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Objective@#To analyze the efficacy and safety of intervertebral endoscopy in the treatment of double segmental protrusion of lumbar intervertebral disc.@*Methods@#From February 2016 to May 2017, 126 patients with double segment lumbar disc herniation diagnosed in Rizhao Central Hospital were divided into the observation group and the control group according to the different treatment methods, with 63 cases in each group.The observation group was treated with intervertebral foramen technique, and the control group was treated with conventional fenestration.The treatment efficacy of the two groups was compared.The differences of VAS score and ODI between the two groups before and after operation were compared.@*Results@#Compared with the control group, the observation group had shorter hospitalization time[(7.1±3.1)d vs.(11.5±4.2)d], smaller incision length[(1.2±0.3)cm vs.(4.3±1.6)cm], less blood loss[(22.3±8.2)mL vs.(36.3±9.2)mL], there were statistically significant differences between the two groups (t=9.365, 3.965, 5.566, all P<0.05). From preoperation to 6 months after operation, the VAS scores of the two groups showed a significant downward trend.There were statistically significant difference in the VAS scores between the two groups at different time points, between groups and at different time points (F=5.688, 4.589, 3.998, all P<0.05). From preoperation to 6 months after operation, the ODI of the two groups decreased first and then increased, and there was statistically significant difference between the two groups of ODI in different time points (F=4.254, P<0.05). The good rate of curative effect in the observation group was 87.3%, which in the control group was 84.1%, the difference was not statistically significant (χ2=0.259, P>0.05). There was no statistically significant difference in the incidence rate of adverse reactions between the two groups (6.4% vs.9.5%) (χ2=0.434, P>0.05).@*Conclusion@#The treatment of double segment lumbar intervertebral disc herniation with intervertebral foraminoscopy is reliable, with small tissue trauma and mild pain.
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Objective To analyze the characteristics and influencing factors of recessive hemorrhagic loss of intertrochanteric fracture in elderly patients with PFNA .Methods The clinical data of 120 elderly patients with IFF from January 2011 to December 2017 in Rizhao Central Hospital were retrospectively analyzed .The dominant blood loss,hidden blood loss and total blood loss after PFNA were calculated ,and the influencing factors were analyzed . Results The total blood loss of 120 elderly patients with intertrochanteric fractures was (911.4 ±240.8) mL,the dominant blood loss was (255.7 ±89.7)mL,occult blood loss was (679.5 ±208.6)mL,the hidden blood loss was significantly greater than the dominant blood loss ,the difference was statistically significant (t=8.669,P<0.05). Hypertension,surgery after injury delayed more than 5d, aged >75, the preoperative use of anticoagulant drugs , unstable fracture and diabetes were the independent risk factors of hidden blood loss of PFNA (OR=2.254,1.676, 0.753,0.965,2.625,all P<0.05).Conclusion Recessive blood loss is the main cause of loss of blood in patients with intertrochanteric fracture of the femur treated with PFNA .Hypertension , surgery after injury delayed more than 5d,aged more than 75 years,the preoperative use of anticoagulant drugs ,unstable fractures and diabetes are risk factors of hidden blood loss of PFNA .
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Objective To develop a medical wastes pyrolysis vehicle for field hospital, countryside hospital and public emergencies.Methods Configuration design, thermodynamics theory, ergonomics and auto control technology were involved in to manufacture open-type compartment, on-board pyrolysis furnace, smoke control system, and pyrolysis furnace control and monitoring system.Results The vehicle passed 7 000 km reliability test, high-low temperature test, smoke emission test and army trials.Conclusion The vehicle behaves well in performances and environment protection, and gains high economic and social benefits.
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BACKGROUND: There are a lot of researches on the protective action of calcium channel blocker(CCB) on diabetic peripheral neuropathy, but the dosage and the effect on injured nerve need to investigate further in clinical application.OBJECTIVE: To observe the results of electrophysiologic assessment of the effect of CCB flunarizine at different dosages on Bell' s palsy after 1-month treatment.DESIGN: Randomized grouping, blank control and l-month follow up.SETTING: Department of Neurology, First Affiliated Hospital of Nanjing Medical University.PARTICIPANTS: Totally 35 patients with Bell' s palsy, including 19males and 16 females aged from 16 to 58 and the mean age of 32. 8, were selected from Outpatients of the Department of Neurology, the First Affiliated Hospital to Nanjing Medical University from November 1999 to May 2001. The course of disease was ≤ 3 days. Patients were without any treatment, and all of the facial nerve palsy was complete. According to random samplings, all patients were divided randomly into control group (basic treatment group) with 12 cases and treatment groups with 10 cases in first subgroup and 13 in second subgroup.METHODS: Basic treatment: 1 mg/kg per day prednisone(the maximal dosage ≤ 60 mg/day) was taken once every day and reducing dosage by half every 5 days, with a course of therapy for 15 days. 500 μg methycobal was taken orally three times a day and 25 mg fursulthiamine also orally three times a day. Ultrashort wave physiotherapy was taken once a day for 15 days. On the basis of the basic treatment, patients in the first subgroup accepted 5 mg flunarizine once every night, and 10 mg flunarizine once every night was given to the patients in the second subgroup. The latency and amplitude of Blink response were checked before treatment and after 1-month treatment.MAIN OUTCOME MEASURES: The latency and amplitude of Blink response in every group after 1-month treatment.RESULTS: According to the imagery analysis, 35 patients entered the resulting analysis. Before treatment, the 3 groups of blink responses were all efferential blocking in facioplegic side, and in addition, R1 and R2 all disappeared. After treatment for 1 month, Blink response of R1, R2 appeared. The latency of R1 and R2 in the second treatment group was better than that in control group[ (9. 608 ± 0. 575) ms, (31. 869 ± 2. 934) ms,(11.208±1.490) ms and (37. 583 ±5. 408) ms, P ＜0.01], but there were no differences in this respect between the first treatment group and the control group. The ipsilateral amplitudes of Blind response in the three groups were not different after 1-month treatment.CONCLUSION: After 1-month treatment with flunarizine(10 mg/day),the recovery of facial nerve function can be promoted, but the protective effect of flunarizine(5 mg/day) on peripheral nerve is not superior to that with normal treatment. The mechanism and the proper dosage are not observed further in this study.