BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mi...BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.展开更多
D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Cli...D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.展开更多
BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. T...BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. This article reports the diagnosis,surgical treatment, and follow-up of a case of lingual thyroid.CASE SUMMARYThe patient was a 54-year-old woman who presented with laryngeal foreign bodysensation and dysphagia for 20 d. The lingual thyroid was considered for generalexamination, and surgery was performed to transpose the lingual thyroid to theright submaxillary region. Pathological analysis confirmed thyroid tissue. Thepatient experienced complete remission after surgery, but developed hypothyroidismand required thyroid hormone replacement therapy, and her thyroidfunction gradually recovered over time.CONCLUSIONWe report a rare case of lingual thyroid with marked laryngeal foreign body sensationand dysphagia. Symptoms were completely relieved by transposition surgerybut postoperative hypothyroidism developed.展开更多
Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch opera...Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch operation and assisted with extracorporeal membrane oxygenation.Conclusion:TGA with aortopulmonary window can be safely correctly with the arterial switch operation.展开更多
Introduction Congenitally corrected Transposition of the great Arteries(cc-TGA)is an uncommon congenital heart defect marked by double discordance of atrioventricular(AV)and ventriculoarterial connections.This dual di...Introduction Congenitally corrected Transposition of the great Arteries(cc-TGA)is an uncommon congenital heart defect marked by double discordance of atrioventricular(AV)and ventriculoarterial connections.This dual discordance naturally corrects the cardiopulmonary circulation.However,the embryological right ventricle(with its right bundle branch)becomes connected to the aorta,while the left ventricle(with its left bundle branch)is attached to the pulmonary artery.展开更多
The Agrobacterium mediated transgenic rice ( Oryza saliva L.) population with inserts of maize transposon Activator/Dissociation (Ac/Ds) was investigated. DNA sequences flanking the T-DNA were analyzed with inverse PC...The Agrobacterium mediated transgenic rice ( Oryza saliva L.) population with inserts of maize transposon Activator/Dissociation (Ac/Ds) was investigated. DNA sequences flanking the T-DNA were analyzed with inverse PCR. Results showed that 65.4% of the T-DNA was integrated in different locations of rice genome, and some T-DNA flanking sequences were located on certain chromosomes. A number of T-DNA was found to have inserted into protein coding regions. In order to induce transposition of the inserted Ds elements, 354 crosses of Ac x Ds and Ds x Ac were constructed. The excision frequency of Ds element trans-activated by Ac transposase was 22.7% in the F-2 populations, and the transposition was confirmed with analyses of DNA sequences flanking the Ds elements. In addition to the transposition due to 'cut-paste' mechanism, Ds can replicate itself and integrate into a new locus, and inaccurate excisions were also found. A proportion of DNA segments flanking the Ds elements showed no homologies to sequences published in GenBank, of which two were registered under the accession numbers AF355153 and AF355770. The strategy of using transposon tagging for rice genomics study was discussed.展开更多
OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decom...OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decompression and anterior submuscular transposition of ulnar nerve,and to provide a theoretical basis for the appropriate surgical programs in treating moderate-severe Cu TS.METHODS:47 consecutive cases of moderate-severe Cu TS were surgically treated in our department from January 2014 to January 2017.All patients were divided into two groups by the doctor in our department.21 Cu TS cases were treated with decompression and anterior subcutaneous transposition of ulnar nerve,and other 26 cases were treated with decompression and anterior submuscular transposition of ulnar nerve.All the patients were followed 1 month,3 months and 6 months after operation to evaluate the recovery degree of ulnar nerve function and the clinical efficiency of the two methods was compared.RESULTS:Clinical symptoms of two groups were significant alleviated.There was no significant statistical difference between two groups in the clinical efficiency.CONCLUSION:Completely releasing of nerve truck is the most important step in treating mediate-severe Cu TS.Theclinical results of the two methods are similar,but the anterior subcutaneous transposition of ulnar nerve is more easy to operate and can be widely used.展开更多
Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair dis...Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair distal nerve and target muscle tissue and restore muscle motor function. To observe the effect of nerve regeneration and motor function recovery after several types of nerve transposition for median nerve defect(2 mm), 30 Sprague-Dawley rats were randomly divided into sham operation group, epineurial neurorrhaphy group, musculocutaneous nerve transposition group, medial pectoral nerve transposition group, and radial nerve muscular branch transposition group. Three months after nerve repair, the wrist flexion test was used to evaluate the recovery of wrist flexion after regeneration of median nerve in the affected limbs of rats. The number of myelinated nerve fibers, the thickness of myelin sheath, the diameter of axons and the cross-sectional area of axons in the proximal and distal segments of the repaired nerves were measured by osmic acid staining. The ratio of newly produced distal myelinated nerve fibers to the number of proximal myelinated nerve fibers was calculated. Wet weights of the flexor digitorum superficialis muscles were measured. Muscle fiber morphology was detected using hematoxylin-eosin staining. The cross-sectional area of muscle fibers was calculated to assess the recovery of muscles. Results showed that wrist flexion function was restored, and the nerve grew into the distal effector in all three nerve transposition groups and the epineurial neurorrhaphy group. There were differences in the number of myelinated nerve fibers in each group. The magnification of proximal to distal nerves was 1.80, 3.00, 2.50, and 3.12 in epineurial neurorrhaphy group, musculocutaneous nerve transposition group, medial pectoral nerve transposition group, and radial nerve muscular branch transposition group, respectively. Nevertheless, axon diameters of new nerve fibers, cross-sectional areas of axons, thicknesses of myelin sheath, wet weights of flexor digitorum superficialis muscle and cross-sectional areas of muscle fibers of all three groups of donor nerves from different anterior horn motor neurons after nerve transposition were similar to those in the epineurial neurorrhaphy group. Our findings indicate that donor nerve translocation from different anterior horn motor neurons can effectively repair the target organs innervated by the median nerve. The corresponding spinal anterior horn motor neurons obtain functional reinnervation and achieve some degree of motor function in the affected limbs.展开更多
Lower extremity nerve transposition repair has become an important treatment strategy for peripheral nerve injury;however, brain changes caused by this surgical procedure remain unclear. In this study, the distal stum...Lower extremity nerve transposition repair has become an important treatment strategy for peripheral nerve injury;however, brain changes caused by this surgical procedure remain unclear. In this study, the distal stump of the right sciatic nerve in a rat model of sciatic nerve injury was connected to the proximal end of the left sciatic nerve using a chitin conduit. Neuroelectrophysiological test showed that the right lower limb displayed nerve conduction, and the structure of myelinated nerve fibers recovered greatly. Muscle wet weight of the anterior tibialis and gastrocnemius recovered as well. Multiple-model resting-state blood oxygenation level-dependent functional magnetic resonance imaging analysis revealed functional remodeling in multiple brain regions and the re-establishment of motor and sensory functions through a new reflex arc. These findings suggest that sciatic nerve transposition repair induces brain functional remodeling. The study was approved by the Ethics Committee of Peking University People's Hospital on December 9, 2015(approval No. 2015-50).展开更多
BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus...BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus femoris muscle flap transposition for vascular graft infections,and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARY We report the case of a 32-year-old male patient,who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure.Using the VSD and muscle flap transposition,the groin wound and vascular graft infection were finally treated successfully.CONCLUSION Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure,especially in consideration of treatable conditions.展开更多
During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the prob...During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining. There was no obvious inflammatory reaction and neuroma formation in the tibial nerve after repair by the small gap bio-sleeve suture with different inner diameters at both ends. The conduction velocity, muscle strength, wet muscle weight, cross-sectional area of muscle fibers, and the number of new myelinated nerve fibers in the biosleeve suture group were similar to those in the epineurial neurorrhaphy group. Our findings indicate that small gap bio-sleeve suture with different inner diameters at both ends can achieve surgical suture between nerves of different diameters and promote regeneration and functional recovery of injured peripheral nerves.展开更多
This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we ...This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials（MUP） of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential（CMAP） appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade Ⅲ at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.展开更多
In an integrated structure low resistance CICC joint, current is conducted by outer cable strands coming into touch with the conductive Cu sole. So it is an important condition for satisfying joint performance that ea...In an integrated structure low resistance CICC joint, current is conducted by outer cable strands coming into touch with the conductive Cu sole. So it is an important condition for satisfying joint performance that each strand of the cable inside the joint is able to come to the outermost by transposition. This paper presents analysis, calculation and figures for the strand transposition. According to the twist procedures of the superconducting cable, the author computed the actual pitch of each stage cable, consecutively computed the projection of each stage cable on the axis of the cable (z axis) and the corresponding twist angle as the z coordinate changes, which is then drawn by AutoCAD. From the results shown in the figures, the minimal cable length, which enables each strand to transpose almost equally to the outermost of the cable in such a length, call be determined as the optimal joint length.展开更多
BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain uncl...BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.展开更多
Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve trans...Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve transposition repair technique has been proposed to treat severe peripheral nerve injury. During nerve transposition repair, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively grow into the repaired distal nerve and target muscle tissues, which is conducive to the recovery of motor function. The aim of this study was to explore regeneration and nerve functional recovery after repairing a long-segment peripheral nerve defect by transposition of different donor nerves. A long-segment(2 mm) ulnar nerve defect in Sprague-Dawley rats was repaired by transposition of the musculocutaneous nerve, medial pectoral nerve, muscular branches of the radial nerve and anterior interosseous nerve(pronator quadratus muscle branch). In situ repair of the ulnar nerve was considered as a control. Three months later, wrist flexion function, nerve regeneration and innervation muscle recovery in rats were assessed using neuroelectrophysiological testing, osmic acid staining and hematoxylin-eosin staining, respectively. Our findings indicate that repair of a long-segment ulnar nerve defect with different donor nerve transpositions can reinnervate axonal function of motor neurons in the anterior horn of spinal cord and restore the function of affected limbs to a certain extent.展开更多
The piggyBac transposon has been long used to integrate foreign DNA into insect genomes.However,undesirable transgene expression can result from random insertions into the genome.In this study,the efficiency of chimer...The piggyBac transposon has been long used to integrate foreign DNA into insect genomes.However,undesirable transgene expression can result from random insertions into the genome.In this study,the efficiency of chimeric Gal4-piggyBac transposase in directing integration onto a DNA target plasmid was evaluated in cultured silkworm Bombyx mori Bm-12 and fruit fly Drosophila Schneider 2(S2) cells.The Gal4-piggyBac transposase has a Gal4 DNA-binding domain(DBD),and the target plasmid has upstream activating sequences(UAS) to which the Gal4 DBD can bind with high affinity.The results indicate that,in the Bm-12 and S2 cells,transpositional activity of Gal4-piggyBac transposase was increased by 4.0 and 7.5 times,respectively,compared to controls,where Gal4-UAS interaction was absent.Moreover,the Gal4-piggyBac transposase had the ability of directing piggyBac element integration to certain sites of the target plasmid,although the target-directing specificity was not as high as expected.The chimeric piggyBac transposase has the potential for use in site-directed transgenesis and gene function research in B.mori.展开更多
Genetic analyses of patients with transposition of the great arteries have identified rare copy number variations,suggesting that they may be significant to the aetiology of the disease.This paper reports the identifi...Genetic analyses of patients with transposition of the great arteries have identified rare copy number variations,suggesting that they may be significant to the aetiology of the disease.This paper reports the identification of a 16 p11.2 microduplication,a variation that has yet to be reported in association with transposition of the great arteries.The 16 p11.2 microduplication is associated with autism spectrum disorder and developmental delay,but with highly variable phenotypic effects.Autism and attention deficit disorders are observed more frequently in children with congenital heart disease than in the general population.Neonatal surgery is proposed as a risk factor,but as yet unidentified genetic abnormalities should also be taken into account.Thus,congenital heart abnormalities may constitute a part of the phenotypic spectrum associated with duplications at 16 p11.2.We suggest chromosomal microarray be considered part of the diagnostic work-up in patients with transposition of the great arteries.展开更多
Before the 1950s,D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life.The Mustard and Senning procedures resulted in a signifi cant increase in the lifespan of t...Before the 1950s,D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life.The Mustard and Senning procedures resulted in a signifi cant increase in the lifespan of these patients but with notable long-term complications,including arrhythmias,sinus node dysfunction,chronotropic incompetence,and right ventricular systolic dysfunction.The arterial switch operation(first described by Adib Jatene)initially resulted in nearly universal death.However,the use of coronary buttons for coronary artery translocation has improved operative survival dramatically.It is now considered the treatment of choice in patients amendable to the arterial switch operation.Considered an anatomic repair,resulting in concordant ventriculoarterial connections and a systemic left ventricle,the arterial switch operation reduces the incidence of ventricular dysfunction.However,it is also associated with long-term complications,including aortic root dilatation,aortic valve regurgitation,right ventricular outfl ow tract obstructions,coronary artery stenosis/compression,and branch pulmonary artery stenosis.展开更多
AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be a...AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.展开更多
ObjectiFe To evaiuate surgicai procedure of corrected transposition of the great arteries(CTGA). Methods Twenty one patients with CTGA were ropaired from September 1990 to December 1996 Eighteen pattents were correcte...ObjectiFe To evaiuate surgicai procedure of corrected transposition of the great arteries(CTGA). Methods Twenty one patients with CTGA were ropaired from September 1990 to December 1996 Eighteen pattents were corrected by biventricular repair. The ventricular septal delect (VSD) was repaired through the right atrium or anatomic left ventricle in 11 patients and through the anatomic right ventricle in 7 patients. There were atrioventricular valvular regurgitation or one side ventricular hypoplasia in 3 patients. Two patients had Fontan operation and one had bidirectional shunt. Results Five patients (45%, 5/11) had complete atrioventricular block (CAVB) in these cases with VSD repaired through the right atrium or left ventricle, and 3 patients died (27%, 3/11). One patient (14%,1/7) had CA VB which the VSD was repaired through the anatomic right ventricle with only one death. Conclusion CAVB could be prevented by VSD rePair through the anatomic right ventricle. CTGA with pulmonary hypertension must be repaired early to prevent pulmonary vascular disease. Fontan or bidirectional shunt were suggested for complex CTGA with valvular regurgitation or ventricular unbalance.展开更多
基金Supported by the General Program of the Hubei Provincial Natural Science Foundation of China Key Project,No.2021CFB520.
文摘BACKGROUND Long head of biceps tendon(LHBT)transposition is a novel technique based on the double-row suture bridge method,utilizing autologous reconstruction to treat massive rotator cuff tears.AIM To evaluate the mid-to-long-term clinical outcomes following the double-row repair method for massive rotator cuff tears.METHODS This retrospective analysis included data from 53 patients with massive rotator cuff tears treated at our hospital between 2020 and 2021.The patients were divided into the double-row repair group(conventional group)and the doublerow repair combined with the LHBT transposition group(transposition group).Postoperative pain was assessed using the visual analogue scale at one week,one year,and the final follow-up.Shoulder function was evaluated using the American Shoulder and Elbow Surgeons and Constant-Murley scores at one year and the final follow-up.Rotator cuff healing was assessed postoperatively for one year using the Sugaya classification,which categorizes tendon integrity based on magnetic resonance imaging findings.RESULTS No perioperative complications were observed in any of the patients at any time.There were no significant differences between the groups regarding operative time and intraoperative blood loss.The transposition group had significantly lower visual analogue scale scores than the conventional group at one week postoperatively;however,there were no significant differences between the groups at one year or the final follow-up.At one year postoperatively,the transposition group showed significantly higher American Shoulder and Elbow Surgeons and Constant-Murley scores than the conventional group;no significant differences were observed at the final followup.There were no significant differences in rotator cuff healing between the groups at one year postoperatively.CONCLUSION Compared to double-row repair alone,double-row repair combined with LHBT transposition for treating massive rotator cuff tears more effectively alleviates short-term postoperative pain and improves shoulder function within the first year.
基金University of Alabama Birmingham Institutional Review Board approval was obtained,IRB Project Number 300012208.
文摘D-transposition of the great arteries(d-TGA)is surgically repaired with the arterial switch operation(ASO)with excellent results,however short and long-term morbidities still develop including neurocognitive delay.Clinically significant central sleep apnea is uncommon in non-premature infants,but when present indicates immature autonomic control of respiration likely due to a neurologic disorder.We report the unanticipatedfinding of central sleep apnea in four-term neonates with d-TGA after uncomplicated ASO,with the short-term complication of delayed hospital discharge and long-term concerns regarding this early marker of brain immaturity and its hindrance to normal development.Within this report,we will review each patient’s clinical course and then examine the literature on pediatric central sleep apnea,neurodevelopmental outcomes after ASO,and the important overlap of these entities in the care of patients going forward.
文摘BACKGROUNDEctopic thyroid at the base of the tongue is a rare congenital condition, and it iseven rarer to have clinical symptoms and require surgical intervention. Thisdisease is easily misdiagnosed preoperatively. This article reports the diagnosis,surgical treatment, and follow-up of a case of lingual thyroid.CASE SUMMARYThe patient was a 54-year-old woman who presented with laryngeal foreign bodysensation and dysphagia for 20 d. The lingual thyroid was considered for generalexamination, and surgery was performed to transpose the lingual thyroid to theright submaxillary region. Pathological analysis confirmed thyroid tissue. Thepatient experienced complete remission after surgery, but developed hypothyroidismand required thyroid hormone replacement therapy, and her thyroidfunction gradually recovered over time.CONCLUSIONWe report a rare case of lingual thyroid with marked laryngeal foreign body sensationand dysphagia. Symptoms were completely relieved by transposition surgerybut postoperative hypothyroidism developed.
文摘Introduction:Transposition of the great arteries(TGA)with aortopulmonary window is a rare type of congenital heart disease with limited experience.We reported a neonate aged 25 days receiving the arterial switch operation and assisted with extracorporeal membrane oxygenation.Conclusion:TGA with aortopulmonary window can be safely correctly with the arterial switch operation.
文摘Introduction Congenitally corrected Transposition of the great Arteries(cc-TGA)is an uncommon congenital heart defect marked by double discordance of atrioventricular(AV)and ventriculoarterial connections.This dual discordance naturally corrects the cardiopulmonary circulation.However,the embryological right ventricle(with its right bundle branch)becomes connected to the aorta,while the left ventricle(with its left bundle branch)is attached to the pulmonary artery.
文摘The Agrobacterium mediated transgenic rice ( Oryza saliva L.) population with inserts of maize transposon Activator/Dissociation (Ac/Ds) was investigated. DNA sequences flanking the T-DNA were analyzed with inverse PCR. Results showed that 65.4% of the T-DNA was integrated in different locations of rice genome, and some T-DNA flanking sequences were located on certain chromosomes. A number of T-DNA was found to have inserted into protein coding regions. In order to induce transposition of the inserted Ds elements, 354 crosses of Ac x Ds and Ds x Ac were constructed. The excision frequency of Ds element trans-activated by Ac transposase was 22.7% in the F-2 populations, and the transposition was confirmed with analyses of DNA sequences flanking the Ds elements. In addition to the transposition due to 'cut-paste' mechanism, Ds can replicate itself and integrate into a new locus, and inaccurate excisions were also found. A proportion of DNA segments flanking the Ds elements showed no homologies to sequences published in GenBank, of which two were registered under the accession numbers AF355153 and AF355770. The strategy of using transposon tagging for rice genomics study was discussed.
文摘OBJECTIVE:To explore the optimal surgery in treating moderate-severe cubital tunnel(CuTS) syndrome by comparing the clinical efficiency of decompression and anterior subcutaneous transposition of ulnar nerve and decompression and anterior submuscular transposition of ulnar nerve,and to provide a theoretical basis for the appropriate surgical programs in treating moderate-severe Cu TS.METHODS:47 consecutive cases of moderate-severe Cu TS were surgically treated in our department from January 2014 to January 2017.All patients were divided into two groups by the doctor in our department.21 Cu TS cases were treated with decompression and anterior subcutaneous transposition of ulnar nerve,and other 26 cases were treated with decompression and anterior submuscular transposition of ulnar nerve.All the patients were followed 1 month,3 months and 6 months after operation to evaluate the recovery degree of ulnar nerve function and the clinical efficiency of the two methods was compared.RESULTS:Clinical symptoms of two groups were significant alleviated.There was no significant statistical difference between two groups in the clinical efficiency.CONCLUSION:Completely releasing of nerve truck is the most important step in treating mediate-severe Cu TS.Theclinical results of the two methods are similar,but the anterior subcutaneous transposition of ulnar nerve is more easy to operate and can be widely used.
基金funded by the National Natural Science Foundation of China,No.31571236,31571235(to YHK,PXZ)National Key Research and Development Program of China,No.2016YFC1101604(to DYZ)+3 种基金National Key Basic Research Program of China(973 Program),No.2014CB542200(to BGJ)Ministry of Education Innovation Program of China,No.IRT_16R01(to BGJ)Beijing Science and Technology New Star Cross Program of China,No.2018019(to PXZ)Peking University People’s Hospital Research and Development Funds,No.RDH2017-01(to HLX)
文摘Our previous studies have confirmed that during nerve transposition repair to injured peripheral nerves, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively repair distal nerve and target muscle tissue and restore muscle motor function. To observe the effect of nerve regeneration and motor function recovery after several types of nerve transposition for median nerve defect(2 mm), 30 Sprague-Dawley rats were randomly divided into sham operation group, epineurial neurorrhaphy group, musculocutaneous nerve transposition group, medial pectoral nerve transposition group, and radial nerve muscular branch transposition group. Three months after nerve repair, the wrist flexion test was used to evaluate the recovery of wrist flexion after regeneration of median nerve in the affected limbs of rats. The number of myelinated nerve fibers, the thickness of myelin sheath, the diameter of axons and the cross-sectional area of axons in the proximal and distal segments of the repaired nerves were measured by osmic acid staining. The ratio of newly produced distal myelinated nerve fibers to the number of proximal myelinated nerve fibers was calculated. Wet weights of the flexor digitorum superficialis muscles were measured. Muscle fiber morphology was detected using hematoxylin-eosin staining. The cross-sectional area of muscle fibers was calculated to assess the recovery of muscles. Results showed that wrist flexion function was restored, and the nerve grew into the distal effector in all three nerve transposition groups and the epineurial neurorrhaphy group. There were differences in the number of myelinated nerve fibers in each group. The magnification of proximal to distal nerves was 1.80, 3.00, 2.50, and 3.12 in epineurial neurorrhaphy group, musculocutaneous nerve transposition group, medial pectoral nerve transposition group, and radial nerve muscular branch transposition group, respectively. Nevertheless, axon diameters of new nerve fibers, cross-sectional areas of axons, thicknesses of myelin sheath, wet weights of flexor digitorum superficialis muscle and cross-sectional areas of muscle fibers of all three groups of donor nerves from different anterior horn motor neurons after nerve transposition were similar to those in the epineurial neurorrhaphy group. Our findings indicate that donor nerve translocation from different anterior horn motor neurons can effectively repair the target organs innervated by the median nerve. The corresponding spinal anterior horn motor neurons obtain functional reinnervation and achieve some degree of motor function in the affected limbs.
基金supported by the National Natural Science Foundation of China,Nos.31771322,81671215(to PXZ)the Beijing National Science Foundation,Nos.7212121(to PXZ)+6 种基金the National Key Research and Development Plan of China,No.2018YFB1105504(to PXZ)Shenzhen Science and Technology Plan Project,No.JCYJ20190806162205278(to PXZ)Sanming Project,No.SZSM202011001(to PXZ)the Fundamental Research Funds for the Central Universities,Clinical Medicine Plus X-Young Scholars Project of Peking University China,No.PKU2020LCXQ020(to YHK)the Key Laboratory of Trauma and Neural Regeneration(Peking University)the Ministry of Education China,No.BMU2019XY007-01the Ministry of Education Innovation Program of China,No.IRT_16R01。
文摘Lower extremity nerve transposition repair has become an important treatment strategy for peripheral nerve injury;however, brain changes caused by this surgical procedure remain unclear. In this study, the distal stump of the right sciatic nerve in a rat model of sciatic nerve injury was connected to the proximal end of the left sciatic nerve using a chitin conduit. Neuroelectrophysiological test showed that the right lower limb displayed nerve conduction, and the structure of myelinated nerve fibers recovered greatly. Muscle wet weight of the anterior tibialis and gastrocnemius recovered as well. Multiple-model resting-state blood oxygenation level-dependent functional magnetic resonance imaging analysis revealed functional remodeling in multiple brain regions and the re-establishment of motor and sensory functions through a new reflex arc. These findings suggest that sciatic nerve transposition repair induces brain functional remodeling. The study was approved by the Ethics Committee of Peking University People's Hospital on December 9, 2015(approval No. 2015-50).
文摘BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus femoris muscle flap transposition for vascular graft infections,and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARY We report the case of a 32-year-old male patient,who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure.Using the VSD and muscle flap transposition,the groin wound and vascular graft infection were finally treated successfully.CONCLUSION Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure,especially in consideration of treatable conditions.
基金funded by the National Natural Science Foundation of China,No.31571236,31571235(to YHK and PXZ)National Key Research and Development Program of China,No.2016YFC1101604(to DYZ)+2 种基金National Key Basic Research Program of China(973 Program),No.2014CB542200(to BGJ)Ministry of Education Innovation Program of China,No.IRT_16R01(to BGJ)Beijing Science and Technology New Star Cross Program of China,No.2018019(to PXZ)
文摘During peripheral nerve transposition repair, if the diameter difference between transposed nerves is large or multiple distal nerves must be repaired at the same time, traditional epineurial neurorrhaphy has the problem of high tension at the suture site, which may even lead to the failure of nerve suture. We investigated whether a small gap bio-sleeve suture with different inner diameters at both ends can be used to repair a 2-mm tibial nerve defect by proximal transposition of the common peroneal nerve in rats and compared the results with the repair seen after epineurial neurorrhaphy. Three months after surgery, neurological function, nerve regeneration, and recovery of nerve innervation muscle were assessed using the tibial nerve function index, neuroelectrophysiological testing, muscle biomechanics and wet weight measurement, osmic acid staining, and hematoxylin-eosin staining. There was no obvious inflammatory reaction and neuroma formation in the tibial nerve after repair by the small gap bio-sleeve suture with different inner diameters at both ends. The conduction velocity, muscle strength, wet muscle weight, cross-sectional area of muscle fibers, and the number of new myelinated nerve fibers in the biosleeve suture group were similar to those in the epineurial neurorrhaphy group. Our findings indicate that small gap bio-sleeve suture with different inner diameters at both ends can achieve surgical suture between nerves of different diameters and promote regeneration and functional recovery of injured peripheral nerves.
文摘This study aimed to investigate the reconstruction of the thumb and finger extension function in patients with middle and lower trunk root avulsion injuries of the brachial plexus. From April 2010 to January 2015, we enrolled in this study 4 patients diagnosed with middle and lower trunk root avulsion injuries of the brachial plexus via imaging tests, electrophysiological examinations, and clinical confirmation. Muscular branches of the radial nerve, which innervate the supinator in the forearm, were transposed to the posterior interosseous nerve to reconstruct the thumb and finger extension function. Electrophysiological findings and muscle strength of the extensor pollicis longus and extensor digitorum communis, as well as the distance between the thumb tip and index finger tip, were monitored. All patients were followed up for 24 to 30 months, with an average of 27.5 months. Motor unit potentials（MUP） of the extensor digitorum communis appeared at an average of 3.8 months, while MUP of the extensor pollicis longus appeared at an average of 7 months. Compound muscle action potential（CMAP） appeared at an average of 9 months in the extensor digitorum communis, and 12 months in the extensor pollicis longus. Furthermore, the muscle strength of the extensor pollicis longus and extensor digitorum communis both reached grade Ⅲ at 21 months. Lastly, the average distance between the thumb tip and index finger tip was 8.8 cm at 21 months. In conclusion, for patients with middle and lower trunk injuries of the brachial plexus, transposition of the muscular branches of the radial nerve innervating the supinator to the posterior interosseous nerve for the reconstruction of thumb and finger extension function is practicable and feasible.
文摘In an integrated structure low resistance CICC joint, current is conducted by outer cable strands coming into touch with the conductive Cu sole. So it is an important condition for satisfying joint performance that each strand of the cable inside the joint is able to come to the outermost by transposition. This paper presents analysis, calculation and figures for the strand transposition. According to the twist procedures of the superconducting cable, the author computed the actual pitch of each stage cable, consecutively computed the projection of each stage cable on the axis of the cable (z axis) and the corresponding twist angle as the z coordinate changes, which is then drawn by AutoCAD. From the results shown in the figures, the minimal cable length, which enables each strand to transpose almost equally to the outermost of the cable in such a length, call be determined as the optimal joint length.
基金the National Natural Science Foundation of China,No.81972125 and No.82172510.
文摘BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,improved ROM,AHD,and reduced the retear rates compared to conventional SCR and other established techniques.More high-quality randomized controlled studies on the long-term outcomes of SCR with LHBT transposition are required to further assess.
基金funded by the National Natural Science Foundation of China,No.31571236,31571235(to YHK,PXZ)National Key Research and Development Program of China,No.2016YFC1101604(to DYZ)+2 种基金National Key Basic Research Program of China(973 Program),No.2014CB542200(to BGJ)Ministry of Education Innovation Program of China,No.IRT_16R01(to BGJ)Beijing Science and Technology New Star Cross Program of China,No.2018019(to PXZ)
文摘Multiple regeneration of axonal buds has been shown to exist during the repair of peripheral nerve injury, which confirms a certain repair potential of the injured peripheral nerve. Therefore, a systematic nerve transposition repair technique has been proposed to treat severe peripheral nerve injury. During nerve transposition repair, the regenerated nerve fibers of motor neurons in the anterior horn of the spinal cord can effectively grow into the repaired distal nerve and target muscle tissues, which is conducive to the recovery of motor function. The aim of this study was to explore regeneration and nerve functional recovery after repairing a long-segment peripheral nerve defect by transposition of different donor nerves. A long-segment(2 mm) ulnar nerve defect in Sprague-Dawley rats was repaired by transposition of the musculocutaneous nerve, medial pectoral nerve, muscular branches of the radial nerve and anterior interosseous nerve(pronator quadratus muscle branch). In situ repair of the ulnar nerve was considered as a control. Three months later, wrist flexion function, nerve regeneration and innervation muscle recovery in rats were assessed using neuroelectrophysiological testing, osmic acid staining and hematoxylin-eosin staining, respectively. Our findings indicate that repair of a long-segment ulnar nerve defect with different donor nerve transpositions can reinnervate axonal function of motor neurons in the anterior horn of spinal cord and restore the function of affected limbs to a certain extent.
基金supported by the National Basic Research Program (973) of China (No. 2009CB119200)the Natural Science Foundation of Zhejiang Province (No. Y304122),China
文摘The piggyBac transposon has been long used to integrate foreign DNA into insect genomes.However,undesirable transgene expression can result from random insertions into the genome.In this study,the efficiency of chimeric Gal4-piggyBac transposase in directing integration onto a DNA target plasmid was evaluated in cultured silkworm Bombyx mori Bm-12 and fruit fly Drosophila Schneider 2(S2) cells.The Gal4-piggyBac transposase has a Gal4 DNA-binding domain(DBD),and the target plasmid has upstream activating sequences(UAS) to which the Gal4 DBD can bind with high affinity.The results indicate that,in the Bm-12 and S2 cells,transpositional activity of Gal4-piggyBac transposase was increased by 4.0 and 7.5 times,respectively,compared to controls,where Gal4-UAS interaction was absent.Moreover,the Gal4-piggyBac transposase had the ability of directing piggyBac element integration to certain sites of the target plasmid,although the target-directing specificity was not as high as expected.The chimeric piggyBac transposase has the potential for use in site-directed transgenesis and gene function research in B.mori.
文摘Genetic analyses of patients with transposition of the great arteries have identified rare copy number variations,suggesting that they may be significant to the aetiology of the disease.This paper reports the identification of a 16 p11.2 microduplication,a variation that has yet to be reported in association with transposition of the great arteries.The 16 p11.2 microduplication is associated with autism spectrum disorder and developmental delay,but with highly variable phenotypic effects.Autism and attention deficit disorders are observed more frequently in children with congenital heart disease than in the general population.Neonatal surgery is proposed as a risk factor,but as yet unidentified genetic abnormalities should also be taken into account.Thus,congenital heart abnormalities may constitute a part of the phenotypic spectrum associated with duplications at 16 p11.2.We suggest chromosomal microarray be considered part of the diagnostic work-up in patients with transposition of the great arteries.
文摘Before the 1950s,D-transposition of the great arteries was associated with nearly 90% mortality within the first year of life.The Mustard and Senning procedures resulted in a signifi cant increase in the lifespan of these patients but with notable long-term complications,including arrhythmias,sinus node dysfunction,chronotropic incompetence,and right ventricular systolic dysfunction.The arterial switch operation(first described by Adib Jatene)initially resulted in nearly universal death.However,the use of coronary buttons for coronary artery translocation has improved operative survival dramatically.It is now considered the treatment of choice in patients amendable to the arterial switch operation.Considered an anatomic repair,resulting in concordant ventriculoarterial connections and a systemic left ventricle,the arterial switch operation reduces the incidence of ventricular dysfunction.However,it is also associated with long-term complications,including aortic root dilatation,aortic valve regurgitation,right ventricular outfl ow tract obstructions,coronary artery stenosis/compression,and branch pulmonary artery stenosis.
文摘AIMTo describe the clinical and echocardiographic features of Nigerian children with transposition of the great arteries and emphasize the need for collaboration with cardiac centres in the developed countries to be able to salvage the children.METHODS Prospective and cross sectional involving consecutive patients diagnosed with transposition of the great arteries using clinical evaluation and echocardiography at the Paediatric Department of Lagos State University Teaching Hospital,Lagos Nigeria as part of a large study between January 2007 and December 2015.RESULTS There were 51 cases of transposition of the great arteries within the study period with a male to female ratio of 2:1 and a prevalence of 1.55 per 10000among population of children who presented to centre during the study.Its proportion amongst children with congenital heart disease was 4.9%,while it was15.4%among those with cyanotic congenital heart disease.The mean age±SD of the subjects was 10.3±21.8 mo.Up to 70%of the patients were less than6 mo of age at initial presentation.The most common mode of presentation was cyanosis.The most common associated intracardiac anomaly was ventricular septal defect which occurred in 56%of the patients.CONCLUSION Transposition of the great arteries is as common in Nigeria as in the other parts of the world.The most common mode of presentation was cyanosis.There is an urgent need to establish paediatric cardiac centres in Nigeria if these children are to be salvaged.
文摘ObjectiFe To evaiuate surgicai procedure of corrected transposition of the great arteries(CTGA). Methods Twenty one patients with CTGA were ropaired from September 1990 to December 1996 Eighteen pattents were corrected by biventricular repair. The ventricular septal delect (VSD) was repaired through the right atrium or anatomic left ventricle in 11 patients and through the anatomic right ventricle in 7 patients. There were atrioventricular valvular regurgitation or one side ventricular hypoplasia in 3 patients. Two patients had Fontan operation and one had bidirectional shunt. Results Five patients (45%, 5/11) had complete atrioventricular block (CAVB) in these cases with VSD repaired through the right atrium or left ventricle, and 3 patients died (27%, 3/11). One patient (14%,1/7) had CA VB which the VSD was repaired through the anatomic right ventricle with only one death. Conclusion CAVB could be prevented by VSD rePair through the anatomic right ventricle. CTGA with pulmonary hypertension must be repaired early to prevent pulmonary vascular disease. Fontan or bidirectional shunt were suggested for complex CTGA with valvular regurgitation or ventricular unbalance.
