Acute respiratory distress syndrome is one of the forms of respiratory failure that seriously threaten human life. It has the characteristics of very high morbidity, mortality and hospitalization costs. How to treat acute respiratory distress syndrome to improve the quality of life of patients is particularly important. Mechanical ventilation is an important treatment for acute respiratory distress syndrome. This article will review the progress in mechanical ventilation therapy for acute respiratory distress syndrome, including non-invasive mechanical ventilation and invasive mechanical ventilation (tidal volume, lung recruitment, positive end-expiratory pressure, prone position ventilation, and high-frequency oscillatory ventilation), aiming to provide basis and reference for future exploration of the treatment direction of acute respiratory distress syndrome.
ObjectiveTo summarize the progress in treatment of unstable atlas fracture, the existing problems, and the research direction.MethodsRelated literature at home and abroad was reviewed. The stability evaluation of atlas fracture and treatment methods were introduced, and the selection of surgical approach and fixation instruments in treatment of unstable atlas fracture were summarized and analyzed.ResultsAt present, atlas fractures are considered as unstable fractures except single anterior arch fractures with complete transverse ligament or simple posterior arch fractures. The treatment of unstable atlas fracture has been developed from nonsurgical treatment and traditional fusion surgery to single-segment fixation. Nonsurgical treatment is less effective, while traditional fusion surgery has a disadvantage of limited the motion of the upper cervical spine. Single-segment fixation can not only restore and fix the fracture, but also preserve the upper cervical motion function. Single-segment fixation approaches include posterior and transoral approaches, and the fixation instruments are being constantly improved, mainly including screw-rod system, screw-plate system, and plate system.ConclusionFor unstable atlas fracture, single-segment fixation is an ideal surgical method, and has more advantages when compared with nonsurgical treatment and traditional fusion surgery. Single-segment fixation via transoral approach is more direct for atlas anterior arch fracture reduction, but there is a high risk of infection; and single-segment fixation via posterior approach is less effective for the reduction of atlas anterior arch fracture. Therefore, a better reduction method should be explored.
Takayasu arteritis (TA) is a primary, chronic, non-specific, inflammatory disease of the aorta and its larger branches. The pulmonary artery trunk and its branches could be impacted by TA, which could cause stenosis or occlusion of lesion vessels. TA also affects the normal function of the aortic valve and other heart valves, mainly due to valvular insufficiency. Aortic regurgitation caused by TA is mainly treated by surgical operation. In this review, the examination technique, operation timing, operation method and prognosis of aortic valve involved in TA are discussed systematically.
ObjectiveTo summarize the research progress of diagnosis and treatment in hypertriglyceridemia pancreatitis in recent years.MethodsThrough the retrieval of relevant literatures, the progress of diagnosis and treatment in hypertriglyceridemia pancreatitis were reviewed.ResultsHypertriglyceridemia pancreatitis is a rare acute pancreatitis, but with the improvement of living standard and the change of diet structure, the incidence of this disease in recent years was increasing, and more likely to lead to complications, causing serious consequences. The treatment of hypertriglyceridemia pancreatitis in addition to the routine treatment of pancreatitis, attention should also be paid to the rapid reduction of blood triglyceride levels, including plasma exchange, the use of low molecular weight heparin and insulin, and the use of lipid-lowering drugs.ConclusionsHypertriglyceridemia pancreatitis is more severe than acute pancreatitis caused by other causes, and the incidence of complications is higher. Maintaining a lower level of blood triglycerides is of great significance for the improvement of this pancreatitis and the prevention of the recurrence of pancreatitis.
Objective To review the injury mechanism and the treatment progress of terrible triad of the elbow, and to analyze the direction of further research. Methods Related literature concerning terrible triad of the elbow was extensively reviewed and comprehensively analyzed. Results The main treatment of terrible triad of the elbow is operation. The ultimate goal of treatment is to reconstruct sufficient stability of the elbow. The treatment includes fixation of the coronoid by suture, screw or plate; fixation of radial head by screw and plate, partial or complete replacement of the radial head; fixation of lateral collateral ligament and the medial collateral ligament by bone suture or anchors and the application of the external fixator. These surgical treatments have their own indications and advantages, most get satisfactory results. Conclusion Generally, surgery is needed to maintain the stability of the elbow for patients of terrible triad elbow. However, medial ligament repair or not, the choice of approach, and mechanism of injury still need further study.
ObjectiveTo understand the current progress of surgical treatment, radiotherapy, chemical drug therapy, endocrine therapy, targeted therapy, and immunotherapy of metaplastic breast cancer (MBC), so as to provide reference for the clinical therapy selection of MBC. MethodThe literature relevant to MBC therapy research in recent years was comprehensively reviewed. ResultsAt present, the pathogenesis of MBC was not clear. The histopathology of MBC was more complex and the prognosis was poor. Compared with the invasive ductal carcinoma, the MBC patients had older age of onset, larger tumor diameter, faster growth and stronger invasiveness. The simple mastectomy was currently used in surgical treatment. The axillary lymph node involvement rate of MBC patients was lower, so the sentinel lymph node biopsy was widely used. The chemical drug therapy, endocrine therapy, and targeted therapy had limited effects on MBC patients. However, with its unique molecular expression by the genomic analysis of MBC and rise of precision medicine, targeted therapy and immunotherapy had become current research hotspots, providing potential therapeutic strategies for MBC patients. ConclusionsDue to the complex histopathology and poor prognosis of MBC, and most research on MBC is retrospective studies, lacking sufficient prospective studies with sufficient sample size, so there is currently no clear consensus on the optimal treatment method for MBC. In order to better improve prognosis of MBC patients, further in-depth research on MBC histopathology, prospective studies with sufficient sample size, and development of targeted and effective therapeutic drugs are needed in the future.
Facial aging is caused by several aspects involving skin, its deep soft tissue (fat, muscles, fascia ligaments, etc), and bones. The skin presents deepen wrinkles, darker, drying, and roughness. Volume loss and sag caused by gravity can be seen in deep soft tissue. And selective absorption can be seen in bones. At present, to combat facial aging caused by different causes, we have adopted comprehensive treatment methods such as facial rhytidectomy, embedded wire ascension, autogenous fat graft, hyaluronic acid or botulinum toxin injection, and optoelectronic techniques, etc.
Robotic gastric cancer surgery had developed rapidly in recent years, and its clinical application had come a long way. More and more studies had demonstrated that the robotic gastric cancer surgery was a safe and feasible procedure, and showed the technical advantages in the lymph node dissection, bleeding control, precise surgery, and postoperative recovery over laparoscopic surgery. However, some limitations such as the high surgical costs, lack of high-quality evidence, insufficient intelligence limited the development of robotic gastric cancer surgery. In the future, with more high-quality evidence-based medicine research and the development of intelligent surgical robots, the robotic gastric cancer surgery will be further standardized and promoted. We believe that robotic gastric cancer surgery will become the mainstream of minimally invasive surgery for the treatment of gastric cancer.