No surgical procedure perfectly treats advanced Kienböck disease. Although vascularized os pisiform transferring (VOPT) is one of the main therapeutic approaches, reports on long-term follow-up and case series for this technique are scarce.We collected postoperative results in 11 patients with advanced Kienböck disease who underwent VOPT between 1986 and 2001 in our Hospital. Follow-up durations ranged from 15 to 26 years.At the last follow-up, excellent and good results were found in 81.8% according to the Modified Green and O’Brien score. Postoperative imaging revealed significantly reduced pisiform bone; carpal height ratio and Nattrass index were decreased, while the radioscaphoid angle was increscent, compared with preoperative and mid-term follow-up results.The favorable long-term results demonstrated that VOPT is a dependable and durable procedure for the treatment of advanced Kienböck disease, with pain relief and functional improvement despite some radiographic findings such as wrist osteoarthritis occurrence.
IntroductionAutism spectrum disorder (ASD) is a complicated diffuse developmental disorder that commonly involves gastrointestinal distress and dysbacteriosis. Emerging lines of evidence have shown faecal microbiota transplantation (FMT) to be a potential therapeutic strategy for improving the clinical outcomes of patients with ASD by re-establishing their intestinal microflora. We are undertaking the first-ever multicentre, double-blind, randomised controlled trial of FMT for the treatment of children with both ASD and gastrointestinal symptoms and will assess the feasibility and efficacy outcomes of this strategy.MethodsIn total, 318 children with both ASD and gastrointestinal symptoms will be enrolled (from 15 hospitals in China) to receive either FMT intervention (n=212) or a placebo (control, n=106). Children aged 3–6 years will take two capsules two times a day, and those older than 6 years will take three capsules two times a day. Each patient will receive four treatment courses, with each 12-day course being repeated every month. Outcomes will be evaluated at baseline, throughout the period of intervention, and at subsequent follow-ups for 2 months. The primary trial objective is to investigate the remodelling effect of FMT on the intestinal microflora in patients with ASD. The secondary objective focuses on the clinical efficacy and safety of FMT, including its improvement of the clinical response and metabonomics.Ethics and disseminationEthical approval was obtained from the hospital Ethics Committee of each Faecal Transfer for ASD China Multicenter Trial Working Group. The ongoing FMT clinical trial is intended to support the approval of the new technology and its administration. The results of this trial will provide high-quality evidence to inform the future clinical application of this new therapy.Trial registration numberChiCTR2100043906; Pre-results.
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Multivessel off-pump coronary artery bypass (OPCAB) has been conducted safely; however, the clinical outcomes of reoperative OPCAB have not been reported clearly. Currently OPCAB is being performed systematically in this institution including reoperative surgeries. Between September 1, 1999, and December 31, 2003, reoperative OPCAB via midline sternotomy was planned for nonemergent patients with normal left ventricular function without valvular disease. The perioperative results of patients who underwent reoperative OPCAB were analyzed. Thirty-five patients were scheduled for OPCAB. Of these, OPCAB was performed in 27 patients, giving OPCAB success rate of 77.1%. Failure of OPCAB was due to graft injury in 2, ischemic EKG change in 1, and dense adhesion and difficulty of dissection in 5 patients. The mean number of grafts with completed OPCAB was 3.0 +/- 1.5. There were no hospital deaths, strokes, or respiratory or renal failures. One patient (3.7%) developed perioperative myocardial infarction. Postoperative angiography was obtained in 12 patients (26 distal anastomoses), and all anastomoses were perfect except for 1 distal anastomosis stenosis, giving an overall stenosis-free patency rate of 95.1%. During a follow-up period (mean 2.5 +/- 0.6 years), all patients survived without cardiac event, except 1 patient who underwent catheter intervention. Cardiopulmonary bypass may be required during cardiac dissection to decompress the heart and to facilitate dissection. However, once lysis of the adhesion is completed, reoperative OPCAB can be performed without increasing surgical risks. Midterm results were satisfactory.
An all-optical high sensitivity atomic magnetometer is investigated and demonstrated experimentally, of which the principle is based on the interaction between laser beam and rubidium atoms in magnetic field. This interaction is dependent on the magnetic field surrounding the Rb atom cell, therefore the magnetic field information can be obtained simply by measuring the changes of the laser power transmitted through the Rb atom cell. The principle of the atomic magnetometer is analyzed and the performance of the experimental setup is investigated. The experimental result agrees well with the theoretical predictions. Furthermore, some important factors that may affect the performance of the magnetometer are discussed, and the ways to improve the sensitivity of the atomic magnetometer are also put forward.
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