ObjectiveTo investigate the effectiveness of repair procedure using biological mesh with Onlay-Reinforce technique in patients with perineal hernia. MethodsBetween January 2005 and December 2012, 9 patients with perineal hernia after laparoscopic abdominoperineal resection for rectal cancer (Miles operation) were treated. There were 3males and 6 females with a mean age of 70 years (range, 61-78 years). The disease duration was 1-9 months (mean, 4.5 months). The most beginning symptom was distending pain in perineal region, and then reducible mass was found without bowel incarceration. All patients underwent hernia repair using biological mesh with Onlay-Reinforce technique through original perineal incision. ResultsThe hernial size was 9.8-20.5 cm2 (mean, 16.0 cm2); the size of biological mesh was 58-80 cm2 (mean, 70.2 cm2); and the intraoperative blood loss was 10-80 mL (mean, 50.5 mL). All of the patients underwent repair operation successfully. The operation time was 45-90 minutes (mean, 60.6 minutes); and the hospitalization time was 4-7 days (mean, 5.9 days). One patient had urine retention, which was relieved after 7 days indwelling catheter. All the wounds healed by first intention without infection. The patients were followed up 14.5-60.7 months (mean, 37.8months). No chronic pain, obvious foreign body sensation, or hernia recurrence developed. ConclusionUse of biological mesh with Onlay-Reinforce technique for the repair of perineal hernia after Miles operation is safe and effective.
ObjectiveTo summarize the new ideas and new instruments in thyroid surgery. MethodsRelated literatures were reviewed and analyzed. ResultsTotal thyroidectomy had become the preferred option for differentiated thyroid cancer and multiple nodule goiter. The key change of surgery was from recurrent laryngeal nerve-protection to parathyroid-protection. Harmonic scalpel, bipolar coagulation forceps and Ligasure were used to thyroid surgery, which could shorten operation time and reduce operative bleeding. ConclusionThe ideas and techniques of thyroid surgery have changed, total thyroidectomy and parathyroid protection are being paid more and more attentions, and new instruments are used more extensively in thyroid surgery.
ObjectiveTo investigate the effectiveness of arthroscopic reinforced reconstruction of anterior cruciate ligament (ACL) with autologous hamstring tendon combined with anchor suture band. MethodsBetween February 2016 and March 2018, 60 patients who were to be treated with arthroscopic ACL reconstruction and met the selection criteria were selected in the study. Among them, 30 cases were reconstructed with autologous hamstring tendon combined with anchor suture band (trial group), and 30 cases were reconstructed with simple autologous hamstring tendon (control group). There was no significant difference in gender, age, disease duration, cause of injury, injury side, and preoperative Lysholm score, Tegner score, and International Knee Documentation Committee (IKDC) score between the two groups (P>0.05). After reconstruction, the patients in the trial group were allowed to start knee flexion and extension activities early without wearing an adjustable brace, while the patients in the control group were required to wear an adjustable brace for 12 weeks. The knee joint function (Lysholm score, Tegner score, IKDC score) and stability (Lachman test and pivot shift test) were compared between the two groups after operation.ResultsThere was no significant difference in graft diameter between the two groups (t=1.061, P=0.115). Compared with the control group, the operation time of the trial group was significantly different (t=4.924, P=0.000). All incisions healed primarily. In the control group, the intramuscular venous thrombosis occurred in 2 cases after operation. Both groups were followed up 18 months. The Lysholm score, Tegner score, and IKDC score of the two groups at each time point after operation were significantly higher than those before operation (P<0.05); the above scores in the trial group were significantly higher than those in the control group at 3, 6, and 9 months after operation (P<0.05); there was no significant difference between the two groups at 18 months after operation (P>0.05). There was no significant difference in Lachman test results between the two groups at each time point after operation (P>0.05). There was a significant difference in pivot shift test results at 6 months after operation between the two groups (P<0.05); but there was no significant difference at other time points (P>0.05). ConclusionThe effectiveness of ACL reinforcedreconstruction with autologous hamstring tendon combined with anchor suture band is satisfactory. Compared with using autologous hamstring tendon alone, it has better initial strength and joint stability, and is more conducive to early postoperative functional exercise and functional recovery of knee joint.
Objective To evaluate the surgical procedure of reinforced acetabular cage with caudal flange in reconstruction of pelvic defect after acetabular tumor resection. Methods Between June 2003 and December 2009, 25 patients with Harrington class III pelvic defect underwent reconstruction with a reinforced acetabular cage with caudal flange and total hip arthroplasty (THA). There were 13 males and 12 females with an average age of 51.2 years (range，13-73 years). The main cl inical manifestations included hip pain and buttock pain, with a median disease duration of 6 months (range, 1-96 months). Pathological findings showed 18 cases of metastasis, 3 cases of multiple myeloma, 1 case of non-Hodgkin’s lymphoma, 1 case of grade I chondrosarcoma, 1 case of giant cell tumor, and 1 case of chondroblastoma. For the patient with chondroblastoma, THA with LINK RIBBED system was used. An artificial total hip system made in China was used in 6 patients and LINK SP II system was used in the other 18 patients. Results No patients died perioperatively. Deep infection and hip dislocations occurred in 1 and 2 patients, respectively. At last follow-up, 8 of 18 patients with metastasis died of cancer and the average survival time was 11 months. The other 10 who were al ive were followed up 15 months on average. One patient with multiple myeloma died of pulmonary infection at 21 months after operation and the other 2 with multiple myeloma and 1 with lymphoma were al ive with an average follow-up of 17 months. The patient with grade I chondrosarcoma and patient with chondroblastoma were followed up 58 and 12 months, respectively, without recurrence. Recurrence occurred in the patient with giant cell tumor at 19 months afteroperation. Loosening of implant occurred in 3 patients because of local tumor recurrence. For the 23 patients at 6 months after operation, the mean Musculoskeletal Tumor Society (MSTS) 93 score was 81% (range, 57%-93%). Conclusion Reinforced acetabular cage with caudal flange could be used together with THA for reconstruction of Harrington class III pelvic defects after acetabular tumor resection, and low incidence of postoperative compl ication and good functional outcome could be expected.
Objective To investigate the value of bipolar coagulation forceps combined with meticulous capsular dissection technique in thyroidectomy. Methods Information of 203 patients with thyroid neoplasms who underwent thyroidectomy in Longyan First Hospital from January 2014 to July 2015, were collected retrospectively. Patients were divide into control group (98 patients who had received conventional thyroidectomy) and observation group (105 patients who had received bipolar coagulation forceps combined with meticulous capsular dissection technique in thyroidectomy) according to the surgery type. Then comparison of 2 groups in incidence of recurrent laryngeal nerve injury, temporary hypocalcemia, temporary or permanent hypoparathyroidism, serum parathyroid hormone (PTH) and serum calcium was performed. Results All the operation of 203 patients went smoothly, and no operative death happened. Operation time of control group and observation group showed no obvious difference〔(68.24±16.59) minvs. (64.78±14.20) min,P>0.05〕, but the intraoperative blood loss of control group was more than observation group〔(25.44±8.35) mLvs. (16.58±5.44) mL,P<0.05〕. There were 25 patients suffered from temporary hypocalcemia after operation, including 18 patients in control group and 7 patients in observation group. There were 38 patients suffered from temporary hypoparathyroidism after operation. including 24 patients in control group and 14 patients in observation group. The incidences of temporary hypocalcemia (χ2=6.426,P<0.05) and temporary hypoparathyroidism (χ2=4.147,P<0.05) were both lower in observation group than corresponding index of control group. But no one suffered from permanent hypoparathyroidism. There were 17 patients existent hoarseness in the control group and 14 patients in observation group, but no one had cough caused by superior laryngeal nerve injury of all the patients, and the incidence of hoarseness of 2 groups had no significant difference (χ2=0.637,P>0.05). Conclusions Bipolar coagulation forceps combined with meticulous capsular dissection technique in thyroidectomy could reduce the temporary hypocalcemia and temporary hypoparathyroidism, and provide the better protection to the blood supply of parathyroid. In addition, bipolar coagulation forceps could reduce thermal injury and heighten hemostasis. So, it is worthy to perform bipolar coagulation forceps combined with meticulous capsular dissection technique in thyroidectomy.
Objective To evaluate the effectiveness of acetabulum reinforcement ring (Cage) with allograft bone for reconstructing acetabular defects in hip revision. Methods Between February 2006 and August 2010, 14 patients (14 hips) with serious acetabular bone defects after total hip arthroplasty underwent acetabular reconstruction by using Cage with allograft bone. There were 6 males and 8 females with a mean age of 59.2 years (range, 45-76 years). The mean time between first replacement and revision was 7.2 years (range, 5-12 years). The revision causes included infection in 8 cases, osteolysis and aseptic loosening in 6 cases. The hip function Harris score was 37.7 ± 5.3. According to America Association of Orthopedic Surgeon (AAOS) standard, the acetabular defect was classified as type III in 8 cases and as type IV in 6 cases. Results All incisions healed by first intention, and no complication occurred. The patients were followed up 14-62 months (mean, 44 months). The pain was relieved or disappeared. At last follow-up, the Harris score was 89.7 ± 3.2, showing significant difference when compared with preoperative score (t= — 44.40, P=0.04). No loosening of the acetabular component or osteolysis was found in 14 hips. No absorption or collapse of the allograft was observed in all patients. Conclusion Cage with allograft bone is a useful method of reconstructing acetabular bone defects in hip revision. Further follow-up is needed to assess the long-term effectiveness.
ObjectiveTo compare the antireflux effects of lip reinforcement, His angle reconstruction with fundoplication, and mechanical anastomosis only in mechanical anastomosis for esophageal and cardiac carcinoma. MethodsOne hundred and seventysix patients with esophageal or cardiac carcinoma admitted to this hospital between March 2008 and October 2009 were included, which were divided into mechanical anastomosis group (n=42), His angle reconstruction group(n=56), and lip reinforcement group (n=78) according to the sequence of admission. Mechanical anastomosis only, mechanical anastomosis His angle reconstruction with fundoplication, and mechanical anastomosis liptype reinforcement were performed in the corresponding group, respectively. Endoscopy and biopsy were conducted to evaluate the antireflux effects on 3 months after operation. ResultsThere were no differences on the gender, age, tumor location, anastomosis site, and incision among three groups (Pgt;0.05). The reflux rates of the mechanical anastomosis group, His angle reconstruction group, and lip reinforcement group were 69.05%, 28.57%, and 14.10%, respectively. The reflux rates in the lip reinforcement group and His angle reconstruction group were significantly lower than those in the mechanical anastomosis group (χ2=37.088, P=0.000; χ2=15.833, P=0.000), moreover, the rate in the lip reinforcement group was significantly lower than that in the His angle reconstruction group (χ2=4.241, P=0.039). There was no anastomotic leakage in the lip reinforcement group and all patients safely discharged from hospital after surgery, only 2 patients had moderately anastomotic stenosis and both of them had good recovery with endoscopic dilatationl. The reflux after operation was independent of anastomosis sites (Pgt;0.05). ConclusionBoth liptype reinforcement and His angle reconstruction can improve the ability of antireflux, liptype reinforcement is better and simple to mainpulate.
This paper studies the active force characteristics of the neck muscles under the condition of rapid braking, which can provide theoretical support for reducing the neck injury of pilots when carrier-based aircraft blocks the landing. We carried out static loading and real vehicle braking experiments under rapid braking conditions, collected the active contraction force and electromyography (EMG) signals of neck muscles, and analyzed the response characteristics of neck muscle active force response. The results showed that the head and neck forward tilt time was delayed and the amplitude decreased during neck muscle pre-tightening. The duration of the neck in the extreme position decreased, and the recovery towards the seat direction was faster. The EMG signals of trapezius muscle was higher than sternocleidomastoid muscle. This suggests that pilots can reduce neck injury by pre-tightening the neck muscles during actual braking flight. In addition, we can consider the design of relevant fittings for pre-tightening the neck muscles.
Synchronization analysis of electroencephalogram (EEG) and electromyogram (EMG) could reveal the functional corticomuscular coupling (FCMC) during the motor task in human. A novel method combining Gabor wavelet and transfer entropy (Gabor-TE) is proposed to quantitatively analyze the nonlinearly synchronous corticomuscular function coupling and direction characteristics under different steady-state force. Firstly, the Gabor wavelet transform method was used to acquire the local frequency-band signals of the EEG and EMG signals recorded from nine healthy controls simultaneously during performing grip task with four different steady-state forces. Secondly, the TE of local frequency-band was calculated and the unit area index of the transfer (ATE) was defined to quantitatively analyze the synchronous corticomuscular function coupling and direction characteristics under steady-state force. Lastly, the effect of EEG and EMG signal power spectrum on Gabor-TE analysis was explored. The results showed that the coupling strength in the beta band was stronger in EEG→EMG direction than in EMG→EEG direction, and the ATE values in the beta band in EEG→EMG direction decreased with the force increasing. It is also shown that the difference in TE values of gamma band present a varying regularity as the increase of force in both directions. In addition, EMG power spectrum was significantly correlated with the result of Gabor-TE inspecific frequency band. The results of our study confirmed that Gabor-TE can quantitatively describe the nonlinearly synchronous corticomuscular function coupling in both local frequency band and information transmission. The analysis of FCMC provides basic information for exploring the motor control and the evaluation of clinical rehabilitation.
Based on force sensing resistor(FSR) sensor, we designed insoles for pressure measurement, which were stable and reliable with a simple structure, and easy to wear and to do outdoor experiments with. So the insoles could be used for gait detection system. The hardware includes plantar pressure sensor array, signal conditioning unit and main circuit unit. The software has the function of data acquisition, signal processing, feature extraction and classification function. We collected 27 groups of gait data of a healthy person based on this system to analyze the data and study pressure distribution under various gait features, i.e. walking on the flat ground, uphill, downhill, up the stairs, and down the stairs. These five gait patterns for pattern recognition and classification by K-nearest neighbors (KNN) recognition algorithm reached up to 90% accuracy. This preliminarily verified the usefulness of the system.