Proof of concept of a self-tightening needle-less suture using a NiTi shapememory alloy

Among surgical procedures,suturing is considered simple.However,in some situations,suturing is not easy or feasible.Here,we present proof of concept of a new self-tightening needle-less suture made of a NiTi alloy.The new device is designed to overcome two demanding steps of traditional suturing:needle introduction and manual knotting.Our novel suture is composed only of a short NiTi wire that is able to change shape by exploiting a thermoelastic phase transition.This shape change is achieved by increasing the temperature from that of the operating room(e.g.,20-22℃)to 32℃using warm water.Suturing consists of two steps:suture introduction,in which the suture is in an open configuration,and shape recovery(i.e.,closed configuration).The closed configuration is maintained at human body temperature thanks to peculiar pseudoelastic properties of the NiTi material.Finally,thermal and functional characterization verified the simplicity and effectiveness of the proposed device.

Early Triassic Volcanic Rocks in the Western Yarlung Zangbo Suture Zone:Implications for the Opening of the Neo-Tethys Ocean

In this study,zircon U-Pb dating of volcanic rocks from the Zhongba ophiolite of the Yarlung Zangbo Suture Zone(YZSZ)in southern Xizang(Tibet)yielded an age of 247±3 Ma.According to whole rock geochemical and Sr-NdPb isotopic data,the Early Triassic samples could be divided into two groups:Group 1 with P-MORB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70253–0.70602,ε_(Nd)(t)values of 4.2–5.3,(^(206)Pb/^(204)Pb)_(t)ratios of 16.353–18.222,(^(207)Pb/^(204)Pb)_(t)ratios of 15.454–15.564,and(^(208)Pb/^(204)Pb)_(t)ratios of 35.665–38.136;Group 2 with OIB affinity,showing initial^(87)Sr/^(86)Sr ratios of 0.70249–0.70513,ε_(Nd)(t)values of 4.4–4.9,(^(206)Pb/^(204)Pb)_(t)ratios of 17.140–18.328,(^(207)Pb/^(204)Pb)_(t)ratios of 15.491–15.575,and(^(208)Pb/^(204)Pb)_(t)ratios of 36.051–38.247.Group 2 rocks formed by partial melting of the mantle source enriched by a former plume,and assimilated continental crustal material during melt ascension.The formation of Group 1 rocks corresponds to the mixing of OIB melts,with the same components as Group 2 and N-MORBs.The Zhongba Early Triassic rocks belong to the continental margin type ophiolite and formed in the continental–oceanic transition zone during the initial opening of the Neo-Tethys in southern Xizang(Tibet).

Outcomes of a non-randomised audit of single pigtail suture stents in urolithiasis management of Asian patients in Singapore

Objective:Double-J(DJ)ureteric stents are commonly placed perioperatively for semirigid or flexible ureteroscopic renal surgery.It is believed that lesser stent material within the bladder mitigates stent-related symptoms.This study aimed to evaluate the J-Fil ureteral stent,a single pigtail suture stent compared with conventional DJ stent in relation to stent symptoms in an Asian population undergoing ureterorenal intervention.Methods:Based on internal audit committee recommendation approval,the records of 50 patients retrieved,available data of 41 patients who were prospectively enrolled into two groups(Group 1[J-Fil stent group],n=21 and Group 2[DJ stent group],n=20)between August 2020 to January 2021,were analysed.Parameters compared were nature of procedure,stone location and size,ease of deployment or removal,and complications.A modified universal stent symptom questionnaire was used to assess morbidity of stent symptoms within 48 h of insertion and at removal.Results:Both groups had similar median age,distribution in male to female ratio,and stone size.The overall median universal stent symptom questionnaire score at insertion was similar for bladder pain,flank or loin pain,and quality of life between Group 1 and 2;however,at removal Group 1 fared significantly better than Group 2,especially for flank or loin pain and pain at voiding.Both groups had similar ease in insertion with no hospital readmissions.Conclusion:Our audit favoured the single pigtail suture stent in Asian ureters in mitigating stent-related issues.It showed a good safety profile with easy deployment and removal.It promises a new standard in stenting.

Double-nylon purse-string suture in closing postoperative wounds following endoscopic resection of large(≥3 cm)gastric submucosal tumors

BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.

Intermittent sliding-lock-knot suture for limbal conjunctival autograft fixation in pterygium surgery:a technique note

AIM:To report a technique used with intermittent slidinglock-knot(ISLK)fixation for limbal conjunctival autografts in pterygium surgery and compared with those of routine intermittent(RI)fixation.METHODS:Consecutive patients with primary pterygium who had undergone pterygium excision combined with limbal conjunctival autograft transplantation between March 2021 and March 2022 at our institute were retrospectively analyzed.Primary outcome measures were mean duration of surgery and suture removal,degree of conjunctival hyperemia on postoperative day 1,pain score at suture removal,postoperative symptoms at 6mo,including conjunctival hyperemia,foreign body sensation,and graft stability.RESULTS:Ninety-eight patients underwent monocular surgery and were divided into ISLK(51 eyes)and RI(47 eyes)groups according to the type of conjunctiva autograft fixation method planned.There was no significant difference in mean duration of surgery between the two groups(18.59±2.39min vs 18.15±2.20min,P=0.417);however,compared to the RI group,shorter suture removal times were observed in the ISLK group[0.58min(0.42-0.87)vs 3.00min(2.21-4.15),P<0.001].The degree of conjunctival hyperemia on postoperative day 1 was milder in the ISLK group(P<0.001).Pain scores at suture removal were lower in the ISLK group than in RI group[1(0-3)vs 2(1-4),P<0.001].Postoperative symptoms at 6mo were comparable between the groups(P=0.487),with no recurrence.CONCLUSION:ISLK is an innovative method for limbal conjunctival autograft fixation after pterygium excision.Compared to RI fixation,ISLK facilitates suture removal and reduces discomfort,with comparable surgery duration and less conjunctival hyperemia.

Late onset endophthalmitis after sutureless intrascleral IOL implantation with Yamane Technique

Dear Editor, We want to present the first reported Propionobacterium acnes(P. acnes) endophthalmitis case after sutureless fixation of posterior chamber intraocular lens(IOL) to the sclera for the traetment of aphakia to the best of our knowledge. A 69-year-old man with aphakia due to complicated cataract surgery underwent sutureless intrascleral fixation of threepiece posterior chamber intraocular lens(PCIOL) with Yamane technique.

Gunsight suture with subcutaneous vacuum drainage during enterostomy decreased the surgical site infection rate in obese rectal cancer patients:A retrospective study

Background:Surgical site infection(SSI)is the most common complication after stoma closure and is particularly common in obese patients.To reduce the incidence of SSI,various skin closure techniques have been proposed;however,the best technique is still under debate.The purpose of this study was to explore the effectiveness of subcutaneous vacuum drains(SVDs)after two surgical suture techniques following stoma reversal in obese patients. Methods:Data from 190 obese patients with rectal cancer who underwent stoma reversal for enterostomy between February 2012 and April 2023 at Jinxiang Hospital Affiliated to Jining Medical University were retrospectively analyzed.These patients were divided into two groups:gunsight suture(GS)with SVD and primary linear suture(PLS)with SVD.The GS group and PLS group included 90 and 100 patients,respectively.The clinical characteristics and short-term outcomes were compared between the two groups.Postoperative pain scores were analyzed using a generalized estimation equation. Results:Surgery was successfully performed in both groups.The rate of SSI in the GS group was significantly lower than that in the PLS group(2.2%vs 9.0%,P=0.046).Patients in the GS group had a significantly shorter wound healing time than did patients in the PLS group,as well as a significantly shorter postoperative fasting time(P<0.05).No significant differences were found between the groups in terms of the postoperative hospital stay,operative time,and estimated blood loss(P>0.05).The results of the generalized estimation equation analysis showed that the GS group had significantly lower pain scores at 12,24,48,and 72 h after surgery than the PLS group(P<0.05).Moreover,the GS group showed significantly better alleviation of wound pain between 12 and 72 h after surgery(P<0.05). Conclusions:The GS technique with SVD may be recommended for wound closure of a nonfunctioning stoma in obese patients.

Comparison of modified gunsight suture technique and traditional interrupted suture in enterostomy closure

BACKGROUND Prophylactic enterostomy surgery is a common surgical approach used to reduce the risk of anastomotic leakage in patients who have undergone partial intestinal resection due to trauma or tumors.However,the traditional interrupted suturing technique used in enterostomy closure surgery has several issues,including longer surgical incisions and higher incision tension,which can increase the risk of postoperative complications.To address these issues,scholars have proposed the use of a“gunsight suture”technique.This technique involves using a gunsight incision instead of a traditional linear incision,leaving a gap in the center for the drainage of blood and fluid to reduce the risk of infection.Building on this technique,we propose an improved gunsight suture technique.A drainage tube is placed at the lowest point of the incision and close the gap in the center of the gunsight suture,which theoretically facilitates early postoperative mobility and reduces the burden of dressing changes,thereby reducing the risk of postoperative complications.AIM To compare the effectiveness of improved gunsight suture technique with traditional interrupted suture in closing intestinal stomas.METHODS In this study,a retrospective,single-center case analysis was conducted on 270 patients who underwent prophylactic ileostomy closure surgery at the Department of Colorectal Surgery of Qilu Hospital from April 2017 to December 2021.The patients were divided into two groups:135 patients received sutures using the improved gunsight method,while the remaining 135 patients were sutured with the traditional interrupted suture method.We collected data on a variety of parameters,such as operation time,postoperative pain score,body temperature,length of hospital stays,laboratory indicators,incidence of incisional complications,number of wound dressing changes,and hospitalization costs.Non-parametric tests and chi-square tests were utilized for data analysis.RESULTS There were no statistically significant differences in general patient information between the two groups,including the interval between the first surgery and the stoma closure[132(105,184)d vs 134(109,181)d,P=0.63],gender ratio(0.64 vs 0.69,P=0.44),age[62(52,68)years vs 60(52,68)years,P=0.33],preoperative body mass index(BMI)[23.83(21.60,25.95)kg/m²vs 23.12(20.94,25.06)kg/m²,P=0.17].The incidence of incision infection in the improved gunsight suture group tended to be lower than that in the traditional interrupted suture group[(n=2/135,1.4%)vs(n=10/135,7.4%),P<0.05],and the postoperative hospital stay in the improved gunsight suture group was significantly shorter than that in the traditional interrupted suture group[5(4,7)d vs 7(6,8)d,P<0.05].Additionally,the surgical cost in the modified gunsight suture group was slightly lower than that in the traditional suture group[4840(4330,5138)yuan vs 4980(4726,5221)yuan,P>0.05],but there was no significant difference in the total hospitalization cost between the two groups.CONCLUSION In stoma closure surgery,the improved gunsight technique can reduce the incision infection rate,shorten the postoperative hospital stay,reduce wound tension,and provide better wound cosmetic effects compared to traditional interrupted suture.

Efficacy of surgical resection and ultra-reduced tension suture combined with superficial radiation in keloid treatment

BACKGROUND There are many available treatment options for keloid;however,single treatments are usually less effective.Therefore,more scientifically rational and effective com-bined treatment methods should be sought to solve the pain associated with keloids.AIM To explore the efficacy and safety of surgical resection and ultra-reduced tension suture combined with superficial radiation as keloid treatment.METHODS Fifteen keloid patients admitted to Qingdao Eighth People's Hospital from June 2020 to January 2022 were enrolled in this retrospective analysis.All patients underwent a comprehensive treatment approach comprising surgical resection,ultra-reduced tension suture incision,and superficial radiation therapy within 24 h postoperatively.The modified Vancouver Scar Scale(mVSS)and Patient and Observer Scar Assessment Scale(POSAS)were used to evaluate the treatment effect,whereas the efficacy,adverse effects,and recurrence rate were observed according to the 12-mo follow-up after treatment.RESULTS The mVSS and POSAS scores at 1 and 6 mo after combination treatment decreased compared to before treatment(P<0.001),and the overall response rate was 93.3%.Only one case recurred,yielding a 6.7%recurrence rate.The incidence of local chromour sedimentation rate in 1–3 mo after radiotherapy was 33.3%(5 patients),all subsiding after 6–9 mo,without complications,such as delayed wound healing or dermatitis.CONCLUSION Surgical resection,super subtraction sutures,and superficial radiotherapy are treatment methods with short courses,low recurrence rates,and good safety profiles.

Feasibility and efficacy of endoscopic purse-string suture-assisted closure for mucosal defects induced by endoscopic manipulations

BACKGROUND Large or transmural defects induced by gastrointestinal endoscopic manipulations are difficult to close,although complete closure is recommended for better recovery.Endoscopic purse-string assisted suturing(EPSS)has been used in clinical practice and has proven to be an effective and safe technique for the closure of large mucosal defects.However,details regarding the efficacy of endoscopic pre-purse-string suture(P-EPSS)are unknown,especially that it offers several advantages over conventional EPSS(C-EPSS).AIM To elucidate the outcomes of EPSS-assisted closure in different clinical situations,and evaluate the efficacy of P-EPSS.METHODS This retrospective observational study included a total of 180 patients who underwent closure assisted by P-EPSS(n=63)or C-EPSS(n=117)between July 2014 and June 2020.The P-EPSS and C-EPSS groups were compared and the intergroup differences in aspects such as the lesion size,location,and morphology,incidence of complete closure,intraoperative perforation,and delayed adverse events were evaluated.Data on the features and clinical course of cases with adverse events were collected for further analysis.RESULTS Patients with lesion size larger than 3 cm,lesions located at the fundus of stomach,or submucosal tumors originating from the deep mucosa were more likely to undergo P-EPSS-assisted closure.The P-EPSS group showed a significantly higher proportion of intraoperative perforation(56%vs 17%)and a much shorter procedure time(9.06±6.14 min vs 14.84±7.25 min).Among adverse events,the incidence of delayed perforation(5%vs 4%;P=0.82)and delayed bleeding(3%vs 4%;P=0.96)did not differ significantly between the groups.Multivariate analysis revealed that lesions with incomplete closure[odds ratio(OR)=21.33;95%confidence interval(CI):5.45-83.45;P<0.01]or size greater than 3 cm(OR=3.14;95%CI:1.08-9.18;P=0.039)showed a statistical tendency to result in an increase in delayed adverse events.CONCLUSION The present study revealed that EPSS could achieve secure complete closure of mucosal defect.PEPSS could shorten the procedure and yield complete closure of mucosal defects.Rather than closure-type selection,incomplete closure or lesion size larger than 3 cm were associated with worse outcomes.

Bedside anterior segment optical coherence tomography-assisted reattachment of severe hemorrhagic Descemet’s membrane detachment after ab externo 360-degree suture trabeculotomy combined with trabeculectomy

Dear Editor,We report a case of severe hemorrhagic Descemet’s membrane detachment(HDD)following ab external360-degree suture trabeculotomy with trabeculectomy that was successfully managed with the guidance of bedside anterior segment optical coherence tomography(ASOCT).Descemet’s membrane detachment(DMD)is a complication that impairs vision and is commonly observed after cataract surgery.It’s reported a high incidence(25%-82%)of focal DMD that were mostly subclinical and detected only with gonioscopy[1].

Oxygen Penetration Through Full-Thickness Skin by Oxygen-Releasing Sutures for Skin Graft Transplantation

The transplantation of full-thickness skin grafts(FTSGs)is important for reconstructing skin barrier and promoting wound healing.Sufficient oxygen supply is closely related to the success of skin grafting.However,full-thickness oxygen delivery is limited by the poor oxygen permeability of skin.Oxygen-releasing sutures(O_(2)sutures)were developed to facilitate oxygen penetration through full-thickness skin.The O_(2)sutures delivered 100 times more oxygen than topical gaseous oxygen therapy at a 15 mm depth in the skin model.Under extreme hypoxia(<0.5%O_(2),v/v),O_(2)sutures could also promote endothelial cell proliferation.After the transplantation of FTSGs in mice,O_(2)sutures accelerated blood re-perfusion and increased the survival area of the skin graft.It is expected that O_(2)sutures will be adopted in clinical applications to increase the success rate of full-thickness skin transplantation.

Formation of South Tianshan suture and its geological significance

South Tianshan–Solonker suture,is the largest and southernmost suture within the Central Asian orogenic belt(CAOB).It records the ultimate collision between Tarim–North China cratons and Siberia craton,and is commonly interpreted as marking the eventual closure of Paleo-Asian Ocean.South Tianshan suture belongs to the western segment of the suture zone,and its evolutionary features are important for defining the formation age of the South Tianshan–Solonker suture.In this paper,the authors review the geochronological,geochemical,petrographic,and paleontological evidence within South Tianshan suture to delineate its formation era and closure characteristics,and thus further revealing the ultimate evolutionary pattern of the western segment of Paleo-Asian Ocean.This suture records strong plate collision before Late Carboniferous,forming a series of high-pressure metamorphic rocks,characterized by the presence of blue schist,eclogite and mica schist.In Permian,the whole area was under a relatively stable post-orogenic setting,with the formation of bimodal volcanic rocks,post-collisional granites,and terrestrial molasses.Sedimentary facies gradually changed from marine to either lacustrine or fluvial during this period.An Early Permian granite dike crosscuts the HP metamorphic belt,and the HP metamorphic rocks also underwent retrograde metamorphism at this time,indicating the formation of the South Tianshan suture was earlier than Permian.Hence,the western section of Paleo-Asian Ocean closed during Late Carboniferous,and Tarim Craton moved northward to collide with Kazakhstan–Yili Block,leading to the formation of the South Tianshan suture.

The Advantages and Disadvantages of Skin Staple Suture Compared with Traditional Suture in Brain Surgery in Primary Hospital:A Randomized Controlled Study

Objective:This paper aims to compare the effect of skin staple suture and traditional silk suture in scalp suture surgery.Methods:A total of 80 craniocerebral surgery patients were included in this study,and the patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group used disposable skin stapler to suture the scalp incision,and the control group used conventional silk suture to suture the incision.Statistical analysis was carried out on 6 indicators including suturing speed,healing under-scab,incision necrosis,incision cerebrospinal fluid(CSF)leakage,incision infection,and postoperative“centipede-shaped”scar incidence rate of the two suture methods.Results:There was no significant difference between the groups in terms of postoperative healing under-scab,incision necrosis,incision CSF leakage,and intracranial infection(P>0.05).The suturing speed in the observation group was 15.2±0.7 cm/min,which was significantly faster than 7.4±0.3 cm/min in the control group(P<0.05).The incidence of“centipede-shaped”scars in the observation group was significantly lower than that in the control group at 1 to 6 months after operation(P<0.05).Conclusion:Compared with traditional silk suture,skin staple suture has obvious advantages in suture speed and cosmetic effect.

Suture Button装置修复下胫腓联合损伤的初步报告

[目的]探讨Suture Button装置治疗下胫腓联合损伤后的手术方法及临床效果。[方法]对截止于2007年9月利用Suture Button装置固定的下胫腓联合急、慢性损伤的13例病人进行连续随访观察,通过术后X线片数字化测量和标准的踝足功能评分,评估其疗效并探讨临床应用前景。[结果]除1例病人因术后短期再次创伤意外,行2次手术更换为传统螺钉内固定外,其余病人均在术后6周开始部分负重功能锻炼,术后第3个月功能平均评分达到满意,术后第6、12个月功能平均评分达到优良,X线片未发现内固定失效。[结论]Suture Button装置治疗下胫腓联合损伤具有技术简单、手术时间短、内固定器物理特性符合人体正常解剖生理、固定强度足够、无需2次手术取出等多项优势,可能成为下胫腓联合损伤新的治疗标准。

5-Bromo-2'-deoxyuridine labeling:historical perspectives,factors infiuencing the detection,toxicity,and its implications in the neurogenesis

The halopyrimidine 5-bromo-2′-deoxyuridine(BrdU)is an exogenous marker of DNA synthesis.Since the introduction of monoclonal antibodies against BrdU,an increasing number of methodologies have been used for the immunodetection of this synthesized bromine-tagged base analogue into replicating DNA.BrdU labeling is widely used for identifying neuron precursors and following their fate during the embryonic,perinatal,and adult neurogenesis in a variety of vertebrate species including birds,reptiles,and mammals.Due to BrdU toxicity,its incorporation into replicating DNA presents adverse consequences on the generation,survival,and settled patterns of cells.This may lead to false results and misinterpretation in the identification of proliferative neuroblasts.In this review,I will indicate the detrimental effects of this nucleoside during the development of the central nervous system,as well as the reliability of BrdU labeling to detect proliferating neuroblasts.Moreover,it will show factors influencing BrdU immunodetection and the contribution of this nucleoside to the study of prenatal,perinatal,and adult neurogenesis.Human adult neurogenesis will also be discussed.It is my hope that this review serves as a reference for those researchers who focused on detecting cells that are in the synthetic phase of the cell cycle.

Clinical Epidemiology and Surgical Treatment of Spontaneous Perforations of the Terminal Ileum: A Multicentre Study in Cameroon

Background: Perforations of the terminal ileum are a frequent clinical situation and a therapeutic challenge. Surgical treatment is controversial. Several surgical modalities have been proposed and postoperative morbidity and mortality remain high. The aim of this study was to review our experience in the surgical management of perforations of the terminal ileum. Patients and methods: This is a descriptive cross-sectional study with retrospective data collection from January 1, 2017 to December 31, 2021, in five hospitals in Cameroon. Patients’ demographic, clinical presentation, surgical findings and 30-days postoperative outcomes data were collected. Results: We collected 34 files. The sex ratio was 1.4 and the average age was 20.28 years. The average consultation time was 9.1 days. Abdominal pain was present in all our patients. Peritoneal irritation was present in 46 cases (88.5%). The mean time to treatment after admission was 17.5 hours. The perforation was unique in 40 cases (76.9%) and located between 6 and 10 cm from the ileocecal valve in 29 cases (55.8%). Typhoid was the most suspected etiology intraoperatively in 38 cases (73.1%). A simple suture was performed in 18 patients (34.6%), resection with anastomosis in 11 patients (21.2%) and an ileostomy in 5 patients (9.6%). The average length of hospitalization was 21.74 days. Postoperative morbidity and mortality were 32.7% and 17.3% respectively. Conclusion: Perforations of the terminal ileum are common and affect young people. Surgical procedures are varied. Reducing consultation and care times and respecting treatment principles could improve postoperative morbidity and mortality, which remain high.

V-Locsutures与普通可吸收线在后腹腔镜肾部分切除术中应用比较

目的:比较V-Loc sutures与普通可吸收线在后腹腔镜肾癌部分切除术中的应用价值。方法:2012年5月-2013年6月,本手术组共收治了25例确诊的病理分期为T1N0M0的肾癌患者,其中12例术中肾脏创面缝合均采用V-Loc sutures,其中男9例,女3例,年龄28-68岁,平均48.2岁;肿瘤大小为0.9-4.7cm,平均2.8cm;另13例术中采用普通可吸收线缝合创面,其中男8例,女5例,年龄34-74岁,平均45.5岁;肿瘤大小为1.2-4.5cm,平均2.6cm;比较两组患者手术中的手术时间、术中出血量、肾动脉阻断时间、创面缝合时间、各组手术前后测血肌酐、胱抑素C变化,术后并发症。结果:25例手术均在后腹腔镜下顺利完成。V-Loc sutures组和普通可吸收线组手术时间、术中出血、肾动脉阻断时间、肾创面缝合时间均有差异(P<0.05);V-Loc sutures组手术前后血肌酐、胱抑素C无明显差异(P>0.05),普通可吸收线组手术前后血肌酐、胱抑素C有差异(P<0.05);V-Loc sutures组出现1例血尿,普通可吸收线组出现1例漏尿。结论:V-Loc sutures较普通可吸收线可缩短手术时间及肾创面缝合时间,减少术中出血,更好的保护小肾癌患者的肾功能。

Suture Endobutton与跖肌腱重建Lisfranc韧带的生物力学对比研究

目的通过Suture Endobutton与跖肌腱重建Lisfranc韧带的生物力学对比研究,评价两种方法对恢复Lisfranc关节稳定性的作用,为临床治疗Lisfranc损伤提供理论依据。方法选取10例成人新鲜尸体小腿标本,依次制备Lisfranc韧带完整模型、损伤模型及损伤后的Suture Endobutton或跖肌腱重建模型,并分别给予轴向或外展载荷,记录内侧楔骨（C1）～第2跖骨（M2）基底的平均位移变化。结果轴向载荷和外展载荷下,完整模型C1～M2的平均位移变化分别为（0.70±0.05）mm、（1.21±0.10）mm,损伤模型为（1.59±0.07）mm、（3.73±0.11）mm,Suture Endobutton重建模型为（0.84±0.04）mm、（1.29±0.06）mm,跖肌腱重建模型为（1.01±0.05）mm、（1.34±0.05）mm。轴向或外展载荷下,完整模型和重建模型C1～M2间位移变化明显小于损伤模型,差异具有统计学意义（P〈0.05）;重建模型的位移变化略大于完整模型,但差异无统计学意义（P〉0.05）;Suture Endobutton与跖肌腱重建模型之间位移变化相似,差异无明显统计学意义（P〉0.05）;任一模型外展载荷时的C1～M2位移变化大于轴向载荷。结论 （1）在恢复Lisfranc关节稳定性上,Suture Endobutton与跖肌腱的重建方法提供的生物力学强度相似;（2）相对于轴向载荷的位移变化,外展载荷的实验结果差异更加明显,推荐使用外展载荷进行Lisfranc关节相关力学试验。

肩关节镜下Suture Bridge双排法手术修复中型肩袖撕裂的临床效果

目的研究肩关节镜下Suture Bridge双排法手术修复中型肩袖撕裂的临床效果。方法选取2019年2月至2020年3月的150例肩袖损伤患者进行研究。按照随机数表法,分为观察组(n=79)和对照组(n=71)。对照组采用单排修复术治疗,观察组采用Suture Bridge双排法手术治疗。对比两组肩关节Constant评分、视觉模拟评分法评分(Visual Analogue Scale/Score,VAS)、美国加州大学肩关节评分系统评分(University of California at Los Angeles Shoulder Scores,UCLA)及愈合时间、康复时间及再撕裂率。结果治疗后3个月,观察组的Constant评分明显高于对照组(P<0.05);观察组治疗后3个月、治疗后1年VAS评分[(2.17±0.60、3.79±1.01)分]明显低于对照组(P<0.05);观察组UCLA评分总分、疼痛、功能、前屈角度、前屈肌力均明显高于对照组(P<0.05);愈合时间、康复时间及再撕裂率明显低于对照组(P<0.05)。结论肩关节镜下Suture Bridge双排法手术在修复中型肩袖撕裂上可取得良好的治疗效果,改善肩袖关节功能,值得推广。