Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance....Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.展开更多
An experimental animal model of malignant soft-tissue tumor was established to investigate the applied value of multi-slice spiral CT perfusion imaging preliminarily. Ten New Zealand white rabbits which were implanted...An experimental animal model of malignant soft-tissue tumor was established to investigate the applied value of multi-slice spiral CT perfusion imaging preliminarily. Ten New Zealand white rabbits which were implanted with VX2 tumor in either proximal thigh were subjected to CT plain scan and perfusion scan two weeks later respectively, then the original perfusion images were transmitted to AW4.0 Workstation. The functional maps and perfusion parameters including blood flow （BF）, blood volume （BV）, mean transit time （MTT） and permeability surface （PS） were computed and analyzed. All the values of BF, BV and PS in VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those in the normal muscular tissues significantly. It was suggested that multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, and can give a quantitative assessment to angiogenesis and blood perfusion of soft-tissue tumors.展开更多
Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate be...Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.展开更多
The glenohumeral joint(GHJ)allows for a wide range of motion,but is also particularly vulnerable to episodes of instability.Anterior GHJ instability is especially frequent among young,athletic populations during conta...The glenohumeral joint(GHJ)allows for a wide range of motion,but is also particularly vulnerable to episodes of instability.Anterior GHJ instability is especially frequent among young,athletic populations during contact sporting events.Many first time dislocators can be managed non-operatively with a period of immobilization and rehabilitation,however certain patient populations are at higher risk for recurrent instability and may require surgical intervention for adequate stabilization.Determination of the optimal treatment strategy should be made on a case-by-case basis while weighing both patient specific factors and injury patterns(i.e.,bone loss).The purpose of this review is to describe the relevant anatomical stabilizers of the GHJ,risk factors for recurrent instability including bony lesions,indications for arthroscopic vs open surgical management,clinical history and physical examination techniques,imaging modalities,and pearls/pitfalls of arthroscopic soft-tissue stabilization for anterior glenohumeral instability.展开更多
Objective： We enrolled retrospective data to determine the efficacy of combined chemotherapy and surgery for local tumour control and survival in patients with high-risk soft-tissue sarcomas. Methods： We collected d...Objective： We enrolled retrospective data to determine the efficacy of combined chemotherapy and surgery for local tumour control and survival in patients with high-risk soft-tissue sarcomas. Methods： We collected data from 25 patients with high-risk soft-tissue sarcomas treated with four cycles of etoposide, ifosfamide and doxorubicin （EIA） followed by definitive surgery with or without postoperative radiotherapy and adjuvant chemotherapy. 21 patients received chemotherapy in a neoadjuvant/adjuvant clinical setting; eighteen of them completed adjuvant chemotherapy. Four patients received chemotherapy in an adjuvant setting only. Results： The objective response rate of neoadjuvant chemotherapy assessable in 21 patients was 43%. Including NED （n=7） and partial remissions （n=3）, the radiographic response rate was 47.6% with additional 42.9% stable diseases （n=9）. Surgery was performed in two patients before completing four neoadjuvant chemotherapy cycles because of disease progression. Median overall survival for all patients was 21.6＋ months. After completion of chemotherapy, in 62% of patients R0-resection could be performed. Conclusion： High proportion of R0-resections supports the idea of tumour down-staging after neoadjuvant treatment. Response to neoadjuvant chemotherapy is predictive for improved local tumour control resulting in long-term survival benefit.展开更多
Objective: To perform a contrast investigation of multi-slice spiral CT (MSCT) perfusion imaging and pathological findings in VX2 soft-tissue tumor of rabbits, and discuss the applicative value of multi-slice spiral C...Objective: To perform a contrast investigation of multi-slice spiral CT (MSCT) perfusion imaging and pathological findings in VX2 soft-tissue tumor of rabbits, and discuss the applicative value of multi-slice spiral CT perfusion imaging in soft-tissue tumors. Methods: 8 Newzealand white rabbits were implanted with 0.1 ml VX2 tumor tissue suspension in bilateral proximal thighs. 14 days and 21 days later, CT plain scan and perfusion scan were performed on these rabbits respectively, then the images were transmitted to AW4.0 workstation, the functional maps and perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS) were computed and analyzed. Subsequently, the rabbits were sacrificed, the tumors of which were taken out for pathological examination. The correlation between MSCT functional parametric images and pathological findings was analyzed. Results: All the values of BF, BV and PS of VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those of the normal muscular tissues significantly (P<0.001). Conclusion: Multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, which can give a quantitative assessment to blood perfusion and angiogenesis of soft-tissue tumors.展开更多
Soft tissue sarcomas (STS) are rare neoplasm with frequencies around 1% of all neoplasms. Although it consists of a high heterogeneous group of tumors, surgery is the mean treatment. The STS surgery is still challengi...Soft tissue sarcomas (STS) are rare neoplasm with frequencies around 1% of all neoplasms. Although it consists of a high heterogeneous group of tumors, surgery is the mean treatment. The STS surgery is still challenging and complex procedure is usually required: this is because STS requires different types of resection and reconstruction due to various tissue-commitment</span><span style="font-family:"">s</span><span style="font-family:""> (nerve, arteries, skin and muscle). So, a multidisciplinary team must be prepared for STS approach to obtain the maximum local control and a limited extremity functional impairment. We, here, showing our experience, wish to introduce some technical contrivances in STS surgery, with special reference to tissue reconstruction. This may illustrate the necessity of a multidisciplinary team approach in this surgery.展开更多
Background:An unidentified body can arise in any form varying from a well-preserved corpse to skeletal remains or charred remains.When all the parameters for identification are lost,a reconstructed face can help in na...Background:An unidentified body can arise in any form varying from a well-preserved corpse to skeletal remains or charred remains.When all the parameters for identification are lost,a reconstructed face can help in narrowing down the search.The morphometric method of facial reconstruction uses tables of average facial soft-tissue thickness(FSTT)data to guide the reconstruction.To date,no statistics on FSTT have been analyzed in the Manipuri population.Aims and Objectives:This study aimed to estimate and develop an FSTT data set of the Manipuri population using computed tomography(CT)scans for forensic facial reconstruction.Materials and Methods:CT scans of the head were collected for 50 males and 50 females and measurement of FSTT in 25 landmarks of the skull was estimated.Descriptive statistics were applied and 10 samples were selected randomly to check the inter-observer variability by two examiners,technical error of measurement(TEM)was calculated,and paired t-test and correlation analysis were adopted.Results:TEM was negligible,statistical significance was observed in two landmarks,positive correlation between the two examiners.FSTT of Manipuri adults is generated.The variation of mean values between males and females is minimal.In comparison with values of other Indian populations,differences were observed in certain landmarks.Conclusion:This study plays a part in the growing database of FSTT globally.The data set provided can be applied for forensic facial reconstruction of the studied population.展开更多
Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and receive...Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed. Results: Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed. Conclusion: Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.展开更多
To the Editor:Metastatic melanoma is a fatal disease with rapid systemic dissemination and a 5-year survival rate of about 17%.[1]More than half of primary metastases involve the skin as nodal,subcutaneous,or distant ...To the Editor:Metastatic melanoma is a fatal disease with rapid systemic dissemination and a 5-year survival rate of about 17%.[1]More than half of primary metastases involve the skin as nodal,subcutaneous,or distant metastasis.[2]Cutaneous metastases of melanoma occur relatively frequently and can arise in early-or late-stage disease,with a variable clinical appearance and pattern distribution.[3]We describe herein a patient with a large subcutaneous nodule on the arm that we initially diagnosed as a lipoma.After obtaining further clinical history and reviewing the pathologic findings after excision,the nodule was determined to represent metastatic melanoma.展开更多
Soft-tissue management and subsequent salvage of the lower extremity following trauma has long presented difficult challenges to the plastic surgeon.Trauma to the lower extremity can produce long-term sequelae consist...Soft-tissue management and subsequent salvage of the lower extremity following trauma has long presented difficult challenges to the plastic surgeon.Trauma to the lower extremity can produce long-term sequelae consisting of psychological trauma,functional deficits,and increased costs to the healthcare system.Avoiding incorrect management is important,and is compounded by the fact that few guidelines exist on appropriate treatment and patient counseling.This study aims to describe the authors’experience at a large limb salvage center in order to further delineate management strategies.展开更多
Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the pre...Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle replacements.Several studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing issues.The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty procedures.Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.展开更多
BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI...BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI),particularly when combined with diffusion-weighted imaging(DWI),has emerged as promising tool for comprehensive,radiation-free assessment of metastatic spread.AIM To systematically review the diagnostic performance and clinical utility of WBMRI in the staging and restaging of cutaneous melanoma,with comparison to conventional imaging modalities such as computed tomography(CT)and positron emission tomography/CT(PET/CT).METHODS A systematic literature review was conducted using PubMed,Embase,Scopus and Web of Science databases for studies published in the last 10 years.Inclusion criteria focused on comparative diagnostic accuracy studies of WB-MRI vs CT and PET/CT for melanoma staging.The methodological quality of the studies was appraised using the QUADAS-2 tool.RESULTS Sixteen studies involving over 700 patients met the inclusion criteria.WB-MRI showed high sensitivity(73%-90%)and specificity(up to 98%)in detecting metastases,particularly in bone,liver and soft tissue.DWI enhanced lesion detection,and WB-MRI often influenced clinical management decisions.However,CT outperformed WB-MRI in identifying small pulmonary nodules.AI-assisted analysis and contrastenhanced sequences further improved diagnostic confidence.CONCLUSION WB-MRI represents a robust imaging modality for staging cutaneous melanoma,offering superior soft-tissue contrast and functional imaging without ionizing radiation.Its strengths lie in detecting bone,liver and brain metastases.Challenges include limited lung lesion detection,cost,and availability.Advances in artificial intelligence,Hybrid PET/MRY systems,and radiomics are poised to expand WB-MRI’s role in personalized melanoma management.展开更多
Artificial intelligence(AI)has been utilized in soft-tissue analysis and prediction in orthodontic treatment planning,although its reliability has not been systematically assessed.This scoping review was conducted to ...Artificial intelligence(AI)has been utilized in soft-tissue analysis and prediction in orthodontic treatment planning,although its reliability has not been systematically assessed.This scoping review was conducted to outline the development of AI in terms of predicting soft-tissue changes after orthodontic treatment,as well as to comprehensively evaluate its prediction accuracy.Six electronic databases(PubMed,EBSCOhost,Web of Science,Embase,Cochrane Library,and Scopus)were searched up to March 14,2023.Clinical studies investigating the performance of AI-based systems in predicting post-orthodontic soft-tissue alterations were included.The Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)and Joanna Briggs Institute(JBI)appraisal checklist for diagnostic test accuracy studies were applied to assess risk of bias,while the Grading of Recommendation,Assessment,Development,and Evaluation(GRADE)assessment was conducted to evaluate the certainty of outcomes.After screening 2500 studies,four non-randomized clinical trials were finally included for full-text evaluation.We found a low level of evidence indicating an estimated high overall accuracy of AI-generated prediction,whereas the lower lip and chin seemed to be the least predictable regions.Furthermore,the facial morphology simulated by AI via the fusion of multimodality images was considered to be reasonably true.Since all of the included studies that were not randomized clinical trials(non-RCTs)showed a moderate to high risk of bias,more well-designed clinical trials with sufficient sample size are needed in future work.展开更多
Objective:To examine the efficacy and safety of anlotinib as first-line therapy to treat locally advanced or metastatic soft-tissue sarcoma.Methods:This is a single-arm trial.Treatment-naïve patients(≥14 years)w...Objective:To examine the efficacy and safety of anlotinib as first-line therapy to treat locally advanced or metastatic soft-tissue sarcoma.Methods:This is a single-arm trial.Treatment-naïve patients(≥14 years)with locally advanced or metastatic soft tissue sarcoma were eligible.Each treatment cycle lasted for 3 weeks,and included liposomal doxorubicin(40-50 mg/m^(2))on day 1 and anlotinib(12 mg)on days 8-21.Starting from the 9th cycle,treatment consisted of only anlotinib.Treatment continued until disease progression or intolerable toxicities.The primary efficacy end point was progression-free survival(PFS).Results:Eight patients were enrolled between July 25,2019 and January 8,2020.The median number of treatment cycles was 5.5.Within 5.9 months median follow-up,PFS events occurred in 4(4/8,50%)patients.The median PFS was 11.3 months and the 6-month PFS rate was 56%.No patients attained complete response and 2 patients(fibrosarcoma,1 patient and undifferentiated pleomorphic sarcoma,1 patient)achieved partial response.Three patients(fibrosarcoma,2 patients and synovial sarcoma,1 patient)had stable disease.The objective response rate was 25%(2/8)for the study population,and the disease control rate was 75%(6/8).No new safety concerns emerged.Conclusions:Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas.Due to the small sample size,further investigations with a larger population should be undertaken to confirm the study findings.展开更多
Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor ...Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor occurs most commonly in superficial locations. The case we describe herein is that of a 60- year-old man with two large hepatic masses. The patient＇s tumor was removed radically through an incision due to the inconclusive imaging findings. Follow-up computed tomography showed no recurrence and metastasis after 37 months, suggesting that enucleation was adequate for tumor eradication. To our knowl-edge, this is the first reported case of low-grade myofibroblastic sarcoma in the liver in the English language literature.展开更多
A polydisperse sphere model with the complex refractive index is employed to describe the propagation of light in biological tissue. The scattering coefficient, absorption coefficient and scattering phase function are...A polydisperse sphere model with the complex refractive index is employed to describe the propagation of light in biological tissue. The scattering coefficient, absorption coefficient and scattering phase function are calculated. At the same time, the inverse problem on retrieving the particles size distribution, imaginary part of the refractive index and number density of scatterers is investigated. The result shows that the retrieval scheme together with the Chahine algorithm is effective in dealing with such an inverse problem. It is also clarified that a group of parameters including the scattering coefficient, absorption coefficient and phase function are associated with another group including the refractive index, particle size distribution and number density of scatterers, which is a problem described in two different ways and the anisotropy factor is not an independent variable, but is determined by the phase function.展开更多
BACKGROUND Nearly 10%of patients undergoing primary total knee arthroplasty(TKA)have valgus deformity(VD)of the knee.For severe VD of the knee,a more lateral structural release is needed to achieve balance between med...BACKGROUND Nearly 10%of patients undergoing primary total knee arthroplasty(TKA)have valgus deformity(VD)of the knee.For severe VD of the knee,a more lateral structural release is needed to achieve balance between medial and lateral space and neutral femorotibial mechanical axis(FTMA),which is challenging and technical.AIM To introduce a new surgical technique of resection,soft tissue release,and FTMA for Ranawat type-Ⅱ VD with a 5-year follow-up.METHODS A retrospective study was conducted on patients who underwent TKA from December 2011 to December 2014.Hip-knee-ankle(HKA),range of motion(ROM),Oxford knee score(OKS),and knee society score(KSS)were used to assess the joint activity of patients in the new theory TKA group(NT-TKA)and were compared with those of the conventional TKA group(C-TKA).RESULTS A total of 103 people(103 knees)were included in this study,including 42 patients with an average follow-up period of 83 mo in the C-TKA group and 61 patients with an average follow-up period of 76 mo in the NT-TKA group.Six patients had constrained prosthesis,one had common peroneal nerve injury,and two had joint instability in the C-TKA group,but none of these occurred in the NT-TKA group.There were significant statistical differences in constrained prosthesis usage and complications between the groups(P=0.002 and P=0.034,respectively).The KSS at 1 mo post-operation for the C-TKA and NT-TKA groups were 11.2±3.8 and 13.3±2.9,respectively,with a significant difference(P=0.007).However,the data of HKA,ROM,OKS KSS,and prosthesis survival rate were insignificant(P>0.05)in both the preoperative and follow-up periods.CONCLUSION Adopting 5°-7°valgus cut angle for VD and sacrificing 2°neutral FTMA for severe VD which cannot be completely corrected during TKA can reduce the need for soft tissue release,maintain early joint stability,reduce the use of constrained prostheses,and minimize postoperative complications.展开更多
Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, ba...Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, bacteremia, meningitis, soft-tissue, and urinary tract infections, and are associated with high mortality and economic burden. We present a case of a 43-year-old woman, admitted at the department of orthopedics, regional hospital of Ourossogui, North-East of Senegal for soft-tissue injuries. Initially diagnosed with Yersinia pestis infection, the patient was well managed before being released. Supplementary sampling for confirmatory tests allowed the detection of an extensively drug-resistant Acinetobacter baumannii clone.展开更多
The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and c...The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and conjectures have been postulated in order to explain the pattern and duration of this explosive radiation of many different phyla of early metazoans.Here,we focus on the evolution of a phylum of marine suspension-feeding animals—the brachiopods,as exemplified by the exceptionally preserved taxa from the celebrated Chengjiang Konservat Lagerst(a|¨)tte(Yunnan,China).The abundant soft-bodied preservation at these fossil quarries gives us the only firm insights into what brachiopods looked like and how they functioned and lived when they first appeared on the Earth.Studies of Chengjiang brachiopods demonstrate that the early animals developed a remarkably varied organization of tissues and organs shortly after the onset of Cambrian explosion.In the marine suspension-feeding brachiopods,most importantly the tentaculate feeding structure of early brachiopods is already differentiated into two shapes of lophophore,anteriorly coiled(spiralled)and posteriorly arching tentacle crowns and the unique latter type was previously not documented from fossil and living brachiopods.Also unlike any known Recent brachiopod,all the known Cambrian brachiopods from Chengjiang have an open digestive tract that was disposed either as a Ushaped gut in linguliform and stem group brachiopods,or straight gut with a posterior anus in some calcareous-shelled stocks.Moreover,in contrast toliving lingulids,all the Cambrian brachiopods have an epibenthic lifestyle either cemented by a ventral valve or attached by variable pedicles to establish complex ecological community encompassing primary tierers and variable secondary tierers.It is therefore assumed that brachiopods were the first benthic metazoan that achieved their success in ecological stratification and tiering complexity by late Atdabanian.The setae are also important for the brachiopod suspension-feeding life style,and in the Chengjiang braehiopods they include two types cilia-like and spine-like setae.The mantle canals of different braehiopod species are also distinctly variable in arrangement,mainly disposed in pinnate,baeulate and peripheral conditions.Of these,the peripheral disposition of mantle canals is for the first time proposed here so as to differentiate from the bifurcate condition in recent lingulids in that the former is devoid of posteriorly extending main trunks of sinus,but possesses a diverging dorsal vascula media in dichotomy.展开更多
基金Supported by the Ministry of Health of the Czech Republic,Grant/Award Number:NU22-05-00475 and NV19-05-00214。
文摘Background:In view of the ever-increasing representation of Staphylococcus spp.strains resistant to various antibiotics,the development of in vivo models for evaluation of novel antimicrobials is of utmost importance.Methods:In this article,we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical anti-microbial agents that matches the real clinical situation.The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one.Results:In the final model,10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia,with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension.One pig was not inoculated and used as the negative control.Subsequently,the bandages were changed on Days 4,8,11,and 15.At these time points,a filter paper imprint technique(FPIT)was made from each wound for semi-quantitative microbiological evaluation.Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological,histopathological,and molecular-biological examination.The infection with the inoculated S.aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples.The dynamics of the inflammatory markers and clinical signs of infection are also described.Conclusions:A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents.
文摘An experimental animal model of malignant soft-tissue tumor was established to investigate the applied value of multi-slice spiral CT perfusion imaging preliminarily. Ten New Zealand white rabbits which were implanted with VX2 tumor in either proximal thigh were subjected to CT plain scan and perfusion scan two weeks later respectively, then the original perfusion images were transmitted to AW4.0 Workstation. The functional maps and perfusion parameters including blood flow （BF）, blood volume （BV）, mean transit time （MTT） and permeability surface （PS） were computed and analyzed. All the values of BF, BV and PS in VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those in the normal muscular tissues significantly. It was suggested that multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, and can give a quantitative assessment to angiogenesis and blood perfusion of soft-tissue tumors.
文摘Diagnosis of extremity soft-tissue tumors can be challenging.Characteristics of tumor margins can help precisely identify locally aggressive or non-aggressive behavior for surgical planning,but cannot differentiate benign from malignant lesions.Most malignant tumors can have inhomogeneous signals on T2-weighted images.Although a uniform signal on T2-weighted images can be a reliable indication of a benign lesion,a well-defined mass with homogeneous internal signal intensity does not definitively identify a benign lesion.Some common and distinctive soft-tissue lesions can have specific clinical and imaging features allowing a diagnosis without biopsy.These are known as determinate lesions.This illustrative report presents a diagnostic guide for extremity soft-tissue tumors based on tissue signal and morphological characteristics on magnetic resonance images.It is important for clinicians to be familiar with the imaging characteristics of common determinate lesions.
文摘The glenohumeral joint(GHJ)allows for a wide range of motion,but is also particularly vulnerable to episodes of instability.Anterior GHJ instability is especially frequent among young,athletic populations during contact sporting events.Many first time dislocators can be managed non-operatively with a period of immobilization and rehabilitation,however certain patient populations are at higher risk for recurrent instability and may require surgical intervention for adequate stabilization.Determination of the optimal treatment strategy should be made on a case-by-case basis while weighing both patient specific factors and injury patterns(i.e.,bone loss).The purpose of this review is to describe the relevant anatomical stabilizers of the GHJ,risk factors for recurrent instability including bony lesions,indications for arthroscopic vs open surgical management,clinical history and physical examination techniques,imaging modalities,and pearls/pitfalls of arthroscopic soft-tissue stabilization for anterior glenohumeral instability.
文摘Objective： We enrolled retrospective data to determine the efficacy of combined chemotherapy and surgery for local tumour control and survival in patients with high-risk soft-tissue sarcomas. Methods： We collected data from 25 patients with high-risk soft-tissue sarcomas treated with four cycles of etoposide, ifosfamide and doxorubicin （EIA） followed by definitive surgery with or without postoperative radiotherapy and adjuvant chemotherapy. 21 patients received chemotherapy in a neoadjuvant/adjuvant clinical setting; eighteen of them completed adjuvant chemotherapy. Four patients received chemotherapy in an adjuvant setting only. Results： The objective response rate of neoadjuvant chemotherapy assessable in 21 patients was 43%. Including NED （n=7） and partial remissions （n=3）, the radiographic response rate was 47.6% with additional 42.9% stable diseases （n=9）. Surgery was performed in two patients before completing four neoadjuvant chemotherapy cycles because of disease progression. Median overall survival for all patients was 21.6＋ months. After completion of chemotherapy, in 62% of patients R0-resection could be performed. Conclusion： High proportion of R0-resections supports the idea of tumour down-staging after neoadjuvant treatment. Response to neoadjuvant chemotherapy is predictive for improved local tumour control resulting in long-term survival benefit.
文摘Objective: To perform a contrast investigation of multi-slice spiral CT (MSCT) perfusion imaging and pathological findings in VX2 soft-tissue tumor of rabbits, and discuss the applicative value of multi-slice spiral CT perfusion imaging in soft-tissue tumors. Methods: 8 Newzealand white rabbits were implanted with 0.1 ml VX2 tumor tissue suspension in bilateral proximal thighs. 14 days and 21 days later, CT plain scan and perfusion scan were performed on these rabbits respectively, then the images were transmitted to AW4.0 workstation, the functional maps and perfusion parameters including blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface (PS) were computed and analyzed. Subsequently, the rabbits were sacrificed, the tumors of which were taken out for pathological examination. The correlation between MSCT functional parametric images and pathological findings was analyzed. Results: All the values of BF, BV and PS of VX2 soft-tissue tumors were obviously higher while the MTT-values were lower than those of the normal muscular tissues significantly (P<0.001). Conclusion: Multi-slice spiral CT perfusion imaging is an accurate, convenient and relatively safe functional imaging technique, which can give a quantitative assessment to blood perfusion and angiogenesis of soft-tissue tumors.
文摘Soft tissue sarcomas (STS) are rare neoplasm with frequencies around 1% of all neoplasms. Although it consists of a high heterogeneous group of tumors, surgery is the mean treatment. The STS surgery is still challenging and complex procedure is usually required: this is because STS requires different types of resection and reconstruction due to various tissue-commitment</span><span style="font-family:"">s</span><span style="font-family:""> (nerve, arteries, skin and muscle). So, a multidisciplinary team must be prepared for STS approach to obtain the maximum local control and a limited extremity functional impairment. We, here, showing our experience, wish to introduce some technical contrivances in STS surgery, with special reference to tissue reconstruction. This may illustrate the necessity of a multidisciplinary team approach in this surgery.
文摘Background:An unidentified body can arise in any form varying from a well-preserved corpse to skeletal remains or charred remains.When all the parameters for identification are lost,a reconstructed face can help in narrowing down the search.The morphometric method of facial reconstruction uses tables of average facial soft-tissue thickness(FSTT)data to guide the reconstruction.To date,no statistics on FSTT have been analyzed in the Manipuri population.Aims and Objectives:This study aimed to estimate and develop an FSTT data set of the Manipuri population using computed tomography(CT)scans for forensic facial reconstruction.Materials and Methods:CT scans of the head were collected for 50 males and 50 females and measurement of FSTT in 25 landmarks of the skull was estimated.Descriptive statistics were applied and 10 samples were selected randomly to check the inter-observer variability by two examiners,technical error of measurement(TEM)was calculated,and paired t-test and correlation analysis were adopted.Results:TEM was negligible,statistical significance was observed in two landmarks,positive correlation between the two examiners.FSTT of Manipuri adults is generated.The variation of mean values between males and females is minimal.In comparison with values of other Indian populations,differences were observed in certain landmarks.Conclusion:This study plays a part in the growing database of FSTT globally.The data set provided can be applied for forensic facial reconstruction of the studied population.
文摘Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs). Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. The outcome measurement was the change of pain rating in the Visual Analogue Scale (VAS) during the first 5 sessions. The adverse effect was also observed. Results: Of the 200 patients recruited, 7 were excluded due to incomplete data. In total, 888 sinew acupuncture treatments were administered to patients at 14 injury sites (including head, neck, shoulder, arm, chest, elbow, wrist, hand, waist and hip, knee, thigh, calf, ankle, and foot) where pain was felt. Compared with the baseline, the VAS rating after the first and last treatments were both significantly reduced at all the injury sites (P<0.01). The VAS rating was also significantly reduced after each session of treatment in the first five sessions (P<0.01). No serious adverse effect was observed. Conclusion: Sinew acupuncture had not only an immediate analgesic effect for STIs, but also an accumulated analgesic effect during the first 5 treatment sessions.
文摘To the Editor:Metastatic melanoma is a fatal disease with rapid systemic dissemination and a 5-year survival rate of about 17%.[1]More than half of primary metastases involve the skin as nodal,subcutaneous,or distant metastasis.[2]Cutaneous metastases of melanoma occur relatively frequently and can arise in early-or late-stage disease,with a variable clinical appearance and pattern distribution.[3]We describe herein a patient with a large subcutaneous nodule on the arm that we initially diagnosed as a lipoma.After obtaining further clinical history and reviewing the pathologic findings after excision,the nodule was determined to represent metastatic melanoma.
文摘Soft-tissue management and subsequent salvage of the lower extremity following trauma has long presented difficult challenges to the plastic surgeon.Trauma to the lower extremity can produce long-term sequelae consisting of psychological trauma,functional deficits,and increased costs to the healthcare system.Avoiding incorrect management is important,and is compounded by the fact that few guidelines exist on appropriate treatment and patient counseling.This study aims to describe the authors’experience at a large limb salvage center in order to further delineate management strategies.
文摘Appreciation of soft-tissue thickness(STT)at surgical sites is an increasingly recognized aspect of arthroplasty procedures as it may potentially impacting postoperative outcomes.Recent research has focused on the predictive value of preoperative STT measurements for complications following various forms of arthroplasty,particularly infections,across procedures such as total knee,hip,shoulder,and ankle replacements.Several studies have indicated that increased STT is associated with a higher risk of complications,including infection and wound healing issues.The assessment of STT before surgery could play a crucial role in identifying patients at a higher risk of complications and may be instru-mental in guiding preoperative planning to optimize outcomes in arthroplasty procedures.Standardized measurement techniques and further research are essential to enhance the reliability and clinical utility of STT assessment for arthro-plasty surgery.
文摘BACKGROUND Cutaneous melanoma is an aggressive skin cancer with high metastatic potential.Accurate staging is critical to guide therapeutic strategies and improve prognosis.Whole-body magnetic resonance imaging(WB-MRI),particularly when combined with diffusion-weighted imaging(DWI),has emerged as promising tool for comprehensive,radiation-free assessment of metastatic spread.AIM To systematically review the diagnostic performance and clinical utility of WBMRI in the staging and restaging of cutaneous melanoma,with comparison to conventional imaging modalities such as computed tomography(CT)and positron emission tomography/CT(PET/CT).METHODS A systematic literature review was conducted using PubMed,Embase,Scopus and Web of Science databases for studies published in the last 10 years.Inclusion criteria focused on comparative diagnostic accuracy studies of WB-MRI vs CT and PET/CT for melanoma staging.The methodological quality of the studies was appraised using the QUADAS-2 tool.RESULTS Sixteen studies involving over 700 patients met the inclusion criteria.WB-MRI showed high sensitivity(73%-90%)and specificity(up to 98%)in detecting metastases,particularly in bone,liver and soft tissue.DWI enhanced lesion detection,and WB-MRI often influenced clinical management decisions.However,CT outperformed WB-MRI in identifying small pulmonary nodules.AI-assisted analysis and contrastenhanced sequences further improved diagnostic confidence.CONCLUSION WB-MRI represents a robust imaging modality for staging cutaneous melanoma,offering superior soft-tissue contrast and functional imaging without ionizing radiation.Its strengths lie in detecting bone,liver and brain metastases.Challenges include limited lung lesion detection,cost,and availability.Advances in artificial intelligence,Hybrid PET/MRY systems,and radiomics are poised to expand WB-MRI’s role in personalized melanoma management.
基金supported by the Research Grants Council of the Hong Kong,China (No.17109619).
文摘Artificial intelligence(AI)has been utilized in soft-tissue analysis and prediction in orthodontic treatment planning,although its reliability has not been systematically assessed.This scoping review was conducted to outline the development of AI in terms of predicting soft-tissue changes after orthodontic treatment,as well as to comprehensively evaluate its prediction accuracy.Six electronic databases(PubMed,EBSCOhost,Web of Science,Embase,Cochrane Library,and Scopus)were searched up to March 14,2023.Clinical studies investigating the performance of AI-based systems in predicting post-orthodontic soft-tissue alterations were included.The Quality Assessment of Diagnostic Accuracy Studies-2(QUADAS-2)and Joanna Briggs Institute(JBI)appraisal checklist for diagnostic test accuracy studies were applied to assess risk of bias,while the Grading of Recommendation,Assessment,Development,and Evaluation(GRADE)assessment was conducted to evaluate the certainty of outcomes.After screening 2500 studies,four non-randomized clinical trials were finally included for full-text evaluation.We found a low level of evidence indicating an estimated high overall accuracy of AI-generated prediction,whereas the lower lip and chin seemed to be the least predictable regions.Furthermore,the facial morphology simulated by AI via the fusion of multimodality images was considered to be reasonably true.Since all of the included studies that were not randomized clinical trials(non-RCTs)showed a moderate to high risk of bias,more well-designed clinical trials with sufficient sample size are needed in future work.
文摘Objective:To examine the efficacy and safety of anlotinib as first-line therapy to treat locally advanced or metastatic soft-tissue sarcoma.Methods:This is a single-arm trial.Treatment-naïve patients(≥14 years)with locally advanced or metastatic soft tissue sarcoma were eligible.Each treatment cycle lasted for 3 weeks,and included liposomal doxorubicin(40-50 mg/m^(2))on day 1 and anlotinib(12 mg)on days 8-21.Starting from the 9th cycle,treatment consisted of only anlotinib.Treatment continued until disease progression or intolerable toxicities.The primary efficacy end point was progression-free survival(PFS).Results:Eight patients were enrolled between July 25,2019 and January 8,2020.The median number of treatment cycles was 5.5.Within 5.9 months median follow-up,PFS events occurred in 4(4/8,50%)patients.The median PFS was 11.3 months and the 6-month PFS rate was 56%.No patients attained complete response and 2 patients(fibrosarcoma,1 patient and undifferentiated pleomorphic sarcoma,1 patient)achieved partial response.Three patients(fibrosarcoma,2 patients and synovial sarcoma,1 patient)had stable disease.The objective response rate was 25%(2/8)for the study population,and the disease control rate was 75%(6/8).No new safety concerns emerged.Conclusions:Anlotinib plus liposomal doxorubicin demonstrated antitumor activities in previously untreated locally advanced or metastatic soft tissue sarcomas.Due to the small sample size,further investigations with a larger population should be undertaken to confirm the study findings.
文摘Low-grade myofibroblastic sarcoma is a recently characterized tumor showing features of myofibroblastic differen-tiation that is part of the spectrum of malignant mesenchymal tumors. This extremely rare type of tumor occurs most commonly in superficial locations. The case we describe herein is that of a 60- year-old man with two large hepatic masses. The patient＇s tumor was removed radically through an incision due to the inconclusive imaging findings. Follow-up computed tomography showed no recurrence and metastasis after 37 months, suggesting that enucleation was adequate for tumor eradication. To our knowl-edge, this is the first reported case of low-grade myofibroblastic sarcoma in the liver in the English language literature.
文摘A polydisperse sphere model with the complex refractive index is employed to describe the propagation of light in biological tissue. The scattering coefficient, absorption coefficient and scattering phase function are calculated. At the same time, the inverse problem on retrieving the particles size distribution, imaginary part of the refractive index and number density of scatterers is investigated. The result shows that the retrieval scheme together with the Chahine algorithm is effective in dealing with such an inverse problem. It is also clarified that a group of parameters including the scattering coefficient, absorption coefficient and phase function are associated with another group including the refractive index, particle size distribution and number density of scatterers, which is a problem described in two different ways and the anisotropy factor is not an independent variable, but is determined by the phase function.
基金the Project of Excellent Young Talents of Traditional Chinese Medicine of Zhejiang Province,No.2019ZQ016the Zhejiang Medical and Health Science and Technology Young Talents Program,No.2019RC059.
文摘BACKGROUND Nearly 10%of patients undergoing primary total knee arthroplasty(TKA)have valgus deformity(VD)of the knee.For severe VD of the knee,a more lateral structural release is needed to achieve balance between medial and lateral space and neutral femorotibial mechanical axis(FTMA),which is challenging and technical.AIM To introduce a new surgical technique of resection,soft tissue release,and FTMA for Ranawat type-Ⅱ VD with a 5-year follow-up.METHODS A retrospective study was conducted on patients who underwent TKA from December 2011 to December 2014.Hip-knee-ankle(HKA),range of motion(ROM),Oxford knee score(OKS),and knee society score(KSS)were used to assess the joint activity of patients in the new theory TKA group(NT-TKA)and were compared with those of the conventional TKA group(C-TKA).RESULTS A total of 103 people(103 knees)were included in this study,including 42 patients with an average follow-up period of 83 mo in the C-TKA group and 61 patients with an average follow-up period of 76 mo in the NT-TKA group.Six patients had constrained prosthesis,one had common peroneal nerve injury,and two had joint instability in the C-TKA group,but none of these occurred in the NT-TKA group.There were significant statistical differences in constrained prosthesis usage and complications between the groups(P=0.002 and P=0.034,respectively).The KSS at 1 mo post-operation for the C-TKA and NT-TKA groups were 11.2±3.8 and 13.3±2.9,respectively,with a significant difference(P=0.007).However,the data of HKA,ROM,OKS KSS,and prosthesis survival rate were insignificant(P>0.05)in both the preoperative and follow-up periods.CONCLUSION Adopting 5°-7°valgus cut angle for VD and sacrificing 2°neutral FTMA for severe VD which cannot be completely corrected during TKA can reduce the need for soft tissue release,maintain early joint stability,reduce the use of constrained prostheses,and minimize postoperative complications.
文摘Emerging and rapidly spreading multidrug resistant bacteria constitute a rising public health concern worldwide. Acinetobacter baumannii is one of these bacteria that cause different infections including pneumonia, bacteremia, meningitis, soft-tissue, and urinary tract infections, and are associated with high mortality and economic burden. We present a case of a 43-year-old woman, admitted at the department of orthopedics, regional hospital of Ourossogui, North-East of Senegal for soft-tissue injuries. Initially diagnosed with Yersinia pestis infection, the patient was well managed before being released. Supplementary sampling for confirmatory tests allowed the detection of an extensively drug-resistant Acinetobacter baumannii clone.
基金supported by the National Natural Science Foundation of China(4070200541072017+8 种基金40830208)the 973 Project(2013CB835002)111 Project of China(P201102007)Swedish Research Council(VR 2009-43952012-1658 to LEH)ZZF acknowledges grants from the Fok Ying Tung Education Foundationthe China Scholarship Counciland the Ministry of Education of China(FANEDD200936NCET-11-1046)
文摘The Cambrian explosion was coined to describe the geologically sudden appearance of numerous bilaterian body plans(Phyla)around the Ediacaran-Cambrian transition,around 565-520million years ago.Many explanations and conjectures have been postulated in order to explain the pattern and duration of this explosive radiation of many different phyla of early metazoans.Here,we focus on the evolution of a phylum of marine suspension-feeding animals—the brachiopods,as exemplified by the exceptionally preserved taxa from the celebrated Chengjiang Konservat Lagerst(a|¨)tte(Yunnan,China).The abundant soft-bodied preservation at these fossil quarries gives us the only firm insights into what brachiopods looked like and how they functioned and lived when they first appeared on the Earth.Studies of Chengjiang brachiopods demonstrate that the early animals developed a remarkably varied organization of tissues and organs shortly after the onset of Cambrian explosion.In the marine suspension-feeding brachiopods,most importantly the tentaculate feeding structure of early brachiopods is already differentiated into two shapes of lophophore,anteriorly coiled(spiralled)and posteriorly arching tentacle crowns and the unique latter type was previously not documented from fossil and living brachiopods.Also unlike any known Recent brachiopod,all the known Cambrian brachiopods from Chengjiang have an open digestive tract that was disposed either as a Ushaped gut in linguliform and stem group brachiopods,or straight gut with a posterior anus in some calcareous-shelled stocks.Moreover,in contrast toliving lingulids,all the Cambrian brachiopods have an epibenthic lifestyle either cemented by a ventral valve or attached by variable pedicles to establish complex ecological community encompassing primary tierers and variable secondary tierers.It is therefore assumed that brachiopods were the first benthic metazoan that achieved their success in ecological stratification and tiering complexity by late Atdabanian.The setae are also important for the brachiopod suspension-feeding life style,and in the Chengjiang braehiopods they include two types cilia-like and spine-like setae.The mantle canals of different braehiopod species are also distinctly variable in arrangement,mainly disposed in pinnate,baeulate and peripheral conditions.Of these,the peripheral disposition of mantle canals is for the first time proposed here so as to differentiate from the bifurcate condition in recent lingulids in that the former is devoid of posteriorly extending main trunks of sinus,but possesses a diverging dorsal vascula media in dichotomy.
