腹股沟疝和痔一样是人类独有的疾病,这是因为人是直立的缘故,当然,猩猩是否也有此问题尚未见报道。在胚胎发育和解剖上,腹股沟有薄弱之处是重要因素,老年人腹股沟部筋膜、肌肉弱化也是重要因素,许多论著和医生经验均有论述。
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.
The sternoclavicular joint is located at the cervicothoracic junction, where various types of lesions such as trauma, infection, inflammation and tumor can occur. In complex chest wall reconstruction, the sternoclavicular joint is often involved. Whether and how to reconstruct the sternoclavicular joint is a difficult problem for surgeons. At present, there is no unified standard for sternoclavicular joint resection and reconstruction. There are many materials and methods for sternoclavicular joint reconstruction. With the development of surgical techniques and treatment concepts, we have a new understanding of the anatomy, function, and surgical treatment of the sternoclavicular joint. This article provides an overview of these developments.
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.
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.
Objective To review the progress of treatments for old calcaneal fractures. Methods The related literature of treatments for old calcaneal fractures were reviewed and analyzed from the aspects such as the pathoanatomy, classifications, and surgical treatments. Results Old calcaneal fractures are common in clinical, the anatomical changes are very complicated. In addition to classical open reduction and internal fixation, arthrodesis, and osteotomy, techniques of minimally invasive operation, external fixator, and three-dimensional printing are more and more widely applied, treatments for old calcaneal fractures nonunion have also received increasing attention. Conclusion Although the perfect strategy for treating old calcaneal fractures has not yet been developed, great progress has been achieved recently, the personalized therapy need to be further studied, and therapies for the early stage old calcaneal fractures and old calcaneal fractures nonunion need to be further explored.
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.
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.