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目的 探究海绵窦区硬脑膜动静脉瘘（cavernous sinus dural arteriovenous fistula，CS-DAVF）不同入路介入治疗策略的安全性和效果。 方法 检索空军军医大学第二附属医院神经外科血管病中心前瞻性血管病数据库，回顾性分析2013年1月—2022年12月所有尝试介入治疗的CS-DAVF患者的相关资料，包括一般资料、临床症状体征、影像学资料、手术相关信息以及患者预后与转归，并对资料进行汇总和分析。 结果 共71例CS-DAVF患者接受介入治疗，其中54例（76.1%）以眼部症状为主，包括视力下降、结膜水肿、眼球突出、活动受限、眼睑下垂等。66例（93.0%）患者成功完成了手术，其中采取静脉入路栓塞40例（60.6%），动脉入路栓塞21例（31.8%），动静脉联合入路栓塞5例（7.6%）。使用弹簧圈联合Onyx胶29例（43.9%），单纯使用Onyx胶36例（54.5%），单纯使用弹簧圈1例（1.5%）。栓塞术后即刻DSA显示达到完全闭塞57例（86.4%），次全闭塞9例（13.6%）。单因素logistic回归分析结果显示，手术入路[校正OR（adjusted OR，aOR）3.854，95%CI 0.821～18.101，P=0.087＜0.1]和Onyx胶联合弹簧圈（aOR 8.282，95%CI 0.972～70.617，P=0.053＜0.1）与治愈率临界相关。19例（28.8%）出现手术相关并发症，其中15例新发眼部症状或眼部症状加重，2例面部感觉异常，2例发生肢体活动的神经功能障碍。单因素logistic回归分析结果显示，手术并发症与各种影响因素无相关性。65例（98.5%）完成1年临床随访，其中19例出现手术相关并发症的患者16例症状完全消失，2例好转，1例失随访，其余患者除1例仍有复视外原有症状均完全消失。40例（60.6%）患者接受了DSA影像随访，均未复发。 结论 CS-DAVF介入治疗中静脉入路相较于动脉入路更具优势，岩下窦入路可作为首选，采用静脉入路和Onyx胶联合弹簧圈栓塞与治愈率临界相关。其疗效是可观的，虽然部分患者出现并发症，但绝大部分患者均为一过性手术并发症，可以获得满意的临床效果。 Abstract: Objective To explore the safety and efficacy of interventional therapy of cavernous sinus dural arteriovenous fistulas (CS-DAVF) with different approaches and strategies. Methods Retrieve the prospective vascular disease database of the Vascular Disease Center, Department of Neurosurgery, The Second Affiliated Hospital of Air Force Medical University. Data from all patients with CS-DAVF who attempted interventional therapy from January 2013 to December 2022 were retrospectively analyzed. All information including patients’ general data, clinical symptoms and signs, imaging data, surgical information, and follow-up results were collected. The data was summarized and analyzed. Results A total of 71 patients with CS-DAVF attempted interventional therapy. Among them, 54 cases (76.1%) presented with ocular symptoms as the main sign, including decreased vision, chemosis, exophthalmos, limited movement, and ptosis. Sixty-six patients (93.0%) successfully completed the operation, with transvenous approach in 40 cases (60.6%), transarterial approach in 21 cases (31.8%), and combined arteriovenous approach in five cases (7.6%). Onyx was combined with coil in 29 cases (43.0%), Onyx alone in 36 cases (54.5%), and coil alone in one case (1.5%). DSA immediately after embolization showed complete occlusion in 57 cases (86.4%) and subtotal occlusion in nine cases (13.6%). Univariate logistic regression analysis showed that surgical approach [adjusted OR (aOR) 3.854, 95%CI 0.821-18.101, P=0.087＜0.1] and Onyx combined with coil (aOR 8.282, 95%CI 0.972-70.617, P=0.053＜0.1) were related to the critical cure rate. Surgery-related complications occurred in 19 patients (28.8%), among of them, 15 were with new or worsened exist ocular symptoms, two were with facial paresthesia, and two were with neurological dysfunction affecting limb movement. Univariate logistic regression analysis results showed that surgical complications were not correlated with various influencing factors. Sixty-five patients (98.5%) completed one-year clinical follow-up. Among the 19 patients with surgical complications, 16 cases completely disappeared, two cases improved, one case lost follow-up, and the original symptoms of the remaining patients completely disappeared except for one case who still had diplopia. Forty patients (60.6%) were followed up with DSA, and no recurrence was reported. Conclusions The transvenous approach is more advantageous than the transarterial approach in the interventional therapy of CS-DAVF, and the inferior petrosal sinus approach can be the first choice. The use of transvenous approach and Onyx combined with coil is related to the critical cure rate. The efficacy is considerable. Although some patients have complications, the majority of patients are transient surgical complications, and satisfactory clinical efficacy can be obtained.

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Objective To compare the clinical outcomes of direct anterior approach (DAA) in lateral position and modified anterolateral approach in supine position (MAASP) in unilateral total hip replacement. Methods 76 patients who were to undergo unilateral total hip replacement were enrolled, and they were randomly divided into group A and group B (38 cases each). Total hip replacement with DAA in lateral position was performed in group A, while total hip replacement with MAASP was performed in group B. The operative indexes (operation time, intraoperative hemorrhage, incision length, first time out of bed activity time, postoperative hospital stay time), postoperative pain levels at 1, 3 d and 7 d after operation, acetabular anteversion and lower limb length difference after operation, hip function scores at 3, 6 months and 1 year after operation and complications with in 1 year were compared between the two groups. Results The operation time, incision length, the first time of getting out of bed after operation and the time of hospitalization in group B were shorter than those in group A (P < 0.05), and the amount of intraoperative bleeding was less than that in group A (P < 0.05). The pain scores at 3 d and 7 d after operation were lower than those at 1 d after operation in both groups (P < 0.05), and the pain scores at 7 d after surgery were lower than those at 3 d after operation (P < 0.05), and the pain scores at 1, 3 d and 7 d after operation in group B were lower than those in group A (P < 0.05). There were no statistical differences in hip joint function scores at 3 months, 6 months and 1 year after operation and complications within 1 year between the two groups (P > 0.05). Conclusion DAA in lateral position and MAASP can both increase hip joint function recovery, but the latter is less traumatic, recovers faster, and has less postoperative pain. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

目的 探讨经环甲间隙裸化甲状腺上极血管入路应用于甲状腺切除手术治疗的疗效。方法 选 取 2020 年 2 月至 2021 年 7 月在该院接受手术治疗的甲状腺切除患者 80 例。根据手术入路方式不同分为对照 组和观察组,每组 40 例,对照组患者应用胸骨舌骨肌-胸骨甲状肌间隙入路,观察组患者经环甲间隙裸化甲状腺 上极血管入路。比较两组患者手术效果和并发症发生情况。结果 观察组患者术中喉上神经寻找所用时间明 显短于对照组,美容效果满意度明显高于对照组,术后1年复发率明显低于对照组,差异均有统计学意义 (P< 0.05) ; 两组患者术中喉上神经显露率、并发症发生率及术后疼痛评分比较,差异均无统计学意义 (P>0.05)。 结论 经环甲间隙裸化甲状腺上极血管入路应用于甲状腺切除手术的效果显著。 [ABSTRACT FROM AUTHOR]

BACKGROUND: The incision of anterolateral approach for femoral head replacement is larger; the cut muscle needs time to heal; and the recovery time is longer. The incision of the SuperPATH approach is very small, and it does not cut off the muscle, so it can recover quickly. However, it needs special artificial prosthesis and special instruments, and the cost is high. OBJECTIVE: To compare the efficacy of conventional instrument SuperPATH approach and anterolateral approach for femoral head replacement. METHODS: From December 2016 to August 2018, 43 elderly patients with femoral neck fracture were randomly divided into experimental group (21 cases, SuperPATH group) and control group (22 cases, anterolateral group). All patients were operated with conventional instruments and femoral head, The incision length, intraoperative blood loss, the time from skin incision to incision closure, the changes of hemoglobin and red blood cells before and after operation, the time of getting off the ground after operation, pain score and hip joint function score were recorded. RESULTS AND CONCLUSION: All patients were followed up for 24 to 36 months. Among them, the length of incision, the time from skin incision to incision closure, the time to get off the ground after operation, Visual Analogue Scale score at 1 week, Harris score at 1 week and 3 months after operation were significantly different between the two groups (P < 0.05), and the experimental group was better than the control group. There was no significant difference in blood loss during operation, changes of erythrocytes and hemoglobin before and after operation, Visual Analogue Scale score at 3 months after operation and Harris score at 6 months after operation between the two groups (P > 0.05). These findings confirm that compared with anterolateral approach, SuperPATH approach has the advantages of shorter incision, less trauma and faster recovery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of three right thoracotomy and two left thoracotomy approach on the operative effect, lymph node metastasis and long-term prognosis of patients with middle thoracic esophageal cancer. Methods: The clinical data of 90 patients with middle thoracic esophageal cancer who were admitted to our hospital from February 2013 to March 2015 were retrospectively selected. According to the different approaches, the patients were divided into two groups: group A (n=44, two left thoracotomy approach) and group B (n=46, three right thoracotomy approach). The operative effect, lymph node metastasis, complications and long-term prognosis of the two groups were compared. Results: The operation time, hospitalization time and postoperative indwelling time of thoracic duct in group B were longer than those in group A, and the intraoperative blood volume was more than that in group A (P<0.05). The number of lymph nodes dissected in group B was more than that in group A, and the total rate of lymph nodes metastasis was lower than that in group A (P<0.05). There was no significant difference in 1-year survival rate between the two groups (P>0.05). The 3-year and 5-year survival rates in group B were higher than those in group A (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Compared with the two left thoracotomy approach, the three right thoracotomy approach is used in the patients with esophageal cancer in the middle part of chest, which has great trauma during operation, and slow recovery after operation. However, the approach way can improve the lymph node metastasis rate and survival rate, and it did not increase the incidence of complications. [ABSTRACT FROM AUTHOR]

Objective To summarize the methods and experiences of petrous apex tumors removal by subtemporal keyhole approach. Methods The clinical data of 9 patients underwent tumors resection through subtemporal keyhole approach from October 2018 to June 2019 were analyzed retrospectively. Results Total resection was done in all 9 patients including 5 meningioma and 4 schwannoma. Postoperative MRI showed no residual tumor in all cases. Subcutaneous hydrops occurred in 3 cases and were all recovered before discharge. Postoperative complications including facial palsy, eye movement disorder, cerebrospinal fluid leak, infection, aphasia or seizure were not found. All patients were followed up from 2 to 10 months and no recurrent case was found. Conclusion Subtemporal keyhole approach provides sufficient exposure for petrous apex tumors while has advantages of less injury， faster recovery and less complications. [ABSTRACT FROM AUTHOR]