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Objective To investigate the spontaneous neural activity in the brain of patients with Alzheimer' s disease (AD) used 3 indicators of resting state-functional magnetic resonance (rs-fMRI) amplitude of low frequency fluctuation (ALFF), fractional amplitude of low frequency fluctuation (fALFF) and percentage amplitude fluctuation (PerAF). Methods Totally 36 clinically diagnosed AD patients and 40 healthy volunteers were scanned by fMRI in resting state respectively. ALFF, fALFF and PerAF were used to calculate and compare the changes of brain regions between the two groups. Results Compared with the normal control group, mALFF value in AD group increased significantly in bilateral caudate nucleus, medial frontal gyrus, superior frontal gyrus, gyrus rectus, anterior cingulate gyrus, olfactive cortex, left middle frontal gyrus and inferior frontal gyrus (P<0. 05). mALFF values decreased significantly in the right middle temporal gyrus, inferior temporal gyrus, inferior occipital gyrus, middle occipital gyrus, bilateral calcarine, cuneus, lingual gyrus, superior occipital gyrus, vermis, precuneus and other regions (P<0. 05). In AD group, mfALFF value of right inferior temporal gyrus, anterior cerebellar lobe, fusiform gyrus, left superior frontal gyrus, medial frontal gyrus, middle frontal gyrus, inferior frontal gyrus, gyrus rectus and anterior cingulate gyrus increased significantly (P<0. 05); mfALFF values decreased significantly in bilateral lingual gyrus, left calcarine, cuneus, superior occipital gyrus, middle occipital gyrus and vermis (P<0. 05). In AD group, mPerAF value increased significantly in bilateral gyrus rectus, anterior cingulate gyrus, medial frontal gyrus, left superior frontal gyrus, caudate nucleus, middle frontal gyrus, inferior frontal gyrus, olfactive cortex and insula (P<0. 05); mPerAF values decreased significantly in bilateral calcarine, cuneus, superior occipital gyrus, lingual gyrus, precuneus, left fusiform gyrus, inferior occipital gyrus, right superior parietal lobule, angular gyrus, middle temporal gyrus, inferior temporal gyrus and middle occipital gyrus (P < 0. 05). Conclusion The default mode network (DMN) and visual network of AD patients are characterized by abnormal brain activity, with the most significant neural activity in the prefrontal cortex and visual cortex.
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[Abstract] ObjectVisualizing the superficial cerebellar vein and its tributaries on suscepxibility weighted imaging (SWI), and to construct superficial cerebellar vein network. Methods According to the inclusion criteria, 80 healthy volunteers (40 males and 40 females) were selected for 3. 0 T MRI scans to obtain conventional sequence cross-section, sagittal tomographic images, and SWI image data. Post-processing was performed on the Extended MR workspace 2. 6. 3. 4 image workstation to reconstruct minimum intensity projection(mIP) images. SPSS 21. 0 statistical software was used to analyze and process each data, and the diameter measurement result were expressed as mean ± standard deviation. Results Both SWI and mIP could image the structures of the cerebellum and its veins. The cerebellar veins were divided into deep and superficial parts. The superficial cerebellar veins were divided into two groups: the vermis and the cerebellar hemispheres. The superficial vein of the cerebellar vermis consisted of superior vermis vein [diameter: (1. 21±0. 24)mm, occurrence rate: 92. 16%], summit vein [ diameter: (0. 66 ± 0. 05) mm, occurrence rate: 95%], mountain vein [diameter: (0. 76±0. 03)mm, occurrence rate: 100%], inferior vermis vein [diameter: (1. 40±0. 27)mm, occurrence rate: 99. 02%]. The superficial cerebellar hemisphere vein consists of anterior superior cerebellar vein [diameter: (1. 09± 0. 12)mm, occurrence rate: 100%], posterior superior cerebellar vein [diameter: (0. 88±0. 13) mm, occurrence rate: 70%], anterior inferior cerebellar vein [ diameter: (1. 34 ± 0. 15) mm, occurrence rate: 100%], posterior inferior cerebellar vein [ diameter: (1. 11 ± 0. 09) mm, occurrence rate: 92. 5%]. The deep veins were divided into cerebellomesencephalic fissure group, cerebellopontine fissure group, and cerebellomedullary fissure group. Conclusion SWI can display the microstructure and venules of the cerebellum, and can construct a network of superficial cerebellar veins.
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Objective To investigate whether physiological asymmetry of normal bilateral superficial veins located in dorsolateral aspects of hemispheres is existed on susceptibility-weighted imaging (SWI). Methods There were 45 healthy young volunteers in this study. After exclusion of intracranial lesions by using common brain magnetic resonance imaging examination, they underwent SWI examination. We observed the number, diameter and signal intensity of superficial veins located in dorsolateral aspects of hemispheres according to the images of SWI on transverse sections through the centrum semiovale, trunk of corpus callosum, splenium of corpus callosum, and superior colliculus. Results The frequencies of asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on transverse sections through the centrum semiovale, trunk of corpus callosum, splenium of corpus callosum, and superior colliculus were 20.0%, 37.8%, 35.6% and 26.7%, respectively. The frequencies of mild asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on above transverse sections were 17.8%, 31.1%, 31.1% and 24.4% respectively, and the frequencies of prominent asymmetry were 2.2%, 6.7%, 4.4% and 2.2%, respectively. According to chi square test, there was no gender difference in asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres. Conclusion SWI technique was used to show the physiological asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on different transverse sections. Most of them are mild. Therefore, when cerebrovascular disease occurs, if transverse sections of images by SWI show asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres, the possibility of physiological phenomenon is needed to take into consideration.
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Objective To image the veins around the foramen of monro (FM), to build the 3D model of them, to construct venous network in this area and to explore the spatial positional correlation between FM and veins around it. Methods Totally 60 healthy subjects were selected to get the original images on 3. 0 T MR and procesed the original images by minimum intensity projections (mIP) and Materialise’ s interactive medical image control system (Mimics), built the 3D model of the veins around FM, observed and analyzed the morphology of FM and the veins around it on original and processed images. Results The displaying rate of FM was 65% (78 sides), the displaying rate of internal cerebellar veins (ICV) was 100% (120 sides), the diameter was (2. 13±0. 30) mm. The displaying rate of anterior septal vein (ASV) was 100% (120 sides), the diameter was(0. 69±0. 19)mm. The displaying rate of superior thalamostriate vein (STV) was 98. 3% (118 sides), the diameter was (1. 47± 0. 38) mm. The displaying rate of superior choroidal vein (SCV) was 82. 5% (99 sides), the diameter was(0. 40±0. 18)mm. According to the relationship between the converging point of the tributaries of ICV and the location of FM, FMs were classified into 5 types:ⅠA, 24. 2% (29 sides), ASV converged into ICV at the venous angle and closed to the posterior edge of FM; ⅠB, 13. 3% (16 sides), ASV converged into ICV away from the venous angle and the posterior edge of FM; ⅡA, 45% (54 sides), ASV converged into ICV at the false venous angle and closed to the posterior edge of FM; ⅡB, 15. 8% (19 sides), ASV converged into ICV away form the false venous angle and the posterior edge of FM. Ⅲ, 1. 7% (2 sides), STV was absent. Conclusion FM and the veins around it are visible on the susceptibility weighted imaging(SWI). It can be constructed by Mimics that the 3D model of ICV, its tributaries, FM and the converging points of the major veins. The classification of FMs is meaningful to the option of surgical approaches through FM.
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Objective Make use of image dentate nucleus and the veins around it on susceptibility weighted images (SWI), explore the correlation between the location of hilum of dentate nucleus and the venous variation of dentate nucleus. Methods Selecting 51 healthy adults (24 men, 27 women) at the age between 18 and 30 years old to get the original images on 3. 0T MR. Process the original images by minimum intensity projections (mIP) observed and analyzed the morphology of dentate nucleus and veins around it on original and processed images. Results The length of dentate nucleus was (16. 64±0. 20)mm, and the width was (8. 36±0. 14)mm. There was no significant difference between bilateral dentate nucleus. The median angle of the long axis of the dentate nucleus was 26. 80° (interquartile distance was 34. 58°). The venous network of dentate nucleus was formed in 2 groups of veins: the lateral group, drained by the vein of the horizontal fissure and nuclear vein; the medial group, drained by vermian vein and central vein of dentate nucleus. These two groups had been further typing as follows: the lateral anterior group drained by the nuclear vein, finally opening to superior petrosal sinus; the lateral median group had plenty of small veins of lateral dentate nucleus converge into the vein of the horizontal fissure; the lateral posterior group drained by a lot of very small veins converging to vermian veins or medullary veins; the medial anterior group that the central vein of dentate nucleus and the paravermian vein were jointed at hilum of dentate nucleus, opening into straight sinus; the medial posterior group usually converged into tributaries of vermian vein, or converged with paravermian vein into tributaries of vermian vein. Totally 75. 49% of hilums of dentate nucleus were located at upper inner quadrant, the other 24. 51% of them were located at lower inner quadrant. Conclusion Dentate nucleus and its veins are clearly visible on the susceptibility weighted images, and the location of the hilum of dentate nucleus may be related to the abouchement of paravermian vein.
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OBJECTIVE@#To explore long-term outcomes of Chiari osteotomy for Legg-Calvé-Perthes disease in children with type Catterall III or IV, and to analyze clinical effect of osteotomy angle on clinical and radiographic results.@*METHODS@#From March 2005 to July 2013, 26 children with Legg-Calvé-Perthes disease with type Catterall III or IV were treated by Chiari osteotomy, including 17 males and 9 females, aged from 4 to 13 years old with an average of (8.9±2.6) years old. Children were divided into low osteotomy angle group and high osteotomy angle group. according to osteotomy angle. There were 10 children in low osteotomy angle group with an osteotomy angle of 10 degrees, including 8 boys and 2 girls, aged from 4 to 13 years old with an average of (9.2±3.3) years old; while there were 16 children in high osteotomy angle group with an osteotomy angle of 15 degress, including 9 boys and 7 girls, aged from 6 to 12 years old with an average of (8.8±2.1) years old. HHS score before operation and at the latest follow-up were recorded to observe clinical results. CE angle of hip joint, acetabular index, Sharp angle, Shenton's line continuity, femoral head coverage, acetabular depth ratio were recorded to compare radiographic results. Stulberg classification was analyzed to compare reshaping ability of femoral head.@*RESULTS@#Twenty-six children were followed up for 4.5 to 12.0 years with an average of (7.9±1.8) years. All incisions were healed at stage I for 10 to 14 days, with an average of(12.3±1.1) days. No inflammation, skin necrosis and injury of vessel and nerve occurred. All osteotomies achieved bone union for 8 to 13 weeks, with an average of(9.8±1.4) weeks. HHS score increased from 75.8±6.5 before operation to 93.5±2.5 at the latest follow-up in low osteotomy angle group(<0.05), and form 77.6±6.2 to 97.8±1.6 in high osteotomy angle group (<0.05). HHS score of high osteotomy angle group at the latest follow-up was higher than that of low osteotomy angle group (<0.05). The acetabular index decreased from (10.1±2.5)° before operation to (4.5±1.3)° at the latest follow-up in low osteotomy angle group (<0.05), and from (10.7±3.3)° before operation to (2.0±1.1)° in high osteotomy angle group (<0.05). The acetabular index of high osteotomy angle group at the latest followup was better than low osteotomy angle group(<0.05). There was no significant difference in CE angle, Sharp angle, Shenton's continuity, femoral head coverage, acetabular depth ratio between two groups. According to Stulberg classification, the femoral head reshaping ability in high osteotomy angle group was better than that of low osteotomy angle group(<0.05).@*CONCLUSIONS@#Chiari osteotomy with 15° for Legg-Calvé-Perthes disease in children with type Catterall III or IV could effectively decrease index of acetabulum, and helpful for femoral head reshaping ability, then in further improve clinical effects.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Acetabulum , Femur Head , Hip Joint , Inflammation , Osteotomy , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To study the clinical efficacy and safety of dexamethasone of different doses combined with bortezomib and thalidomide for treatment of primary multiple myeloma.</p><p><b>METHODS</b>Ninety-six patients with multiple myeloma from January 2013 to January 2014 were randomly divided into group A (high-dose dexamethasone + bortezomib + thalidomide, 32 cases), group B (low-dose dexamethasone + bortezomib + thalidomide, 32 cases) and group C (placebo + bortezomib + thalidomide, 32 cases). The clinical efficacy and safety of patients was compared among 3 groups.</p><p><b>RESULTS</b>The overall remission rate (ORR) in group A and B was significantly higher than that in group C (P<0.05), but the ORR was not significant difference between group A and group B (P>0.05). After treatment, the KPS and RNS score in 3 groups were significantly higher and lower than those before treatment, respectively; the KPS score in group A and B was significantly higher than that in group C (P<0.05), the RNS score in group A and B was significantly lower C (P<0.05). After treatment, the positive expression rates of CD38, CD56 and CD138 as well as small residual lesion (SRL) positive rate in 3 grops were significantly lower than those before treatment, but the positive expression rate of CD19 was significantly higher that before treatment; the positive expression rates of CD38, CD56 and CD138 as well as SRL positive rate in group A and B were significantly lower thant those in group C, while the positive expression rate of CD19 was significantly higher that in group C (P<0.05), but the positive expression rates of CD19, CD38, CD56 and CD138 as well as SRL positive rate were not significantly different between group A and B (P>0.05). The incidence of fatigue, rash, peripheral neuropathy, anlmia, granulocyte deficiance and so on in group B and C was significantly lower than that in group A(P<0.05), but the difference in group B and C was not significant (P>0.05).</p><p><b>CONCLUSION</b>The therapeutic efficacy of different doses of dexamethasone combined with bortezomib and thalidomide for patients with multiple myeloma is similar, can obviously enhance remission rate, prolong the survival time, promote life quality, but the incidence of adverse reactions in low dose dexamethason rigemen is significantly reduced, and the safety is better.</p>
Subject(s)
Humans , Antineoplastic Combined Chemotherapy Protocols , Bortezomib , Dexamethasone , Disease-Free Survival , Multiple Myeloma , Thalidomide , Treatment OutcomeABSTRACT
Objective To observe the clinical efficacy of acupuncture at cranial sutures plus rehabilitation training in treating post-stroke spastic palsy.Method Sixty patients with post-stroke spastic palsy were randomized into a treatment group and a control group, 30 cases each. The treatment group was intervened by acupuncture at cranial sutures plus rehabilitation training, while the control group was intervened by rehabilitation training alone. The Modified Ashworth Scale (MAS), Fugl-Meyer Assessment, and activities of daily living (ADL) in the Modified Barthel Index (MBI) were observed before and after the treatment for the two groups.Result After the intervention, there was a significant difference in MAS score between the two groups (P<0.05). The FMA and ADL scores were changed significantly after the treatment in both groups (P<0.05). The FMA and ADL scores in the treatment group were significantly different from those in the control group after the treatment (P<0.05).Conclusion Acupuncture at cranial sutures plus rehabilitation is an effective approach in treating post-stroke spastic palsy.
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Shouwu is a traditional Chinese medicine (TCM) with neuroprotective effect. Shouwu Yizhi decoction (SYD) was designed based on TCM theory. However, little is known about the roles of SYD in Vascular dementia (VaD). The present study aimed to evaluate the potential effects of SYD on the vascular cognitive impairment and explore the underlying mechanism by establishing focal cerebral ischemia/reperfusion (I/R) rat model to induce VaD. SYD administration (54 mg·kg) for 40 days obviously improved the vascular cognitive impairment in the middle cerebral artery occlusion (MCAO) rats as evidenced by the declined neurological deficit score and shortened escape latency via neurological deficit assessment and Morris water maze test. Moreover, SYD decreased neuron damage-induced cell death and ameliorated the ultrastructure of endothelial cells in the MCAO rats, thereby alleviating VaD. Mechanistically, SYD caused increases in the expression of vascular endothelial growth factor (VEGF), CD34 and CD31, compared with the MCAO rats in coronal hippocampus. Simultaneously, the expression level of miR-210 was elevated significantly after SYD administration, compared with the vehicle rats (P < 0.01). The expression of Notch 4 at both mRNA and protein levels was upregulated remarkably along with the notably downregulated DLL4 expression under SYD administration compared with the vehicle rats (P < 0.05). Overall, the above results indicated that SYD promoted angiogenesis by upregulating VEGF-induced miR210 expression to activate Notch pathway, and further alleviated neuron damage and ameliorated the ultrastructure of endothelial cells in the MCAO rats, ultimately enhancing the cognition and memory of MCAO rats. Therefore, our findings preliminarily identified the effect and the mechanism of action for SYD on VaD in rats. SYD could be a potential candidate in treatment of VaD.
Subject(s)
Animals , Humans , Male , Rats , Angiogenesis Inducing Agents , Dementia, Vascular , Drug Therapy , Genetics , Metabolism , Psychology , Drugs, Chinese Herbal , Intracellular Signaling Peptides and Proteins , Genetics , Metabolism , Membrane Proteins , Genetics , Metabolism , Memory , Neuroprotective Agents , Rats, Wistar , Receptor, Notch4 , Genetics , Metabolism , Vascular Endothelial Growth Factor A , Genetics , MetabolismABSTRACT
Objective To develop a set of wearable device for dynamic monitoring of human vital signs and environmental information during exercise.Methods By using system integration mode,multiple sensor modules were integrated in the design of the device.A microcontroller was selected as the core of the hardware circuit.Then serial ports simulation was used to connect all sensors to the microcontroller.Wireless data transmission between the handset and the primary control module was implemented with Bluetooth component.Results The device behaved well in low energy consumption,small volume,low weight and data accuracy,and met the design requirements for wearable mobile monitoring device.Conciusion The device provides real-time data monitoring to the users so as to contribute to human health.
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<p><b>BACKGROUND</b>A single drilled tunnel from the lateral mastoid cortex to the cochlea via the facial recess is essential for minimally invasive cochlear implant surgery. This study aimed to explore the safety profile of this kind of new image-guided and bi-planar device-assisted surgery procedure in vitro.</p><p><b>METHODS</b>Image-guided minimally invasive cochlear implantations were performed on eight cadaveric temporal bone specimens. The main procedures were: (1) temporal bone specimens were prepared for surgery and fiducial markers were registered. (2) computed tomography (CT) scans were performed for future reference. (3) CT scan images were processed and drill path was planned to minimize cochlear damage. (4) bi-planar device-assisted drilling was performed on the specimens using the registration. (5) surgical safety was evaluated by calculating the deviation between the drill and the planned paths, and by measuring the closest distance between the drilled path and critical anatomic structures.</p><p><b>RESULTS</b>Eight cases were operated successfully to the basal turn of the cochlear with intact facial nerves (FNs). The deviations from target points and entrance points were 0.86 mm (0.68-1.00 mm) and 0.44 mm (0.30-0.96 mm), respectively. The angular error between the planned and the drilled trajectory was 1.74° (1.26-2.41°). The mean distance from the edge of the drilled path to the FN and to the external canal was 0.60 mm (0.35-0.83 mm) and 1.60 mm (1.30-2.05 mm), respectively. In five specimens, the chorda tympani nerves were well preserved. In all cases, no injury happened to auditory ossicles.</p><p><b>CONCLUSIONS</b>This exploratory study demonstrated the safety of the newly developed image-guided minimally invasive cochlear implantation assisted by the bi-planar device and established the operational procedures. Further, more in vitro experiments are needed to improve the system operation and its safety.</p>
Subject(s)
Humans , Cochlear Implantation , Methods , Cochlear Implants , Feasibility Studies , Minimally Invasive Surgical Procedures , Methods , Software , Temporal Bone , General SurgeryABSTRACT
In this study, we intend to confirm our hypothesis that cold inducible RNA-binding protein (CIRP) can inhibit neuronal apoptosis through suppressing the formation of oxygen free radicals under hypothermia. Primary rat hippocampal neurons were isolated and cultured in vitro, and were divided into five groups: (1) normal control group (37 °C), (2) cells infected by empty viral vector group, (3) CIRP over-expressed group, (4) CIRP knock-down group, and (5) hypothermia control group. Cells in groups 2-5 were cultured under 32 °C, 5% CO2. Apoptosis of hippocampal neurons were detected by Annexin V-FITC/PI staining and flow cytometry; Expression of CIRP was determined by Western blot; Redox-related parameters (T-AOC, GSH-Px, SOD, MDA) were detected by ELISA kits. Results showed that CIRP expression levels were significantly increased (P < 0.01) and the apoptotic rates were significantly decreased (P < 0.01) in hypothermia control group and CIRP over-expressed group when compared with normal control group. On the other hand, the apoptotic rate was significantly increased (P < 0.05) in CIRP knock-down group compared with that in hypothermia control group. The levels of redox parameters in hypothermia control group and CIRP over-expressed group were significantly changed in comparison with those in normal control group, CIRP knock-down group and empty viral vector infected group, respectively (P < 0.05 or P < 0.01). These results suggest that up-regulation of CIRP by hypothermia treatment can protect the neuron from apoptosis through suppressing the formation of oxygen free radicals.
Subject(s)
Animals , Rats , Apoptosis , Cells, Cultured , Cold Shock Proteins and Peptides , Metabolism , Cold Temperature , Hippocampus , Cell Biology , Hypothermia , Neurons , Cell Biology , Oxidation-Reduction , RNA-Binding Proteins , Metabolism , Up-RegulationABSTRACT
AIM: To observe the clinical curative effect of sparse wind clearing heat method combined with western medicine treatment on epithelial herpes simplex keratitis ( HSK) . METHODS: A total of 75 cases ( 75 eyes ) of patients with epithelial HSK were divided into the treatment group 38 cases ( 38 eyes ) and the control group 37 cases ( 37 eyes) . The patients of the control group were treated with ganciclovir drop and symptomatic treatment. On the basis of the above treatment plan, the patients of the treatment group were treated with sparse wind clearing heat decoction. Clinical curative effect was observed and analyzed. RESULTS:In the treatment group, curative rate was 79% and effective rate was 95%. In the control group, curative rate was 54% and effective rate was 78%. The differences had significant difference between the two groups (PCONCLUSION: Sparse wind clearing heat method combined with western medicine treatment on epithelial HSK has preferably curative effect.
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<p><b>OBJECTIVE</b>To analyze the surgical failure of lumbar spondylolisthesis and investigate the clinical effect of three vertebral reduction and fixation in revision of lumbar spondylolisthesis.</p><p><b>METHODS</b>The clinical data of 19 patients underwent revision to lumbar spondylolisthesis was retrospectively analyzed between January 2009 and December 2012. There were 12 males and 7 females, aged from 36 to 68 years old with an average of 51.5 years. Reduction loss of olisthy segment had in 6 cases, internal fixation loosening or breakage had in 5 cases, slippage aggravating had in 8 cases. Clinical symptoms including lower back pain, unilateral or bilateral lower extremity pain and numbness, etc. Revision surgery was performed with three vertebral pedicle screw internal fixation and posterior decompression, reduction, and posterolateral bone graft between vertebral body. For the first time after surgery pedicle screw loosening or fracture of vertebral body, to switch thick or long pedicle screws implanted into again, or with bone cement perfusion and implanted with pedicle. The condition of intervertebral fusion and clinical effect were respectively assessed by X-ray films and JOA score.</p><p><b>RESULTS</b>All patients were followed up from 10 to 30 months with an average of 18 months. X-ray showed all bone graft obtained fusion and fusion time was from 5.5 to 7 months after revision. No pedicle screws loosening and breakage were found and no reduction loss vertebral body. JOA score were statistically analyzed between preoperative and postoperative at 6 months, in 3 cases with degree I, the score respectively was 13.33 ± 1.53 and 26.33 ± 0.58; in 7 cases with degree II, the score respectively was 12.85 ± 2.19 and 26.29 ± 2.21; in 9 cases with degree III, the score respectively was 12.21 ± 2.73 and 26.44 ± 1.81; there was statistical significance between preoperative and postoperative at 6 months, the improvement rate of JOA was (78.06 ± 3.90)%.</p><p><b>CONCLUSION</b>For the patients with lumbar spondylolisthesis, the reason of primary surgical failure mainly concerned with internal fixation loosening and breakage, and bone graft no-fusion. Revision surgery using three vertebral pedicle screw internal fixation, can get rigid fixation, complete decompression, bone graft fusion, combined with the guidance of the postoperative functional exercise for patients, can obtain satisfactory therapeutic effects.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Decompression, Surgical , Lumbar Vertebrae , General Surgery , Pedicle Screws , Retrospective Studies , Spinal Fusion , Methods , Spondylolisthesis , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To retrospectively compare the therapeutic effects of simple Pemberton's ilium osteotomy and combined unter-trochanter derotation-varisation osteotomy for developmental dysplasia of the hip (DDH).</p><p><b>METHODS</b>Clinical data of 141 DDH patients who received either simple Pemberton's ilium osteotomy (n=57; 12 male and 45 female; age range 3-8 years) or combined unter-trochanter derotation-varisation osteotomy (n=84; 15 male and 69 female; age range 4-9 years) from January 2004 to January 2009 were collected. Postoperative complications, Severin's radiological outcomes and therapeutic outcomes as evaluated by Mcay criteria were compared between the two groups 2 years after operation.</p><p><b>RESULTS</b>The patients in simple Pemberton group were followed-up for 30-52 months (mean 38 months) and the patients in the combination group were followed-up for 32-51 months (mean 37 months). There were 7 cases of dislocation, 4 cases of avescular necrosis of femoral head and 5 cases of joint stiffness in simple Pemberton group vs 0 case of dislocation, contraction of the limb and ANFH,2 cases of joint stiffness in the combination group. Two years after surgery, the result as evaluated by McKay criteria was excellent in 27 cases, good in 18 cases and fair in 12 cases in simple Pemberton group vs. 52, 25 and 7 cases in the combination group. The overall clinical outcome in the combination group was better than that in simple Pemberton group. Severin X-ray evaluation showed excellent in 27 cases, good in 15 cases and fair in 15 cases in simple Pemberton group vs. 53, 22 and 9 cases in the combination group,indicating that the overall result in the combination group was better than that in simple Pemberton group.</p><p><b>CONCLUSION</b>The overall clinical outcome of the combination group is better than that of simple Pemberton group in the treatment of pediatric DDH, especially in reducing postoperative complications and functional recovery. The patients in the combination group reported a higher postoperative satisfaction as compared with those in simple Pemberton group.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Bone Diseases, Developmental , General Surgery , Femur , General Surgery , Hip Dislocation, Congenital , General Surgery , Ilium , General Surgery , Osteotomy , MethodsABSTRACT
Objective To investigate the clinical significance of airway hyperresponsiveness, eosinophil (Eos) percentage,levels of eosinophil cationic protein (ECP) and interleukin-5 (IL-5) in induced sputum in elderly patients with late onset asthma (LOA) during the remission period. Methods Fifty-eight elderly patients with LOA during the remission period were selected.Bronchial challenge test was performed and the percentage of Eos and levels of ECP and IL-5 in induced sputum were measured by Wrights' stain,immuno-CAP system and ELISA,respectively.Twenty-five elderly patients with LOA during their exacerbation period and 15 healthy elderly subjects were selected as control.Results In fifty-eight LOA patients during their remission period,49 cases (84.5%) showed positive bronchial challenge test and 9cases(15.5%) negative.The percentage of Eos,levels of ECP and IL-5[(9.3?3.1)%],[(144.2?68.1)?g/L]and [(20.3?6.3)?g/L],in induced sputum in patients with LOA during their remission period were lower than those[(21.1?9.8)%, (399.3?172.5)?g/L and[(50.6?10.7)?g/L,respectively]in LOA group during the exacerbation period,and higher than those[(1.3?0.7)%,(48.7?21.9)?g/L and (10.3?3.2)?g/L]in healthy group(all P