Interventional radiology (IR) has developed rapidly since its introduction into our country. More and more patients choose this minimally invasive procedure for treatment, but the incidence of infectious complications and potential mortality following IR procedures should not be underestimated. As the number and breadth of IR procedures grow, it becomes increasingly evident that interventional radiologists and infection control practitioners must possess a thorough understanding of these potential infectious complications and put more emphasis on the quality of care, so as to control the infections and expenses, and maximize the patient safety. This article reviews infectious complications associated with percutaneous ablation of liver tumors, transarterial embolization of liver tumors, percutaneous transhepatic cholangial drainage, and intravascular stents or grafts. Emphasis is placed on incidence, risk factors, and prevention. With the use of these strategies, IR procedures can be performed with reduced risk of infectious complications.
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 Mucin 1 （MUC1）and Thomsen-Friedenreich related antigens （TFRA）gene play an important role in the occurrence and development of tumor，so we will discuss its research advancements and clinical applications below. Methods Foreign and native related literatures published in recent 10 years were retrieved，and a further exploration on the expression relationship and clinical research progression of MUC1 and TFRA were reviewed. Results MUC1 and TFRA expressed in a high degree of specificity in malignant tumors，and their expressions interacted with each other. Many MUC1 related vaccines had been introduced to clinical in recent years，and some drugs based on TFRA had been put into clinical experiment as gene therapy methods too. Conclusions MUC1 and TFRA may be used as new target antigens of specific immunotherapy for malignant tumor. That they express in high or low level is closely related to tumor biological behavior and prognosis， moreover， they are important to the diagnosis and treatment of cancer.
Objective To assess the effectiveness of acupuncture for tension-type headache. Methods A systematic review of the relevant randomized controlled trials (RCTs) of acupuncture for tension-type headache was performed using the methods of The Cochrane Collaboration. Trials were collected from The Cochrane Library, Issue 4, 2003, MEDLINE (1966 to March 2004), CBM (1978 to August 2003), VIP (1989 to April 2003) and handsearched all related articles published in Chinese in 2003. The quality of literature was reviewed, and data were extracted by two reviewers independently. Meta-analysis was conducted using RevMan 4.2 software. Results Thirteen RCTs involving 571 patients were included, of the thirteen RCTs, six were of high methodological quality according to Jadad scale (the Jadad score≥3), and “sham acupuncture” was used as controlled intervention in eight trials. Meta-analysis indicated that no statistical difference was detected between acupuncture and sham acupuncture groups on effectiveness with RR 1.55, 95%CI 0.97 to 2.47 and P=0.07 at the end of treatment. No statistical difference was detected between acupuncture and sham acupuncture groups on visual analogue scale at the end of treatment with WMD －0.55, 95%CI －1.20 to 0.09 and P=0.09; at the end of follow-up of less than 2 months with WMD －0.22, 95%CI －0.87 to 0.42 and P= 0.50 and at the end of follow-up of more than 2 months with WMD －0.65, 95% CI －1.41 to 0.11 and P=0.09. Conclusions Comparing acupuncture with sham acupuncture and other treatments, current evidence can not evaluate whether acupuncture is significantly effective for tension-type headache, more RCTs of high methodological quality are required.
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.
Objective To evaluate the effectiveness of unsupported reduction ascending aortoplasty for dilatation of the ascending aorta. Methods Between September 2005 and May 2011, 53 patients with aortic valve disease and dilatation of the ascending aorta underwent aortic valve replacement with unsupported reduction ascending aortoplasty. There were 41males and 12 females, aged 22-75 years (mean, 52 years). The disease duration was 1 month to 14 years. The color Doppler echocardiography showed that the diameter of the ascending aorta before surgery was (45.9 ± 3.3) mm; bicuspid aortic valve and tri-aortic valve were observed in 13 and 40 cases respectively. The heart functions were graded as II level in 19 cases, III level in 33 cases, and IV level in 1 case according to the standard of New York Heart Disease Academy (NYHA). Results After operation, mediastinum errhysis occurred in 1 case, pneumonia in 3 cases, and III degree atrioventricular block in 1 case. There was no related complication of the aortoplasty. All the patients were followed up 3-68 months (mean, 15 months), and had no obvious chest tightness and palpitation. At last follow-up, the NYHA heart functions were graded as I level in 22 cases, II level in 31 cases; the diameter of the ascending aorta was (35.2 ± 4.0) mm, showing significant difference when compared with the preoperative one (P=0.000), but no significant difference when compared with the one at discharge (34.0 ± 2.5) mm (P=0.245). There was significant difference in the diameter of the ascending aorta between last follow-up and preoperation, at discharge in the patients who were followed up more than 60 months (P lt; 0.05); significant difference was found between last followup and preoperation in patients with bicuspid aortic valve (P lt; 0.05), but no significant difference between last follow-up and preoperation (P gt; 0.05) in patients whose diameter of the ascending aorta was more than 50 mm before operation. Conclusion Unsupported reduction ascending aortoplasty has good short- and mid-term results in treating aortic valve disease with mild to moderate dilatation (diameter range, 40-50 mm) of the ascending aorta. Inclusion criteria of the aortoplasty should be strict. Long-term results need further follow-up.
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive brain stimulation technique that has been paid attention to with increasing interests as a therapeutic neural rehabilitative tool. Studies confirmed that high-frequency rTMS could improve the cognitive performance in behavioral test as well as the excitability of the neuron in animals. This study aimes to investigate the effects of rTMS on the cognition and neuronal excitability of Kunming mice during the natural aging. Twelve young mice, 12 adult mice, and 12 aged mice were used, and each age group were randomly divided into rTMS group and control group. rTMS-treated groups were subjected to high-frequency rTMS treatment for 15 days, and control groups were treated with sham stimulation for 15 days. Then, novel object recognition and step-down tests were performed to examine cognition of learning and memory. Whole-cell patch clamp technique was used to record and analyze resting membrane potential, action potential (AP), and related electrical properties of AP of hippocampal dentate gyrus (DG) granule neurons. Data analysis showed that cognition of mice and neuronal excitability of DG granule neurons were degenerated significantly as the age increased. Cognitive damage and degeneration of some electrical properties were alleviated under the condition of high-frequency rTMS. It may be one of the mechanisms of rTMS to alleviate cognitive damage and improve cognitive ability by changing the electrophysiological properties of DG granule neurons and increasing neuronal excitability.
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 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.