Objective To investigate the effectiveness of double-needle suture for mixed meniscus tear repair under arthroscope. Methods Between April 2006 and January 2011, 22 patients with mixed meniscus tear were treated with double-needle suture under arthroscope. There were 14 males and 8 females, aged 18-41 years (mean, 31.3 years). All injuries were caused by sports. The time between injury and admission ranged from 2 days to 4 years (median, 11 months). International Knee Documentation Committee (IKDC) score was 42.5 ± 15.2, Lysholm score was 45.5 ± 13.5, and Tegner score was 2.9 ± 1.6. Seventeen cases complicated with anterior cruciate ligament injury. Results Healing of incision by first intention was achieved in all patients. No injury of nerve and blood occurred. The patients were followed up 12-48 months with an average of 27.6 months. According to Barrett et al. standard, 19 cases (86%) got clinical healing. The IKDC, Lysholm, and Tegner scores were improved to 77.1 ± 8.9, 79.8 ± 9.9, and 6.8 ± 1.6 respectively at last follow-up, showing significant differences when compared with preoperative scores (P lt; 0.05). Conclusion Arthroscopic meniscus repair using double-needle suture can provide good effectiveness because it has high firmness.
OBJECTIVE To investigate the mechanism of electrothrombosis by copper needle, in order to supply the referential data for clinical treatment of vessel deformity. METHODS The mechanism and condition of thrombus formation by copper needle were studied in vivo and in vitro using electrophysics, atom absorption spectrophtometry, histological, and histochemical methods. RESULTS Great deal of copper ion was dissociated, and agglutination of red blood cells(RBC) in blood could be observed in vitro after the current applied by copper needles. Formation of stable thrombus was related to voltage and time of application of electric current. CONCLUSION Dissociation of copper ion and agglutination of RBC are the basic principle of electrothrombosis with copper needle. A 4V direct current and 17.5 minutes are the safe and effective conditions for thrombus formation in the blood vessels.
Objective To find a simple, practical and cheap way in suturation to prevent incision complications after celoscope surgery. Methods Using the elastic snell needle to stitch small incision under laparoscopy. Chosed 3 120 cases using the elastic snell needle to stitch stratified suturation as research group, and 3 120 cases by using trditional arc shaped needle in celoscope surgery as control group. The incident rate of incisional hernia and incision bleeding among groups were compared. Results In research group, the incident rate of incision bleeding was 0.16%, among which was 0.15% in epigastrium group, 0.18% in hypogastrium group, while in control group, the incident rate of incision bleeding was 0.68%, among which was 0.64% in epigastrium group, 0.70% in hypogastrium group. The incident rate of incision bleeding was obviously decreased (P＜0.05), and the incident rate of incision bleeding in hypogastrium group was obviously decreased as well (P＜0.05), compared research group and control group. In research group, the incident rate of incisional hernia was 0.07%, among which was 0 in epigastrium group, 0.12% in hypogastrium group, 0.15% in gerontism group, while in control group, the incident rate of incisional hernia was 0.44%, among which was 0.24% in epigastrium group, 0.59% in hypogastrium group, 0.99% in gerontism group, and the incident rate of incisional hernia after surgery was obviously decreased (P＜0.05), the incident rate of incisional hernia after surgery in hypogastrium group was obviously decreased as well (P＜0.05), comparing research group and control group. Conclusions Using the elastic snell needle to stitch small incision under laparoscopy, the peritoneal layer and muscular layer can be apposition sutured in the case without prolonging incision and costing more, hidden hernia and abdominal wall defects located at the incision can be found, ligation and stitched, thereby the incident rate of incisional hernia and incisional bleeding after celoscope surgery are significantly reduced.
According to the working principle of vertical ultrasonic vial washing machine, receiving respective force of small water droplets on the inside wall of vials and the minimum air velocity of blowing off water droplets can be obtained based on the analysis of water-droplet-related parameters. The inside wall model of 7 mL vial created by GAMBIT was divided into fine grids. Then the Realizable k-epsilon Two Equation Turbulence Model was adopted and the flow field of vial by FLUENT software was simulated when air was flushing inside the wall. In that case, the optimal position, inner diameter and the corresponding minimum air velocity of needle can be acquired to meet the needs of vial washing machine applied to 7 mL vial.
ObjectiveTo investigate the application value of the intravenous indwelling needle in radionuclide imaging examination. MethodsA total of 120 patients underwent single photon emission computed tomography for bone and kidney dynamic imaging between October 2012 and April 2013 were randomly divided into group injected by venous indwelling needle (observagtion group) and group injected by traditional steel needle (control group), with 60 cases in each. We calculated the one-time success rate of venipuncture, the leakage rate of intravenous injection, residual radioactive dosage within the syringe and average exposure time of medical staff to radionuclide in the two groups of patients. ResultsThe one-time success rate of venipuncture in observation group was similar to that in the control group (P > 0.05). During the injection, no leakage was found in observation group, while 4 leakage in 37 patients underwent bone imaging and 3 leakage in 23 patients underwent kidney dynamic imaging in the control group were found; there was no significant difference between the two groups (P > 0.05). The residual radioactive dosage within the syringe in observation group was lower than that in the control group, and the exposure time of medical staff to radionuclide in observation group was also lower than that in the control group (P < 0.01). ConclusionsIntravenous indwelling needle for venous puncture can avoid leakage of radioactive imaging agent, reduce the residual radiological dosage within the syrings, increase the one-time puncture success rate and imaging resolution of dynamic scan, and improve the diagnostic accuracy and work efficiency effectively. Besides, the intravenous indwelling needle technique can reduce average exposure time of medical staff to radionuclide, acheaving the goal of optimized protection.
To analyze the cl inical effect of retained copper needles well as neoplasm l igation, retained copper needles associated with Pingyangmycin injection and inserted copper needles followed by DC in treating hemangiomaso as to treat hemangioma with copper needles. Methods From January 1999 to January 2006, 55 cases of hemangioma in superficial body were treated with copper needles, including 28 males and 27 females and aging 3-50 years(median 19 years). There were 42 cases of cavernous hemangiomas, 4 cases of racemose hemangiomas and 9 cases of multipl icate hemangiomas. The size ranged from 6 cm × 4 cm to 40 cm × 25 cm. Retaining copper needles were used in 29 cases, retaining copper needles with l igating neoplasm in 21 cases, retaining copper needles associated with Pingyangmycin injection in 3 cases and inserting copper needles followed by DC in 2 cases. Results Fifty cases were treated with copper needles only once and 5 cases twice. All cases were followed up for three to eighteen months. According to Wang Yongjie’s criterion, 15 (27.3%) cases were cured, 38 (69.1%) improved, and 2（3.6%）failed to respond; the response rate was 96.4% (53). Conclusion Copper needle is efffective for treating hemangioma in superficial body. Retaining copper needles with l igation neoplasm or with Pingyangmycin injection can achieve better effect.
To search for the relationship between immune state and tumor metastases, CD3,CD4,CD8 and CD44 contents in 13 speciments of fine needle aspiration (FNA) from thyroid cancer patients were detected by the flowcytometry (FCM) and comparison between thyroid cancer and benign tumor was made. The result showed :in thyroid cancer group, CD＋3，CD＋4 cells and the ratio of CD＋4/CD＋8 reduced significantly (Ｐ＜0.01),and CD＋8 cell increased significantly (Ｐ＜0.01), in metastases group,this change was much significantly. CD44 expressed significantly higher in cancer group than that of the benign thyroid neoplasms, and the change was related to the tumor metastases. The results indicate that CD44 can be as a marker of tumor and indicator of metastases. The disturbance of immune system results in active expression of CD44 by tumor cells, so, lead to metastases. It is helpful to the diagnosis of thyroid cancer, assessment of metastases and management in surgery.
ObjectiveTo analyse epidermal growth factor receptor (EGFR) gene mutations in pathologically confirmed lung adenocarcinoma (LAC) samples obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). MethodsClinical data of 964 consecutive patients who underwent EBUS-TBNA in Department of Thoracic Surgery, Fudan University Shanghai Cancer Center from April 2009 to September 2013 were retrospectively reviewed. EGFR gene mutations in 77 LAC patients who were comfirmed by cell morphology and immunohistochemistry were analyzed. There were 48 males and 29 females with their median age of 61 (range 33-78) years, and 43 patients were smokers. ResultsAll the 77 LAC patients were confirmed by immunohistochemistry. Among them, 31 patients (40.26%) were found to have EGFR gene mutations. There was no statistical difference in EGFR gene mutations between male and female patients (P=0.088). Mutation rate of EGFR genes of non-smokers was significantly higher than that of smokers (P=0.032). ConclusionSamples obtained by EBUS-TBNA can be used for EGFR gene mutations analysis. The mutation rate of EGFR genes of non-smokers is higher than that of smokers.
ObjectiveTo investigate the clinical value of veress needle with thread for laparoscopic high ligation of hernia sac in children. MethodsThe clinical data of 56 cases of pediatric inguinal hernia using laparoscopic high ligation of hernia sac with veress needle from May 2013 to May 2014 were analyzed retrospectively. ResultsAll patients were successfully carried out operation by laparoscopic high ligation of hernia sac.Forty-one cases underwent unilateral surgery, and operative time was 6-18 min (mean 9.6 min); 15 cases underwent bilateral surgery, and operative time was 10-32 min (mean 14.3 min).Nine cases of contralateral recessive hernia were found and ligated during operation.There was no complications, such as scrotal edema, scrotal gas or incision infection after operation, and all patients were discharged in l-2 days after operation.No recurrence or testicular dysplasia was found during 3 to 15 months (mean 10.8 months) follow-up. ConclusionsThere are many advantages in laparoscopic high ligation of hernia sac with veress needle, such as less damage, hidden incision, faster recovery, shorter hospital stay, simple operation, and better efficacy.We can find contralateral recessive hernia during operation and avoid second surgery with high clinical value, therefore it is worthy of clinical application.
ObjectiveTo observe the effectiveness and safety of pars plana vitrectomy (PPV) combined with inner limiting membrane (ILM) removal and 41G microneedle subretinal injection of balanced salt solution (BSS) in the treatment of refractory macular hole. MethodsA prospective clinical study. From January to June 2023, 20 cases (20 eyes) of refractory macular hole patients diagnosed through examination at The Affiliated Eye Hospital of Nanchang University were included in the study. The basal diameter of the affected eye's basal diameter (BD) was ＞1 000 μm. Macular hole index (MHI) was ＜0.5. The affected eye received treatment with 23G PPV combined with ILM removal and 41G microneedle subretinal injection of BSS. Best corrected visual acuity (BCVA), microperimetry, and optical coherence tomography angiography (OCTA) were performed before and 1, 2, 3, and 6 months after surgery for the affected eye. BCVA examination was performed using standard logarithmic visual acuity chart, and convert it to logarithmic minimum resolution angle (logMAR) visual acuity for statistical purposes. MP-3 microperimetry was used for micro view examination, record the mean sensitivity (MS) of the retinal within a 12° range of the fovea. OCTA was used to measure the area of the avascular zone of the macula (FAZ), perimeter of the FAZ (PERIM), retinal vascular length density (VLD), and vascular perfusion density (VPD). The changes in BCVA, MS, FAZ area, PERIM, VLD, VPD before and after surgery were compared and analyzed. After the same time, the closure of macular hole and the occurrence of complications after surgery were observed. Single factor analysis of variance was used to compare the observation indicators at different times before and after surgery. The correlation between various observation indicators and preoperative minimum diameter (MD), BD, and hiatus height at 6 months after surgery were analyzed using Pearson correlation analysis. ResultsAmong the 20 cases with 20 eyes, there were 2 males with 2 eyes and 18 females with 18 eyes. Age was (61.45±8.56) years old. The logMAR BCVA, MS, FAZ area, PERIM, VLD, and VPD of the affected eye were 1.46±0.21, (16.20±5.81) dB、(0.40±0.17) mm2, (2.89±0.99) mm, (6.23±3.59) mm−1, (0.17±0.10)%, respectively. Six months after surgery, out of 20 eyes, macular hole closure and incomplete closure were 18 (90.0%, 18 /20) and 2 (10.0%, 2 /20) eyes, respectively. The logMAR BCVA, MS, FAZ area, PERIM, VLD, and VPD were 0.80±0.20, (22.20±4.60) dB, (0.18±0.10) mm2, (1.83±0.80) mm, (9.54±2.88) mm−1, (0.31±0.14)%. Compared with before surgery, the differences were statistically significant (P＜0.05). The correlation analysis results showed a positive correlation (P＜0.05) between preoperative BD and postoperative 6-month PERIM and VPD. There was a negative correlation between preoperative MD and postoperative VLD at 6 months (P＜0.05). There was a negative correlation between preoperative MHI and logMAR BCVA and VPD at 6 months after surgery (P＜0.05). No complications such as elevated or decreased intraocular pressure, damage to retinal pigment epithelium, retinal hemorrhage, endophthalmitis, or retinal detachment occurred after surgery in all affected eyes. ConclusionMinimally invasive PPV combined with ILM removal and 41G microneedle subretinal injection of BSS can effectively improve the closure rate of refractory macular hole patients in the short term, improve vision, and have good safety.