Colorectal cancer is one of the common malignant tumor in the world, and about 57.6% of colorectal cancer surgical cases in our country are rectal cancer patients, which occupies a major proportion. Some patients with rectal cancer may already have emergencies such as intestinal obstruction or limited perforation at the time of consultation, which require immediate relevant treatment measures. Currently, there are multiple surgical and endoscopic treatment strategies available for obstructive and perforated rectal cancer. Surgeons need to perform an accurate and comprehensive assessment of the disease, define the goals of the current treatment, and formulate an appropriate treatment plan based on the patient’s clinical and oncological status in order to optimize the patient’s oncological outcome while minimizing the risk of complications associated with emergency colorectal surgery.
Objective To analyze the impact of robot assistance on the restoration of limb length and offset distance in total hip arthroplasty (THA). Methods A retrospective analysis was conducted on the clinical data of 316 patients who underwent unilateral primary THA between September 2019 and August 2023. Among them, 117 patients underwent robot-assisted THA (group A), and 199 patients underwent conventional THA (group B). There was no significant difference between the two groups in the gender, age, or side of the hip replacement (P>0.05); but there was a significant difference in the preoperative diagnosis (P<0.05). The leg length discrepancy (LLD) and global offset (GO) dfference were measured on preoperative anteroposterior pelvic X-ray films, and absolute values were used for comparison between groups. Results The operations in both groups were successfully completed. Postoperative imaging measurements showed that the LLD and GO dfference in group A were significantly lower than those in group B (P<0.05). Among them, group A had 32 cases (27.4%), 5 cases (4.3%), and 0 case (0) of LLD>3 mm, >5 mm, and >10 mm, respectively, while group B had 115 cases (57.8%), 75 cases (37.7%), and 22 cases (11.1%), respectively; and the differences in above indicators between groups were significant (P<0.05). Group A had 40 cases (34.2%), 3 cases (2.6%), and 0 case (0) of GO dfference>5 mm, >10 mm, and >20 mm, respectively; group B had 103 cases (51.8%), 54 cases (27.1%), and 7 cases (3.5%), respectively. There was no significant difference in the proportion of patients with GO>20 mm between groups (P>0.05), while there were significant differences in other indicators between groups (P<0.05). Conclusion Compared with traditional THA, robot assisted THA has more advantages in restoration of limb length and offset distance.
Inherited retinal diseases (IRD) are a group of genetic disorders with high genetic and clinical heterogeneity. Genetic diagnosis has become one essential method for patients with IRD in their clinical management. So far, about 30% of the patients with IRD cannot get molecular diagnosis (no pathogenic variant detected or only mono-allele variant identified in AR genes) using target or whole exome sequencing. Most missing heritability or variants for these patients were variants located in no-coding regions (deep intron or promoter regions) and structure variants of the known IRD genes. It is more challenge to reveal this kind of missing variants, which need using whole genome sequencing combined with other cellular or molecular assays.
ObjectiveTo compare the application effects between personal specific instrumentation (PSI) and computer-assisted navigation surgery (CAS) in total knee arthroplasty (TKA). MethodsThe literature comparing the application effects of PSI and CAS in TKA in recent years was widely consulted, and the difference between PSI-TKA and CAS-TKA in operation time, lower limb alignment, blood loss, and knee function were compared. ResultsCompared to CAS-TKA, PSI-TKA simplifies operation procedures and shortens operation time but probably has worse lower limb alignment. It is still controversial in comparison of perioperative blood loss and knee function between two techniques. ConclusionPSI-TKA and CAS-TKA both have advantages and disadvantages, and their differences need to be confirmed by further high-quality clinical trial.
ObjectiveTo review the current situation of total knee arthroplasty (TKA) used in young patients with osteoarthritis. MethodsThe recent literature in the treatment of osteoarthritis with TKA in young patients was extensively reviewed. The characteristics, curative effect, and postoperative satisfaction degree of TKA in young patients were analyzed and summarized. ResultsYoung patients have longer life expectancy and higher activity, which may lead to much higher expectation of the TKA. Comparing with elderly patients, young patients obtain equal or better effectiveness after TKA, but they are likely to not be satisfied with the effects because of low survival rate of the prosthesis. At present, continuous development of implant design, prosthesis material, and operation technique are in progress to reduce wear, hence to prolong the implant survivorship so as to meet the desire of young patients. However, the studies of the big samples and long-term follow-up are required to confirm the clinical advantages of such developments. ConclusionWith the trend of TKA in young patients, surgeons should have a good understanding of the patients' demands, select suitable prosthesis and give appropriate preoperative counseling to build up an objective expectation of curative effect, which will lead to a better doctor-patient relationship.
Inherited retinal diseases (IRD) are a group of genetic disorders with high genetic and clinical heterogeneity. Patients with IRD may have their clinical diagnosis confirmed by genetic testing. Over the past 30 years, rapid advances in molecular genetics have raised the disease-causing gene variant detection rate and the accuracy of genetic testing, which provide hope to patients. The genetic diagnosis of patients with IRD is complicated due to the overlapping clinical phenotypes, and the fact that different variants lead to different phenotypes and severity even of the same gene. It is very important to overall evaluate the clinical phenotype of patients, precisely select genetic testing methods, and reasonably define disease-causing genes and variants during genetic diagnosis, which can guide the patient's subsequent treatment and provide genetic counseling.
Objective To review the research progress of injection sites of local infiltration analgesia (LIA) in total knee arthroplasty (TKA). MethodsThe relevant domestic and foreign literature in recent years was extensively reviewed. The neuroanatomy of the knee, and the research progress of the selection and the difference of effectiveness between different injection sites of LIA in clinical studies were summarized. ResultsLarge concentrations of nociceptors are present throughout the various tissues of the knee joint. Patellar tendon, subpatellar fat pad, lateral collateral ligament insertions, iliotibial band insertions, suprapatellar capsule, and posterior capsule were more sensitive to pain. Most current studies support injections into the lateral capsule, collateral ligament, retinaculum, quadriceps tendon, fat pad, and subcutaneous tissue. Whether to inject into the back of the knee and subperiosteum is controversial. ConclusionThe relative difference of knee tissue sensitivity to pain has guiding significance for the selection of LIA injection site after TKA. Although researchers have conducted clinical trials on injection site and technique of LIA in TKA, there are certain limitations. The optimal scheme has not been determined yet, and further studies are needed.
To review the literature about the development of the periodontal tissue engineering. Methods Based on an extensive review of the latest literature concerned, we analyzed and evaluated themethod of the periodontal tissue engineering. Results The development of the periodontal tissue engineering in the fields of the seed cells, modifier genes, cell factors, and scaffold materials provided a brand-new thinking and method for complete regeneration of the eriodontal tissues. Conclusion The periodontal tissue engineering has an excellent future butmany problems still require a further study and a satisfactory solution.
ObjectiveTo evaluate the early effectiveness of local infiltration anesthesia (LIA) with compound betamethasone in total knee arthroplasty (TKA). MethodsThe clinical data of 102 patients with knee osteoarthritis who were treated by TKA and met the selection criteria between May 2022 and March 2023 were retrospectively analyzed. They were divided into control group and study group according to whether LIA preparation was added with compound betamethasone, with 51 cases in each group. There was no significant difference of baseline data, such as age, gender, body mass index, operative side, preoperative range of motion (ROM), Knee Society Score (KSS), white blood cell (WBC), and hematocrit between the two groups (P>0.05). The intraoperative total blood loss and hidden blood loss were recorded, and WBC was recorded on the 1st, 2nd, and 3rd days after operation. Pain was assessed by visual analogue scale (VAS) score on the 1st, 2nd, and 3rd days after operation and morphine intake milligrames equivalent within 48 hours after operation. Passive ROM, maximum extension and flexion angles of knee joint were measured on the 3rd day after operation; the early postoperative complications were recorded. ResultsThere was no significant difference in total blood loss and hidden blood loss between the two groups (P>0.05). The postoperative pain levels in both groups were relatively mild, and there was no significant difference in VAS scores in the first 3 days after operation and in morphine intake milligrams equivalent within 48 hours after operation between the two groups (P>0.05). The WBC in the first 3 days after operation was significantly improved in both groups (P<0.05). The WBC in the study group was significantly higher than that in the control group on the 1st and 2nd days after operation (P<0.05), but there was no significant difference between the two groups on the 3rd day after operation (P>0.05). On the 3rd day after operation, the maximum extension angle of knee joint in the study group was smaller than that in the control group, while the maximum flexion angle and passive ROM of knee joint in the study group were larger than those in the control group, and the differences were significant (P<0.05). There were 6 cases of fever and 17 cases of deep venous thrombosis in the control group, and 1 case and 14 cases in the study group, respectively. There was no poor wound healing and periprosthetic joint infection in the two groups, and there was no significant difference in the incidence of complications between the two groups (P>0.05). ConclusionThe application of compound betamethasone in LIA during TKA is a safe and optimal strategy to promote the early postoperative rehabilitation of patients.