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Over recent years,pedicle screw fixation is widely used in spine surgery,which allows 3-dimensional fixation with a more rigidconstruct and permits a shorter fusion length.However,its fixationeffect is not so good for patients with severe osteoporosis.Cortical bone trajectory screw insertion has been advocated because it is reportedly less invasive,improvesscrew-bone purchase and reduces neurovascular injury.Based on the present evidence,the author evaluates the relative advantages of cortical bone channels.To this end,a search of relevant published studies reporting biomechanical,morphemetricor clinical outcomes after using of cortical bone trajectory screws in patients with spinal pathologies is reviewed.
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Objective To explore the clinical significance of the inferior displacement sign on the initial anterioposterior (AP) view X-ray for fractures of humeral greater tuberosity.Methods This study retrospectively analyzed the imaging and clinical data of 24 patients with isolated fracture of humeral greater tuberosity who had sought medical treatment during the period from January 2008 to June 2015.They were 10 males and 14 females,with an average age of 54 years (from 19 to 68 years).Laterality:8 left sides and 16 right sides.The AP view X-ray films of the 24 patients present the inferior displacement sign defined as the inferior cortical margin of the greater tuberosity overlapping the proximal humeral shaft on the initial AP view.The patients received further CT examination to determine the displacement direction and whether the humeral neck fracture was complicated.Results A slight displacement of humeral anatomic neck fracture was shown on the initial AP view X-ray in 10 patients.Further CT examination revealed that humeral anatomic neck fracture was confirmed in 23 patients,the greater tuberosity was displaced posteriorly in 22 patients and posteroinferiorly in 2 patients.Radiographic measurements showed:the mean posterior displacement was 10.5 ±4.5 mm;the displacement between the humeral head and the humeral shaft was 2.5 ± 1.5 mm;the neck shaft angle was 147.2° ± 9.2°;the distance between the humeral head and greater tuberosity was 10.8 ± 3.4 mm;the overlap between the inferior edge of greater tuberosity and the upper edge of lateral humeral shaft was 12.5±5.9 mm.Pearson correlation analysis showed no correlation between the overlap and the head-tuberosity distance (P ＞ 0.05),but a significant correlation between the overlap and the neck-shaft angle (P ＜ 0.05).Conclusions The inferior displacement sign on the initial AP view X-ray is actually the overlap of posterior displaced greater tuberosity fracture shown on the X-ray.The posterior displaced greater tuberosity fracture complicated with slight displaced anatomic neck fracture is a presentation of the valgus impacted fracture of the proximal humerus.The inferior displacement sign in the fracture of humeral greater tuberosity can highly suggest the presence of occult or slight displacement of the humeral anatomic neck fracture.
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<p><b>OBJECTIVE</b>The aim of this review is to comprehensively and unbiasedly summarize the improvements in the techniques for classical corneal collagen cross-linking (CXL) by covering the reasons for this improvement, measure, and effect to approach the future direction of the CXL.</p><p><b>DATA SOURCES</b>All articles used in this review were mainly retrieved from the PubMed database.</p><p><b>STUDY SELECTION</b>Original articles and reviews were selected if they were related to the improvement in the technique of classical CXL. Data were mainly extracted from 94 articles, which are listed in the reference section of this review.</p><p><b>RESULTS</b>This innovative research involves every step such as instrument preparation, epithelial management, riboflavin instillation, and UVA irradiation. These clinical and experimental results seem promising.</p><p><b>CONCLUSIONS</b>CXL treatment is the only recent promising method for preventing the progress of keratoconus. The limitations and potential complications that accompany classical CXL such as corneal thickness limitations, ultraviolet-A (UVA) light injury, and the impact of de-epithelialization encourage people to research new improvements in techniques. While this research needs to be further investigated, we hope our review can help related researchers and patients.</p>
Subject(s)
Humans , Collagen , Metabolism , Cornea , Metabolism , Radiation Effects , Ultraviolet RaysABSTRACT
Objective To observe the effect of Yingliu mixture combined with methimazole on autoantibodies and traditional Chinese medical syndromes of patients with Graves’ disease ( GD) . Methods A randomized, paralleled and controlled trial was carried out in 92 GD patients. The patients were evenly randomized into treatment group and control group, and were separately treated with Yingliu mixture combined with methimazole, and methimazole. The treatment for both groups lasted 12 weeks, and forty patients in each group completed the whole treatment. The changes of thyroid function, thyroid autoantibodies, and traditional Chinese medical syndrome scores were observed before and after treatment, and the clinical efficacy was also evaluated. Results (1) After treatment for 12 weeks, serum levels of thyroid peroxidase antibody (TPOAb), thyroglobulin antibody ( TGAb) and thyrotrophin receptor antibody ( TRAb) were decreased, and thyroid stimulating hormone ( TSH) was increased obviously in both groups after treatment ( P<0.01 compared with those before treatment) . The treatment group has better effect on improving TGAb and TRAb than the control group ( P<0.05). ( 2) Compared with those before treatment, the total scores of clinical symptoms and signs were decreased in the two groups at different time points of treatment course ( P<0.001) , and the decrease value in the treatment group was larger than that in the control group ( P<0.05) . ( 3) The total effective rate of the treatment group was 92.50%, higher than 82.50% of the control group ( P<0.05) . Conclusion Yingliu mixture combined with methimazole is effective on improving thyroid function, decreasing autoantibodies levels and relieving clinical symptoms and signs, and has better effect than methimazole alone for the treatment of GD.