Fatal Pulmonary Fat Embolism Occurring in Lumbar Spinal Fusion Surgery: Case Report and Review of Literature

Fat embolism system is one of the serious complications of orthopedic surgery, which is common seen in cases of severe trauma with long bone fractures. However, in clinical medical practice, it is rarely seen for Fat embolism system in orthopaedic lumbar fusion surgery. This paper report a case of sudden shock and death during lumbar fusion due to lumbar intervertebral disc disease. By forensic pathological examination, the pulmonary and brain fat embolism were observed in tissue sections, and the patient was diagnosed as FES. Based on the review of relevant literature and the pathological findings of this case, the clinical characteristics, diagnosis and treatment of FES in lumbar fusion are commentated in this paper. At the same time, it is emphasized that the clinical practise should strengthened the understanding and attention of non-traumatic fat embolism cases in order to timely identify, diagnose and treat the disease, improve the effectiveness of treatment, and reduce the corresponding medical disputes.

Clinical Analysis of a Case of Pseudohypoparathyroidism

Objective — To investigate the clinical treatment effect of pseudoparathyroidism. Methods — A case of pseudoparathyroidism admitted to our hospital was clinically diagnosed and treated, and analyzed. Results — The patient received standard treatment in our hospital, and the clinical symptoms were significantly improved. Conclusion — Timely and correct diagnosis and symptomatic supportive treatment are of great significance to improve the prognosis of pseudohypoparathyroidism patients.

Clinical Analysis of NICU Oxygen Therapy over 28 Days in a Single Center

Objective — To investigate the main causes, related factors and clinical outcomes of neonates with continuous oxygen therapy ≥ 28 days in neonatal intensive care unit（NICU） of our hospital. Methods — Clinical data of neonates admitted to NICU from January 2015 to December 2020 who needed continuous oxygen therapy ≥ 28 days after birth were retrospectively analyzed. The causes of continuous oxygen therapy ≥ 28 days, general condition with oxygen and respiratory support, duration and clinical outcomes were recorded. Independent samples t test, Mann-Whitney rank sum test, c² test were used for statistical analysis. Results — In the past 6 years, 115 cases met the inclusion criteria and who received continuous oxyogen therapy ≥ 28 days after birth. 1. Gestational age: 25+1~40+0, <32 weeks of gestation accounted for 83.5%. The peak gestational age occurred at 28+0~29+6 weeks after continuous oxygen therapy for ≥ 28 days. 2. Main causes: 37 cases (32.2%) of bronchopulmonary dysplasia (BPD), 36 cases (31.3%) of neonatal pneumonia, 20 cases (17.4%) of apnea of prematurity (AOP), Pulmonary hypertension was reported in 8 cases (7.0%), laryngotrachealacia in 2 cases (1.7%), cyanosis congenital heart disease in 4 cases (3.5%), and other causes in 8 cases (7.0%). 3. Short-term prognosis: of 105 premature infants, 90 were successfully deoxygenated, accounting for 85.7%; In 10 cases, 5 cases (50%) were successfully deoxygenated. 20 cases gave up treatment or died. 4. Long-term oxygen therapy was related to gestational age and duration of ventilator. The younger the gestational age, the longer the mechanical ventilation time and the longer the total oxygen therapy time (P < 0.05). Conclusion — Continuous oxygen therapy ≥ 28 days received in all gestational age group. Preterm infants with gestational age < 32 weeks had the highest incidence. The main causes of premature infants with gestational age < 32 weeks are BPD, neonatal pneumonia, AOP and pulmonary hypertension. Neonatal pneumonia was the main cause in preterm infants with gestational age 32+0~34+6 weeks, and congenital dysplasia and genetic metabolic diseases were the main cause in neonates above 35 weeks gestational age group.

Emotions and Modern Psychology Studies: Development and Application of Traditional Chinese Medical Theories in Seven Emotions

Objective — To summarize the concept of the Seven Emotions Theory in Traditional Chinese Medicine (TCM), the characteristics of the disease, and the influence on the viscera, combined with the research results of modern psychology, this paper studies the etiology and pathogenesis of the Seven Emotions from the perspective of psychology to achieve the purpose of guiding clinical practice. Methods — Through consulting a large number of documents, analyze and understand the meaning of Seven Emotions Theory. By analyzing the emotion-related arguments of the mainstream schools of modern psychology, the basic emotion theory and the relationship between the Seven Emotions of TCM, the concept of TCM sentiment, and the relationship between TCM sentiment and basic emotions are explained. Through the systematic analysis of emotions, explore the relationship between the seven emotions of Chinese medicine. Results — Through research on the development of the Seven Emotions Theory and its etiology, pathogenesis, emotional disease syndromes, and emotional therapy in Yellow Emperor’s Classic of Internal Medicine (Huangdi Neijing) and other historical documents, we can discuss the significance of the Seven Emotions theory systematically comb the theory, and hope to guide clinical practice.Conclusion — In clinical diagnosis and treatment of diseases caused by emotions, it is advisable to consider the mutual influence of multi-emotional factors, whether it is a disease with other emotions, and whether multiple organs are injured, so as to better diagnose and treat disease syndromes.

A Case of Placental Abruption Complicated by Vaginal Trial of Labor in a Unicornuate Uterus

Unicornuate uterus has a low incidence,it is a congenital uterine developmental anomaly, it has many complications during pregnancy, and it is less common in pregnancy to term. This article retrospectively analyzes a case of unicornuate uterus with a full-term vaginal trial of labor and delivery with placental abruption resulting in neonatal asphyxia. We also present the typology of unicornuate uterus, diagnosis, and discuss the mode of delivery in the light of the literature, in order to raise awareness of this type of disease among medical professionals and reduce the occurrence of adverse pregnancy outcomes.

Migration Inhibition Induced by Gypenosides and Its Combination Effect with 5-fluorouracil on Human Colon Cancer SW-620 Cells

In this study we investigate the migration inhibition of Gypenosides (Gyp) and its combined effects with 5-fluorouracil (5-FU) on human colon cancer SW-620 cells, hoping to explore more potential clinical use of Gyp. Our data implied Gyp could significantly inhibit the migration potential of SW-620 cells including down-regulating matrix Metalloproteinases expression and decreasing cells adhesion ability. What’s more, evidence showed cells treated with Gyp exerted serious microfilament network collapse as well as a significant decline in the number of microvilli. A significant migration inhibitory effect was seen in Gyp groups along with the decline of cell adhesion. Further, the combination studies suggested Gyp could synergistically enhance the antitumor effect of 5-FU in SW-620 cells through the apoptosis way. The present study indicated Gyp could prevent cell migration and further enhance the cell killing effect of 5-FU on human colon cancer SW-620 cells.

Design and Application of a New Artificial Intelligence Screening Program for Scoliosis

Objective — Intelligent Scoliosis screening Application (ISSAPP) is an intelligent scoliosis screening application based on back photos, which is used to determine the effectiveness and reliability of the new tool and reduce the cost of screening by comparing it with traditional physical examination. Method — To design and upgrade the measurement procedures for back photographs during physical examination, including the measurement of bilateral shoulder apex line and horizon plus angle, and the measurement of the angle between the thoracic apex line and horizon during Adams' spinal flexion experiment so as to determine the validity and reliability of measurement program tools. Results — The first and second versions of the designed AI measurement program were more sensitive than the traditional physical examination, Adams spinal flexion test, and lateral flexion instrument. The majority of patients who were tested positive using the measurement procedure tool met the requirements for diagnosis of scoliosis. Conclusions — This new AI based measurement and screening tool can be used for early detection of shoulder and thoracic malformation caused by scoliosis, which is a simple, convenient and sensitive early screening tool. Based on this development idea, an upgraded version can be further developed for early screening of scoliosis.

Effects of Ropivacaine Combined with Ketorolac Transverse Abdominis Plane Block on Postoperative Analgesia in Patients Undergoing Gynecological Laparoscopic Surgery

Objective — To observe the effects of ropivacaine combined with ketorolac transverse abdominis plane (TAP) block on postoperative analgesia in patients undergoing gynecological laparoscopic surgery. Methods — 90 ASAⅠorⅡpatients, aged 18-65 years and weighting 40-80 kg, scheduled for gynecological laparoscopic surgery were recruited and divided into three groups using random number table:ropivacaine combined with ketorolac 15 mg/side for TAP block (KR group), ropivacaine for TAP block and 30 mg preoperatively intravenous ketorolac (KIVR group) and ropivacaine for TAP block alone (R group) with 30 patients in each group. Intraoperative opioid consumption, Bruggrmann comfort scale (BCS) scores at 2h (T1), 4h (T2), 8h (T3), 12h (T4), 16h (T5), 24h (T6) after surgery were recorded. Adverse reactions such as nausea and vomiting, respiratory depression, local anesthetic poisoning, gastrointestinal bleeding, and complications related to TAP block operation were recorded. Results — The total consumpsion of sufentanil was higher in the R group than that in the KIVR group and KR group (P < 0.05). The total dosage of remifentanil in R group was higher than that in KR group (P < 0.05). The BCS scores of the three groups at T3, T4, T5 and T6 were lower in R group than that in KR group (P < 0.05) while R Group was lower than KIVR group at T3 and T4 (P < 0.05), and KIVR group was lower than KR group at T5 and T6. There was no statistically differences in BCS score between the three groups at T1 and T2 (P > 0.05). No statistical differences in the incidence of adverse reactions among all groups were observed. Conclusion — Ropivacaine combined with ketolorac transverse abdominisplane block reduced the intraoperative opioid consumption, improved postoperative comfort score and do not increased the incidence of adverse reactions in gynecological laparoscopic surgery.

Investigation on Preoperative Interview of Standardized Training for Anesthesiologists

Objective — To investigate the current situation of preoperative interview of standardized training anesthesiologists in Hebei province by online questionnaire. To understand the current situation of preoperative interview of standardized training anesthesiologists and screen out the main factors affecting the preoperative interview of standardized training anesthesiologists. Methods — The questionnaire is designed by the authors and is distributed through Wechat Mini Program. Questionnaire survey was conducted among standardized training anesthesiologists in several training bases in Hebei Province. Results — 313 valid questionnaires were collected. The standardized training anesthesiologists had problems such as lack of basic knowledge, lack of teacher's evaluation on their preoperative interview, and don't know how to improve. In addition, the number of preoperative interviews in neurosurgery and cardiothoracic surgery was relatively small, and the ability of preoperative interviews in specialized surgery was insufficient. Conclusion — To improve the quality of preoperative interviews, standardized training anesthesiologists need to improve the training and evaluation system and enhance teaching.

The Value of Bedside Ultrasound in the Diagnosis and Treatment of Pulmonary Embolism in Severe Patients

Objective — To explore the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography in patients with venous thromboembolism. Methods — Select 97 patients with high-risk Caprini scores and high-risk Padua scores from December 2019 to April 2021 in the Second Affiliated Hospital of Shandong First Medical University as the research objects, all of whom completed bedside transthoracic echocardiography combined with bedside lower limbs or upper extremity venous ultrasound examination; compare the results of different ultrasound examinations with spiral CT pulmonary angiography (CTPA); analyze the diagnostic value of bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasound in patients with pulmonary embolism. Results — 97 patients with high-risk Caprini score and high-risk Padua score were confirmed by CTPA in 41 cases of pulmonary embolism; bedside transthoracic echocardiography, bedside lower extremity or upper extremity venous ultrasonography for venous thromboembolism were all positive in 35 cases; among them, 32 cases were confirmed by CTPA as pulmonary embolism, and the diagnostic compliance rate with the gold standard was 87.63%; bedside transthoracic echocardiography combined with bedside lower extremity venous ultrasonography had a diagnostic sensitivity of 78.05% and a diagnostic specificity of 94.64%; Conclusion — Bedside transthoracic echocardiography and bedside lower extremity venous ultrasonography combined for venous thromboembolism can improve the specificity of diagnosis, and it is worthy of popularization and application.