ObjectiveTo systematically evaluate the efficacy and safety of simultaneous transurethral resection of bladder cancer and prostate (TURBT+TURP) in the treatment of bladder cancer with benign prostatic hyperplasia (BPH). MethodsWe searched PubMed, EMbase, The Cochrane Library, Web of Science, CBM, CNKI, WanFang Data and VIP from inception to January 2015, to collect randomized controlled trials (RCTs) and cohort studies investigating the efficacy and safety of TURBT with TURP in the treatment of bladder cancer with BPH. Two reviewers independently screened literature, extracted data, and assessed the risk bias of included studies, and then meta-analysis was performed using RevMan 5.3 software. Results3 A total of 3 RCTs (n=137) and 10 retrospective cohort studies (n=998) were included. The results of meta-analysis showed that there were no significant differences between the simultaneous resection group and the control group in the overall recurrence rate (RCT:OR=0.55, 95% CI:0.24 to 1.24, P=0.15; retrospective cohort study:OR=0.78, 95% CI:0.60 to 1.01, P=0.06), postoperative recurrence rate in the prostatic fossa/urethra (RCT:OR=1.40, 95% CI:0.28 to 7.60, P=0.68; retrospective cohort study:OR=1.36, 95% CI:0.49 to 3.74, P=0.55), progression rate (OR=0.93, 95% CI:0.53 to 1.61, P=0.79) and overall perioperative complication rate (RCT:OR=0.35, 95% CI:0.08 to 1.55, P=0.17; retrospective cohort study:OR=0.1.75, 95% CI:0.44 to 6.98, P=0.43). ConclusionCompared with only TURBT or sequential TURBT and TURP, simultaneous TURBT and TURP do not increase the overall recurrence rate, postoperative recurrence rate in the prostatic fossa/urethra, progression rate and overall postoperative complication rate. However, due to the limited quality and quantity of included studies, larger sample size and higher quality RCTs are needed to verify the above conclusion.
This paper is to report our study in which the differences between prosthetic restoration and surgical reconstruction using traditional clasp retention technology were analyzed based on three-dimensional finite element methods in our laboratory. Firstly, the maxillary unilateral defect model was developed using medical image processing software MIMICS. Secondly, the prosthesis was generated by mirroring technology. The clasp was designed according to the methods raised by Aramany. Then, the stress distribution of maxilla was calculated by simulating occlusion. According to the results, after osseointegration of surgical reconstruction, stresses of unaffected abutments were reduced significantly, and less stress of junction occurred near zygoma of affected side, which were all less than stresses of prosthesis restoration. Thus, removing the clasp of surgical reconstruction increased the stresses of unaffected abutments. The stress trends of maxillary components were different between prosthetic restoration and surgical reconstruction. Surgical reconstruction is better than prosthesis restoration in protection of the abutments. Clasp can alleviate the occlusal burden of maxilla. Varieties of retentive technologies can be considered in prosthesis restoration. The surgical reconstruction is more conducive to rehabilitate unilateral maxilla biomechanically in clinic.
Steady-state visual evoked potential (SSVEP) is one of the commonly used control signals in brain-computer interface (BCI) systems. The SSVEP-based BCI has the advantages of high information transmission rate and short training time, which has become an important branch of BCI research field. In this review paper, the main progress on frequency recognition algorithm for SSVEP in past five years are summarized from three aspects, i.e., unsupervised learning algorithms, supervised learning algorithms and deep learning algorithms. Finally, some frontier topics and potential directions are explored.
ObjectiveTo explore the differential diagnosis value of subpleural bandlike ground-glass opacity (GGO) in thoracic CT in paraquat poisoning pneumonia. MethodsA retrospective study was carried out by retrieving the patients CT database from March 2013 to March 2015. The patients with paraquat poisoning pneumonia, interstitial pneumonia and pulmonary alveolar proteinosis (PAP) were recruited and their radiological characteristics of thoracic CT were analyzed. ResultsA total of 698 newly diagnosed interstitial pneumonia patients were finally enrolled in this study, 392 of them (56.2%) presented with GGO in thoracic CT. A total of 38 newly diagnosed PAP patients and 14 paraquat poisoning patients were enrolled, and GGO presented in thoracic CT of 100.0% and 42.9% of them respectively. Subpleural bandlike GGO was mostly commonly found in 83.3% of the paraquat poisoning pneumonia patients with GGO in thoracic CT, followed by 18.4% of the PAP patiens and 5.6% of the interstitial pneumonia patients with GGO in thoracic CT, which were significantly lower than that in the paraquat poisoning pneumonia patients (P < 05). GGO associated crazy paving pattern in thoracic CT was mostly commonly found in 94.7% of the PAP patients, followed by 0.5% of the interstitial pneumonia patients and none of the paraquat poisoning pneumonia patients. All the PAP patients with subpleural bandlike GGO were found associated with crazy paving pattern, while none of such association was found in the interstitial pneumonia or the paraquat poisoning pnuemonia patients. GGO coexisting with honeycombing and subpleural line were respectively found in 22.7% and 11.2% of the interstitial pneumonia patients, and none of such association was found in the PAP or the paraquat poisoning pneumonia patients. ConclusionsSubpleural bandlike GGO is mostly commonly found in paraquat poisoning pneumonia patients and rarely in PAP and interstitial pneumonia patients. Combined with crazy paving pattern and subpleural line, subpleural bandlike GGO may be a valuable feature in the diagnosis of paraquat poisoning pneumonia patients.
ObjectiveTo evaluate the early and mid-term safety of transcatheter aortic valve replacement via transfemoral (TF), transapical (TAp) and transsubclavian (TSc) approaches by meta-analysis.MethodsWe systematically searched the clinical comparative trials published from inception to June 2019 from PubMed, Web of Science, EMbase and The Cochrane Library, to evaluate the safety of transcatheter aortic valve replacement through TF, TAp or TSc approaches. The information of all-cause mortality at 30 days, 1 year, 2 years and the incidence of common complications at 30 days after operation (including pacemaker-dependent block, major vascular complications, severe bleeding events, acute renal injury and stroke) were exacted, and a meta-analysis was conducted by RevMan 5.3 software.ResultsThis study included 11 literatures, with a total of 7 833 patients, among whom 5 348 patients were treated by TF TAVR, 1 796 patients by TAp TAVR and 689 patients by TSc TAVR. The results of the meta-analysis were as follows: (1) at 30 days after operation, the mortality of TF and TSc approaches were lower than that of the TAp approach (TF vs. TAp: OR=0.57, 95%CI 0.39-0.84, P=0.004; TSc vs. TAp: OR=4.12, 95%CI 1.93-8.79, P=0.000 3). There was no statistical difference between the TF and TSc approaches (TF vs. TSc: OR=0.98, 95%CI 0.38-2.51, P=0.97); at 1 year, there was no statistical difference in mortality among the three approaches (P>0.05); at 2 years, there was no statistical difference between TSc and TF or TAp approaches (TF vs. TSc: OR=1.21, 95%CI 0.95-1.54, P=0.13; TSc vs. TAp: OR=1.02, 95%CI 0.76-1.36, P=0.91). (2) The incidence of acute kidney injury after TF approach was lower than that of the TAp approach (OR=0.30, 95%CI 0.22-0.41, P<0.000 01). (3) There was no statistical difference in major vascular complications between TSc and TF or TAp approaches (TF vs. TSc: OR=0.75, 95%CI 0.38-1.49, P=0.41; TSc vs. TAp: OR=1.37, 95%CI 0.56-3.32, P=0.49). (4) There was no statistical difference in severe bleeding events between TF and TSc (OR=0.97, 95%CI 0.53-1.76, P=0.92). (5) There was no statistical difference in the incidence of postoperative stroke, pacemaker dependent block among the three approaches (P>0.05).ConclusionTAp and TSc approaches are safe and effective. They are not only an alternative to TF approach, but also the first choice in some patients with poor condition of iliofemoral artery.
ObjectiveTo summarize the clinical morphological classification feature of symptomatic spontaneous isolated celiac artery dissection (SICAD), basing on the relative diameter of the true lumen (TLRD) and type of lesion, and then summarize the reasonable clinical treatment strategies and timing of arterial reconstruction.MethodsRetrospectively analyzed the imaging data, treatment methods, perioperative complications, and follow-up results of 26 symptomatic SICAD patients admitted to the Department of Endovascular Surgery of The First Affiliated Hospital of Zhengzhou University from May 2012 to May 2019, patients were divided into conservative treatment group (n=12) and endovascular intervention group (n=14) according the treatment, and then compared the clinical data of the two groups.ResultsTwelve patients in the conservative treatment group had an average of 12.6 days (5–22 days) and discharged from hospital with better condition, of which 11 patients’ TLRD≥30%. In the endovascular intervention group, 2 patients continued to aggravate the symptoms at the 3rd day of admission and received endovascular intervention, the remaining 12 patients’ symptoms were not significantly relieved or the symptoms reappeared after averaged 11.4 days, whose TLRD<30% or diameter >1.5 cm. Compared with the endovascular intervention group, the duration of symptoms was shorter (P=0.04), proportions of back pain (P=0.02) and chest pain (P=0.04) were lower, TLRD value and proportion of TLRD value>30% (subtype of a) were higher (P=0.01, P=0.02). The average follow-up duration of 26 patients was 28.2 months (12–83 months). The follow-up results of all patients in the conservative treatment group were good and no relevant symptoms had appeared since discharge. One patient in the endovascular intervention group had transient liver function damage, 1 patient had severe deformation of the proximal end of the stent at 1 year after implantation of the celiac artery stent. The remaining patients were stable with no progress.ConclusionsFor symptomatic SICAD, if the clinical symptoms are stable after hospitalization, conservative medication and close imaging follow-up are preferred, if there is no relief of symptoms, continuous organ perfusion and other manifestations based on medication, endovascular intervention can be considered for arterial reconstruction, the early and medium follow-up results were satisfactory under this treatment algorithm. In addition, there are differences in TLRD value between the conservative treatment group and the endovascular intervention group, suggesting that TLRD as the morphological characteristics of the classification has a potential guiding significance for the development of clinical treatment strategy.
Objective To compare the effectiveness of posterior axillary edge approach and arthroscopic assisted reduction in the treatment of Ideberg type Ⅰ and Ⅱ scapular fractures. Methods The clinical data of 26 patients with fresh Ideberg type Ⅰ and Ⅱ scapular fractures admitted between June 2021 and September 2024 who met the selection criteria were analyzed retrospectively. The patients were divided into two groups according to different treatment methods. Ten cases in the arthroscopic group were treated with suture anchor fixation under arthroscopy, and 16 cases in the posterior axillary edge group were fixed by open reduction plate through the posterior axillary edge approach. There was no significant difference in baseline data between the two groups (P>0.05), such as gender, age, surgical side, Ideberg type, cause of injury, time from injury to operation, rotator cuff injury, and superior labrum anterior posterior (SLAP) injury, etc. The operation time and fracture healing time were recorded and compared between the two groups, and the shoulder pain was evaluated by visual analogue scale (VAS) score at 1 week, 1 month, and 3 months after operation. At 3 and 6 months after operation, the range of motion of shoulder joint in anteflexion, abduction, external rotation, internal rotation and backward extension was evaluated, the upper limb dysfunction was evaluated by the Disability Assessment Scale of Arm, Shoulder, and Hand (DASH), and the shoulder joint function was evaluated by the Constant-Murley Scale. The changes between 6 months and 3 months after operation were statistically analyzed. ResultsPatients in both groups were followed up 11-13 months, with an average of 12.5 months. The operation time and fracture healing time in the posterior axillary edge group were significantly shorter than those in the arthroscopic group (P<0.05). There was no complication such as wound infection, vascular and nerve injury, loss of reduction, bone nonunion, and glenohumeral instability in both groups. At 1 week after operation, the VAS score in the posterior axillary edge group was significantly higher than that in the arthroscopic group (P<0.05); there was no significant difference in the VAS score between the two groups at 1 and 3 months after operation (P>0.05). At 6 months after the operation, the changes of shoulder flexion, internal rotation range of motion and DASH scores in the posterior axillary edge group were significantly lower than those in the arthroscopic group (P<0.05), while the changes of abduction, external rotation, extension range of motion and Constant-Murley scores were not significantly different between the two groups (P>0.05). ConclusionFor Ideberg type Ⅰ and Ⅱ scapular glenoid fractures, the posterior axillary edge approach for internal fixation has a short operation time, fast fracture healing, and is beneficial for early functional recovery; arthroscopic assisted reduction has minimal trauma and can handle joint injuries simultaneously. Both surgical procedures are safe and effective, and individualized selection should be made based on soft tissue conditions and combined injuries.