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AIM: To compare ultrasound-guided vertebroplasty (percutaneous vertebroplasty, PVP) with X-ray guided vertebroplasty (PVP) to confirm the success rate of puncture point, X-ray radiation dose, operation time and postoperative outcome to explore the clinical application value of ultrasound-guided vertebroplasty. METHODS: Patients with thoracolumbar vertebral compression fractures treated by PVP in our hospital from November 2018 to October 2021 were divided into ultrasound-guided group and X-ray guided group. The success rate of puncture, the X-ray radiation dose, operation time and postoperative outcome were compared between the two groups. RESULTS: A total of 97 patients were included in this study, with an average follow-up time of (14.412±10.261) months. The success rate of one-time puncture was 60.4% in the ultrasound-guided group and 30.6% in the X-ray guided group (P<0.05). The X-ray radiation dose, fluoroscopy times and operation time in the ultrasound-guided group were significantly lower than those in the X-ray-guided group (P<0.05). The difference was statistically significant (P<0.05). The VAS of low back pain was significantly relieved in the two groups, but there was no significant difference between the two groups. There were no postoperative complications such as infection, puncture site hematoma and fracture nonunion between the two groups. CONCLUSION: Ultrasound guidance is a safe and effective method to determine the needle entry point of PVP. Skillful operation can improve the success rate of one-time puncture. Compared with traditional X-ray guidance, it can shorten the operation time, reduce the number of X-ray fluoroscopy and radiation during PVP operation.
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Objective To explore the efficiency of continuous glucose monitoring system(CGMS) and blood glucose self-monitoring (SMBG)in evaluating blood glucose excursion in type 1 diabetes mellitus (T1DM) complicated with pregnancy. Methods Twenty-five patients having suffered from T1DM complicated with pregnancy were selected randomly during June 2012 to July 2015. All subjects underwent blood glucose monitoring by CGMS and SMBG for 72 h, including the data of blood glucose before meal, 2 h post-meal blood glucose (2hBG) and blood glucose at 2:00 AM. Results The level of the highest blood glucose in CGMS was significantly higher than that in SMBG:(10.60 ± 2.11) mmol/L vs. (7.50 ± 1.18) mmol/L, P0.05. The rate of hypoglycemia(blood glucose<3.3 mmol/L) in CGMS was 4.6%, and in SMBG was 1.9%. Through adjusting the treatment by CGMS, the blood glucose before meal, 2hBG and blood glucose at 2:00 AM at 49-72 h were significantly lower than that at 0-24 h (P<0.05). Conclusions Compared with SMBG, CGMS has a relatively larger blood glucose monitoring range and can sensitively evaluate blood glucose excursion, CGMS provides a scientific basis to develop a more rational and effective strategies for controlling diabetes.
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Objective To evaluate the effect of family interventions on the prevention of falls in elderly hypertensive patients. Methods One hundred elderly hypertensive patients were divided into the experiment group and the control group in equal number. The control group returned for regular visits after discharge while the experiment group received the family intervention including cognitive,psychological,behavioral and environmental intervention.The two groups were compared in terms of fall rate and degree of injury.Results The incidence of falls in the experiment group was significantly lower than that of the control group,the incidence of soft tissue injury after a fall in the experiment group was significantly lower than that of the control group(both P<0.05).Conclusion Family intervention is effective in prevention of falls in elderly hypertensive patients for it may reduce the incidence of falls and the degree of fall injuries.
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Objective To investigate the role ofglutamic acid decarboxylase autoantibody(GAD-Ab)and protein tyrosine phosphatase autoantibody(IA-2A) in postpartum follow-up of gestational diabetes mellitus (GDM).MethodsGAD-Ab,IA-2A,insulin and glucose metabolism index were measured in 82subjects with normal glucose tolerance (control group) and 84 patients with GDM(GDM group) during 24 to 28 weeks in pregnancy,postpartum 6 to 12 weeks and 2 years.GDM group was divided into antibodies positive group (GAD-Ah or IA-2A were positive) with 18 cases and antibodies negative group (GAD-Ab and IA-2A was negative) with 66 cases.Results Homeostasis model insulin resistance index (HOMA-IR) in GDM group was higher than that in control group (3.87 ± 2.17 vs.2.31 ± 0.52,P ＜ 0.05 ).Homeostasis β -cell function index (HBCI) and 30 min net increment of insulin/30 min net increment of glucose ( △ I30/△ G30) in GDM group were lower than those in control group[206.38 ± 138.06 vs.422.43 ± 228.93 and (20.16 ±11.38) mU/mmol vs.(26.54 ±24.30) mU/mmol,P ＜0.05].The numbers who had the family history of diabetes mellitus and the used of insulin for treatment in antibodies positive group were higher than those in antibodies negative group[ 83.3％ (15/18) vs.28.8％ (19/66) and 77.8％ ( 14/18 ) vs.30.3％ (20/66) ],HOMA-IR,△ I30/ △ G30 and HBCI in antibodies positive group were lower than those in antibodies negative group [3.20±0.84 vs.4.02±0.36,(16.81 ±2.91) mU/mmol vs.(21.55± 11.11) mU/mmol and 124.95 ± 5.03 vs.217.43 ± 115.64,P＜ 0.01 ].Fasting plasma glucose (FPG),2 hours postprandial glucose (2hPG)and glycosylated hemoglobin (HbA1c) in antibodies positive group were higher than those in antibodies negative group during postpartum 6 to 12 weeks and 2 years [postpartum 6 to 12 weeks: (8.20 ±3.11)mmol/L vs.(5.39 ±0.76) mmol/L,(15.22 ±7.29) mmol/L vs.(8.15 ± 1.93) mmol/L,(7.26 ± 1.04)％ vs.(5.88 ±0.41)％ ;postpartum 2 years: (8.91 ±2.80) mmol/L vs.(4.93 ±0.66) mmol/L,(15.75 ±7.87)mmol/L vs.(7.85 ± 1.79) mtmol/L,(7.18 ± 1.22)％ vs.(5.64 ± 0.32 )％,P ＜ 0.01].△ I30/ △ G30 and HBCI were significantly decreased in antibodies positive group postpartum 2 years.No change of the above parameters in antibodies negative group was found.The occurrence rate of type 1 diabetes mellitus (T1DM) was 16.7％(3/18) and 33.3％(6/18) postpartum 6 to 12 weeks and 2 years in antibodies positive group,there was no T1DM in antibodies negative group.ConclusionsWomen with GDM are partly associated with T1DM.Requiring insulin therapy during pregnancy and GAD-Ab or IA-2A positive have considerable risk for developing T1DM.It is also an important predictor to GDM after parturition.
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The clinical data of 5 cases of fulminant type 1 diabetes mellitus were analyzed retrospectively.This disease was characterized by abrupt onset and severe diabetic ketoacidosis.The mean duration from the appearance of hyperglycemic symptoms to first hospital visit was 3.4 days.The mean plasma glucose level was 47.7 mmol/L,but the mean value of HbA_(1C) level was 6.8% at first visit.The mean fasting serum C-peptide was 40.0 pmol/L,and mean serum postprandial C-peptide was 68.0 pmol/L at onset.β-cell function did not recover after 3-26 months of follow-up.