目的 研究低碘饮食对大鼠甲状腺功能的影响及c-Jun在肾组织中的表达差异，探讨c-Jun在低碘大鼠肾脏组织中表达的意义。 方法 给予Wistar大鼠低碘饲料，通过饮用不同碘浓度饮水分组,测定甲状腺功能。利用免疫组织化学方法分析肾脏组织中c-Jun的激活变化情况。 结果 重度低碘组与轻度低碘组、正常对照组比较三碘甲状腺原氨酸(TT3)、血清总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)均明显下降(Plt;0.05)。轻度低碘组与正常对照组相比，TT4、FT3明显下降(Plt;0.05)，TT3、FT4稍有降低(Pgt;0.05)。c-Jun在低碘大鼠肾组织中表达增强，与低碘程度有依赖关系，且在肾小球内的表达明显强于肾小管。 结论 低碘摄入可引起肾组织中c-Jun的过度表达，进而引起肾脏损伤。
Objective To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula. Methods A retrospective analysis of clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference (P>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up. ResultsThe intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group (P<0.05); however, there was no significant difference in operation time and hospital stay between the two groups (P>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant (P>0.05). At last follow-up, the VAS score for shoulder pain in the robot group were lower compared to the control group, and the Constant-Murley score was higher, with significant differences (P<0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant (P>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant (P>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups (P>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups (P>0.05). Conclusion Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss, shorten incision length, alleviate pain, and better promote shoulder joint functional recovery.
Objective To explore the effectiveness of reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures. Methods Between January 2022 and February 2023, 10 patients with Tile type B pelvic fractures were admitted. There were 6 males and 4 females with an average age of 45.5 years (range, 30-71 years). The fractures were caused by traffic accident in 5 cases, bruising by heavy object in 3 cases, and falling from height in 2 cases. The interval between injury and operation ranged from 4-13 days (mean, 6.8 days). There were 2 cases of Tile type B1 fractures, 1 case of Tile type B2 fracture, and 7 cases of Tile type B3 fractures. After closed reduction under assistance of reduction robot, the anterior ring was fixed with percutaneous screws with or without internal fixator, and the posterior ring was fixed with sacroiliac joint screws under assistance of navigation robot. The time of fracture reduction assisted by the reduction robot was recorded and the quality of fracture reduction was evaluated according to the Matta scoring criteria. The operation time, intraoperative fluoroscopy frequency and time, intraoperative bleeding volume, and incidence of complications were also recorded. During follow-up, the X-ray film of pelvis was taken to review the fracture healing, and the Majeed score was used to evaluate hip joint function. Results The time of fracture reduction was 42-62 minutes (mean, 52.3 minutes). The quality of fracture reduction according to the Matta scoring criteria was rated as excellent in 4 cases, good in 5 cases, and poor in 1 case, with excellent and good rate of 90%. The operation time was 180-235 minutes (mean, 215.5 minutes). Intraoperative fluoroscopy was performed 18-66 times (mean, 31.8 times). Intraoperative fluoroscopy time was 16-59 seconds (mean, 28.6 seconds). The intraoperative bleeding volume was 50-200 mL (range, 110.0 mL). No significant vascular or nerve injury occurred during operation. All patients were followed up 13-18 months (mean, 16 months). X-ray films showed that all fractures healed with the healing time of 11-14 weeks (mean, 12.3 weeks). One case of ectopic ossification occurred during follow-up. At last follow-up, the Majeed score was 70-92 (mean, 72.7), and the hip joint function was rated as excellent in 2 cases and good in 8 cases, with the excellent and good rate of 100%. Conclusion The reduction robot combined with navigation robot-assisted minimally invasive treatment for Tile type B pelvic fractures has the characteristics of intelligence, high safety, convenient operation, and minimally invasive treatment, which can achieve reliable effectiveness.