu, Z Z Zhu, Z Liu","doi":"10.3760/cma.j.cn112137-20240328-00708","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240328-00708","url":null,"abstract":"<p><p><b>Objective:</b> To explore the feasibility of using the entry point and screw path parameters of sacroiliac (S₂AI) screws inserted under O-arm 3D computer navigation as a reference for freehand screw insertion in patients with degenerative spinal deformities. <b>Methods:</b> A retrospective analysis was conducted on the clinical data of 66 patients with degenerative spinal deformities who received S₂AI screw fixation assisted by the O-arm 3D computer navigation system at Nanjing Drum Tower Hospital Affiliated with Nanjing University Medical School from January 2017 to April 2022. The patients included 6 males and 60 females, with a mean age of (64.3±5.9) years. Preoperatively, the entry point was set as the intersection of 1 mm from the outer and lower edges of the S₁ foramen, adjusted intraoperatively by navigation, and verified postoperatively by full spinal CT scans and 3D reconstructions. Using the S₁ screw entry point as the origin, the position of the bilateral S₂AI screw entry points, tailward angulation (SA), outward angulation (TA), and vertical distance from the entry point to the skin (SD) were measured on postoperative CT 3D images. The accuracy of S₂AI screw placement and any intraoperative and postoperative complications were recorded. Differences in entry point coordinates and screw path parameters between the left and right sides were compared. The intraclass correlation coefficient (ICC) was used to assess intra-observer and inter-observer agreement. <b>Results:</b> The coordinates and screw path parameters for the S₂AI screws placed using the O-arm navigation demonstrated good intra-observer and inter-observer consistency (ICC>0.75). The left entry point was located (8.08±1.39) mm laterally and (24.47±2.20) mm caudally from the S₁ entry point, while the right entry point was (8.09±1.41) mm laterally and (24.40±2.54) mm caudally, with no significant difference between the left and right sides (both <i>P</i>>0.05). The left TA was 46.33°±3.44°, SA was 39.14°±6.12°, and SD was (60.38±13.37) mm; the right TA was 46.37°±3.41°, SA was 39.59°±5.89°, and SD was (60.30±12.24) mm, with no significant differences between the left and right parameters (all <i>P</i>>0.05). There was no significant neurovascular complications intraoperatively or two weeks postoperatively, with a screw insertion accuracy of 97.7% (129/132). <b>Conclusions:</b> In the fixation of the pelvis in degenerative spinal deformities, the use of O-arm navigation-assisted S₂AI screw insertion has a high accuracy rate. It is recommended that for freehand screw insertion, the entry point should be located 24 mm caudally and 8 mm laterally from the outer and lower edges of the superior articular process of S₁, with an TA of approximately 46° and a SA of approximately 39°.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3800-3806"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Establishment and validation of a predictive model for postoperative pulmonary complications in elderly patients undergoing non-cardiac surgery].","authors":"L B Ma, C S Zhang, X J Ma, J Q Zhang, S H Rong, J B Cao, Z K Zhou, W D Mi","doi":"10.3760/cma.j.cn112137-20240318-00602","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240318-00602","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To develop and validate a predictive model for postoperative pulmonary complications (PPCs) in elderly patients undergoing non-cardiac surgery. &lt;b&gt;Methods:&lt;/b&gt; This retrospective study included 51 354 elderly patients over 65 years old who underwent non-cardiac surgery at the First Medical Center of Chinese PLA General Hospital from January 2009 to December 2018. The patients were randomly divided into a modeling group [&lt;i&gt;n&lt;/i&gt;=41 084; 21 550 males, 19 534 females; age: 70 (67, 74) years] and an internal validation group [&lt;i&gt;n&lt;/i&gt;=10 270; 5 458 males, 4 812 females; age: 70 (67, 74) years] at a ratio of 4∶1. Additionally, an external validation group of 14 378 patients [7 893 males, 6 845 females; age: 70 (67, 75) years] who underwent non-cardiac surgery at Henan Provincial People's Hospital between November 2014 and May 2022 was retrospectively included. Multivariate logistic regression were performed to identify factors associated with PPCs. A nomogram prediction model was constructed based on these factors and validated internally and externally. The model's performance and clinical applicability were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curves. &lt;b&gt;Results:&lt;/b&gt; Among the 51 354 elderly patients underwent general anesthesia for non-cardiac surgery, the incidence of PPCs was 17.5% (9 008/51 354). Multivariate logistic regression analysis reveals that anesthesia duration 130-&lt;183 min (&lt;i&gt;OR&lt;/i&gt;=1.858, 95%&lt;i&gt;CI&lt;/i&gt;: 1.529-2.266), anesthesia duration 183-&lt;250 min (&lt;i&gt;OR&lt;/i&gt;=2.537, 95%&lt;i&gt;CI&lt;/i&gt;: 2.079-3.108), anesthesia duration≥250 min(&lt;i&gt;OR&lt;/i&gt;=3.533, 95%&lt;i&gt;CI&lt;/i&gt;: 2.868-4.368), crystalloid infusion volume 1 400-&lt;2 000 ml (&lt;i&gt;OR&lt;/i&gt;=1.481, 95%&lt;i&gt;CI&lt;/i&gt;: 1.204-1.829), crystalloid infusion volume 2 000-&lt;9 000 ml (&lt;i&gt;OR&lt;/i&gt;=1.776, 95%&lt;i&gt;CI&lt;/i&gt;: 1.426-2.220), upper abdominal surgery (&lt;i&gt;OR&lt;/i&gt;=1.658, 95%&lt;i&gt;CI&lt;/i&gt;: 1.498-1.835), malignancy (&lt;i&gt;OR&lt;/i&gt;=1.796, 95%&lt;i&gt;CI&lt;/i&gt;: 1.606-2.012), fentanyl dosage 0.40-&lt;0.55 mg (&lt;i&gt;OR&lt;/i&gt;=1.404, 95%&lt;i&gt;CI&lt;/i&gt;: 1.203-1.640), fentanyl dosage≥0.55 mg (&lt;i&gt;OR&lt;/i&gt;=1.601, 95%&lt;i&gt;CI&lt;/i&gt;: 1.386-1.854), prophylactic use of antibiotics (&lt;i&gt;OR&lt;/i&gt;=7.897, 95%&lt;i&gt;CI&lt;/i&gt;: 5.124-12.983), age (&lt;i&gt;OR&lt;/i&gt;=1.039, 95%&lt;i&gt;CI&lt;/i&gt;: 1.030-1.049), smoking (&lt;i&gt;OR&lt;/i&gt;=1.124, 95%&lt;i&gt;CI&lt;/i&gt;: 1.014-1.246), preoperative chest X-ray abnormalities (&lt;i&gt;OR&lt;/i&gt;=2.139, 95%&lt;i&gt;CI&lt;/i&gt;: 1.820-2.509) and intraoperative hypotension (&lt;i&gt;OR&lt;/i&gt;=3.184, 95%&lt;i&gt;CI&lt;/i&gt;: 2.120-4.795) were risk factors for PPCs, while elective surgery (&lt;i&gt;OR&lt;/i&gt;=0.301, 95%&lt;i&gt;CI&lt;/i&gt;: 0.220-0.417) was a protective factor. The nomogram model incorporating these factors had an area under the curve (AUC) of 0.757 (95%&lt;i&gt;CI&lt;/i&gt;: 0.748-0.766, &lt;i&gt;P&lt;/i&gt;=0.309) in the modeling group, 0.779 (95%&lt;i&gt;CI&lt;/i&gt;: 0.760-0.796, &lt;i&gt;P&lt;/i&gt;=0.171) in the internal validation group, and 0.778 (95%&lt;i&gt;CI&lt;/i&gt;: 0.763-0.792, &lt;i&gt;P&lt;/i&gt;&lt;0.001) in the external validation group. Calibration curves and decision curves demonstrated good consiste","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3792-3799"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Strategies for applying noninvasive brain stimulation techniques to treat psychiatric disorders].","authors":"H X Wang, X L Liu","doi":"10.3760/cma.j.cn112137-20240524-01185","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240524-01185","url":null,"abstract":"<p><p>With the continuous development of science and technology, medical science, and bioengineering technology, various neuromodulation techniques, such as electrical, magnetic, acoustic, and optical modalities, are rapidly emerging in the therapeutic regime of psychiatric disorders. How to choose the appropriate noninvasive brain stimulation techniques for different psychiatric disorders and their clinical features is becoming a practical dilemma in clinical setting. In this paper, by describing the complex pathogenesis of psychiatric disorders and the limitations of existing therapeutic approaches on psychiatric disorders, combining with the characteristics of different neuromodulation techniques, we propose a new strategy of combined noninvasive brain stimulation to intervene in psychiatric disorders: high-intensity stimulation modulating the whole brain without inducing epilepsy should be as the basic treatment of psychiatric disorders, applying low-intensity stimulation with the advantage of specific targets/brain regions to modulate the residual symptoms or/and single symptom, and for refractory and acute psychiatric disorders, ECT/MECT is preferred for rapid symptom control; different noninvasive brain stimulation techniques can be combined with pharmacological and psychotherapeutic treatments, which will provide a new idea for the future development of this field.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3785-3791"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Biological variation and analytical performance specification study of erythrocyte and related parameters].","authors":"L Xu, H Lu, K Guo, X H Wang, X R Feng, C B Li, M T Peng","doi":"10.3760/cma.j.cn112137-20240418-00923","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240418-00923","url":null,"abstract":"<p><p><b>Objective:</b> To study biological variation (BV) and analytical performance specifications (APS) of 15 erythrocyte and related parameters. <b>Methods:</b> Sixty healthy participants from Beijing Hospital were prospectively recruited for the study, from July to December, 2023, including 30 males [aged (41.3±11.9) years] and 30 females [aged (40.3±12.4) years]. The study was designed based on the Biological Variation Data Critical Appraisal Checklist and the characteristics of erythrocyte detection. Whole blood samples were collected 10 times at 2-week intervals during 20 weeks. All samples were tested in duplicate using Mindray BC-7500 hematology analyzer and its accompanying reagents. Within-subject biological variation (<i>CV</i>_I) and between-subject biological variation (<i>CV</i>_G) were estimated by the nested ANOVA method. The BV data in this study were compared with the BV data of the European Database of Biological Variation. APS, reference change value (RCV) and index of individuality (II) were calculated. <b>Results:</b> The <i>CV</i>_I for 15 parameters ranged from 0.49% to 86.46%, and the <i>CV</i>_I data for red cell distribution width (RDW)-<i>CV</i>, RDW-<i>SD</i>, reticulocyte (RET) percentage, RET count, reticulocyte hemoglobin content (RHE), medium fluorescence reticulocyte (MFR) and high fluorescence reticulocyte (HFR) were significantly higher in females than in males (all <i>P</i><0.05). The <i>CV</i>_G ranged from 1.27% to 100.79%, and the <i>CV</i>_G data for HFR were significantly different between genders (<i>P</i><0.05). The <i>CV</i>_I data for red blood cell (RBC), hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC) and RHE in this study were lower than those recommended by the European database. The derived indicators of most parameters were influenced by gender. The II values for all parameters were<1.4, where the II values of MCHC and HFR were between 0.6 and 1.4; the II values for the remaining 13 parameters were<0.6. <b>Conclusions:</b> A BV study protocol for erythrocyte parameters is designed. When the reference intervals differ between genders, BV data should be calculated separately and the lower BV data are recommended for calculating APS; the RCV should be set separately for each gender.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3822-3829"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The effect of single pigtail bile duct stents without lateral wings bile duct drainage after removal of common bile duct stones in endoscopic retrograde cholangiopancreatography].","authors":"A H Huang, C Zhang, Y L Yang, C Q He, B S Zhang","doi":"10.3760/cma.j.cn112137-20240513-01101","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240513-01101","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the effect of single pigtail bile duct stents without lateral wings bile duct drainage after removal of common bile duct stones in endoscopic retrograde cholangiopancreatography (ERCP). <b>Methods:</b> Patients who underwent ERCP and implantation of a single pigtail bile duct stent for choledocholithiasis in Cholelithic Center of East Hospital Affiliated to Tongji University from January 2019 to September 2023 were retrospectively selected and divided into lateral wingless group (without the lateral wing) and lateral wing group(with the lateral wing) according to whether the lateral wings of the single pigtail bile plastic stents were preserved. The patients were followed up for 1 to 3 months. The stent detachment rate at 2 days, 1 week and 1 month, as well as the incidence of postoperative complications at 1 week and 1 month after ERCP were compared between the two groups. <b>Results:</b> A total of 402 patients were included, including 177 males and 225 females, aged 32-83 (58±12) years. There were 215 cases in the lateral wingless group and 187 cases in the lateral wing group. The stent detachment rate in the lateral wingless group was higher than that in the lateral wing group at 2 days after ERCP [12.6% (27/215) vs 5.9% (11/187), <i>P</i>=0.022]. The stent detachment rate in the lateral wingless was higher than that in the lateral wing group at 1 week after ERCP [87.0% (187/215) vs 25.1% (47/187), <i>P</i><0.001]. The stent detachment rate in the lateral wing group was higher than that in the lateral wing group at 1 month after ERCP [97.2% (206/215) vs 67.3% (126/187), <i>P</i><0.001]. The incidence of postoperative complications at 1 week after ERCP revealed no statistical significance between the two groups[(10.7% (23/215) vs 8.6% (16/187), <i>P</i>>0.05]. The incidence of postoperative complications at 1 month after ERCP in the lateral wingless group was lower than that in the lateral wing group [0.9% (2/215) vs 9.6% (18/187), <i>P</i>=0.001]. <b>Conclusion:</b> After the removal of choledocholithiasis with ERCP, bile is drained by a single pigtail bile duct stent with lateral removal, which has a high rate of natural shedding and a low incidence of complications.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3835-3839"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical efficacy and its influencing factors of ustekinumab in the treatment of patients with Crohn's disease].","authors":"Y F Bao, D Y Hu, X X Shao, C X Dai, J H Lu, J H Wu, Y Jiang","doi":"10.3760/cma.j.cn112137-20240304-01129","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240304-01129","url":null,"abstract":"<p><p>To analyze the clinical efficacy and its influencing factors of ustekinumab (UST) in the treatment of patients with Crohn's disease (CD). From January 2021 to January 2024, CD patients who received UST treatment were retrospectively collected from the Second Affiliated Hospital of Wenzhou Medical University. Harvey-Bradshaw index were applied to assess clinical activity of CD patients, C-reactive protein was used to evaluate biochemical remission rate, and simplified Crohn's disease endoscopy score was used to evaluate the degree of intestinal inflammation. Logistic regression model was used to analyze the influencing factors for the clinical response rate at week 8, as well as the clinical remission rate and endoscopic remission rate at week 32. A total of 138 CD patients were included, including 93 males and 45 females. The age of diagnosis [<i>M</i> (<i>Q</i>₁<i>, Q</i>₃)] was 24 (19, 32) years old. At week 8, the clinical response rate and biochemical remission rate was 58.0% and 49.3%, respectively. Multivariate logistic regression model analysis showed that disease behavior (stenosis or penetration) was the risk factor of the clinical response rate at week 8 (<i>OR</i>=0.46, 95%<i>CI</i>: 0.23-0.95). The clinical remission rate and endoscopic remission rate at week 32 were 56.5% and 37.7%, respectively. Multivariate logistic regression model analysis showed that disease behavior (stenosis or penetration) was the risk factor of the clinical remission rates (<i>OR</i>=0.18, 95%<i>CI</i>: 0.08-0.42) and endoscopic remission rates (<i>OR</i>=0.25, 95%<i>CI</i>: 0.11-0.55) at week 32. Failure to achieve clinical response at week 8 was the risk factor of the clinical remission rates (<i>OR</i>=0.21, 95%<i>CI</i>: 0.09-0.52) and endoscopic remission rates (<i>OR</i>=0.19, 95%<i>CI</i>: 0.07-0.50) at week 32. UST treatment has good clinical efficacy in CD patients. CD patients with intestinal stenosis or penetrating lesions can decrease the efficacy of UST treatment. Failure to achieve clinical response at week 8 can decrease the efficacy at week 32.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3840-3843"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy comparison of the S8 navigation-assisted correction versus manual correction in adolescent congenital scoliosis].","authors":"S Li, Y He, Q D Li, S L Gao, X N Cheng, Y K Lei, M Z Feng, J P Du, L Zhu, Y F Huang, Z Chang, Z G Zhao, L Yan, H Hui, X F Zhang, B R He","doi":"10.3760/cma.j.cn112137-20240329-00714","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240329-00714","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; Comparison of the efficacy of S8 navigation system-assisted correction versus manual correction in the treatment of adolescent congenital scoliosis (ACS). &lt;b&gt;Methods:&lt;/b&gt; A cohort study. A retrospective analysis was conducted on the clinical and imaging data of 48 patients with congenital scoliosis who were treated at the Honghui Hospital Affiliated with Xi'an Jiaotong University between May 2021 and January 2023. Based on the auxiliary systems, the patients were divided into two groups: the S8 navigation system-assisted correction group (navigation group, &lt;i&gt;n&lt;/i&gt;=20) and the C-arm-assisted manual correction group (manual group, &lt;i&gt;n&lt;/i&gt;=28). The primary outcome measures were coronal balance (CB), sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), pelvic incidence-lumbar lordosis mismatch (PI-LL), and the Scoliosis Research Society-22 (SRS-22) questionnaire. The secondary outcome measures included surgery-related conditions and postoperative complications. &lt;b&gt;Results:&lt;/b&gt; Of the 48 patients, there were 21 males and 27 females, with a mean age of (13.3±3.0) years. There was no statistically significant differences in preoperative distance of C&lt;sub&gt;7&lt;/sub&gt; plumb line to center sacral vertical line (C&lt;sub&gt;7&lt;/sub&gt;PL-CSVL), SVA, LL, PI, PT, PI-LL mismatch, or SRS-22 scores between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Postoperatively, the C&lt;sub&gt;7&lt;/sub&gt;PL-CSVL and SVA in the navigation group were both better than in the manual group [(12.51±11.86) mm vs (19.64±1.33) mm, (15.72±3.64) mm vs (25.42±2.53) mm, both &lt;i&gt;P&lt;/i&gt;&lt;0.05]. There was no statistically significant differences in postoperative LL, PI, PT, PI-LL mismatch, or SRS-22 scores between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The accuracy rates for Grade 0 and Grade 0+1 screw placements were 91.17% (93/102) and 95.09% (97/102) in the navigation group, respectively, which were higher than those in the manual group [84.45% (125/148) and 91.89% (136/148), respectively] (both &lt;i&gt;P&lt;/i&gt;&lt;0.05). The rates of adjacent facet joint violation in Grades A, B, and C were 88.23% (90/102), 11.76% (12/102), and 0 (0/102) in the navigation group, respectively, which were all better than those in the manual group [83.44% (121/145), 8.96% (13/145), and 7.58% (11/145)] (&lt;i&gt;P&lt;/i&gt;=0.015). The navigation group had shorter operative time, single screw placement time, and total screw placement time, and the distance between the screws and the cortex was closer compared to the manual group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Intraoperative blood loss in the manual group was higher than that in the navigation group (&lt;i&gt;P&lt;/i&gt;&lt;0.05). The average curve correction rate in the navigation group (74.68%±10.70%) was better than that in the manual group (59.60%±6.90%) (&lt;i&gt;P&lt;/i&gt;&lt;0.001). The intraoperative fluoroscopy dose in the navigation group was higher than that in the manual group [(416±70) mGy vs (360±81) mGy, &lt;i&gt;P&lt;/i&gt;=0.015]. The incision length in the navigation group was longer","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3807-3814"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Efficacy of domestic single-hole robotic surgery system in the treatment of pediatric urological diseases].","authors":"X Y Zou, Y P Hou, J S Lian, K P Bai, S Feng, J Sun","doi":"10.3760/cma.j.cn112137-20240522-01160","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240522-01160","url":null,"abstract":"<p><p>To explore the efficacy of domestic single-hole robotic surgery system in the treatment of pediatric urological diseases. A prospective review of clinical data of children who underwent laparoscopic surgery in the Department of Urology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, was conducted from July to November 2023. All surgeries were performed using the sharp single-port serpentine arm robotic surgery system, with an umbilical access route. All surgeries are performed by the same chief physician. Operative time, intraoperative blood loss, incision size, and postoperative complications were recorded. A total of 12 patients were included, consisting of 8 males and 4 females, aged 8.0-17.0 (13.5±2.7) years. The procedures included 5 pyeloplasties (1 case of bilateral pyeloplasty), with a unilateral operative time [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃) ]of 180 (145, 200) minutes and a blood loss of 5 (5, 10) ml. Oral mucosa ureteroplasty was performed in 1 patient, taking 3 hours and 52 minutes with a blood loss of 10 ml. Renal cyst decortication was conducted in 1 case in 85 minutes with a blood loss of 20 ml. High ligation of the spermatic vein was conducted in 3 patients, with an average operative time of 97 minutes and no intraoperative blood loss. Bilateral gonadectomy was completed in 80 minutes with a blood loss of 5 ml. Ovarian cystectomy (1 case) was performed in 69 minutes with a blood loss of 5 ml. All surgeries were successfully completed without conversion to open surgery. Except for the oral mucosa ureteroplasty, which required an additional 5 mm auxiliary port, all procedures were performed through a 3 cm umbilical incision. Among the patients who underwent pyeloplasty, 1 case of urinary leak was identified and successfully treated conservatively with adequate drainage over 25 days. Re-stenosis was experienced by 1 patient with a long segment ureteral stricture postoperatively, while no Clavien-Dindo grade≥2 complications were observed in other patients. All umbilical wounds were concealed, and satisfactory postoperative appearances were noted. The domestic single-hole robotic surgery system is effective in treating pediatric urological diseases.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 41","pages":"3844-3847"},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guideline for medical nutritional treatment of adult patients with gastrointestinal dysfunction (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20240815-01881","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240815-01881","url":null,"abstract":"<p><p>Gastrointestinal dysfunction is a common clinical disease. Due to abnormal gastrointestinal digestive and absorption functions, nutrients, water, and electrolytes cannot be absorbed properly, and therefore, scientific and reasonable nutritional intervention is needed. In order to further standardize medical nutrition treatment of patients with gastrointestinal dysfunction, the Chinese Society of Parenteral and Enteral Nutrition (CSPEN) organized experts and scholars in related fields in China to elaborate on the following topics based on current evidence-based medical evidence: the standard process of medical nutrition treatment for patients with gastrointestinal dysfunction, the time and mode of enteral and parenteral nutrition application, and the nutritional intervention mode for patients with gastrointestinal dysfunction in special disease state. Finally, 29 questions and 58 recommendations were formed to provide reference for the standardized application of medical nutrition therapy for patients with gastrointestinal dysfunction.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 ","pages":"1-27"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Postoperative outcome of special primary aldosteronism undergoing surgery based on adrenal vein sampling results].","authors":"L Lan, M C Zhou, L L Huo, X B Yang, W Deng, Y Luo","doi":"10.3760/cma.j.cn112137-20240518-01139","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20240518-01139","url":null,"abstract":"<p><p>To further demonstrate the gold standard role of adrenal vein sampling (AVS) in the subtyping diagnosis of primary aldosteronism (PA). In this study, 9 patients with special PA, whose functional advantages indicated by AVS were contrary to the results of CT examination, were selected. Laparoscopic adrenalectomy was performed based on AVS results, and the surgical outcome was followed up. Nine patients, aged[<i>M</i>(<i>Q</i>₁, <i>Q</i>₃)] 58.0 (52.0, 63.0) years, including 7 males and 2 females, were followed up for 12 (9, 12) months. CT revealed unilateral morphological abnormalities in 5 cases (the functional advantage side indicated by AVS was contrary to the results of CT examination), and bilateral abnormalities in 4 cases (AVS results confirmed unilateral abnormalities). During the follow-up, all 9 patients achieved complete biochemical remission, 4 patients achieved complete clinical remission, and 5 patients achieved partial clinical remission. The study indicates that compared with CT imaging, AVS has better accuracy in PA subtyping, and selecting surgical side based on AVS results is a reliable and effective strategy.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"104 40","pages":"3775-3779"},"PeriodicalIF":0.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}