Dear Editor,We present a case of acute Bacillus cereus(B.cereus)endophthalmitis in a patient with an intraocular perforation injury combined with occult intravitreal cilium implantation.B.cereus endophthalmitis is a s...Dear Editor,We present a case of acute Bacillus cereus(B.cereus)endophthalmitis in a patient with an intraocular perforation injury combined with occult intravitreal cilium implantation.B.cereus endophthalmitis is a severe intraocular infection commonly caused by post-traumatic injuries.It often leads to significant vision loss or even eye loss within 12-48h[1].The presence of an intraocular foreign body(IOFB)increases the risk of infection,while early surgical removal of IOFBs can prevent endophthalmitis,some IOFBs are difficult to detect preoperatively.The Medical Ethics Review Board of West China Hospital of Sichuan University waived application for a clinical study because this was a retrospective report of a single patient based on imaging and because no human experimentation was involved.The patient provided written informed consent to use the imaging data for publication.展开更多
BACKGROUNDOsteofbrous dysplasia （OFD） is a developmental ske-letal disorder, and cases with a giant affected area in the pelvis are rare.CASE SUMMARYIn this case report, a 48-year-old man presented with a large tumo...BACKGROUNDOsteofbrous dysplasia （OFD） is a developmental ske-letal disorder, and cases with a giant affected area in the pelvis are rare.CASE SUMMARYIn this case report, a 48-year-old man presented with a large tumor in the right iliac region that turned out to be OFD. The patient had rebound tenderness in his right hip. After radiography examination, magnetic resonance imaging examinations and some physical examination, extensive bone destruction in the right ilium was confirmed. Moreover, changes in bone mi-neral density and peripheral cortical bone sclerosis with surrounding soft tissue swelling were observed. Thus, this patient was considered to have giant monostoticOFD of the ilium. The tumor-related area was removed completely by surgery, and the remaining cavity was filled by artificial bones from the opposite ilium. According to the results of follow-up, the patient had normal fexion and extension activities of the right hip joint, and there was no evidence of recurrence of the tumor.CONCLUSION Suture of iliopsoas and gluteus medius muscle following focus curettage and bone grafting is a promising and effective method to treat giant OFD of the ilium. It is a feasible way to fll a large cavity after removing a lesion like the one is this case.展开更多
目的探讨扩髓-灌注-吸引(reamer-irrigator-aspirator,RIA)技术取骨用于成人下肢长骨非感染性骨不连翻修的安全性和有效性。方法回顾性分析2021年1月至2024年6月于郑州市骨科医院手术治疗的42例成人下肢长骨非感染性骨不连患者的资料,...目的探讨扩髓-灌注-吸引(reamer-irrigator-aspirator,RIA)技术取骨用于成人下肢长骨非感染性骨不连翻修的安全性和有效性。方法回顾性分析2021年1月至2024年6月于郑州市骨科医院手术治疗的42例成人下肢长骨非感染性骨不连患者的资料,男33例、女9例,年龄(47.0±14.4)岁(范围18~62岁),左侧23例、右侧19例。首次手术采用钢板固定19例、髓内钉16例、外固定支架5例、钢板联合髓内钉2例。骨不连均采用断端新鲜化、内固定调整及自体骨植骨治疗,19例采用RIA取骨植骨术(RIA组)、23例采用髂骨植骨术(髂骨组)。比较两组患者的性别、年龄、身高、体重、体质指数、术前合并疾病、骨不连部位、初次手术至翻修时间、手术时间、术中出血量、是否输血、输血量、围手术期并发症、胫骨或股骨骨不连及骨折部位疼痛视觉模拟评分(visual analogue scale,VAS)、供区外观形态功能评分及胫骨骨折影像学愈合评分系统(radiographic union score for tibia,RUST)的差异。结果RIA组与髂骨组患者性别、年龄、身高、体重、体质指数的差异均无统计学意义(P>0.05)。RIA组较髂骨组的术中出血量多[800(700,900)ml和300(150,720)ml,Z=-3.072,P=0.002]、输血率高[73.7%(14/19)和34.8%(8/23),χ^(2)=6.313,P=0.012],差异均有统计学意义。RIA组与髂骨组取骨量[分别为40(35,60)cm^(3)和40(35,40)cm^(3),Z=-1.077,P=0.281]的差异无统计学意义。所有患者均获得随访,随访时间(16.5±2.8)个月(范围7~40个月)。RIA组与髂骨组骨折部位术后3个月VAS[分别为(3.2±1.0)分和(3.3±1.4)分,t=4.754,P=0.720]、术后6个月VAS[分别为(1.6±0.8)分和(1.8±1.2)分,t=6.841,P=0.542],差异均无统计学意义;RIA组供区外观形态功能评分术后3、6个月分别为14.5(13.0,15.5)分和15.5(15.0,16.0)分,均高于髂骨组的9.0(7.0,10.0)分和11.0(10.0,13.0)分,组间差异均有统计学意义(Z=-3.748,P<0.001;Z=-3.782,P<0.001);RIA组与髂骨组术后12个月时RUST评分分别为(10.6±1.2)分和(10.4±1.5)分,差异无统计学意义(t=0.483,P=0.632)。RIA组与髂骨组围手术期并发症发生率[42%(8/19)和30%(7/23),χ^(2)=0.617,P=0.432]的差异无统计学意义。结论RIA技术和髂骨植骨应用于成人下肢长骨非感染性骨不连翻修均可取得较好的临床效果,整体并发症发生率、骨愈合能力无明显差异。RIA技术的术中出血量大,但对供区外观形态的影响较小。展开更多
Background：Many clinical studies have been published involving the use of a high hip center （HHC）,achieved good follow-up.However,there is a little anatomic guidance in the literature regarding the amount of bone s...Background：Many clinical studies have been published involving the use of a high hip center （HHC）,achieved good follow-up.However,there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium.The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC.Methods：A total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study.After importing the data to the mimics software,we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis,then we measured the thickness and width of the ilium for each cross section in axial plane,calculated the cup coverage at each chosen section.Results：At the acetabular dome,the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm,respectively,whereas at 1 cm above the dome,decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively,and 2 cm above the dome,decreased to 31.25 ± 4.04 and 26.65 ± 3.43,respectively.Acetabular cup averaged coverage for 40-,50-,and 60-mm hemispheric shells,was 100%,89%,and 44% at the acetabular dome,100%,43.7%,and 27.5% for 1 cm above the dome,and 37.5%,21.9%,and 14.2% for 2 cm above the dome.Conclusions：HHC reconstructions within 1cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better.展开更多
Primary cilium,which protrudes from the cell,is a microtubule-based structure ensheathed by a highly specialized plasma membrane(PM).It serves as a signaling hub for sensing and transducing various external stimuli in...Primary cilium,which protrudes from the cell,is a microtubule-based structure ensheathed by a highly specialized plasma membrane(PM).It serves as a signaling hub for sensing and transducing various external stimuli including fluids,light,odorants as well as extracellular molecules.Of various signal transduction pathways that act through the primary cilium,the Hedgehog(Hh)pathway draws the most attention owing to its essential role in vertebrate development and its intimate link to carcinogenesis(Bangs and Anderson,2017).The major components of the Hh pathway include the secreted ligand Hh,two transmembrane proteins Patched(Ptch)and Smoothened(Smo),and the transcription factor glioma-associated oncogene(Gli).Ptch is the receptor for Hh which,in the absence of Hh,resides at the primary cilium and prevents ciliary localization and activation of Smo.Upon Hh binding,however,Ptch is suppressed and displaced from the ciliary membrane.This permits Smo to enter the primary cilium and initiate a cascade of events that lead to the activation of Gli transcription factors and transcription of downstream target genes.展开更多
BACKGROUND The appendix vermiformis is a part of the gastrointestinal tract,situated in the lower right quadrant of the abdomen.Acute appendicitis,acute inflammation of the appendix vermiformis,is the most common caus...BACKGROUND The appendix vermiformis is a part of the gastrointestinal tract,situated in the lower right quadrant of the abdomen.Acute appendicitis,acute inflammation of the appendix vermiformis,is the most common cause of acute abdomen requiring surgical intervention.Although computed tomography(CT)offers high diagnostic efficacy in assessing the appendix across various anatomical positions,it also involves radiation exposure.Reducing exposure factors and narrowing the field of view(FOV)are ways to decrease the radiation dose to the patient.To narrow the FOV,appendix locations within the population must be defined using metric markers.AIM To determine the location of the appendix vermiformis on CT using the vertebrae and the right iliac bone as anatomical landmarks.METHODS This retrospective study examined 470 patients presenting with abdominal pain who underwent abdominal CT scans between January 01,2015 and January 01,2018.Forty-three patients were excluded due to various reasons.The most superior and inferior points and the origin of the appendix were measured separately in relation to the vertebrae and right iliac bone for localization.The population was divided into normal and acute appendicitis groups,and the relationship between appendix location and anthropometric parameters relationship was examined.P values below 0.05 were considered statistically significant.RESULTS The final analysis included 427 adult patients(206 females and 221 males)with a mean age of 42.1±19.5 years.An ascending appendix course was the most common(90.4%).The appendix ranged from the L2 vertebral body level to the coccygeal vertebral level relative to the vertebrae.The appendix ranged between(−)140.5 mm and(+)87.4 mm relative to the right iliac bone.A negative correlation was found between patient age,height,body mass index,and the highest and lowest points of the appendix in regard to the vertebrae.CONCLUSION The study’s findings unveiled the locations of the appendix in the population in relation to the bony anatomical landmarks.These data can be used as the basis for future research aimed at reducing patient exposure to ionizing radiation.展开更多
文摘Dear Editor,We present a case of acute Bacillus cereus(B.cereus)endophthalmitis in a patient with an intraocular perforation injury combined with occult intravitreal cilium implantation.B.cereus endophthalmitis is a severe intraocular infection commonly caused by post-traumatic injuries.It often leads to significant vision loss or even eye loss within 12-48h[1].The presence of an intraocular foreign body(IOFB)increases the risk of infection,while early surgical removal of IOFBs can prevent endophthalmitis,some IOFBs are difficult to detect preoperatively.The Medical Ethics Review Board of West China Hospital of Sichuan University waived application for a clinical study because this was a retrospective report of a single patient based on imaging and because no human experimentation was involved.The patient provided written informed consent to use the imaging data for publication.
文摘BACKGROUNDOsteofbrous dysplasia （OFD） is a developmental ske-letal disorder, and cases with a giant affected area in the pelvis are rare.CASE SUMMARYIn this case report, a 48-year-old man presented with a large tumor in the right iliac region that turned out to be OFD. The patient had rebound tenderness in his right hip. After radiography examination, magnetic resonance imaging examinations and some physical examination, extensive bone destruction in the right ilium was confirmed. Moreover, changes in bone mi-neral density and peripheral cortical bone sclerosis with surrounding soft tissue swelling were observed. Thus, this patient was considered to have giant monostoticOFD of the ilium. The tumor-related area was removed completely by surgery, and the remaining cavity was filled by artificial bones from the opposite ilium. According to the results of follow-up, the patient had normal fexion and extension activities of the right hip joint, and there was no evidence of recurrence of the tumor.CONCLUSION Suture of iliopsoas and gluteus medius muscle following focus curettage and bone grafting is a promising and effective method to treat giant OFD of the ilium. It is a feasible way to fll a large cavity after removing a lesion like the one is this case.
文摘目的探讨扩髓-灌注-吸引(reamer-irrigator-aspirator,RIA)技术取骨用于成人下肢长骨非感染性骨不连翻修的安全性和有效性。方法回顾性分析2021年1月至2024年6月于郑州市骨科医院手术治疗的42例成人下肢长骨非感染性骨不连患者的资料,男33例、女9例,年龄(47.0±14.4)岁(范围18~62岁),左侧23例、右侧19例。首次手术采用钢板固定19例、髓内钉16例、外固定支架5例、钢板联合髓内钉2例。骨不连均采用断端新鲜化、内固定调整及自体骨植骨治疗,19例采用RIA取骨植骨术(RIA组)、23例采用髂骨植骨术(髂骨组)。比较两组患者的性别、年龄、身高、体重、体质指数、术前合并疾病、骨不连部位、初次手术至翻修时间、手术时间、术中出血量、是否输血、输血量、围手术期并发症、胫骨或股骨骨不连及骨折部位疼痛视觉模拟评分(visual analogue scale,VAS)、供区外观形态功能评分及胫骨骨折影像学愈合评分系统(radiographic union score for tibia,RUST)的差异。结果RIA组与髂骨组患者性别、年龄、身高、体重、体质指数的差异均无统计学意义(P>0.05)。RIA组较髂骨组的术中出血量多[800(700,900)ml和300(150,720)ml,Z=-3.072,P=0.002]、输血率高[73.7%(14/19)和34.8%(8/23),χ^(2)=6.313,P=0.012],差异均有统计学意义。RIA组与髂骨组取骨量[分别为40(35,60)cm^(3)和40(35,40)cm^(3),Z=-1.077,P=0.281]的差异无统计学意义。所有患者均获得随访,随访时间(16.5±2.8)个月(范围7~40个月)。RIA组与髂骨组骨折部位术后3个月VAS[分别为(3.2±1.0)分和(3.3±1.4)分,t=4.754,P=0.720]、术后6个月VAS[分别为(1.6±0.8)分和(1.8±1.2)分,t=6.841,P=0.542],差异均无统计学意义;RIA组供区外观形态功能评分术后3、6个月分别为14.5(13.0,15.5)分和15.5(15.0,16.0)分,均高于髂骨组的9.0(7.0,10.0)分和11.0(10.0,13.0)分,组间差异均有统计学意义(Z=-3.748,P<0.001;Z=-3.782,P<0.001);RIA组与髂骨组术后12个月时RUST评分分别为(10.6±1.2)分和(10.4±1.5)分,差异无统计学意义(t=0.483,P=0.632)。RIA组与髂骨组围手术期并发症发生率[42%(8/19)和30%(7/23),χ^(2)=0.617,P=0.432]的差异无统计学意义。结论RIA技术和髂骨植骨应用于成人下肢长骨非感染性骨不连翻修均可取得较好的临床效果,整体并发症发生率、骨愈合能力无明显差异。RIA技术的术中出血量大,但对供区外观形态的影响较小。
文摘Background：Many clinical studies have been published involving the use of a high hip center （HHC）,achieved good follow-up.However,there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium.The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC.Methods：A total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study.After importing the data to the mimics software,we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis,then we measured the thickness and width of the ilium for each cross section in axial plane,calculated the cup coverage at each chosen section.Results：At the acetabular dome,the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm,respectively,whereas at 1 cm above the dome,decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively,and 2 cm above the dome,decreased to 31.25 ± 4.04 and 26.65 ± 3.43,respectively.Acetabular cup averaged coverage for 40-,50-,and 60-mm hemispheric shells,was 100%,89%,and 44% at the acetabular dome,100%,43.7%,and 27.5% for 1 cm above the dome,and 37.5%,21.9%,and 14.2% for 2 cm above the dome.Conclusions：HHC reconstructions within 1cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better.
基金the National Natural Science Foundation of China(31771568,32021003 and 91954203)the Ministry of Science and Technology of China(2016YFA0500100).
文摘Primary cilium,which protrudes from the cell,is a microtubule-based structure ensheathed by a highly specialized plasma membrane(PM).It serves as a signaling hub for sensing and transducing various external stimuli including fluids,light,odorants as well as extracellular molecules.Of various signal transduction pathways that act through the primary cilium,the Hedgehog(Hh)pathway draws the most attention owing to its essential role in vertebrate development and its intimate link to carcinogenesis(Bangs and Anderson,2017).The major components of the Hh pathway include the secreted ligand Hh,two transmembrane proteins Patched(Ptch)and Smoothened(Smo),and the transcription factor glioma-associated oncogene(Gli).Ptch is the receptor for Hh which,in the absence of Hh,resides at the primary cilium and prevents ciliary localization and activation of Smo.Upon Hh binding,however,Ptch is suppressed and displaced from the ciliary membrane.This permits Smo to enter the primary cilium and initiate a cascade of events that lead to the activation of Gli transcription factors and transcription of downstream target genes.
文摘BACKGROUND The appendix vermiformis is a part of the gastrointestinal tract,situated in the lower right quadrant of the abdomen.Acute appendicitis,acute inflammation of the appendix vermiformis,is the most common cause of acute abdomen requiring surgical intervention.Although computed tomography(CT)offers high diagnostic efficacy in assessing the appendix across various anatomical positions,it also involves radiation exposure.Reducing exposure factors and narrowing the field of view(FOV)are ways to decrease the radiation dose to the patient.To narrow the FOV,appendix locations within the population must be defined using metric markers.AIM To determine the location of the appendix vermiformis on CT using the vertebrae and the right iliac bone as anatomical landmarks.METHODS This retrospective study examined 470 patients presenting with abdominal pain who underwent abdominal CT scans between January 01,2015 and January 01,2018.Forty-three patients were excluded due to various reasons.The most superior and inferior points and the origin of the appendix were measured separately in relation to the vertebrae and right iliac bone for localization.The population was divided into normal and acute appendicitis groups,and the relationship between appendix location and anthropometric parameters relationship was examined.P values below 0.05 were considered statistically significant.RESULTS The final analysis included 427 adult patients(206 females and 221 males)with a mean age of 42.1±19.5 years.An ascending appendix course was the most common(90.4%).The appendix ranged from the L2 vertebral body level to the coccygeal vertebral level relative to the vertebrae.The appendix ranged between(−)140.5 mm and(+)87.4 mm relative to the right iliac bone.A negative correlation was found between patient age,height,body mass index,and the highest and lowest points of the appendix in regard to the vertebrae.CONCLUSION The study’s findings unveiled the locations of the appendix in the population in relation to the bony anatomical landmarks.These data can be used as the basis for future research aimed at reducing patient exposure to ionizing radiation.
