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ObjectiveTo observe the effects of Internet plus continuous rehabilitation nursing on older patients after lumbar fusion. MethodsFrom January, 2018 to August, 2021, 157 older patients after transforaminal lumbar interbody fusion (TLIF) in Department of Orthopedics, Chongqing General Hospital were retrospectively studied. A total of 66 patients accepting routine continuous rehabilitation nursing care were as control group, and 91 patients accepting internet plus continuous rehabilitation nursing care were as intervention group. They were assessed with Visual Analog Scale for pain (VAS), Oswestry Disability Index (ODI), Huaxi Emotional-distress Index (HEI) and Adult Health Self-management Skill Rating Scale (AHSMSRS) before, and one and three months after intervention. The compliance and nursing satisfaction were investigated with self-made questionnaire three months after intervention, and the postoperative complications were recorded. ResultsA total of 148 patients finished follow-up of three months, including 61 patients for the control group and 87 patients for the intervention group. The VAS, ODI, HEI and AHSMSRS scores improved in both groups one and three months after intervention (F > 85.4, P < 0.001), and improved more in the intervention group than in the control group (|t| > 3.645, P < 0.001). Both the compliance and nursing satisfaction were better in the intervention group than in the control group (χ2 > 5.478, P < 0.05), and no postoperative complication was observed in both groups. ConclusionInternet plus continuous rehabilitation nursing can promote the recovery of function, pain and psychological emotion, ability of self-management, compliance, and nursing satisfaction.
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Objective To evaluate the effects of unilateral and bilateral diffusion of cement on osteoporotic vertebral compression fractures treated with percutaneous kyphoplasty (PKP). Methods A retrospective case control study was conducted on the clinical data of 127 patients with single segment osteoporosis vertebral compression fracture (OVCF) treated by unilateral puncture PKP between July 2013 and July 2015. According to whether the diffusion of bone cement crossed the median, all cases with OVCF were divided into unilateral and bilateral diffusion groups. The unilateral diffusion group (72 cases) included 29 males and 43 females, with an average age of 69.5 ± 2.6 years (range, 63-76 years). In terms of the injured segment, there were 38 cases of L1, 20 L2, 11 L3, two L4, and one L5. In the unilateral diffusion group, the preoperative visual analog score (VAS) was (7.8 ±0.9) points, the preoperative anterior vertebral height compression ratio was (32.5 ±6. 3)％, and the preoperative Cobb's angle of the injured vertebra was (9.2±1.3)°. The bilateral diffusion group (55 cases) included 22 males and 33 females, with an average age of 71.2 ±2.9 years (range, 61-80 years). In terms of the injured segment, there were 32 cases of L1, 13 L2, six L3, three L4, and one L5. In the bilateral diffusion group, the preoperative VAS was (7.6 ±0. 9)points, the preoperative anterior vertebral height compression ratio was (34.5 ±5.8)％, and the preoperative Cobb's angle of the injured vertebra (9.8± 1.5)°. The VAS, anterior vertebral height compression ratio of the injured vertebra, Cobb's angle of the injured vertebra, and injured and non-injured vertebra refracture 1 month and 1 year after operation were recorded. Results The patients were followed up for 12-16 months (mean, 14.6 ± 0.6 months) in unilateral diffusion group and for 13- 16 months (mean, 15.2 ±0.2 months) in bilateral diffusion group. The VAS score of the unilateral diffusion group was (3.0 ±0.4) points at 1 month after the operation and (2.2±0. 4) points at 1 year after the operation, respectively. The VAS score of the bilateral diffusion group was (2.1 ±0.4) points at 1 month after the operation and (1.5 ± 0.4) points at 1 year after the operation, respectively. The VAS score decreased significantly 1 year after operation compared with that before operation (P ＜0.05), and significant difference was noted between two groups (P ＜0.05). The anterior vertebral height compression ratio of the unilateral diffusion group was (15.2±3.9)％ at 1 month after the operation and (16.3 ±3.4)％ at 1 year after the operation, respectively. The anterior vertebral height compression ratio of the bilateral diffusion group was (15.6±3.5)％ at 1 month after the operation and (16.8 ±3.9)％ at 1 year after the operation, respectively. The Cobb's angle of the injured vertebra of the unilateral diffusion group was (2.9±0.7)° at 1 month after the operation and (3.0±0.6)°at 1 year after the operation, respectively. The Cobb's angle of the injured vertebra of the bilateral diffusion group was (3.0 ± 0.7) ° at 1 month after the operation and (3.2 ± 0.7) ° at 1 year after the operation, respectively. The anterior vertebral height compression ratio and Cobb's angle of the injured vertebra decreased significantly after surgery (P ＜ 0.05), but no statistically significant differences were observed between two groups (P＞0.05). The injured vertebra refracture ratio was 6.9％ in unilateral diffusion group and 0 in bilateral diffusion group. The non-injured vertebra refracture ratio was 5.6％ in unilateral diffusion group and 5.5％ in bilateral diffusion group. No nerve root injury, cerebrospinal fluid leakage, pulmonary embolism, anaphylactic shock and postoperative infection were found in the two groups. Paravertebral bone cement leakage occurred in two cases of the unilateral diffusion group and anterior vertebral bone cement leakage occurred in one case of the bilateral diffusion group. Conclusion Compared with unilateral diffusion, bilateral diffusion of bone cement has better analgesic effect and can reduce the incidence of re fracture of injured vertebra, without increasing the risk of re-fracture of the non-injured vertebrae.
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Objective To investigate the effect of α7 nicotinic acetylcholine receptor(α7nAChR) agonist agent PNU282987 on bone cement particles stimulated secretion of inflammatory cytokines in peripheral blood monocytes and its molecular mechanism.Methods Mouse peripheral blood monocytes were isolated and the inflammatory response were induced by PMMA particles.TNF-α, IL-1β and IL-6 concentration in culture supernatant were measured by ELISA.TNF-α, IL-1β and IL-6 mRNA expression were measured by RT-PCR.p-p65, p65, p-JAK2, JAK2, p-STAT3, STAT3, and β-actin expression were detected by Western blot.NF-κB DNA binding activity were measured by ELISA.ResultsAfter stimulation of PMMA particles, TNF-α, IL-1β and IL-6 concentration in culture supernatant was significantly increased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression was significantly increased (P<0.05), p-p65, p-JAK2 and p-STAT3 expression and NF-κB DNA binding activity was also increased significantly (P<0.05).However, after PNU282987 treatment, TNF-α, IL-1β and IL-6 concentration in culture supernatant decreased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression decreased in a concentration gradient way(P<0.05), p-p65, p-JAK2 and p-STAT3expression and NF-κB p65 DNA binding activity was also decreased(P<0.05).Conclusions α7nAChR agonist PNU282987 significantly inhibites PMMA bone cement particles induced secretion of inflammatory cytokines in peripheral blood monocytes of mice.
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PurposeTo investigate the clinical value of inverted X-ray plain film and MRI examination in the diagnosis of congenital anorectal malformation (CARM). Materials and Methods Thirty-eight cases with operatively proved anorectal malformation were reviewed; inverted X-ray plain film and MRI examination were performed in all patients before surgery. The relationship between the rectum blind side and pubococcygeal line (PC line), and the type of anal atresia was determined, to compare the diagnostic accuracy of inverted plain film with MRI for CARM typing. Results Of all the 38 cases, 19 cases were with low imperforate anus, 8 cases with median imperforate anus, and 11 cases with high imperforate anus. The accuracy rate of inverted X-ray plain film and MRI examination for the diagnosis of CARM typing was 92.1% (35/38) and 97.4% (37/38) respectively, and the difference between them was not statistically significant (χ2=1.37, P>0.05). 7 cases of fistula, 5 cases of spinal cord malformations and 1 case of right kidney agenesis can be clearly demonstrated on MRI. Conclusion Both inverted X-ray plain film and MRI can diagnose the typing of CARM accurately, but MRI is also able to diagnose the fistula, visceral, spinal cord lesion and other abnormalities accompanied with CARM, while reducing the dose of X-ray radiation and damage in children, thus has higher clinical application value compared with inverted X-ray plain film.
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<p><b>OBJECTIVE</b>To investigate the clinical value of MRI examination in congenital anorectal malformation (CARM).</p><p><b>METHOD</b>Forty-four cases with operatively proved anorectal malformation from May 2008 to May 2012 in the authors' hospital were reviewed. Of the 44 cases, 25 were males and 19 females, their age ranged from 1 day to 2 years. MRI was performed in all patients.</p><p><b>RESULT</b>Of all 44 cases, 15 cases had high imperforate anus (34%), rectum blind end were above PC line, the distance of rectum blind end and anus nest was (29.12 ± 2.35) mm; 8 cases had median imperforate anus (18%), rectum blind ends were near PC line, the distance of rectum blind end and anus nest was (18.98 ± 2.21) mm; 21 cases had low imperforate anus (48%), rectum blind ends were below PC line, the distance of rectum blind end and anus nest was (7.54 ± 1.08) mm. Twenty-five cases with fistula in 44 cases were confirmed by rectal angiography and surgery, accounting for 57%. In 13 cases with fistula, the lesion could be clearly demonstrated on MRI, in the remaining 12 cases with fistula, the lesion could not be visualized clearly or no image development occurred on MRI. Of all 44 cases, 1 case had tethered cord with filum terminale lipoma, 1 case had tethered cord, 2 cases had syringomyelia, 1 case had right kidney agenesis, 1 case had hydrocele. In 44 cases of multi-planar MRI imaging could clearly show the perianal muscles developmental situation, 36 cases had perianal muscles dysplasia, amd showed levator ani muscle, puborectalis and anal sphincter asymmetry, muscle belly slim.</p><p><b>CONCLUSION</b>MRI examination has a high clinical value in CARM diagnosis, can help accurately judge the anal atresia type, display the presence and running of most of the fistula, and diagnose perianal muscle development and other systems malformations, finally provide a reliable diagnostic basis for surgical program and prognostic assessment.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Abnormalities, Multiple , Anal Canal , Congenital Abnormalities , General Surgery , Anus, Imperforate , Diagnosis , General Surgery , Fistula , Epidemiology , Magnetic Resonance Imaging , Perineum , Pathology , Rectum , Congenital Abnormalities , General Surgery , Retrospective Studies , Urinary Fistula , EpidemiologyABSTRACT
Objective To explore the ideal reconstruction after total gastrectomy.Methods Following-up information on one postoperation year of 62 cases underwent continuous jejunal interposition pouch(CJIP)recon- struction and 60 cases of Roux-en-Y pouch(RYP)was compared.Results Although no statistical difference was found in nutritional status(body weight and serum nutritional paramerers)between the two groups,frequency of meals of CJIP was less than that of Roux-en-Y.The quantity of every meal and pouch enlargement of CJIP were ob- viously larger than those of RYP group.There were 9 cases of digestive fluid reflux syndrome,8 cases of dumping syndrome in RYP group simultaneously.Conclusion CJIP demonstrated no substantial nutritional advangate to RYP,but it still was the prefered type of reconstruction,because of its less postprandial disturbance than that of RYP.