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OBJECTIVE@#To investigate the risk factors of vertebral refracture after percutaneous kyphoplasty (PKP) for osteoprotic vertebral compression fractures (OVCFs), and to provide reference for clinical prevention.@*METHODS@#A retrospective analysis of 228 OVCFs patients who met the inclusion criteria admitted from November 6, 2013 to December 14, 2018. There were 35 males and 193 females, with a male-to-female ratio of 3∶20, and aged 58 to 91 years with an average of (69.70±7.03) years. All patients were treated with PKP and had complete clinical data. According to whether refracture occurred after operation, they were divided into refracture group (24 cases) and non refracture group (204 cases). Factors that may be related to refracture (including gender, age, surgical segment, number of vertebral bodies in the surgical segment, whether combined with degenerative scoliosis, whether anti-osteoporosis treatment) were included in the univariate analyses, and the single factor analysis of statistically significant risk factors was carried out with multiple Logistic regression analysis to further clarify the independent risk factors for vertebral body refracture after PKP. Survival analysis was performed using the time of vertebral refracture after PKP as the end time of follow up, the occurrence of refracture after PKP as the endpoint event, and the presence or absence of degenerative lateral curvature as a variable factor.@*RESULTS@#All 228 patients were followed up for 1.8 to 63.6 months with an average of (28.8±15.6) months, and the refracture rate was 10.5%(24/228). There were statistically significant differences between two groups in age, number of operative vertebral bodies, whether combinedwith degenerative scoliosis and whether anti osteoporosis treatment (@*CONCLUSION@#Combined scoliosis is an independent risk factor for refracture after OVCFs vertebroplasty, and it is also a possible high-risk factor for refracture after surgery.
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Female , Humans , Male , Fractures, Compression/surgery , Kyphoplasty/adverse effects , Osteoporotic Fractures , Retrospective Studies , Risk Factors , Spinal Fractures/surgery , Vertebral BodyABSTRACT
OBJECTIVE@#To explore effectiveness and safety of an inside-out, arthroscopic deep medial collateral ligament pie-crusting release in treating posterior horn of medial meniscus (PHMM) tear in tight medial tibiofemoral compartment of knee joint.@*METHODS@#From January 2016 to December 2017, 61 patients (61 knees) were underwent arthroscopic partial meniscectomies for PHMM tear in tight medial tibiofemoral compartment of knee joint, who were divided into valgus group and pie-crusting group according to exposure of PHMM region . There were 28 patients in valgus group, including 12 males and 16 females aged from 27 to 60 years old with an average age of (35.75±7.57) years old;who were performed conventional valgused knee to exporsure PHMM region. There were 33 patients in pie-crusting group, including 15 males and 18 females aged from 26 to 58 years old with an average age of (36.06±7.93) years old;who were treated with inside-out, arthroscopic deep MCL pie crusting release technique with MM-Ⅱ meniscus suture package (Smith & Nephew). Operation time, preoperative and postopertaive Lysholm score of knee joint, injury of MCL between two groups were recorded and compared.@*RESULTS@#All patients were followed up from 12 to 18 months with an average of (15.19±2.22) months. The incisions were healed at stageⅠ. There were no statistical difference in anatomical classification of PHMM between two groups(@*CONCLUSION@#The inside-out, arthroscopic deep MCL pie-crusting release for the treatment of posterior horn of medial meniscus tear in tight medial tibiofemoral could expand working apace, shorten operation time, reduce injury to MCL and obtain good clinical efficacy.
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Adult , Female , Humans , Male , Middle Aged , Arthroplasty, Replacement, Knee , Arthroscopy , Collateral Ligaments , Knee Joint/surgery , Menisci, Tibial/surgery , Treatment OutcomeABSTRACT
Objective:To investigate the knowledge, attitudes and practices of medical staff rehabilitating COVID-19 survivors to provide references for related training.Methods:A questionnaire survey was administered in early March 2020 to 296 medical staff assessing their knowledge, attitudes, and practices in COVID-19 rehabilitation.Results:More than half of those surveyed received full marks on knowledge and attitudes, but only about 43% received full marks for their practices. Significant differences were found in the knowledge, attitude and practices scores among medical staff of different ages, with different numbers of years of training and working experience, with different professional titles, and in different departments.Conclusion:The COVID-19 rehabilitation knowledge and practices of a minority of the medical staff tested needed improving, and targeted training should be conducted.
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Objective: To rapidly identify Cyathula officinalis and its adulterant C. capitata and C. officinalis*C. capitata and doped adulterant. Method: Properties combined with foam test method were used for identifying C.officinalis, its adulterant and doped adulterant. In the aspect of properties,6 aspects including shape,size,texture,color,smell and taste,were observed, smelled and tasted. In the aspect of foam test,the volume of foam produced was used as the determination index to investigate the sample amount,water amount, shaking time,particle size,water temperature,repeatability,adulteration ratio and its stability. Result: In the aspect of properties,C. officinalis and its adulterant showed obvious difference in the shape,size,color,texture,smell and taste,especially the red color and bitter taste of its adulterant. In the aspect of foam test,the optimum parameters were as follows:sample particle (screened with 3 sieves) 0.3 g,a test tube with plug and scale,water 10 mL and airtight,forced shaking up and down for 1 min,settling for 5 min. Such method can be used to identify C. officinalis, its adulterant and doped adulterant. The volume of foams produced by C. officinalis and its adulterant and different ratio of doped adulterant showed no change within 5-30 min,slightly decreases after 9 h; the higher adulteration ratio; the larger volume of foam and better stability. The 8 batches of C. officinalis and 8 batch of adulterants proved that the volume of the foams produced was all less than 2 mL in the C. officinalis,more than 13 mL in the adulterant is,and more than 5 mL in 5% doped adulterant, showing statistical difference. From the properties combined with foam test,5 specific identification elements were obtained for identifying C. officinalis, its adulterant and doped adulterant. Conclusion: Through the 5 specific identification elements,the properties combined with foam test can be used to distinguish the C. officinalis from its adulterant C. officinalis and C. officinalis*C. capitata and doped adulterant,characterized by accuracy,simpleness,short time,low cost and feasibility. It can provide a new method and reference for identifying C.officinalis from its adulterant and doped adulterant.
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Cyathula capitate is the main adulterant of C.offinalis. According to the literature reported, there are obvious differences in properties, taste and pharmacological activity between C. capitate and C.offinalis. Therefore, C. capitate can only be used as a local conventional medicine and can't be a substitute for C. offinalis. Since the appearance of C.capitata is very similar to the C.offinalis and the content of cyasterone also can reach the limit of the current pharmacopoeia standard, the C.capitata is mostly sold in the form of impersonation oradmixture, which seriously affected the safety of the clinical medication and the development of the genuine crude drugs. In view of this, HPLC characteristic fingerprint was used to reveal the difference of multi-ingredients of C. offinalis, C. capitata and their admixture. According to the HPLC chromatogram of C.offinalis, C. capitata. and their admixture, 65 different components were obtained to set up a peak area data matrix of 26×65, which was applied to perform the characteristic peak difference analysis, similarity analysis, hierarchical clustering analysis HCA and principal component analysis (PCA). Characteristic peak difference analysis showed that the characteristic peaks of C. capitata and their admixture are more and higher respond than those of C. offinalis. The 9 characteristic peaks were used to distinguish C. capitata, 2 of which were used to distinguish C. offinalis mixed with 5% C. capitata. UV spectra of 9 characteristic peaks are mostly similar to the end absorption spectra of saponins, indicating that C. capitata may contain a large amount of saponins. By the reference fingerprint of C.offinalis established, the similarity analysis showed that the similarity degree of C. offinalis are higher than 0.942, while the similarity degree of C. capitata, C.offinalis mixed with 5% C. capitata are less than 0.383 and 0.399. C.offinalis, C. capitata, C.offinalis mixed with 5% C. capitata could be obviously divided into 3 classes by HCA and PCA. These results showed that there are obvious difference in the chemical composition of C. offinalis, C. capitata and their admixture, which could provide evidence for their identification.
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The vertebrate vascular system development is a very important and complicated process. MicroRNAs regulate gene expression at transcriptional and post-transcriptional levels and play important roles in many physiological and pathological processes. MicroRNAs mainly participate in the regulation of vascular smooth muscle cell and vascular endothelial cell development. In this paper, we summarize the recent progress regarding the microRNAs involved in the vascular development. In particular, we focus on the microRNAs including miR-126, miR-17/92 family in endothelial cell's regulation, and miR-143/145 family, miR-21 in vascular smooth muscle cell's regulation. The future research on the role of microRNAs in vascular development is also prospected.
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BACKGROUND:Percutaneous vertebroplasty, percutaneous kyphoplasty and expandable pedicle screw fixation can treat primary osteoporotic thoracolumbar fractures. The three methods have their own advantages and disadvantages. OBJECTIVE:To investigate the methods and clinical effects of primary osteoporotic thoracolumbar fractures. METHODS:Clinical data of 61 patients with primary osteoporotic thoracolumbar fractures were col ected and retrospectively analyzed. Perioperative preparation must be done. Al patients were treated by percutaneous vertebroplasty, percutaneous kyphoplasty and expansive pedicle screw fixation. We recorded Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) before treatment, 3 months after treatment, as wel as sagittal index (SI) and Cobb angle of vertebral fracture before treatment, 3 days and 3 months after treatment. RESULTS AND CONCLUSION:(1) Al cases were fol owed up for 12-18 months. (2) There was no significant difference in VAS scores, ODI, SI and Cobb angle of vertebral fracture among the three groups of patients preoperatively. (3) At 3 months after treatment, there were significant differences in VAS scores and ODI in the three groups as compared with that preoperation (P0.05). (4) SI and Cobb angle of vertebral fracture were significantly increased;the difference was statistical y significant (P0.05), and was better than the percutaneous vertebroplasty group (P<0.05). (5) Three kinds of treatment can effectively restore the vertebral height and intensity, relieve pain and stabilize the spine, and no significant vertebral compression was found in the short term. However, restoration of postoperative vertebral height was better in percutaneous kyphoplasty and expansive pedicle screw fixation groups than in the percutaneous vertebroplasty group. In view of their respective indications, advantages and disadvantages, the key point of raising therapeutic effect was to choose appropriate surgical procedures.
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AIM:To investigate the serum miRNA-101 expression level in patients with newly diagnosed type 2 diabetes mellitus (T2DM),and to evaluate the clinical implications of miRNA-101 expression level variation.METHODS:qRT-PCR was used to determine the serum miRNA-101 expression level.Pearson correlation analysis was performed to observe the relationship between two variables.Multiple stepwise linear regression analysis was used to assess the association of serum miRNA-101 level and other parameters.RESULTS:Serum miRNA-101 level in patients with newly diagnosed T2DM was significantly higher than that in control subjects (P ＜ 0.05).The serum level of miRNA-101 was positively correlated with the glycosylated hemoglobin A1c (HbA1c,P ＜0.05).Multiple linear regression analysis revealed that the circulating miRNA-101 was in significant positive correlation with HbA1c (P ＜ 0.05) after adjustment for age,sex and body weight.CONCLUSION:Enhanced circulating miRNA-101 level in newly diagnosed T2DM patients may be associated with elevation of HbA1 c.
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BACKGROUND: The evaluation for posterolateral rotatory dislocation of knee joint often relys on traditional imaging techniques to obtain static anatomical information; meanwhile, the knee function was assessed by Lysholm and the International Knee Documentation Committee scores. However, none can quantitatively evaluate the kinematic characteristics, let alone providing guidance for postoperative rehabilitation.OBJECTIVE: To analyze the gait characters of the patients with acute posterolateral rotatory dislocation of knee joint and to dynamically evaluate the postoperative kinematic parameters and displacement indicators, thereby providing guidance for rehabilitation.METHODS: Twelve patients with acute knee posterolateral rotatory dislocation were admitted in the West China Hospital,Sichuan University between January 2011 and December 2014, and all patients underwent one-stage reconstruction or repair of ligaments under arthroscopy, followed by routine rehabilitation training. Opti-Knee? analysis system was used to collect 6 degrees of freedom (movement angle and displacement) of the ipsilateral (injury group) and contralateral knee joints (normal group), the change levels were calculated, and were then compared between two groups.RESULTS AND CONCLUSION: (1) There was no significant difference in the maximum varus/valgus angles and maximum intersion/extorsion angles (P > 0.05). While, the minimum flexion angle, maximum flexion angle, as well as the change level of flexion/extension angles, varus/valgus angles and maximum intersion/extorsion angles in the injury group were significantly higher than those in the normal group (P < 0.05). (2) There was no significant difference in the maximum forward, inward and outward displacement as well as the change levels of inward/outward displacement between two groups (P > 0.05). The maximum backward, and downward displacement as well as the change levels of forward/backward displacement in the injury group were significantly higher than those in the normal group; while the maximum upward displacement and the change levels of upward/downward displacement in the injury group were significantly lower than those in the normal group (P < 0.05). (3) These results suggest that the arthroscopy-assisted one-stage treatment of the acute posterolateral rotatory dislocation of the knee joint can remarkably restore the gait.Opti-Knee? analysis system can provide objective information of motion parameters, and the change in the degree of freedom provides guidance for clinical rehabilitation.
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<p><b>OBJECTIVE</b>To explore the advantages of minimally invasive expandable in surgery of lumbar discectomy and interbody fusion and internal fixation.</p><p><b>METHODS</b>The clinical data of 48 patients who underwent lumbar discectomy and interbody fusion and internal fixation from January 2010 to March 2016 was retrospectively analyzed. According to the admission queue, the patients were randomly assigned into channel group (26 cases) or traditional group (22 cases). In channel group, surgical approach of minimally invasive expandable channel was applied, and in traditional group, open posterior operation approach (including posterior lumbar interbody fusion and transforaminal lumbar interbody fusion, etc.) was applied. In channel group, there were 20 males and 6 females, aged from 43 to 74 years with an average of(56.6±5.1) years; course of disease was ranged from 4 to 22 months with an average of (6.7±1.8) months; 1 case was complicated with diabetes, 6 cases were complicated with hypertensive disease, and 2 cases were complicated with arrhythmia. In traditional group, there were 15 males and 7 females, aged from 43 to 73 years with an average of(55.9±4.6) years; course of disease was ranged from 4 to 26 months with an average of (6.2±2.1) months; 2 cases were complicated with diabetes, 5 cases were complicated with hypertensive disease, and 1 case was complicated with arrhythmia. Operation time, bleeding volume, and hospitalization time were compared between two groups and visual analogue scale(VAS), Oswestry Disability Index(ODI), bone fusion information, and complications correlated with incision were observed in two groups.</p><p><b>RESULTS</b>All 48 patients were followed up for more than 6 months. Postoperative VAS and ODI were significantly improved (<0.01), but 3 and 6 months after operation, there was no significant difference in VAS between two groups, and ODI score of channel group was lower than that of traditional group(<0.01). Operation time, bleeding volume, hospitalization time in channel group respectively were (167.3±30.2) min, (786.8±147.8) ml, (12.3±2.4) d, and in traditional group were (197.5±48.7) min, (786.8±147.8) ml, (16.5±3.8) d, there was significant differences between two groups. There was no significant difference in fusion rate and fusion time between two groups. There were 4 cases and 7 cases developed incision related complications in channel group and traditional group, respectively. The difference between two groups was significant(<0.01).</p><p><b>CONCLUSIONS</b>Compared with conventional surgery minimally invasive lumbar discectomy and interbody fusion and internal fixation has advantages of less trauma, shorter operative time and better functional recovery.</p>
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<p><b>OBJECTIVE</b>To observe the changes in electrocardiographic parameters in children with complete left bundle branch block (CLBBB) after the transcatheter closure of simple ventricular septal defect (VSD).</p><p><b>METHODS</b>A total of 21 children with CLBBB early after transcatheter closure of perimembranous VSD were recruited. Another 21 children without any type of arrhythmia after transcatheter closure of perimembranous VSD were enrolled as the control group. The sex, age, and the size of occluder were matched between the two groups. The changes in the following indices were compared between the two groups: left ventricular voltage, QT interval, corrected QT interval (QTc), QT dispersion (QTd), corrected QT dispersion (QTcd), JT dispersion (JTd), and corrected JT dispersion (JTcd) on the electrocardiogram before transcatheter closure and at 1, 3, 5, 30 days after transcatheter closure.</p><p><b>RESULTS</b>Left ventricular voltage and JTcd changed with operation time in the CLBBB and control groups (P<0.05). There were interaction effects between time and grouping in the changes in left ventricular voltage and QTd (P<0.05). There was a significant difference in JTcd between the CLBBB and control groups (P<0.05). There was also a significant difference in left ventricular voltage between the CLBBB and control groups at 3 and 5 days after the transcatheter closure (P<0.05).</p><p><b>CONCLUSIONS</b>There are significant differences in electrocardiographic left ventricular voltage and JTcd between VSD children with and without CLBBB early after transcatheter closure. JTcd might be useful in predicting the development of CLBBB early after transcatheter closure of VSD.</p>
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Adolescent , Child , Child, Preschool , Female , Humans , Male , Bundle-Branch Block , Cardiac Catheterization , Electrocardiography , Heart Septal Defects, Ventricular , General Surgery , Postoperative ComplicationsABSTRACT
Objective To evaluate the operation methods and effects of transforaminal wedge osteotomy (TWO) combined with intervertebral grafting bone for correcting the rigid thoracolumbar kyphosis.Methods From January 2003 to June 2013, treatment of 52 cases of the rigid thoracolumbar kyphosis by TWO combined with intervertebral bone graft were studied (including 33 males and 19 females, and the age range was from 15 to 72 with average age of 42.3 years old).In these 52 cases, there were 17 cases of ankylosing spondylitis, 25 cases of obsolete thoracolumbarvertebral fractures, 7 cases of chronic thoracolumbar tuberculosis and 3 cases of congenital vertebral malformations.52 cases presented as lumbar kyphosis, low back pain aggravated,with an average VAS score of 8.6;24 cases were accompanied with different extent of neurological dysfunction which obviously influenced daily life or work.Osteotomy was located at thoracolumbar intervertebral disc.Pedicle screws internal fixation system combined with intervertebral grafting bone was used to compress the vertebra and fuse after TWO for correction.Preoperative and postoperative low back pain was evaluated by visual analog score (VAS), Frankel score and Oswestry disability index(ODI) in patients with neurological dysfunction.The above indexes were compared with the PSO osteotomy group.Results Preoperative mean kyphosis Cobb angle was 65.6°(31°-137°).The average post-operative kyphosis Cobb angle was 19.2° (8°-35°), and the average correction rate was 68.4％.The mean operation time was 3.8 h (2.2-5.3 h), and the mean intraoperative blood loss was 1220ml (500-2 900 ml).Preoperative VAS score was 8.6± 1.2 while the last follow-up was 1.8±0.5;preoperative Oswestry dysfunction index was 75.6±8.2 while the last follow-up was 18.4±8.1.The results were statistically significant.The spinal function was 4 cases of Frankel C and 20 cases of Frankel D before operation, all of which dropped to E level after operation.52 patients were followed up with the average time of 41 months (from 6 to 60 months).The bony fusion rate was 94.23％ at 6 months after operation.All of the patients were fused in 3 years after operation.The average loss of kyphosis Cobb angle was 5.5°(4°-12°).Compared with PSO, the average operation time, the amount of bleeding and the improvement of neurological function after surgery all had some advantages.Conclusion Transforaminal wedge osteotomy has many advantages, such as less bleeding wounds, less nerve interference and limited multi-segmental osteotomy, with little trauma and high bony fusion rate.
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<p><b>OBJECTIVE</b>To establish questionnaire scaling and reliability and examine the clinical and psychometric validity of the quality of life assessment based on Traditional Chinese Medicine for advanced gastric cancer (QLASTCM-Ga).</p><p><b>METHODS</b>The QLASTCM-Ga was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pretesting and quantitative statistical procedures. The questionnaire was administered to 240 patients diagnosed with advanced gastric cancer before and after treatment. Structured group methods were employed to establish a general and a specifific module respectively. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness.</p><p><b>RESULTS</b>The three identified scales of the QLASTCM-Ga and the total score demonstrated good psychometric properties. Test-retest reliability of the total scale and all domains ranged from 0.90 to 0.94, and internal consistency ranged from 0.86 to 0.93. Correlation and factor analysis demonstrated good construct validity. Signifificant difference in the subscales and the total score were found among groups differing in traditional Chinese medicine syndrome, supporting the clinical sensitivity of the QLASTCM-Ga. Statistically signifificant changes were found for each scale and the total score. Responsiveness was also good.</p><p><b>CONCLUSIONS</b>The QLASTCM-Ga demonstrates good psychometric and clinical validity to assess quality of life in patients with advanced gastric cancer undergoing traditional Chinese medicine therapy. This study is an important fifirst step for future research in this area.</p>
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Medicine, Chinese Traditional , Neoplasm Staging , Psychometrics , Methods , Quality of Life , Reproducibility of Results , Stomach Neoplasms , Pathology , SyndromeABSTRACT
AIM:To evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment 6, 12 and 18mo with blood oxygenation level dependent - function magnetic resonance imaging techniques ( BOLD-fMRI) . METHODS: In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children which was the first phase of research for amblyopic treatment. Functional MRI data were processed by using SPM8 which based on the Matlab 7. 12. 0. 635. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test. RESULTS: The functional area that was left occipital lobe (BA18), middle occipital gyrus (BA19), limbic lobe (BA19), lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe ( BA7 ) expanded after amblyopia treatment 6, 12mo, compared those treatment phase, mean t value was 1. 5762, 1. 6856 respectively (P CONCLUSION: In children anisometropic amblyopia, the speed of function reconstruction about visual cortical functional mediating stereopsis increase slowly after amblyopia treatment 1a.
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BACKGROUND:Nowadays, growth factors are commonly used to induce bone marrow mesenchymal stem cells. However, this is a high-cost method with a great amount of growth factors. In addition, the chondrogenic potential of bone marrow mesenchymal stem cells wil decrease significantly with increasing times of culture. OBJECTIVE:To observe the directed differentiation of bone marrow mesenchymal stem cells co-cultured with human synovial fluid. METHODS:Human bone marrow mesenchymal stem cells were isolated and cultured by adherence screening method. The synovial fluid of the knee was aspirated from healthy volunteers by aseptic operation. Passage 3 human bone marrow mesenchymal stem cells were co-cultured with the fol owing media:synovial fluid+complete medium;synovial fluid+bone marrow mesenchymal stem cells+complete medium;bone marrow mesenchymal stem cells+complete medium. The morphology and growth of the cells were observed under an inverted microscope every day. At days 7, 14 and 21 of induction, toluidine blue staining and immunocytochemical staining were performed. RESULTS AND CONCLUSION:After co-culture with human synovial fluid, human bone marrow mesenchymal stem cells proliferated slowly, and varied from fusiform to oval or polygonal;toluidine blue and col agen II staining were positive. These findings indicate that the synovial fluid has a positive role in the chondrogenic differentiation of bone marrow mesenchymal stem cells. The synovial fluid may contain substances that promote the chondrogenic differentiation of bone marrow mesenchymal stem cells.
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BACKGROUND:During cervical posterior expansive open-door laminoplasty for multisegmental cervical spondylosis, spinal canal restenosis, loss of cervical lordosis, and axial symptoms are the important factors affecting curative effects. It is very necessary to maintain spinal canal expanded state and to reduce interference of the posterior cervical structure in the clinical treatment. OBJECTIVE:To observe clinical outcomes and short-term fol ow-up effect of posterior expansive open-door laminoplasty via titanium miniplate in treatment of cervical spondylotic myelopathy. METHODS:A total of 67 patients with cervical spondylotic myelopathy who underwent posterior expansive open-door laminoplasty at the Zhongshan Hospital, Xiamen University from April 2006 to April 2013 were retrospectively analyzed. Titanium miniplate group (n=27) received titanium miniplate fixation. Suture group (n=40) received traditional suture suspension. Al patients had decompression ranged from C 3-7 . Operation time, intraoperative blood loss, improvement rate of Japanese Orthopedic Association score during fol ow-up, value of cervical curvature, axial symptoms, and lamina opened angle were compared between the two groups. RESULTS AND CONCLUSION:No significant difference in operation time, intraoperative blood loss and improvement rate of Japanese Orthopedic Association score was detectable between two groups (P>0.05). Cervical curvature changes in both groups:loss of cervical curvature at 6 months postoperation was not significant in the titanium miniplate group, but cervical curvature partial y lost in the suture group, and significant differences in the cervical curvature were detected between the two groups (P0.05). These data suggested that posterior expansive open-door laminoplasty for treatment of cervical spondylotic myelopathy using both titanium miniplate and suture methods can obtain good clinical outcomes. However, titanium miniplate fixation can relieve postoperative axial symptoms and prevent loss of cervical curvature.
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There are few articles or reports collecting evidence about Kudiezi injection from premarketing and postmarketing research or studies systematically. This article is an exact miniature of a systematical report about Kudiezi injection. We analyzed information from four aspects, such as quality control reports, non-clinical premarketing safety experiments, postmarketing research (efficacy studies, hospital information system data and national spontaneous reporting system data), and literature analysis. All the four aspects build an evidence body for Kudiezi injection in order to inform its safety use in clinical practice and further study.
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Humans , Drugs, Chinese Herbal , Hospital Information Systems , InjectionsABSTRACT
Objective To investigate the effects of neuromuscular electrical stimulation (NMES) combined with swallowing training for relieving dysphagia in stroke patients.Methods A total of 150 chronic stroke patients at least 3 months post-stroke who were afflicted with dysphagia were randomly and evenly divided into a conventional swallowing training group,an NMES group,and an NMES combined with conventional swallowing training group.Prior to and after treatment,surface electromyography (sEMG) signals from the swallowing muscles were detected,swallowing function was evaluated using the standardized swallowing assessment (SSA),their swallowing was studied videofluoroscopically (VFSS),and a swallowing-related quality of life questionnaire (SWAL-QOL) was administered.Results There were significant differences in the maximum amplitude of sEMG signals,and the scores on the SSA,VFSS and SWAL-QOL in both groups between prior to and after treatment.After 4 weeks of treatment,the maximum amplitude of the sEMG signals and all three assessment scores were significantly higher where NMES had been combined with conventional swallowing training group compared with the other two groups.Indeed,there was no significant difference between the group which had received conventional swallowing training and the NMES groups.The analysis of coefficients revealed correlation between sEMG maximum amplitude and the SSA,VFSS and SWALQOL results.Conclusions NMES combined with conventional swallowing training is helpful for improving swallowing function in chronic stroke patients with dysphagia.
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<p><b>OBJECTIVE</b>To identify the risk factors for accelerated junctional escape rhythm (AJER) in children early after percutaneous ventricular septal defect (VSD) closure.</p><p><b>METHODS</b>A retrospective controlled study was conducted on 42 children who had AJER within one week after percutaneous VSD closure between January 2008 and October 2012. These subjects were compared with controls without AJER after VSD closure in terms of age, sex, diameter of VSD, occluder size, difference between occluder size and diameter of VSD, and distance between VSD and aortic valve ring. Risk factors for AJER were identified by logistic regression analysis.</p><p><b>RESULTS</b>Compared with the control group, the AJER group had a longer distance betweenVSD and aortic valve ring, a larger diameter of VSD (basal diameter), a larger occluder size (waist diameter) , and a bigger difference between the waist diameter of occluder and diameter of VSD (P<0.05). Logistic regression analysis showed that distance between VSD and aortic valve ring (OR=1.813, P<0.05) and occluder size (OR=1.671, P<0.05) are primary risk factors for AJER.</p><p><b>CONCLUSIONS</b>AJER early after percutaneous VSD closure is related to diameter of VSD, occluder size, difference between the waist diameter of occluder and diameter of VSD, and distance between VSD and aortic valve ring. The distance between VSD and aortic valve ring and occluder size are primary risk factors for AJER.</p>
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Child , Child, Preschool , Female , Humans , Male , Arrhythmias, Cardiac , Heart Septal Defects, Ventricular , General Surgery , Logistic Models , Postoperative Complications , Risk FactorsABSTRACT
<p><b>OBJECTIVE</b>To explore radiographic results and clinical effects of posterior atlanto axial vertebra internal fixation in treating instability of occipitocervical.</p><p><b>METHODS</b>The clinical data of 155 patients with instability of occipitocervical treated by posterior atlanto axial vertebra internal fixation were respectively analyzed from September 2005 to January 2011. There were 68 males and 87 females, ranging in age from 6 to 75 years old with an average of 45.6 years old. Of them, 53 cases were fresh odontoid fractures(Aderson type II C), 30 cases were os odontoideum, 20 cases were old odontoid fractures, 18 cases were unstable atlas fractures, 12 cases were atlanto axial rotatory dislocation, 11 cases were atlanto axial dislocation after rheumatoid arthritis, and 11 cases were basilar invagination. Radiographic results were evaluated in terms of atlas pedicle screw fixation, bone healing and bone graft fusion. Clinical effect evaluation included relief of pain in the occipital-cervical region by VAS score and JOA score.</p><p><b>RESULTS</b>Totally 300 screws were set through atlas pedicle screw fixation in 150 patients. Five patients receivde hook fixation. Postoperative CT showed ideal nailing were 275 (91.7%),acceptable nailing were 14 (4.7%) and unacceptable nailing were 11 (3.6%). All patients were followed up, and the duration ranged from 16 to 40 months with an average of 25.4 months. The fresh fractures healed and 140 cases got bone graft fusion. Preoperative VAS and JOA score were respectively improved from (7.2 +/- 1.1), (7.3 +/- 2.4) to (3.2 +/- 1.1), (13.3 +/- 2.4) at the latest follow-up.</p><p><b>CONCLUSION</b>Posterior atlanto axial vertebra internal fixation in treating instability of occipitocervical can effectively recover physiological curvature of cervical, provide mechanical stability, and obtain good clinical effect. For the young patients who require further activity, posterior fixation and non-fusion technology is a good choose, which can avoid bone graft.</p>