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Functional assessment and influencing factors after staged functional training in patients with ankle fractures

World Journal of Clinical Cases 2024年第21期12卷 4499-4507页

作者： Min-Qiong Fang department of Foot and Ankle surgery The Fourth Hospitai of WuhanWuhan 430000Hubei ProvinceChina

BACKGROUND The recovery of limb function after ankle fracture surgery is a gradual *** main purpose of implementing early functional exercise,joint mobility,muscle contraction function,passive ankle flexion and extension exercises,or physical factor therapy techniques is to achieve the rapid recovery of normal physiological limb ***,currently the most effective rehabilitation training method is staged limb functional exercise,which promotes rapid recovery of limb function while preventing adverse consequences caused by overwork or insufficient *** limb functional exercise divides the rehabilitation process into multiple stages,each of which has specific training objectives and *** method helps patients gradually restore limb ***,some patients still exhibit poor limb function after standardized ***,a functional evaluation should be performed to analyze the impact of staged functional training after ankle fracture *** To perform a functional evaluation and determine the influencing factors of staged functional training in patients with ankle *** A retrospective study enrolled 150 patients who underwent surgical treatment for ankle fracture from May 2020 to May 2022 at our *** and multivariate linear regression analyses were performed on general data,functional exercise compliance scale for orthopedic patients,Social Support Rating Scale(SSRS),American Orthopedic Foot and Ankle Score(AOFAS)Ankle-Hindfoot Score,and pain factors[serum bradykinin(BK),prostaglandin E2(PGE2),5-hydroxytryptamine(5-HT)].RESULTS Based on the AOFAS Ankle-Hindfoot Scale,the cases were divided into the excellent function(n=111)and ordinary function(n=39)*** analysis revealed that monthly family income,education level,diabetes mellitus,functional exercise compliance scale of orthopedic patients score,SSRS,BK,PGE2,and 5-HT significantly influenced limb function after ankle

关键词： Ankle fracture Staged functional training Ankle function Serum pain factor

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The Management of Neonatal Peritonitis in the Paediatric surgery department of the Donka National Hospital

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Open Journal of Pediatrics 2024年第5期14卷 823-833页

作者： Mohamed Lamine Sadou Sacko Thierno Saidou Barry Balla Keita Mory Sangare Jacques Faya Millimono Moussa Conde Seydou Keita Daniel Agbo-Panzo Pediatric surgery department at Conakry University Hospital Conakry Guinea Universit Gamal Abdel Nasser de Conakry Conakry Guinea General surgery department Ignace Deen University Hospital Conakry Guinea

Introduction: Neonatal peritonitis is a rare but serious condition requiring early diagnosis and management. The lack of antenatal diagnosis, the precariousness of neonatal intensive care, and the delay in diagnosis and treatment are the factors of poor prognosis. The objective of this study was to study the epidemiological, diagnostic and therapeutic aspects of neonatal peritonitis in order to improve its management in the pediatric surgery department of the CHU-Donka. Materials and Methods: This is a retrospective descriptive study of the records of patients treated for neonatal peritonitis from January 1, 2017 to December 31, 2022. Results: Results: We compiled 17 records of patients operated on for neonatal peritonitis, representing a frequency of 3.85% and an incidence of 2.83 cases/year. The mean age of our patients was 8.29 days, with extremes of D0 and D25. Males were more dominant, with a frequency of 71% and a sex ratio of 2.4. The average consultation time was 72 h, with extremes of 12 h and 144 h. Abdominal bloating was the main reason for consultation (100%). Fever and vomiting were frequent, at 70.59% and 82.35% respectively. PSA revealed pneumoperitoneum in 12 patients (70.59%). The colon was the most frequent site of perforation at 29.41%. ECUN was the main etiology with 35.29%. Ostomy was the main surgical procedure in 58.82% of cases, followed by suture excision in 29.41%. Postoperative follow-up was simple in 3 patients (17.65%) and complicated in 14 (82.35%). Sepsis was the main cause of death (47.59%). The mortality rate was 76.47%. Conclusion: Mortality from neonatal peritonitis remains high in developing countries. Early diagnosis, early surgical management, and the presence of well-equipped neonatal intensive care units with qualified staff are essential for an improvement in the prognosis of neonatal peritonitis.

关键词： Etiology Newborns Gastrointestinal Perforation

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Postoperative Complications in the General surgery department of the Cs Ref of Commune I of the District of Bamako Mali

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Surgical Science 2024年第6期15卷 409-419页

作者： Tounkara Cheickna Samake Hamidou Dembele Lamine Diarra Issaka Togola Modibo Sanogo Modibo Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana department of General surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of Social and Health Services of the Armies Bamako Mali department of General surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were

关键词： Complications Post Opératoires Chirurgie Cs Ref CI Bamako Mali

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Endocrine therapy of short duration prevents local and contralateral recurrence of ductal carcinoma in situ of the breast: A multicenter retrospective cohort study in China

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中华医学杂志(英文版) 2024年第14期137卷 1756-1758页

作者： Wang Zhen Jin Zining Zhang Huanrui Xu Guiying Zhang Dianlong Fang Fengqi Xing Hua Wang Jia Guo Baoliang Zhu Guolian Liu Yongzhi Li Jieqing Cai Zhengang Sun Liang Zhang Yuting Zhou Tianyang Liu Chang Zhou Baosen Jin Feng Zhang Yan Song Dong Chen Bo department of Breast surgery The First Hospital of China Medical University Shenyang Liaoning China department of Breast and Thyroid surgery Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan Shandong China department of Geriatric Medicine The First Hospital of China Medical University Shenyang Liaoning China department of Breast surgery Jilin Cancer Hospital Changchun Jilin China department of Breast and Thyroid surgery Affiliated Zhongshan Hospital of Dalian University Dalian Liaoning China department of Oncology The First Affiliated Hospital of Dalian Medical University Dalian Liaoning China department of Breast surgery China-Japan Union Hospital Affiliated to Jilin University Changchun Jilin China department of Breast surgery The Second Hospital of Dalian Medical University Dalian Liaoning China department of Breast surgery The Second Affiliated Hospital of Harbin Medical University Harbin Heilongjiang China department of Breast surgery The Fifth People’s Hospital of Shenyang Shenyang Liaoning China department of Breast surgery General Hospital of Benxi Iron &amp Steel Industry Group of Liaoning Health Industry Group Benxi Liaoning China department of Breast surgery The Fourth People’s Hospital of Shenyang Shenyang Liaoning China department of Breast surgery The First Affiliated Hospital of Dalian Medical University Dalian Liaoning China department of Clinical Epidemiology and Center of Evidence Based Medicine The First Hospital of China Medical University Shenyang Liaoning China department of Breast surgery The Second Hospital of Jilin University Changchun Jilin China department of Breast surgery General Surgery Center The First Hospital of Jilin University Changchun Jilin China

To the Editor: De-escalating the treatment of ductal carcinoma in situ (DCIS) of the breast has been investigated in recent years. A 5-year adjuvant endocrine therapy (AET) regimen is the recommended treatment for hormone receptor-positive DCIS. Selective estrogen receptor modulators (such as the commonly used tamoxifen and toremifene) and aromatase inhibitors (AIs) are the currently used AET drugs. However, long-term AET is accompanied by severe side effects such as menopausal symptoms, endometrial carcinoma, cardiovascular events, venous thromboembolic events, osteoporosis, and joint pain that can significantly reduce patients’ quality of life. It was reported that only 50% of the patients completed the recommended 5-year AET mainly because of side effects, while higher adherence rates were observed with shorter-duration regimens. Therefore, de-escalation of AET should be considered to reduce the side effects of AET and improve adherence.

关键词： ADHERENCE

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Feeding the vasculature with cruciferous vegetables:a secret for organ protection

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Signal Transduction and Targeted Therapy 2024年第3期9卷 828-830页

作者： Priya Veluswamy Jens Wippermann Max Wacker Heart surgery Research Department of Cardiothoracic SurgeryOtto-von-Guericke University HospitalMagdeburgGermany

Two very recent back-to-back papers published in Nature1,2 decipher the holistic role of the aryl hydrocarbon receptor(AHR)/dietary-ligand axis,in enteric and pulmonary vasculature to emphasize tolerance induction and vessel integrity during homeostasis,sterile inflammation and *** studies spectacularly highlight the significance of endothelium in orchestrating tissue tolerance by demonstrating the multifaceted activities of endothelial-expressed AHR that protects the vasculature to maintain organ homeostasis.

关键词： maintain sterile homeostasis

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Review of Two Years of Surgical Activities of the General surgery department of the Reference Health Center of Commune I of Bamako Mali

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Surgical Science 2024年第4期15卷 195-206页

作者： Tounkara Cheickna Cisse Amadou Beydi Samake Hamidou Diarra Issaka Sanogo Modibo Diarra Bogoba Doumbia Seydou Yena Sadio department of General surgery of the Reference Health Center of Commune I Bamako Mali Directorate of Social and Health Services of the Armed Forces of Mali department of Public Health of the Faculty of Medicine and Odontology-Stomatology Bamako Mali department of surgery Mali Hospital Bamako Mali

The objectives of this work were to evaluate the surgical activities carried out in the general surgery department of the Reference Health Center of Commune I of Bamako, to describe the sociodemographic characteristics of the operated patients, to determine the main pathologies encountered and to evaluate qualitatively the result of the treatment. In order to improve performance, and the quality of care, and to identify common pathologies in the surgical department, we undertook a retrospective study on surgical activities from January 2009 to December 2010. At the end of this study, out of 474 men and 187 women (equal sex ratio 2.53);we were able to determine the frequency of surgical pathologies. Farmers, housewives and pupils/students were the most represented with 25.9% respectively;20% and 13.3%. The most frequently observed pathologies were wall hernia (44.8%), prostate adenoma (12%) and acute appendicitis (10.5%). The average length of hospitalization was 3.43 days. Infectious complications affected 25 patients (3.8% of cases) and a death rate of 0.45% (i.e. 3 patients). The average cost of care was 53,500 FCFA. Indeed, the reality of surgical practice in health centers was not the same because of the level of skills of practicing surgeons.

关键词： Assessment Surgical Activities 2 Years Reference Health Center of Commune I Bamako

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Near-infrared cholangiography with intragallbladder indocyanine green injection in minimally invasive cholecystectomy

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World Journal of Gastrointestinal surgery 2024年第4期16卷 1017-1029页

作者： Savvas Symeonidis Ioannis Mantzoros Elissavet Anestiadou Orestis Ioannidis Panagiotis Christidis Stefanos Bitsianis Vasiliki Bisbinas Konstantinos Zapsalis Trigona Karastergiou Dimitra Athanasiou Stylianos Apostolidis Stamatios Angelopoulos fourth department of surgery Medical SchoolAristotle University of ThessalonikiThessaloniki 57010Greece ENT department Royal Cornwall Hospitals NHS TrustCornwall TR13LJUnited Kingdom 1^(st)Propedeutic Surgical department University Hospital of ThessalonikiAristotle University of ThessalonikiThessaloniki 54636Greece

Laparoscopic cholecystectomy(LC)remains one of the most commonly performed procedures in adult and paediatric *** the advances made in intraoperative biliary anatomy recognition,iatrogenic bile duct injuries during LC represent a fatal complication and consist an economic burden for healthcare systems.A series of methods have been proposed to prevent bile duct injury,among them the use of indocyanine green(ICG)*** most commonly reported method of ICG injection is the intravenous administration,while literature is lacking studies investigating the direct intragallbladder ICG *** narrative mini-review aims to assess the potential applications,usefulness,and limitations of intragallbladder ICG fluorescence in *** screened the available international literature to identify the reports of intragallbladder ICG fluorescence imaging in minimally invasive cholecystectomy,as well as special issues regarding its *** search retrieved four prospective cohort studies,three case-control studies,and one case *** the three case-control studies selected,intragallbladder near-infrared cholangiography(NIRC)was compared with standard LC under white light,with intravenous administration of ICG for NIRC and with standard intraoperative cholangiography(IOC).In total,133 patients reported in the literature have been administered intragallbladder ICG administration for biliary mapping during *** includes several reports of intragallbladder ICG administration,but a standardized technique has not been established *** data suggest that NIRC with intragallbladder ICG injection is a promising method to achieve biliary mapping,overwhelming limitations of IOC including intervention and radiation exposure,as well as the high hepatic parenchyma signal and time interval needed in intravenous ICG ***-based guidelines on the role of intragallbladder ICG fluorescence in LC require the assessment of furth

关键词： Minimally invasive cholecystectomy Laparoscopic cholecystectomy Biliary tract mapping Indocyanine green Near-infrared fluorescent cholangiography Intracystic indocyanine green Intragallbladder indocyanine green Bile duct injury

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Efficacy and safety of clarithromycin for patients with sepsis or septic shock:a systematic review and meta-analysis

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Emergency and Critical Care Medicine 2024年第2期4卷 90-96页

作者： Pengyue Zhao Renqi Yao Jiaqi Yang Wei Wen Yongming Yao Xiaohui Du department of General surgery First Medical Center of the Chinese PLA General HospitalBeijingChina Translational Medicine Research Center Medical Innovation Research Division and Fourth Medical Center of the Chinese PLA General HospitalBeijingChina department of Burn surgery the First Affiliated Hospital of Naval Medical UniversityShanghaiChina department of General surgery Hainan Hospital of Chinese PLA General HospitalSanyaHainanChina

Background:Clarithromycin exerts an immunomodulatory role in several human ***,whether this effect improves the prognosis in patients with sepsis remains controversial,and higher levels of clinical evidence are urgently *** the best of our knowledge,no meta-analysis to date has reported the clinical efficacy and safety of clarithromycin in ***:A comprehensive literature search of PubMed,EMBASE,and the Cochrane Library was conducted up to December 31,*** randomized controlled trials comparing the clinical efficacy and safety of clarithromycin with controls among patients with sepsis or septic shock were *** were pooled by applying a fixed-effects model and a relative risk(RR)estimate with 95%confidence intervals(CIs)using Review Manager(version 5.3;Cochrane Collaboration,Copenhagen,Denmark).Results:Three randomized controlled trials involving a total of 910 patients were *** pooled results confirmed that clarithromycin had no beneficial effect on progression to multiple organ dysfunction syndrome(RR:1.51;95%CI:1.02-2.25;P=0.04;I^(2)=0%),28-day mortality(RR:1.09;95%CI:0.87-1.36;P=0.46;I^(2)=0%),and 90-day mortality(RR:0.86;95%CI:0.71-1.03;P=0.10;I^(2)=81%)in patients with sepsis or septic ***,there was no difference in other serious adverse events between patients who received clarithromycin and those in the control group(RR:1.02;95%CI:0.87-1.19;P=0.83;I^(2)=18%).Conclusion:Our meta-analysis did not reveal an improvement to short-term outcomes in patients with sepsis treated with ***,administration of clarithromycin did not increase the risk of adverse events.

关键词： Clarithromycin Meta-analysis Outcomes Sepsis Septic shock

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Paeoniflorin,the Main Monomer Component of Paeonia lactiflora,Exhibits Anti-inflammatory Properties in Osteoarthritis Synovial Inflammation

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Chinese Journal of Integrative Medicine 2024年第5期30卷 433-442页

作者： CHEN Pu ZHOU Jun RUAN An-min MA Yu-feng WANG Qing-fu department of Orthopaedic surgery Beijing University of Chinese Medicine Third Affiliated HospitalBeijing 100029China department of Orthopaedic surgery Guangdong Provincial Hospital of Chinese MedicineGuangzhou 510120China department of Orthopaedic surgery Beijing Longfu HospitalBeijing 100010China

Objective:To explore the mechanism of paeoniflorin(PF)on osteoarthritis(OA)synovial inflammation from network pharmacology to experimental ***:Targets of OA were constructed by detecting the database of network database platforms(Therapeutic Target database,Drug Bank and Gene Cards),and the targets of PF were constructed by Pub Chem and Herbal Ingredients'Targets *** Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis of these co-targeted genes were conducted via Database for Annotation,Visualization,and Integrated Discovery(DAVID)database,and protein-protein interaction(PPI)networks were conducted via the search tool for the retrieval of interacting genes(STRING)*** counting kit-8(CCK-8)assay was performed to assess the potential toxicity of PF on human OA fibroblast-like synoviocytes(FLS),quantitative real-time polymerase chain reaction(q PCR),enzyme-linked immunosorbent assay(ELISA)and Western blot were used to verify the potential mechanism of PF in synovial ***:Twenty-six co-targeted genes were *** enrichment results showed that these co-targeted genes were most likely localized in the cytoplasm,and the biological processes mainly involved'cellular response to hypoxia''lipopolysaccharide(LPS)-mediated signaling pathway'and'positive regulation of gene expression'.KEGG pathway analysis indicated that these co-targeted genes may function through pathways associated with'hypoxia-inducible factor-1(HIF-1)signaling pathway'and'tumornecrosis factor(TNF)signaling pathway'.The PPI network showed that the top 3 hub genes were TP53,TNF,and *** docking results showed that PF was well docking with ***-8 showed no potential toxicity of 10,20 and 50μmol/L PF on human OA *** PF significantly decreased the expression levels of interleukin-1β,interleukin-6,TNF-αmatrix metalloproteinase 13(MMP13),and a disintegrin and metalloproteinase with thrombospondin motifs 5(ADAMTS5)and TNF

关键词： paeoniflorin osteoarthritis synovial inflammation tumor necrosis factor-α network pharmacology Paeonia lactiflora

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Artificial intelligence-assisted repair of peripheral nerve injury: a new research hotspot and associated challenges

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Neural Regeneration Research 2024年第3期19卷 663-670页

作者： Yang Guo Liying Sun Wenyao Zhong Nan Zhang Zongxuan Zhao Wen Tian department of Hand surgery Beijing Jishuitan HospitalBeijingChina

Artificial intelligence can be indirectly applied to the repair of peripheral nerve ***,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on peripheral nerve injury and repair can provide valuable data to enrich artificial intelligence *** investigate advances in the use of artificial intelligence in the diagnosis,rehabilitation,and scientific examination of peripheral nerve injury,we used CiteSpace and VOSviewer software to analyze the relevant literature included in the Web of Science from 1994–*** identified the following research hotspots in peripheral nerve injury and repair:(1)diagnosis,classification,and prognostic assessment of peripheral nerve injury using neuroimaging and artificial intelligence techniques,such as corneal confocal microscopy and coherent anti-Stokes Raman spectroscopy;(2)motion control and rehabilitation following peripheral nerve injury using artificial neural networks and machine learning algorithms,such as wearable devices and assisted wheelchair systems;(3)improving the accuracy and effectiveness of peripheral nerve electrical stimulation therapy using artificial intelligence techniques combined with deep learning,such as implantable peripheral nerve interfaces;(4)the application of artificial intelligence technology to brain-machine interfaces for disabled patients and those with reduced mobility,enabling them to control devices such as networked hand prostheses;(5)artificial intelligence robots that can replace doctors in certain procedures during surgery or rehabilitation,thereby reducing surgical risk and complications,and facilitating postoperative *** artificial intelligence has shown many benefits and potential applications in peripheral nerve injury and repair,there are some limitations to this technology,such as the consequences of missing or imbalanced data,low data accuracy and reproducibility,and ethical issues(e.g.,privac

关键词： artificial intelligence artificial prosthesis medical-industrial integration brain-machine interface deep learning machine learning networked hand prosthesis neural interface neural network neural regeneration peripheral nerve

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