Ternary hydrides, with their superior chemical and structural flexibility over binary systems, open up new avenues for advancing high-performance superconductor research. The Y-Ca-H system is a promising candidate for...Ternary hydrides, with their superior chemical and structural flexibility over binary systems, open up new avenues for advancing high-performance superconductor research. The Y-Ca-H system is a promising candidate for high-temperature superconductors, as both Im3m YH_(6) and Im3m CaH_(6) exhibit similar structures and excellent superconducting properties, while Y and Ca atoms possess close atomic radii and electronegativities.Here, we report the successful synthesis of Im3m(Y, Ca)H_(6) achieving a maximum superconducting transition temperature(T_(c)) approximately 224 K at 155 GPa through five independent high-temperature and high-pressure experiments. Remarkably, the T_(c) of Im3m(Y, Ca)H_(6) remains highly stable(ΔT_(c) ≤ 1 K) during decompression between 148 and 165 GPa, significantly outperforming binary Im3m CaH_(6) and Im3m YH_(6). The enhanced superconducting properties may stem from the cooperative chemical template effect of Y and Ca atoms near the s-d border, which significantly reinforces H lattice stability and thus maintains superior superconductivity.This study highlights the potential of multicomponent cooperative effects in designing hydride superconductors,offering new insights for achieving high-T_(c) hydrides at lower pressures in the future.展开更多
In this editorial,the authors of this paper comment on the article by Bokov et al published in the recent issue of World Journal of Orthopedics.We reviewed a general overview of oblique lumbar interbody fusions(OLIF)a...In this editorial,the authors of this paper comment on the article by Bokov et al published in the recent issue of World Journal of Orthopedics.We reviewed a general overview of oblique lumbar interbody fusions(OLIF)and lateral lumbar interbody fusions(LLIF),their indications and complications as an increasingly popular minimally invasive technique to address several lumbar pathologies.This editorial thoroughly discusses and reviews the literature regarding factors affecting outcomes of indirect decompression utilized through OLIF and LLIF procedures.Several parameters play a critical role in patient outcomes including restoration of disc height,foraminal height,central canal squared,and foraminal area.The indirect decompression allows for unbuckling of the ligamentum flavum which can significantly decompress the neural elements as well as aid in reduction of spondylolisthesis.However,the authors further highlight the limitations of indirect decompression and factors that may predict unsuccessful outcomes including bony foraminal stenosis,severe central canal stenosis,and osteoporosis.As a result,failure of indirect decompression can lead to persistent pain,radiculopathy and unsatisfied patients.Spinal surgeons may be left to reimage patients and consider additional procedures with direct decompression.展开更多
BACKGROUND Acute colonic pseudo-obstruction(ACPO)is defined as colonic obstruction without a mechanical or extrinsic inflammatory factor.Colonic decompression is advised for patients with ACPO after the failure of con...BACKGROUND Acute colonic pseudo-obstruction(ACPO)is defined as colonic obstruction without a mechanical or extrinsic inflammatory factor.Colonic decompression is advised for patients with ACPO after the failure of conservative and medical management.AIM To systematically review and analyze the efficacy and safety of colonoscopic decompression in ACPO.METHODS A search was conducted in MEDLINE,EMBASE,and Scopus from inception to August 2024.Studies reporting the clinical success,perforation,recurrence,and need for surgery after colonoscopic decompression in ACPO were included.A random-effects inverse-variance model was used to calculate the pooled proportion.RESULTS Sixteen studies were included in the final analysis.The pooled rates of success after the first session of colonoscopic decompression and overall success were 78.8%(95%CI:72.0-85.6)and 91.5%(95%CI:87.0-96.0),respectively.The first session of colonoscopic decompression had a significantly higher success than the first dose of neostigmine with OR 3.85(95%CI:2.00-7.42).The pooled incidence of perforation was 0.9%(95%CI:0.0-2.0),while recurrence was observed in 17.1%(95%CI:12.9-21.3)of the patients after clinical success.The pooled rates of surgery in all cases undergoing colonoscopic decompression and those who had a successful procedure were 10.5%(95%CI:5.0-15.9)and 3.7%(95%CI:0.3-7.1),respectively.Subgroup analysis,excluding the low-quality studies,did not significantly change the event rates.CONCLUSION Colonoscopic decompression for ACPO is associated with a clinical success rate of>90%with a perforation rate of<1%,demonstrating high efficacy and safety.展开更多
Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evalu...Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evaluates the efficacy of fully endoscopic MVD for dcTN and presents our early experience.Methods:This retrospective study included patients with dcTN who underwent fully endoscopic MVD in the Department of Neurosurgery,the First Affiliated Hospital,Zhejiang University School of Medicine from November 2020 to February 2023.We recorded basic patient clinical information,clinical outcomes,offending vessels,complications,and recurrences,and assessed outcomes via the Barrow Neurological Institute(BNI)pain intensity score and the numeric rating scale(NRS)score.Results:All 42 patients had dcTN with preoperative BNI scores of V and NRS scores of 8e10.Endoscopic visualization enabled the precise identification of neurovascular conflicts,including small and deeply located vessels.Immediately after surgery,90.5%of patients achieved complete pain relief(BNI score of I,NRS score of 0).At the final follow-up,85.7%of patients had complete pain relief.All patients’pain was significantly relieved at immediate after surgery(0 vs.9,p<0.001)and at the final follow-up(0 vs.9,p<0.001),with lower NRS scores.Complications,including vertigo,headache,and transient facial numbness,occurred in 14.4%of patients and were manageable.展开更多
Endoscopic transnasal optic nerve decompression surgery plays a crucial role in minimal invasive treatment of complex traumatic optic neuropathy.However,a major challenge faced during the procedure is the inability to...Endoscopic transnasal optic nerve decompression surgery plays a crucial role in minimal invasive treatment of complex traumatic optic neuropathy.However,a major challenge faced during the procedure is the inability to visualize the optic nerve intraoperatively.To address this issue,an endoscopic image-based augmented reality surgical navigation system is developed in this study.The system aims to virtually fuse the optic nerve onto the endoscopic images,assisting surgeons in determining the optic nerve’s position and reducing surgical risks.First,a calibration algorithm based on a checkerboard grid of immobile points is proposed,building upon existing calibration methods.Additionally,to tackle accuracy issues associated with augmented reality technology,an optical navigation and visual fusion compensation algorithm is proposed to improve the intraoperative tracking accuracy.To evaluate the system’s performance,model experiments were meticulously designed and conducted.The results confirm the accuracy and stability of the proposed system,with an average tracking error of(0.99±0.46)mm.This outcome demonstrates the effectiveness of the proposed algorithm in improving the augmented reality surgical navigation system’s accuracy.Furthermore,the system successfully displays hidden optic nerves and other deep tissues,thus showcasing the promising potential for future applications in orbital and maxillofacial surgery.展开更多
Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to...Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.展开更多
目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯...目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯减压联合治疗早中期股骨头坏死的随机对照试验。采用Cochrane偏倚风险评估工具对文献质量进行评价,运用GRADE系统评价证据等级,基于贝叶斯框架构建网状Meta分析模型。采用标准化均数差进行效应估计,结果以累积排序概率曲线下面积进行干预优效性排序。敏感性分析采用逐项剔除法评估模型稳健性,并通过基线协变量评估传递性假设。结果:最终纳入73项随机对照试验,共计5148例患者、5777个髋关节,涵盖15种联合治疗方法。结果显示:①在提高综合临床疗效方面,髓芯减压联合自体骨髓单核细胞浓缩注射、骨髓间充质干细胞移植、支撑性植骨及补肾活血类中药复方汤剂等均优于单纯髓芯减压,其中髓芯减压联合自体骨髓单核细胞浓缩注射显示出最优的干预效果(累积排序概率曲线下面积=96.23%);②在髋关节功能改善方面,髓芯减压联合中医药序贯治疗疗效最优(累积排序概率曲线下面积=93.85%);③在疼痛缓解方面,髓芯减压联合中成药(补肾活血+活血化瘀)与活血化瘀类中药复方汤剂效果突出;④在影像学改善方面,髓芯减压联合自体源性干细胞局部植入效果最佳(累积排序概率曲线下面积=82.56%);⑤在临床安全性方面,髓芯减压联合活血化瘀类中药复方汤剂在降低不良事件发生率方面具有相对优势(P<0.05)。为评估结果稳健性,采用逐项剔除法进行敏感性分析,显示模型稳定,主要干预结果对单项研究不敏感,传递性假设成立。结论:髓芯减压联合干细胞移植、中医药序贯治疗等多种治疗方案在改善早中期股骨头坏死临床疗效方面优于单纯髓芯减压,表现为关节功能保护、结构重建与疼痛控制等多重优势。考虑部分干预文献数量有限及研究质量差异,仍需高质量、多中心、大样本随机对照试验进一步验证。展开更多
[目的]比较ARCOⅠ~Ⅱ期股骨头坏死(osteonecrosis of the femoral head,ONFH)髓芯减压多孔生物活性陶瓷棒置入是否联合磷酸三钙颗粒植入的临床疗效。[方法]2021年9月—2022年9月于本院就诊的60例(87髋)ARCOⅠ~Ⅱ期ONFH患者纳入本研究,...[目的]比较ARCOⅠ~Ⅱ期股骨头坏死(osteonecrosis of the femoral head,ONFH)髓芯减压多孔生物活性陶瓷棒置入是否联合磷酸三钙颗粒植入的临床疗效。[方法]2021年9月—2022年9月于本院就诊的60例(87髋)ARCOⅠ~Ⅱ期ONFH患者纳入本研究,采用随机数字表法将患者分为两组,其中,30例在髓芯减压后联合植入磷酸三钙颗粒和陶瓷棒(复合组),另外30例在髓芯减压后单纯置入陶瓷棒(单纯组)。比较两组围手术期、随访和影像资料。[结果]两组均顺利手术,无感染等并发症。两组的手术时间、切口长度、住院天数差异无统计学意义(P>0.05),复合组的术中失血量[mL,(65.7±14.7)vs(76.6±14.7),P=0.005]、术后引流量[mL,(101.4±9.8)vs(112.6±10.4),P<0.001]显著少于单纯组,尽管复合组的平均术中透视次数显著多于单纯组(P<0.001)。两组患者术后随访24个月以上,复合组恢复完全负重时间显著早于单纯组[d,(114.8±20.4)vs(154.6±21.2),P<0.001]。两组患者的VAS评分、Harris评分、髋伸-屈ROM和髋内旋-外旋ROM均显著改善(P<0.05)。术后12、24个月时,复合组的VAS、Harris评分和内旋-外旋ROM均显著优于单纯组(P<0.05),但两组伸-屈ROM的差异没有统计学意义(P>0.05)。截至末次随访,两组均无患者接受翻修THA。影像方面,随时间推移,两组ARCO分级、病灶面积、关节积液征像、股骨头塌陷及Tönnis分期均显著改善(P<0.05)。术后24个月时复合组的ARCO分级、关节积液征像、股骨头塌陷及Tönnis分期均显著优于单纯组(P<0.05)。[结论]ARCOⅠ~Ⅱ期ONFH的治疗中磷酸三钙人工骨颗粒联合多孔生物活性陶瓷棒的临床结果优于单纯多孔生物活性陶瓷棒置入。展开更多
Background:Hemifacial spasm(HFS)is a neurological disorder characterized by involuntary facial muscle contractions,significantly impacting quality of life.This study aims to provide a comprehensive bibliometric analys...Background:Hemifacial spasm(HFS)is a neurological disorder characterized by involuntary facial muscle contractions,significantly impacting quality of life.This study aims to provide a comprehensive bibliometric analysis of global research trends,collaborations,and scientific contributions in the field of HFS,addressing publication patterns,influential authors and institutions,and prominent research topics from 1999 to 2024.Methods:We conducted a bibliometric analysis based on 1,884 publications retrieved from the Web of Science Core Collection using the keyword"Hemifacial Spasm."Data analysis and visualization were performed using Microsoft Excel,R/Bibliometrix,Scimago Graphica,VOSviewer,Pajek,and CiteSpace.Parameters assessed included publication trends,author collaborations,institutional contributions,core journals,citation metrics,and keyword clusters.Results:Among the analyzed publications,1,646 were original research articles,and 238 were reviews,involving 6,063 researchers and citing 25,252 references.The United States,China,and Japan were identified as leading contributing countries,with prominent institutions including Shanghai Jiao Tong University,Sungkyunkwan University,and the University of Pittsburgh.Top authors by publication count were Li Shiting,Park Kwan,and Zhong Jun,whereas Peter J.Jannetta,Albert R.Møller,and Janko Jankovic were most frequently cited.Core journals,identified via Bradford’s Law,included Acta Neurochirurgica,World Neurosurgery,and Journal of Neurosurgery.Keyword analysis highlighted focal research areas:"hemifacial spasm","microvascular decompression",and"trigeminal neuralgia".Conclusion:This bibliometric study provides critical insights into the evolution of research on HFS,highlighting key contributors,institutional influence,and research hotspots.The findings underscore ongoing collaborative opportunities and essential areas for future research exploration.展开更多
基金supported by the National Key R&D Program of China (Grant No.2022YFA1405500)the National Natural Science Foundation of China (Grant No.52372257)。
文摘Ternary hydrides, with their superior chemical and structural flexibility over binary systems, open up new avenues for advancing high-performance superconductor research. The Y-Ca-H system is a promising candidate for high-temperature superconductors, as both Im3m YH_(6) and Im3m CaH_(6) exhibit similar structures and excellent superconducting properties, while Y and Ca atoms possess close atomic radii and electronegativities.Here, we report the successful synthesis of Im3m(Y, Ca)H_(6) achieving a maximum superconducting transition temperature(T_(c)) approximately 224 K at 155 GPa through five independent high-temperature and high-pressure experiments. Remarkably, the T_(c) of Im3m(Y, Ca)H_(6) remains highly stable(ΔT_(c) ≤ 1 K) during decompression between 148 and 165 GPa, significantly outperforming binary Im3m CaH_(6) and Im3m YH_(6). The enhanced superconducting properties may stem from the cooperative chemical template effect of Y and Ca atoms near the s-d border, which significantly reinforces H lattice stability and thus maintains superior superconductivity.This study highlights the potential of multicomponent cooperative effects in designing hydride superconductors,offering new insights for achieving high-T_(c) hydrides at lower pressures in the future.
文摘In this editorial,the authors of this paper comment on the article by Bokov et al published in the recent issue of World Journal of Orthopedics.We reviewed a general overview of oblique lumbar interbody fusions(OLIF)and lateral lumbar interbody fusions(LLIF),their indications and complications as an increasingly popular minimally invasive technique to address several lumbar pathologies.This editorial thoroughly discusses and reviews the literature regarding factors affecting outcomes of indirect decompression utilized through OLIF and LLIF procedures.Several parameters play a critical role in patient outcomes including restoration of disc height,foraminal height,central canal squared,and foraminal area.The indirect decompression allows for unbuckling of the ligamentum flavum which can significantly decompress the neural elements as well as aid in reduction of spondylolisthesis.However,the authors further highlight the limitations of indirect decompression and factors that may predict unsuccessful outcomes including bony foraminal stenosis,severe central canal stenosis,and osteoporosis.As a result,failure of indirect decompression can lead to persistent pain,radiculopathy and unsatisfied patients.Spinal surgeons may be left to reimage patients and consider additional procedures with direct decompression.
文摘BACKGROUND Acute colonic pseudo-obstruction(ACPO)is defined as colonic obstruction without a mechanical or extrinsic inflammatory factor.Colonic decompression is advised for patients with ACPO after the failure of conservative and medical management.AIM To systematically review and analyze the efficacy and safety of colonoscopic decompression in ACPO.METHODS A search was conducted in MEDLINE,EMBASE,and Scopus from inception to August 2024.Studies reporting the clinical success,perforation,recurrence,and need for surgery after colonoscopic decompression in ACPO were included.A random-effects inverse-variance model was used to calculate the pooled proportion.RESULTS Sixteen studies were included in the final analysis.The pooled rates of success after the first session of colonoscopic decompression and overall success were 78.8%(95%CI:72.0-85.6)and 91.5%(95%CI:87.0-96.0),respectively.The first session of colonoscopic decompression had a significantly higher success than the first dose of neostigmine with OR 3.85(95%CI:2.00-7.42).The pooled incidence of perforation was 0.9%(95%CI:0.0-2.0),while recurrence was observed in 17.1%(95%CI:12.9-21.3)of the patients after clinical success.The pooled rates of surgery in all cases undergoing colonoscopic decompression and those who had a successful procedure were 10.5%(95%CI:5.0-15.9)and 3.7%(95%CI:0.3-7.1),respectively.Subgroup analysis,excluding the low-quality studies,did not significantly change the event rates.CONCLUSION Colonoscopic decompression for ACPO is associated with a clinical success rate of>90%with a perforation rate of<1%,demonstrating high efficacy and safety.
基金supported by financial assistance from the Zhejiang Provincial Natural Science Foundation of China under Grant No.LY18H160020.
文摘Objective:Microvascular decompression(MVD)is the gold standard for treating drug-resistant classic trigeminal neuralgia(dcTN),with endoscopy enhancing surgical precision through improved visualization.This study evaluates the efficacy of fully endoscopic MVD for dcTN and presents our early experience.Methods:This retrospective study included patients with dcTN who underwent fully endoscopic MVD in the Department of Neurosurgery,the First Affiliated Hospital,Zhejiang University School of Medicine from November 2020 to February 2023.We recorded basic patient clinical information,clinical outcomes,offending vessels,complications,and recurrences,and assessed outcomes via the Barrow Neurological Institute(BNI)pain intensity score and the numeric rating scale(NRS)score.Results:All 42 patients had dcTN with preoperative BNI scores of V and NRS scores of 8e10.Endoscopic visualization enabled the precise identification of neurovascular conflicts,including small and deeply located vessels.Immediately after surgery,90.5%of patients achieved complete pain relief(BNI score of I,NRS score of 0).At the final follow-up,85.7%of patients had complete pain relief.All patients’pain was significantly relieved at immediate after surgery(0 vs.9,p<0.001)and at the final follow-up(0 vs.9,p<0.001),with lower NRS scores.Complications,including vertigo,headache,and transient facial numbness,occurred in 14.4%of patients and were manageable.
基金the National Natural Science Foundation of China(Nos.82330063 and M-0019)the Interdisciplinary Program of Shanghai Jiao Tong University(Nos.YG2022QN056,YG2023ZD19,and YG2023ZD15)+2 种基金the Cross Disciplinary Research Fund of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(No.JYJC202115)the Translation Clinical R&D Project of Medical Robot of Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine(No.IMR-NPH202002)the Shanghai Key Clinical Specialty,Shanghai Eye Disease Research Center(No.2022ZZ01003)。
文摘Endoscopic transnasal optic nerve decompression surgery plays a crucial role in minimal invasive treatment of complex traumatic optic neuropathy.However,a major challenge faced during the procedure is the inability to visualize the optic nerve intraoperatively.To address this issue,an endoscopic image-based augmented reality surgical navigation system is developed in this study.The system aims to virtually fuse the optic nerve onto the endoscopic images,assisting surgeons in determining the optic nerve’s position and reducing surgical risks.First,a calibration algorithm based on a checkerboard grid of immobile points is proposed,building upon existing calibration methods.Additionally,to tackle accuracy issues associated with augmented reality technology,an optical navigation and visual fusion compensation algorithm is proposed to improve the intraoperative tracking accuracy.To evaluate the system’s performance,model experiments were meticulously designed and conducted.The results confirm the accuracy and stability of the proposed system,with an average tracking error of(0.99±0.46)mm.This outcome demonstrates the effectiveness of the proposed algorithm in improving the augmented reality surgical navigation system’s accuracy.Furthermore,the system successfully displays hidden optic nerves and other deep tissues,thus showcasing the promising potential for future applications in orbital and maxillofacial surgery.
文摘Objective: Thorough, prompt enteral decompression technique without contamination was de- veloped to ensure safety for emergent colon resection and primary anastomosis. Methods: After isolating the mesentery, the “to be resected colon segment” was cut at its lower end, then the proximal cut end was put into a plastic bag which was adhered to one side of the operating table. After releasing the clamp, the content could ?ow into this bag. The operator could squeeze the bowel with two hands by turns, from proximal to farness, and from small bowel to large bowel, until the entire bowel content was fully discharged. Then the upper end of this “to be resected colon segment” was cut, and was removed together with the plastic bag. Results: 31 cases of left colon cancer with acute obstruction were decompressed with this technique. They all recovered smoothly, without anastomosis ?stula. Another 6 cases of hepatic seg- mentectomy with incidental colonectomy were decompressed with this technique and had the same results. This technique was also used in di?erent kinds of acute small intestinal obstruction and gained satisfactory results. Conclusion: This technique could be considered as the preferable choice for intraoperative enteral decompression.
文摘目的:探讨髓芯减压联合不同治疗策略对早中期股骨头坏死患者的疗效及安全性评价。方法:系统检索PubMed、Web of Science、Cochrane Library、EMbase、中国知网、维普、万方和中国生物医学文献数据库,纳入截至2025-01-19发表的关于髓芯减压联合治疗早中期股骨头坏死的随机对照试验。采用Cochrane偏倚风险评估工具对文献质量进行评价,运用GRADE系统评价证据等级,基于贝叶斯框架构建网状Meta分析模型。采用标准化均数差进行效应估计,结果以累积排序概率曲线下面积进行干预优效性排序。敏感性分析采用逐项剔除法评估模型稳健性,并通过基线协变量评估传递性假设。结果:最终纳入73项随机对照试验,共计5148例患者、5777个髋关节,涵盖15种联合治疗方法。结果显示:①在提高综合临床疗效方面,髓芯减压联合自体骨髓单核细胞浓缩注射、骨髓间充质干细胞移植、支撑性植骨及补肾活血类中药复方汤剂等均优于单纯髓芯减压,其中髓芯减压联合自体骨髓单核细胞浓缩注射显示出最优的干预效果(累积排序概率曲线下面积=96.23%);②在髋关节功能改善方面,髓芯减压联合中医药序贯治疗疗效最优(累积排序概率曲线下面积=93.85%);③在疼痛缓解方面,髓芯减压联合中成药(补肾活血+活血化瘀)与活血化瘀类中药复方汤剂效果突出;④在影像学改善方面,髓芯减压联合自体源性干细胞局部植入效果最佳(累积排序概率曲线下面积=82.56%);⑤在临床安全性方面,髓芯减压联合活血化瘀类中药复方汤剂在降低不良事件发生率方面具有相对优势(P<0.05)。为评估结果稳健性,采用逐项剔除法进行敏感性分析,显示模型稳定,主要干预结果对单项研究不敏感,传递性假设成立。结论:髓芯减压联合干细胞移植、中医药序贯治疗等多种治疗方案在改善早中期股骨头坏死临床疗效方面优于单纯髓芯减压,表现为关节功能保护、结构重建与疼痛控制等多重优势。考虑部分干预文献数量有限及研究质量差异,仍需高质量、多中心、大样本随机对照试验进一步验证。
文摘[目的]比较ARCOⅠ~Ⅱ期股骨头坏死(osteonecrosis of the femoral head,ONFH)髓芯减压多孔生物活性陶瓷棒置入是否联合磷酸三钙颗粒植入的临床疗效。[方法]2021年9月—2022年9月于本院就诊的60例(87髋)ARCOⅠ~Ⅱ期ONFH患者纳入本研究,采用随机数字表法将患者分为两组,其中,30例在髓芯减压后联合植入磷酸三钙颗粒和陶瓷棒(复合组),另外30例在髓芯减压后单纯置入陶瓷棒(单纯组)。比较两组围手术期、随访和影像资料。[结果]两组均顺利手术,无感染等并发症。两组的手术时间、切口长度、住院天数差异无统计学意义(P>0.05),复合组的术中失血量[mL,(65.7±14.7)vs(76.6±14.7),P=0.005]、术后引流量[mL,(101.4±9.8)vs(112.6±10.4),P<0.001]显著少于单纯组,尽管复合组的平均术中透视次数显著多于单纯组(P<0.001)。两组患者术后随访24个月以上,复合组恢复完全负重时间显著早于单纯组[d,(114.8±20.4)vs(154.6±21.2),P<0.001]。两组患者的VAS评分、Harris评分、髋伸-屈ROM和髋内旋-外旋ROM均显著改善(P<0.05)。术后12、24个月时,复合组的VAS、Harris评分和内旋-外旋ROM均显著优于单纯组(P<0.05),但两组伸-屈ROM的差异没有统计学意义(P>0.05)。截至末次随访,两组均无患者接受翻修THA。影像方面,随时间推移,两组ARCO分级、病灶面积、关节积液征像、股骨头塌陷及Tönnis分期均显著改善(P<0.05)。术后24个月时复合组的ARCO分级、关节积液征像、股骨头塌陷及Tönnis分期均显著优于单纯组(P<0.05)。[结论]ARCOⅠ~Ⅱ期ONFH的治疗中磷酸三钙人工骨颗粒联合多孔生物活性陶瓷棒的临床结果优于单纯多孔生物活性陶瓷棒置入。
基金supported by grants from the National Natural Science Foundation of China(No.82271426).
文摘Background:Hemifacial spasm(HFS)is a neurological disorder characterized by involuntary facial muscle contractions,significantly impacting quality of life.This study aims to provide a comprehensive bibliometric analysis of global research trends,collaborations,and scientific contributions in the field of HFS,addressing publication patterns,influential authors and institutions,and prominent research topics from 1999 to 2024.Methods:We conducted a bibliometric analysis based on 1,884 publications retrieved from the Web of Science Core Collection using the keyword"Hemifacial Spasm."Data analysis and visualization were performed using Microsoft Excel,R/Bibliometrix,Scimago Graphica,VOSviewer,Pajek,and CiteSpace.Parameters assessed included publication trends,author collaborations,institutional contributions,core journals,citation metrics,and keyword clusters.Results:Among the analyzed publications,1,646 were original research articles,and 238 were reviews,involving 6,063 researchers and citing 25,252 references.The United States,China,and Japan were identified as leading contributing countries,with prominent institutions including Shanghai Jiao Tong University,Sungkyunkwan University,and the University of Pittsburgh.Top authors by publication count were Li Shiting,Park Kwan,and Zhong Jun,whereas Peter J.Jannetta,Albert R.Møller,and Janko Jankovic were most frequently cited.Core journals,identified via Bradford’s Law,included Acta Neurochirurgica,World Neurosurgery,and Journal of Neurosurgery.Keyword analysis highlighted focal research areas:"hemifacial spasm","microvascular decompression",and"trigeminal neuralgia".Conclusion:This bibliometric study provides critical insights into the evolution of research on HFS,highlighting key contributors,institutional influence,and research hotspots.The findings underscore ongoing collaborative opportunities and essential areas for future research exploration.
