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Clinical efficacy of intradermal type Ⅰ collagen injections in treating skin photoaging in patients from high-altitude areas
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作者 Bin Yang Ao He +6 位作者 Bin-Bin Bu Gong Zhuo Qing-Zhu Zhou Jia-Hang He Liu Liu Wen-Li Huang Xian Zhao 《World Journal of Clinical Cases》 SCIE 2024年第16期2713-2721,共9页
BACKGROUND Photoaging,a result of chronic sun exposure,leads to skin damage and pigmentation changes.Traditional treatments may have limitations in high-altitude areas like Yunnan Province.Intradermal Col Ⅰ injection... BACKGROUND Photoaging,a result of chronic sun exposure,leads to skin damage and pigmentation changes.Traditional treatments may have limitations in high-altitude areas like Yunnan Province.Intradermal Col Ⅰ injections stimulate collagen production,potentially improving skin quality.This study aims to assess the efficacy and safety of this treatment for photoaging.AIM To evaluate the efficacy and safety of intradermal typeΙcollagen(ColΙ)injection for treating photoaging.METHODS This prospective,self-controlled study investigated the impact of intradermal injections of ColΙon skin photodamage in 20 patients from the Yunnan Province.Total six treatment sessions were conducted every 4 wk±3 d.Before and after each treatment,facial skin characteristics were quantified using a VISIA skin detector.Skin thickness data were assessed using the ultrasound probes of the Dermalab skin detector.The Face-Q scale was used for subjective evaluation of the treatment effect by the patients.RESULTS The skin thickness of the right cheek consistently increased after each treatment session compared with baseline.The skin thickness of the left cheek significantly increased after the third through sixth treatment sessions compared with baseline.The skin thickness of the right zygomatic region increased after the second to sixth treatment sessions,whereas that of the left zygomatic region showed a significant increase after the fourth through sixth treatment sessions.The skin thickness of both temporal regions significantly increased after the fifth and sixth treatment sessions compared with baseline(P<0.05).These findings were also supported by skin ultrasound images.The feature count for the red areas and wrinkle feature count decreased following the treatment(P<0.05).VISIA assessments also revealed a decrease in the red areas after treatment.The Face-QSatisfaction with Facial Appearance Overall and Face-Q-Satisfaction with Skin scores significantly increased after each treatment session.The overall appearance of the patients improved after treatment.CONCLUSION Intradermal ColΙinjection improves photoaging,with higher patient satisfaction and fewer adverse reactions,and could be an effective treatment method for populations residing in high-altitude areas. 展开更多
关键词 PHOTOAGING TypeΙcollagen Face-Q high-altitude area Skin photodamage Patient satisfaction
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Atmospheric transmission algorithm for pulsed X-rays from high-altitude nuclear detonations based on scattering correction
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作者 Ding-Han Zhu Xiong Zhang +3 位作者 Xiao-Qiang Li Peng Li Yan-Bin Wang Shuang Zhang 《Nuclear Science and Techniques》 SCIE EI CAS CSCD 2024年第3期40-52,共13页
In high-altitude nuclear detonations,the proportion of pulsed X-ray energy can exceed 70%,making it a specific monitoring signal for such events.These pulsed X-rays can be captured using a satellite-borne X-ray detect... In high-altitude nuclear detonations,the proportion of pulsed X-ray energy can exceed 70%,making it a specific monitoring signal for such events.These pulsed X-rays can be captured using a satellite-borne X-ray detector following atmospheric transmission.To quantitatively analyze the effects of different satellite detection altitudes,burst heights,and transmission angles on the physical processes of X-ray transport and energy fluence,we developed an atmospheric transmission algorithm for pulsed X-rays from high-altitude nuclear detonations based on scattering correction.The proposed method is an improvement over the traditional analytical method that only computes direct-transmission X-rays.The traditional analytical method exhibits a maximum relative error of 67.79% compared with the Monte Carlo method.Our improved method reduces this error to within 10% under the same conditions,even reaching 1% in certain scenarios.Moreover,its computation time is 48,000 times faster than that of the Monte Carlo method.These results have important theoretical significance and engineering application value for designing satellite-borne nuclear detonation pulsed X-ray detectors,inverting nuclear detonation source terms,and assessing ionospheric effects. 展开更多
关键词 high-altitude nuclear detonation Atmospheric transmission Pulsed X-rays Scattering correction Analytical method Monte Carlo method
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Single-Arm Clinical Study of Combination Perindopril-Amlodipine Tablets in the Treatment of High-Altitude Hypertension
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作者 Miao Shao Jin Tian Jacinda Huang Wentao Wu 《Journal of Clinical and Nursing Research》 2024年第9期168-173,共6页
Objective:To evaluate the efficacy of combination perindopril/amlodipine tablets in patients with high-altitude hypertension who were previously unable to control their blood pressure with monotherapy.Methods:A total ... Objective:To evaluate the efficacy of combination perindopril/amlodipine tablets in patients with high-altitude hypertension who were previously unable to control their blood pressure with monotherapy.Methods:A total of 151 patients with high-altitude hypertension whose blood pressure remained inadequately controlled with previous monotherapy were enrolled in this study.All patients received an 8-week treatment with a combination of perindopril/amlodipine tablets,consisting of perindopril 10 mg/day and amlodipine 5 mg/day.Blood pressure measurements,including both diastolic and systolic pressures,were taken at baseline,and after 2,4,6,and 8 weeks of treatment.Results:After 8 weeks of treatment,there was a significant reduction in both average systolic and diastolic blood pressure compared to baseline(P<0.0001).Specifically,the average systolic blood pressure decreased by 24.45±13.75 mmHg,and the average diastolic blood pressure decreased by 13.37±8.40 mmHg.The overall heart rate showed no significant changes during the treatment period.Conclusion:A combination of perindopril/amlodipine tablets significantly improved blood pressure control in patients with high-altitude hypertension after 8 weeks of treatment.These results support the efficacy of combination perindopril/amlodipine as a viable treatment option for high-altitude hypertension. 展开更多
关键词 high-altitude hypertension Perindopril/amlodipine Blood pressure control Systolic and diastolic pressure reduction
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Geostructures, dynamics and risk mitigation of high-altitude and long- runout rockslides 被引量:6
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作者 Yueping Yin Bin Li +3 位作者 Yang Gao Wenpei Wang Shilin Zhang Nan Zhang 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2023年第1期66-101,共36页
Long-runout rockslides at high altitude could cause disaster chain in river basins and destroy towns and major infrasturctures.This paper firstly explores the initiation mechanism of high-altitude and long-runout rock... Long-runout rockslides at high altitude could cause disaster chain in river basins and destroy towns and major infrasturctures.This paper firstly explores the initiation mechanism of high-altitude and long-runout rockslides.Two types of sliding-prone geostructure models,i.e.the fault control type in orogenic belt and the fold control type in platform area,are proposed.Then,large-scale experimental apparatus and associated numerical simulations are conducted to understanding the chain-style dynamics of rockslide-debris avalanche-debris flow.The results reveal the fragmentation effects,the rheological behaviors and the boundary layer effect of long-runout avalanche-debris flow.The dynamic character-istics of quasi-static-transition-inertia state and solid-liquid coupling in rapid movement of rockslide-debris avalanche-debris flow are investigated.Finally,the risk mitigation strategy of the non-structure and structure for resilient energy dissipation are illustrated for initiation,transition and deposition zones.The structural prevention and mitigation methods have been successfully applied to the high-altitude and long-runout rockslides in Zhouqu and Maoxian of the Wenchuan earthquake zone,as well as the other major geohazards in Qinghai-Tibet Plateau and its adjacent areas. 展开更多
关键词 ROCKSLIDE high-altitude and long-runout Sliding-prone geostructure Large-scale experimental apparatus Risk mitigation strategy Structural prevention technique
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New direction for surgery:Super minimally invasive surgery 被引量:2
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作者 En-Qiang Linghu 《World Journal of Gastroenterology》 SCIE CAS 2024年第12期1676-1679,共4页
The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm... The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS. 展开更多
关键词 Super minimally invasive surgery Minimally invasive surgery Treatment mode Traditional surgery New direction for surgery
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Bariatric surgery and diabetes:Current challenges and perspectives 被引量:2
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作者 Yan-Fei He Xiao-Dong Hu +2 位作者 Jun-Qiang Liu Hu-Ming Li Shuang-Feng Lu 《World Journal of Diabetes》 SCIE 2024年第8期1692-1703,共12页
Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are ... Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice. 展开更多
关键词 Bariatric surgery Diabetes mellitus OBESITY Metabolic surgery CHALLENGE
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Fully automatic AI segmentation of oral surgery-related tissues based on cone beam computed tomography images 被引量:1
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作者 Yu Liu Rui Xie +5 位作者 Lifeng Wang Hongpeng Liu Chen Liu Yimin Zhao Shizhu Bai Wenyong Liu 《International Journal of Oral Science》 SCIE CAS CSCD 2024年第3期413-424,共12页
Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully autom... Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry. 展开更多
关键词 surgery CBCT BEAM
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Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients? 被引量:2
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作者 Zi-Wei Li Xiao-Juan Luo +7 位作者 Fei Liu Xu-Rui Liu Xin-Peng Shu Yue Tong Quan Lv Xiao-Yu Liu Wei Zhang Dong Peng 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第4期1334-1343,共10页
BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,... BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality. 展开更多
关键词 Enhanced recovery after surgery Gastric cancer ELDERLY MORTALITY
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Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery 被引量:1
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作者 Mei-Hua Sun Liu-Sheng Wu +2 位作者 Ying-Yang Qiu Jun Yan Xiao-Qiang Li 《World Journal of Clinical Cases》 SCIE 2024年第12期2040-2049,共10页
BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate ... BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection. 展开更多
关键词 Enhanced recovery after surgery Non-small cell lung cancer Perioperative care Propensity score Video-assisted thoracic surgery
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Glaucoma surgery experiments using digital microscope-integrated optical coherence tomography and OCT-compatible instruments 被引量:1
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作者 Tianliang Jiang Jinyu Fan +2 位作者 Ning Tang Yi He Guohua Shi 《Journal of Innovative Optical Health Sciences》 SCIE EI CSCD 2024年第5期105-113,共9页
There is a certain failure rate in traditional glaucoma surgery because of the lack of depth information in microscope images.In this work,we present a digital microscope-integrated optical coherence tomography(MIOCT)... There is a certain failure rate in traditional glaucoma surgery because of the lack of depth information in microscope images.In this work,we present a digital microscope-integrated optical coherence tomography(MIOCT)system and several custom-made OCT-compatible instruments for glaucoma surgery.Sixteen ophthalmologists were asked to perform trabeculectomy and canaloplasty on live porcine eyes using the system and instruments.After surgery,a subjective feedback survey about the user experience was taken.The experiment results showed that our system can help surgeons easily locate important tissue structures during surgery.The custom-made instruments also solved the shadowing problem in OCT imaging.Surgeons preferred to use the system in their future practice. 展开更多
关键词 Microscope-integrated optical coherence tomography OCT-compatible instruments glaucoma surgery TRABECULECTOMY CANALOPLASTY
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Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report 被引量:2
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作者 Kaoru Kakinuma Toshiyuki Kakinuma +4 位作者 Kyouhei Ueyama Rora Okamoto Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada 《World Journal of Clinical Cases》 SCIE 2024年第26期5968-5973,共6页
BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,pr... BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs. 展开更多
关键词 Cervical dilation Hysteroscopic surgery Uterine artery pseudoaneurysm Uterine artery embolization Case report
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Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity:Insight from recent research 被引量:1
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作者 Hui-Hong Tang Dong Wang Cheng-Chun Tang 《World Journal of Diabetes》 SCIE 2024年第4期586-590,共5页
Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and su... Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism. 展开更多
关键词 Bariatric surgery OBESITY DIABETES Animal models Diabetes patients
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Treatment of hemolymphangioma by robotic surgery: A case report 被引量:1
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作者 Tian-Ning Li Yan-Hong Liu +2 位作者 Jia Zhao Hong Mu Lei Cao 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第2期596-600,共5页
BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,... BACKGROUND Hemolymphangioma of the jejunum is rare and lacks clinical specificity,and can manifest as gastrointestinal bleeding,abdominal pain,and intestinal obstruction.Computed tomography,magnetic resonance imaging,and other examinations show certain characteristics of the disease,but lack accuracy.Although capsule endoscopy and enteroscopy make up for this deficiency,the diagnosis also still re-quires pathology.CASE SUMMARY A male patient was admitted to the hospital due to abdominal distension and abdominal pain,but a specific diagnosis by computed tomography examination was not obtained.Partial resection of the small intestine was performed by robotic surgery,and postoperative pathological biopsy confirmed the diagnosis of hemo-lymphangioma.No recurrence in the follow-up examination was observed.CONCLUSION Robotic surgery is an effective way to treat hemolymphangioma through minima-lly invasive techniques under the concept of rapid rehabilitation. 展开更多
关键词 Hemolymphangioma ENTEROSCOPY Robotic surgery REHABILITATION Case report
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Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer 被引量:1
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作者 Xian Qin Chen Chen +4 位作者 Yang Liu Xian-Hong Hua Jia-Yi Li Meng-Jie Liang Fang Wu 《World Journal of Clinical Cases》 SCIE 2024年第9期1569-1577,共9页
BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditi... BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing. 展开更多
关键词 Early-stage ovarian cancer EFFICACY Minimally invasive LAPAROSCOPY SAFETY surgery
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Effect of ankle versus thigh tourniquets on post-operative pain in foot and ankle surgery 被引量:2
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作者 Ashish Mishra Ahmed Barakat +5 位作者 Jitendra Mangwani Jakub Kazda Sagar Tiwatane Sana Mohammed Aamir Shaikh Linzy Houchen-Wolloff Vipul Kaushik 《World Journal of Orthopedics》 2024年第2期163-169,共7页
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ... BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site. 展开更多
关键词 Lower limb surgery Tourniquet time Tourniquet pressure Tourniquet site Post-operative pain Pain scores
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Cardiac rehabilitation after cardiac surgery:An important underutilized treatment strategy 被引量:1
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作者 Christos Kourek Stavros Dimopoulos 《World Journal of Cardiology》 2024年第2期67-72,共6页
Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,sur... Physical inactivity remains in high levels after cardiac surgery,reaching up to 50%.Patients present a significant loss of functional capacity,with prominent muscle weakness after cardiac surgery due to anesthesia,surgical incision,duration of cardiopulmonary bypass,and mechanical ventilation that affects their quality of life.These complications,along with pulmonary complications after surgery,lead to extended intensive care unit(ICU)and hospital length of stay and significant mortality rates.Despite the well-known beneficial effects of cardiac rehabilitation,this treatment strategy still remains broadly underutilized in patients after cardiac surgery.Prehabilitation and ICU early mobilization have been both showed to be valid methods to improve exercise tolerance and muscle strength.Early mobilization should be adjusted to each patient’s functional capacity with progressive exercise training,from passive mobilization to more active range of motion and resistance exercises.Cardiopulmonary exercise testing remains the gold standard for exercise capacity assessment and optimal prescription of aerobic exercise intensity.During the last decade,recent advances in healthcare technology have changed cardiac rehabilitation perspectives,leading to the future of cardiac rehabilitation.By incorporating artificial intelligence,simulation,telemedicine and virtual cardiac rehabilitation,cardiac surgery patients may improve adherence and compliance,targeting to reduced hospital readmissions and decreased healthcare costs. 展开更多
关键词 Cardiac rehabilitation Cardiac surgery Cardiopulmonary exercise testing Early mobilization TREATMENT TECHNOLOGY
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Safety and effectiveness of neuromuscular electrical stimulation in cardiac surgery:A systematic review 被引量:2
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作者 Christos Kourek Marios Kanellopoulos +4 位作者 Vasiliki Raidou Michalis Antonopoulos Eleftherios Karatzanos Irini Patsaki Stavros Dimopoulos 《World Journal of Cardiology》 2024年第1期27-39,共13页
BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction an... BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength and function and,most of them,found increase of muscle strength and improvement in muscle function after NMES.NMES was safe in all studies without any significant complication.CONCLUSION NMES is safe,feasible and has beneficial effects on muscle strength and function in patients after cardiac surgery,but has no significant effect on functional capacity. 展开更多
关键词 Neuromuscular electrical stimulation Cardiac surgery coronary artery bypass grafting Heart valve replacement Peak VO2 SAFETY
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Impact of frailty on short-term postoperative outcomes in patients undergoing colorectal cancer surgery:A systematic review and meta-analysis 被引量:1
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作者 Yao Zhou Xiao-Lei Zhang +2 位作者 Hong-Xia Ni Tian-Jing Shao Ping Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期893-906,共14页
BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optima... BACKGROUND Colorectal cancer is a major global health challenge that predominantly affects older people.Surgical management,despite advancements,requires careful consideration of preoperative patient status for optimal outcomes.AIM To summarize existing evidence on the association of frailty with short-term postoperative outcomes in patients undergoing colorectal cancer surgery.METHODS A literature search was conducted using PubMed,EMBASE and Scopus databases for observational studies in adult patients aged≥18 years undergoing planned or elective colorectal surgery for primary carcinoma and/or secondary metastasis.Only studies that conducted frailty assessment using recognized frailty assess-ment tools and had a comparator group,comprising nonfrail patients,were included.Pooled effect sizes were reported as weighted mean difference or relative risk(RR)with 95%confidence intervals(CIs).RESULTS A total of 24 studies were included.Compared with nonfrail patients,frailty was associated with an increased risk of mortality at 30 d(RR:1.99,95%CI:1.47-2.69),at 90 d(RR:4.76,95%CI:1.56-14.6)and at 1 year(RR:5.73,95%CI:2.74-12.0)of follow up.Frail patients had an increased risk of any complications(RR:1.81,95%CI:1.57-2.10)as well as major complications(Clavien-Dindo classification grade≥III)(RR:2.87,95%CI:1.65-4.99)compared with the control group.The risk of reoperation(RR:1.18,95%CI:1.07-1.31),readmission(RR:1.70,95%CI:1.36-2.12),need for blood transfusion(RR:1.67,95%CI:1.52-1.85),wound complications(RR:1.49,95%CI:1.11-1.99),delirium(RR:4.60,95%CI:2.31-9.16),risk of prolonged hospitalization(RR:2.09,95%CI:1.22-3.60)and discharge to a skilled nursing facility or rehabilitation center(RR:3.19,95%CI:2.0-5.08)was all higher in frail patients.CONCLUSION Frailty in colorectal cancer surgery patients was associated with more complications,longer hospital stays,higher reoperation risk,and increased mortality.Integrating frailty assessment appears crucial for tailored surgical management. 展开更多
关键词 FRAILTY Frail adults Colorectal surgery Colorectal cancer COMPLICATIONS Mortality Survival Slinical outcomes META-ANALYSIS
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Indocyanine green:The guide to safer and more effective surgery
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作者 Pietro Fransvea Maria Michela Chiarello +2 位作者 Valeria Fico Maria Cariati Giuseppe Brisinda 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期641-649,共9页
In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyan... In this editorial we comment on the article by Kalayarasan and co-workers published in the recent issue of the World Journal of Gastrointestinal Surgery.The authors present an interesting review on the use of indocyanine green fluo-rescence in different aspects of abdominal surgery.They also highlight future perspectives of the use of indocyanine green in mini-invasive surgery.Indo-cyanine green,used for fluorescence imaging,has been approved by the Food and Drug Administration and is safe for use in humans.It can be administered in-travenously or intra-arterially.Since its advent,there have been several advance-ments in the applications of indocyanine green,especially in the surgical field,such as intraoperative mapping and biopsy of sentinel lymph node,measurement of hepatic function prior to resection,in neurosurgical cases to detect vascular anomalies,in cardiovascular cases for patency and assessment of vascular ab-normalities,in predicting healing following amputations,in helping visualization of hepatobiliary anatomy and blood vessels,in reconstructive surgery,to assess flap viability and for the evaluation of tissue perfusion following major trauma and burns.For these reasons,the intraoperative use of indocyanine green has become common in a variety of surgical specialties and transplant surgery.Co-lorectal surgery has just lately begun to adopt this technique,particularly for perfusion visualization to prevent anastomotic leakage.The regular use of in-docyanine green coupled with fluorescence angiography has recently been pro-posed as a feasible tool to help improve patient outcomes.Using the best available data,it has been shown that routine use of indocyanine green in colorectal surgery reduces the rates of anastomotic leak.The use of indocyanine green is proven to be safe,feasible,and effective in both elective and emergency scenarios.However,additional robust evidence from larger-scale,high-quality studies is essential before incorporating indocyanine green guided surgery into standard practice. 展开更多
关键词 Indocyanine green Colorectal surgery Fluorescence-guided surgery Gastrointestinal surgery Hepato-biliary surgery Pancreatic surgery Surgical oncology
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Construction Technology of Warm Mix Asphalt Pavement in Cold High-Altitude Areas
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作者 Guangxi Wu 《Journal of Architectural Research and Development》 2023年第5期27-33,共7页
With the continuous development of domestic highway construction,highway civil engineering and service level quality have attracted much attention.Good pavement quality and high-quality service make people feel comfor... With the continuous development of domestic highway construction,highway civil engineering and service level quality have attracted much attention.Good pavement quality and high-quality service make people feel comfortable and smooth when traveling.High-quality pavement can significantly reduce the probability of traffic accidents.At present,there is a direct relationship between pavement quality and pavement construction operations.Carrying out pavement construction operations in cold high-altitude areas requires a reasonable selection of construction equipment and methods.The application of warm-mix asphalt pavement construction technology can ensure pavement quality.Therefore,this paper analyzes the advantages of warm-mix technology,the environmental characteristics of cold high-altitude areas,and construction preparations,and discusses the construction technology of warm-mix asphalt pavement in cold high-altitude areas in detail,to improve the overall road quality of cold high-altitude areas. 展开更多
关键词 Cold high-altitude areas Warm mix asphalt Pavement construction technology
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