bluuebunny/crossref_metadata_2025 huggingface dataset:
Ureteral inflammatory edema grading clinical application
Authors: Li Jialin , Jiang Chengming , Liao Xinzhi , Yan Sheng , Huang Sigen , Liu Shengyin , Liu Quanliang
Published: January 2023

Purpose

To evaluate the relationship between endoscopic ureteral inflammatory edema (UIE) and ureteral lumen, formulate a preliminary grading method for the severity of UIE, and analyze the impact of different grades of UIE on endoscopic ureteral calculi surgery and prognosis.

Materials and methods

We retrospectively analyzed 185 patients who underwent ureteroscopic lithotripsy (URSL) for upper urinary tract stones between January 2021 and November 2021. The UIE grade and lumen conditions were assessed by endoscopic observation. The effect of UIE grade on URSL and on patient prognosis were analyzed by multiple linear regression and binary logistic regression.

Results

A total of 185 patients were included in the study. UIE grade showed a significant correlation with age, hydronephrosis grading (HG), ureteroscope placement time (UPT), surgery time (ST), hemoglobin disparity value (HDV), and postoperative ureteral stenosis (PUS) (P < 0.05). Logistics regression analysis showed a gradual increase in intraoperative UPT and ST with increase in UIE grade. The severity of UIE showed a negative correlation with improvement of postoperative hydronephrosis (IPH) and the appearance of PUS. HDV was significantly increased in patients with UIE grade 3.

Conclusions

UIE grading can be used as an adjunctive clinical guide for endoscopic treatment of upper urinary tract stones. The postoperative management measures proposed in this study can help inform treatment strategy for ureteral stones.
Efficacy of a novel percutaneous pedicle screw fixation and vertebral reconstruction versus the traditional open pedicle screw fixation in the treatment of single-level thoracolumbar fracture without neurologic deficit
Authors: Rui Lining , Li Fudong , Chen Cao , E Yuan , Wang Yuchen , Yuan Yanhong , Li Yunfeng , Lu Jian , Huang Shengchang
Published: January 2023

Objective

The aim of this study was to compare the efficacy and safety of a novel percutaneous pedicle screw fixation and vertebral reconstruction (PPSR) vs. that of open pedicle screw fixation (OPSF) in the treatment of thoracolumbar fractures.

Methods

This retrospective study enrolled 153 patients who underwent PPSR and 176 patients who received OPSF. Periprocedural characteristics, radiographic parameters, and clinical outcomes were compared between the two groups.

Results

The operation duration was 93.843 ± 20.611 in PPSR group and 109.432 ± 11.903 in OPSF group; blood loss was 131.118 ± 23.673 in PPSR group and 442.163 ± 149.701 in OPSF group, incision length was 7.280 ± 1.289 in PPSR group and 14.527 ± 2.893 in OPSF group, postoperative stay was 8.732 ± 1.864 in PPSR group and 15.102 ± 2.117 in OPSF group, and total hospitalization costs were 59027.196 ± 8687.447 in PPSR group and 73144.432 ± 11747.567 in OPSF group. These results indicated that these parameters were significantly lower in PPSR compared with those in OPSF group. No significant difference was observed in the incidence of complications between the two groups. The radiographic parameters including height of the anterior vertebra, Cobb angle, and vertebral wedge angle were better in PPSR group than in OPSF group. Recovery rate of AVH was 0.449 ± 0.079 in PPSR group and 0.279 ± 0.088 in OPSF group. Analysis of clinical results revealed that during postoperative period, the VAS and ODI scores in PPSR group were lower than those in OPSF group.

Conclusions

Collectively, these results indicated that PPSR more effectively restored the height of anterior vertebra and alleviated local kyphosis compared with OPSF. Moreover, the VAS and ODI scores in PPSR group were better than those of OPSF group.
Clinical characteristics and management of 106 patients with pyogenic liver abscess in a traditional Chinese hospital
Authors: Nie ShiJiao , Lin Da , Li XiaoWen
Published: January 2023

This is a retrospective study of clinical data from 106 patients with pyogenic liver abscess (PLA) treated in a traditional Chinese hospital during the eight years preceding this publication. We aimed to provide evidence to improve the diagnosis accuracy and the treatment strategies for PLAs. We collected records of patients treated at the Guangxing Hospital, which is affiliated to the Zhejiang Traditional Chinese University in Hangzhou, and we collected their general background information, laboratory and imaging features, and clinical manifestations and outcomes to perform a retrospective analysis. Diabetes mellitus (45.3%, 48/106), biliary calculi (36.8%, 39/106), and history of abdominal surgery (15.1%, 16/106) were the three most common PLA risk factors present in our cohort. Fever and chills (95.3%, 101/106), right upper quadrant pain/epigastric discomfort (68.9%, 73/106), nausea and vomiting (38.8%, 41/106), and cough and sputum (14.2%, 15/106) were the most common clinical manifestations of PLA. Most patients had the abscesses in the right liver lobe, and the most commonly found bacteria were Klebsiella pneumoniae (54.8%, 42/76), Escherichia coli (35.1%, 27/76), and Streptococcus pneumoniae (3.9%, 3/76). Liver Doppler ultrasound is a conventional and effective method to identify liver abscesses. Most patients were treated using a percutaneous puncture under B-ultrasound guidance. Most patients (n = 104 or 98.1%) were cured, one patient (0.9%) died, and one was discharged with multiple abscesses post treatment.
Association between acute kidney injury and prognoses of cardiac surgery patients: Analysis of the MIMIC-III database
Authors: Sun Chun , Chen Deqing , Jin Xin , Xu Guangtao , Tang Chenye , Guo Xiao , Tang Zhiling , Bao Yixin , Wang Fei , Shen Ruilin
Published: January 2023

Background

Acute kidney injury (AKI) is the most common major complication of cardiac surgery field. The purpose of this study is to investigate the association between acute kidney injury and the prognoses of cardiac surgery patients in the Medical Information Mart for Intensive Care III (MIMIC-III) database.

Methods

Clinical data were extracted from the MIMIC-III database. Adult (≥18 years) cardiac surgery patients in the database were enrolled. Multivariable logistic regression analyses were employed to assess the associations between acute kidney injury (AKI) comorbidity and 30-day mortality, 90-day mortality and hospital mortality. Different adjusting models were used to adjust for potential confounders.

Results

A total of 6,002 patients were involved, among which 485 patients (8.08%) had comorbid AKI. Patients with AKI were at higher risks of prolonged ICU stay, hospital mortality, 90-day mortality (all P < 0.001), and 30-day mortality (P = 0.008). AKI was a risk factor for hospital mortality [Model 1, OR (95% CI) = 2.50 (1.45–4.33); Model 2, OR (95% CI) = 2.44 (1.48–4.02)], 30-day mortality [Model 1, OR (95% CI) = 1.84 (1.05–3.24); Model 2, OR (95% CI) = 1.96 (1.13–3.22)] and 90-day mortality [Model 1, OR (95% CI) = 2.05 (1.37–3.01); Model 2, OR (95% CI) = 2.76 (1.93–3.94)]. Higher hospital mortality, 30-day mortality and 90-day mortality was observed in higher KDIGO grade for cardiac surgery patients with AKI (all P < 0.05).

Conclusion

Comorbid AKI increased the risk of hospital mortality, 30-day mortality, and 90-day mortality of cardiac surgery patients in the MIMIC-III database.
Anterior cervical discectomy and fusion to treat cervical instability with vertigo and dizziness: A single center, retrospective, observational study
Authors: Zheng Huo-Liang , Li Bo , Song Shao-Kuan , Chen Peng-Bo , Jiang Lei-Sheng , Jiang Sheng-Dan
Published: January 2023

Purpose

The current study attempts to investigate the role of anterior cervical discectomy and fusion (ACDF) in alleviating symptoms in patients with cervical vertigo associated with cervical instability.

Methods

The patients of cervical instability with vertigo and dizziness who underwent ACDF between January 2011 and December 2019 were followed-up for more than two years. Demographic data (age, sex, follow up period and levels of instable cervical segments) were assessed; Symptoms of vertigo and dizziness before and after surgery were assessed by the 15-item version of the Vertigo Symptom Scale (VSS) and the 25-item Dizziness Handicap Inventory (DHI). The severity and frequency of other symptoms like neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache, diplopia and blurring of vision before and after surgery were also assessed.

Results

A total of 92 patients underwent ACDF for cervical instability with vertigo and dizziness between January 2011 and December 2019, of which 79 patients were included in the final analysis. The number of instable levels had no correlation with VSS and DHI scores before surgery (p > 0.05), while patients with C3/4 instability suffering a severer vertigo than other levels. Both DHI and VSS scores were significantly reduced after ACDF and this was sustained within two years after surgery (p < 0.001). Although there was no statistical difference in the ratio of patients with vertigo relief, patients with one-level cervical instability demonstrated a more rapid recovery than patients with multi-level cervical instability (p = 0.048). Also, there was improvement in other symptoms such as neck and occipital pain, gastrointestinal discomfort, nausea, vomiting, tinnitus, palpitations, headache and blurring of vision after surgery.

Conclusions

Vertigo caused by C3/4 instability was severer than other levels such as C4/5 and C5/6. During 2 years' follow-up the significant relief of vertigo and dizziness was observed after anterior cervical surgery. Other accompanying symptoms except hypomnesia were also extenuated in follow-up period.
Global research trends in catheter ablation and surgical treatment of atrial fibrillation: A bibliometric analysis and science mapping
Authors: Gao Xiang , Liu Kai , Zhao Xinke , Lv Xinfang , Wu Xue , Ren Chunzhen , Chen Qilin , Li Yingdong
Published: January 2023

Introduction

To evaluate the global research results of the catheter ablation and surgical treatment of atrial fibrillation in the past 40 years by bibliometrics, and to explore the hotspots and prospects for future development.

Methods

Relevant literatures were selected from the Web of Science Core Collection. VOSviewer 1.6.17, SciMAT 1.1.04, and CiteSpace 5.8.R1 were used to analyze the data objectively, deeply and comprehensively.

Results

As of July 14, 2021, 11,437 studies for the catheter ablation and surgical treatment of atrial fibrillation have been identified from 1980 to 2021. The Journal of Cardiovascular Electrophysiology and Circulation respectively ranked first in terms of the number of publications and the number of co-citations. A total of 6,631 institutions from 90 countries participated in the study, with USA leading the way with 3,789 documents. Cryoablation, atrial fibrosis, substrate modification, minimally invasive and access surgery will still be the research focus and frontier in the next few years.

Conclusions

The publication information for the catheter ablation and surgical treatment of atrial fibrillation were reviewed, including country, institution, author, journal publications, and so on. Developed countries had the advantage in this research areas, and cooperation with low-income countries should be improved. The former research hotspots in the field of catheter ablation and surgical treatment of atrial fibrillation were analyzed, and the future research direction was predicted.
Robot-assisted thoracoscopic surgery vs. sternotomy for thymectomy: A systematic review and meta-analysis
Authors: Wang Cheng-qian , Wang Jie , Liu Fei-yu , Wang Wei
Published: January 2023

Introduction

Surgeons have widely regarded sternotomy (ST) as the standard surgical method for thymectomy. Minimally invasive methods for thymectomy, including video-assisted and robot-assisted thoracoscopic surgery (RATS), have been explored. There are some studies have researched and compared the outcomes of patients after robotic and sternotomy procedure.

Methods

We searched the databases of Pubmed, the Cochrane Library, Embase and selected the studies on the efficacy and safety of RATS or ST for thymectomy. Meta-analysis was performed for operation time, operation blood loss, postoperative drainage time, operative complications and hospitalization time.

Results

A total of 16 cohort studies with 1,089 patients were included. Compared to ST, RATS is an appropriate alternative for thymectomy which reduced operation blood loss [standardized mean difference (SMD) = −1.82, 95% confidence interval (95% CI): (−2.64, −0.99), p = 0.000], postoperative drainage time [SMD = −2.47, 95% Cl: (−3.45, −1.48), p = 0.000], operative complications [odds ratio (OR) = 0.31, 95% Cl: (0.18, 0.51), p = 0.000] and hospitalization time [SMD = −1.62, 95% Cl: (−2.16, −1.07), p = 0.000].

Conclusions

This meta-analysis based on cohort studies shows that RATS has more advantages over ST. Therefore, RATS is a more advanced and suitable surgical method for thymectomy.
Machine learning algorithms to predict atypical metastasis of colorectal cancer patients after surgical resection
Authors: Yang Xiaoyan , Yu Wei , Yang Feimin , Cai Xiujun
Published: January 2023

Background

The prognosis of colorectal cancer with atypical metastasis is poor. However, atypical metastasis was less common and under-appreciated.

Methods

In this study we attempted to present the first machine learning models to predict the risk of atypical metastasis in colorectal cancer patients. We evaluated the differences between metastasis and non-metastasis groups, assessed factors associated with atypical metastasis using univariate and multivariate logistic regression analyses, and preliminarily developed the multiple machine learning models to predict atypical metastasis.

Results

168 patients were included. Prognostic Nutritional Index (PNI) [OR =  0.998; P = 0.030], Cancer antigen 19–9 (CA19-9) [OR = 1.011; P = 0.043] and MR-Distance [-mid OR = 0.289; P = 0.009] [-high OR = 0.248; P = 0.021] were shown to be independent risk factors for the atypical metastasis via multivariate analysis. Furthermore, the machine learning model based on AdaBoost algorithm (AUC: 0736) has better predictive performance comparing to Logistic Regression (AUC: 0.671) and KNeighbors Classifier (AUC: 0.618) by area under the curve (AUC) in the validation cohorts. The accuracy, sensitivity, and specificity of the model trained using the Adaboost method in the validation set are 0.786, 0.776 and 0.700, while 0.601, 0.933, 0.508 using Logistic Regression and 0.743, 0.390, 0.831 using KNeighbors Classifier.

Conclusion

Machine-learning approaches containing PNI, CA19-9 and MR-Distance show great potentials in atypical metastasis prediction.
Reliability and repeatability of a modified thoracolumbar spine injury classification scoring system
Authors: Lu Wen-jie , Zhang Jiaming , Deng Yuan-guo , Jiang Wei-yu
Published: January 2023

Purpose

On the basis of the Thoracolumbar Injury Classification and Severity Score (TLICS), an modified TLICS classification system was presented, its reliability and repeatability were assessed, and the factors influencing classification consistency were examined.

Methods

Five spinal surgeons were chosen at random. The clinical data of 120 patients with thoracolumbar fractures admitted to the Department of Spine Surgery, Ningbo Sixth Hospital from December 2019 to June 2021 were categorized using the modified TLICS system. After 6 weeks, disrupt the order of data again. Using unweighted Cohen's kappa coefficients, the consistency of the modified TLICS system was assessed in five aspects: neurofunctional status, disc injury status, fracture morphology, posterior ligament complex (PLC) integrity, and treatment plan.

Results

In terms of reliability, the average kappa values for the subclasses of the modified TLICS system (neurofunctional status and disc injury status) were 0.920 and 0.815, respectively, reaching the category of complete confidence. Fracture morphology and treatment plan had average kappa values of 0.670 and 0.660, respectively, which were basically reliable. The average kappa value of PLC integrity was 0.453, which belonged to the category of moderate confidence. The average kappa coefficients of each subcategory (neurological status, disc injury status) had excellent consistency, and the kappa values were 0.936 and 0.879, respectively, which belonged to the completely credible category. The kappa values of fracture morphology and treatment plan repeatability were 0.772 and 0.749, respectively, reaching the basic credibility category. PLC integrity repeatability kappa value is low, 0.561, to moderate credibility category.

Conclusion

The modified TLICS system is intuitive and straightforward to understand. The examination of thoracolumbar fracture injuries is more exhaustive and precise, with excellent reliability and repeatability. The examination of neurological status and disc injury status is quite reliable and consistent. The consistency of fracture morphology is slightly poor, which is basically credible; the PLC integrity consistency is poor, reaching a reliability level of moderate, which may be associated with the subjectivity of clinical evaluation of PLC.
The clinical efficacy of anterior cervical discectomy and fusion with ROI-C device vs. plate-cage in managing traumatic central cord syndrome
Authors: Song Dawei , Deng Zicheng , Feng Tao , Wang Jinning , Liu Yijie , Wang Heng , Yang Huilin , Niu Junjie
Published: January 2023

Purpose

To assess the efficacy and complications of anterior cervical discectomy and fusion (ACDF) with ROI-C device vs. conventional anterior plate and cage system (APCS) in managing traumatic central cord syndrome (TCCS).

Methods

A total of 37 patients diagnosed with TCCS who underwent ACDF with ROI-C implant and APCS were recruited in this retrospective study from June 2012 to February 2020. Radiological parameters and clinical results were recorded and compared through follow-up time. Characteristics of patients and complications were also recorded.

Results

All patients tolerated the procedure well. The average follow-up time was 25.00 ± 7.99 months in the ROI-C group, and 21.29 ± 7.41 months in the APCS group. The blood loss and operation time were significantly lower in the ROI-C group than in the APCS group. Radiological parameters and clinical results were all improved postoperatively and maintained at the final follow-up. Fusion was achieved in all patients. ROI-C group had a lower incidence of postoperative dysphagia than the APCS group. Only 1 case of ALD was observed at the final follow-up in the APCS group.

Conclusions

Both ROI-C device and APCS demonstrated satisfactory clinical effects and safety in managing symptomatic single-level traumatic central cord syndrome with underlying instability. Both techniques could improve and maintain cervical lordosis and disc height. ROI-C device was related to a lower incidence of postoperative dysphagia, shorter operation time, and less blood loss.
Cervical spine involvement in pediatric mucopolysaccharidosis patients: Clinical features, early diagnosis, and surgical management
Authors: Liu Hai-Tao , Song Jia , Zhou Fu-Chao , Liang Zhi-Hui , Zhang Qiu-Qi , Zhang Yue-Hui , Shao Jiang
Published: January 2023

Mucopolysaccharidosis (MPS) is a progressive genetic disease that causes a deficiency in lysosomal enzymes, which play an important role in the degradation pathway of glycosaminoglycans. As a result of enzyme defects, mucopolysaccharides cannot be metabolized and thus accumulate. The cervical spine is one of the most commonly involved sites; thus, prompt surgical management before the onset of severe neurological deterioration is critical. However, because of the rarity of the disease, there is no standard treatment. In this review, we characterize the cervical spinal involvement in pediatric patients with MPS, describe the useful imaging technologies for diagnosis, and provide screening procedure for children with MPS. Surgical managements, including indications, surgical methods, possible difficulties, and solutions, are reviewed in detail.
Postoperative diaphragmatic hernia following endoscopic thoracic sympathectomy for primary palmar hyperhidrosis: A case report
Authors: Wang Ling , Wu Xike , Tang Yuepu , Fan Zheyuan
Published: January 2023

Postoperative diaphragmatic hernia (DH) following endoscopic thoracic sympathectomy for primary palmar hyperhidrosis is extremely rare. We present a 21-year-old female patient who developed a left DH with herniation of the stomach and gastric perforation on the first postoperative day after undergoing bilateral video-assisted thoracoscopic sympathectomy R4 ablation. She complained of severe dyspnea and chest pain, and an emergency chest x-ray and computed tomography revealed left pleural effusion, collapsed lung, and left DH, which allowed the stomach to herniate into the chest. Emergency thoracoscopic surgery was performed. We repaired the diaphragmatic defect intraoperatively and replaced the stomach with the peritoneal cavity from the thoracic field. The patient was discharged without complications. She did not present with recurrent symptoms at the 3-month follow-up. Postoperative DH should be considered when patients complain of gastrointestinal or respiratory symptoms after sympathectomy, although it is very rare.
Can oblique lateral interbody fusion (OLIF) create more lumbosacral lordosis in lumbar spine surgery than minimally invasive transforaminal interbody fusion (MIS-TLIF)?
Authors: Li Jie , Chen Yilei , Wu Hao , Gan Kaifeng , Bei Dikai , Fan Tengdi , Chen Jian , Zhao Fengdong , Chen Binhui
Published: January 2023

Objective

To compare the differences in the correction effect for lumbosacral lordosis and clinical outcomes between OLIF with/without posterior pedicle screw fixation (PSF) and MIS-TLIF through a retrospective cohort study.

Method

There were 98 consecutive patients originally enrolled for the study, but 15 patients were excluded due to intraoperative endplate injury or osteotomy performed for severe spinal deformity. Thus, 83 patients included in this study (36 males and 47 females, mean age 66.0 ± 10.8 years) underwent single to three-segment OLIF (including OLIF + PSF and OLIF Standalone) or MIS-TLIF surgery from 2016 to 2018. The operation time, bleeding and blood transfusion, fusion rate, complication, pre-and postoperative visual analogue scale (VAS), Oswestry Disability Index (ODI) were evaluated. In addition, radiological parameters including lumbosacral lordosis (LL), fused segment lordosis (FSL), anterior disc height (ADH) and posterior disc height (PDH) were measured. The clinical outcomes, LL, FSL, ADH and PDH restored and were compared between the OLIF group, OLIF subgroups and MIS-TLIF group.

Results

The average operation time and intraoperative bleeding were significantly less in the OLIF group than in the MIS-TLIF group (189 ± 83 vs. 229 ± 80 min, 113 ± 138 vs. 421 ± 210 ml), P < 0.001). There was no statistically significant difference between the OLIF group and the MIS-TLIF group in VAS and ODI improvements, fusion rate, complication, LL and FSL correction (P > 0.05). The ADH and PDH increases in the OLIF group were more than that in MIS-TLIF group (P < 0.001). The correction of LL was significantly more in the OLIF+PSF group than in the MIS-TLIF group (10.6 ± 8.7 vs. 4.0 ± 6.1 deg, P = 0.005).

Conclusion

OLIF and MIS-TLIF are both safe and effective procedures, capable of restoring lumbosacral lordosis and disc height partly. Combined with PSF, OLIF can achieve a better correction effect of lumbosacral lordosis than MIS-TLIF.
Lateral approach for insertional Achilles tendinitis with Haglund deformity
Authors: Jiang Jiantao , Wang Cheng , Fu Shaoling , Wang Jiazheng , Wu Chenglin , Yao Guangxiao , Song Guoxun , Gu Wenqi , Yang Kai , Xue Jianfeng , Shi Zhongmin
Published: January 2023

Objective

The study aims to investigate the functional outcome of the lateral approach for insertional Achilles tendinitis (IAT) with Haglund deformity.

Methods

From January 2016 to September 2019, 14 cases of IAT with Haglund deformity that resisted conservative treatment received surgery in our department. A lateral approach was used to debride the bony and soft tissue and reattach the insertion of the Achilles tendon. The Visual Analog Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and Victorian Institute of Sport Tendon Study Group-Achilles Tendinopathy score (VISA-A) were used to evaluate clinical outcomes.

Result

The mean patient age was 39.57 years at the time of surgery. The mean follow-up was 14.74 months. The mean VAS score significantly decreased from 4.86 ± 0.86 preoperatively to 1.21 ± 1.58 postoperatively (P < 0.001). The mean AOFAS score significantly improved from 66.64 ± 6.23 preoperatively to 90.21 ± 11.50 postoperatively (P < 0.001). The mean preoperative and the last follow-up VISA-A were 66 (range 56.75–69.25) and 86 (range 75.75–97.00) points, respectively (P < 0.05).

Conclusion

The lateral approach was effective and safe for IAT with Haglund deformity. Moreover, the mid-term functional outcome was promising.

Level of Clinical Evidence

IV
Total knee arthroplasty and femoral osteotomy with a patient-specific cutting guide to treat haemophilic arthritis with severe extra-articular deformity: A case report and review of literatures
Authors: Lv Shuai-Jie , Wang Zheng-Ming , Wang Rui , Jin Heng-Kai , Tong Pei-Jian , Liu Xun
Published: January 2023

Background

Total knee arthroplasty (TKA) is recommended for haemophilic patients with end-stage arthritis. TKA combined with a one-stage extraarticular osteotomy is uncommon in the treatment of haemophilic arthritis (HA) with severe extra-articular deformities (EADs) and a history of inhibitors under the guidance of a patient-specific cutting guide (PSI).

Case presentation

We reported a 20-year-old male patient with severe haemophilia, limited knee functionality, a 30° sagittal deformity on the femoral side and a history of inhibitors. We adopted the Van Creveld protocol to decrease the inhibitors. TKA and extra-articular osteotomy (EAO) were performed simultaneously and sequentially under the guidance of PSI. An appropriate central alignment of the lower limb was restored by using cement prostheses with antibiotics and femur shaft locking compression plates. The last follow-up showed that the knee function was good, the VAS score was 0, the WOMAC score was 18 and the ROM was 0°–95°.

Conclision

Regular haematology management can reduce the perioperative bleeding risk in haemophilic patients treated with inhibitors. PSI plays an important role in guiding the TKA and EAO of end-stage HA patients with severe EAD.
Trends of rhinoplasty research in the last decade with bibliometric analysis
Authors: Zhu Xuanru , Zhang Bin , Huang Yuesheng
Published: January 2023

Background

As rhinoplasty (RP) with different requirements is becoming more and more popular in the latest decade, this study aims to quantitatively and qualitatively explore the trends in RP research, depict research hotspots, and point out the future direction with a bibliometric analysis.

Methods

All RP literature studies in the last decade (from 2012 to 2021) were retrieved from the Web of Science Core database. Annual output, institutions, authors, journals, and most-cited literature studies were analyzed by bibliometric tools, including CiteSpace, bibliometric online platform, bibliometrix R language kit, BICOMB, and gCLUTO.

Results

A total of 2,590 RP research studies dated between 2012 and 2021 were included according to our criterion. As for the country, the United States, Turkey, and Korea maintained the top three in RP research. As for the institutions, the University of California, Irvine, Stanford University, and University of Ulsan ranked top three in RP research publications based on article counts. Professor Rhorich RJ, Most SP, and Jang YJ were the most contributed authors according to article counts and citation number. The top journals were The Plastic and Reconstructive Surgery, JAMA Facial Plastic Surgery, and Aesthetic Surgery Journal. The 10 most-cited literature studies were also listed explicitly in this study. Finally, biclustering analysis on the most frequent keywords were conducted which helped us to identify seven hotspot clusters in RP research.

Conclusions

We comprehensively summarized the publication information of RP literature studies in the past decade, highlighted the current status and trends over time, and provide guidance for in-depth research direction on RP for the future.
The treatment of a Morel-Lavallée lesion of the thigh with incision and drainage along with tissue debridement and a surgically placed drain: A case report and literature review
Authors: Hu Minhua , Chen Junbang , Ma Luyao , Huang Feng , Cai Qunbin
Published: January 2023

Background

A Morel-Lavallée lesion (MLL) is a rare closed degloving injury that usually occurs around the hips and is associated with pelvic fractures after high-energy trauma, which is commonly overshadowed by other severe post-traumatic manifestations. An isolated MLL, mostly caused by low-energy violence, is even rarer. Thus, the rates of misdiagnosis and missed diagnosis are often high. In this case report and literature review, we review the pathophysiology, clinical manifestations, imaging data, and treatment of this lesion to increase awareness of this rare disease.

Case report

We report the case of an isolated MLL in the right thigh caused by trauma, which happened to be one of missed diagnosis both at the initial visit and at the return visit of the patient, with a significant sign of a mass on MRI. Given the size of the lesion, open debridement and irrigation were adopted to treat the lesion, and the patient recovered well post-operatively.

Conclusion

Young surgeons should pay attention to the MLL with sufficient recognization to avoid missed diagnosis and misdiagnosis. Comprehensive physical examination and imaging data play important roles in the diagnosis of MLL. In the early stages of this injury, a detailed history review combined with physical examination and MRI, can reduce the rates of missed diagnosis and misdiagnosis. The choice of the therapeutic scheme depends on the size and severity of the lesion. For an isolated MLL, compared with conservative treatments, we suggest that incision and drainage, along with tissue debridement and a surgically placed drain, will reduce the rates of infection and recurrence.
Secondary tuberculosis of adjacent segments after anterior cervical discectomy and fusion: A case report
Authors: Liu Chengjiang , Liu Yidong , Ma Boyuan , Zhou Mengmeng , Zhao Xinyan , Fu Xuanhao , Kan Shunli , Hu Wei , Zhu Rusen
Published: January 2023

Introduction

Anterior cervical discectomy and fusion (ACDF) is a common operation for spinal surgery to treat a variety of cervical diseases. The postoperative infection rate of this procedure is extremely low, and adjacent segments are rarely involved. Tuberculosis (TB) is a common infectious disease that affects the spine in less than 1% of cases and is more common in the thoracolumbar and rarely cervical spine. Herein, for the first time, we report tuberculosis infection in adjacent segments after ACDF.

Case presentation

We report a 50-year-old patient with cervical spondylotic myelopathy (CSM) who was discharged from the hospital after receiving ACDF at the C3/4 level. Two months later, he was admitted to the hospital with neck pain and found to be infected with tuberculosis in C4/5. After 4 months of anti-tuberculosis treatment, the vertebral body was fused.

Conclusion

After ACDF, the adjacent cervical vertebrae were infected with TB but the infection was limited. We believe that the special vertebral blood supply and postoperative secondary blood-borne infection may lead to the occurrence of extrapulmonary tuberculosis.
Comprehensive analysis of global research on overactive bladder: A scientometric approach
Authors: Wang Lu , Deng Sheng , Meng Fanchao , Zhang Lun , Min Zhenxing , Li Jitao , Wang Jisheng
Published: January 2023

Background

Overactive bladder, a syndrome marked by an urgent need to urinate, is a globally prevalent ailment. Human health and quality of life are seriously affected. Therefore, it is essential to investigate the current progress and trends in this field.

Objective

No bibliometric analysis of overactive bladder has been conducted. Through the use of bibliometrics and visualization, this study intends to examine the current progress and development trend of this field.

Methods

Global publications on overactive bladder between January 2004 and August 2022 were extracted from the Web of Science core collection database. A bibliometric and visual analysis was carried out using VOSviewer software and CiteSpace.

Results

Over the last 20 years, publications have grown rapidly, but after 2019, they started to fall. According to the collaboration network, the United States, Univ Pittsburgh AND NEUROUROLOGY AND URODYNAMICS are the most active countries, institutes AND journals in the field, respectively. All keywords were categorized by the symbiosis analysis into four categories: experimental study, symptoms, clinical use, and quality of life. The most prevalent keyword across all clusters is “overactive bladder.”

Conclusion

Year after year, there have been more publications in the field of overactive bladder research in many countries, and there has been a deeper level of cooperation and exchange. Researchers will still be interested in overactive bladder in the future. Currently, the clinical application of the disease and the safety and effectiveness of medications are being investigated. However, radical innovation in relevant experimental technologies is a significant obstacle in this field.
Case report: Fully endoscopic microvascular decompression for glossopharyngeal neuralgia
Authors: Jiang Haotian , Zhou Dewei , Wang Pan , Zeng Longwei , Liu Jie , Tang Chao , Zhang Gang , Tan Xiaorong , Wu Nan
Published: January 2023

With the advances in endoscopic technology, endoscopy is widely used in many neurosurgical procedures, such as microvascular decompression, which is an effective method to treat glossopharyngeal neuralgia, trigeminal neuralgia, and facial spasm. The purpose of this study was to determine the efficacy of fully endoscopic microvascular decompression in the treatment of glossopharyngeal neuralgia. We managed a patient with glossopharyngeal neuralgia in our department, whose main clinical manifestation was recurrent left ear and facial pain for 3 years. The patient underwent a fully endoscopic microvascular decompression. The pain in the left ear and face was significantly relieved postoperatively, and there was no recurrence at the 6-month follow-up evaluation. We describe a case of glossopharyngeal neuralgia that was successfully treated by fully endoscopic microvascular decompression, which showed that endoscopy has advantages in microvascular decompression, and fully endoscopic microvascular decompression is an effective method for glossopharyngeal neuralgia.
Case Report: Adult degenerative scoliosis in two patients treated with percutaneous spinal endoscopic-assisted lumbar interbody fusion and percutaneous pedicle screw fixation
Authors: Du Jian-wei , Zhang Lei-ming , Yan Yu-qiu , Zhang Ya-ning , Rong Xue-qin , Xiao Song-hua , Zhang Xi-feng
Published: January 2023

Adult degenerative scoliosis (ADS) is a serious disease that often affects middle-aged and elderly people. ADS does not only cause sagittal and coronal deformity of the lumbar spine but also causes severe back and leg pain secondary to the compression of the neural structures. Open surgery remains the main method for correcting the occurring deformity and decompression of the neural structures; however, its benefit is limited in cases of large trauma. Minimally invasive spinal (MIS) surgery is an alternative method that has recently witnessed rapid development. It has the advantage of providing rapid recovery with less trauma as compared to conventional open surgery. We report two cases of ADS treated with percutaneous spinal endoscopic-assisted lumbar interbody fusion (EALIF) and percutaneous pedicle screw fixation. Both cases had moderate deformities of the lumbar spine (load-sharing classification 4–7 points) with severe back and leg pain, and they underwent successful MIS surgery. At 6 months of follow-up, the visual analog scale and Oswestry disability index scores of both patients improved and the deformity was corrected. For moderate ADS, percutaneous spinal EALIF and percutaneous pedicle screw fixation may achieve an effective correction of the deformity with direct decompression of neural structures.
A novel predictive model of hospital stay for Total Knee Arthroplasty patients
Authors: Liu Bo , Ma Yijiang , Zhou Chunxiao , Wang Zhijie , Zhang Qiang
Published: January 2023

Objective

This study aimed to explore the main risk factors affecting Total Knee Arthroplasty (TKA) patients and develop a predictive nomogram of hospital stay.

Methods

In total, 2,622 patients undergoing TKA in Singapore were included in this retrospective cohort study. Hospital extension was defined based on the 75% quartile (Q3) of hospital stay. We randomly divided all patients into two groups using a 7:3 ratio of training and validation groups. We performed univariate analyses of the training group, in which variables with P-values < 0.05 were included and then subjected to multivariate analysis. The multivariable logistic regression analysis was applied to build a predicting nomogram, using variable P-values < 0.01. To evaluate the prediction ability of the model, we calculated the C-index. The ROC, Calibration, and DCA curves were drawn to assess the model. Finally, we verified the accuracy of the model using the validation group and by also using the C-index. The ROC curve, Calibration curve, and DCA curve were then applied to evaluate the model in the validation group.

Results

The final study included 2,266 patients. The 75% quartile (Q3) of hospital stay was six days. In total, 457 (20.17%) patients had hospital extensions. There were 1,588 patients in the training group and 678 patients in the validation group. Age, Hb, D.M., Operation Duration, Procedure Description, Day of Operation, Repeat Operation, and Blood Transfusion were used to build the prediction model. The C-index was 0.680 (95% CI: 0.734–0.626) in the training group and 0.710 (95% CI: 0.742–0.678) for the validation set. The calibration curve and DCA indicated that the hospital stay extension model showed good performance in the training and validation groups.

Conclusion

To identify patients' risk factors early, medical teams need to plan a patient’s rehabilitation path as a whole. Its advantages lie in better resource allocation, maximizing medical resources, improving the functional recovery of patients, and reducing the overall cost of hospital stay and surgery, and will help clinicians in the future.
Case report: Microsurgical replantation of heel skin and subcutaneous tissue
Authors: Zhou Jian , Chang Shusen , Deng Chengliang , Huang Guangtao , Jin Wenhu , Chen Wei , Wei Zairong
Published: January 2023

A 36-year-old healthy male patient was presented to the emergency room 3 h after experiencing a laceration to the left foot caused by a porcelain shard. The defect measured 7.5 × 6.0 × 0.8 cm, and the composite amputated tissue consisted of skin and subcutaneous layers. The terminal branch of the lateral calcaneal artery was first anastomosed end-to-end to the corresponding artery in the wound defect. The lateral calcaneal nerve was anastomosed after blood flow was restored. The two lateral veins were anastomosed end-to-end to the corresponding veins in the wound defect. Postoperatively, 1.0 × 1.5 cm area of skin necrosis was present at the distal end of the tissue, which healed smoothly after two weeks of dressing changes. The patient had retained excellent aesthetic and functionality by the 37 month follow up. Although such isolated amputation is relatively rare, microsurgical replantation is, thus, a feasible option in the management of heel amputation.
Total knee arthroplasty and physical therapy for arthropathy in alkaptonuria: A 4-year follow-up case report
Authors: Wu Linfeng , Hu Yu
Published: January 2023

Introduction

Alkaptonuria is a rare autosomal recessive metabolic disorder which leads to accumulation of homogentisic acid in the body.

Case Presentation

We report a rare case of an alkaptonuria-related knee arthritis who underwent left total knee arthroplasty and received postoperative systematic physical therapy in a 57-year-old male patient. The patient has suffered from bilateral knee pain for over 4 years. The patient developed melanin pigmentation on the skin of the whole body, especially on the face and auricle. He self-reported that fresh urine was normal color but after standing overnight, the color deepened to black or soy color. He underwent routine urine examination for many times, but no obvious abnormality was found. The patient has suffered from low back pain for more than 20 years. He had been considered for lumbar disc herniation and ankylosing spondylitis after many in-hospital visits. After symptomatic medication, there was no obvious relief. We followed the patient for 4 years after surgery.

Result

The patient presented with pain relief and enhanced range of motion at the 4-year follow-up. The improvements of daily living and the pain relief suggest that the surgery is appropriate for this rare disease.

Conclusion

It is rare that the knee pain is diagnosed as alkaptonuria. After total knee arthroplasty and physical therapy, the patient had a good outcome. This case provides experience for the diagnosis and treatment of alkaptonuria-related knee arthritis.
Case report: Surgical treatment of McCune-Albright syndrome with hyperthyroidism and retrosternal goiter: A case report and literature review
Authors: Xing Zhiwei , Tao Gongshuai , Pan Wanwan , Wu Delin , Pan Tingting , Wan Lingfeng , Ma Xiaopeng , Wang Yangyi
Published: January 2023

Introduction

McCune-Albright syndrome (MAS) is a low-incidence syndrome consisting of the clinical triad of fibrous structural dysplasia of bone, endocrine disease, and skin pigmentation. Thyroid dysfunction is the second most common endocrine dysregulation in MAS. However, there are no treatment guidelines for MAS complicated with hyperthyroidism. Notably, no case of MAS complicated with retrosternal goiter and hyperthyroidism has been reported to our knowledge.

Case presentation

We report a 27-year-old man with MAS who developed the typical triad of bone fibrous dysplasia, skin pigmentation and hyperthyroidism, complaining of recent fast-growing neck mass and difficulty in breathing. Hyperthyrodism was under control by Thiamazole, and computed tomography showed an enlarged thyroid extending retrosternally. We performed a total thyroidectomy on the patient. At the 1-year follow-up, the patient's dyspnea, hyperthyroidism, and bone pain were all significantly alleviated.

Review

We searched the literature for previous case reports concerning MAS patients complicated with thyroid dysregulation. A total of 17 articles and 22 patients were identified to form our database. Among them, 9 studies clearly mentioned surgical intervention in 11 patients, and prognoses were also reported. Surgery was the most common intervention chosen and indicated a satisfactory prognosis.

Conclusion

We report a rare case of MAS patient complicated with retrosternal goiter and hyperthyroidism. Our review provides an overview of MAS cases requiring interventions on thyroid function, and total thyroidectomy should be a proper treatment for these patients.
First study on the outcomes of biliopancreatic diversion with duodenal switch in Chinese patients with obesity
Authors: Wang Lun , Zhang Zheng , Wang Zeyu , Jiang Tao
Published: January 2023

Background

Biliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric procedure used in the treatment of obesity and related metabolic disorders. However, to date, the data on BPD-DS among Chinese patients with obesity is completely lacking.

Objective

This is the first study to evaluate the safety and efficacy of BPD-DS in the treatment of Chinese patients with obesity.

Methods

Data from 12 patients undergoing BPD-DS between September 2019 and March 2020 were analyzed retrospectively to evaluate complications, weight loss, comorbidity resolution, and nutritional status.

Results

All patients completed the 1-year follow-up. There was no conversion to laparotomy or death. Mean operative time was 257.08 ± 29.27 min. The median length of stay was 7 days (ranging from 4–38 days). Complications occurred in three patients. The 1-year body mass index was 25.13 ± 4.71 kg/m2 with a mean excess weight loss of 100.11 ± 33.29% and a mean total weight loss of 43.22 ± 7.71%. Remission was achieved in 100% (7/7 cases) for type 2 diabetes, in 83.3% (10/12 cases) for hypertension, and in 62.5% (5/8 cases) for hyperuricemia. At 1 year after BPD-DS, the prevalence of albumin deficiency was 16.7%, for iron deficiency was 16.7%, and for zinc deficiency was 50%. There were 8.3% of the patients who were anemic. High deficiency rates for vitamins were presented mainly in vitamin A and vitamin E: vitamin A in 58.3% of the patients and vitamin E in 50% of the patients. The prevalence of asymptomatic gallstones increased significantly from 0% preoperatively to 41.7% postoperatively.

Conclusion

BPD-DS had excellent weight loss and resolution of comorbidities among Chinese patients with obesity. However, high rates of nutritional deficiencies and complications were found after BPD-DS, especially for vitamin A and vitamin E.
Establish a new parameter “horizontal view-axial angle” and explore its role in the treatment of atlantoaxial instability diseases
Authors: Huang Hongxiang , Sheng Minfeng , Zeng Guangliang , Sun Chao , Li Rujun
Published: January 2023

Objective

The objective of the study is to establish a new parameter that can be clearly measured on x-ray images to complement the description of the sagittal alignment of the craniocervical junction. The authors anticipate that this new parameter will enhance surgeons' understanding of the sagittal alignment of the craniocervical junction and play a positive role in the guidance of intraoperative reduction and in the evaluation of postoperative outcomes of patients with atlantoaxial instability.

Methods

From November 2018 to June 2020, a total of 159 asymptomatic subjects who underwent frontal and lateral cervical x-ray examination in the Second Affiliated Hospital of Soochow University were included in the study. Age, gender, previous spinal trauma, and disease history of each subject were recorded. After screening, 127 effective samples were finally obtained. When taking lateral cervical radiographs, all subjects placed their neck in a neutral position and looked straight ahead with both eyes. On the obtained lateral x-ray images, a straight line was drawn from the radix to the anterior clinoid process; another line was made along the posterior edge of the C2 vertebral body; and the angle between the two lines was measured, which was defined as the “horizontal view-axial angle.” The angle formed by the tangent of the posterior edge of the C2 vertebra and C7 vertebral body is the “C2–C7 angle,” which was used to describe the curvature of the lower cervical vertebra. The normal range of horizontal view-axial angle and its relationship with C2–7 angle were evaluated.

Results

The average C2–C7 angle of male subjects was (14.0° ± 7.4°), while that of female subjects was (11.09° ± 7.36°). The average horizontal view-axial angle of male subjects was (92.79° ± 4.52°), and that of female subjects was (94.29° ± 4.50°). Pearson correlation test showed that there was a significant negative correlation between horizontal view-axis angle and C2–C7 angle.

Conclusions

For patients with atlantoaxial instability diseases, the horizontal view-axis angle is expected to be a sagittal parameter to guide the intraoperative reduction and evaluate postoperative outcomes.