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Objective:To investigate the safety and feasibility of the occipital condyle screw and evaluate the safepath parameters for the occipital condyle screw.Methods:Data of 64 patients with upper cervical computed tomographic angiograms from September 2016 to September 2018 were retrospectively collected. Excluded occipito-cervical injury, tumor, and vertebral artery course variation. Mimics software was used to reconstruct the occiput, atlas and vertebral artery. Three candidate entry points were placed for each occipital condyle, the midpoint of posterior of occipital condyle as middle entry point, and the medial and lateral entry points were located 3 mm medial and lateral to the middle entry point. The vertebral artery-occipital bone distance (VOD) of each entry point were measured on sagittal plane, and the minimum feasible value was determined to be 4mm. After that 3.5 mm diameter virtual screw was inserted into each candidate entry point with VOD>4 mm, each screw with maximum and minimum cranial angulation was combined with appropriate medial angulation to get the maximum screw length. Then, the screw placement parameters were measured by 3-Matic, and the safe range of cranial angulation and the success rate of screw placement were calculated.Results:The VOD of medial and middle entry point were 8.07±2.13 mm and 7.70±2.19 mm respectively, and the feasibility rate of screw placement of those entry point were 97.7% and 96.1%, respectively. There were significant differences inVOD and feasibility rate of screw placement between medial and middle entry point. The VOD of lateral entry point was 5.63±1.66 mm, and the feasibility rate was only 78.9%, which was significantly lower than that of medial and middle entry point. The lateral entry point could obtain a larger medial angulation, which was supplemented by a longer screw length. The medial angulation and length of screw gradually decreased with the inward movement of the entry point. There were significant differences in medial angulation and screw length among groups. The safe range of cranial angulation of medial, middle and lateral entry points were 8.17°±2.55°, 12.58°±4.23° and 12.09°±3.83°, respectively, and the difference were statistically significant. Among the screw entry point that could accommodate screw fixation, the maximum screw placement success rate can be obtained by adding 5° cranial angulation to the lateral and middle entry point, which were 98.02% and 98.37%, respectively,while 100% success rate of screw placement could be obtained at the medial entry point at 3° cranial angulation.Conclusion:In the selection of the entry point in the horizontal direction, middle and medial entry points have higher success rate of screw placement and wider safe range of cranial angulation because of less affection of horizontal segment of the vertebral artery. However, the screw length of medial entry point is much shorter than middle and lateral entry point. As a result, the middle entry point may be an optimal entry point for the occipital condyle screw.
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Objective To discuss the improvement of the seven steps of exercise rehabilitation to improve the cardiac function of patients with acute myocardial infarction after percutaneous coronary intervention(PCI),making patients to take care of themselves as early as possible. Methods A total of 60 cases of patients with acute myocardial infarction after stent implantation were selected to be admitted to our hospital from January to December 2016,using the random number table method to divide into the rehabilitation group (30 cases) and the control group (30 cases). The control group received PCI routine nursing and the rehabilitation group received seven steps of rehabilitation training. The left ventricular ejection fraction(LVEF)of the two groups was observed one day after operation.The LVEF and self-care ability of the two groups were observed nine days after operation. The evaluation of cardiac function adopted the heart color ultrasound, and the improved Barthel Index (MBI) was adopted in life self-care ability. Results The first day after surgery,the incidence rate of LVEF below 50% in the rehabilitation group and control group were 53.30%(16/30)and 50.00%(15/30)respectively.There was no statistically significant difference between the two groups (χ2= 0.067, P > 0.05), the ninth day after surgery, the incidence rate of LVEF below 50% in the rehabilitation group and control group were 26.70%(6/30)and 46.70% (14/30), the two groups had statistically significant difference (χ2= 4.800, P < 0.05). The MBI scores of the recovery group and the control group were respectively 80.167 ± 4.111 and 64.200 ± 3.145 respectively.The two groups had statistically significant difference(t=16.896,P<0.01). Conclusions The rehabilitation training can significantly improve the cardiac function and self-management ability of patients after myocardial infarction,and can be used in clinic.
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Objective To provide data evidence for early diagnosis of bone and joint damage derived from brucellosis by analyzing its clinical and imaging characteristics.Methods Patients with brucellosis accepted in Ji'nan Infectious Disease Hospital form December 2013 to December 2014 were selected.Patients with bone and joint damage confirmed through imaging were further studied,their epidemiological and clinical characters,CT and MRI characteristics,treatment and outcome were summarized.Results Total of 97.8％ (45/46) patients had a clear contact history,most of them worked in poultry farming,taking up to 67.4％ (31/46).July to October was its peak time for attacking,taking up to 58.7％ (27/46).The clinical manifestations of patients were joint pain,swelling and activities obstacles.In the CT images,there was obvious bony destruction,characterized by multiple round or large areas of low density insect damage sample spots.There was osteosclerotic bone lesions or osteophyte formatted in edge.The paravertebral soft tissue was swelling,and the vertebral body deformation was not obvious,and there was vertebra small joint damage occasionally.In the MRI images,there was vertebral ligaments damage,or soft tissue damage,or osteoproliferation at the edge of the vertebral bodies.There was abnormal signal T1W1 or T2W1 signal,and FS-T1W1 showed high signal,while FS-T2W1 showed slightly high signal.The diagnosis rate of CT,MRI and CT combined MRI for bone and joint damage derived from brucellosis was 76.1％ (35/46),84.8％ (39/46) and 91.3％ (42/46),respectively.The main therapeutic drugs were doxycycline and rifampicin,and the clinical effective rate was 91.3％ (42/46).Conclusion The epidemiological characters,CT and MRI characteristics of bone and joint damage derived from brucellosis have certain representativeness,and the comprehensive investigation is beneficial for clinical diagnosis.
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Objective To investigate the influence of elastic band resistance training on cardiac function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods 64 hospitalized patients with acute myocardial infarction after PCI from January 2016 to June 2016,were randomly divided into two groups:rehabilitation group (n=30) and control group (n =34).The control group received a routine treatment and guidance,rehabilitation group received elastic band training as add-on therapy to above routine treatment and guidance.After 6 months of therapy,cardiac function,the number of daily chest discomfort and its duration were compared between two groups.Results After six months of therapy,6MWT [(530.9 ± 39.9) m versus (328.3±26.8)m,(t=24.104,P＜0.01)]and LVEF ≥50％ [n(％)] (83.3％ versus 50％)(x2 =7.850,P＜ 0.01)were significantly higher in the rehabilitation group than in control group,with statistically significant difference (t =24.104,x2 =7.850,all P ＜ 0.01).In addition,an average number of daily chest discomfort (x2=11.563,P＜ 0.01) and its duration (x2=9.067,P＜ 0.05) were obviously improved in rehabilitation group than in control group,with statistically significant difference.Conclusions Anti-resistance training can significantly improve the cardiac function of patients with acute myocardial infarction after PCI and can be applied in clinical practice.
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Objective To analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.
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@#This study was to investigate the effect and mechanism of saikosaponin D(SSD)combined with oxaliplatin on nude mice bearing human lung carcinoma A549 cells. The A549 cell-bearing nude mice model was established and then the optimal dosage of SSD for intragastric administration was valued by tumor inhibitory ratio in vivo. The effect of SSD combined with oxaliplatin on tumor growth in A549 cells-bearing nude mice was observed. The apoptosis was detected by TUNEL method, the concentration of prostaglandin E2(PGE2)in plasma was checked by ELISA method, and the expression of COX-2 in tumor was analyzed by Western blot. The result showed that SSD exerted best tumor inhibitory effect(40. 96%)at the dosage of 1. 0 mg/kg. SSD combined with oxaliplatin group induced better apoptosis effect in A549 cells-bearing nude mice than those of SSD group and oxaliplatin group, respectively. The concentration of PGE2 and the expression of COX-2 in model group were increased markedly, while decreased significantly in SSD, oxaliplatin or SSD combined with oxaliplatin treated groups(P< 0. 05), and the concentration of PGE2 and the expression of COX-2 in SSD combined with oxaliplatin group were significantly lower than those treated by SSD or oxaliplatin alone(P< 0. 01). In conclusion, SSD combined with oxaliplatin could exert synergistic effect to induce apoptosis of A549 cells in nude mice, which may achieved by down-regulation of the expression of COX-2.