Minimally invasive thalamic hematoma drainage can improve the six-month outcome of thalamic hemorrhage

为了探索 thalamic 出血的 6 月的临床的结果的预言者，并且如果最低限度地侵略的 thalamic hematoma 排水(THD ) 能与自发的 thalamic 改进它 54 个病人的 prognosis.MethodsA 总数，评估，出血回顾地被评估。包括人口分布，击风险因素， neuroimaging 变量，承认上的格拉斯哥昏迷分数(GCS ) ，外科的策略，和结果，临床的数据是镇定的。临床的结果用修改 Rankin 规模被估计，六 ? 在发作以后的月。 Univariate 分析和 multivariate 逻辑回归分析被执行决定差的 outcome.ResultsConservative 治疗的预言者为五个病人(9.3%)被执行，为 20 个病人(37.0%)的外部室的排水( EVD )，为四个病人(7.4%)的 THD ，并且 EVD 为 25 个病人(46.3%)与 THD 结合了。在在发作以后的六个月， 21 (38.9%) 病人们完成了有利结果，当(61.1%) 33 有差的结果时。在 univariate 分析，差的 6 月的结果的预言者是承认上的更低的 GCS (P = 0.001 ) ，更大的 hematoma 体积(P < 0.001 ) ，中线移动(P = 0.035 ) ，急性脑水肿(P = 0.039 ) ，并且没有 THD (P = 0.037 ) 。差的结果的独立预言者，根据 multivariate 逻辑回归分析，不是 volume.ConclusionsMinimally 侵略的 THD，在一些天以内移开大多数 hematoma，改进了的 THD 和更大的 hematoma thalamic 的 6 月的结果出血。因此， THD 能广泛地被使用与 thalamic 出血对待病人。

Nickel release rate of 18KW gold alloy for ornaments

Nickel is widely used as a bleaching element in white gold alloys, but it is a potential allergen. In this paper, a popular 18 KW gold alloy, often called ＂safe nickel,＂ was chosen as the experimental material; its nickel release rates under six different processing conditions were evaluated according to the EN1811 standard. The results reveal that both the surface processing method and heat treatment technology significantly affect the nickel release rate. A coarse surface releases more nickel ions than a smooth surface. The sample normalized at 700 ~C in the single region has a lower nickel release rate than the one treated at 550 ~C in the two-phase phase region, while high temperature normalizing at 800 ~C will accelerate it. All the measured nickel release rates of the experimental material under various processing conditions exceed the permitted threshold value in the Nickel Directive, which indicates that there exists the potential risk of nickel- induced allergy when it is used to make jewelries, espe- cially for piercing types.

Predictors of difficult endoscopic resection of submucosal tumors originating from the muscularis propria layer at the esophagogastric junction

BACKGROUND Endoscopic resection approaches,including endoscopic submucosal dissection(ESD),submucosal tunneling endoscopic resection(STER)and endoscopic fullthickness resection(EFTR),have been widely used for the treatment of submucosal tumors(SMTs)located in the upper gastrointestinal tract.However,compared to SMTs located in the esophagus or stomach,endoscopic resection of SMTs from the esophagogastric junction(EGJ)is much more difficult because of the sharp angle and narrow lumen of the EGJ.SMTs originating from the muscularis propria(MP)in the EGJ,especially those that grow extraluminally and adhere closely to the serosa,make endoscopic resection even more difficult.AIM To investigate the predictors of difficult endoscopic resection for SMTs from the MP layer at the EGJ.METHODS A total of 90 patients with SMTs from the MP layer at the EGJ were included in the present study.The difficulty of endoscopic resection was defined as a long procedure time,failure of en bloc resection and intraoperative bleeding.Clinicopathological,endoscopic and follow-up data were collected and analyzed.Statistical analysis of independent risks for piecemeal resection,long operative time,and intraoperative bleeding were assessed using univariate and multivariate analyses.RESULTS According to the location and growth pattern of the tumor,44 patients underwent STER,14 patients underwent EFTR,and the remaining 32 patients received a standard ESD procedure.The tumor size was 20.0 mm(range 5.0–100.0 mm).Fourty-seven out of 90 lesions(52.2%)were regularly shaped.The overall en bloc resection rate was 84.4%.The operation time was 43 min(range 16–126 min).The intraoperative bleeding rate was 18.9%.There were no adverse events that required therapeutic intervention during or after the procedures.The surgical approach had no significant correlation with en bloc resection,long operative time or intraoperative bleeding.Large tumor size(≥30 mm)and irregular tumor shape were independent predictors for piecemeal resection(OR:7.346,P=0.032 and OR:18.004,P=0.029,respectively),long operative time(≥60 min)(OR:47.330,P=0.000 and OR:6.863,P=0.034,respectively)and intraoperative bleeding(OR:20.631,P=0.002 and OR:19.020,P=0.021,respectively).CONCLUSION Endoscopic resection is an effective treatment for SMTs in the MP layer at the EGJ.Tumors with large size and irregular shape were independent predictors for difficult endoscopic resection.

Microfluidics-based assay on the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors

Abstract A new microfluidic system with four different microchambers （a circle and three equilateral concave polygons） was designed and fabricated using poly（dimethylsiloxane） （PDMS） and the soft lithography method. Using this microfluidic device at six flow rates （5, 10, 20, 30, 40, and 50 μL/h）, the effects of microenvironmental geometry and aqueous flow on bacterial adhesion behaviors were investigated. Escherichia coli HB101 pGLO, which could produce a green fluorescent protein induced by L-arabinose, was utilized as the model bacteria. The results demonstrated that bacterial adhesion was significantly related to culture time, microenvironment geometry, and aqueous flow rates. Adhered bacterial density increased with the culture time. Initially, the adhesion occurred at the microchamber sides, and then the entire chamber was gradually covered with increased culture time. Adhesion densities in the side zones were larger than those in the center zones because of the lower shearing force in the side zone. Also, the adhesion densities in the complex chambers were larger than those in the simple chambers. At low flow rates, the orientation of adhered bacteria was random and disorderly. At high flow rates, bacterial orientation became close to the streamline and oriented toward the flow direction; All these results implied that bacterial adhesion tended to occur in complicated aqueous flow areas.The present study provided an on-chip flow system for physiological behavior of biological cells, as well as provided a strategic cue for the prevention of bacterial infection and biofilm formation.

桡动脉侧支穿支皮瓣在肘后皮肤严重缺损中的应用

exposed wound of deep tissue behind elbow. Methods From April 2016 to December 2018, 28 patients with posterior elbow skin and soft tissue defect with exposed bone and tendon were treated in our hospital. the radial collateral artery perforator flap was used to repair the wound. There were 19 cases of skin defect with ulna exposure after electric shock injury, 5 cases of hot compression injury and 4 cases of bone exposure caused by skin contusion after traffic accident. Results There is no complication after the operation, all the flaps were survived. The flaps had good quality and satisfactory recovery of appearance and function. Conclusion The lateral upper arm flap designed by perforating branch of radial collateral artery is an effective method for posterior elbow skin and soft tissue defect because of its constant anatomic position and long vascular pedicle.

Correction of Scar Contracture Deformity of Dorsal Hand by Invisible Full-thickness Mesh Skin Graft

Objective To investigate the effect of invisible full-thickness mesh skin graft in the treatment of scar contracture deformity of the dorsal hand.Methods From January 2016 to February 2019,25 patients with cicatricial contracture deformity of dorsal hand admitted to our hospital underwent full thickness skin graft.During the operation,the scar healed completely and the superficial fascia remained intact.The wound surface was transplanted with invisible mesh full thickness skin graft.The survival of the skin graft and the recovery of hand function and appearance in the later period were observed after the operation.Results The skin grafts of 20 patients survived with high quality,3 cases had partial epidermis exfoliation,and 2 cases had partial epidermis scattered in blisters.After intensive dressing change,all wounds healed and no complications occurred after the operation.The hand function and appearance of the patients were obviously improved.Conclusion The application of full thickness skin graft to correct scar deformity has the advantages of good functional and appearance recovery and difficult postoperative contracture.Invisible full-thickness mesh skin graft is one of the ideal methods to correct scar contracture deformity of the dorsal hand.